Aim: To evaluate the incidental prostate cancer (PCa) rate and predictive factors in patients who underwent open prostatectomy (OP) with a pre-diagnosis of benign prostatic hyperplasia (BPH). Methods: This cross-sectional, retrospective study included patients with a pre-diagnosis of BPH, who underwent OP due to symptomatic prostate enlargement. Our database included age, medications, prostate-specific antigen (PSA), free/total PSA ratio, PSA density, digital rectal examination (DRE), prostate volume, serum neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, presence of metabolic syndrome (MetS), and histopathological results after OP. Results: Of the 430 patients that underwent OP with a pre-diagnosis of BPH, 406 (94.4%) with a benign pathological diagnosis were evaluated as the benign group in and 24 (5.6%) detected to have PCa constituted the incidental PCa group. In the univariate analysis, age, AST/ALT ratio, MetS, and DRE significantly differed between the groups (p=0.008, p=0.005, p=0.004 and p<0.001, respectively). The rate of incidental PCa was much higher in the elderly patients. The cut-off value of age was 71.5 years in the PCa group according to the receiver operating characteristic curve analysis. According to the multivariate analysis, only DRE and presence of MetS were effective in predicting PCa. DRE was found 16 times more effective and MetS was 2.8 times more effective than the other parameters. Conclusion: Our results showed that DRE and presence of MetS can be useful predictive factors of incidental PCa in OP.

Aim: To analyze the ureteral injury and incidence of ureteral stricture in a series of patients who underwent retrograde intrarenal surgery with using smallest ureteral access sheath. Materials and Methods: Between September 2016 and March 2019, 154 consecutive retrograde intrarenal surgery procedures with adjunctive use of an ureteral access sheath for kidney stone were prospectively included the study. A 9.5/11.5-F ureteral access sheath was used during procedures. The patients were evaluated in terms of intraoperative postoperative and late complications. Ureteral injuries after retrograde intrarenal surgery were assessed visually with flexible and semirigid ureterorenoscope. All patients were evaluated by computed tomographic urography in the first year after treatment for detection of ureteral stricture. Results: The mean age of the patients was 47±15 (12-81) years. Of the patients, 86 were male and 68 were female. Mean stone size was 17.1±8 (7-40) mm and mean operative time was 56±23 (30-120) minutes. Overall 79.9% of patients had evidence of injury to the ureter wall. Non-significant lesion (grade 0) was seen in 39.0% of patients. Grade 1 lesions were assigned in 40.9% of patients. There were no grade 2 and higher lesions detected. A total of 5 patients (3.2%) had minor complications. Urinary sepsis developed as a major complication in 3 patients (1.9%). No ureteral stricture was detected in the patients at first year control. Conclusions: The results of our series indicate that the 9.5/11.5-F ureteral access sheath is safe for routine use to facilitate flexible ureteroscopy and there was no long-term adverse effect.