Search

Purpose: Bladder diary and questionnaire forms have an important role in the diagnosis of overactive bladder (OAB) syndrome and can predict response to OAB treatment. We aimed to evaluate the correlation between three different validated Turkish OAB questionnaires and bladder diary form. Methods: Patients aged over 18 years who admitted to the urology outpatient clinic with OAB symptoms between March 2019 and April 2020 were enrolled into the study. Demographic data of the patients were recorded, and they were asked to complete a 3-days bladder diary. In addition, the patients filled Turkish validated OAB version-8 (OABv8), the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF), and OAB Symptom Score (OABSS) questionnaire. The relationship between these questionnaire forms and bladder diary was evaluated with statistical analysis. The significant p was p Results: A total of 592 patients were included in the study. The mean total points of the questionnaire forms were 22.07 ± 8.34 (0–38) for OABv8, 10.78 ± 7.21 (0–21) for ICIQ-SF, and 9.36 ± 3.53 (0–15) for OABSS, respectively. There was a positive poor correlation between OABv8 questionnaire form and nocturia ( r = 0.287, p = 0.013). There was a positive moderate correlation between OABSS and the number of micturition ( r = 0.405, p = 0.03) and nocturia ( r = 0.508, p = 0.036), and the urgency incontinence was negatively moderate correlations ( r = −0.525, p = 0.041). Conclusion: Both questionnaire forms and bladder diaries are important in the evaluation of OAB patients. According to our results the bladder diary and OABSS questionnaire forms were interrelated.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the quality of life of patients with lifelong and acquired premature ejaculation and to examine its relationship with depression and anxiety. METHODS: Between February 2017 and January 2018, a total of 175 patients with premature ejaculation and 132 control men who applied to the urology department of the training and research hospital with the complaint of Premature Ejaculation were included. Patients were divided into three groups according to International Society for Sexual Medicine (ISSM) criteria as follows: Group 1, lifelong premature ejaculation; Group 2, acquired premature ejaculation, and Group 3, control group without premature ejaculation. A detailed medical history of patients was obtained and physical examinations were performed. Intravaginal ejaculation latency time (IELT) was recorded and patients were administered International Erectile Function Index-5 (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Sexual Health Inventory for Men (SHIM), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI)-1 and STAI-2, and Short Form-36 (SF-36). RESULTS: The mean mental component score (MCS) of the SF-36 was 51.65±6.57 in the lifelong premature ejaculation group, 49.33±8.65 in the acquired premature ejaculation group, and 61.12±11.09 in the control group (p

Mean platelet volume (MPV) has been related to erectile dysfunction (ED). However, its value in predicting therapeutic response to phosphodiesterase-5 inhibitors is not evaluated. This study aimed to investigate the value of MPV as a marker for the prediction of the response of the tadalafil treatment of ED. A retrospective analysis of patients who were admitted to the andrology outpatient clinic between 2020-2022 were performed. The inclusion criteria were, ≥40 years old male, International Index of Erectile Function-Erectile Function domain score 26, not received any ED treatment before, have a stable heterosexual relationship, and prescribed 5 mg daily tadalafil for primary treatment of ED. A total of 116 patients were included in the study. The mean age of the patients was 53.7 ± 8.7 years. The response rate to 5 mg tadalafil treatment was 52.6% (Group-1; N = 61). An MPV value

Clean intermittent catheterization (CIC) is an effective and reliable catheterization method widely used to ensure bladder management. However, pain or discomfort that is commonly seen during catheterization in individuals performing CIC may lead to anxiety and changes in many activities of daily living, particularly in sexual function. The aim of this study was to determine the anxiety levels and sexual functions of patients performing CIC and the relationship between. This descriptive study included a total of 102 patients performing CIC who were followed at a urology outpatient clinic of a state hospital. Data were collected by using Structured Information Form, Visual Analog Scale (VAS), State-Trait Anxiety Inventory (STAI), Female Sexual Function Scale (FSFI) and International Erectile Function Index-5 (IIEF-5). Statistical analyses were performed using descriptive statistical methods, Pearson Product-Moment Correlation Coefficient and Regression Analysis. Mood scores (VAS) of the patients were 6.56 ± 1.52. The mean IIEF-5 score was 8.47 ± 4.59 in male patients and the mean FSFI score was 17.62 ± 6.2 in female patients. Erectile dysfunction was found in 73.47% of male patients and sexual dysfunction was present in 64.15% of female patients. The STAI-1 score was found to have a negative moderate correlation with IIEF-5 and FSFI scores (p ≤ 0.05). Furthermore, evaluation of the factors related to sexual dysfunction showed that smoking, female sex, anxiety level, duration of CIC, mood and wheelchair use increased the probability of developing sexual dysfunction. Determining the anxiety and sexual function levels of individuals performing CIC, prioritizing the factors that may affect sexual function, and using appropriate therapeutic approaches are thought to be able to increase the individual's adaptation and have a positive effect on their sexual lives.

