The effect of health literacy on patient compliance in patients to whom prostate biopsies were recommended.

BACKGROUND: Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is the gold standard diagnostic method for prostate cancer. In people with low health literacy, accurate and early diagnosis rates decrease, making it difficult to maintain health and compliance with treatment. In our study, we investigated how health literacy and sociocultural parameters affected compliance and awareness in patients with suspected prostate cancer, for whom TRUS-Bx was planned. METHODS: In the study, 98 male patients aged 50-80 years, recommended for TRUS-Bx, were included in our study. The data including age, prostate-specific antigen, prostate volume, digital rectal examination findings, education leveland area of residence of the patients included in the study were recorded. Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 forms were completed by the patients who agreed to participate in the study, and their scores were recorded. Patients scheduled for TRUS-Bx were divided into two groups: those who attended their appointments and underwent the biopsy, and those who did not attend their scheduled appointments. The effect of health literacy and other parameters on the TRUS-Bx requirement was examined between the two groups. Furthermore, 52 patients who underwent TRUS-Bx were divided into two groups as malignancy (malignant) detected and not-detected (benign) patients according to the pathology results, and the parameters were analyzed separately for these groups. RESULTS: The education level of the patients who underwent the TRUS-Bx procedure was found to be statistically higher (p = 0.026). Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 scores were statistically significantly higher in the TRUS-Bx group (p = 0.001, p < 0.001, respectively). In the logistic regression analysis, education level, Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 were found to be important predictors for awareness of the requirement for TRUS-Bx. CONCLUSION: The study's findings indicate that patients with higher health literacy and education levels were more likely to receive an early diagnosis and promptly proceed with the recommended TRUS-Bx after visiting a urologist.

Factors affecting the need for ureteral catheterization in symptomatic pregnancy hydronephrosis.

PURPOSE: In our study, considering the clinical parameters we aimed to determine the most appropriate treatment approach for symptomatic gestational hydronephrosis and conditions requiring DJS insertion. METHODS: Our study was a retrospective cross-sectional study and 137 patients were included. The patients were divided into two groups: those with conservative follow-up and those with DJS. Demographic and clinical data, the degree of HUN detected in urinary ultrasonography and the anteroposterior diameter of the renal pelvis were evaluated. Factors affecting the need for DJS between groups were investigated. Also, it was aimed to determine the cut-off value for the HUN degree and renal pelvis AP diameter in patients with DJS. RESULTS: The presence of urinary system stones was statistically significantly higher in the group with DJS than in the group without DJS (p = 0.014). HUN degrees and AP diameter were statistically significantly higher in the DJS group (p < 0.001, p < 0.001, respectively). HUN degree and renal pelvis AP diameter were the two most important predictors for DJS insertion (p = 0.005, p = 0.015, respectively). The AP diameter cut-off value for DJS installation was determined as 20.5 mm. CONCLUSION: Although there are conservative and surgical treatment options for symptomatic hydronephrosis of pregnancy, the factors at the decision point between these options are still a matter of debate. In our study, we concluded that the most important determinants at this decision point are the HUN degree and renal pelvis AP diameter. We think that the cut-off values we have determined for these markers will guide clinicians in deciding on treatment.

The relationship between heart failure and smoking, and development of urethral stricture.

OBJECTIVE: To evaluate the relationship between heart failure (HF), chronic obstructive pulmonary disease (COPD), and smoking with the development of urethral stricture (US) by examining the patients who underwent transurethral prostate resection procedure, with and without the development of US in their follow-ups. METHODS: Among the patients who underwent transurethral resection of the prostate, 50 patients who developed US during their follow-ups formed group 1, while a total of 50 patients who did not develop US and were selected by lot formed group 2. The relationship between the patients' data on HF, COPD and smoking status and the development of US was investigated. RESULTS: The mean number of cigarettes smoked was statistically significantly high in the group with stricture (p = 0.007). Furthermore, pulmonary function test parameters of patients such as forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were found to be statistically significantly higher in Group 2 (p < 0.001, p < 0.001, and p = 0.008, respectively). In the logistic regression analysis, being a smoker was found to be the strongest predictor (p = 0.032). CONCLUSION: Our study concluded that smoking, HF, and COPD significantly increase the risk of developing stricture after transurethral resection of the prostate.

OBJETIVO: Evaluar la relación de la insuficiencia cardiaca, la enfermedad pulmonar obstructiva crónica y el tabaquismo con el desarrollo de estenosis de uretra en pacientes sometidos a resección transuretral de próstata con y sin desarrollo de estenosis de uretra en su seguimiento. MÉTODO: Cincuenta pacientes que desarrollaron estenosis de uretra durante su seguimiento formaron el grupo 1, y 50 pacientes que no desarrollaron estenosis de uretra y fueron seleccionados por lote formaron el grupo 2. Se investigó la relación de los datos de los pacientes sobre insuficiencia cardiaca, enfermedad pulmonar obstructiva crónica y tabaquismo con el desarrollo de estenosis uretral. RESULTADOS: La media de cigarrillos fumados fue significativamente más alta en el grupo con estenosis (p = 0.007). Además, se encontró que los parámetros de las pruebas de función pulmonar de los pacientes, como FEV1, FVC y FEV1/FVC, eran significativamente más altos en el grupo 2 (p < 0.001, p < 0.001 y p = 0.008, respectivamente). CONCLUSIONES: El tabaquismo, la insuficiencia cardiaca y la enfermedad pulmonar obstructiva crónica aumentan significativamente el riesgo de desarrollar estenosis después de una resección transuretral de próstata.

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.

