Purpose This study aimed to compare perioperative and postoperative results of right and left laparoscopic adrenalectomy (LA), and to evaluate the impact of challenging factors on these outcomes.Materials and Methods A total of 272 patient’s medical records that underwent single side LA between October 2006 and September 2017 were retrospectively reviewed. The patients were divided into 2 groups according to operation side. Moreover, pheochromocytoma, metastatic masses and adrenal lesions >5cm in size were considered to be difficult adrenalectomy cases and the outcomes of these cases were compared between two groups.Results 135 patients (49.6%) underwent right LA and 137 patients (50.4%) underwent left LA. Operation time, estimated blood loss (EBL) and hospitalization time were similar between the groups (p=0.415, p=0.242, p=0.741, respectively). Although EBL was higher on the right side than the left (p=0.038) in the first 20 cases, after this learning period has been completed, there was no significant difference between the groups. In patients with pheochromocytoma, metastatic mass and a mass >5cm in size, despite bleeding complications were clinically higher on the right side, this difference was not statistically significant.Conclusions During the learning period of LA, EBL is higher on the right side. Due to the greater risk of bleeding complications on the right side even on the hands of experienced surgeons, extra care and preoperative planning are required in patients with pheochromocytoma, metastatic masses and masses >5cm in size.

<b><i>Introduction:</i></b> To compare the prostate removal speeds of 3 enucleation techniques and to evaluate how the operating times change depending on the prostate volume. <b><i>Methods:</i></b> Medical records of patients with 80-g or larger prostates who underwent holmium laser enucleation of the prostate (HoLEP), laparoscopic simple prostatectomy (LSP), or open prostatectomy (OP) due to medical treatment-resistant benign prostatic hyperplasia (BPH) were reviewed retrospectively. Patients were classified into 3 groups according to the surgical procedure. Age, BMI, prostate weights, total operation times, prostate removal speeds, hospitalization and catheterization days, complications, and improvements on functional outcomes in the 3rd month of follow-up were compared between groups. In addition, the association between prostate weight and total operation time was analyzed for each group. <b><i>Results:</i></b> HoLEP, LSP, and OP groups consisted of 60, 61, and 37 patients, respectively. While HoLEP was similar to OP in terms of prostate removal speed and total operation time, LSP was statistically slower and required more operation time than HoLEP and OP. There was a relationship between prostate weight and total operation time only in HoLEP. <b><i>Conclusion:</i></b> LSP, one of the enucleation techniques in the treatment of large prostates, was slower and required more operation time than HoLEP and OP in terms of total operation time and prostate removal speed. HoLEP seems going to be the fastest candidate for the rapid removal of large prostates in the future.

This study aimed to investigate the protective effect of tadalafil on reactive oxygen species induced by a hyperoxia model in rats, both in terms of enzymes such as superoxide dismutase (SOD) and nitric oxide (NO), and its pathological effects on the corpus cavernosum. Overall, 24 rats were divided into three groups. The control group (eight rats) was not exposed to any intervention. The second group (eight rats), was exposed to hyperoxia in a hyperoxia cabinet for 8 h a day for 10 days. The third group (eight rats) was exposed to hyperoxia the same as in the second group, tadalafil at a dose of 10 mg/kg was given orally as a dissolved form in water in the amount of 10-12 ml/100 g/day to the rats placed in separate cages having removed from the hyperoxia cabin. SOD levels differ enough to create a difference, but there was no significant difference in terms of NO levels. The SOD level was highest in hyperoxia conditions and lowest in the group given tadalafil. While corpus cavernosum hyperemia was found to be higher statistically in the experimental groups than in the control group, we found that the severity of hyperemia was less in the group given tadalafil. The corpus cavernosum was found to be statistically more dilated in the experimental groups than in the control group. We determined that hyperoxia status increased the level of SOD and this level decreased with tadalafil administration, which would make a statistical difference.

A fistula is defined as an abnormal association of two or more epithelial lining. Therefore, vesicocutaneous fistula (VCF) represents an extra anatomic communication between the bladder wall and the external surface of the skin. The most common cause is iatrogenic; however, numerous factors may play a role in the formation of VCFs. When a VCF is identified, it should be treated properly due to its bothersome complaints and social effects. Nonetheless, no certain consensus has been achieved, yet. In this case, we report the feasibility and efficacy of omental flap interposition during VCF repair.

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