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This study sought to investigate the correlation between Helicobacter pylori (Hp) and arteriogenic erectile dysfunction (ED). This study included 30 patients diagnosed with ED due to penile arterial insufficiency, in accordance with the International Index of Erectile Function scores and penile Doppler ultrasonography results, and 30 healthy individuals without ED in the control group. The levels of fasting blood glucose, serum lipid and C-reactive protein (CRP) were recorded. Enzyme-linked immunosorbent assay revealed that the levels of Hp-specific Immunoglobulin G (IgG) antibodies in the patient and control groups were 39.7 ± 23.2 and 21.0 ± 19.8 arbU/ml, respectively (p = .001); the mean CRP levels were 0.3 ± 0.2 and 0.1 ± 0.1 mg/dl, respectively (p = .01). A positive correlation was detected between ED and the levels of Hp-specific IgG and CRP. Further comprehensive studies supporting these preliminary results may facilitate the use of Hp seropositivity as an auxiliary marker in the diagnosis of ED. These findings may also guide future research on the clinical benefits of Hp eradication strategies for the prevention and treatment of ED.

This study investigated the role of carotid artery intima-media thickness (IMT) as a morphological marker of the response of vasculogenic erectile dysfunction (ED) patients to tadalafil, one of the phosphodiesterase 5 inhibitor (PDE5-I). Through March-December 2016, 51 men with vasculogenic ED aged over 30 years were enrolled in this prospective study. Vasculogenic ED was accepted as a normal testosterone level, with penile colour Doppler ultrasonography showing arteriogenic ED, venogenic ED or mixed arteriogenic and venogenic ED. All patients underwent biochemical and hormonal blood tests, ultrasonographic evaluation of the common carotid artery (CCA) IMT and penile colour Doppler ultrasonography. On-demand tadalafil (10 mg or 20 mg in cases of a non-response to 10 mg) was administered to each patient for 2 months. ED was assessed using the short form of International Index of Erectile Function (IIEF-5) before and after the drug therapy. According to the patients' responses to the medication, they were grouped as non-responders or responders. Thirty-one of the 51 patients responded to tadalafil. The mean CCA IMT of the non-responders and responders was 0.9 ± 0.2 mm and 0.6 ± 0.2 mm, respectively (P = 0.000). The IMT of 90% of the non-responders was >0.67 mm, whereas it was >0.67 mm in 40% of the responders. The data were analysed using the Kolmogorov-Smirnov test, Chi-square test, t-test, Mann-Whitney U test and receiver operator characteristic (ROC) curves. Measurement of CCA IMT may offer an alternative and simple method to predict the response of vasculogenic ED patients to PDE5-Is.

Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in kidney stone surgeries. Surgical success is assessed according to residual stone amount after surgery. The purpose of this study is to compare the two methods' success and practicality that are applied after the fracture of the stone in the patients who applied PCNL and which enable the removal of the residual stones. Among 102 patients who underwent a single-session of PCNL at our department between June 2015 and November 2016 were evaluated. Previously identified irrigation method and our aspiration method which described used in post-operative patients divided into two groups of residual fragments was assessed by computed tomography. The results were evaluated in statistical analyses. Significant p was accepted as p 0.05. The age and gender distribution of patients in the irrigation and aspiration groups did not differ significantly (p 0.05). In irrigation and aspiration groups, stone size did not differ significantly (p 0.05). The amount of residue stones and dust remaining in the irrigation group was significantly higher (p 0.05) than the aspiration group. Although many methods have been tried before, we think that the aspiration method we have described is a cheaper, more effective and feasible option.

The study objective was to evaluate the safety and efficacy of mini-laparoscopic pyeloplasty (mLP) in an adult population and to demonstrate the functional and cosmetic results.Data for 29 patients (19 men and 10 women) undergoing mLP for ureteropelvic junction obstruction (UPJO) from May 2014 to December 2016 in Turkey were collected in this prospective study. Inclusion criteria were age ? 18 years, body mass index (BMI) ? 30 kg/m2 and primary UPJO, and no previous surgery on the affected kidney or previous abdominal surgery. Postoperative Visual Analogue Scale scores and the Patient Scar Assessment Questionnaire (PSAQ) were used. Demographic data, perioperative parameters, complications, and postoperative functional and cosmetic results were recorded. All statistical analyses were done by SPSS software. P value of05 was considered statistically significant.Twenty-nine adults with a mean age of 29.4 ± 10.2 years (19-38 years) were included. The patients' mean BMI was 22.4 ± 4.3 kg/m2 (a range of 16-29 kg/m2). The procedures were performed using three ports (one 5 mm port for the camera and two 3 mm ports). Mean operative time was 119 ± 28.5 minutes (85-144 minutes). Major complications were not observed, as per the Clavien-Dindo classification of surgical complications (grades IV-V). The mean VAS score was 1.2 ± 0.2 points. Functional obstruction was reported in one patient on renal scintigraphy at 12 months postoperatively. The success rate of mLP was 97%. The minimum and maximum PSAQ scores at month 3 postoperatively were 24 and 86, respectively. All the patients were satisfied with the intervention and with their cosmetic results.mLP is a safe, effective and feasible treatment method for UPJO in adult patients. This treatment modality offers excellent cosmetic and functional results following treatment for UPJO.

