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    Does type 2 diabetes mellitus have an impact on postoperative early, mid-term and late-term urinary continence after robot-assisted radical prostatectomy?
    (Mary Ann Liebert, Inc, 2019) Çakmak, Serdar; Canda, Abdullah Erdem; Ener, Kemal; Atmaca, Ali Fuat; Altınova, Serkan; Balbay, Mevlana Derya
    Objective: We evaluated the effect of diabetes mellitus (DM) on urinary continence after robotic radical prostatectomy (RARP). Patients and Methods: Overall, 99 patients with DM and 213 patients without DM who underwent RARP with at least 2-year follow-up were included. The preoperative prostate biopsy Gleason scores and clinical stages of the groups were similar. The patients who were dry or used one safety pad per day were regarded as continent. Early (0-3 months), mid-term (4-12 months), and late-term (>12 months) continence rates were evaluated. Results: In diabetic and nondiabetic groups, mean age was 63.36.5 and 61.3 +/- 6.8 years, respectively (p=0.015). On the day of the removal of the urethral catheter, 61.6% (n=61) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At third-month follow-up, 80.8% (n=80) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At sixth-month follow-up, 89.9% (n=89) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At first-year follow-up, 93.9% (n=93) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.001). At 18th-month follow-up, 96.0% (n=95) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.013). At second-year follow-up, 98.0% (n=97) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.115). Multivariate analysis showed that age and body mass index had no impact on urinary continence (p>0.05). Presence of diabetes (p=0.008) and duration (5 years) of diabetes (p=0.004) were independent factors that had a significant negative impact on urinary continence. Conclusions: Diabetes seems to be a significant disadvantage in gaining urinary continence compared with nondiabetic patients particularly in the first 18 months after RARP. Diabetic patients should be informed about possible late recovery of postoperative urinary continence compared with nondiabetic patients after RARP.
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    A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study
    (Karger, 2023) Keske, Murat; Canda, Abdullah Erdem; Karadag, Mert Ali; Ciftci, Halil; Erturhan, Sakip; Kactan, Cagri; Soytas, Mustafa
    Introduction: Herein, we analyzed the histopathological, oncological and functional outcomes of testis-sparing surgery (TSS) in patients with distinct risk for testicular cancer. Methods: This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups. Results: TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 +/- 10.32 years), pathological tumor size (14.67 +/- 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 +/- 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions. Conclusion: TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling.