Impact of Obesity on Perioperative and Clinical Outcomes After Robotic Assisted Radical Prostatectomy Sahin Kilic, Murat Sambel Scientific Reports, 2025 The aim of this study is to evaluate the effect of obesity on robotic-assisted radical prostatectomy (RARP) outcomes. This study included 120 obese patients [body mass index (BMI) ≥ 30 kg/m²] and 124 normal weight (BMI ≤ 25 kg/m²)] patients from a total of 750 patients who underwent RARP between January 2017 and March 2023. The perioperative and long-term oncological and functional outcomes were also analyzed. No significant differences were observed between the groups regarding age, prostate-specific antigen (PSA) levels, or International Society of Urological Pathology (ISUP) grade distribution (p > 0.05). The obese group had significantly longer median surgical times, vesicourethral anastomosis times, hospital stays and drain removal times compared to the control group (p < 0.05). The control group demonstrated significantly better continence recovery rate at the 1st month and erectile dysfunction (ED) recovery rate at the 12th month (p < 0.05). Bilateral nerve sparing (OR: 16.59; p < 0.001) and the preoperative IIEF score (OR: 1.29; p < 0.001) were identified as independent predictors of ED recovery in the multivariable logistic regression model. Bilateral nerve sparing (OR: 3.00; p < 0.001) and the absence of metabolic syndrome (OR: 2.03; p < 0.05) were found to be independent predictors of early continence recovery. There were no differences in systemic progression or overall survival at a median follow-up of 24 months (p > 0.05). While obesity adversely impacts perioperative outcomes, short-term continence recovery rates, and mid-term ED recovery rates, it does not affect mid-term oncological outcomes after RARP.
The predictive utility of the E-PASS score for postoperative complications in robot-assisted partial nephrectomy: a retrospective cohort study Cagatay Ozsoy, Erhan Ates, Resat Inal, Mucahit Gelmis, Sahin Kilic, Mutlu Ates BMC Urology, 2025 BACKGROUND: Robot-assisted partial nephrectomy (RAPN) is widely used for small renal tumors and provides favorable oncological and functional outcomes. However, a significant risk of postoperative complications remains a concern. Existing nephrometry scores focus on tumor anatomy but neglect patient-specific and intraoperative factors. The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score, originally developed for gastrointestinal surgery, combines physiological and surgical parameters for the prediction of postoperative risk. This study evaluates the predictive performance of the E-PASS score in RAPN. METHODS: This observational study retrospectively analyzed 166 patients who underwent RAPN between March 2015 and September 2024. The preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) were calculated. Complications developing within 30 days were classified using the Clavien-Dindo system, with Grade 2 or higher events being considered significant. The performance of the CRS in predicting postoperative complications was evaluated via receiver operating characteristic (ROC) curve analysis, while model calibration was assessed by means of a calibration plot. Logistic regression was used to identify independent predictors of postoperative complication risk. Bootstrap resampling was used to estimate 95% confidence intervals. RESULTS: Grade 2 or higher complications occurred in 26 patients (15.7%). CRS was significantly greater in the complication group (p < 0.001). ROC analysis demonstrated good discrimination (AUC: 0.721; 95% CI: 0.629-0.812). A CRS cut-off of 0.083 yielded 76.8% sensitivity and 59.5% specificity. The calibration plot indicated good agreement between predicted and observed probabilities. Multivariate analysis identified CRS (OR: 1.537, p = 0.044), tumor size (OR: 1.048, p = 0.020), and off-clamp surgery (OR: 4.569, p = 0.003) as independent predictors. CONCLUSIONS: E-PASS CRS reliably predicts postoperative complications in RAPN and enhances risk stratification by incorporating patient-specific surgical factors. Its integration may assist more personalized perioperative management in urological surgery.
