Aim This study aims to evaluate the results of patients we treated with nephrectomy due to Xanthogranulomatous pyelonephritis (XGP) and the effects of kidney volume on the results. Patients and methods Records of 22 patients who underwent nephrectomy due to renal masses at our clinic between January 2008 and May 2018 and whose pathology results indicated XGP were retrospectively evaluated. The computed tomography (CT) measurement of the kidney volumes of the patients was calculated as the product of the longest length, width, and height of the kidney. The mean kidney volume of the patients was calculated and the patients were distributed into two groups: those that presented volumes below average (Group 1) and above average (Group 2). The patients’ mean ages, operative duration, hospitalization days, differences in pre- and postoperative hemoglobin and creatinine levels, and postoperative complications were compared across groups. Results Group 1 consisted of 12 patients and Group 2 of 10 patients. The mean kidney volume of the patients was calculated as 33.4 cm 3 ± 26.0 cm 3 . The mean kidney volume of the patients was 15.8 cm 3 ± 9.9 cm 3 in Group 1 and 56.8 cm 3 ± 21.8 cm 3 in Group 2. There were no statistical differences between the two groups in terms of operative times, preop-postop hemoglobin (Hgb) levels and complications. Conclusion In cases where XGP is considered probable, the priority in preoperative CT must be to thoroughly evaluate the relationship of the kidney with the surrounding tissue and organs rather than to investigate the patients’ kidney volumes.

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Brucellosis is a zoonotic disease that involved genitourinary system in 2-20% and most commonly cause single sided epididymo-orchitis. In our country Brucella is an endemic disease and causes serious and different diagnosis of acute scrotum and epididymoorchitis. In this paper six cases of epididymo-orchitis cases which were resistant to classical treatment were discussed according to clinical and laboratory findings. We describe different types of presentation of Brucella epididymoorchitis with diagnosis and treatment modalities. SummaryNo conflict of interest declared.Patient developed joint and muscle pain lately. At physical examination, body temperature was 37.2°C, swelling on right testicle with extensive tenderness was present, epididymis was hard, scrotum was erythematous and local temperature increased. Examination of other systems was normal. Scrotal color Doppler ultrasonography reported findings consistent with right epididymo-orchitis. Laboratory findings included leucocytes 8700/mm 3 , sedimentation rate 27 mm/h, CRP 30 mg/L and tube agglutination test positive at 1/160 titers. There was no growth in blood cultures. Patient was treated with rifampicin 600 mg/day, doxycycline 200 mg/day and anti-inflammatory treatment for 6 weeks. Symptoms were regressed after first week of treatment. There was no recurrence on the follow up. Case 2 (septicemia)A 63 year old male patient working with farm animals, presented with fever, night sweating and joint pain for 15 days For the last 2 days he had dysuria, swelling in the right testicle and pain. Physical examination showed 37.8°C body temperature, right epididymis very tender and swelling of the testicle, local erythema of the scrotum with temperature increase. Physical examination of other systems was normal. Laboratory results showed leucocyte count 13500/mm 3 , sedimentation rate 67 mm/h, CRP 70 mg/L, Brucella tube agglutination test positive for 1/640 titer. Brucella spp. growth was documented in blood cultures. Whereas there was no growth in urine culture. Patient' s treatment was planned for 6 weeks with rifampicin 600 mg/day, doxycycline 200 mg/day and anti-inflammatory treatment but in the second week of his treatment testicular pain was not regressed and patient continued to have frequent fever (38°C). One g/day streptomycin IM was added to treatment for two weeks and treatment was finished up to 6 weeks. After addition of streptomycin on the 3 rd day of treatment patient complaints were relieved dramatically. There was no relapse in 18 months follow up.Case 3 (acute scrotum, septicemia) A 27 year old male farmer presented with acute left testicular pain, fever, shivering, nausea and vomiting start-

Objective: First objective of this study was to find out factors influencing development of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PNL). Secondary objective was to point out the role of preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in SIRS estimation. Method: The data of 756 patients that underwent PNL for kidney stones between 2012 and 2019 were evaluated retrospectively. Patients were divided into 2 groups as non-SIRS and SIRS group. The effects of NLR, PLR and other operative and demographic variables on development of SIRS were investigated. Multivariate logistic regression analysis that was performed on variables that were significant in the univariate analyses was used to establish independent risk factor for post-PNL SIRS. Results: Univariate analysis revealed a significant association between presence of SIRS and preoperative PLR (p<0.001), preoperative NLR (p<0.001), blood transfusion (p<0.001), stone volume (p=0.03), staghorn stone (p<0.001), and preoperative creatinine levels (<0.001). Multivariate logistic regression analyses of these risk factors showed that NLR (p<0.001), PLR (p<0.001), and blood transfusions (p<0.001) were independently associated with SIRS. When the cut-off value of PLR was 120.5, the development of SIRS was predicted with 80.1% specificity and 81% sensitivity. When the cut-off value of NLR was 2.75, the development of SIRS was predicted with 64% specificity and 63.7% sensitivity. Conclusion: Preoperative PLR and NLR are effective and inexpensive biomarkers that can be used to predict SIRS and sepsis after PNL. We recommend that patients with PLR >120.5, NLR >2.75, and blood transfusions should be monitored closely due to the possible development of serious complications.