In limited number of studies performed concerning the psychological moods of female, and male with the diagnosis of infertility, data related to increased incidence of depression, and anxiety have been reported. The objective of this study is to determine whether azoospermia has any psychological effects on men, and investigate the potential effects of psychological mood on seminal, and plasma oxidative parametres.Twenty-seven patients whose two consecutive semen analyses were reported as pellet -negative azoospermia constituted the azoospermic group, and 30 healthy individuals who applied to the infertility polyclinic with normal seminal parametres comprised the normozoospermic group.BECK Anxiety scores were significantly higher in the azoospermic group (P = 0.009). When compared with the normozoospermic group, higher levels of oxidative parametres, but lower levels of the antioxidative parametre were detected in the azoospermic group (P0.05). In the azoospermic group, a positive correlation was detected between BECK Anxiety and total oxidant status. Anxiety may increase oxidative parametres in both plasma, and seminal fluid (r = 473, p = 0.026).Anxiety may increase oxidative parametres in both plasma, and seminal fluid. Oxidative milieu may impair sperm quality, and affect the success rates of assisted reproductive treatments. The determination of oxida-tive potential in infertile men, thiol, and prolidase may be used as biomarkers.

Objectives: Apoptosis effect of oral alpha-blockers is known in the prostate. Apoptosis index of silodosin has not been proved, yet. Aims are to present apoptosis index of silodosin in prostate and to compare this with other currently used alpha-blocker's apoptosis indexes together with their clinical effects. Materials and Methods: Benign prostatic hyperplasia (BPH) patients were enrolled among those admitted to urology outpatient clinic between June 2014 and June 2015. Study groups were created according to randomly prescribed oral alpha-blocker drugs as silodosin 8mg (Group 1; n=24), tamsulosin 0.4mg (Group 2; n=30), alfuzosin 10mg (Group 3; n=25), doxazosin 8mg (Group 4; n=22), terazosin 5mg (Group 5; n=15). Pa- tients who refused to use any alpha-blocker drug were included into Group 6 as control group (n=16). We investigated apoptosis indexes of the drugs in prostatic tissues that were taken from patient's surgery (transurethral resection of prostate) and/or prostate biopsies. Immunochemical dyeing, light microscope, and Image Processing and Analy- sis in Java were used for evaluations. Statistical significant p was p

Objective: Kidney stones are an important urological problem in both adults and children. They may be accompanied by metabolic disorders and genetic diseases and children make up approximately 20% of stone patients in our country. In our clinic, we evaluated the results from pre-school children 6 years of age and younger who underwent percutaneous nephrolithotomy (PNL) surgery. Material and Methods: Between March 2012 and June 2016, 54 pediatric patients aged 0-6 years were treated with PNL for stones that were larger than 2 cm or ESWL-resistant, after undergoing the appropriate tests at the Urology Department of the Harran University Faculty of Medicine. PNL operations were performed under general anesthesia. After cystoscopy in the supine position, a ureteral catheter was inserted, accompanied by C-arm fluoroscopy. Afterwards, the patients were placed in the prone position before the kidney was entered using a metal needle with a fluoroscopy attachment. We dilated the entrance with amplatzer renal dilators and entered with a 17 fr nephroscope. After the procedure, the nephrostomy catheter was placed in the renal sheath. 4 mm residual fragments remaining after the operation were accepted as clinically insignificant stone residues. Results: A total of 54 patients underwent PNL operations; 23 females and 31 males. The mean age was 3.16± 0.8. 25 left-sided and 29 right-sided procedures were used. Three patients had bilateral kidney stones; co-administration was not staged. Mean stone size was 370±45 mm2, while the mean operation time was 55 ± 21 minutes. 45 (83.3%) of the patients were stone-free after the operation. Postop, 2 (3.7%) had free fluid and ileus and 6 (11.1%) required additional blood products. They were stabilized with additional JJ stents. After a nephrostomy drain, 4 (7.4%) patients had a JJ stent inserted. Average duration of the nephrostomy was 3.1 ± 0.9 days. Conclusion: As with every age group, PNL was effective in treating stones larger than 2 cm as well as smaller ESWL-resistant specimens. Success in preschool children is practically guaranteed, with a minimally invasive surgical procedure.

Objective Understanding genetic polymorphisms might facilitate the analysis of differences between individuals in their susceptibility to developing cancers as a result of environmental carcinogens. Skin, lung, colon and bladder cancers emerge from biological defects in GSTM1, GSTT1 and GSTP1 gene expressions. In this study, we aimed to investigate whether there was an association between CYP1A1 and GSTP1 gene polymorphisms and bladder cancer in a Turkish population. Material and methods Blood samples were collected from 120 individuals (60 patients with bladder cancer and 60 healthy individuals), and their DNAs were isolated. A polymerase chain reaction-restriction fragment length polymorphism (PCR - RFLP) method was used to detect the frequencies of CYP1A1 NM_000499.3: c.*1189T > C and GSTP1 NM_000852.3: c.313A > G polymorphisms in bladder cancer patients. Results The frequency of the CYP1A1: c.*1189 TC genotype and C allele were significantly different between bladder cancer patients and healthy individuals (p=0.001 and p=0.005, respectively). However, there was no significant difference for the GSTP1: c.313 AG genotype or G allele between both study groups (p=0.699 and p=0.360, respectively). Conclusion A polymorphic site of the CYP1A1 gene might be involved in the development of bladder cancer. However, the investigated GSTP1 polymorphic site did not represent an important risk factor for the development of bladder cancer in a Turkish population.

