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Introduction: The primary objective of this investigation is to explore the impact of ejaculation on urinary flow rates in men experiencing lower urinary tract symptoms., Materials and Methods: This study involved the enrollment of 55 male patients who presented with lower urinary tract symptoms. An assessment encompassed components, including medical history, questionnaires related to sexual activity and lower urinary tract symptoms, bladder diary, physical examination, urinalysis, urine culture, ultrasound examination and measurements of serum prostate-specific antigen, free flow uroflowmetry, and post-void residual urine volume. All participants were instructed to abstain from ejaculation for 3 days before undergoing uroflowmetry (UF1). Subsequently, they were required to ejaculate. Subsequent uroflowmetry assessments were conducted at 2 to 4 h (UF2) and 48 to 50 h (UF3) after ejaculation. No further ejaculations were permitted during this timeframe., Results: The patients had a mean age of 50.97 ± 1.47 years. Statistically significant differences were observed in the mean values of Q max and corrected Q max (cQ max ) between UF1 and UF2 measurements (p < 0.05). These differences were only in patients with benign prostatic enlargement (BPE) (p < 0.05). Furthermore, the number of patients with Q max <15 mL/s showed a statistically significant difference between UF1 and UF2 measurements, specifically in the BPE group (p = 0.016)., Conclusions: In this study, we have observed a significant and temporary increase in the Q max following ejaculation, particularly among patients with BPE. This indicates that ejaculation can potentially complicate the interpretation of uroflowmetry results. Therefore, further research is necessary to gain a more comprehensive understanding of this phenomenon., (© 2024 Wiley Periodicals LLC.)

Introduction and Hypothesis: This study was aimed at investigating the hypothesis that sexual intercourse positions may have an impact on the occurrence of coital urinary incontinence (CUI) in women., Methods: This case-control observational study enrolled 360 married, heterosexual, sexually active female participants with CUI. Each patient was evaluated using medical and sexual histories, questionnaires, physical examinations, and laboratory tests, including urodynamics. Participants were asked whether or not their intercourse positions had an impact on the occurrence of their CUI. Patients with intercourse position-dependent CUI were included in group 1, and those independent of it were allocated to group 2. The clinic and laboratory findings of the patient groups were compared., Results: The patients' mean age was 47.24 ± 0.57 years. Of these women, 28.9% (n = 104) were in group 1, and 71.1% (n = 256) were in group 2. Group 1 had a lower mean age, body mass index, Charlson comorbidity index, number of urinary incontinence episodes, severity of CUI and incontinence, and pad weight than group 2 (p < 0.05). The rates of detrusor overactivity and penetration type of CUI were higher in group 1 than in group 2 (p < 0.0009, p = 0.009 respectively). According to logistic regression analysis, the likelihood of sexual position-related CUI was 3.5 times higher in women with detrusor overactivity., Conclusions: In certain patients, intercourse position is associated with the occurrence of CUI. This condition seems to be related to detrusor overactivity and is inversely associated with incontinence severity. However, further studies are necessary to explain this phenomenon., (© 2024. The International Urogynecological Association.)

Introduction: We aimed to investigate the diagnostic value of International Prostate Symptom Score voiding symptom score (IPSS-VS) and Bristol Female Lower Urinary Tract Symptoms-short form voiding score (BFLUTS-VS) in female patients with urodynamically diagnosed voiding dysfunction., Methods: The medical records of female patients who underwent urodynamic examination between May 2007 and November 2021 for lower urinary tract complaints were retrospectively evaluated. A total of 1858 female patients were included in the study. Patients investigated between 2007 and 2014 were asked to fill the IPSS, and patients investigated after 2015 were asked to fill the BFLUTS-SF., Results: The mean age of the patients was 49.06 ± 0.33 in the IPSS group and 50.02 ± 0.47 in the BFLUTS group. On the pressure flow study, voiding dysfunction was found in 14.8% ( n = 95) in the IPSS group and 15.1% ( n = 183) in the BFLUTS group. The area under curve value was found to be 0.58 for IPSS and 0.64 for BFLUTS. Threshold values were found as >9 for IPSS-VS and >4 for BFLUTS-VS. The sensitivity, specificity, false negative, and false positive rates for IPSS-VS were 33.3%, 78.8%, 66.7%, and 21.2%, respectively. The same parameters were 45.5%, 78.9%, 54.5%, and 21.1% for BFLUTS-VS, respectively., Conclusion: The diagnostic performance of both the questionnaires was found to be low for diagnosing voiding dysfunction in female patients according to our data. Therefore, the assessment of the voiding phase in women should not solely rely on the current questionnaires. However, further studies using questionnaires including all voiding symptoms are required., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Urology.)

Aım: Superficial urothelial urinary bladder tumors are neoplasms that frequently recur and have a potential for invasion and metastasis. REG gene family is composed of various acute phase reactants, lectins, antiapoptotic factors, and growth factors that are effective on pancreatic island cells, neural cells, and epithelial cells. REG1A and REG1B are two forms of the human REG1 gene. It is reported that they are expressed in several cancers and are correlated with the prognosis of the patient. Claudins are integral transmembrane proteins that interconnect cells. However, their role in human tumorigenesis is extremely controversial. The aim of this study is to evaluate the relationship of REG1A, claudin 7 protein expressions, and Ki67 proliferation index in superficial urothelial urinary bladder tumors with well-known parameters of prognosis and tumor recurrence, and also to clarify whether these parameters are independent prognostic factors or not., Materials and Methods: A hundred and eleven patients diagnosed with superficial urothelial carcinoma between 2011 and 2016 years in our hospital and followed up in our urology clinic were included in this study. The slides prepared from paraffin blocks were immunohistochemically stained with REG1A, claudin 7, and Ki67 antibodies., Results: REG1A showed positive staining in 37 (33%) and negative staining in 74 (67%) of urothelial tumors. Claudin 7 was positive in 24 (22%) and negative in 87 (78%) cases. REG1A expression showed a positive correlation with tumor stage and tumor recurrence; a high Ki67 proliferation index was positively correlated with tumor stage and grade. The loss of claudin 7 expression was related to tumor recurrence. Besides, tumors with REG1A expression and claudin 7 loss had a shorter survival independent of recurrence., Conclusıon: In urothelial tumors, REG1A expression and loss of claudin 7 might be significant markers of prognosis that predict tumor recurrence., Competing Interests: None

Introduction and Hypothesis: To develop and validate a questionnaire (coital incontinence questionnaire-CIQ) for CI and perform clinical and urodynamic analysis of patients with CI., Methods: A total of 414 female patients with urinary incontinence undergoing urodynamics were included in this study. All patients were evaluated with a detailed history, questionnaires, physical examination, relevant laboratory tests and urodynamics. Content, construct and convergent validity of the questionnaire were evaluated. Patients were divided into groups: with CI (group 1) and without CI (group 2)., Results: Overall test-retest reliability coefficients of CIQ were high (r = 0.968, p = 0.01), and the internal consistency was excellent (Cronbach's alpha, 0.964). The test-retest scores did not show a statistically significant difference (p = 0.158). Approximately 34% of these women had CI. Body mass index (BMI), parity, daily incontinence episodes, daily pad counts and 1-h pad test results were higher in group 1 than group 2 (p < 0.05). Multivariate analysis revealed that a daily incontinence episode, BMI, maximum cystometric capacity and PdetQmax were statistically significant factors associated with CI. Urinary incontinence types were different between groups (p < 0.0001). Incontinence with both penetration and orgasm was the most common form of CI (54.4%), and CI severity differed significantly among the forms of CI (p = 0.007). CI negatively interferes with patients' sexual life, their relationship with their partner and quality of life in most patients., Conclusions: The CIQ is a reliable, valid and useful tool for assessment of all aspects of CI in women. CI seems to be related to the severity of urinary incontinence. Further studies are needed to clarify this subject.

The purpose of the study was to evaluate the functional and morphological recovery of solitary kidneys following the relief of obstruction by two different approaches. Data of 65 adult patients with acute renal failure in obstructed solitary kidney were evaluated. Depending on the type of emergent decompression procedure while 34 patients were treated with a double J stent placement only 31 patients underwent ureteroscopic lithotripsy with double J stent placement. Following these procedures, in addition to the amount of excreted urine during the first 24 h, changes in the serum creatinine levels and the degree of hydronephrosis were noted and evaluated during the first week of follow-up after intervention. Evaluation of the urine output values during the first 24-h period revealed a statistically significant difference in favour of ureteroscopic lithotripsy. Serum creatinine levels in terms of the mean change in serum creatinine values and also percentage of the changes revealed no statistically significant change between two groups. Comparative evaluation of the change in the degree of hydronephrosis between baseline and post-procedural seventh day values revealed a statistically significant decrease in favour of ureteroscopic lithotripsy. Lastly, there was a statistically insignificant but meaningful difference with respect to the percent of change in the degree of hydronephrosis between two group of cases. Although temporary decompression of the obstructed solitary kidney by placing a double J stent may relieve the obstruction to a certain extent; emergent ureteroscopic lithotripsy could be applied as a reasonable alternative where adequate experience and technical availability are present.

