Objective: COVID‐19, which is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is a global health problem that can cause multiorgan damage because of its use of the angiotensin‐converting enzyme 2 (ACE2) receptor in its pathophysiology. We aimed to investigate whether SARS‐CoV‐2 had a short‐term effect on spermatogenesis, which plays an important role in male reproductive health as it has abundant ACE2 expression in testicular tissue.Material and methods: This multicenter study included 69 patients aged 20–45 years, who admitted to our hospitals between April 2020 and October 2020 with a history of a positive test result for SARS‐CoV‐2 based on the nasopharyngeal or oropharyngeal swab samples and had recovered from the disease at least three months earlier and who had undergone a spermiogram test in the hospital database within the last year before the onset of disease. The patients were divided into two groups according to their COVID‐19 symptoms being mild or moderate, depending on whether they had received home treatment or required hospitalization for oxygen therapy. Semen samples taken before and after COVID‐19 were compared within and between the groups in terms of sperm parameters.Results: The mean age of the patients included in the study was 30.4±4.8 years in the mild symptomatic COVID‐19 group and 31.06±4.2 years in the moderate symptomatic group. When the spermiogram samples of the patients before and after COVID‐19 were evaluated, it was found that motility and vitality significantly decreased in the mild symptomatic group, while the decrease in all semen parameters was statistically significant in the moderate symptomatic group.Conclusion: Although the mechanism by which COVID‐19 causes testicular involvement remains uncertain, its short‐term results on spermatogenesis reveals that COVID‐19 negatively affects sperm parameters.

Purpose: This study aimed to examine the short and long-term complications of thermocautery-assisted circumcisions with local anesthesia done in a sterile environment in operating room conditions, accompanied by literature. Materials and Methods: The participants who consecutively underwent thermocautery-assisted circumcision with local anesthesia from June 2018 to May 2019 were included in the study. They were one month-17 years old, same ethnic origin, in same location. The age groups were compared in terms of complications. Results: The participant age and surgical duration means were 4.89 +/- 2.08 (30 days-17 years) years old and 7.484 +/- 1.524 (5-20 minutes) minutes, respectively. Complications were observed in fifty-three participants or 2.9% of the whole observation set. The participants under intervals of one six months and over 6 years of age had significantly lower complication rates when compared to the other participants, and this comparison was statistically significant (P = 0.001). Conclusion: The study results demonstrated that circumcision with thermocautery after local anesthesia is a viable, reliable, and effective method. It can be assumed that circumcisions in males especially may be effective in 1-6 months, and over 6 years of age. Parents choose this method because it is more appropriate and eliminates the risk of general anesthesia.

Objective: Large language models (LLMs) are increasingly used as guideline-decision support in oncology, but most validation has occurred in common cancers, where clinicians can usually recognize errors. The safety-critical setting is the opposite — rare cancers, where local expertise is limited, and errors may go unrecognized. Whether common-cancer concordance reflects the reliability needed there is unclear. Methods: We benchmarked GPT-5.2 against the EAU-ASCO 2025 Penile Cancer Guidelines using 100 guideline-derived questions across five domains and three zero-shot prompting strategies, yielding 300 responses. Two experienced urologists, blinded to prompt identity, scored concordance on a 3-point scale and classified errors as hallucination, omission, temporal, or reasoning. The primary analysis was a mixed-effects ordinal logistic regression with question as a random intercept; a cluster-robust logistic regression served as sensitivity. Reporting followed TRIPOD-LLM. Results: GPT-5.2 was fully concordant in 236 of 300 responses (78.7%; 95% confidence interval, 73.7–82.9; weighted κ=0.914). Prompt strategy did not improve performance (role-play +3 percentage points; 95% credible interval, −2 to +9). The domain effect was not robust once between-question clustering was modeled. Among 64 non-concordant responses, omission predominated (47.7%) and reasoning errors followed (37.5%); in treatment, omission accounted for 68.0% of errors, including loss of guideline-specified detail. Four questions were uniformly discordant across all three prompts. Conclusion: Headline concordance overstated clinical reliability. The clinically informative finding was not the overall accuracy but the structure of failure — omission of decision-critical treatment detail and stable errors. Prompt engineering did not rescue performance. Current LLM output may assist orientation in rare-cancer decision pathways but is not ready as stand-alone guideline-decision support.