Open radical cystectomy and ileal loop diversion under combined spinal-epidural anaesthesia for the elderly and frail Sahin Kilic, Tayfun Sugur, Hayri Fatih Metinyurt, Yigit Demir, Eray Ozturk, Murat Sambel BMC Surgery, 2025 BACKGROUND: The association between prolonged general anaesthesia duration in radical cystectomy (RC) and increased complication rates is well established. This study compared clinical outcomes of open RC performed under combined spinal-epidural anaesthesia (CSEA) versus general anaesthesia in elderly and frail patients. METHODS: A retrospective evaluation was conducted on data from patients who underwent open RC at our institution between February 2023 and October 2024. Patients with missing data or previous open abdominal surgery, who underwent additional surgical intervention during RC, or who underwent different urinary diversions from ileal loop diversion were excluded. The study comprised two cohorts, designated as CSEA and general anaesthesia groups. Various demographics, including age, body mass index (BMI), comorbidities, pre-and postoperative blood values, operative times, estimated blood loss, and recovery parameters, were retrospectively analyzed. RESULTS: The CSEA group had a higher mean age than the general anaesthesia group (72.40 ± 9.79 vs. 64.40 ± 10.70 years, p = 0.098), though this difference was not statistically significant. BMI values were similar for both groups (25.50 ± 2.80 and 25.34 ± 4.20 kg/m², p = 0.922). The prevalence of comorbidities was significantly higher in the CSEA group (100% vs. 40%, p = 0.011). The mean preoperative albumin level was lower in the CSEA group (3.23 ± 0.68 vs. 3.97 ± 0.51 mg/dL, p = 0.013). Duration of surgery, estimated blood loss and need for blood transfusion were similar between both groups (p > 0.05). Postoperative oral feeding initiation time was significantly earlier in the CSEA group (1 day and 3 days, p < 0.001). Visual Analog Scale (VAS) scores were significantly lower in the CSEA group (3.0 vs. 4.6, p = 0.004). The number of lymph node removals was significantly higher in the CSEA group (28.80 ± 7.77 vs. 12.90 ± 7.13, p < 0.001). Locally advanced disease rate was more common in the CSEA group (80% vs. 20%, p < 0.010). However, Clavien-Dindo Grade ≥ III complication rates and length of hospitalization were similar between the groups (p > 0.05). CONCLUSIONS: Open RC under CSEA is a preferable option for elderly patients and those with comorbidities who are not suitable for general anaesthesia. It offers advantages in postoperative bowel function recovery and pain management compared with general anaesthesia. TRIAL REGISTRATION: retrospectively registered.
Factors affecting complications and outcomes in penile fractures: a decade of surgical experience from a single center Murat Sambel, Abdullah Erdogan, Sahin Kilic, Eren Erdi Aksaray, Batuhan Furkan Berk, Asuman Arslan Onuk, Mutlu Ates Sexual Medicine, 2025 Background Penile fracture (PF) is a urological emergency that can lead to significant complications if not treated promptly and understanding the factors influencing complications and outcomes in PFs is crucial for improving patient management. Aim This study aims to evaluate the impact of various factors on postoperative complications and outcomes in patients with PFs based on 10 years of experience at a single center. Methods In this retrospective study, we analyzed data from 106 patients who underwent surgical treatment for PFs between 2013 and 2023 at our institution. Patient demographics, fracture characteristics, and postoperative outcomes were analyzed. Factors affecting complications including the timing of surgery, defect size were evaluated. Outcomes The study revealed that early surgical intervention significantly reduced the risk of complications. Factors such as larger defect size and delayed surgery were associated with higher rates of postoperative complications. Results The mean age of the participants was 46.3 ± 13.9 years. The primary causes of PFs were sexual intercourse (62.3%), masturbation (19.8%), forced penile bending (11.3%), rolling over in bed (4.7%), and falling from bed (1.8%). The mean time from trauma to surgery was 10.5 ± 8 hours, with a mean defect size of 12.7 ± 5.5 mm. Postoperative complications included