Laparoscopic and Robotic Surgery

Original Article

Grand J Urol 2022;2(2):064-071, DOI: 10.5505/GJU.2022.68077

Robot-Assisted Radical Prostatectomy in Patients with Enlarged Median Lobe: Matched Analysis

Taner Kargi, Kamil Gokhan Seker, Abdullah Hizir Yavuzsan, Buğra Dogukan Torer, Muhammed Yusuf Demir, Deniz Noyan Ozlu, Serdar Karadag, Selcuk Sahin, Volkan Tugcu, Ali Ihsan Tasci

Objective: Evaluation of surgical, oncological and functional results in patients with prostate cancer and enlarged median lobe who underwent robot- assisted radical prostatectomy (RARP). Materials and Methods: Medical records of 489 patients who underwent RARP between August 2009 and December 2013 were retrospectively evaluated. Among them, 40 patients who had enlarged median lobe were included in Group 1. Forty patients without median lobe hyperplasia were included with matched analysis (Group 2). Patients who were followed up for 12 months were assessed. Results: No significant differences were found between the two groups in terms of demographic values, erectile function, preoperative PSA levels, prostate dimensions, distribution of clinical stages, Gleason scores and D"Amico risk classification (p˃0,05). Perioperative data revealed that mean operative times were 219.9 ± 64.5 (130-360) min and 185.6 ± 57.1 (120-355) min in Groups 1 and 2, respectively which was significantly prolonged in Group 1 (p˂0.05). Bladder neck reconstruction was performed in Groups 1 (n=14: 5%) and 2 (n=1: 3%). Rates of full continence after removal of urethral catheter on day 7 and at the end of months 1, 3, 6 and 12 were similar in Groups 1 and 2 (p˃0.05). Rates of potency and biochemical recurrence were similar at the end of the postoperative 6 months and one year in Groups 1 and 2 (p˃0.05). Conclusion: RARP in patients with prostate cancer with an enlarged median lobe is a challenging operation with significantly longer operative times. With its inherent procedural difficulties, RARP is a good treatment option in patients with prostate cancer and an enlarged median lobe with its successful surgical dissection and anastomosis possibilities.

Grand J Urol 2022;2(3):093-099, DOI: 10.5505/GJU.2022.52724

Comparison of Open and Laparoscopic Simple Prostatectomy Outcomes: Experiences of a Single Surgeon

Ferhat Yakup Suceken

Objective: To compare the open simple prostatectomy (OSP) and laparoscopic simple prostatectomy (LSP) performed due to benign prostatic enlargement greater than 80 cc. Materials and Methods: Between January 2015 and July 2021, patients who underwent OSP and LSP were retrospectively screened. The patients" demographic, preoperative, perioperative, and postoperative data were noted and compared. Results: The data of a total of 90 patients, including 55 (61.1%) cases in the OSP and 35 cases (38.9%) in the LSP group were analyzed. Age, comorbidity rates, and body mass index scores of the patients were comparable. There was also no significant difference in the preoperatively calculated mean prostate volume, and Qmax of the cases. The mean operative time was significantly longer for LSP (p

Case Report

Grand J Urol 2023;0(0):, DOI: 10.5505/GJU.2024.63835

Isolated Renal Involvement Requiring Surgical Treatment in Systemic Cat Scratch Disease

Bakytbek Kozubaev, Şaban Oğuz Demirdöğen, Tugay Aksakallı, Abdulcelil Budak, Yakup Hilal, Ebru Şener, Turgut Yapanoğlu

Cat scratch disease (CSD) is a self-limiting infectious disease that develops after a cat bite or scratch, caused by the Gram-negative bacillus Bartonella henselae. The disease is generally characterized by fever and regional granulomatous lymphadenopathy, but in 5-10% of cases it can occur as a systemic disease and lead to various diseases. A 31 year old healthy woman applied to the internal medicine clinic with right side pain. He was referred to the urology clinic after the urinary system USG revealed a 4x3cm cystic mass in the right kidney. There was no finding in the patient's history other than a cat bite 3 months ago. Radiological evaluations showed RCC suspicion in the right kidney with the classification of Bosniak type 3 cyst. Upon being reported as a medical condition, the patient underwent laparoscopic partial nephrectomy. Multiple abscesses in the liver and spleen, and microabscesses in both kidneys, accompanied by systemic inflammatory symptoms, have previously been reported in systemic CSD. However, as far as we know, this is the first case of Bartonella henselae in the literature showing isolated single kidney involvement of this size without showing systemic inflammatory symptoms.