Objective: The aim of this study is establish the optimal non- invaszive urine sample collection method for the microbiota studies. Methodology: 12 men with bladder carcinoma underwent first voided and midstream urine collection. Urine samples were analyzed by using V3-V4 regions of bacterial 16s ribosomal RNAs. Bacterial groups with relative abundance above 1% were analyzed in first voided urine and midstream urine samples at phylum, class, order, and family level. At the genus level, all of the identified bacterial groups’ relative abundances were analyzed. The statistical significance (p<0.05) of differences between first voided and midstream urine sample microbiota were evaluated using the Wilcoxon test. Results: According to analysis, 8 phyla, 14 class, 23 orders, 39 families, and 29 different genera were identified in the first voided and the midstream urine samples. Statistical differences were not identified between first voided and mid-stream urine samples of all bacteria groups except the Clostridiales at order level (p:0.04) and Clostridia at class level (p:0.04). Conclusions: Either first voided or midstream urine samples can be used in urinary microbiota studies as we determined that there is no statistically significant difference between them regarding the results of 16s ribosomal RNA analysis. What’s known? According to widespread acceptance, first voided urine and midstream urine should be collected separately for standard microbiologic evaluation. What’s new? We found that there is no exact statistically significant difference between two collection methods even on microbiota analysis. We believe that either first voided or midstream uyrine samples can be used in urinary microbiota studies.

Purpose: To assess the ability of urology residents and experienced urologists to accurately predict pathological features of bladder tumors based solely on cystoscopic appearance, and evaluate how accurately urologists can decide eligible patients for postoperative intravesical chemotherapy. Methods: 104 patients with bladder mass were included, 7 senior urologists and 4 residents joined the study. Before resection, both specialists and residents were asked to predict the stage, grade of the tumor, and presence of CIS. We obtained resident predictions for 104 patients and senior predictions for 72 of these patients. Based on these predictions, eligibility of the patients for single postoperative immediate chemotherapy were determined according to EAU NMIBC guidelines. After final pathology report, risk scores recalculated and compared with surgeons’ predictions. Results: In correlation analysis, strong agreement with the pathological report could not be demonstrated with any of the stages, grades, and presence of CIS for both senior and resident urologists. Urology residents’ predictions were slightly more accurate than the senior urologists’. According to senior urologists’ predictions, 14/72 (19,4%) of the patients, and according to residents’ predictions, 19/104 (18,2%) of the patients were found to be either overtreated or undertreated. Conclusions: Cystoscopic visual prediction is not sufficient to decide on immediate postoperative intravesical chemotherapy regardless of the experience, and we need more objective parameters to improve the appropriate patient selection. What’s known: In patients with non-muscle invasive bladder cancer (NMIBC), decision of immediate postoperative chemotherapy instillation is made by urologists according to clinical and “presumed” pathological parameters as definitive pathology is unkown. Therefore, the concordance of this presumption with the final pathology is important. What’s new: In our study, we demonstrated that urologists’ predictions on pathological features are not reliable to decide on immediate postoperative intravesical chemotherapy instillation and better criteria for patient selection are needed.

Purpose: To investigate the prediction values of the preoperative NLR, LMR, PLR, MPV, RDW for recurrence and progression of patients with non-muscle invasive bladder cancer (NMIBC). Methods: In this prospective study, 94 consecutive patients, newly diagnosed with NMIBC between July 2017 - August 2018 were included. The blood samples were collected from patients before transurethral resection of bladder tumor (TURB) and NLR, LMR, PLR, RDW, MPV values were calculated. The effect of these preoperative inflammatory parameters and other clinicopathological parameters on recurrence and progression rates were evaluated. Kaplan-Meier and multivariate Cox regression analyses were performed to identify significant prognostic variables. Results: The mean follow-up was 11 ± 6.4 months. Recurrence was observed in 35.1% and progression was detected in 7.4% of the patients. Neutrophil-lymphocyte ratio was statistically significantly associated with both recurrence (p = 0.01) and progression (p = 0.035) whereas lymphocyte-monocyte ratio was only associated with recurrence (p = 0.038). In the survival analyses, the relationship between recurrence and LMR was confirmed in both univariate (p = 0.021) and multivariate (p = 0.022) analyses. The relationship between NLR and recurrence was confirmed in univariate analysis (p = 0.019), however in multivariate analysis was found to be statistically insignificant (p = 0.051). Conclusions: Lymphocyte-monocyte ratio might be an easy obtainable, non-invasive and cost-effective method for predicting recurrence of disease in patients with non-muscle invasive bladder cancer.