penile curvature, palpable plaques, and painful erections, with rates of 10.4%, 39.6%, and 23.6%, respectively. International Index of Erectile Function (IIEF-5) scores significantly decreased from preoperative (21.36 ± 2.9) to postoperative values at 6 months (19.48 ± 3.7) (P &lt; 0.001). The time from trauma to surgery significantly correlated with the change in IIEF-5 scores between preoperative and postoperative values (P = 0.007, R2 = 0.067). The group experiencing complications exhibited a mean defect size of 14.54 ± 6 mm, whereas the non-complication group had a mean defect size of 11.07 ± 4.5 mm (P &lt; 0.001). Clinical Implications The findings suggest that timely surgical intervention and careful assessment of defect size are critical in managing PFs and these insights can guide urologists in optimizing treatment strategies and improving patient outcomes. Strengths and Limitations This study benefits from a substantial sample size and a decade of surgical experience at a single center. However, the study's retrospective design and unknown patient history with erectogenic drugs are limitations. Conclusion The timing of surgery significantly impacts IIEF-5 scores, while the size of the defect was associated with other postoperative complications; understanding the factors influencing complications in PFs can improve surgical outcomes.
Comparative Analysis of Robot-Assisted versus Traditional Laparoscopic Retroperitoneal Partial Nephrectomy Şahin Kılıç, E. M. Yorulmaz, Çağatay Özsoy, Murat Sambel, Y. Akin, Mutlu Ateş Van Medical Journal, 2025 Introduction: This study aimed to assess the effectiveness of laparoscopic retroperitoneal partial nephrectomy (LRPN) and robot-assisted retroperitoneal partial nephrectomy (RRPN) in managing renal tumors, with a focus on perioperative efficiency, oncological safety, and preservation of renal function. Materials and Methods: The cohort comprised 80 patients who underwent partial nephrectomy (PN), (centre A-LRPN =26,
A Comparison of Periodic Rebiopsy versus Patient-Based Rebiopsy in Prostate Cancer Active Surveillance Murat Sambel, Sahin Kilic, Eray Ozturk, Talip Kahilogullari, Yigit Demir, Deniz Bayar, Oguz Ergin, Askin Eroglu Cancer Control, 2025 Introduction In low-risk prostate cancer (PCa), the aim of active surveillance (AS) is to reduce overtreatment and avoid potential adverse effects. The rebiopsy approach in AS remains debated, spanning routine scheduled biopsies to clinically- or imaging-driven rebiopsies based on PSA kinetics or multiparametric MRI (mpMRI). In this retrospective, single-center comparative cohort study, we examined outcomes of periodic vs patient-based rebiopsy during AS and evaluated oncological outcomes in patients with PCa. Methods Seventy-four patients who underwent at least one year of AS for PCa between January 2019 and July 2024 were retrospectively analyzed. Two distinct AS protocol patients were included in the study from 4 different physicians in our clinic. Demographic data, PSA levels, PSA kinetics, mpMRI findings, and rebiopsy pathology results were documented. Radical prostatectomy (RP) pathology results and factors influencing definitive treatment (DT) decisions were compared between the 2 groups: periodic rebiopsy (n = 41), and patient-based rebiopsy (n = 33). Results The median rebiopsy time was shorter in the periodic group (12.5 months, IQR: 1) than in the patient-based group (14 months, IQR: 9; P < 0.001). First-year rebiopsies were more frequent in the periodic group (68.3%) than in the patient-based group (45.5%; P = 0.048). No significant difference in DT switching rates or final pathology outcomes was observed, though patients in the periodic group switched to DTs earlier ( P = 0.045). A positive Spearman’s correlation was identified between the maximum PSA density and the International Society of Urological Pathology (ISUP) score of RP specimens [rho = 0.62, P = 0.001]. A PSA density cut-off value of ≥0.17 ng/mL 2 was found to predict an ISUP grade ≥2 in the final pathological assessment with high accuracy (AUC = 0.891, 95% CI: 0.753-1.00, P = 0.003). Conclusions Patient-based rebiopsy protocols driven by PSA kinetics and mpMRI results can minimize unnecessary procedures, prevent overtreatment, and optimize monitoring in AS of PCa.