The aim of this study was to evaluate the effect of vitamin D replacement in patients with lower urinary tract symptoms (LUTS)/erectile dysfunction (ED) who did not respond to tadalafil 5 mg treatment. Patients who applied to the Andrology Clinic with LUTS/ED between September 2017 and August 2020 and used 5 mg Tadalafil daily for treatment and did not benefit from treatment for 1 month were included in the study. Vitamin D levels of the patients were analysed and Vitamin D3 100,000 IU/week oral therapy was administered for a month to the patients with low levels of Vitamin D(20 ng/ml).The values of the patients before and after Vitamin D replacement were compared. A total of 84 patients were included in the study. The mean age was 49.175 ± 11.63(28-70) years and the mean BMI was 25.93 ± 6.82(18.26-37.87). Testosterone levels of the examined patients were 3.45 ± 0.99 ng/ml. After 1 month of Vitamin D replacement + Tadalafil 5 mg/d treatment, the international index of erectile function-erectile function (IIEF-EF) (pre-treatment: 10.73 ± 6.12, post-treatment: 24.18 ± 4.87; p = 0.001) and International Prostate Symptom Score (pre-treatment: 9.12 ± 7.16, post-treatment: 3.11 ± 1.08; p = 0.003) scores of the patients improved significantly. Evaluation of Vitamin D levels is important to improve treatment response, especially in patients who do not respond to PDE-5 inhibitors.

The aim of this study was to evaluate the content, reliability and quality of YouTube videos related to pelvic floor muscle exercise training. This study was carried out on the descriptive model in order to evaluate the content, reliability and quality of the videos on YouTube related to pelvic floor muscle exercise training. “Pelvic floor muscle exercise” was searched on YouTube in English in March 2020, and a total of 107 videos were watched. Quality Criteria for Consumer Health Information (DISCERN) survey was used to analyze the videos in terms of their reliabilities, and Global Quality Score (GQS) was used to evaluate their qualities. When the contents of 59 videos included in the study were examined, it was determined that 52 of them contained useful information and 7 of them contained misleading information. Comprehensiveness mean scores, DISCERN mean scores and GQS means of the useful videos were found to be statistically higher than that of the moderate and misleading videos (p

Objective:Overactive bladder (OAB) may be interrelated with chronic inflammation. The aim of this study was to assess the role of neutrophillymphocyte ratio (NLR) levels in men and women with OAB symptoms.Methods:Between January 2017 and February 2018, a total of 157 subjects (77 OAB patients and 80 controls) were included in the study. The subjects divided into two groups. Group 1=OAB patients and group 2=normal controls. Patients with active urinary tract infections, previous pelvic surgery or neurogenic patients were excluded. The enrolled both patients and control group were questioned using the 8-item OAB questionnaire (OAB-v8) complete blood count and serum C-reactive protein (CRP) levels were measured in the first visit.Results:The mean NLR was 1.73±0.67 in patients and 1.48±0.75 in control groups (p

Aside from the ordinary plasma lipid level measurements, the ratios based on individual plasma lipid levels such as atherogenic index of plasma (AIP), Castelli's risk index 1/2 (CRI-1/2), and atherogenic coefficient (AC) are the novel parameters to evaluate the patients with a high risk of CVD. In this study, we aim to evaluate the relationship between AIP, AC, and CRI-1/2 with increased risk of ED. Between April 2018 and February 2019, 253 patients, who were diagnosed as a vasculogenic ED in our clinic, were enrolled in the study. While the first group (

Introduction Peyronie’s disease (PD) prevalence varies between 0.39% and 20% and studies on PD prevalence are limited. Aim This study aims to determine the prevalence of PD in males aged ≥30 years in Turkey and to evaluate etiological factors associated with it. Methods The study was conducted in 12 regions of Turkey according to the Eurostat Nomenclature of Territorial Units for Statistics 1 classification and included 1,208 patients. Survey questionnaires including questions about demographic features and basic health status as well as about diagnosis and etiology of PD were put forth to the volunteers who agreed to participate in the study. Diagnosis of probable PD was established by evaluating the questionnaires. Patients with a diagnosis of congenital penile curvature were excluded from the group with PD. Chi-square test, Fisher’s exact test, and Mann-Whitney U test were used. Main Outcome Measure The primary outcome analyzed in this article was the prevalence rate of PD in Turkey and the associated comorbidities. Results The prevalence of PD was determined as 5.3%. The rates of participants with PD were found to be the highest in the 50–59 years group (27%) and in the North-East Region (20%). Compared with participants without PD, participants with PD were older (median: 52 interquartile range [41–64] vs 45 [37–55]; P < .001) and the rates of smokers (73% vs 60.9%; P = .036) and those having diabetes mellitus (17.5% vs 9.2%; P = .045), hypertension (14.3% vs 6.9%; P = .041), and heart failure were higher (7.9% vs 2.5%; P = .027). Male with PD symptoms preferred their partners on top during sexual intercourse (15.2% vs 34.1%; P < .001). This is the first study to evaluate premature ejaculation prevalence and related comorbidities with face-to-face interviews. Conclusion The prevalence of PD was 5.3% in Turkey. Besides advanced age, smoking, position of sexual intercourse, and presence of comorbidities especially diabetes mellitus, hypertension, and heart failure were the factors associated with PD prevalence.

SUMMARY OBJECTIVE: Stress-type and urgency-type urinary incontinence are seen together in mixed-type urinary incontinence. Treatment is usually chosen according to the predominant type of incontinence. The aim of this study is to evaluate the effect of mirabegron and duloxetine combination in the treatment of mixed-type urinary incontinence. METHODS: The data of 88 mixed-type urinary incontinence patients who applied to the urology outpatient clinic between January 2018 and December 2019 were retrospectively analyzed. We applied mirabegron and duloxetine treatment to the patients. The International Consultation of Incontinence Questionnaire-Short Form, Overactive bladder symptom score questionnaire and daily pad count were statistically evaluated before and after the treatment. RESULTS: Statistically significant improvements were observed using the questionnaire forms and decreased daily pad usage after the eight-week treatment (p