Objective Oxidative stress is the main pathogenetic mechanism in bladder cancer among many other causes. We aimed to investigate whether a potential relationship exists between bladder cancer and the activities of paraoxonase (PON1) and arylesterase (ARE) enzymes. Material and methods The study included 56 patients with bladder cancer, and 57 healthy individuals. The relationships between enzyme activity and tumour grade, stage, muscular invasion and tumour size were evaluated. For statistical analysis, One-Sample Kolmogorov-Smirnov, Independent-T, ANOVA and Post-Hoc Bonferroni tests were used. Results Serum levels of PON1 and ARE enzymes, and total cholesterol were significantly lower in bladder cancer group. While other lipid parameters were similar in both the patient and the control groups. Levels of ARE were positively correlated with lipid parameters except for HDL cholesterol. Conclusion Our results showed that decreased serum PON1 and ARE enzyme activities are related with tumour load and recurrence. Further studies with larger samples are needed to confirm predictive role of enzymatic activities of PON1 and ARE in the diagnosis and prognosis of bladder cancer.

Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009-May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4-201) and a median follow-up period of 14 months (3-113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one with C-RE. Two patients (2/17 - 11.7%) had neurogenic bladder due to meningomyelocele, accompanied by imperforate anus in C-RE group. There were no significant differences in other associated urological anomalies between two groups. Renal impairment developed mostly in patients with additional urinary anomaly. The children with RE may have associated urinary anomalies, of which VUR is the most common. Complete urological investigation and regular follow-up are required in selected cases.

To introduce a novel endoscopic surgical technique with mini-nephroscope by suprapubic transvesical route for cystolithotripsy in children.This was a non-randomized study with a series of 12 boys, between February 2012 and September 2013. Demographic, operative, and postoperative data were recorded. Our new endoscopic surgery technique could be performed in all patients. Complications were noted.Mean age was 35.1 ± 8.6 months (19-46 months), the average stone size was 16.5 ± 5.2 mm (10-20 mm). Mean operation time was 28.9 min (21-40), and mean hospital stay was 2.2 (2-3) days. In all procedures, stones were successfully fragmented and extracted by the new surgical technique. There was no intraoperative and/or postoperative complication or urethral stricture during follow-up period. In stone analyses, the main components were ammonium acid urate, calcium oxalate, and struvite.The new endoscopic surgery technique is safe and effective for bladder stones in children. Thus, our technique can be a strong candidate for an alternative treatment of childhood bladder stones.

Introduction Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide. It is an important health problem especially in women of reproductive age. IDA may cause anxiety, which is the major factor for female sexual dysfunction (FSD). Aim The aim of the present study was to determine the impact of IDA on FSD in women of reproductive age. Methods In total, 207 women were enrolled. Women with IDA who were admitted in an outpatient clinic of family medicine were asked to complete Beck Anxiety Inventory (BAI), Female Sexual Function Index (FSFI), and Quality of Life (QoL) questionnaires. Questionnaires were completed before and after IDA treatments. Blood samples were obtained for measurements of hemoglobin, hematocrit, levels of serum iron, and iron‐binding capacity. Main Outcome Measures Outcomes of blood samples were used for diagnosing of IDA. BAI, FSFI, and QoL scores were evaluated. Paired samples t ‐tests and Pearson correlation analyses were used to assess relationship between findings of IDA treatments and other parameters. Results The mean age was 33.6 ± 8.4 years. There were statistical significant differences between pre‐ and posttreatment in terms of hemoglobin, hematocrit, serum iron, and serum iron‐binding capacity. BAI scores were decreased and FSFI scores, which were statistically significant, increased after IDA treatments ( P Conclusion There is a risk for anxiety as well as FSD in IDA women of reproductive age. Treatment of IDA can significantly improve sexual functions and QoL in these women population in short term. Gulmez H, Akin Y, Savas M, Gulum M, Ciftci H, Yalcinkaya S, and Yeni E. Impact of iron supplementation on sexual dysfunction of women with iron deficiency anemia in short term: A preliminary study. J Sex Med 2014;11:1042–1046.

Tuberculosis is a disease that affects almost every organ. The diagnosis and treatment of primary genitourinary tuberculosis is cumbersome and often requires invasive procedures for diagnosis. It is mandatory to differentiate tuberculous epididymitis from other causes of intrascrotal diseases such as bacterial epididiymitis and tumors. We discussed a case of tuberculous epididymitis presenting with a scrotal mass, to emphasize that tuberculous should also be considered in the differential diagnosis, besides malignancy

Objective To compare the outcomes of mini-percutaneous nephrolithotomy (m-PCNL) and retrograde intrarenal surgery (RIRS) in treating renal stones in preschool-aged children. Materials and Methods Forty-five patients treated with m-PCNL and 32 patients treated with RIRS for renal stones were compared retrospectively. The operative and postoperative outcomes of both groups were analyzed retrospectively. Results The mean age and gender were similar between the groups. The mean stone size was 19.30 ± 4.21 mm for the RIRS group and 21.06 ± 5.61 mm for the PCNL group ( P = .720). The mean operative times, fluoroscopy times, and hospitalization times were statistically higher in the PCNL group. The stone-free rates (SFRs) after a single procedure were 84.4% in the PCNL group and 75% in the RIRS group ( P = .036). After auxiliary procedures, the overall SFRs reached 91.1% for the PCNL group and 90.6% for the RIRS group ( P = .081). No major complications were observed for both groups. Minor complication (Clavien 1-3) rates were 15.5% and 12.5% for the PCNL and RIRC group, respectively ( P = .385). Conclusion RIRS has some advantages over PCNL such as shorter hospitalization times, shorter fluoroscopy times, and shorter operative time in treating renal stones. However, PCNL achieves higher SFR after a single session.

