SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 – both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure.

I n d e x e d i n P u b M e d , W e b o f S c i e n c e a n d S c o p u s Pankaj M. Joshi and Sanjay B. Kulkarni. A new technique of double-face buccal graft urethroplasty for female urethral strictures.

Purpose: To investigate the predictive value of systemic immune-inflammation index (SII) in recurrence of urethral stricture in patients undergoing internal urethrotomy Methods: In this two-center, retrospective study, 703 patients who had internal urethrotomy for urethral stricture were included. Demographic, clinical, and laboratory characteristics and operative data were obtained. Two groups were formed from the patients as non-recurrent urethral stricture ( n = 490) and recurrent urethral stricture ( n = 213). Results: There was no significant difference in the mean age between the patients with and without recurrence. There was a significant difference in the mean SII values and albumin levels between the recurrence and non-recurrence groups ( p = 0.001 and p = 0.006, respectively). Using a cut-off value of 252 for the SII; the sensitivity was 59.62%, the specificity was 70.41%, the positive predictive value was 46.69%, the negative predictive value was 80.05% and the accuracy was 67.14%, respectively. Statistically significant correlation was found between the presence of recurrence and the established cut-off value of the SII ( p = 0.001 and p < 0.01, respectively). The risk of recurrence was stated that 3.514 times higher in patients with a SII value of ⩾252. Conclusion: Using the SII the inflammatory state of the urethral tissue can be evaluated. Thus the risk of recurrence after internal urethrotomy operation can be predicted. Open urethroplasty technique instead of DVIU in patients with high SII values may increase the surgical success rates.

Aim: This study aims to assess the admission times, manual detorsion rates and outcomes of the testicular torsion cases during COVID-19 pandemic. Methods: A retrospective analysis of the testicular torsion cases was done through our hospital’s electronic archive. Patients with were distributed into two groups as “COVID-19 era” (between 11th of March 2020 – March 2021) and “pre-COVID-19 era” (between January 2018 and 10th of March 2020). Time between the onset of symptoms and the moment of detorsion was calculated as the duration of ischemia. Two groups were compared in terms of ischemia duration, manual detorsion rates and operational outcomes. Results: No statistically significant differences was detected between groups in terms of ischemia duration, manual detorsion rates and surgical procedure type (all p>0.05). During the COVID-19 pandemic, the number and percentage of manual detorsions have increased, resulting in a numerical decrease in orchiectomies. Conclusions: Conditions caused by COVID-19 may prompt urologists to manual detorsion more to set up safer surgical environment. Moreover, this approach may result in a decrease in orchiectomy rates by saving time and preserving the vascularity of the testis. Further studies with larger samples sizes and meta-analyses may support this concept. Keywords: testicular torsion, COVID-19, manual detorsion, orchiectomy, emergency