This study aimed to compare the predictive performance of Triple-D, Quadruple-D, and Mayo Adhesive Probability (MAP) scoring systems in estimating stone-free (SF) status following extracorporeal shock wave lithotripsy (ESWL) in patients with renal stones. This retrospective cohort study was conducted on patients who underwent ESWL between January 2020 and January 2024. Pre-treatment non-contrast computed tomography was used to assess stone characteristics and calculate Triple-D, Quadruple-D, and MAP scores. Patients were categorized into stone-free (SF) and residual stone (RS) groups based on imaging performed three months after treatment. Residual fragments of < 4 mm were defined as SF. The study included 198 patients (60.6% male; mean age 45.5 ± 13.1 years). According to logistic regression analysis, a low MAP score (< 2.5) was the strongest independent predictor of SF status (OR: 15.5; 95% CI: 5.1–47.1; p < 0.001), followed by a high Quadruple-D score (> 1.5) (OR: 7.4; 95% CI: 2.2–24.1; p = 0.001) and low stone density (< 600 HU) (OR: 4.9; 95% CI: 1.1–21.8; p = 0.037). Conversely, a higher number of shockwaves and the need for additional procedures were associated with RS (both p < 0.001). Among the scoring systems, MAP score demonstrated the highest predictive accuracy with an AUC of 0.817, outperforming Quadruple-D (AUC: 0.722) and Triple-D (AUC: 0.639). MAP score was the most powerful and accurate independent predictor of SF status after ESWL, offering superior clinical utility compared to Triple-D and Quadruple-D scores in pre-treatment evaluation.

Introduction: The aim of this study was to explore the role of systemic immune indices (systemic immune-inflammation index [SII] and systemic inflammatory response index [SIRI]) in the differential diagnosis between chromophobe renal cell carcinoma (chRCC) and oncocytoma. Methods: The medical records of 162 patients diagnosed with chRCC and 90 patients with oncocytoma, who underwent surgery for renal masses between January 2013 and December 2022, were reviewed. Inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), SII, and SIRI, were calculated for both groups. The results were compared to assess the effects of these markers on renal cell carcinoma (RCC) subtypes. Results: Median age was significantly higher in the oncocytoma group (65 vs. 61 years, p = 0.01). Tumor size was larger in the chRCC group (p < 0.001). NLR, MLR, PLR, SII, and SIRI values were significantly higher in chRCC (all p < 0.001). ROC analysis showed area under the curve (AUC) values of 0.688 (NLR), 0.673 (MLR), 0.750 (PLR), 0.720 (SII), and 0.679 (SIRI). The optimal SII cut-off was 460 (AUC: 0.692), and for SIRI, 0.7 (AUC: 0.647), offering the best discriminative performance between chRCC and oncocytoma. Conclusion: Inflammatory indices, particularly PLR, SII, and SIRI, are accessible and cost-effective tools that can aid in the preoperative distinction of chRCC from oncocytoma, potentially guiding treatment planning.

Background and Objectives: Evidence linking sarcopenia and myosteatosis to oncological outcomes in renal cell carcinoma (RCC) remains inconsistent. We aimed to evaluate whether preoperative psoas muscle measurements are associated with tumor stage, recurrence, and survival in RCC patients undergoing nephrectomy. Materials and Methods: A total of 199 patients who underwent nephrectomy with a diagnosis of RCC between 2018 and 2024 were retrospectively evaluated. Preoperative computed tomography images were used to measure the bilateral psoas muscle area at the L3 vertebral level and Hounsfield unit (HU) values. The psoas muscle index (PMI) was calculated. PMI and psoas HU values were analyzed as continuous variables, as this approach preserves statistical information and avoids misclassification bias inherent to arbitrary dichotomization, particularly given the absence of population-specific validated thresholds for Turkish RCC patients. Tumor stage, metastasis, recurrence, and survival data were analyzed. Results: The mean age of the patients was 60.29 ± 11.62 years, and 67.84% were male. The mean PMI was 5.11 ± 1.54 cm²/m² while the mean psoas HU value was 38.63 ± 8.95 HU. PMI was significantly higher in patients with advanced-stage (T3 and T4) disease than in those with early-stage (T1 and T2) disease (5.57 ± 1.49 vs. 4.30 ± 1.28, p < 0.001). A positive correlation was found between T stage and PMI (r = 0.396, p < 0.001) and between tumor size and PMI (r = 0.215, p = 0.002). Modest but significant correlations were found between age and both PMI (r = −0.274, p < 0.001) and psoas HU values (r = −0.347, p < 0.001). Conclusions: In this retrospective nephrectomy series, conducted in a cohort inherently enriched for adequate performance status and surgical fitness, PMI showed a positive correlation with pathological T stage and tumor size, intriguingly higher PMI values were observed in patients with advanced T stages. These findings suggest that the role of psoas-based muscle measurements in the prognostication of this subset of RCC patients (advanced disease but candidates for surgical treatment) may be limited.

Malignant neoplasms of the penis are uncommon, the most common being squamous cell carcinoma. Non-Hodgkin's lymphoma occurs in extranodal sites in half of patients, but is extremely rare in the penis. Here, a 24 years old case of a penile mass is reported as non-Hodgkin lymphoma. On physical examination and imaging, two-centimeter lesion was detected on the left distal corpus cavernosum of the penis and extending to the proximal corpus cavernosum. Excisional biopsy from distal left corpus cavernosum performed under general anesthesia. Histopathological examination of the excision material revealed diffuse large B-cell lymphoma with a post-germinal center cell phenotype. Although it is rare in patients presenting with a penile mass, the possibility of lymphoma involvement should be kept in mind. It can mimic Peyronie's disease or corpus cavernosum thrombosis.

Purpose: This study aimed to evaluate the diagnostic value of pressure-flow study parameters in female patients with anatomical bladder outlet obstruction (BOO) and to investigate the association between obstruction location and urodynamic findings.Methods: A total of 72 women with anatomical BOO who underwent urodynamic examination between January 2007 and October 2023 were retrospectively analyzed. Based on obstruction location, patients were categorized into 3 groups: external urethral meatus stenosis (n=18), urethral stricture (n=49), and bladder neck obstruction (n=5). Urodynamic assessments included free-flow maximum flow rate (Qmax), postvoid residual urine volume, filling cystometry, and a pressure-flow study.Results: Statistically significant differences were observed between groups in free-flow Qmax, urethral caliber, and pressure-flow parameters. Bladder Outlet Obstruction Index - Female, Dybowski index, urethral resistance factor, obstruction coefficient (OCO), and Woman Obstruction Index values were significantly higher in the urethral stricture group than in the other groups (P=0.022, P=0.025, P=0.031, P=0.031, and P=0.031, respectively). The Blaivas-Groutz nomogram classified all patients as obstructed, regardless of obstruction location. Diagnostic accuracy exceeded 90% when using the Barco-Castillo, Dybowski, and OCO indices; however, the accuracy varied by obstruction location.Conclusions: In women with anatomical BOO, the diagnostic performance of pressure-flow studies varies by the anatomical location of the obstruction. While urethral strictures yield high diagnostic rates, external urethral meatus stenosis may be underdiagnosed by urodynamic assessment alone. This variability remains a challenge in standardizing BOO diagnosis in women.