Penile fracture is a trauma accompanied by sudden pain, swelling, loss of erection, deviation, and ecchymosis along with a breaking sound in the penis. It can be accompanied by urethral injuries in 11-22% of patients, occurring due to force/blunt trauma to the erect penis. In this case report, we present two cases of penile fracture with accompanying urethral injury, occurring approximately one month apart. In our first case, surgical repair was performed approximately 1 hour after the incident, and in the second case, it was performed approximately 2 hours after the incident. Ultrasound (USG) was used as radiological imaging in both cases. In the second case, suspicion of urethral injury was mentioned in the USG. In both cases, a subcoronal circumferential incision was made, and the penile skin was degloved up to the radix. Damaged areas in the intraoperative tunica albuginea and urethra were observed in both cases. Postoperatively, the penile bandage of the first case was removed on the 4th day, and that of the second case was removed on the 6th day. The catheter was removed on the 20th day in both cases. In both cases, no loss of erection or penile deviation was observed at the 3-month postoperative follow-up. No clinical or uroflowmetric findings compatible with urethral stenosis were found in the 2nd and 3rd months post-op. The current approach to penile fractures is emergency surgical decompression and repair.

Prostat Anatomisi Mehmet Ali KARAGÖZ Prostat Enfeksiyonları Görkem AKÇA Benign Prostat Hiperplazisinde Etyoloji ve Patogenez Mahmut UĞURLU Furkan Abdullah VURAL Bph Tedavi Yöntemleri Erdem ORMAN Bph Tedavisinde Lazer Kullanımı Cihat ÖZCAN Prostat Kanserinde Etiyoloji, Epidemiyoloji, Tanı ve Evreleme Enis Mert Yorulmaz Prostat Biyopsi Yöntemleri İlke Onur KAZAZ Recep Serhat TEPE Lokalize Prostat Kanserinde Tanı ve Tedavi Mücahit KABAR Radikal Prostatektomi Cerrahisi Sonrası İzlem ve Komplikasyon Yönetimi Olcay KARAOĞLU Lokal İleri Hastalıkta Tedavi Yöntemleri Mubariz AYDAMIROV Kadir KARKIN Metastatik Prostat Kanserinde Tedavi Seher Nazlı KAZAZ Göktuğ ATNALLAR Prostat Kanseri Tedavisi Sonrası Erektil Disfonksiyona Yaklaşım Nihat KARABACAK Cihat AYTEKIN Çocuklarda Prostat ve Genitoüriner Travmalar Nur Deniz EYÜPOĞLU KARAOĞLU Olcay KARAOĞLU Bening Prostat Hiperplazisine Bağlı Postrenal Azotemi Ercüment KESKİN Ömer BÜYÜKTEPE

Background/Objectives: Acute obstructive pyelonephritis (AOP) is a urological emergency requiring urgent decompression. We aimed to develop and internally validate an interpretable admission-based score (AP-Score) to predict the likelihood of undergoing percutaneous nephrostomy (PCN) and to test whether it outperforms hydronephrosis grade alone. Methods: We retrospectively analyzed 231 adults with AOP treated with antibiotics alone, double-J stenting, or PCN at a single center. Four admission variables (temperature, C-reactive protein [CRP], serum creatinine, and hydronephrosis grade) were evaluated by multivariable logistic regression and likelihood ratio testing. Discrimination was compared against hydronephrosis grade alone using the DeLong test; calibration and clinical usefulness were assessed, and optimism was estimated using 1000 bootstrap resamples. Results: In the likelihood ratio test, while adding CRP to hydronephrosis grade significantly improved model fit (p < 0.001), serum creatinine provided a smaller additional contribution (p = 0.013). The AP-Score (0–8 points) combined these three variables included in the model; in the categorical model, the grade of hydronephrosis and CRP appeared as independent predictors, whereas creatinine was included due to its contribution on a continuous scale. The score achieved an AUC of 0.830 (95% CI 0.771–0.886), performing significantly better than the model using only the grade of hydronephrosis (AUC 0.772; ΔAUC = +0.058, DeLong p = 0.010; IDI = 0.061, p = 0.002). The optimism-corrected AUC was calculated as 0.827, and calibration was found to be adequate (Hosmer–Lemeshow p = 0.342). A threshold value of ≥4 points yielded a sensitivity of 85.3% and a specificity of 65.0% (OR = 10.79, 95% CI 5.12–22.70); no patients scoring 0–1 points (n = 37) underwent nephrostomy. Conclusions: The AP-Score—which combines a structural parameter (degree of hydronephrosis) with two systemic markers (CRP and creatinine)—is a simple and well-calibrated score that performs significantly better than the degree of hydronephrosis alone. The AP-Score was also associated with additional clinical outcomes, suggesting that it captures aspects of the underlying clinical course in addition to local treatment patterns. However, because the primary endpoint reflects the drainage modality selected under a single-center institutional protocol, the score should be considered hypothesis-generating until externally validated in independent, preferably multicenter cohorts with different drainage practices.