{"id":1478,"date":"2021-12-27T14:24:57","date_gmt":"2021-12-27T14:24:57","guid":{"rendered":"https:\/\/endourolojibulteni.com\/en\/?page_id=1478"},"modified":"2021-12-27T15:01:02","modified_gmt":"2021-12-27T15:01:02","slug":"last-issue","status":"publish","type":"page","link":"https:\/\/endourolojibulteni.com\/en\/last-issue\/","title":{"rendered":"Last Issue"},"content":{"rendered":"\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><ul class=\"wp-block-latest-posts__list has-author wp-block-latest-posts is-layout-flow wp-block-latest-posts-is-layout-flow\"><li><div class=\"wp-block-latest-posts__featured-image\"><img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/endourolojibulteni.com\/en\/wp-content\/uploads\/sites\/2\/2025\/10\/17-3-cover-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" style=\"\" \/><\/div><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/endourolojibulteni.com\/en\/vol-18-issue-3\/\">Vol 18 Issue 3<\/a><div class=\"wp-block-latest-posts__post-author\">by Endouroloji_Bulteni<\/div><div class=\"wp-block-latest-posts__post-full-content\">\n<h3 class=\"wp-block-heading\">Editorial Board Message<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Prof.Dr. R. G\u00f6khan ATI\u015e<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/18-03-Editor-mesaji.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image.png\" alt=\"\" class=\"wp-image-1637\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">Editorial Board<\/h3>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/18-03-Yayin-Kurulu.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-1.png\" alt=\"\" class=\"wp-image-1638\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">Reviewers\u2019 List<\/h3>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/18-03-Hakem-Listesi.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-2.png\" alt=\"\" class=\"wp-image-1639\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">Contents<\/h3>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/18-03-Icindekiler.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-3.png\" alt=\"\" class=\"wp-image-1640\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Efficacy of Simultaneous Ureterorenoscopy for Ipsilateral Ureter and Kidney Stone: A Single-Center Experience<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Ilkin Hamid-Zada, \u00d6zg\u00fcr Ar\u0131kan, Talha Nuro\u011flu, Elbrus Fehruzlu, Ferhat Keser, As\u0131f Y\u0131ld\u0131r\u0131m<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> This study aimed to evaluate the efficacy and safety of simultaneous endourological management of ureteral and ipsilateral renal stones and to identify predictive factors associated with stone-free outcomes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> A retrospective analysis was conducted on seventy-nine patients who underwent single-session treatment for concurrent ureteral and ipsilateral renal stone. Demographic data, stone characteristics, operative details, and postoperative outcomes were collected. Stone-free rates (SFR) were assessed on postoperative day 1 and at 1 month. Comparative analyses were performed to determine factors associated with 1-month SFR.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The overall 1-month SFR was 75.9%. Renal stone size, ureteral stone density (HU), hydronephrosis grade, and number of stones were significant predictors of SFR (p &lt; 0.05). Patients who were stone-free on postoperative 1 day were significantly more likely to remain stone-free at 1 month (p &lt; 0.001). Larger renal stones and a higher number of stones were associated with decreased success rates. Complication rates were low, with 6.3% experiencing postoperative events, most of which were minor. Auxiliary procedures were required in 16.5% of patients during follow-up.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Simultaneous management of ureteral and ipsilateral renal stones is a safe and effective treatment option, providing high SFR with low morbidity. Stone size and number of stones are the key determinants of postoperative success and should be considered during preoperative planning.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> lithotripsy, simultaneous treatment, ureteral and renal stone, ureteroscopy<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/1-1840851-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Evaluating Kidney Cyst Information from Chatbots: A Comparative Study<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Burak Koseo\u011flu, Eser \u00d6rdek, Kerem Gencer Kutman<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> Kidney cysts are the most common acquired lesions of the kidney. This study aims to assess the reliability and quality of responses provided by three different artificial intelligence chatbots to questions related to kidney cysts.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> Using the Semrush platform, we analyzed kidney cyst-related search trends over five years. We examined 25 questions, categorized into four subgroups: \u201cgeneral information\u201d, \u201csymptoms and diagnostic methods\u201d, \u201ctreatment and follow-up procedures\u201d, and \u201cside effects and complications\u201d. These questions were posed to three chatbots (ChatGPT-4, Gemini Pro, Llama 3.1 Large). Response readability was assessed using Flesch-Kincaid Grade Level (FKGL) test and Flesch Reading Ease Score (FRES) test. Reliability and quality were evaluated using the Ensuring Quality Information for Patients (EQIP) score and modified DISCERN score.