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Item Does Robot-assisted Surgery in Urology Has Benefits? The Current Status(2019) Sah, Cem; Kuzgunbay, Baris; 0000-0001-5598-4666Minimally invasive surgery has gradually replaced the conventional surgery with the introduction of laparoscopy. Subsequently, with intensive advertisement and marketing strategies, robot-assisted surgery became popular and robot-assisted surgery has been used in almost every surgical procedure. Despite its high cost, the robotic platform, which has proven its general advantages such as less hospital stay and less blood loss, has become controversial in the literature in terms of cost effectiveness. In this study, the advantages and disadvantages of the robot-assisted surgery in urology have been reviewed in the light of current literature.Item The Risk Stratifications in Non-Muscle Invasive Bladder Cancer: How Much Accurate are the Methods That We Use? A Multi-Directional View(2015) Kuzgunbay, Baris; Beyazit, YildirimNon-muscle invasive bladder cancer (NMIBC) have heterogeneous pattern inside, rapid recurrence might be seen in some of the patients while earlier progression might be seen in other patients. Recently, European Organization for Research and Treatment of Cancer (EORTC) risk tables are the most commonly used as scoring systems in stratifying the risk group in NMIBC. The scoring system was developed based on tumor number and size, prior recurrence rate, T stage, concurrent CIS and tumor grade, thus the total score should be calculated individually for recurrence and progression. EAU guidelines also advices stratifying the patients into 3 risk groups according to the prognostic factors and data from the EORTC tables. In addition, the maintenance BCG therapy, secondary TUR operation, substaging in T1 tumors, pathological variants of uroepithelial carcinoma, lymphovascular invasion and some molecular markers have been reported to significantly affect the prognosis of NMIBC in consecutive studies. Today, EORTC and other stratification remains valid, however, needs to be improved and validated under the guidance of the previous studies.Item The Treatment Modalities in Stage 1 Seminoma; Alterations in Last Five Years(2015) Kuzgunbay, BarisSeminomas are diagnosed generally in early period. Eighty-five percent of the patients were in clinical stage (CS) 1 at the time of diagnosis and occult metastasis rate was 10-15% and systemic relapse rate after retroperitoneal treatment was 1-4%. However, there have been significant alterations in treatment of stage 1 seminomas for 20 years; thus, dog-leg radiotherapy had been recommended as the only choice of adjuvant therapy in 1990s, totally 20 Gy adjuvant radiotherapy to para-aortic (PA) field or hockey stick field and single dose carboplatinium based chemotherapy have been recommended since 2010. Active surveillance has become popular after the relation between radiotherapy and platinum based chemotherapy with cardiovascular toxicity and seconder malignancy was proven and long term results of surveillance were reported. Achieving the cure rates of % 100 in CS 1 seminoma patients with all kind of therapy modalities, adjuvant radiotherapy, chemotherapy or active surveillance, indicate that all kinds of therapies are appropriate. However, the relapse rate of 15-20% of the disease in the patients under surveillance without any treatment indicates the over-treatment risk of 80-85%. In conclusion, the identified side effects of the radiotherapy and chemotherapy, the report of successfully treatment of the disease even in the relapse under active surveillance caries the surveillance as the first choice in guidelines however it is seem that the best approach is to give the decision with the patient after detailed information by taking into consideration of the patients expectations.Item The Role of Radical Prostatectomy in the Treatment of Patients with High-Risk Prostate Cancer(2015) Kuzgunbay, Baris; Yaycioglu, OzgurHigh-risk prostate cancer (PCa), which is defined as PSA > 20 ng/mL or Gleason Score (GS) > 7 or >= cT3a, accounts for up to 40% of newly diagnosed cases and carries a significant risk of progression and death. However, the best management approach for patients with high-risk PCa is still under debate. Recently, radical prostatectomy (RP) with extended lymphadenectomy (LND) has become popular for the treatment of high-risk PCa with good prognosis in selected patients in the context of multimodal approach. However, decision should be made after all treatments have been discussed by a multidisciplinary team and the patient should be informed about the likelihood of a multimodal approach. On the other hand, necessity of sufficient surgical expertise for RP to keep the level of morbidity acceptable in high-risk PCa patients should be kept in mind.Item Risk Factors for Urothelial Cancers(2016) Kuzgunbay, Baris; Gul, Umit; 0000-0003-3249-0895; AAK-8394-2021Urothelial cancers affect renal pelvis and ureters in the upper urinary tract, however they affect bladder and urethra in the lower urinary tract. The rate of the urothelial carcinoma makes up 3% pf cancers in the world. Although urothelial cancer locations and frequencies show difference, their etiology are similar. Environmental factors are responsible for most urothelial cancer cases. Major risk factors are smoking and chemical carcinogens. Other important factors include radiotherapy, alcohol, coffee consumption, artificial sweeteners, arsenic exposure, schistomiasis, cronical cystitis, urolithiasis, analgesics, cyclophosphamide and genetic predisposition. Identification of these factors and avoiding them are important for the prevention of the disease. The evaluation and follow up of the whole urothelium is critical since the urothelial cancers are a kind of panurethelial diseases.