Testosterone Deficiency Does Not Predict Penile Curvature or Plaque Size in Men with Peyronie’s Disease M Şambel, A Erdoğan, Ç Özsoy, Ş Kılıç, B Arslan, MR İnal, S Taş The New Journal of Urology 21 (1), 30-38 , 2026 2026
Minimally Invasive Adrenalectomy: The Technical Steps of the Laparoscopic and Robotic Approaches M Sambel, S Kilic, M Ates Current Endourology, 213-229 , 2026 2026
Effects of orchiectomy on genital self-image, sexual function, and satisfaction: a comparative study S Kilic, M Duvarci, HA Durak, H Karakayali, T Kahilogullari, N Hamidi, ... World Journal of Urology 43 (1), 677 , 2025 2025
A Comparison of Periodic Rebiopsy versus Patient-Based Rebiopsy in Prostate Cancer Active Surveillance M Sambel, S Kilic, E Ozturk, T Kahilogullari, Y Demir, D Bayar, O Ergin, ... Cancer Control 32, 10732748251390961 , 2025 2025
The predictive utility of the E-PASS score for postoperative complications in robot-assisted partial nephrectomy: a retrospective cohort study C Ozsoy, E Ates, R Inal, M Gelmis, S Kilic, M Ates BMC urology 25 (1), 197 , 2025 2025
Ereksiyon nörofizyolojisi ve epilepsi hastalarında erektil disfonksiyon patofizyolojisi. M Şambel, Ş Kılıç, A Kadıoğlu Androloji Bülteni (Andrology Bullettin) 27 (2) , 2025 2025
Open radical cystectomy and ileal loop diversion under combined spinal-epidural anaesthesia for the elderly and frail S Kilic, T Sugur, HF Metinyurt, Y Demir, E Ozturk, M Sambel BMC surgery 25 (1), 222 , 2025 2025 Citations: 1
Factors affecting complications and outcomes in penile fractures: a decade of surgical experience from a single center M Sambel, A Erdogan, S Kilic, EE Aksaray, BF Berk, AA Onuk, M Ates Sexual Medicine 13 (2), qfaf030 , 2025 2025
Sutureless versus conventional suture renorrhaphy in clampless robotic partial nephrectomy: A single center propensity score matching analysis S Kilic, M Ates Actas Urológicas Españolas (English Edition) 49 (2), 501704 , 2025 2025 Citations: 2
Renorrafia sin sutura frente a renorrafia convencional con sutura en nefrectomía parcial robóti̇ca sin clampaje: análisis unicéntrico de emparejamiento por puntuación de propensión S Kilic, M Ates Actas Urológicas Españolas 49 (2), 501704 , 2025 2025
Antithrombotic Therapy Does Not Jeopardize Emergency Percutaneous Nephrostomy Ş Kılıç, AS Alparslan, E Kölükçü, Ç Özsoy, M Şambel, S Taş The New Journal of Urology 20 (1), 13-20 , 2025 2025
Impact of obesity on perioperative and clinical outcomes after robotic assisted radical prostatectomy S Kilic, M Sambel Scientific Reports 15 (1), 225 , 2025 2025 Citations: 8
Comparative Analysis of Robot-Assisted versus Traditional Laparoscopic Retroperitoneal Partial Nephrectomy. S Kilic, EM Yorulmaz, C Ozsoy, M Sambel, Y Akin, M Ates Van Tip Dergisi 32 (1) , 2025 2025
Comparison of Hydrocelectomy Techniques: A Retrospective Cohort Study on Surgical Outcomes, Complicatons and Recurrence Rates. Y AKTAŞ, K KARAMIK, K YILMAZ, Ş KILIÇ, M ŞAMBEL, M ATEŞ, ... Journal of Reconstructive Urology 14 (3) , 2024 2024 Citations: 1
Prospective evaluation of surgical margins in non-muscle invasive bladder cancer following primary transurethral resection Ç Özsoy, Y Demir, K Yılmaz, MT Ölçücü, Ş Kılıç, M Ateş The French Journal of Urology 34 (9), 102705 , 2024 2024
Modified Urethral Anastomosis Technique in Patients Undergoing Robotic Radical Prostatectomy: Tube-Shaped Bladder Neck M Ateş, Y Aktaş, K Yilmaz, MT Ölçücü, Ş Kiliç, M Şambel Videourology 38 (1), 1-3 , 2024 2024
Hidroselektomi Tekniklerinin Karşılaştırılması: Cerrahi Sonuçlar, Komplikasyonlar ve Tekrarlama Oranları Üzerine Retrospektif Bir Kohort Çalışması Y Aktaş, K Karamık, K YILMAZ, S Kilic, M SAMBEL, M Ateş, M ÖLÇÜCÜ Journal of Reconstructive Urology 14 (3) , 2024 2024
Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction? M Sambel, A Erdogan, V Caglayan, S Avci, S Kilic, HE Yildiz, E Keskin Sexual Medicine 11 (6), qfad069 , 2023 2023 Citations: 9
Early outcomes of robotic retroperitoneal partial nephrectomy: evaluating surgical success with margin, ischemia, and complication score S Kilic, M Sambel, MR Inal, BF Berk, K Yilmaz, MT Olcucu, M Ates Revista da Associação Médica Brasileira 69 (12), e20230825 , 2023 2023 Citations: 3
Evolution of the Percutaneous Nephrolithotomy: A Holistic Investigation of Global Outputs with Bibliometric Analysis E Kölükçü, BS Parlaktaş, Ş Kılıç, E Demir Journal of Urological Surgery , 2023 2023 Citations: 3
MOST CITED SCHOLAR PUBLICATIONS
Weight loss and melatonin reduce obesity‐induced oxidative damage in rat testis D Atilgan, BS Parlaktas, N Uluocak, F Erdemir, S Kilic, U Erkorkmaz, ... Advances in urology 2013 (1), 836121 , 2013 2013 Citations: 30
Comparison between ciprofloxacin and trimethoprim-sulfamethoxazole in antibiotic prophylaxis for transrectal prostate biopsy D Atılgan, Y Gençten, E Kölükçü, Ş Kılıç, N Uluocak, BS Parlaktaş, ... Turkish journal of urology 41 (1), 27 , 2015 2015 Citations: 16
Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction? M Sambel, A Erdogan, V Caglayan, S Avci, S Kilic, HE Yildiz, E Keskin Sexual Medicine 11 (6), qfad069 , 2023 2023 Citations: 9
Comparison of early urinary continence, oncological outcomes, and postoperative complications in Retzius-sparing and standard approach robot-assisted radical prostatectomy K Yılmaz, MT Ölçücü, Ç Özsoy, EE Aksaray, Ş Kılıç, M Ateş Journal of Laparoendoscopic & Advanced Surgical Techniques 33 (2), 150-154 , 2023 2023 Citations: 9
Contralateral testicular metastasis of renal cell carcinoma: A case report E Kolukcu, S Kilic, BS Parlaktas, FA Deresoy, D Atilgan, O Gumusay, ... The Eurasian Journal of Medicine 51 (3), 310 , 2019 2019 Citations: 9
Efecto de la obesidad inducida por dieta en el tejido testicular y parámetros de estrés oxidativo en el suero F Erdemir, D Atilgan, F Markoc, O Boztepe, B Suha-Parlaktas, S Sahin Actas Urológicas Españolas 36 (3), 153-159 , 2012 2012 Citations: 9
Impact of obesity on perioperative and clinical outcomes after robotic assisted radical prostatectomy S Kilic, M Sambel Scientific Reports 15 (1), 225 , 2025 2025 Citations: 8