Mean platelet (PLT) activation has an important role in the development of vascular diseases. In this study, we aimed to investigate the PLT volume in patients with vasculogenic and nonvasculogenic erectile dysfunction (ED) and compare it with the control group. Mean PLT volume (MPV) levels were measured in 50 patients with vasculogenic ED, in 30 patients who developed ED after radical prostatectomy (nonvasculogenic) and in 40 healthy controls. Ages were similar between the three groups. The diagnosis of ED was based on detailed sexual history, physical examination, laboratory assessment and color Doppler ultrasonography and is defined as the inability to attain or maintain a penile erection that is sufficient for successful vaginal intercourse. The results are given as mean ± s.d. of the mean. The mean age of the patients with vasculogenic ED, of patients with ED after radical prostatectomy and of the control group were 53.70 ± 12.39 (range 24-77), 54.60 ± 11.40 (range 43-61) and 53.85 ± 9.5 (range 30-73), respectively (P = 0.853). The MPV and PLT values were significantly higher in patients with vasculogenic ED than in patients with ED after radical prostatectomy and in control groups: 7.49 ± 1.4, 6.43 ± 1.19 and 6.85 ± 1.2 for MPV and 262.97 ± 68, 251.77 ± 78 and 252.89 ± 82 for PLT values, respectively (P = 0.033). The MPV and PLT values were not statistically significant in postprostatectomy ED patients and in control groups (P = 0.663). There was no significant difference among the three groups in terms of white blood cells and hemoglobin levels. PLT count and mean PLT volume were detected to be increased in patients with vasculogenic ED. This finding may suggest a role for PLT volume in the pathogenesis of vasculogenic ED.

The aim of this study was to evaluate the sexual functions and quality of life of women who have undergone tubal sterilization after tubal surgery. In all, 90 active premenopausal women, who had undergone tubal sterilization at least 1 year ago and been admitted to four different hospitals, were included in the study group. A total of 100 women at a similar age range, admitted to the same four hospitals for routine health controls, were included in the control group. To obtain sexual function assessments, the patients were asked to fill out Female Sexual Function Index (FSFI) questionnaire. The participants were also asked to fill out Medical Outcomes Study Short Form (SF-36) questionnaire. All values were found to be lower in the tubal sterilization (TS) group and the differences between groups were statistically significant in domain except for pain and lubrication. Similarly, in the analysis of SF-36 scores, there were differences in comparison with the TS group in all domains. In the evaluation of the relationship of FSFI with educational level in the TS group, it was found that, while the educational level increased, all domain scores also increased, and this increase was statistically significant in all domains except pain. The termination of fertility, which is one of the important abilities of women, with tubal sterilization, may be a risk factor for female sexual dysfunction in people with low educational levels.

Epidemiological and experimental studies indicate that kidney disease is associated with increased oxidative stress. Our aim was to determine whether paraoxonase 1 (PON1) activity is altered in patients with moderately decreased glomerular filtration rates (GFRs) compared to healthy controls.Forty-eight patients showing relatively low GFRs upon renal scintigraphy with (99m)Tc-DTPA were compared to 40 age-matched healthy subjects. Serum PON1 activity was measured spectrophotometrically. Lipid hydroperoxide levels were measured via iodometric assay.The mean ages of the patient and control groups were 32.09 +/- 6.10 (range 23-50) and 31.30 +/- 5.30 (range 20-46) years, respectively. Serum PON1 (p= 0.949) and high-density lipoprotein (p= 0.473) levels did not differ between groups. Significant differences were detected between groups in terms of mean triglyceride (p= 0.009), very-low-density lipoprotein (p = 0.010), lipid hydroperoxide (p = 0.026), urea (p = 0.012), and creatinine (p = 0.001) levels, whereas total cholesterol (p = 0.520) and low-density lipoprotein (p = 0.161) were similar between groups. Mean GFR was significantly lower in the low GFR group compared to the control (p = 0.000).Our results indicate that PON1 activity and high-density lipoprotein levels may not be determining factors in premature vascular aging in patients with moderately decreased GFRs. Instead, some other undetermined factor(s) may be involved in modulating enzymatic activity.

Objective: Chronic scrotal pain (CSP) is one of the difficult medical evaluations. Approximately 25% of patients with chronic orchialgia have no obvious cause for the pain. The aim

Aim: In this study we examined the effect of oral application of garlic form [garlic oil (GO)] on rats after renal ischemia-reperfusion (I/R) injury. Materials and methods: Forty male Wistar albino rats were divided into four groups: control, sham-operated, I/R, and I/R + GO. GO was diluted in water and administered by oral intubation three times each week for 6 weeks. All rats except sham-operated underwent 45 min of bilateral renal ischemia followed by 6 hr of reperfusion. Blood samples and kidney tissues were harvested from the rats, and then rats were killed. Serum urea, creatinine, and cystatin C levels were determined. Total antioxidant capacity (TAC), catalase (CAT), total oxidant status (TOS), oxidative stress index (OSI), myeloperoxidase (MPO), nitrite oxide (NO), and protein carbonyl (PC) levels in kidney tissue and blood were measured. In addition, kidney tissue histopathology was evaluated. Results: The serum urea, creatinine, and cystatin C levels were significantly higher in I/R group compared to I/R + GO group (p < 0.01). The serum and tissue antioxidant markers (TAC, CAT) were significantly lower in I/R group than I/R + GO group (p < 0.01). The serum oxidant markers (TOS, MPO, NO, and PC) were significantly higher in I/R group than I/R + GO group (p < 0.01). Also oral application of GO was effective in decreasing of tubular necrosis score. Conclusion: Based on the present data, we conclude that increased antioxidants and decreased oxidants modulated by oral application of GO attenuated the renal I/R injury.