Objective: To compare 2 urethral stricture models and determine the appropriate model for the generation of urethral stricture in rabbits., Methods: A total of 28 adult male New Zealand rabbits were included in the present study. They were separated randomly into 3 groups. Urethroscopy was performed using a pediatric resectoscope (13F). In 1 group (10 rabbits), circumferential electrocoagulation of the anterior urethra 2-3 mm long was performed until ulceration of the mucosa occurred. In the second group (10 rabbits), 2-3 mm wide resection from the anterior urethra was performed that was deep enough to expose the periurethral tissue to allow urine leakage from the lumen. The remaining 8 rabbits as the control group underwent only urethroscopy. On the 30th day, retrograde urethrography and urethroscopy were performed to evaluate urethral stricture formation. Histologic examination was done to evaluate the urethral pathologic changes., Results: According to the urethrography and urethroscopy findings, no rabbits in the electrocoagulation or control group developed urethral stricture; however, significant stricture formation was observed in every case of the electroresection group. Regenerating urothelium at the luminal side of the urethra was seen in 6 rabbits in the electrocoagulation group and 4 showed normal urethra. In the electroresection group, extensive fibrosis that obstructed the urethral lumen and nodular collagen bundles in the urethral wall were seen., Conclusion: The electroresection method is more reliable than the electrocoagulation method in developing urethral stricture in the rabbit model. A 2-3-mm-wide resection from the anterior urethra can successfully generate urethral stricture with respect to electrocoagulation. Electroresection offers an ideal animal model for generating urethral stricture., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The objective of this study was to establish standard penile size in healthy full-term Turkish newborns and to evaluate the relation between penile and other anthropometric measures. For this prospective study, stretched penile length (SPL) and penile diameter (PD) of live-borns delivered in our hospital between September 2007-December 2008 were measured, and their birthweight, length and head circumference were recorded. Penile versus other anthropometric correlations were determined by Pearson analyses, followed by linear regression. In 1217 full-term subjects, mean SPL was 3.16 +/- 0.39 cm (+/- 2.5 SD = 2.19-4.14 cm), and mean PD was 1.21 +/- 0.11 cm (+/- 2.5 SD = 0.93-1.49 cm). Linear regression analysis showed a strong correlation of SPL (p = 0.0001) to height, and PD to height (p = 0.0001) and birthweight (p = 0.002). Formulas were calculated for predicted individual values for PL and PD of newborns. In conclusion, there is a correlation between neonatal anthropometric measurements and penile anthropometry. Mean anthropometric differences of various ethnicities may account for the differences in mean SPL and PD among various ethnic populations.

Introduction: In this study, we aimed to evaluate efficiency of subureteral injection of calcium hydroxylapatite treatment for primary vesicoureteral reflux (VUR)., Materials and Methods: A total of 25 children (mean age 6.9 +/- 2.7 years) underwent subureteral injection of calcium hydroxylapatite for primary VUR. Reflux was present in 39 ureteral units that were unilateral in 11 cases and bilateral in 14 cases. According to "International Reflux Classification"; grade II in 12 (30.8%), grade III in 18 (46.2%) and grade IV in 9 (23.1%) ureteral units were found., Results: The refluxes were resolved in 23 (59.0%) ureteral units after a single injection and 5 ureteral units (12.8%) after a second injection. Overall success rate of reflux treatment with calcium hydroxylapatite was 71.8% in all ureteral units., Conclusion: Endoscopic subureteral injection of calcium hydroxylapatite in children with primary low-grade VUR appears to be an effective, safe and minimally invasive technique.

Introduction: Interest in the regulation of nerve growth factor (NGF) production in the urinary tract derives from its probable involvement in obstructive, inflammatory and developmental disorders. Our aim was to investigate the presence of low-affinity nerve growth factor receptor (LNGFR) in the vesical urothelium of patients with bladder outlet obstruction., Subjects and Methods: The study included 20 patients with urodynamically confirmed outflow obstruction and 10 control patients without outflow obstruction. Cold cup biopsies of the posterior wall of the urinary bladder were obtained from all patients. Intensity and distribution of LNGFR in the human urinary bladder were examined immunohistochemically., Results: We detected LNGFR immunostaining in all specimens, and it was observed at the (luminal) epithelial surface and in nerve fibers. In the obstruction group, LNGFR immunoreactivity scores were higher than in the control group, but there was no statistically significant difference (p > 0.05)., Conclusions: The presence of LNGFR was demonstrated in the urothelium of the human urinary bladder, and these findings show that cells in hypertrophied and normal bladder can synthesize NGF. This observation may have a potential role for therapeutic implications. However, further studies are needed for an explanation of the pathophysiology and the role in treatment.