Comparison of three different tadalafil regimens for erectile dysfunction treatment in patients with diabetes mellitus microvascular complications.

We aimed to compare the efficacy of three tadalafil regimens for patients with type-2 diabetes mellitus (DM), at least one microvascular complication and erectile dysfunction (ED). Sixty patients attending our urology clinic with erectile problems and diagnosed with ED, having DM for at least 5 years, and at least one microvascular complication linked to DM were identified and randomly divided into three groups-Group I: used 5 mg tadalafil daily, Group II: used 20 mg tadalafil 2 h before sexual relations twice a week and Group III: used 5 mg tadalafil daily and an extra 15 mg tadalafil 2 h before sexual relations twice a week. After treatment, the median International Index of erectile function (IIEF-5) scores were significantly higher in Group III (15) compared to Groups I (8.5, p = 0.01) and II (9, p = 0.035). The groups were comparable in terms of the percentage of positive responses to the sexual encounter profile (SEP) 2 and the Global Assessment Questionnaires (GAQ)-1. However, the percentage of patients with positive responses to SEP-3 (20%, 40% and 75%, respectively) (p = 0.002) and GAQ-2 (20%, 45% and 75%, respectively) (p = 0.002) was significantly higher in Group III. Therefore, using a combination treatment (daily 5 mg + 15 mg when needed) to treat erectile function in patients with DM-related ED in the first stage may be more efficient with the same reliability and greater patient satisfaction.

Evaluation of quality and reliability of YouTube videos on female urinary incontinence.

OBJECTIVES: Women often feel embarrassed about urinary incontinence, hesitate to see a doctor and search the internet to gain information on the disease. The objective of this study was to evaluate the quality of the most viewed YouTube™ pertaining to female urinary incontinence. MATERIAL AND METHODS: Sixty videos that met the inclusion criteria were assessed by two urologists through Quality Criteria for Consumer Health Information (DISCERN), Journal of the American Medical Association (JAMA) and Video Power Index (VPI) scoring systems. Videos' image type, video uploaders, general content, length, view counts, date of uploading, comment, like and dislike counts were also recorded and analyzed. RESULTS: Forty videos included real and 20 animation images. Nine videos were uploaded directly by physicians, 32 videos by health channels, 14 videos by hospital channels, 2 videos by herbalists and 3 videos by other sources. The mean comment, like and dislike counts of the videos were found as 49.4 ± 172.9, 642.5 ± 2,112.9 and 66.7 ± 192.4. The mean DISCERN score was found as 38.2 ± 11.5, JAMA score as 1.4 ± 0.6 and VPI score as 85.1 ± 12.1. There was no significant difference between physicians and non-physicians and between real and animated videos in terms of DISCERN and JAMA scores (p>0.05). CONCLUSIONS: The quality of the videos on YouTube™ pertaining to female urinary incontinence was at an average level. Healthcare professionals should be encouraged for uploading more accurate quality health related contents. Policy makers should develop policies for supervision of the videos uploaded on the internet.

Urinary undiversion transforming an ileal conduit into an orthotopic continent neobladder: First case in our country.

Radical cystectomy (RC) with urinary diversion (UD) is still the standard treatment method for muscle-invasive bladder cancer. Type of UD is determined according to some characteristics of the patient and the tumor. Even in the most experienced hands, alternative scenarios may require an alternative diversion, including emergency UD for complications requiring immediate take down of the initial UD, tumor recurrence impacting the urinary tract or the UD, progressive impairment of renal function (in patients with a continent UD), malfunction/complications of the initial UD, and patient dislike of a stoma. We report a case of undiversion with natural history and outcome in a patient who had previously undergone RC and ileal conduit performed.