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> Llama had a significantly higher FKGL score than ChatGPT (p = 0.022), with no significant difference between Llama and Gemini (p = 0.500), or Gemini and ChatGPT (p = 0.525). On the FRES scale, ChatGPT scored higher than Gemini, and Gemini outperformed Llama (p = 0.006 and p = 0.012, respectively). The median modified DISCERN score was lowest for ChatGPT (2), compared to Gemini (3) and Llama (3) (p &lt; 0.001). The mean EQIP score was 71.22 \u00b1 3.91 for ChatGPT, 77.72 \u00b1 1.16 for Gemini and 73.26 \u00b1 2.70 for Llama (p &lt; 0.001). ChatGPT had significantly lower quality scores than the other two chatbots.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Although ChatGPT generated the most readable responses according to the FRES score, it demonstrated lower quality and reliability than Gemini and Llama. Overall, chatbot responses remained challenging in terms of readability and comprehension, highlighting the need for further improvements before they can be considered a reliable standalone source of patient education.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> artificial intelligence, chatbot, ChatGPT, Gemini, kidney cysts, Llama<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/2-1848567-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Evaluation of the Quality and Reliability of Youtube Videos Related to Commonly Performed Kidney Stone Surgeries in Urology Practice<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Abdulkadir \u00d6zmez, Mehmet \u00d6zay \u00d6zg\u00fcr<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> Patients increasingly turn to online video platforms for information about surgical options before making treatment decisions. YouTube\u2122 is the most commonly used video-sharing website and contains a large volume of health-related material with variable accuracy and educational value. This study evaluated the quality, reliability, and informational content of Turkish-language YouTube videos about kidney stone surgery, with particular emphasis on whether uploader characteristics were associated with video quality.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> In this cross-sectional study, YouTube\u2122 was searched in January 2026 using the Turkish term \u201cb\u00f6brek ta\u015f\u0131 ameliyat\u0131\u201d. The first 200 relevant Turkish-language videos were reviewed. For each video, we recorded duration, view count, likes and comments. Video quality was scored with the Journal of the American Medical Association (JAMA) benchmark criteria and the Global Quality Score (GQS). Uploaders were classified as specialist urologists or academic urologists (associate professor\/professor). Surgical procedures mentioned in each video were also documented. Statistical analyses were used to compare video characteristics and quality scores between the two groups.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> Among the 200 included videos, 112 (56%) had been uploaded by specialist urologists and 88 (44%) by academic urologists. Videos published by academic urologists showed significantly higher median JAMA and GQS values and also attracted higher view and like counts (p &lt; 0.05). Video length was not significantly associated with quality scores. Most videos concentrated on a single operative technique, especially ureterorenoscopy, whereas discussion of complications and alternative treatment options was limited.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Although videos uploaded by academic urologists were generally more reliable and of better quality, Turkish-language YouTube content on kidney stone surgery overall was not sufficient as a stand-alone patient education source. These findings support the need for standardized, evidence-based video materials prepared by professional urological organizations.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> kidney stone surgery, video analysis, YouTube, health information quality<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/3-1878545-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Frailty Matters: The Success of the Modified Frailty Index-5 Score in Predicting Postoperative Outcomes in Radical Prostatectomy<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Osman Murat \u0130pek, Erdin\u00e7 Din\u00e7er, Ahmet Halil Sevin\u00e7, Burcu Hanc\u0131 Sevin\u00e7, Cengiz \u00c7anak\u00e7\u0131, Yi\u011fit Kudret Akyol, Orkunt \u00d6zkaptan<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> Patients undergoing radical prostatectomy generally belong to an older population; therefore, in addition to chronological age, frailty has a substantial impact on clinical outcomes. This study aimed to evaluate the predictive value of the modified frailty index (mFI-5) for post-operative complications and functional outcomes in patients undergoing radical prostatectomy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> A retrospective analysis was conducted on 200 individuals who underwent radical prostatectomy between January 2016 and January 2024 in a high-volume tertiary center. Data collection included demographic characteristics, comorbidity profiles, histopathological findings, perioperative variables, postoperative complications and follow-up outcomes. Patients were stratified as having either high risk (\u2265 2) or low risk (&lt; 2) according to pre-operative mFI-5 scores. Postoperative complications constituted the primary endpoint, whereas functional outcomes were assessed as secondary endpoints.