Overactive bladder (OAB) is a syndrome with symptoms such as urinary frequency, urinary urgency and urge incontinence. The aim of this study is to assess the validity and reliability of the Turkish overactive bladder symptom score (OABSS) and to evaluate the results of mirabegron treatment with OABSS. The study was carried out with 117 patients who applied to the urology outpatient clinic between June 2018–January 2019. OABSS Turkish validation was developed from the English version. Demographic data of the patients were recorded. The OABSS, overactive bladder questionnaire (OAB-v8) and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were filled out by the patients. The patients were asked to fill in these questionnaires after 2 weeks. Patients receiving mirabegon treatment were evaluated with the same questionnaires and bladder diaries after 8 weeks. A total of 117 OAB patients, including 82 OAB-wet and 35-OAB dry, were included in the study. The mean age of the patients was 46.79 ± 14.26 (18–78) years, and the mean duration of OAB complaint was 32.28 ± 32.21 months. The mean score of the OABSS is 9.9 ± 3.14. The results of the reliability assessment showed that the intraclass correlation coefficient of the total OABSS score was 0.71 (weighted coefficients of individual item points, 0.635–0.831), and the Cronbach α was 0.736. In the validity analysis, the OABSS total score was highly correlated with that belonging to other questionnaire forms (OAB-v8, ICIQ-SF and bladder diary). After the treatment with mirabegron, mean OABSS scores of the patients improved significantly from baseline to the 8th week (p

Aim and objectives The aim of this was to examine the effect of bladder training on bladder functions. Background Urinary catheterization is frequently performed in order to evaluate the outcomes of the surgical procedures and to monitor the urine output after urology operations. Design and methods This quasi-experimental study was conducted in the urology clinic in Istanbul, Turkey in which 50 males were nonrandomly assigned to either a bladder training (n = 28) or a control group (n =22). In the bladder training groups, the urinary catheters of the patients were clamped at 4-hr intervals and then were left open for 5 min on the second postoperative day. This study was created in accordance with TREND Statement Checklist. Results The first urgency time and the first voiding time were longer, and the prevoiding and the voiding volumes were higher following the removal of the catheter in the training group (p = 0.001). In addition, the evaluation of the patient bladder diaries in the first three days after the discharge period revealed that the daily frequencies of micturition and nocturia were lower (p = 0.04), the mean duration of intervals between the micturition was longer (p = 0.006), and the mean voided urinary volume was higher (p = 0.024) in the training group. Conclusion At the end of the study, it is observed that bladder training performed by clamping the catheter on postoperative day 2 after Transurethral Resection of Prostate (TUR-P) operation is a significant positive effect on the storage symptoms of the patients. Relevance to clinical practice Before removing the urinary catheter, bladder training programme affects positively to patients, especially prevoiding and the voiding volumes, the daily frequencies of micturition and nocturia on postoperative periods.

Introduction Even though lifelong premature ejaculation (PE) is highly prevalent, few studies have investigated the neural mechanisms underlying PE. Aim This study aimed to investigate whether patients with lifelong PE exhibit macrostructural or microstructural alterations of the parts of the brain involved in the male sexual response. Materials and Methods We enrolled 42 healthy participants and 54 lifelong PE patients. Lifelong PE was diagnosed according to the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT). We compared measures of cortical morphology, such as volumes of gray matter, white matter, cerebellum volumes, and subcortical structures (ie, amygdala, caudate, hippocampus, globus pallidus, putamen, and thalamus) between the groups using a voxel-based morphometry method from whole-brain T1-weighted magnetic resonance imaging. Moreover, we evaluated the relationships between the relevant cerebral alterations and the severity of symptoms obtained from participants via self-reported questionnaires. Main Outcome Measures Cerebral macrostructural and microstructural alterations were assessed in PE patients and controls, along with the correlation of caudate nucleus changes in PE patients with clinical data (including the PEDT and the IELT). Results The mean volume of the caudate nucleus was significantly larger in the lifelong PE patients compared with healthy controls (P = .048). Moreover, caudate nucleus volume was positively correlated with PEDT score (r = 0.621; P = .0179) and negatively correlated with the IELT (r = −0.592; P = .0101). However, cortex morphology and the other subcortical volumes were not significantly different between the 2 groups (P > .05). Clinical Implications Microstructural alterations in deep gray matter nuclei might be a useful parameter for studying the mechanism of the neurobiology underlying PE. Strengths and Limitations There are few studies examining microstructural changes in PE patients. This study furthers our understanding of the etiology of PE. Limitations include the small sample, which limits our ability to make an absolute determination as to whether such subcortical changes are the cause or the consequence of lifelong PE. Conclusions We found a significant difference in caudate nucleus volume between patients with PE and healthy controls. In addition, the caudate nucleus volume was positively associated with the severity of PE symptoms. More extensive and possibly longitudinal studies are needed to improve our understanding of the mechanism of the neurobiology underlying PE.

Erectile dysfunction (ED) is seen very often in the men with type 2 diabetes mellitus (DM). Due to the ability of vitamin D to reduce endothelial damage and oxidative stress, its role in preventing cardiovascular risk has been demonstrated in some studies. Since ED and cardiovascular disease have common pathogenic mechanisms, many studies have evaluated a possible relationship between vitamin D deficiency and ED. Total 120 patients with type 2 diabetes mellitus were evaluated in this study. Vitamin D and HbA1c values were statistically compared according to International Index of Erectile Dysfunction (IIEF-5) scores. 23.3% of 120 patients had mild, 38.3% had mild to moderate, 21.7% had moderate and 16.7% had severe ED. There was statistically difference in vitamin D levels of the patients according to IIEF-5 scores. Also, significant difference was found in HbA1c levels between the patients with severe ED and other groups. Cut-off point for vitamin D and HbA1c were determined according to IIEF-5 score in patients who were divided in to two groups (14.41 and 11.1). A statistically significant correlation was found between both cut-off points and IIEF-5 scores. Our study shows that patients with ED have a vitamin D deficiency and a poor glycemic control.

