Purpose: Residual fragments not removed with urinary stone surgery may become symptomatic. In this context, this study was carried out to investigate the effect of performing retrograde intrarenal surgery, which is conventionally performed in the lithotomy position, in the modified lithotomy position (Trend-side) on stone-free rates following the surgery. Methods: This prospective study consisted of 100 patients with a single kidney stone smaller than 2 cm between 2021 and 2023. These patients were randomized into two groups of 50 patients each to be operated on in the conventional lithotomy and Trend-side positions. Variables were compared using independent t test for continuous variables and chi-square test for categorical variables. Results: There was no significant difference between the lithotomy and Trend-side position groups in terms of preoperative size, density, location of the stone, and hydronephrosis degree. Stone-free rate was 72% (n = 36) in the lithotomy group and 92% (n = 46) in the Trend-side group. Hence, there was a significant difference between the groups in the stone-free rate in favor of the Trend-side group (p = 0.009). Fragmentation time was statistically significantly shorter in the Trend-side group than in the lithotomy group (34 ± 17 min vs. 43 ± 14 min; p = 0.006). There was no significant difference between the groups in postoperative complication rates. Conclusion: Performing retrograde intrarenal surgery in the Trend-side position shortened the duration of fragmentation compared to the lithotomy position and was associated with higher stone-free rates. In conclusion, the Trend-side position can be safely preferred in patients undergoing retrograde intrarenal surgery due to kidney stones.

BACKGROUND: Radical cystectomy (RC) is one of the most complex surgeries and has a high rate of morbidity. Gastrointestinal complications are the most common type of complications. To reduce these complications some modifications have been described. OBJECTIVE: To evaluate perioperative outcomes of our extraperitoneal antegrade RC technique (EARTC), where the peritoneum is opened at the end of cystectomy just before of ileal reconstruction. METHODS: Group 1 included 120 patients who were operated with a standard RC technique and Group 2 included 80 patients who were operated with the EARC technique in this study. Groups were compared according to preoperative variables including patient characteristics, perioperative parameters, pathologic data, and postoperative overall and gastrointestinal complications. RESULTS: There were no significant differences between the two groups in terms of preoperative characteristics and mean operative time. The group 1 has longer time for the exposure of abdominal cavity to the atmosphere ( p < 0.01). Hospitalization time was significantly lower in Group 2 ( p < 0.01). Concerning the rate of 90-day overall perioperative complication, no statistically significant difference was determined between the groups. Gastrointestinal complication was significantly higher in Group 1 ( p:0.048). The average number of removed lymph nodes was similar between the groups ( p:0.85). The time for recovery of bowel function, the time for passage of stool and the rate of postoperative ileus were significantly lower in Group 2 ( p < 0.01, p < 0.01 and p < 0.043) respectively). CONCLUSIONS: EARC provides advantages over the standard technique in terms of gastrointestinal symptoms and poses no disadvantage when the oncological outcome and operative difficulty were considered.

Background: Benign prostate hyperplasia is one of the most common diseases in middle-aged or older men. Approximately 50% of men over 60 years old suffer from benign prostatic hyperplasia. Giant prostatic hyperplasia is defined as a prostate exceeding 500 g. In all the literature, ten case reports were published with giant prostatic hyperplasia. Case presentation: In this case report, we present a 72-year-old man with edema of lower extremities. In physical examination, bilateral pitting edema of the lower extremities was detected. Serum prostate-specific antigen level was > 100.00 ng/ml. He did not have lower urinary tract symptoms. International Prostate Symptom Score (IPSS) and uroflowmetry results proved that the patient did not have lower urinary tract symptoms. Radiologic imaging revealed a huge pelvic mass behind bladder. Grade 1 hydronephrosis in the right kidney was detected, but serum creatinine value was normal. This mass was excised with open surgery. This mass was measured 1090 g, and histopathologic examination showed benign prostatic hyperplasia. The patient had no complication at the 12-month follow-up. After 5 years, prostate volume was calculated approximately 108 cc by computer tomography but still the patient did not have any lower urinary tract symptoms. Conclusion: It is important to approach the retroperitoneal mass. Clinicians usually think about malignity, but sometimes that mass can be relevant with benign process. Intra-operative biopsy can help clinicians for both diagnosis and surgical approach. In this case presentation, we report a patient with one of the largest sizes of prostate gland that measured 1090 g.

This controlled study assessed whether there was a correlation between serum total testosterone levels and bladder cancer (BCa) in terms of tumor grade and stage as objective measures in adult men....