Effects of Klotho protein, vitamin D, and oxidative stress parameters on urinary stone formation and recurrence.

PURPOSE: The present study aimed to investigate the effects of α-Klotho and oxidative stress markers on urinary stone disease (USD) and demonstrate their use as biochemical markers in USD. METHODS: Among the 90 individuals included, 30 individuals were healthy controls (Group 1), 30 individuals presented with USD for the first time (Group 2), and 30 individuals demonstrated recurrent USD (Group 3). Serum levels of α-Klotho, vitamin D, malondialdehyde (MDA), total oxidant status, and total antioxidant status were determined using spectrophotometry analysis. Serum calcium and parathormone levels and 24-h urine calcium levels were measured via biochemical analysis. RESULTS: No significant intergroup difference was noted in terms of age and sex. The groups had significant differences regarding α-Klotho, oxidative stress index (OSI), MDA, and 24-h urine calcium levels. α-Klotho was a determinant of 24-h urine calcium level and OSI. An increase of 1 pg/mL in α-Klotho level appeared to result in a decrease of 8.55 mg in 24-h urine calcium level and a decrease of 0.04 Arbitrary Unit in OSI. In patients experiencing USD for the first time, α-Klotho values were < 21.83 pg/mL and showed 66% sensitivity and 64% specificity. In individuals with recurrent stone formation, α-Klotho values below 19.41 pg/mL had 60% sensitivity and 77% specificity. CONCLUSIONS: The biochemical markers investigated herein, i.e., α-Klotho, OSI, and MDA, were involved in the pathogenesis of stone formation and can be used in day-to-day clinical practices of urology clinics to identify patients at risk for both first time and recurrent USD.

Complementary and Alternative Medicine Usage and Quality of Life in Patients With Renal Colic Attack.

Decreased quality of life is observed in individuals who fear surgery or experience severe symptoms due to urinary system stone disease (USSD). As a result, some patients seek complementary and alternative medicine (CAM) methods. This research evaluates preoperative CAM usage and its effects on quality of life for patients who experience renal colic (RC) due to USSD. The research was conducted between April 2020 and 2021 in the application and research center of a university. One hundred ten patients who were scheduled to have surgery due to USSD were included in the study. The data were collected using the "personal information form," "Use of CAM Methods of Individuals," and 36-item Short-Form Health Survey (SF-36) forms. Of research participants, 47.3% reported using at least one CAM method. The most common methods were exercise combined with phytotherapy (16.4%) and dietary supplements (15.5%). The proportion of participants who reported using 1 or multiple CAM methods for pain was 48.1%. The Social Functioning scores obtained from the SF-36 of the CAM users were statistically significant. For the participants who used a CAM method, the average Role-Emotional score obtained from the SF-36 was statistically significant. Health professionals should know which CAM methods patients may prefer and to what extent various CAM methods affect quality of life. More studies are needed to identify factors affecting the use of CAM methods in patients with RC attacks and to understand the relationship between CAM method(s) and quality of life.

Evaluation of male sexual parameters in infertile couples with a history of abortion.

INTRODUCTION: It is thought that both individuals are affected psychologically and sexually in couples experiencing abortion. In addition to the stress caused by infertility, sexual life may also be negatively affected in couples who experience psychogenic wear, such as abortion and curettage. The aim of this study is to evaluate male sexual functions in infertile couples with a history of abortion and male infertility component. METHODS: Five hundred forty-seven male patients' data were evaluated retrospectively. Group 1 was the included the males of the couples without abortion history and the rest with abortion history was group 2. In addition to demographic data, abortion history, libido level, presence of morning erection and intercourse frequency were evaluated. Hormone levels of all patients were evaluated. After that we created sub-group 1 and sub-group 2 from these groups, respectively, due to whether the patients fulfilled the international index of erectile function (IIEF), Beck anxiety inventory (BAI) and Beck depression inventory (BDI). RESULTS: There were not any significant differences between the groups regarding psychiatric scale scores, hormone levels, libido, intercourse frequency and IIEF scores. Only orgasmic dysfunction was significant in the males of the couples with abortion history. CONCLUSION: Man is not affected from abortion process in which woman get involved. Men only have orgasmic dysfunction when there is one or more abortion history in couples.

Can Annual Daylight Cycles and Seasons Have an Effect on Male Sexual Functions?

Introduction Mammals' sexual functions exhibit seasonal variations that have been attributed to changes in the daylight. In this study, taking into consideration endocrine and psychogenic status, we aimed to investigate whether human males experience changes in erectile functions and sexual desire depending on daylight periods and seasons, and whether periodicity exists in human sexual behavior. Materials and methods International Index of Erectile Function (IIEF) and psychiatric scale scores of 221 male patients were evaluated. In addition, hormonal parameters of the patients were examined. These data were first evaluated in two groups (summer and winter) according to local daylight amounts the participants received. Then IIEF scores were also analyzed according to four conventional seasons (winter, spring, summer, and autumn). Results There was no significant difference in laboratory data, psychiatric scale scores and IIEF evaluations between summer and winter groups. Moreover, no significant difference was found in terms of sexual desire and erectile functions in terms of four seasons (p > 0.05). Conclusion According to the results of this study, there is no periodicity in human sexual functions both in relation to daylight and four seasons.