This study aims to assess the validity and reliability of the Turkish version of the FSFI-6 questionnaire,an abbreviated version of FSFI-19,a common tool for evaluating female sexual function. The study included 120 female patients aged between 18–65 years who presented to the urology clinic between December 2019 and March 2020. The Turkish version of FSFI-6 was translated from the English version for validation. The abridged FSFI-6 questionnaire consists of questions 2, 4, 7, 11, 16, and 17 of the FSFI-19 form. We recorded the demographic data of the patients. All subjects filled out the FSFI-19 and FSFI-6 questionnaires. The patients were asked to fill out the questionnaires again after two weeks. The mean age of the subjects was 46.58 ± 9.89 years (28–63). The results of the reliability analysis indicated that the intraclass correlation coefficient of the total FSFI-6 score was 0.92 (weighted kappa coefficients of individual items, 0.868–0.975) and the Cronbach’s alpha was 0.862. The validity analysis indicated that the mean total FSFI-6 score was strongly correlated with the mean FSFI-19 score (p

AIM To assess the functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG). MATERIALS AND METHODS A total of 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3-day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence-Short Form" (ICIQ-SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status. RESULTS The most common urinary symptoms were nocturia (80.5%), incontinence (61%) and urgency (47%). OABSS was higher in patients than controls (P = .008). Duration of urinary symptoms was longer, and nocturia was more common in late-onset MG (LOMG) than in early-onset MG (EOMG; P = .029, P = .023). The duration of disease and urinary symptoms statistically increased in ACh-Ab (-) group compared with ACh-Ab (+) group (P = .003, P = .027). Night-time urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared with EOMG (P = .003 and P = .01). Residual volume on the US was significantly higher in LOMG than that in EOMG (P = .004). The duration of disease was positively correlated with tQmax and daytime urination frequency (P = .013, r = .48; P = .016, r = .398). A negative association was found between duration of disease and daytime VV (P = .04, r = -.344). CONCLUSION LUT dysfunction may manifest disease in MG, particularly in late-onset forms. The lack of ACh-Ab seemed to prolong the duration of disease and urinary disturbances.

Aetiologic and predisposing factors are still controversial about Peyronie's disease (PD). However, it is thought to be the result of connective tissue disorder or healing defect. Androgens are known to affect collagen metabolism and wound healing in the body. The aim of this study was to investigate the relationship between PD and low testosterone levels. One hundred and forty-seven Peyronie patients and 137 healthy volunteers were included in the study. In both groups, demographic data, medical history, physical examination and erectile capacity were recorded. Blood samples were collected from all subjects in the early morning hours after an overnight fast. The mean level of serum total testosterone was lower in men with PD compared with the controls (3.9 ± 1.1 vs. 4.2 ± 1.7 ng/ml respectively) (p = .062). However, statistically significant relationship was not found between PD and low serum testosterone levels. There was no significant correlation between penile plaque dimension or penile curvature degree and testosterone levels. Large randomised-controlled prospective studies are needed to reveal this possible association.

We aimed to investigate the pre-operative predictive role of haematological parameters in patients with testicular torsion. The medical records of patients operated between January 2016 and November 2018 were retrospectively analysed. The demographic characteristics and complete blood count of the patients were recorded. We divided the patients who operated with testicular torsion into two groups: detorsion (Group 1) and orchiectomy (Group 2). A control group (Group 3) was created from healthy volunteers. All haematological parameters and other demographic data were compared between three groups. A total of 144 participants were included; Group 1, Group 2 and Group 3; 61, 27 and 56 respectively. The duration of symptoms and monocyte counts were found statistically significantly higher in patients undergoing orchiectomy than detorsion (p

Background The aim of this study is to evaluate the validity and reliability of the Targeting the Individual's Aetiology of Nocturia to Guide Outcomes (TANGO) screening tool, which is used to determine nocturia etiology. Methods Patients hospitalized in urology, orthopedics, and general surgery clinics between September 2019 and January 2020 were included in the study. Demographic characteristics of the participants such as age, gender, drug use, and nocturia severity were assessed by the researchers. The Turkish version of the TANGO questionnaire consisting of 22 questions was filled in by the patients. The patients were asked to repeat the same test 4 weeks later. Results A total of 124 patients were included in the study. The mean age of the patients participating in the study was 51.20 ± 18.50 (38-82). The result of the reliability assessment showed that the total score intraclass correlation coefficient was 0.715 (individual item score weighted kappa coefficients, 0.696-0.731) and the Cronbach's alpha coefficient was 0.727. A total of 112 patients filled in the TANGO screening tool again after 4 weeks. The test-retest reliability analysis kappa value was 0.75 (0.68-0.83). In the validity analysis, a moderately positive correlation was observed between the TANGO-Urinary Incontinence Score and the number of nocturia (r = 0.452, P = .003). Conclusion According to the validation study, the TANGO screening tool is valid and reliable to determine the nocturia etiology for the Turkish population.