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The study included 200 male patients, with a mean age of 64.7 \u00b1 6.03 years. Fifty-four out of 200 patients (27%) were in the high-risk group (mFI-5\u2009\u2265\u20092) while 146 patients (73%) were in low-risk group (mFI-5 &lt; 2). While the rate of major complications (Clavien-Dindo \u2265 3) was significantly higher in high-risk group, the overall complication rate was similar between the groups. Readmission and reoperation rates were increased in the high-risk group; however, the difference did not reach statistical significance. Regarding functional outcomes, erectile dysfunction and urinary incontinence rates were similar between the groups.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> This study highlights an association between higher mFI-5 scores and an increased risk of major postoperative complications after radical prostatectomy. Although mFI-5 should not be used as a stand-alone criterion for treatment selection, it may serve as a simple, rapid, and cost-effective adjunctive tool for preoperative risk stratification and individualized surgical decision-making.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> prostate cancer, radical prostatectomy, modified frailty index-5, complication, functional outcomes<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/4-1883616-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical Outcomes of Antegrade Double-J Stent Placement in Patients with Failed Retrograde Ureteral Stenting<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Fahri Ayd\u0131n, Mustafa Ye\u015filyurt, Esra \u0130bi\u015f, \u015eaban O\u011fuz Demird\u00f6\u011fen<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> This study aimed to evaluate the technical and clinical success, complication profile, and clinical effectiveness of antegrade double-J (DJ) stent placement in patients in whom retrograde ureteral stenting had failed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> This retrospective study included patients who underwent antegrade DJ stent placement between 2021 and 2025 due to unsuccessful retrograde access. All procedures were performed under ultrasonographic and fluoroscopic guidance. Patients were categorized into single-stage and 2-stage antegrade stenting groups based on their clinical condition. All interventions were performed by a single experienced interventional radiologist. Technical and clinical success rates were assessed, and procedure-related complications were classified according to the Society of Interventional Radiology (SIR) guidelines.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> A total of 40 patients were included in the study; 45.0% were treated for benign and 55.0% for malignant ureteral obstruction. Antegrade double-J stent placement was technically successful in all patients, with a significant reduction in the degree of hydronephrosis observed after the procedure. Clinical evaluation demonstrated a statistically significant decrease in serum creatinine levels and visual analog scale (VAS) pain scores at 24 hours post-procedure (p &lt; 0.001). No clinically significant decrease in hemoglobin levels was observed. The overall complication rate was 7.5%, and all complications were minor and resolved with conservative management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Antegrade DJ stenting represents a safe, effective, and minimally invasive alternative in patients with failed retrograde access. When performed within a multidisciplinary framework involving urology and interventional radiology, this approach improves patient comfort and reduces the need for long-term percutaneous nephrostomy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> ureteral obstruction, stents, percutaneous nephrostomy, urinary diversion, interventional radiology<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/5-1885162-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Association Between Comorbidity Burden and Tissue-Adjusted Enucleation Time During HoLEP: A Retrospective Cohort Study<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yunus Kayal\u0131, Tahsin Batuhan Aydo\u011fan, Alpcan Torun, Fatih B\u0131\u00e7akl\u0131o\u011flu, Bilal \u00c7etin, Onur Erdemo\u011flu, U\u011fur Y\u0131lmaz, Bilal Ery\u0131ld\u0131r\u0131m<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> To quantify phase-specific operative performance during holmium laser enucleation of the prostate (HoLEP) and evaluate the association between comorbidity burden and tissue-adjusted enucleation performance.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> This single-center retrospective cohort screened 574 HoLEP procedures performed between January 2023 and June 2025 and included 349 patients. Enucleation efficiency (g\/min), morcellation efficiency, and overall extraction efficiency were calculated descriptively. To avoid mathematical coupling, the primary inferential analysis modeled natural log-transformed enucleation time and adjusted for age, log-transformed enucleated tissue weight, prostate-volume stratum, and antithrombotic use. Heteroscedasticity-consistent HC3 standard errors were used.