ARTICLE INfO ______________________________________________________________ ______________________Objective: To compare cancer detection rates according to the number of biopsy cores in patients on whom a repeat prostate biopsy was performed for atypical small acinar proliferation (ASAP). Materials and Methods:The data of 4950 consecutive patients on whom prostate biopsies were performed were assessed retrospectively. A total of 107 patients were identified as having ASAP following an initial prostate biopsy, and they were included in the study. A six-core prostate biopsy (PBx) was performed on 15 of the 107 patients, 12 PBx on 32 patients, and 20 PBx on 60 patients. Cancer detection rates were compared according to the number of biopsy cores. The localization of the cancer foci was also evaluated.Results: The cancer detection rates in patients on whom 6 PBx, 12 PBx, and 20 PBx were performed were 20% (3/15), 31% (10/32), and 58% (35/60), respectively, and a statistically significant difference was found (p = 0.005). When cancer detection rates in patients with total prostate specific antigen (PSA) < 10ng/mL, PSA density ≥ 0.15, normal digital rectal examination, and prostate volume ≥ 55mL were compared according to the number of biopsy cores, a significant difference was identified (p = 0.02, 0.03, 0.006, and 0.04, respectively). Seventy-five percent of the foci where cancer was detected were at the same and/or adjacent sites as the ASAP foci in the initial biopsy, and 54% were identified in contralateral biopsies in which ASAP foci were present. Conclusion: As the biopsy core number increases, the cancer detection rate increases significantly in patients on whom a repeat biopsy is performed due to ASAP. The highest cancer rate is found in 20-core repeat biopsies performed equally from all foci.

Urinary stone disease is a common health problem in the community. In the last two decades, percutaneous nephrolithotomy (PNL), extracorporeal shock wave lithotripsy (ESWL), and retrograde intrarenal surgery (RIRS) have become popular as minimally invasive methods. The European Association of Urology 2014 urinary stones guideline recommends PNL as the first line of treatment for kidney stones above 20 mm. ESWL remains the first choice for stones of <1 cm within the renal pelvis and upper or middle calices. For kidney stones between 10 to 20 mm, the location and movement of the stone, stone type, calyx anatomy, and patients status contribute to the choice of treatment. RIRS in combination with holmium YAG laser is effective and safe. Initially, RIRS was offered for was lower calyceal stones, multiple stones, post-ESWL failure, comorbid illnesses, reduction in the diameter of development of surgical experience ureteroscopy, the development of optics providing better visibility, and the diversification of the equipment. At present, RIRS has become an alternative treatment modality to other minimally invasive therapy. It is thought that advances in technology will lead to more flexible instruments and surgical equipment for RIRS therapy. (JAREM 2015; 5: 85-8)