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Item How did the COVID-19 pandemic affect audience's attitudes in webinars?(WILEY-HINDAWI, 2021-01-01) Tanidir, Yiloren; Gokalp, Fatih; Akdogan, Nebil; Batur, Ali Furkan; Sekerci, Cagri Akin; Egriboyun, Sedat; Deger, Mutlu; Sahin, Bahadir; Akarken, Ilker; Aydin, Cemil; Altan, Mesut; Ozman, Oktay; Ucar, Murat; Gudeloglu, Ahmet; Ongun, Sakir; Akbal, Cem; Esen, AdilIntroduction Following the COVID-19 pandemic, the face-to-face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID-19 pandemic era. Methods From December 2017 to July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviours such as content views, engagement time, total unique attendees, average engagement time and the number of audience to leads. Data were split into two groupsItem Turkey Prostate Cancer Map 2021: Turkish Urooncology Association Prostate Cancer Database Report(GALENOS YAYINCILIK, 2022-01-01) Sahin, Bahadir; Celik, Serdar; Tinay, Ilker; Eskicorapci, Saadettin; Aslan, Guven; Sozen, Sinan; Ataus, Suleyman; Turkeri, LeventObjective: This study aimed to present the data of patients with prostate cancer (PCa) whose detailed information was stored in the Urologic Cancer Database-Prostate, Urooncology Association, Turkey with the title of ``Turkey Prostate Cancer Map 2021.{''} Materials and Methods: Patient data between 1995 and 2020 were retrospectively scanned. The age of the patients, their distribution according to age groups, symptoms during diagnosis, examination findings {[}digital rectal examination (DRE)], prostate-specific antigen (PSA) values, biopsy methods in the diagnosis, metastatic disease rates, treatment methods, and progression rates at follow-up were examined. These results were compared with the results of the previous report, namely ``Prostate Cancer Incidence (Incidence) in Turkey,{''} by the Urooncology Association in Turkey in 2009. Results: This study analyzed the data of 5040 patients from 19 different centers. The mean patient age was 63.6 (37-97) years. The age distribution examination revealed that most patients (49.8\%) were aged 60-69 years. Of the patients, 51.8\% were symptomatic at the time of diagnosis. The presence of symptoms was determined in 88.6\% in 2009 data. The ORE of patients revealed that 25\% of patients had malignancy findings. The PSA distribution examination revealed a >10 ng/mL PSA value in 37.5\% of patients. With the increasing use of magnetic imaging resonance (MRI) in PCa diagnosis over the years, increased MR-fusion biopsy rates have been observed. Considering the biopsy data, 91\% of patients were diagnosed with a classical transrectal ultrasound-guided biopsy, whereas 9\% were diagnosed with MR-Fusion biopsy. Fusion biopsies revealed that 23\% of patients with Prostate Imaging-Reporting and Data System (PI-RADS) 4 lesion and 57\% with PI-RADS 5 lesion were diagnosed with cancer. Of the patients, 8.9\% of patients had metastases during the initial diagnosis. This rate was 17\% in 2009 data. The treatment methods examination after the diagnosis revealed that 73.9\% of patients had undergone radical prostatectomy. This rate was 51.8\% in 2009. Robotic and laparoscopic approaches, which are among the surgical modalities, have increased over the years. However, the most frequently applied modality in our country was open radical prostatectomy with 62.6\%. Considering the follow-up data after treatment, 8.9\% of patients had progression, of which 62.6\% was biochemical, 30.2\% was radiological, and 6.9\% was a clinical progression. Conclusion: Technological advancements for PCa diagnosis (MRI and MR-guided biopsies) are becoming a routine part of daily practice compared to the results of the ``Prostate Cancer Incidence in Turkey{''} project in 2009. The comparative study results revealed that the rate of symptomatic and metastatic disease decreases at the time of diagnosis, and laparoscopic and robotic surgery methods are used at increasing rates for localized disease.Item Comparison of TRUS and combined MRI-targeted plus systematic prostate biopsy for the concordance between biopsy and radical prostatectomy pathology(WILEY, 2021-01-01) Aslan, Guven; Celik, Serdar; Sozen, Sinan; Akdogan, Bulent; Izol, Volkan; Bilen, Cenk