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> Median age was 67 years, and 67.9% had at least one comorbidity. Unadjusted enucleation time was similar in patients without and with comorbidity (41.5 vs 42.0 min; p = 0.337), whereas enucleation efficiency was lower in those with comorbidity (0.93 vs 1.75 g\/min; p &lt; 0.001). In the adjusted model, each additional comorbidity was associated with a 9.9% longer enucleation time for a given tissue burden (95% CI: 4.8%-15.2%; p &lt; 0.001; adjusted R\u00b2=0.167). The association persisted after additional adjustment for operative technique category (8.0%; 95% CI: 4.5%-11.6%; p &lt; 0.001). Antithrombotic use was not independently associated with enucleation time.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Comorbidity burden was associated with slower tissue-adjusted enucleation performance despite similar unadjusted enucleation times. Total operating-room occupancy was not assessed. These hypothesis-generating findings require multicenter validation with operator-level, anesthetic, and intraoperative bleeding data before use in scheduling or benchmarking.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> comorbidity, enucleation, holmium laser enucleation of the prostate, operative time, prostatic hyperplasia<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/6-1898671-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Beyond Statistical Accuracy: Decision Curve Analysis and Single-Center Independent Validation of the SHA.LIN Score for PCNL Outcomes<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u0130brahim Hac\u0131bey, Veysel Sezgin, Abdullah Akda\u011f, \u00c7a\u011fri \u015eevik, Emre Y\u0131lmaz, Emin Taha Keskin, Halil L\u00fctfi Canat<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> To perform a single-center independent validation of the SHA.LIN score and compare its predictive accuracy and clinical net benefit with the Guy\u2019s Stone Score (GSS), S.T.O.N.E. score, and CROES nomogram in a large cohort of patients undergoing percutaneous nephrolithotomy (PCNL).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> We retrospectively analyzed 271 adult patients undergoing PCNL between 2020 and 2025. Stone-free status (SFS) was defined as the absence of stones or asymptomatic fragments &lt;4 mm on non-contrast computed tomography at 1 month. Predictive performance was assessed using area under the curve (AUC), calibration plots, and Decision Curve Analysis (DCA).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The SFS rate was 73.1%. The CROES nomogram demonstrated the highest predictive accuracy (AUC: 0.802, 95% CI: 0.765\u20130.839), followed by the SHA.LIN score (AUC: 0.756, 95% CI: 0.715\u20130.797). The SHA.LIN score significantly outperformed both GSS (AUC: 0.719, p=0.023) and S.T.O.N.E. (AUC: 0.690, p&lt;0.0001). In both univariate and multivariable analyses, the CROES nomogram and SHA.LIN score emerged as significant independent predictors of stone-free status, whereas Guy and STONE scores failed to retain significance after multivariable adjustment. In DCA, the SHA.LIN score showed superior net clinical benefit compared with GSS and S.T.O.N.E. across threshold probabilities between 40% and 80%.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> The SHA.LIN score is a reliable, independently validated single-center tool for predicting PCNL outcomes. Although the CROES nomogram demonstrates high statistical accuracy, the SHA.LIN score provides superior clinical utility and net benefit in decision curve analysis. Furthermore, CROES and SHA.LIN scores remained independent predictors of stone-free status, whereas Guy and STONE scores failed to demonstrate independent predictive value in multivariable analyses. Further prospective studies with larger cohorts are warranted to validate these findings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> percutaneous nephrolithotomy, nephrolithometry, SHA.LIN score, stone-free status, predictive models<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/7-1911968-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Impact of Zero Ischemia Versus Standard Warm Ischemia on Long-Term Renal Function in Robotic Partial Nephrectomy: A Retrospective Cohort Study<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yasin Akta\u015f, Hasan Arda Durak, Kayhan Y\u0131lmaz, \u015eahin K\u0131l\u0131\u00e7, Murat \u015eambel, Mutlu Ate\u015f, Mahmut Taha \u00d6l\u00e7\u00fcc\u00fc<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> The aim of this study was to evaluate and compare the perioperative, oncological and long-term renal functional outcomes of the zero ischemia (off-clamp) and standard warm ischemia (on-clamp) approaches in patients undergoing robotic partial nephrectomy (RPN).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> This retrospective cohort study examined 56 consecutive patients who underwent RPN for renal masses. The patients were divided into two groups: a zero ischemia group (n = 26) and a warm ischemia group (n = 30). Preoperative demographics, tumour characteristics (RENAL, PADUA and C-index) and perioperative data were recorded. Renal function was assessed using serum creatinine levels and estimated glomerular filtration rates (eGFR) before surgery, on the first day after surgery, and after one year.