The effects of oral 5-alpha reductase inhibitors on penile intracavernosal pressures and penile morphology in rat model S Kilic, E Kolukcu, F Erdemir, I Benli, A Arici Urology Journal 16 (2), 205 , 2019 2019 Citations: 8
The effects of oxytocin on penile tissues in experimental priapism model in rats E Kolukcu, S Kilic, BS Parlaktas, F Erdemir, V Unsal, D Atılgan, N Uluocak International urology and nephrology 51 (2), 231-238 , 2019 2019 Citations: 7
Robot-assisted laparoscopic retroperitoneal partial adrenalectomy: the first case in the literature M Ates, S Kilic, C Ozsoy, K Yilmaz, MT Olcucu Central European journal of urology 73 (2), 238 , 2020 2020 Citations: 6
Varikosel F Erdemir, Ş Kılıç Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi 3 (2), 1-11 , 2011 2011 Citations: 6
Early outcomes of robotic retroperitoneal partial nephrectomy: evaluating surgical success with margin, ischemia, and complication score S Kilic, M Sambel, MR Inal, BF Berk, K Yilmaz, MT Olcucu, M Ates Revista da Associação Médica Brasileira 69 (12), e20230825 , 2023 2023 Citations: 3
Evolution of the Percutaneous Nephrolithotomy: A Holistic Investigation of Global Outputs with Bibliometric Analysis E Kölükçü, BS Parlaktaş, Ş Kılıç, E Demir Journal of Urological Surgery , 2023 2023 Citations: 3
Our Stone Breaking Results with Extracorporeal Shock Waves in the Treatment of Upper Ureter Stones E Kölükçü, Ş Kılıç, BS Parlaktaş, N Uluocak, D Atılgan, E Alkan, F Erdemir, ... J Health Sci Med 2 (1), 13-17 , 2019 2019 Citations: 3
Clinical relevance of preoperative neutrophil to lymphocyte and platelet to lymphocyte ratio in renal cell carcinoma E Kölükçü, Ş Kılıç, D Atılgan, B Parlaktaş, S Ceylan, V Ünsal, İ Etikan Journal of Urological Surgery , 2018 2018 Citations: 3
Renal cell carcinoma with concomitant solid pseudopapillary tumor of the pancreas: A case report D Atilgan, S Kilic, HA Kayaoglu, RD Koseoglu International Journal of Surgery Case Reports 4 (10), 828-830 , 2013 2013 Citations: 3
Sutureless versus conventional suture renorrhaphy in clampless robotic partial nephrectomy: A single center propensity score matching analysis S Kilic, M Ates Actas Urológicas Españolas (English Edition) 49 (2), 501704 , 2025 2025 Citations: 2
Üst üreter taşlarının tedavisinde vücut dışı şok dalgası ile taş kırma sonuçlarımız E Kölükçü, Ş Kiliç, BS Parlaktaş, N Uluocak, D Atılgan, E Alkan, F Erdemir, ... Journal of Health Sciences and Medicine 2 (1), 13-17 , 2019 2019 Citations: 2
Open radical cystectomy and ileal loop diversion under combined spinal-epidural anaesthesia for the elderly and frail S Kilic, T Sugur, HF Metinyurt, Y Demir, E Ozturk, M Sambel BMC surgery 25 (1), 222 , 2025 2025 Citations: 1
Comparison of Hydrocelectomy Techniques: A Retrospective Cohort Study on Surgical Outcomes, Complicatons and Recurrence Rates. Y AKTAŞ, K KARAMIK, K YILMAZ, Ş KILIÇ, M ŞAMBEL, M ATEŞ, ... Journal of Reconstructive Urology 14 (3) , 2024 2024 Citations: 1