Purpose: Urethral stricture represents a significant late complication of transurethral resection of the prostate (TURP), leading to deterioration in urinary function and quality of life. This study aimed to compare the impact of 22Fr and 26Fr continuous-flow resectoscope sheaths on postoperative urethral stricture formation and perioperative outcomes. Methods: Patients who underwent bipolar TURP between 2021 and 2025 were retrospectively evaluated. Patients were divided according to sheath size into 22Fr (n = 135) and 26Fr (n = 145) groups. The primary endpoint was postoperative urethral stricture. A multivariable Cox proportional hazards model with Firth’s penalized likelihood correction was used to identify independent predictors of stricture. Stricture-free survival was analyzed using Kaplan-Meier curves and compared with the log-rank test. Results: Urethral stricture occurred in 5 patients (3.7%) in the 22Fr group and 22 patients (15.2%) in the 26Fr group (p = 0.0011). Operation time was shorter in the 26Fr group, while functional outcomes were comparable between groups. In multivariable Firth’s penalized Cox regression analysis, use of a 26Fr sheath was the only independent predictor of urethral stricture (adjusted HR 4.08; 95% CI 1.16–14.37; p = 0.029). Kaplan-Meier analysis demonstrated a significantly higher cumulative incidence of urethral stricture in the 26Fr group (log-rank p = 0.003). Conclusions: Use of a 22Fr resectoscope sheath is associated with a significantly lower hazard of postoperative urethral stricture without compromising functional outcomes. Sheath diameter represents a clinically relevant and modifiable technical factor that may significantly influence long-term urethral morbidity after TURP.

Background: Stress urinary incontinence (SUI) negatively affects women's physical, psychological, and social well-being and reduces comfort. Although pelvic floor muscle exercise (PFME) is the first-line conservative treatment, the additional contribution of progressive muscle relaxation exercise (PMR) to patient comfort remains unclear. This study aimed to evaluate the effects of PFME, PMR, and their combined application on comfort levels in women with SUI. Methods: This four-arm randomized controlled trial included 80 women diagnosed with SUI who were randomly assigned to the PFME group ( n = 20), PMR group ( n = 20), PFME + PMR group ( n = 20), or control group ( n = 20). Data were collected using a Descriptive Information Form and the Urinary Incontinence Frequency and Comfort Questionnaire (UIFCQ). Participants in the intervention groups performed the assigned exercise program for six weeks. Comfort was assessed at baseline and at Weeks 2, 4, and 6 through telephone interviews. Data were analyzed using descriptive statistics and mixed-design analysis of variance (Mixed ANOVA). A p -value of 0.05). Significant effects of time and the group×time interaction were observed ( p < 0.001). Participants in the PFME group demonstrated significant improvements in comfort beginning at Week 2, which were maintained throughout the study. The PMR group showed gradual improvements in comfort across the follow-up period. In the combined PFME + PMR group, significant improvements became evident at the third and fourth assessments. Although slight changes were observed in the control group over time, the trajectories of improvement in all intervention groups were significantly greater than those in the control group. Conclusions: PFME, PMR, and their combined application improved comfort over time in women with stress urinary incontinence. These findings suggest that structured conservative interventions, particularly the integration of PMR into pelvic floor rehabilitation programs, may enhance patient comfort and support comprehensive SUI management. Further multicenter randomized controlled trials with larger sample sizes and longer follow-up periods are warranted. Clinical trial registration: ClinicalTrials.gov, Identifier: NCT07762391, https://clinicaltrials.gov/study/NCT07762391

Background/Objectives: Adherent perinephric fat (APN) is common in laparoscopic partial nephrectomy (LPN). It is absent from the lists of recognised positive surgical margin (PSM) predictors. We tested whether APN is associated with PSM risk and whether the effect varies by resection technique. Methods: We analysed 401 International Society of Urological Pathology (ISUP)-gradable renal cell carcinomas (31 PSM events; chromophobe RCC was excluded from the primary cohort because the WHO/ISUP grade is not assignable) carried out at three centres by eight surgeons from 2013 to 2024. Nested logistic models added APN, then an APN × enucleation interaction, to a guideline-based covariate set (tumour size, ISUP grade ≥ 3, cT1b stage, centre fixed effects, surgeon-documented enucleation). Firth penalisation and a 2000-replicate bootstrap were used to limit small-sample bias; they cannot add information beyond the 31 observed events. Results: APN was an independent PSM predictor (adjusted odds ratio [OR] 2.68, 95% confidence interval [CI] 1.21 to 5.95, p = 0.02). The effect was technique-conditional: APN × enucleation interaction OR 7.83 (95% CI 1.08 to 56.92, p = 0.04), consistent in direction across estimators but imprecise in magnitude. PSM occurred in 29.4% of APN-positive enucleation cases (odds ratio 10.21, 95% CI 2.07 to 50.30; Fisher exact p = 0.003), against 5.0% in enucleoresection and 10.8% in resection. Conclusions: In this cohort the APN-to-PSM association was technique-conditional. The penalty concentrates in enucleation; the rim-retaining strata gave estimates compatible with both no association and clinically important harm (OR 0.99 and 1.96, both intervals wide). Because the interaction rests on few margin events and the technique was not randomised, this finding is hypothesis-generating: when APN is encountered intraoperatively, retaining a parenchymal rim (enucleoresection or resection) rather than enucleation may be considered, pending prospective validation.