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> There were no differences in demographic variables or tumour complexity scores (RENAL, PADUA) between the groups. The C-index score was significantly higher in the zero ischemia group (median 3.1 vs. 1.86, p = 0.001), indicating a more peripheral tumour location. Although postoperative complication (p = 0.494) and positive surgical margin (PSM) (p = 0.140) rates were comparable, estimated blood loss (300 ml vs. 100 ml, p &lt; 0.001) and hospital stay (4 days vs. 3 days, p = 0.001) were higher in the zero ischemia cohort. Both groups experienced an initial deterioration in renal function, but the zero ischemia group\u2019s eGFR and creatinine levels recovered to baseline within one year (p = 0.970). In contrast, the warm ischemia group experienced a significant decline in eGFR that persisted at one year (p = 0.001).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> The zero ischemia approach in RPN may offer functional advantages, particularly in selected patients, in terms of complete long-term preservation of renal function compared to standard warm ischemia. Despite slightly increased intraoperative bleeding, this approach demonstrates comparable PSM rates, particularly for anatomically suitable, peripherally located tumours.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> robotic partial nephrectomy, zero ischemia, warm ischemia, c-index, renal cell carcinoma<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/8-1917844-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Performing Extended Pelvic Lymph Node Dissection Before Prostatectomy was Associated with Lower Apical Positive Surgical Margin Rates During Robot-Assisted Radical Prostatectomy: A Single-Centre Retrospective Cohort Study<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Abdurrahman \u0130nkaya, Hasan Samet G\u00fcng\u00f6r, Nurullah Mustafa \u015ei\u015fik, Muhammed Emre Top\u00e7u, Bahad\u0131r \u00d6ks\u00fcz, Sencer S\u00f6zen, Murat Beyatl\u0131, Cemil Emre Yurtseven, Abdullah Esmeray, Ahmet Tahra, Ferhat Yakup Su\u00e7eken, Resul Sobay, Ey\u00fcp Veli K\u00fc\u00e7\u00fck<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> Positive surgical margins remain clinically relevant after robot-assisted radical prostatectomy (RARP). Whether performing extended pelvic lymph node dissection (ePLND) before, rather than after, prostatectomy is associated with lower apical positive surgical margin (PSM) rates has not been evaluated with adjusted comparative data.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> We performed a retrospective cohort study of 250 consecutive patients who underwent primary RARP with ePLND at a single tertiary centre. Patients were classified by operative sequence as ePLND-first (n = 121) or prostatectomy-first (n = 129). The primary multivariable analyses were conducted in the full 250-patient cohort with nerve-sparing intent coded as a 3-level categorical variable; a pre-specified subgroup analysis was conducted in the 188 patients undergoing any form of nerve-sparing surgery. The primary endpoint was apical PSM. Because apical PSM events were sparse, the adjusted analysis used Firth penalised logistic regression.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> Baseline characteristics were similar between groups. Apical PSM occurred in 6 of 121 patients (5.0%; 95% confidence interval [CI] 2.3% to 10.4%) in the ePLND-first group and 13 of 129 (10.1%; 95% CI 6.0% to 16.5%) in the prostatectomy-first group. In the primary multivariable analysis of the full 250-patient cohort, ePLND-first sequencing was associated with lower adjusted odds of apical PSM (adjusted OR 0.38; 95% CI 0.14 to 1.03; p = 0.056); in the pre-specified nerve-sparing subgroup (n = 188), the adjusted association was stronger (OR 0.19; 95% CI 0.04 to 0.97; p = 0.046; unadjusted 1.2% vs 8.8%, Fisher\u2019s exact p = 0.023). Total operative time was shorter in the ePLND-first group (195.2 vs 202.9 min; p = 0.029). Lymph node yield and major complication rates were similar between groups.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> In this retrospective cohort, performing ePLND before prostatectomy was associated with directionally lower adjusted odds of apical PSM during RARP in the full 250-patient cohort, with a stronger association in the pre-specified nerve-sparing subgroup analysis. For men undergoing nerve-sparing RARP with planned ePLND, sequence may represent a practical operative strategy associated with lower apical margin risk without an evident perioperative penalty.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> robot-assisted radical prostatectomy, extended pelvic lymph node dissection, positive apical surgical margin, prostate cancer<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/9-1920320-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Comparative Analysis of Avicenna Roboflex\u00ae and Conventional Ureteroscopy: A Porcine Model Study of Safety and Feasibility in Stone Management<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Rifat Burak Erg\u00fcl, Feyzi Arda Atar, Ahmet Sinan Kabak\u00e7\u0131, Zafer Tokatl\u0131, Ahmet Bar\u0131\u015f Ayd\u0131n, Pelin \u00c7elikbilek Erkasap, Se\u00e7kin Serdar Arun, Mustafa Sofikerim, Tzevat Tefik<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> Robotic-assisted ureteroscopy is increasingly adopted in endourology. We aimed to evaluate the feasibility and safety of the Avicenna Roboflex\u00ae Urology system (Elmed, Ankara, Turkey) compared with conventional ureteroscopy in a porcine model.