WOS:000576289000011 PubMed ID: 33017899 Purpose: The aim of this study was to assess the clean intermittent catheterization (CIC) training and education videos on YouTube. Methods: This study was conducted in English language in descriptive type to evaluate the content, reliability, and quality of Internet videos related to CIC training. The search was performed by using term "clean intermittent catheterization" and "intermittent self catheterization" on YouTube in August 2019. The content of the selected videos was analyzed by 2 independent experts in the field. The DISCERN questionnaire was used to analyze the reliability of the video and the global quality score (GQS) was used for the quality of the video. Results: When the contents of the 64 videos included in the study were examined, it was found that 41 of them contained useful information and 23 of them contained misleading information. DISCERN scores, video coverage scores, and GQS of videos with useful information were found to be statistically higher than those with misleading information (P< 0.001). When the sources of the videos were examined, it was seen that 78.05% of the videos containing useful information were published by medical advertisement/for-profit companies (P< 0.001). The reliability scores, coverage scores, and GQS of the videos from medical advertisement/for-profit companies were significantly higher than the other sources (P< 0.001). Conclusions: In this study, it was seen that the majority of YouTube CIC training videos examined within the scope of the research were published by medical advertisement/for-profit companies and most of these videos contain useful information.

Testicular sperm extraction is a common surgical procedure to retrieve spermatozoa from men with azoospermia which may affect the tissue and cause hypogonadism (Human Reproduction Update, 24, 2018, 442). We aimed to evaluate the acute effect of micro-TESE on blood total testosterone (TT) and luteinising hormone (LH) levels. Between April 2018 and September 2019, 60 selected NOA (i.e. with normal TT and LH) patients were included in the study. After procedure, blood samples were collected to evaluate the levels of TT and LH at 1st and 24th hour and first week. Values were compared. In addition, patients were divided into two groups according to their body mass index. Mean age of patients was 27.37 ± 4.52 years, and mean of body mass index was 24.49 ± 3.78 kg/m2 . Mean TT levels at the 1st hour, 24th hour and the 1st week were 3.81, 3.50 and 3.05 ng/ml respectively. Mean LH levels at the 1st hour, 24th hour and the 1st week were 5.03, 5.15 and 5.46 IU/L respectively. Statistically significant differences between pre- and post-operative 24th hour and 1st week values were detected (p = .001, p < .001 respectively). No statistical differences were found between two BMI's groups. TT decreased in acute period after the procedure, whereas the increase of LH levels was observed after 24th hour.

In our study, we examined the effect of the three-dimensional (3D) stone segmentation volume and its ratio to the renal collecting system on complication rates. Data from141 patients who underwent PCNL surgery were analyzed retrospectively. Volume segmentation of both the renal collecting system and stones was obtained from 3D segmentation software with the images on CT data. After creation of a 3D surface volume rendering of renal stones and the collecting system, segmentation of the renal collecting system volume (RCSV) and analyzed stone volume (ASV) was analyzed and the ASV-to-RCSV ratio was calculated. Univariate analysis and multivariate logistic regression model were used to determine factors that affected complication status. Diagnostic value for the prediction of complication rates was analyzed using receiver operating characteristic (ROC) incline. Overall, there were 141 (92 male and 49 female) eligible patients included in the current study. The overall complication rate for PCNL monotherapy was 31.9%. Multivariate regression analysis (forward stepwise) revealed that the ASV-to-RCSV ratio and number of tracts were independent risk factors for developing complications (OR 1.17, p

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is often associated with erectile dysfunction (ED). However, the underlying pathophysiological mechanisms of ED occurrence are still unclear in patients with CP/CPPS. The aim of the study was to investigate superoxide anion (O2•−) and total reactive oxygen species (ROS) production in semen of men with category IIIA CP/CPPS and their association with ED. This prospective study included 33 men with category IIIA CP/CPPS. Control group consisted of 13 healthy men. Total ROS and O2•− production were assayed by luminol and lucigenin-dependent chemiluminescence (CL) methods, respectively. ED was evaluated using the IIEF-5 questionnaire. Patients with CP/CPPS had significantly higher seminal total ROS and O2•− levels than healthy control subjects (2.9 ± 0.5 relative light unit (RLU) vs. 2.4 ± 0.2 RLU, p

Background: The aim of this study was to evaluate the relationship between mean platelet volume (MPV) and vitamin D levels according to ED severity.Methods: Between October 2015 and September 2017,...

Introduction: We investigated the clinical characteristics of patients who underwent penile fracture surgery.Methods:Between December 2005 and February 2015, a total of 45 patients underwent surgery for repair of penile fracture at our institution. The age and body mass index (BMI) of these patients were recorded along with their medical history and physical examination findings. Moreover, the duration of the operation was noted, and the preoperative International Index of Erectile Function-Erectile Function (IIEF-EF) scores were compared with postoperative scores.Results:Average age of patients was 41.25±11.78 (20-65) years, and average BMI was 26.36±3.17 (23.67-29.72) kg/m2. Of the patients, 18 (40%), 16 (35.5%), 5 (11.1%), 3 (6.7%), and 3 (6.7%) cases had the fracture during sexual intercourse, during sleep, with sudden penile maneuvers, during masturbation, and with trauma, respectively. Mean operation time was 38.32±19.74 (20-90) min, and mean hospital stay was 1.28±0.61 (1-3) days. Most of the cases (26/45) were performed under spinal anesthesia. There was only one patient with urethral injury. Mean preoperative IIEFEF score was 26.12±3.21 (19-30), and mean IIEF-EF score at postoperative 3rd month was 23.37±3.87 (10-27). We found significant differences between preoperative and postoperative scores (p=0.011). Postoperative penile curvature was observed in 2 (4.4%) cases, and painful erection was seen in 2 (4.4%) cases.Conclusion:Penile fracture requires urgent intervention in the urological practice. The majority of the cases occur during sexual intercourse. Although the management of penile fracture is not complicated, postoperative erectile problems are not rare.

