No abstract

BACKGROUND: Radical cystectomy (RC) is one of the most complex surgeries and has a high rate of morbidity. Gastrointestinal complications are the most common type of complications. To reduce these complications some modifications have been described. OBJECTIVE: To evaluate perioperative outcomes of our extraperitoneal antegrade RC technique (EARTC), where the peritoneum is opened at the end of cystectomy just before of ileal reconstruction. METHODS: Group 1 included 120 patients who were operated with a standard RC technique and Group 2 included 80 patients who were operated with the EARC technique in this study. Groups were compared according to preoperative variables including patient characteristics, perioperative parameters, pathologic data, and postoperative overall and gastrointestinal complications. RESULTS: There were no significant differences between the two groups in terms of preoperative characteristics and mean operative time. The group 1 has longer time for the exposure of abdominal cavity to the atmosphere (p < 0.01). Hospitalization time was significantly lower in Group 2 (p < 0.01). Concerning the rate of 90-day overall perioperative complication, no statistically significant difference was determined between the groups. Gastrointestinal complication was significantly higher in Group 1 (p:0.048). The average number of removed lymph nodes was similar between the groups (p:0.85). The time for recovery of bowel function, the time for passage of stool and the rate of postoperative ileus were significantly lower in Group 2 (p < 0.01, p < 0.01 and p < 0.043) respectively). CONCLUSIONS: EARC provides advantages over the standard technique in terms of gastrointestinal symptoms and poses no disadvantage when the oncological outcome and operative difficulty were considered.

Purpose: This controlled study assessed whether there was a correlation between serum total testosterone levels and bladder cancer (BCa) in terms of tumor grade and stage as objective measures in adult men. Materials and method: Our prospectively-designed study included 257 patients who were diagnosed with primary BCa and its surgery between January 2017 and January 2020. Hundred and forty patients who had surgery in the same period with TUR for prostate or endoscopic ureteral stone treatment were included in the study as a control group. All patients in the study and control groups were male. The age range of the patients was between 34 and 90 years old. In order to examine groups, fasting blood glucose, lipid profile, albumin, total testosterone, and vitamin D levels of all patients included in the study. Results: The relationship between tumor aggression and total testosterone level was investigated with a multinomial logistic regression model, where the control group was accepted as a reference, following adjustment for potential confounding variables, including age and serum albumin levels. Testosterone level was not found to be associated with any of the categories that determine tumor aggressiveness (p > 0.05). Conclusion:In the present study, there was no correlation between any categories that determine tumor aggressiveness of BCa and total testosterone levels in adult men. It is obvious that our findings should be supported and further investigations are needed.

<b><i>Introduction:</i></b> To avoid mesh-related complications, autologous transobturator-tape (a-TOT) technique is a viable option in stress urinary incontinence (SUI) surgery. The method differs from TOT and retropubic tape (RT) in the usage of autologous tissue. We hypothesized that a-TOT improves female sexual dysfunction (FSD) more than TOT and RT. <b><i>Methods:</i></b> This is a retrospective cohort study. Patients who underwent a-TOT, TOT, and RT surgeries were surveyed regarding the cure of SUI, complications, and FSD parameters. The groups were compared according to baseline and postoperative data. <b><i>Results:</i></b> A-TOT, TOT, and RT groups included 37, 69, and 36 patients, respectively. The median follow-up time was 19 months. The groups were similar in terms of preoperative characteristics. The objective cure, subjective cure, and overall complication rates were comparable among the groups (<i>p</i> &#x3e; 0.05). A-TOT group had significant improvements in mean female sexual function index (FSFI) scores, TOT group deteriorated, and RT group remained stable (<i>p</i> = 0.001, <i>p</i> = 0.001, and <i>p</i> = 0.226, respectively). The postoperative mean total FSFI scores were 25.73 ± 2.46, 23.17 ± 3.35, and 21.53 ± 2.47 for the a-TOT, TOT, and RT groups, respectively. The a-TOT group had better results than the TOT and RT groups (<i>p</i> &#x3c; 0.05 and <i>p</i> &#x3c; 0.05), and besides, the difference between the TOT and RT groups was statistically significant (<i>p</i> &#x3c; 0.05). According to percentage changes in domain scores following the operations, the a-TOT group had significantly better results in desire, arousal, lubrication, satisfaction, and pain domains than the TOT group (<i>p</i> &#x3c; 0.05) as well as better desire, arousal, and pain domains (<i>p</i> &#x3c; 0.05) than the RT group. <b><i>Discussion/Conclusions:</i></b> Besides comparable outcomes in SUI treatment, the a-TOT technique provides improvements in female sexual functions while TOT worsens and RT does not change. Favorable outcomes in sexual functions caused by improvements in desire, arousal, satisfaction, and pain domains are observed following the a-TOT technique.

No abstract