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.

Purpose: Our aim was to assess the efficacy and safety of Rezum therapy in patients with symptomatic benign prostatic hyperplasia (BPH) in comparison to Holmium laser enucleation of the prostate (HoLEP). Methods: The retrospective study included 338 patients (204 HoLEP and 134 Rezum) operated on for BPH between January 2020 and November 2024. A 1:1 matching of treated patients (Rezum) to HoLEP patients based on the closest propensity score value was conducted for 131 successful matching pairs. The groups were compared regarding; Age, Prostate volume, PSA, Catheter-dependence, Qmax, PVR, IIEF, IPSS, PGI-I, operation time (OT) and hospital time (HS). Results: Concerning perioperative data, there was a statistically significant difference between the Rezum and HoLEP groups regarding OT (8.29 ± 1.21 vs. 68.01 ± 31.01 min; P < 0.001) and HS (1 vs. 2.61 ± 1.53 days; P < 0.001) with higher values for HoLEP. At the same time, the catheter duration was longer in the Rezum group (7.6 ± 2.19 vs. 3.49 ± 1.16 days; P < 0.001). In terms of clinical outcomes, there was a statistically significant improvement in Qmax, IPSS and a decrease in PVR at 12 months for the HoLEP group compared to the Rezum group (16.82 ± 2.27 ml/sn vs. 22.14 ± 7.17 ml/sn, P < 0.001; 12.1 ± 2.1 vs. 7.1 ± 1.9, P < 0.001; 43.05 ± 32.62 ml vs. 29.73 ± 43.73 ml, P = 0.006; respectively). PGI-I scores ( p = 0.620) and antegrade ejaculation ( p < 0.001) were in favour of Rezum therapy. Conclusion: The HoLEP technique demonstrates superior functional outcomes compared to Rezum, particularly in cases with larger prostates. However, Rezum is an ejaculation-sparing technique demonstrating high tolerability, and patient satisfaction even in larger prostates.

BACKGROUND: The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications. METHODS: A total of 920 kidney transplantations were performed between 2008 and 2015. All patients were followed up for at least 1 year after transplantation. Complications regarded as urological were urinary leakage, ureteral stricture, urinary malignancy, bladder outlet obstruction (BOO) and urinary calculi. We evaluated data from the time of occurrence of urological complications and the type of the management prescribed. RESULTS: Among 920 transplantations performed in our clinic, 41 (4.4%) urological complications arose. Twenty (48.8%) of the complications occurred during the first 3 months and 21 (51.2%) occurred after 3 months, postoperatively. Ureteral strictures were found in 14 (34.1%) patients, urinary' tract stones in seven (17%), BOO in 6 (14.6%) and urinary leakage was observed in 5 (12.1%) patients. Ureteral stricture was managed with endoscopic approach in eight (61.3%) patients. Urinary tract stones and urinary leakage were managed in 7 (100%) and 4 (75%) patients with endoscopic approach. Overall 29 (70.7%) of 41 umlogical complications were managed with endourological approaches. CONCLUSIONS: It is likely that the importance of open surgery could decrease in the future. Endoscopic management of urological complications have come to have an important role in the treatment of urological complications after transplantation.

The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction (ED). The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years (range: 31-71 years). The study group contained 162 patients (89.5%) with malleable prostheses and 19 (10.5%) with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% (n = 58). The number of complications with inflatable and malleable prostheses was 7 (3.9%) and 51 (28.1%), respectively. Overall, 21 prostheses (11.6%) had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates (ƛ = 14.606, P < 0.05, Chi-square test). The main reasons for removal were erosion (n = 11; 6.1%) and infection (n = 3; 2.1%). With respect to satisfaction during intercourse, we found that 104 (57.5%) patients described themselves as very satisfied with the prosthesis, while 21 (11.6%) were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.