Purpose: To identify the factors increased fluoroscopy time during percutaneous nephrolithotomy and investigate the relationship between the 3D segmentation volume ratio of stone to renal collecting system and fluoroscopy time. Materials and Methods: Data from 102 patients who underwent percutaneous nephrolithotomy were analyzed retrospectively. Volume segmentation of both the renal collecting system and stones were obtained from 3D segmentation software with the images on CT data. Analyzed stone volume (ASV), renal collecting system volume (RCSV) measured and the ASV-to-RCSV ratio was calculated. Several parameters were evaluated for their predictive ability with regard to fluoroscopy time. Results: The stone-free rate was 55.9% after the percutaneous nephrolithotomy. Complications occurred in 31(30.4%) patients. The mean fluoroscopy time was 199.4±151.1 seconds. The fluoroscopy time was significantly associated with the ASV-to-RCSV ratio (p

Micropercutaneous nephrolithotomy (microperc) is a new minimal-invasive technique.We aimed to investigate whether preoperative hydronephrosis has an impact on the stone-free rate of microperc.In this study, 66 consecutive patients were included and divided into 2 groups:patients without preoperative hydronephrosis (group-1) and patients with preoperative hydronephrosis (group-2).Both groups were compared for age, gender, body mass index (BMI), stone burden, stone location, fluoroscopy and operative time, blood loss, stone-free rate and perioperative and postoperative complication rates. Parameters were analyzed using univariate and multivariate analyses for the stone-free rate.The mean age, gender, BMI, stone location, and blood loss were similar in both groups (p0.05). Stone burden in group-2 was greater than group-1 (p=0.011). In addition, mean fluoroscopy time in group-1 was found to be significantly lower (p0.05). However, operative time was comparable among the groups (p=0.169). Lastly, group-2 had a higher rate of perioperative and postoperative complication rates and lower success rate (p=0.023, p=0.027 and p=0.001, respectively). The success was significantly affected by hydronephrosis, stone burden and location (p0.05). Logistic regression analysis revealed that unsuccessful outcome was significantly associated only with the presence of hydronephrosis (OR 0.225,p=0.033).This study seems to suggest that presence of hydronephrosis is a major factor on the stone free rate of microperc procedures.La nefrolitotomíamicropercutanea (microperc) es una nueva técnica mínimamente invasiva. Investigamos si la hidronefrosis preoperatoria tiene un impacto sobre la tasa de pacientes libres delitiasis de la microperc.MÉTODOS: En este estudio, 66 pacientes consecutivos fueron incluidos y divididos en 2 grupos: pacientes sin hidronefrosis preoperatoria (grupo 1) y pacientes con hidronefrosis preoperatoria (grupo 2). Se compararon ambos grupos por edad, género, índice de masa corporal (IMC), carga litiásica, localización de la litiasis, fluoroscopia y tiempo operatorio, sangrado, tasa de pacientes libres de litiasis, y tasas de complicaciones peri y postoperatorias. Las variables fueron analizadas utilizando análisis uni y multivariado para la tasa de pacientes libres de litiasis.Edad media, género, localización de la litiasis y sangrado fueron similares en ambos grupos (p0,05). La carga litiásica en el grupo 2 era mayor que en grupo 1 (p=0,011). Además, el tiempo medio de fluoroscopia en el grupo 1 era significativamente menor (pera comparable en los dos grupos (p=0,169). Finalmente, el grupo 2 tenía una tasa de complicaciones peri y postoperatorias mayor y una tasa de éxitos menor (p=0,023, éxito estaba significativamente influido por la hidronefrosis, la carga litiásica y la localización de la litiasis (p0,05). El análisis de regresión logística reveló que los resultados sin éxito se asociaban significativamente sólo con la presencia de hidronefrosis (OR 0,225,p=0,033).CONCLUSIÓN: Este estudio parece sugerir que la presencia de hidronefrosis es un factor principal en la tasa de pacientes libres de litiasis de los procedimientos de microperc.

Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologic factors among patients with acquired PE. Between May and July 2016, 53 men with acquired PE were included in the study. Self-estimated intravaginal ejaculation latency time (IELT) of these patients was recorded along with their medical history and physical examination findings. Moreover, 5-item version of the International Index of Erectile Function (IIEF-5), premature ejaculation profile (PEP), anxiety and depression scales (STAI-1, STAI-2, and BECK), and chronic prostatitis symptom index (NIH-CPSI) were administered. Fasting plasma glucose, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total and free testosterone, total prostate specific antigen, thyroid and thyroid stimulating hormone levels were measured. Urine analysis and 2 cup tests were also studied. Mean age of the patients was 42.41 ± 11.14 (22–60). Mean duration of the PE complaint was 34.18 ± 36.76 (3–144) months. Mean IELT time of the patients was 38.28 ± 30.79 (3–180) s. Of the patients; 69.81%, 62.26%, 56.60%, 45.28%, 30.19%, 24.53%, 16.98%, 15.09%, and 7.55% had depression, chronic prostatitis, erectile dysfunction, anxiety, diabetes mellitus, abnormal FSH or LH, hypoprolactinemia, hyperthyroidism, and high testosterone levels, respectively. The results of our study revealed that anxiety disorders, depression, erectile dysfunction, and chronic prostatitis are common among patients with acquired PE and may play role in the etiology of this problem. There is a need for further researches related to the exact pathophysiology of acquired PE with larger number of patients.

