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    ChatGPT-3.5 and ChatGPT-4 Performance in Testicular Cancer: A Comparative Study
    (Galenos Publ House, 2025) Uysal, Umit; Ucar, Murat; Sagir, Suleyman
    Objective: The aim of our study is to assess the reliability of Chat Generative Pre-trained Transformer (ChatGPT), compare the performance of ChatGPT-4 to ChatGPT-3.5, and explore its potential roles in healthcare decision-making. Materials and Methods: Thirty questions related to testicular cancer were prepared, based on the 2023 European Association of Urology guidelines and clinical experience. These questions were systematically posed to ChatGPT-3.5 and ChatGPT-4, and responses were rated by three independent urologists using a six-point Likert scale. The median score from the three specialists was used as the final score. Results: Both ChatGPT versions provided an incorrect answer to one question, scoring a one. For GPT-3.5 and GPT-4, the percentage of responses considered incorrect by the urologists was 20% and 13.3%, respectively, while correct responses (scoring 3 or higher) accounted for 80% and 86.7%. For general information-diagnosis questions, GPT-3.5 and GPT-4, had average scores of 4.29 and 4.80, with median values of 4.27 and 4.67. For treatment follow-up questions, average scores were 3.60 and 4.16, with median values of 3.60 and 4.20. GPT 4 generally outperformed GPT-3.5, but the difference was not statistically significant (p>0.05). Conclusion: Our study shows that ChatGPT-4 is more reliable and accurate than ChatGPT-3.5 in testicular cancer-related queries. Continued development of its database and clinical capabilities could optimize ChatGPT's utility in healthcare.
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    Female Urethroplasty with a Buccal Mucosa Graft using a Supraurethral Approach
    (Springer London Ltd, 2024) Kuo, Tricia; Ucar, Murat; Venugopal, Suresh; Osman, Nadir I.; Inman, Richard D.; Chapple, Christopher R.
    Introduction and HypothesisIn the setting of recurrent female urethral stricture, urethroplasty offer the best chance of cure. However, which approach (dorsal or ventral) and which tissue (buccal mucosa, vaginal graft, vaginal flap) remain areas of controversy. In this article and accompanying video, we describe female urethroplasty with a supraurethral approach using a buccal mucosa graft.MethodsA stricture of 3 cm in length was observed in the mid urethra. A supraurethral semi-lunar incision was made and dissection was performed up to the stricture. A dorsal urethrotomy was performed and a 3 x 2 cm oral mucosal graft was harvested from the left cheek. The mucosal graft was anastomosed to both urethral edges with running sutures. The graft was fixed to the supraurethral tissue with quilting sutures. A urethral catheter and a suprapubic catheter were left in place for 3 weeks.ResultsFollowing removal of the catheters, the patient was able to void satisfactorily with no incontinence. No complications were observed in the urethral area or at the graft harvest site.ConclusionsBuccal mucosa graft urethroplasty with a supraurethral approach is a reliable method in the treatment of female urethral stricture.
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    İki santimetreden küçük izole böbrek pelvis taşlarının tedavisinde rijit üreteroskopik litotripsi, fleksibl üreteroskopik litotripsiye alternatif olabilir mi?