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> The Avicenna Roboflex\u00ae platform was compared with conventional ureteroscopy in a live porcine model (n = 6) in the supine lithotomy position. Two experienced endourologists assessed task performance using Likert scales (1\u20134) for accuracy\/workaround and ease of completion. Intraoperative events and ureteral injury were evaluated using the post-ureteroscopic lesion scale (PULS, 0\u20135). Histopathological assessment of tissue samples was performed by a blinded pathologist. Paired comparisons were performed using the 2-sided Wilcoxon signed-rank test, with p &lt; 0.05 considered statistically significant.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> A total of 12 ureteroscopic procedures (6 conventional, 6 robotic) were completed without intraoperative complications. Histopathological analysis revealed no significant differences between groups, with minimal epithelial loss observed only in the proximal ureter. Task performance scores were comparable between groups; however, the robotic system showed a trend toward improved ease in flexible ureteroscope insertion and simulated stone removal. PULS scores were low and similar in both groups.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> The Avicenna Roboflex\u00ae system demonstrated procedural feasibility and an acute tissue safety profile comparable to conventional ureteroscopy in this porcine model. Given the exploratory nature and small sample size of the study, these findings should be considered preliminary and require validation in adequately powered studies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> kidney calculi, robotic surgical procedures, ureteroscopy<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/10-1937415-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Association of the Preoperative Albumin-to-Globulin Ratio with Pathological Stage and Tumor Grade in Primary Bladder Tumor<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Mehmet Erhan Ayd\u0131n, \u0130smail Basmac\u0131, G\u00fcrkan Cesur, \u0130brahim Halil Bozkurt, Ertu\u011frul \u015eefik, Serdar \u00c7elik, Deniz Bolat, Aykut Ayka\u00e7, Tansu De\u011firmenci<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> This study aimed to investigate the association between the preoperative albumin-to-globulin ratio (AGR) and pathological stage and tumor grade in patients who underwent transurethral resection of bladder tumor (TURBT) for primary bladder tumors.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> A total of 153 patients who underwent transurethral resection of bladder tumor (TURBT) for primary urothelial carcinoma between March 2017 and February 2020 were included in the study. AGR was calculated using preoperative serum albumin and total protein levels. Among the exclusion criteria were active infection, autoimmune disease, hepatic disease, and concomitant malignancy. The optimal AGR cut-off value was determined using receiver operating characteristic (ROC) curve analysis and the Youden index. Independent predictors of pathological stage (NMIBC\/MIBC) and tumor grade (low\/high Grade) were evaluated using logistic regression analysis.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The median age of the patients was 68 years (IQR: 59\u201375), and 88.9% were male. The pathological stage distribution was Ta in 39.9%, T1 in 39.9%, and T2 in 20.3% of patients, while tumor grade distribution was low Grade in 54.2% and high Grade in 43.1%. The median AGR value of the cohort was 1.32 (IQR: 1.17\u20131.50). AGR was significantly lower in both the MIBC group (p = 0.003) and the high-grade group (p &lt; 0.001) compared to their respective counterparts. ROC analysis identified an optimal cut-off value of 1.35 for both clinical outcomes (AUC=0.649, 95% CI: 0.542\u20130.755 for MIBC and AUC=0.656, 95% CI: 0.568\u20130.744 for high-grade disease). In multivariate logistic regression analysis, AGR was independently associated with both MIBC (OR=0.16, 95% CI: 0.03\u20130.97; p = 0.046) and high-grade disease (OR=0.18, 95% CI: 0.04\u20130.74; p = 0.018).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Preoperative AGR is independently associated with pathological stage and tumor grade in primary bladder tumors. The ability to calculate this parameter from routine biochemical tests without additional cost makes it clinically valuable for preoperative risk stratification. Further validation of these findings in larger patient cohorts is warranted.