Yucel; Sahin, Bahadir; Turkeri, Levent; Assoc, UrooncologyAim: To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing conventional 12-core TRUS-Bx at radical prostatectomy specimens (RP). Methods: Consecutive patients diagnosed prostate cancer (127 with combination of both targeted biopsy (TBx) plus systematic biopsies (SBx) and separate patient cohort of 330 conventional TRUS-Bx without mpMRI) with a PSA level of <20 ng/mL prior to RP were included. The primary end point was the grade group concordance between biopsy and RP pathology according to biopsy technique. Results: Clinically significant prostate cancer detection was 51.2\% for TRUS-Bx, 49.5\% for SBx, 67\% for TBx and 75.7\% for TBx + SBx. Upgrading and downgrading of at least one Gleason Grade Group (GGG) was recorded in 43.3\%/ 6.7\% patients of the TRUS-Bx and in 20.5\%/ 22\% of the TBX + SBx group, respectively (all P <.001). Concordance level was detected to be significantly higher for ISUP 1 in combined TBx + SBx method compared to conventional TRUS-Bx (61.3\% vs 37.9\%, P =.014). In ISUP 1 exclusively, significant upgrading was seen in TRUS-Bx (62.1\%) when compared to TBx (41.4\%) and TBx + SBx (38.7\%). Conclusions: MRI-targeted biopsies detected more significant PCa than TRUS-Bx but, superiority in significant cancer detection appears as a result of inadvertant selective sampling of small higher grade areas. Within an otherwise low grade cancer and does not reflect accurate GGG final surgical pathology. TBx + SBx has the greatest concordance in ISUP Grade 1 with less upgrading which is utmost important for active surveillance.Item The Early Impact of COVID-19 Pandemic on Surgical Urologic Oncology Practice in Turkey: Multi-Institutional Experience From Different Geographic Areas(ELSEVIER SCIENCE INC, 2020-01-01) Tinay, Ilker; Ozden, Ender; Suer, Evren; Bozkurt, Ozan; Izol, Volkan; Sahin, Bahadir; Turkeri, LeventItem Risk Factors of Patients with Prostate Cancer Upgrading for International Society of Urological Pathology Grade Group 1 After Radical Prostatectomy(GALENOS YAYINCILIK, 2022-01-01) Ozgur, Abdurrahman; Ozgur, Gunal; Sahin, Bahadir; Filinte, Deniz; Tinay, Ilker; cam, Haydar Kamil; Turkeri, LeventObjective: This study aimed to determine the predictive factors for patients whose International Society of Urological Pathology (ISUP) score was upgraded in radical prostatectomy (RP) pathologies with a prostate biopsy pathology of ISUP grade group 1. Materials and Methods: Among patients who underwent RP in our clinic within 10 years, 158 patients with prostate biopsy pathology of ISUP grade group 1 were examined retrospectively. Age, serum prostate-specific antigen (PSA) level, prostate biopsy ISUP grade group, number of cores taken in the prostate biopsy, number of tumor-positive cores, RP pathology ISUP grade group, and pathological stage were evaluated. Results: The mean age (+/- standard) of the 158 patients whose prostate biopsy pathology was ISUP grade group 1 were 64.07 (+/- 6.6). ISUP group upgrading was detected in 47 patients (29.7\%). The mean PSA value of these patients was 10.6 ng/mL (+/- 6.9). The mean PSA value of the other 111 patients without ISUP group upgrading was 7.98 ng/mL (+/- 4.9). The serum PSA level was significantly higher in patients with upgraded ISUP in the RP pathology (p=0.02). The percentage of tumor-positive cores in the group with ISUP group upgrading (37\%) was significantly higher than that in the group without ISUP group upgrading (27\%) (p=0.01). The detection rates of surgical margin positivity (42.6\% vs. 18\%), capsule invasion (55.3\% vs. 19.8\%), and seminal vesicle invasion (23.6\% vs. 3.6\%) were also significantly higher in the upgraded ISUP group after RP (p<0.05). Conclusion: The results of this trial suggest that active surveillance may not be an appropriate option for patients with biopsy ISUP grade group 1 with PSA level >10 ng/mL. Moreover, the presence of a higher number and percentage of tumor-positive cores constituted risks of ISUP group upgrading with concomitant poor pathological outcomes such as surgical margin positivity, capsule invasion, and seminal vesicle invasion.