The presence of more than two testes confirmed by histology is called polyorchidism. Polyorchidism is an extremely rare congenital anomaly with a few more than 100 cases reported in the literature. The majority of reported cases are asymptomatic patients, others present with cryptorchidism, hydrocele, varicocele, epididymitis, infertility, testicular malignancy and testicular torsion. Over a 2-year period, we encountered three patients who were found to have polyorchidism; two men presented with cryptorchidism and one with chronic scrotal pain. Physical examination of the first and the third patient revealed normal testes in the scrotal sac, the other scrotal sac was empty and small solid mass (atrophic left testes) was palpated in the inguinal canal. Ultrasonographic examination of the scrotum and inguinal region confirmed the findings of the physical examination. Ultrasonographic examination of the second patient revealed supernumerary testes within the scrotum. Orchiectomy was made on the first and third patients' supernumerary testes and ipsilateral inguinal high ligation was applied for herniorrhaphy. A conservative approach was preferred for the second patient, maybe preserving a potentially functional supernumerary testis to improve the capacity for spermatogenesis. The risk of malignancy justifies the removal of an atrophic and ectopic testis in polyorchidism. However, it would appear safe to preserve a viable intrascrotal supernumerary testis found incidentally at surgery, provided that the patient is followed-up in the long term.

OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5) inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (p

The aims of our study are to evaluate ureterovesical jet flow Doppler ultrasound (US) in patients with residual ureteral stone after extracorporeal shock wave lithotripsy (ESWL) and to compare with unobstructed contralateral ureter. Patients who have residual ureteral stone in intravenous pyelography (IVP) and/or computed tomography (CT) after ESWL and unobstructed contralateral ureter in 20 patients were prospectively evaluated with Doppler US. The mean peak velocity of the Doppler waveforms was obtained on the residual ureteral stone and contralateral non-obstructed ureter (17.10 ± 20), (56.0 ± 32), respectively (P < 0.05). In conclusion, due to the absence of contraindications and side-effects, Doppler US is sensitive and highly specific that can contribute significantly to the diagnosis of residual ureteral stone after ESWL. It can replace IVP and/or CT, in condition where IVP is undesirable and in addition Doppler US can supply a functional investigation of the obstructed ureter. © 2009 Springer-Verlag.

Erectile dysfunction (ED) is prevalent among men, and several factors can contribute to the failure of ED treatment based on phosphodiesterase-5 (PDE-5) inhibitors. The aim of this study was to investigate the impact of penile size in treatment of ED with PDE-5 inhibitor (tadalafil; 20 mg). We prospectively scrutinized and enrolled in the present study 42 consecutive patients with ED. All measurements of penile length in fully stretched states and the erectile function domain of the International Index of Erectile Function (IIEF-EF) scores were recorded by the same physician (M.S.). Patients were divided into 3 groups according to stretched penile length: small (25th percentile), normal (25th to 75th percentiles), and large (75th percentile). Mean IIEF-EF scores were recorded before and after treatment period. Patients received tadalafil (20 mg), taken on demand, a minimum of 6 times. The mean stretched penile length was 13.44 +/- 2.4 cm (range, 9.50-18.00 cm). Overall mean IIEF-EF domain scores were 11.90 +/- 4.78 and 18.67 +/- 6.70 for before and after the treatment period, respectively. Although PDE-5 inhibitor treatment significantly improved all domains of the IIEF-EF scores (P.05), no statistically significant difference was found among the 3 groups according to mean IIEF-EF domain scores before and after treatment (P.05). We conclude that penile size is not a factor in treatment of ED patients with a PDE-5 inhibitor.

Summary Introduction Despite of the tissue engineering efforts to substitute the bladder, almost all the urinary diversion techniques still need gastrointestinal segments that have many well documented complications including the life threatening ones such as renal insufficiency and electrolytes imbalances. In this preliminary incomplete animal model, we aimed to introduce the idea of the possibility of scrotal urinary diversion via inguinal canal and speculate its clinical advantages with its low morbidity and surgical technique of human application. Technical considerations After a laporotomy and its left ureter dissection, a male rabbit underwent urinary diversion from kidney to the scrotum via catheter through the inguinal canal. Abdominal and scrotal incision closed with sutures but a potential gap was left at the scrotum for urinary leakage. Urinary leakage was observed from the ipsilateral scrotum postoperatively. The Hypothesis Although this study can be regarded as just a hypothesis, we would like to introduce the idea of scrotal pouch as a urinary reservoir. We speculated that scrotal urinary diversion is better and applicable technique with many advantages and low morbidity, mortality and short operation time over the intestinal ones especially in selected patients. Further human studies may improve this novel technique.