The aim of this study is to investigate whether serum vitamin D level predicts the risk of Peyronie's disease. Calcium and inflammatory cytokines play an important role during fibrocalcification of the plaques in Peyronie's Disease. TGF-β1 is one of the most fibrogenic cytokines. Increasing serum vitamin D levels is considered that induce expression of TGF-β1. Serum vitamin D levels and TGF-β1 are related with calcifications of some soft tissues in previous studies. One hundred and three Peyronie patients and 162 healthy volunteers were included in the study. In both groups, demographic data, medical history, physical examination and erectile capacity were recorded. Serum 25-hydroxyvitamin D, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and testosterone levels were measured. The mean level of serum 25 (OH) D was significantly higher in men with Peyronie's disease compared with the controls (32.6 ± 7.9 ng/ml vs. 18.5 ± 6.6 ng/ml respectively. p < 0.001). There is a relationship between Peyronie's disease and high serum vitamin D levels. Also, increased low-density lipoprotein and total cholesterol levels, diabetes mellitus, and cardiovascular diseases were associated with Peyronie's disease.

Purpose: Peyronie disease (PD) occurs as a result of recurrent microvascular injuries or trauma of the tunica albuginea, although its precise etiology is unknown. Mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), which are parameters indicative of platelet activity, are considered to be functional markers of platelets involved in the pathophysiology of related inflammatory and vascular diseases. In this study, we aimed to examine the relationship between PD and platelet indices. Materials and Methods: We evaluated participants who presented to the andrology department of our institution between December 2015 and May 2018. Ninety-two men with PD and 80 healthy volunteers were included in this study. Participants who had received medical treatment affecting platelets or had any hematologic or systemic diseases were excluded from the study. Results: The mean age of men with PD was 53.8±10.2 years, and the mean age of the control group was 52.2±8.0 years (p=0.465). There were no significant differences in the mean IIEF-5 scores, platelet count, MPV, PDW, or PCT between the patients with and without PD (p

Objectives: The aim of the study is to investigate the predictive value of ischemia-modified albumin (IMA) as an oxidative stress indicator in renal ischemia-reperfusion (I/R) injury. Methods: Forty female Wistar Albino rats were divided into 5 groups: Group-1, sham; group-2, 20 min I/R, group-3, 30 min I/R; group-4, 40 min I/R; and group-5, 60 min I/R. Blood samples were taken, and nephrectomy was performed in the sham group before ischemia was induced. At the end of the defined periods for each group, reperfusion was achieved and a blood sample was taken and nephrectomy was performed. At the end of the 6-hour reperfusion period, the blood sample was taken again and the other kidney is removed. IMA in serum and total anti-oxidant status (TAS), total oxidant status (TOS), and oxidative stress index in both serum and tissue were examined. Results: Serum IMA values were significantly different between the groups (p = 0.009), and there was a significantly difference in TOS values between ischemic serum (p = 0.024) and tissue samples (p = 0.02). However, there was no significant difference in serum and tissue TAS values after ischemia (p = 0.9). Serum IMA, TOS and TAS and tissue TOS and TAS values after reperfusion were not significantly different. There was a significant correlation between tubular damage and ischemia duration in histopathological examination of renal tissue after I/R (p < 0.0001). Conclusion: Serum IMA values increased in parallel with the duration of ischemia, and this increase was supported by histopathological damage findings.

Introduction: This study aimed to evaluate the clinical results of penile prosthesis implantation for treating patients with organic erectile dysfunction (ED).Methods: Between January 2006 and December 2015, medical records of penile prosthesis implantation for treating 47 patients with organic ED were retrospectively reviewed. The demographic data of patients, causes and duration of ED, operation time, hospitalization time, types of prosthesis, and intra- and postoperative complications were evaluated.Results: The mean age of patients was 54.63±9.69 years, and the mean body mass index of the patients was 26.71±6.57 kg/m2. The mean duration of ED was 45.36±24.82 months. Etiological factors were diabetes mellitus in 30 patients (%64), cardiovascular diseases in eight (%17), radical pelvic surgery in four (9%), radiotherapy in two (4%), spinal surgery in two (4%), and genital trauma in one (2%). Thirty-three patients (70.2%) were smokers. The mean operation time was 109.6±28.41 min, and the mean hospitalization time was 2.64±1.57 days. In 42 patients (88.8%) who were implanted with malleable penile prosthesis, malleable penile prostheses of two different trademarks were used. Five (11.2%) inflatable penile prostheses were implanted in the remaining patients. The penile prosthesis implantation was performed under general anesthesia with antibiotic prophylaxis using vancomycin and gentamicin. No preoperative complications were observed. Postoperative complications were acute urinary retention in one patient, penile pain in one, and re-implantation because of mechanical failure in one. Two prostheses were completely removed because of an infection. The patients were followed up for 21.04±28.72 months. The satisfaction rate of the patients was 67%.Conclusion: Although penile prosthesis implantation is an invasive treatment option for patients with organic ED, it can be safely and effectively performed in these patients. Despite appropriate surgical techniques, infection is the most common complication of this operation, although it provides patient and their partner’s satisfaction.

Renal angiomyolipoma (AML), a rare benign mesenchymal neoplasm, is characterized by the presence of vessels, smooth muscle, and adipose tissue. Treatment should be considered for symptomatic patients or for those at risk for complications, in particular for retroperitoneal bleeding, which is correlated to the size of the tumor, grade of the angiogenic component, and presence of tuberous sclerosis complex. Herein, we report the case of a 39-year-old female with renal AML who was treated in a conservative approach by super-selective embolization.

