Articles in Press-Grand Journal of Urology

Articles in Press

Original Article

Reconstructive Urology, Online First: 30 December 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.83584

Staged Bulbar Urethroplasty Using Bilateral Perineal Skin Flaps as The Urethral Plate

Ali Atan, Murat Yavuz Koparal, Ender Cem Bulut, Burak Elmas, Fazlı Polat, Süleyman Yeşil

Objective: To assess outcomes of staged bulbar urethroplasty using bilateral perineal skin flaps as urethral plate substitutes in patients with obliterative or nearly obliterative bulbar urethral strictures. Materials and Methods: A retrospective analysis was conducted on 19 male patients with severe bulbar urethral strictures who underwent two-stage urethroplasty using scrotal or penile fasciocutaneous flaps. Inclusion criteria included urethral mucosa widths less than 3 mm and stricture length exceeding 3 cm. Initially, perineal skin flaps reconstructed the urethral plate. Six months later, a tubularized neourethra was created using scrotal or penile flaps. Patients were evaluated preoperatively and at 1 month and 6 months postoperatively using uroflowmetry and International Prostate Symptom Score (IPSS). Results: Patient ages ranged from 27 to 76 years, with a median of 60. The median stricture length was 4.6 cm. For those with cystostomy, median IPSS at six months post-surgery was 5 (range: 0-8). Postoperative Qmax values at first (Qmax-1) and sixth months (Qmax-6) were 22 ml/s (range: 14–26 ml/s) and 21 ml/s (range: 14–29 ml/s). In patients with urinary difficulties, the maximum urinary flow rate (Qmax) improved from 4.6 to 20 ml/s post-surgery (p = 0.0001), with IPSS reduction from 23 to 4 (p = 0.005). Complications were minimal, with no infections, fistulas, or penile deformities. Two patients developed circular strictures requiring internal urethrotomy, and three experienced terminal dribbling. Conclusion: Staged urethroplasty using bilateral perineal skin flaps is viable and effective for complex bulbar urethral strictures. This method shows favorable functional and cosmetic outcomes with low complications, particularly where single-stage repair is unfeasible.

General Urology, Online First: 23 December 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.86570

Chatbots in Urology: A Bibliometric and Trend Analysis of the Emerging Landscape (2023-2025)

Çağatay Özsoy, Mücahit Gelmiş, Erhan Ateş

Objective: Chatbot applications powered by large language models (LLMs) have garnered growing interest in healthcare, including urology. Although recent studies suggest potential roles in patient education, decision support, and medical training, no bibliometric analysis has yet evaluated the research landscape within urology. This study aims to comprehensively reveal the current research trends and scientific contributions related to chatbots in urology. Materials and Methods: A comprehensive bibliometric analysis was conducted using the Web of Science Core Collection (Urology and Nephrology section) to identify original articles on chatbot use in urology published between January 2023 and May 2025. Data were analyzed using the Bibliometrix R package and the Biblioshiny interface. Key metrics included publication trends, citation data, keyword networks, authorship patterns, and international collaboration rates. Results: A total of 81 original articles met the inclusion criteria. The annual growth rate in publication output was 45.3%, with an average of 10.6 citations per article. Most articles appeared in Science Citation Index Expanded indexed journals. The United States (32.1%) and Türkiye (25.9%) were the most prolific countries. However, international collaboration remained low (23.5%). Urolithiasis, prostate cancer, and urinary incontinence were leading clinical themes. Keyword network analysis identified clusters focused on patient education, decision support, and chatbot performance. Conclusions: This study offers a foundational understanding of chatbot-related research in urology and highlights the need for enhanced international collaboration, clinical validation, and data integration to fully realize their transformative potential.

Pediatric Urology, Online First: 18 December 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.59672

Effect and Results of Retrograde Intrarenal Surgery in Pediatric Patients According to Stone Size and Location

Mehmet Özay Özgür, İbrahim Halil Baloğlu, Gökçe Karlı, Kaya Horasanlı

Objective: We aimed to evaluate the effects and results of RIRS according to the location and size of kidney stones in the pediatric population. Materials and Methods: A total of 32 pediatric patients with upper urinary tract stones with 40 renal units were investigated in terms of stone size and location. Stone location, gender, stone size, stone Hounsfield unit, preoperative stenting, access sheath size, complication, length of hospital stay, and stone-free rates were retrospectively analyzed . Patients were divided into two groups. The first group patients who had stones smaller than 2cm, and the second group who had stones larger than 2 cm. Results: The mean age of the patients in Group 1 was determined as 10,8 (4-17) years, and the mean age of Group 2 was determined as 15,1 (10-17) years. The age difference was statistically significant (p: 0,003). There was no statistically significant difference in gender distribution (p: 0,289). The average stone size of Group 1 was measured as 12,6 mm (11-17), and the Group 2 stone size was measured as 25,2 mm (20-43) on average. In terms of operation times, the average operation time in Group 1 was 48 (30-70) minutes, and the average operation time in Group 2 was 65 (40-95) minutes, and a statistically significant difference was observed (p: 0.015). In the first group, the stone-free rate in a single session was 76.3%, and in the second group, the stone-free rate in a single session was 62%. There was no statistically significant difference between the groups in terms of stone-free rates (p: 0,295). Conclusion: RIRS is a method that can be used safely and effectively in pediatric patients with kidney stones smaller than 2 cm, with high stone-free rates. Although; the stone-free rate was lower in stones larger than 2 cm compared to those smaller than 2 cm, this difference was not statistically significant.

Pediatric Urology, Online First: 27 October 2025

Grand J Urol 2025; DOI: 10.5505/GJU.2026.00922

Testicular Microlithiasis in Pediatric Patients

Onursal Varlıklı, Mustafa Alper Akay, Necla Gürbüz Sarıkaş, Yonca Anık

Objective: Testicular microlithiasis (TM) is characterized by parenchymal calcifications, identified as hyperechoic, shadowless foci measuring between 1 and 3 mm in diameter within the testicular parenchyma. This condition is typically detected incidentally through ultrasonography in rare inguinal-scrotal disorders in pediatric patients. TM has been linked to various pathological conditions of the testis, notably an elevated risk of tumor development. A retrospective review of TM cases was conducted to assess clinical features and long-term follow-up outcomes. Materials and Methods: This retrospective analysis was conducted over a 12-year period involving children diagnosed with TM through scrotal Doppler ultrasonography at our outpatient clinic. Medical records were examined to evaluate patient age, indications for ultrasound, associations with inguinal-scrotal pathologies, and follow-up findings. Results: In this study, fifty-six patients aged between 2 and 17 years (median age of 9 years) were included. Bilateral TM was observed in all cases, except for 15 patients who exhibited unilateral foci. Among the participants, 27 patients (48.2%) presented with concomitant inguinal-scrotal pathology, while 3 patients (5.3%) had systemic disease. Notably, microlithiasis and Leydig cell tumors were identified in one patient who underwent ultrasonography due to testicular pain. Conclusion: TM is predominantly bilateral and of the classic type, with testicular pain potentially indicating its presence. Ultrasonography is generally adequate for both the diagnosis and monitoring of testicular microlithiasis. An association with testicular tumors is noted, particularly within the pediatric population. Given that both benign and malignant lesions are linked to TM, studies involving larger populations and extended follow-up periods are warranted.