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> albumin-to-globulin ratio, neoplasm grading, neoplasm staging, transurethral resection of bladder tumor, urinary bladder neoplasms<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/11-1954790-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Diagnostic Value of Dual-Energy CT Attenuation Ratios for Urinary Stone Characterization in Patients Presenting with Acute Abdominal Pain<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Mustafa Ye\u015filyurt, Abdulmecit Kantarc\u0131<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> To evaluate attenuation ratios derived from dual-energy computed tomography (DECT) in patients presenting with acute abdominal pain who were diagnosed with urinary stone disease, and to analyze their distribution among different stone categories in a real-world emergency setting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> This prospective single-center study was conducted in the emergency department of a tertiary referral hospital. A total of 210 consecutive adult patients presenting with acute abdominal pain underwent DECT examination. Among these, 56 patients diagnosed with urolithiasis on non-contrast DECT were included in the final analysis. Attenuation values were measured at 80 kVp and 140 kVp, and attenuation ratios were calculated. Stone size, localization, and number were recorded. Differences among stone types were analyzed using One-Way ANOVA or the Kruskal-Wallis test, depending on the normality of data distribution. Post-hoc comparisons were performed using Bonferroni or Games-Howell tests based on the homogeneity of variances.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The mean attenuation ratio across all stones was 1.32 \u00b1 0.20. Uric acid stones demonstrated the lowest mean attenuation ratio (0.96 \u00b1 0.09), whereas hydroxyapatite (1.54 \u00b1 0.07) and calcium oxalate stones (1.40 \u00b1 0.05) showed significantly higher values (p &lt; 0.001). Statistically significant differences were observed among stone categories in terms of low-energy attenuation, high-energy attenuation, and attenuation ratios (p &lt; 0.001). No significant differences were found regarding age or stone size. Distinct clustering patterns were observed, particularly between uric acid and calcium-containing stones.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> DECT-derived attenuation ratios demonstrated significant differentiation among urinary stone types in patients presenting with acute abdominal pain. These findings support the clinical utility of DECT for non-invasive stone characterization in the emergency setting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> tomography, x-ray computed, urinary calculi, urolithiasis, absorptiometry, photon, emergency service, hospital<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/12-1896965-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Occupational Radiation Safety and Stone Analysis Practices Among Urologists in T\u00fcrkiye: A National Cross-Sectional Survey<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Engin Denizhan Demirk\u0131ran, Serdar Madendere, M\u00fcslim Do\u011fan De\u011fer, H\u00fcseyin Alperen Y\u0131ld\u0131z<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> To evaluate real-world occupational radiation-safety and post-procedural stone-analysis practices among urologists in T\u00fcrkiye, and associated factors.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> A cross-sectional, web-based survey was e-mailed to 2,305 urologists in T\u00fcrkiye. The Google Forms questionnaire covered demographic, institutional, radiation-safety, and stone-analysis\/metabolic-evaluation practices. Categorical comparisons used the Chi-square or Fisher\u2019s exact test, and independent factors were assessed with multivariable logistic regression.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> Of 346 respondents, 301 were analysed after excluding incomplete responses (61.5% specialists, 23.6% residents, 14.9% academics). A personal dosimeter was unavailable to 68.1%, regular dosimeter feedback was absent in 62.8%, a statutory radiation leave was not granted to 99.0%, and a periodic medical examination was not performed in 81.4%. Lead aprons (95.3%) and thyroid shields (81.7%) were common, whereas protective eyewear (20.6%) and gloves (9.3%) were rare. Routine stone analysis was performed by 47.5%; an in-house analysis facility was available to only 25.9% (0% of state-hospital respondents), while 78.7% referred specimens to an external institute. Metaphylaxis was applied by 56.1%. Routine analysis was independently associated with academic title (OR 2.85) and an in-house facility (OR 3.07), and inversely with &gt;10 years\u2019 experience (OR 0.25); metaphylaxis was associated with university (OR 3.99) and training-and-research (OR 2.40) hospital practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Occupational radiation protection and guideline-recommended stone analysis are incompletely implemented and vary widely among urologists in T\u00fcrkiye. The fact that a statutory radiation leave was granted to only 1.0% of respondents, together with the institution-dependent availability of stone analysis, indicates that systemic and regulatory measures, not individual awareness alone, are needed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> metaphylaxis, occupational exposure, radiation protection, stone analysis, surveys and questionnaires, urolithiasis<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/13-1976766-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Original Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Assessing Awareness and Knowledge Regarding the Popularity of Robotic Surgery in Prostate Cancer Treatment Preferences, Survey Research<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Fatih Sand\u0131k\u00e7\u0131, Ahmet Be\u015f\u00e7ocuklu<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong> The goal is to enhance patient education and consent procedures by assessing the awareness of robotic surgery among prostate cancer patients and their families, the determinants influencing their treatment choices, and their technological misunderstandings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong> This cross-sectional survey research, carried out from February to May 2026, encompassed 50 patients with prostate cancer and 50 families of those patients. Data were gathered via surveys and analyzed employing multivariable logistic regression.