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Objective: In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal fora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal fora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. Material and methods: A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program. Rectal swab samples were taken from all patients prior to biopsy. The presence of complications have been evaluated after a week following the biopsy procedure. Patients with fever were also evaluated. The possible correlation between the presence of ciprofloxacin-resistant bacteria in faecal fora and the risk of urinary tract infection development and the other complications were evaluated. Results: E. coli bacteria were present in all cultures of rectal swab samples obtained from 142 patients prior to prostate biopsy. Of all these patients, while ciprofloxacin-resistant E. coli (CR E. coli) grew in 76 (53.5%) patients; ciprofloxacin susceptible E. coli (CS E. coli) was obtained in 66 (46.5%) patients. In 16 patients (11.3%), infectious complications were observed. While the infective complications were present in the 14.5% of patients with CR E. coli; they were present in the 7.6% of patients with CS E. coli (p=0.295). High fever was observed in nine patients (6.3%). Of these nine patients, although six had CR E. coli growth as detected during culture sensitivity tests; three had CS E. coli growth in their rectal swab culture tests. Sepsis was observed in three (2.1%) of these patients with high fever. Ciprofloxacin-resistant E. coli grew in all of the rectal swab cultures obtained from these patients with sepsis. Conclusion: In the light of our findings we may say that, it will be appropriate to reconsider the ciprofloxacin prophylaxis and prefer to use other prophylactic agents for a certain period of time in populations with higher rates of resistance to this medical agent. Furthermore, it will be appropriate again to obtain rectal swab specimens for culture tests before biopsy procedure in order to perform targeted prophylaxis according to the culture antibiogram test results. This approach will enable us to evaluate the cost- effectiveness of the procedure in detail. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free and complex prostate-specific antigen (PSA) levels and their effect on biopsy decisions. Material and methods: Our study includes 47 men older than 45 years with symptomatic benign prostatic hyperplasia (BPH). Patients' PSA levels were under 2.5 ng/mL, and there were no known conditions to preclude ejaculation. Eight patients with similar demographic, and clinical characteristics were chosen as a control group. With three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels, and then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total, free and complexed PSA levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation. Results: The mean age of the patients was 59.13±1.38 years in the study group, and 63.75±3.13 years in the control group. The mean international prostate symptom scores (IPSS) were 11.78±1.12 and 11.63±3.32 in the study, and the control groups, respectively. The mean baseline total, free, and complexed PSA values were 1.07±0.09, 0.31±0.03, and 0.71±0.08 ng/mL, respectively. In the study group, total PSA value was found to be 1.29±0.12 ng/mL (p=0.008) at first hour after ejaculation, and this change was statistically significant when compared with baseline values. Mean total PSA level rose up to 1.28±0.13 ng/mL (p=0.05) by the 5th hour after ejaculation, but this change was not statistically significant relative to the baseline values. Mean free PSA level rose after the first hour postejaculation to 0.37±0.04 ng/mL (p=0.01) and after the fifth hour postejaculation to 0.37±0.04 ng/mL (p=0.002), and these changes were statistically significant relative to the baseline values. There were no statistically significant changes at the other sampled times as for the total, free or complexed PSA serum levels. When all three values were considered individually, in only 2.12% of the patients, biopsy decisions could be affected by the elevation in PSA levels. Conclusion: When the PSA value is borderline with respect to biopsy decisions, the effect of ejaculation on serum PSA levels may be clinically important. In these patients, ejaculation must be questioned, and repeated. PSA levels should be evaluated 24 hours after ejaculation. There were no statistically significant changes in the levels of complex PSA values. Further studies are needed to clarify the relationship between complexed PSA and ejaculation. [ABSTRACT FROM AUTHOR]

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Objective: Sexual dysfunction considerably affects the life of patients with multiple sclerosis. In this study, we aimed to investigate the relationship between sexual dysfunction and the type and degree of multiple sclerosis in patients, in addition to the effects of sexual dysfunction on their quality of life. Material and methods: Fifty-eight patients (33 females and 25 males) with multiple sclerosis were included in the study. All of the patients underwent a detailed neurological examination, according to the clinical course of multiple sclerosis. For the assessment of quality of life, the Expanded Disability Status Scale (EDSS), Barthel Index (BI) for daily-life activities, and the Multiple Sclerosis Quality of Life-54 Instrument (MSQOL-54) were used. To determine sexual dysfunction, the Female Sexual Function Index (FSFI) and International Index of Erectile Function Questionnaire (IIEF) were used for females and males, respectively. The relationship between the scores of FSFI, IIEF and MSQOL-54, EDSS, BI was investigated. Results: The average age of the patients and the period of disease were 38.24±1.28 and 7.30±0.84 years, respectively. The mean scores were 2.88±0.26 for EDSS, 88.62±2.64 for BI, 59.10±2.90 for the mental health score of MSQOL-54 and 59.11±2.84 for physical health score of MSQOL-54. Sexual dysfunction was observed in 19 females (57.6%) and 16 males (64.0%) with MS. There were no statistically significant differences in the FSFI and IIEF scores among subtypes of multiple sclerosis (p>0.05). The FSFI and IIEF scores were correlated with MS quality of life scores. However, FSFI and IIEF were not correlated with the period of disease, EDSS or Barthel scores (p>0.05). Conclusion: Sexual dysfunction is frequently observed in multiple sclerosis patients. The decrease in quality of life due to sexual dysfunction is independent from the type of MS and the disability state of patients. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate the change of quality of life of patients with localized and metastatic prostate cancer after treatment. Materials and methods: Twenty-eight patients (mean age 62.45±7.11 years) who were treated with radical prostatectomy and 14 patients (mean age 69.94±8.39 years) who were treated with orchioectomy between December 2007 and June 2010 were included in the study. Patients were asked to complete EORTC QOL-30 instrument before (T0) and 1st (T1), 3rd (T2), 6th (T3), and 12th (T4) months after the treatment. QOL-C30 scores were calculated and converted to 0-100 scale. Score changes of QOL-C30 were the change in scores of related time period from basal score (T1-T0, T2-T0, T3-T0, and T4-T0). Optimum time to evaluate quality of life was defined by determining the score which was closest to the basal score. In addition, the affected quality of life parameters were determined. Results: The mostly affected parameter was the social functioning in radical prostatectomy group. Quality of life got worse in each time period. Total quality of life was the most affected parameter in orchioectomy group. Quality of life significantly increased in first month measurement, and this increase continued in 3rd, 6th, and 12th months. In both groups, quality of life deteriorated from baseline mostly in 1st month after the treatment. Quality of life was closest to the basal values in 12th month measurements. Conclusion: Patients' quality of life should be assessed at 3rd month following treatment of localized and metastatic prostate cancer. Although quality of life of metastatic prostate cancer patients was initially worse than that of localized prostate cancer patients, improvement of quality of life in patients with metastatic cancer was more obvious. [ABSTRACT FROM AUTHOR]