The population of elderly adults is increasing globally, and due to metabolic changes related to advanced age, many elderly adults experience kidney stones. Flexible ureteroscopy (f-URS) is a minimally invasive procedure to treat kidney stones, but it is not free of complications. The goals of this study were to analyze the efficacy and safety of f-URS in the management of kidney stones in patients aged ≥60 years and compare the outcomes of this surgery with the outcomes of the same surgery in a younger population. We retrospectively reviewed patient data from 1750 patients who met our inclusion criteria and received f-URS at the urology clinic of our hospital from 2012 to 2017. Patients were assigned into two groups: those aged ≥60 years (Group 1, n=291) and those aged 19-59 years (Group 2, n=1459). The perioperative results were evaluated comparatively. We performed multivariable analyses for factors predicting complications. When we compared the groups on demographic attributes, we noted statistically significant differences in gender, body mass index (BMI), and American Society of Anesthesiologists scores. Stone size and operation time were higher in the ≥60-year age group (Group 1). Other stone characteristics and operative features were similar. Stone-free rates (SFR) after the first procedure were 88.0% in Group 1 and 89.2% in Group 2. SFR and success rates at three months were similar for both groups. The complication rates were similar, and multivariable regression analysis revealed the most important factor affecting the complications was the presence of residual stones in both groups. The second most important factor affecting the complication was the operation time in Group 1 and the number of stones in Group 2. In our study, there were no significant differences in terms of results and complications among elderly and young patients after f-URS except for the duration of the operation. The prolongation of operation time results in worse outcomes in terms of perioperative complications in patients aged ≥60 years. f-URS is a relatively safe and efficient procedure, with a small risk of minor complications even in the elderly population, with increased comorbidity.

This study aimed to compare the incidence of postoperative ileus (POI) between end-to-end hand-sewn and side-to-side stapled ileo-ileal anastomoses and to identify independent risk factors associated with POI. We conducted a retrospective analysis of patients who underwent radical cystectomy with urinary diversion at Ankara Etlik City Hospital between October 2022 and October 2024. Patients were categorized according to the anastomosis technique used: end-to-end hand-sewn or side-to-side stapled. Perioperative data, including demographic characteristics, comorbidities, preoperative laboratory parameters, operative variables, and postoperative outcomes, were collected. POI was defined as intolerance to oral intake accompanied by abdominal distension and absence of flatus or stool beyond postoperative day five, requiring medical or surgical management. Univariable and multivariable logistic regression analyses were performed to identify risk factors for POI. A total of 71 patients were included in the analysis. POI occurred in nine patients (23.7%) in the hand-sewn group and in four patients (12.1%) in the stapled group, indicating a significantly lower incidence in the stapled group. Multivariable analysis identified side-to-side stapled anastomosis as an independent protective factor against POI. Additional independent predictors included age ≥65 years, abnormal body mass index (BMI), preoperative constipation, hypoalbuminemia, and prolonged operative time. Receiver operat-ing characteristic (ROC) curve analysis demonstrated good predictive performance of the model. Side-to-side stapled ileo-ileal anastomosis is associated with a lower risk of POI compared to end-to-end hand-sewn anastomosis in patients undergoing radical cystectomy with urinary diversion.

Background/objectives: Muscle-invasive bladder cancer requiring radical cystectomy is associated with substantial postoperative morbidity, particularly in elderly patients. This study evaluated the predictive capacity of the preoperative Geriatric Nutritional Risk Index (GNRI) for 90-day complications following open radical cystectomy with ileal conduit urinary diversion. Methods: We conducted a single-center retrospective cohort study of 80 consecutive patients who underwent open radical cystectomy and exclusively ileal conduit urinary diversion (100.0%) between November 2022 and December 2025. Preoperative GNRI was calculated from serum albumin and body weight metrics. Multivariable analysis was conducted using a 3-covariate Firth's penalized logistic regression model. An empirical threshold (GNRI < 94.5) derived from ROC analysis was evaluated alongside continuous GNRI scores. Results: The overall 90-day complication rate was 82.5% (66/80). Mean preoperative GNRI was 94.81 ± 7.24. The ROC-derived optimal cutoff for overall complications was GNRI < 94.5 (AUC = 0.628, Sensitivity: 71.2%, Specificity: 57.1%). While continuous GNRI was not an independent predictor of total complications in multivariable analysis (OR: 1.052 per 1-unit decrease, 95% CI: 0.948–1.168, p = 0.342), patients with GNRI < 94.5 exhibited significantly higher rates of specific severe morbidity subtypes, including infectious complications (67.7% vs. 34.7%, OR: 3.95, p = 0.004), gastrointestinal complications (74.2% vs. 36.7%, OR: 4.95, p = 0.001), and cardiovascular adverse events (25.8% vs. 4.1%, OR: 8.17, p = 0.005). Advanced pathological stage (≥pT3) remained the sole independent predictor of overall 90-day morbidity (OR: 4.187, p = 0.024). Conclusions: Preoperative GNRI is not an independent predictor of overall 90-day post-cystectomy complications; however, lower GNRI values (<94.5) strongly correlate with organ-specific infectious, gastrointestinal, and cardiovascular morbidity. GNRI serves as a valuable, objective screening tool within Enhanced Recovery After Surgery (ERAS) pathways to trigger targeted perioperative prehabilitation and nutritional optimization.

Objective: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is an important public health problem that mainly affects middle-aged female patients. Diagnosis of IC/BPS is difficult as there is no disease-specific diagnostic test. Our study analyzed the hematological parameters in female patients with IC/BPS to determine whether these parameters could assist in diagnosing IC/BPS and investigate the relationship between these parameters and disease severity. Methods: Fifty female patients with IC/BPS (i.e., patient group) and 50 healthy volunteers (i.e., control group) with no systemic diseases or complaints were included. The patients' O'Leary Sant Interstitial Cystitis Symptom Index (ICSI) scores were recorded at diagnosis. Blood neutrophil, lymphocyte, platelet counts, mean platelet volumes (MPV), neutrophil/lymphocyte (NLR), and platelet/lymphocyte ratios (PLR) were recorded and calculated based on the complete blood count results obtained during the initial outpatient clinic encounters. Patients and healthy volunteers were compared regarding age, neutrophil, lymphocyte, platelet counts, and MPV, NLR, and PLR values. The correlation between laboratory parameters and ICSI levels of the cases in the patient group was also analyzed. Results: The demographic data of the groups were similar. There was no significant difference between the groups regarding neutrophil, lymphocyte, platelet counts, and MPV levels. On the other hand, the median NLR values were significantly higher in the patient group compared to the control group (2.34 vs. 1.85, p<0.001). In the patient group, the lymphocyte count was significantly higher in the group with an ICSI score≥14 compared to the group with an ICSI score<14 (median, 1.90 vs. 1.62, p=0.009). Conclusion: Our study found that NLR was higher in IC/BPS patients than in healthy individuals and that lymphocyte counts might be associated with disease severity. Thus, hematological parameters can provide clinicians with valuable insights regarding IC/BPS disease severity and aid treatment planning.