Infection is one of the most devastating complications of penile prosthesis implantation. Although the infection prevalence have decreased owing to new technologies and growing surgical experience, it is still a troublesome situation. We present a 50-year-old male patient who had necrotizing fungal infection after penile prosthesis implantation caused by Trichosporon asahii.

Intrauterine contraceptive devices (IUDs) are frequently used for birth control. Side-effects such as vaginal bleeding and localized pelvic pain are most common, and uterine perforation and migration of the adjacent organs are rare, but serious, complications. Herein we present the case of a 46-year-old woman who had a bladder stone because of an IUD that had migrated to the bladder and encrusted.

Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetine/sildenafil combination therapy for these patients. The aim of this study is to evaluate the clinical efficacy and safety of the dapoxetine/sildenafil combination (Dapoxil® 30/50 mg film-coated tablet) in the treatment of patients with PE and concomitant ED. In a single-center, single-arm, open-label clinical study conducted between October 2016 and September 2017, 74 patients with lifelong or acquired PE and ED were included. All patients were instructed to record their intravaginal ejaculatory latency time (IELT) with a stopwatch for 4 weeks. After the screening, they were requested to complete Premature Ejaculation Diagnostic Tool (PEDT), Premature Ejaculation Profile (PEP), and International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaires before the treatment. The patients received on demand Dapoxil® 1–3 h before sexual intercourse for the next 4 weeks (2 days a week and no more than once a day). The patients were also assessed with global impression of change (GIC) question for the treatment satisfaction and the side effects were recorded. The study was completed with 53 patients (53/74, 71.62%). Mean age of the patients was 45.32 ± 10.05 years. At the end of the 4-week treatment period, the geometric mean IELT of the patients significantly increased (from 22.72 ± 15.16 to 68.25 ± 82.33 s; p

The aim of the study was to determine the effect of anticholinergics used for overactive bladder treatment on the sexual function of women. Between January 2016 and August 2018, over 18 years old, 216 sexual active women with OAB and 165 healthy women as control group were prospectively enrolled in the study. Five different anticholinergics were used for the treatment. Female Sexual Function Index (FSFI), eight-item overactive bladder awareness tool (OAB-V8), and Beck Depression Inventory form were completed before and after 3 months. Baseline and post-treatment scores were compared with a control group of age-matched healthy women. Patients with OAB reported at baseline significantly worse sexual function in all FSFI domains compared to healthy control group (21.47 ± 3.22 vs. 26.79 ± 5.56, p

Purpose: The objective of this study was to evaluate the effects of intratunical injection of platelet rich plasma (PRP) for the treatment of Peyronie’s disease (PD) in a rat model. Materials and Methods: Twenty male Sprague-Dawley rats (300–350 g) were randomly divided into 4 groups: sham, PD, PD + PRP, and PRP. The PD + PRP groups received intratunical injections with 0.1 mL PRP on day 15 (treatment) or day 0 (PRP effect). Forty-five days following transforming growth factor-beta 1 injection, rats underwent pathological examination. Tissues were evaluated histologically for fibrosis grade (Haematoxylin & Eosin staining), collagen/smooth muscle ratio (Masson Trichrome staining) and type III/type I collagen ratio (Picro-sirius red staining). Statistical analysis was performed by Kruskal-Wallis and chi-square followed by the Mann-Whitney U test for post hoc comparisons. Results: Significant changes were found in all 3 groups compared to the sham group (p < 0.0001 for fibrosis, p = 0.001 for collagen/smooth muscle ratio and p = 0.003 for type III/type I collagen ratio). The values in the PRP group and the findings in the PD group are similar (p = 0.122 for fibrosis, p = 0.221 for collagen/smooth muscle ratio and p = 1.0 for type III/type I collagen ratio). Conclusion: This is the first study of PRP on PD. As a result of pathological examinations, PRP shows PD-like effects in rats. PRP may be a cheap, easily accessible, and an effective disease model for PD treatment research.

Introduction 5-Alpha reductase inhibitors (5-ARIs) are widely used in the treatment of benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA). Aim To examine all available data on the effects of 5-ARIs on sexual functioning in AGA treatment and to assess whether 5-ARIs increase the risk of sexual dysfunction. Methods A literature review of publications at PubMed related to the subject was used. Main Outcome Measure We assessed erectile dysfunction, ejaculation impairment, and decreased libido. Results 5-ARIs may cause side effects such as erectile dysfunction, ejaculation problems, and decreased libido in patients. Their long-term impact and precise mechanism have not been clarified. Data from studies on 5-ARIs are important for drug selection and patient counseling. More training and awareness is needed for clinicians and patients to recover many patients from sexual adverse effects. Conclusion 5-ARIs used in the treatment of AGA have well-defined side effects, which can negatively affect sexual life. It is unknown and unpredictable which men using these drugs may be subject to these side effects and when these effects may appear. Studies have been insufficient to provide a clear answer to this question. Coskuner ER, Ozkan B, Culha MG. Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Sex Med Rev 2019;7:277–282.

The aim of this prospective, observational study was to investigate the relationship between premature ejaculation (PE) and female sexual response cycle, using the female sexual function index (FSFI). The FSFI evaluates female sexual function in six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. All men were considered to have PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine (ISSM) Committee. All men were also assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT) using stopwatch which was held by the partner. All women completed the FSFI. A total of 181 couples who had regular sexual intercourse with one partner for the past 6 months were enrolled the study. By the definition of ISSM Committee, there were 117 men with PE and 64 men without PE. Partners of men with PE had significantly lower total FSFI scores than did partners of men without PE (21.8 ± 3.5 for PE and 26.4 ± 3.1 for non-PE, p