    (Selçuk BAŞAK, 2020) Akkoç, Ali; Ucar, Murat
    Amaç: Her ne kadar böbrek taşlarının tedavisinde fleksibl üreteroskopi rijit üreteroskopiye tercih edilse de, birçok hastada renal pelvise ulaşmak için rijit üreteroskopi yeterli olmaktadır. Bu çalışmada, 2 cm'den küçük izole böbrek pelvis taşı tedavisinde rijit ve fleksibl üreteroskopik litotripsi sonuçlarını taşsız oranları, operasyon süreleri ve ilişkili komplikasyonları değerlendirerek analiz etmeyi amaçladık.Yöntemler: Bu retrospektif kohort çalışması, Haziran 2012 ile Mayıs 2017 tarihleri arasında, 2 cm'den küçük izole renal pelvis taşı için RURSL (grup 1, n=24) ve FURSL (grup 2, n=21) uygulanan hastaları kapsamaktadır. Tüm hastalara rutin olarak rijit üreteroskopi uygulandı ve rijit üreteroskop ile ulaşılan taşlar holmiyum lazer ile parçalandı. Rijit üreteroskop ile ulaşılamayan taşlara fleksibl üreteroskopi yapıldı ve aynı lazer kaynağı ile kırıldı. Bulgular: 45 hastanın 24'ünde (%53,3) rijit üreteroskop ile taşlara ulaşıldı ve holmiyum lazer ile kırıldı. Rijid üreteroskop ile taşlara ulaşılamayan 21 (%46,7) hastada fleksibl üreteroskop ile taşlara ulaşıldı ve aynı lazer kaynağı ile parçalandı. Rijit üreteroskopi 25 kadından 15'sinde (%60) taşlara ulaşmada başarılı olurken; 20 erkek hastanın 9'unda (%45) taşlara ulaşıldı (P=0,173). İki grup arasında yaş, cinsiyet, taşın yönü, ortalama taş boyutu, hastanede kalış süresi, taşsızlık oranları ve ilişkili komplikasyonlar açısından istatistiksel olarak anlamlı bir fark yoktu (sırasıyla P=0,298, P=0,396, P=0,775, P=0,266, P=0,742, P=0,428, P=0,186). Ortalama ameliyat süreleri rijit üreteroskopik litotripsi grubunda fleksibl üreteroskopik litotripsi grubuna göre anlamlı olarak daha düşüktü ve sırasıyla 66,75 (15,77) dakika ve 89,54 (17,71) dakika idi (P<0,001).Sonuç: Fleksibl üreteroskopik litotripsi böbrek taşlarının tedavisi için daha uygun bir prosedür olmakla beraber, daha kısa operasyon süresi, benzer taşsızlık ve komplikasyon oranları ile rijit üreteroskopik litotripsi 'nin seçilmiş izole böbrek pelvis taşlarında fleksibl üreteroskopik litotripsiye alternatif bir prosedür olduğu unutulmamalıdır.
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    Medical malpractice related to urology: an analysis of court decisions in Turkey
    (Springer, 2025) Uysal, Umit; Ucar, Murat
    ObjectivesThe aim of this study is to examine the lawsuits filed against urologists in Turkey, to reveal the results of these lawsuits and the sub-branch of urology they are related to, to discuss the possible reasons for the lawsuits and what can be done to prevent them.Materials and methodsThe case outcomes obtained using the keyword Urology from the publicly accessible official website of the Presidency of the Supreme Court of the Republic of Turkey between 2018 and 2024 were analyzed by two expert urologists.ResultsOf the 215 cases reviewed, the outcomes of 25 cases that met our inclusion criteria were analyzed. Sixteen of these cases were filed against private hospitals. Fourteen of the Supreme Court rulings involved civil (compensation) lawsuits, while 11 were criminal cases. Thirteen cases were related to endourology, and 9 patients had urinary system stone disease. Seventeen of the lawsuits involved allegations of postoperative medical errors. Five cases were attributed to procedural skill errors, and four were due to a lack of informed consent. Complications led to the death of seven patients. The decisions of the first-instance courts resulted in 12 acquittals, 7 compensation rulings, and 6 criminal convictions. At the Supreme Court level, 12 cases were ruled against the physicians.ConclusionsNearly half of the cases resulted in rulings against urologists, with the majority being related to endourology. Our study emphasizes the importance of adhering to international medical guidelines, providing informed consent to patients, and carefully conducting postoperative follow-ups.
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    The effect untreated right subclinical varicocele on the outcomes of contralateral left clinical varicocelectomy in infertile patients
    (Pagepress Publ, 2023) Yilmaz, Sevgin; Topcuoglu, Murat; Cakan, Murat; Akkoc, Ali; Ucar, Murat
    Purpose: The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA). Materials and methods: Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up. Results: The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations. Conclusions: Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.