Comparison of tubularized incised plate urethroplasty and onlay island flap urethroplasty techniques in the repair of primarily proximal hypospadias / Comparación entre la uretroplastia tubularizada con incision de la placa uretral y las técnicas de Uretroplastia con colgajo pediculado para la reparación del hipospadias proximal primario

OBJECTIVES: To compare the success of the "tubularized incised plate urethroplasty" (TIPU) and "Onlay island flap urethroplasty" (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology, Ministry of Health Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4±3.1 years in Group 1 and 8.0±4.6 years in Group 2 (p = 0.09). The mean operating time was significantly lower in Group 1. (Group 1- 104.8±16.8 min, Group 2-125.4±24.7min; p < 0.001) The distribution of meatus localization was similar in both groups. At 1 year postoperatively, urethrocutaneous fistula was the only complication and the definitive success rates were 81.6% in Group 1 and 72% in Group 2. CONCLUSION: Despite less frequent usage since the description and popularization of TIPU for proximal hypospadias repair, OIFU remains a valuable technique as a single-stage procedure in cases where the urethral plate is insufficient. Currently, both TIPU and OIFU are used successfully in the treatment of patients with proximal hypospadias

OBJETIVOS: Comparar las tasas de éxito de las técnicas de Uretroplastia tubularizada con incisión de la placa uretral (TIP) y la Uretroplastia con colgajo en la reparación del hipospadias primario proximal. MÉTODOS: Realizamos una evaluación retrospectiva de las historias clínicas de 68 pacientes con hipospadias primario no complicado, que fueron operados en el departamento de Urología del Ministry of Health Ankara Education and Research Hospital entre enero del 1997 y diciembre del 2012. El grupo 1 incluyó los pacientes intervenidos de hipospadias mediante la técnica TIP y el grupo 2 los pacientes intervenidos con la técnica de colgajo no pediculado. Se evaluaron la edad del paciente, la localización del meato nativo, el tiempo operatorio, el tipo de derivación, el éxito de la operación y las complicaciones. El éxito de la operación fue evaluado con visión directa de la micción y flujometría en el momento de la retirada de la sonda, y posteriormente a las dos y seis semanas, a los 6 meses y al año. RESULTADOS: El grupo 1 incluía 43 pacientes y el grupo 2 25. La edad media de los pacientes fue 6,4 ± 3,1 años en el grupo 1 y 8,0 ± 4,6 años en el grupo 2 (p = 0,09). El tiempo medio operatorio fue significativamente menor en el grupo 1. (Grupo 1- 104,8 ± 16,8 min, Grupo 2-125,4 ± 24,7min; p < 0,001). La distribución de la localización del meato fue similar en ambos grupos. Al año de la operación, la única complicación fue fístula uretrocutánea y la tasa de éxitos era de 81,6% en el Grupo 1 y 72% en el Grupo 2. CONCLUSIONES: A pesar del menor uso desde la descripción y popularización de la Uretroplastia TIP para la reparación del hipospadias proximal, la Uretroplastia con colgajo sigue siendo una técnica válida como procedimiento único en casos en los que la placa uretral es insuficiente. Actualmente, ambas técnicas de uretroplastia, TIP y con colgajo, se utilizan con éxito en el tratamiento de pacientes con hipospadias proximal

Comparison of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy in moderate-size renal stones / Comparación de la nefrolitotomía percutánea ultra-mini y micro-nefrolitotomía percutánea en cálculos renales de tamaño moderado

OBJECTIVE: We aimed to compare the success and complications of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy techniques. METHODS: We retrospectively analyzed data from 74 patients. Moderate-size stones were included in the study. RESULTS: Forty-two patients were included in MPNL, and 32 patients were included in UPNL groups. Among our patient cohort, 42 (56.7%) were males, and 32 (43.3%) were females. The mean age of the patients was 40±13.2 years in the MPNL group, and the mean age of the patients was 42±14.1 years in the UPNL group. The mean stone size was 17±3.2 mm in the MPNL group and 16.4±3.7 mm in the UPNL group. The stonefree rates were 88.1% (37/42) and 90.6% (29/32) in the MPNL and UPNL groups, respectively; there was no statically significant difference between the groups. The mean hospital stay was 1.4±0.23 days in the MPNL group and 1.1±0.12 day in the UPNL group. CONCLUSIONS: Two techniques have similar success and complication rates, and both may be preferred particularly in moderate-size stones. Our experience supports that our UPNL technique is safe and effective using with a standard ureteroscope

OBJETIVO: Comparar las tasas de éxito y las complicaciones de las técnicas ultra-mini nefrolitotomia percutánea (UNLP) y micro Nefrolitotomía percutánea (MNLP). MÉTODOS: Analizamos retrospectivamente los datos de 74 pacientes. Se incluyeron en el estudio litiasis de tamaño moderado. RESULTADOS: Cuarenta y dos pacientes se incluyeron en el grupo de MNLP y 32 pacientes en el de UNLP. En nuestra cohorte de pacientes, 42 (56,7%) eran varones y 32 (43,3%) mujeres. La edad media de los pacientes fue de 40±13,2 años en el grupo de MNLP y 42±14,1 años en el grupo de UNLP. El tamaño medio de la litiasis fue de 17±3,2 mm en el grupo de MNLP y 16,4±3,7 mm en el grupo de UNLP. Las tasas de pacientes libres de litiasis fueron del 88,1% (37/42) y 90,6% (29/32) en los grupos de MNLP y UNLP, respectivamente; no había diferencias estadísticamente significativas entre los grupos. La estancia hospitalaria media fue de 1,4±0,23 días en el grupo de MNLP y 1,1±0,12 días en el de UNLP. CONCLUSIONES: Las dos técnicas tienen tasas de éxito y de complicaciones similares, y ambas pueden ser las preferidas para litiasis de tamaño moderado. Nuestra experiencia apoya que nuestra técnica de UNLP es segura y efectiva utilizando un ureteroscopio estándar