2025, Vol 5, Issue 2 - Grand Journal of Urology

Current Issue

Original Article (4) Case Report (2) Authors Index

Original Article

General Urology, Online First: 06 March 2025

Grand J Urol 2025;5(2):037-041, DOI: 10.5505/GJU.2025.94824

AI-Assisted Cystoscopy Image Analysis for Detecting Urological Pathologies: A Novel Approach

Halil İbrahim İvelik, Okan Alkış, İbrahim Güven Kartal, Mehmet Sevim, Bekir Aras

Objectives: This study aims to develop and evaluate an AI-assisted system for detecting urological pathologies using cystoscopy images. Materials and Methods: A dataset comprising 500 pathological and 500 healthy cystoscopy images was collected from the urology clinic of training and research hospital. Images were obtained using three different endovision systems (Karl Storz [Germany], Stryker [USA], Richard Wolf [Germany]). The dataset was preprocessed, augmented, and used to train a Convolutional Neural Network (CNN) model to classify images as either normal or pathological. The model"s performance was evaluated on a test set comprising 100 pathological and 100 healthy images, using metrics such as accuracy, sensitivity, specificity, and F1-score. Statistical analyses were performed using IBM SPSS version 25.0, with a p-value of

Urological Oncology, Online First: 23 April 2025

Grand J Urol 2025;5(2):042-048, DOI: 10.5505/GJU.2025.83702

Prognostic Implications of Variant Urothelial Carcinoma: Survival Outcomes and Risk Factors from a Single-Center Experience

Metin Kılıç, Mehmet Özer, Deniz Barali, Anıl Erkan, Murat Demirbaş

Objectives: Variant urothelial carcinoma (VUC) represents a diverse group of bladder cancer subtypes with distinct clinical behaviors and prognostic implications. This study aims to evaluate survival outcomes and prognostic factors in patients diagnosed with VUC. Materials and Methods: A retrospective analysis was conducted on 1844 bladder cancer patients treated at our center between 2018 and 2022. Among them, 59 patients with histologically confirmed VUC were included. Survival outcomes were assessed using Kaplan– Meier analysis, and prognostic factors were evaluated via multivariable Cox regression models. Results: The most common VUC subtypes were squamous (39%), micropapillary (23.7%), and sarcomatoid (6.8%). The median overall survival (OS) was 11 months, while cancer-specific survival (CSS) was 7 months. Micropapillary and sarcomatoid variants exhibited significantly poorer CSS, with an approximately 8-fold and 7-fold increased mortality risk compared to squamous subtype, respectively. Age and the presence of metastases were key predictors of worse CSS. While radical cystectomy was performed in 30.5% of patients, it did not significantly improve survival. Conclusion: Our findings underscore the aggressive nature of micropapillary and sarcomatoid VUC subtypes, highlighting the need for individualized treatment approaches. Age and metastatic status were significant determinants of survival, emphasizing the necessity for early diagnosis and targeted therapeutic strategies. Future research should explore molecular profiling and novel treatment modalities, including immunotherapies, to improve patient outcomes.

Pediatric Urology, Online First: 28 April 2025

Grand J Urol 2025;5(2):049-054, DOI: 10.5505/GJU.2025.98159

Thermocautery-assisted Circumcision: A Single-center Experience from the First Two Years of Surgical Expertise

Alper Şimşek, Mehmet Kırdar, Aykut Başer, Ümit Uysal

Objectives: Circumcision, the surgical removal of the foreskin covering the penile glans, is one of the oldest and most commonly performed surgical procedures worldwide. In recent years, thermocautery has gained popularity as a cost-effective and practical method. This study aims to present the results of the modified three-stage circumcision technique performed with the help of a thermocautery device in response to the intense demand for circumcision in our region and to contribute to the circumcision literature. Materials and Methods: This retrospective study analyzed 604 circumcision patients operated on using the three-stage guillotine method with thermocautery while preserving the glans. These procedures were performed by a single surgeon in the first two years of his specialization at Siverek State Hospital between October 2022 and September 2024. Results: The mean operative time was 12.5±2.8 minutes (range: 8–25 minutes). The mean age of the patients was 7.04±4.1 years (range: 0.33–15.7 years). Bleeding in the form of minor leakage was observed in 3 patients (0.52%). Complications such as infection, penile injury, meatal stenosis, or secondary phimosis were not encountered in any patient. Conclusion: Thermocautery shortens the duration of the procedure, reducing the child's exposure to anesthesia and surgical stress, while also lowering the risk of bleeding. Circumcision performed with a thermocautery is practical and safe when conducted by trained doctors in an appropriate setting.

Urological Oncology, Online First: 05 May 2025

Grand J Urol 2025;5(2):055-061, DOI: 10.5505/GJU.2025.36349

Urological Complications in Gynecological Oncology Surgeries: A Tertiary Center Experience

Tolga Çiftpınar, Gözde Şahin, Süleyman Şahin, Ali Yılmaz, Nilüfer Çetinkaya

Objective: The close proximity of the female genital system and the urinary system predisposes both systems to operative complications. We examined the causes and management of these complications, which are even more prevalent in oncological surgeries. Materials and Methods: In total, 135 malignant cases operated on in the Gynecological Oncology clinic of Çam and Sakura City Hospital between December 2022 and April 2024 were retrospectively examined. Management of urological complications was carried out together with the urology clinic. Results: A total of 10 urological complications developed in nine patients during the 16-month period. All of them were seen in surgeries performed by laparotomy. Four of the patients who underwent major oncological surgery had bladder damage, and the other four had ureter damage. In one patient, both bladder and ureter damage were observed. Eighty percent of complications were diagnosed intraoperatively. Bladder injuries developed during dissection and ureter injuries, which generally occurred during energy use and ligation. While damage to the bladder and mid-ureter was primarily repaired, a more difficult procedure such as ureteroneocystostomy was performed for distal ureter injuries. Defects in the bladder trigone were also difficult to treat. Conclusion: The female genital and urinary systems, which are in close proximity to each other, make them prone to urinary complications during gynecological surgeries. Due to the nature of oncological surgery, the disrupted anatomy and the different biology of tumor cells may increase these complication rates. Therefore, every surgeon dealing with gynecological oncology must be familiar with urological anatomy and master the management of complications.