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong> The majority of participants (76% of patients, 78% of patients\u2019 families) favored robotic surgery. Across all socio-demographic categories, irrespective of age and educational background, a prevalent \u201cautonomous robot fallacy\u201d (the misconception that the robot independently conducts the surgery) has been recognized. An affinity for technology is associated with 5.6-fold higher odds of preferring robotic surgery and 4.9-fold higher odds of expecting extraordinary outcomes. The odds of encountering technical safety anxiety (device malfunction, wrong procedure, etc.) are 6.8 times (OR: 6,794) greater for individuals who source their initial information from media or the internet than for those who consult a physician. Individuals possessing a bachelor\u2019s degree or higher are 5.2 times more likely to perceive robotic surgery as a symbol of institutional status.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong> Patients\u2019 choices regarding surgery are influenced more by their fascination with technology, the media\u2019s portrayal of \u201cautonomy,\u201d and the perceived prestige of institutions than by actual medical requirements. It is essential for physicians to openly address patients\u2019 unrealistic aspirations for perfection and baseless safety apprehensions stemming from media influence during collaborative decision-making.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> awareness, robotic surgery, autonomous robot fallacy, technological perception<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/14-2003419-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Review Article<\/em><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Immunology of Urinary Tract Infections: Historical and Scientific Development From Uroscopy to the Present Day<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Elifnaz \u0130lgar<\/p>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>Abstract<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<p class=\"wp-block-paragraph\">For thousands of years, uroscopy has served as one of the fundamental diagnostic methods in medicine and has played an important role in the understanding of urinary system diseases. The earliest written records of urinary tract infections (UTIs) date back to the Ebers Papyrus, reflecting early historical descriptions of the disease (1). In this review, the evolution of knowledge regarding UTIs from early observational approaches to modern immunological understanding is evaluated, with particular emphasis on the role of innate and adaptive immune response mechanisms in disease pathogenesis. Key immunological pathways, including Toll-like receptors (TLRs), Th1\/Th2 balance, and tissue-resident memory T (TRM) cells, are discussed in relation to infection control and recurrence, while differences in immune responses between animal models and human systems are highlighted. In conclusion, a deeper understanding of immunological mechanisms in UTI pathogenesis represents an important research area that may contribute to the development of targeted and immunomodulatory therapeutic strategies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> history of medicine, immunology, immune response, infection, urinary system<\/p>\n\n<\/div><\/details><\/div>\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/15-1851389-PDF.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-6.png\" alt=\"\" class=\"wp-image-1643\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\">Full Text<\/h4>\n\n\n<div class=\"lightweight-accordion wp-block-lightweight-accordion-lightweight-accordion\"><details><summary class=\"lightweight-accordion-title\"><span>PDF<\/span><\/summary><div class=\"lightweight-accordion-body\">\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/endourolojibulteni.com\/bultenler\/2026\/18-03\/Cilt-18-Sayi-3-Endouroloji-Bulteni.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/endourolojibulteni.com\/wp-content\/uploads\/2024\/02\/image-9.png\" alt=\"\" class=\"wp-image-1646\"\/><\/a><\/figure>\n\n<\/div><\/details><\/div>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<\/div><\/li>\n<\/ul><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1478","page","type-page","status-publish","hentry"],"blocksy_meta":[],"_links":{"self":[{"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/pages\/1478","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/comments?post=1478"}],"version-history":[{"count":14,"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/pages\/1478\/revisions"}],"predecessor-version":[{"id":1511,"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/pages\/1478\/revisions\/1511"}],"wp:attachment":[{"href":"https:\/\/endourolojibulteni.com\/en\/wp-json\/wp\/v2\/media?parent=1478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}