Introduction: We tried to prove the effectiveness of trimetazidine (TMZ) on testicular torsion-detorsion injury. Materials and Methods: 15 male rats were equally divided into three groups: group 1 was the sham-operated control group; group 2 had 2 h of unilateral testicular ischemia followed by 3 days of reperfusion, and group 3 had 2 h of unilateral testicular ischemia followed by 3 days of oral TMZ treatment (5 mg/kg, bid) during reperfusion. In the removed testicles, tissue reduced glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), malondialdehyde (MDA) levels and pathological modified Johnson scores (MJS) were evaluated. Mann-Whitney U test was used for statistical evaluations. Results: In group 2, on the ipsilateral side, GSH were significantly lower and MDA were higher than in groups 1 and 3, though GSH and MDA were not statistically different between groups 1 and 3. On the other hand, GPx in the control testicles of group 3 was significantly lower compared to those in the counterparts of both groups 1 and 2. Among three groups, GR determined in both testicles were not statistically different. On the ipsilateral side, MJS in group 3 were lower than in the sham group, but significantly higher than in group 2. Conclusions: According to this study, TMZ has an antioxidant effect on testicular torsion-detorsion injury, though the protective effect of TMZ seems to decrease in control testicles. Consequently it has been considered that TMZ can be only used in torsion patients with a healthy contralateral testicle after further studies have been conducted.

Objective: The aim of this study was to evaluate the long-term functional outcomes of laparoscopic pyeloplasty (LP) in children for consecutive cases of single institute. Materials and Methods: Our laparoscopy database was investigated for children in terms of LP between June 2008 and April 2015. All the patients had ureteropelvic junction obstruction (UPJO) and LP was performed. Demographic data including age, gender, side of UPJO, operation time, estimated blood loss (EBL), hospital stay and complications according to Clavien classifications were recorded. Renal ultrasonography and diethylenetriamine penta-acetate (DTPA) scintigraphies were respectively performed 3, 12 and 24 months after surgery. Statistical analyses were performed and p value was accepted as significant at Result: Mean follow-up was 34 ± 4.7 months. The mean age was 13 (6-72) months. A total of 153 (110 boys and 43 girls) LP patients enrolled. Of that, 93 (60.78%) LP were in left side and 60 (39.21%) were in right side. Three cases needed open conversation according to difficulties in anastomosis. Aberrant crossing vessel was observed in 12 (7.84%) patients. The mean operation time was 155 ± 21 min and the mean EBL was 22 ± 11.1 ml. The mean hospital stay was 3.4 days. Anastomotic leakage was the common complication (in 13 patients) that was successfully managed conservatively (Clavien 1). Eight patients experienced unsuccessful LP and underwent open pyeloplasty (Clavien 3b). The mean split renal function significantly increased in DTPA scintigraphy in follow-up. The overall success was 91%. Conclusions: The LP procedure can be an effective and safe surgical method for childhood UPJO, specifically in the experienced hands of pioneer centers.

To investigate the relationship between the HSP 70 genepolymorphism and primary infertility in males with normal sperm-parameters.The case-control study was conducted in Sanliurfa, Turkey, from September 2010 to August 2011and comprised infertile males as cases and healthy fertile controls. Deoxyribonucleicacid was isolated from the blood of both groups, and polymorphisms of the HSPA1B gene (NM_005346.4, GI: 3304):c.1059GA, (PstI GA; dbSNP: rs1061581GA) and HSPA1L gene (NM_005527.3, GI: 3305) c.1478CT (NcoICT, dbSNP: rs2227956) were analysed with polymerase chain reaction-restriction fragment length polymorphism technique. SPSS version 11.5 was used for statistical analysis.Of the 140males in the study, 68(28.5%) were infertile cases and 72(51.4%) fertile controls. There was no statistically significant difference between GA (heterozygous) and AA (homozygous, polymorphic) genotypes of the c.1059GA polymorphic point of the HSPA1B gene or between the A allele of the cases and controls (p0.05). There was no statistically significant difference between the CT (heterozygote) and TT (homozygous, polymorphic) genotypes of the c.1478CT polymorphic area of the HSPA1Lgene or between the T alleles of the cases and the controls (p0.05).Infertility in males with normal sperm parameters was not significantly associated with HSPA1B:c.1059GA and HSPA1L:c.1478CT gene polymorphisms. Further prospective studies with larger sample sizes and different gene groups are required to clarify the issue.

Introduction: Female sexual dysfunction (FSD) is a significant age-related, progressive and highly prevalent problem that affects a substantial number of women that causes personal distress and has negative effects on quality of life and interpersonal relationships. Definitions: The female sexual response cycle consists of three phases: desire, arousal, and orgasm, and is initiated by non-adrenergic/non-cholinergic, e.g. vasoactive intestinal polypeptide and nitric oxide, neurotransmitters that maintain vascular and non-vascular smooth muscle relaxation resulting in increased pelvic blood flow, vaginal lubrication, and clitoral and labial engorgement. Furthermore, hormonal status may influence female sexual function. For the diagnosis of FSD, a detailed history should be taken initially, followed by a physical examination and laboratory studies. Conclusion: Due to the fact that there has been little research and attention on FSD, our knowledge in this field is quite limited and there is still no approved therapy. Future advances in evaluation and treatment of female sexual problems are forthcoming.

Introduction: Since comprehensive urometabolic analyses are currently more preferred for the patients with recurrent stones and with high risk of stone recurrence, we have tried to determine simple patient data increasing stone recurrence to limit sophisticated analyses to certain cases at least in particularly deprivation districts. Materials and methods: For the study 173 with first-time or recurrent urinary stone were taken. After stone treatment, various empirical metaphylaxis methods were counselled to the patients. The parameters evaluated were (a) age at onset of the disease, (b) gender, (c) urinary pH and (d) specific gravity, (e) serum calcium and (f) uric acid, (g) stone burden, (h) side, and (i) location, (j) treatment modality and (k) recurrence history. New stone formation or growing of the existing stone was considered as stone recurrence. In statistics, independent samples t, chi-square test, Kaplan–Meier, Log rank and Cox regression tests were used. Results: The mean age was 35 years. The male to female ratio was 88/85. Recurrence occurred in 49 (28%) cases at a mean of 30 months. Stone burden was significantly larger in patients with recurrent stone. In subjects treated with open surgery and with previous recurrence history, stone recurrence rate was significantly higher. In survival analyses, higher serum calcium level, larger stone burden, renal stones and previous recurrence influenced stone prognosis poorly. However in multivariate analysis, none of them was the most significant independent factor. Conclusions: According to our study, detailed urometabolic analyses may be somewhat reserved for the patients with ordinary factors increasing risk of stone recurrence including relatively high serum calcium level, large stone burden, upper urinary stone, history of recurrence and open surgery. As a result, it has been thought that the stone risk evaluation guiding detailed laboratory examination may be partially performed with first-line clinical data under limited conditions.

Circumcision has always been regarded as both an important social event and a milestone of a young man’s life in Turkish culture, especially in the Ottoman period. Herein we study an exceptional circumcision festivity which lasted 15 days in the early autumn of the year 1720, for the 4 princes of Sultan III Ahmed, some sons of two high-ranking Ottoman officials and thousands of male children of poor citizens of Istanbul as representing the beneficent of the Sultan. All the organizations of the Empire participated in this huge event, including many shows and a feast, and the preparations were initiated months before. Traditionally, this kind of important social event of Ottoman culture had been described in a literary manner, and Surname-i Vehbi was the special name for the book of this circumcision festivity with 137 colored paintings and a total of 175 pages. The original of this work, which is in the library of Topkapi Palace Museum in Istanbul, was written by Vehbi and illustrated by Levni. The importance of this antique book is that it is the last important example of the illustrated festivity books of Ottoman literature.

The acute effects of 50 mg of sildenafil on tear functions were evaluated in 12 impotent patients. Mean tear breakup time, cotton thread, and Schirmer I tests were 19.42±6.45 s, 13.92±6.63 mm, and 16.58±12.19 mm, respectively before sildenafil and 20.33±10.40 s, 10.92±6.14 mm, and 18.08±12.36 mm, respectively, 1 hour after sildenafil. The results suggest that sildenafil does not adversely affect tear functions.

The aim of the study is to determine and to compare the oxidative and antioxidative status of penile corpus cavernosum and peripheral venous blood. A total of 28 adult healthy males were included in the study. Whole blood was simultaneously withdrawn from penile corpus cavernosum and the cubital vein and their plasma separated. Total antioxidant capacity (TAC), vitamin C, total protein, albumin, uric acid, bilirubin and total peroxide (TP) levels of both plasma samples were measured and compared. While TAC, total protein, albumin, bilirubin and uric acid levels were higher, vitamin C levels were lower in cavernosal blood than that of peripheral blood. On the other hand, TP level was found to be higher in penile blood samples than that of peripheral blood. We thought that the normal erectile process of the penile cavernosal body leads to increased production of oxidants as in the mechanism of ischaemia-reperfusion; however, the increase of TAC can prevent development of oxidative injury.

The aim of this study was to evaluate the effects of tension-free vaginal tape (TVT) on sexual function in women with stress urinary incontinence (SUI) by questionnaire. Thirty-two sexually active and married women who were planned for TVT to treat SUI constituted the patient group, and 25 women who were healthy, sexually active and married, were selected as the control group; the ages of both groups matched. Sexual functions (desire, arousal, orgasm, pain and satisfaction) were evaluated with the Index of Female Sexual Function (IFSF), and continence status during sexual intercourse was asked about both preoperatively and postoperatively in the 6th month. The mean domain scores of sexual functions such as desire, arousal, orgasm, pain and overall satisfaction preoperatively and postoperatively were 3.37+/-0.69, 3.82+/-0.62, 3.40+/-0.95, 3.41+/-0.98, 3.16+/-1.09 and 3.32+/-0.79, 3.71+/-0.53, 3.06+/-1.04, 2.75+/-1.29, 2.88+/-0.63, respectively, and postoperative scores insignificantly decreased. Also, these scores in the control group were 3.64+/-0.66, 3.96+/-0.73, 4.12+/-0.78, 3.96+/-1.14 and 3.68+/-0.92. In comparison with the control group, whereas all of the preoperative domain scores were found to be decreased but were statistically insignificant except orgasmic function, postoperative scores significantly worsened, except for desire and arousal. However, preoperatively nine patients explained that they had incontinence during sexual intercourse, and this problem persisted in two postoperatively ( p = 0.043). This study shows that both SUI and the TVT procedure negatively affect sexual function in women.

Female Sexual Dysfunction (FSD) is defined as a complex chain of events. The mechanism has been still evaluating. However, there are some proven factors for FSD, the accurate causes and their threatments have not been reported, yet. At this point, smoking is a growing health problem and can also indirectly cause some diseases such as male sexual dysfunction. The endothelial injury indirectly cased smoking is the fact of FSD. There is no published report on relationship between FSD and smoking. In this review, the current published studies are going to be evaluated for FSD considering smoking.

The objectives of this study were to compare the protective influence of exogenous nitric oxide on renal ischemia reperfusion (I/R) injury with that of the antioxidant vitamins C and E. Sprague-Dawley rats were divided into three groups ( n=12 per group). Normal saline solution was given in group 1, a vitamin C (200 mg/kg/d) plus vitamin E (100 mg/kg/d) combination in group 2 for 3 days before operating and Na-nitroprusside (5 mg/kg/d) in group 3 before reperfusion. The left kidneys were exposed to warm ischemia for 40 min followed by reperfusion for 90 min. The right kidneys were used as internal controls. After both kidneys were removed, histopathological examinations were performed, and oxidative and antioxidative parameters were measured. In the postischemic reperfused rat kidneys, the renal lipid peroxidation level was significantly lower, and the renal GSH level higher in the group given Na-nitroprusside compared with groups 1 and 2. Renal specific xanthine oxidase activity was also significantly lower in the group treated with Na-nitroprusside than in the groups given vitamins or saline. There was a significant, negative correlation between lipid peroxidation and reduced glutathione levels. Our results suggest that the exogenous nitric oxide (Na-nitroprusside) inhibits xanthine oxidase, and has more apparent preventive features for renal I/R injury than the antioxidant vitamins C+E.

Objective: To evaluate the effectiveness and complications of the combination of minimal transurethral resection of the prostate and bladder neck incision in comparison with those of the standard transurethral resection of the prostate (TURP). Patients and Methods: Forty patients with prostates of ≤25 ml were randomized to two equal groups (20 cases in each). In group I minimal transurethral resection of the prostate followed by bladder neck incision at the 6 o’clock position and in group II standard TURP were performed. Patients were evaluated in terms of the change in symptom severity, maximal flow rate and sexual function in addition to operating time, length of hospital stay, problems of catheter positioning at the end of the operation and the rate of bladder neck contracture using χ2 and independent t tests. Results: Age, prostate volume postoperative follow-up time, improvement in international prostate symptom score and maximal flow rate, length of hospital stay and erectile dysfunction rates were not statistically different between the 2 groups. Operation time was shorter in group I (p = 0.001). Although the urethral catheter was easily positioned at the end of the operation in group I, it was not possible in group II for 4 patients (p = 0.053). Postoperative retrograde ejaculation for groups I and II were determined in 7 and 16 patients, respectively (p = 0.005). Bladder neck contracture was not found in group I, while it was seen in 2 patients in group II (p = 0.487). Conclusion: The combination of minimal transurethral resection and bladder neck incision in patients with small prostates appears to provide a satisfactory clinical outcome, comparable with standard TURP, while preventing the difficulty of urethral catheter positioning at the end of the operation, decreasing bladder neck contracture and lowering the incidence of retrograde ejaculation.

To compare the outcomes of the open-ended six to ten sessions of biofeedback against a novel regime of four sessions of biofeedback to treat children with dysfunctional voiding.Patients from two centers using different methods were retrospectively analyzed. Group 1 comprised 20 patients treated with four sessions of biofeedback. Group 2 comprised 20 patients treated with six to ten sessions of biofeedback. Each group was evaluated with subjective and objective parameters pre-treatment, immediately post-treatment and 6 months post-treatment.All patients in Group 1 were treated with four sessions of biofeedback and in Group 2 the mean number of sessions was 7.35±1.30 (range 6-10). Normalized voiding flow curves after treatment were determined in 18 patients in Group 1 (90%) and 19 patients in Group 2 (95%) (p=0.553). There were seven patients (35%) in Group 1 and eight patients (40%) in Group 2 with reflux. When units were compared, there were 11 units (4 bilateral) in Group 1 and 13 units (5 bilateral) in Group 2 with reflux (p=0.747). At 6 months post-treatment, in Group 1, seven had resolved (63.6%), three had improved (27.2%) and one persisted (9.01%). In Group 2, ten had resolved (76.9%) and three had improved (23.1%) (p=0.553).Biofeedback therapy is one of the most widely used techniques in dysfunctional voiding in children. The regime of use has not been well defined, and the results of this study showed that a regime of four sessions of biofeedback therapy may be as safe and effective as the previously defined open-ended six to ten sessions.

Objective. To investigate a possible association between enuresis in childhood and premature ejaculation in adult life. Methods. The authors conducted a retrospective study, with two cohorts, consisting of 60 men with premature ejaculation, and 60 comparison subjects who were asked to assess their enuresis in childhood, a history of psychological problems. Results. While 20 (33.3%) subjects with premature ejaculation reported a history of enuresis in childhood, only seven (11.6%) subjects without premature ejaculation had this problem in childhood. Enuresis in childhood was significantly more common in men with a premature ejaculation than controls. While 35 (58.3%) patients with premature ejaculation reported a history of psychological problems, only four (6.6%) controls reported this kind of problems. There was a significant difference between these groups regarding psychological problems. Conclusion. The results of this study suggest that the history of enuresis in childhood seems to increase the risk of having premature ejaculation and psychological problems in adult life. These results lead to a premise that these disorders may share a common etiology and/or neurological pathophysiology.