Prediction of The Energy Required for Ho:YAG Laser Lithotripsy of Urinary Stones.

PURPOSE: In this study, we aimed to find a more accurate predicting constant value of energy per mm3xHounsfield Unit (HU) to ablate urinary stones by endoscopic stone treatment. MATERIAL AND METHODS: The files of 142 patients who underwent rigid or flexible ureteroscopic laser lithotripsy in our clinic between December 2018 and March 2020 were evaluated retrospectively. Total energy administered for the ablation of the stone was obtained from the registry of the Ho:YAG laser and recorded to the follow-up forms. The constant value was calculated for each stone, and the final mean value was figured out by calculation of the mean of all constant values. RESULTS: The study was conducted with 142 patients; 102 males and 40 females. The mean age of the population was 46.61 ± 14.58 years. The number of stones was 1.27 ± 0.67. The mean constant value of energy needed per mm3xHU for urinary stones was 22.87 milliwatt. CONCLUSION: This study was conducted to report a predictive constant value and is the very first study evaluating the energy prediction per mm3xHU. The data of the study showed that the constant value is 22.87 mW/mm3xHU. Urologists may estimate the required energy and plan the surgery according to the outcomes of the study. As a future aspect of our study, the constant value may represent predictive information about the time and accuracy of the operation.

Effect of Endoscopic Ureteral Stone Treatment on Kidney Function.

INTRODUCTION: Ureteral stones may have an influence on kidney functions due to postrenal obstruction or urinary infections. Urgent decompression or stone removal is necessary and recommended to prevent further complications in case of severe conditions such as anuria and urosepsis. Although it is believed that ureteral stone removal would result in renal function improvement, there are still unclear points on whether ureteroscopy (URS) can provide benefit as expected and has some adverse effects. In this study, we aimed to evaluate the alteration of kidney functions of patients who undergo rigid or flexible URS for ureteral stones and find if there are any influencing factors on kidney function alteration. MATERIALS AND METHOD: We analyzed 126 patients who underwent retrograde intrarenal surgery (RIRS) for renal stones between May 2018 and February 2020 prospectively. The estimated glomerular filtration rate (eGFR) was calculated on the day before the surgery, by modification of diet in renal disease (MDRD) formula. The calculation was repeated and saved three times during follow-up for the same patient; on the day after the operation, on the postoperative 30th day, and the postoperative 90th day. Then, we evaluated the renal function by comparing eGFR and assessed the predicting factors affecting the kidney function. RESULTS: Preoperative mean eGFR was 82.28 ± 25.20 mL/min/1.73 m2 for the study group. Mean eGFR was calculated 90.92 ± 22.97 mL/min/1.73 m2 on the first postoperative day, and 94.54 ± 21.95 mL/min/1.73 m2 on the third-month follow-up. The mean change in eGFR was 8.63 ± 16.68 mL/min/1.73 m2 in the early period and 12.26 ± 21.09 mL/min/1.73 m2 in the long-term follow-up period. Fifty-one patients improved on chronic kidney disease (CKD) stage, and 13 deteriorated in three months follow-up. CONCLUSION: Removing the stone and relieving the obstruction by ureteroscopic treatment have an alteration on eGFR. Although eGFR improves in the short-term follow-up, amelioration is evident in long-term follow-up, especially in female patients. The other predictive factors for eGFR improvement after URS are the presence of ureteral obstruction and high preoperative serum creatinine levels.

External Validation and Comparison of Nephrolithometric Scoring Systems Predicting Outcomes of Retrograde Intrarenal Surgery.

Introduction: Preoperative assessment of renal stones is essential to selecting treatment options and achieving high success rates; thus, some nephrolithometric scoring systems have been developed by using preoperative clinical data and stone characteristics. Initially, nomograms predicting stone-free rates (SFRs) were designed for percutaneous nephrolithotomy. After this, some were modified, and new scoring systems were developed for retrograde intrarenal surgery (RIRS). In this study, we aimed at validating and comparing the accuracy of four scoring systems predicting the SFR of RIRS. Materials and Methods: We conducted a prospective study. The data of 110 consecutive patients who required RIRS for renal stones between May 2018 and February 2020 were evaluated. The patients were divided into four groups regarding total score: 0, 1, 2, ≥3 according to the Resorlu-Unsal Stone Score (RUSS). The scores were calculated between 5 and 15 for the size of the stone, topography or location, degree of obstruction of the urinary system, number of stones, and evaluation of Hounsfield units (S.T.O.N.E.) scoring system. Modified Seoul National University Renal Stone Complexity (S-ReSC) scores of the patients were between 1 and 12. Finally, the patients were classified between 4 and 10 points with the R.I.R.S. scoring system. Results: The mean RUSS, S.T.O.N.E., R.I.R.S., and modified S-ReSC scores were 1.14 (±0.818), 10.78 (±1.499), 6.50 (±1.305), and 2.29 (±1.710), respectively. The area under curve values of RUSS, S.T.O.N.E., R.I.R.S., and S-ReSC were 0.735 (95% confidence interval [CI] 0.623-0.826), 0.725 (95% CI 0.626-0.823), 0.752 (95% CI 0.646-0.857), and 0.755 (95% CI 0.660-0.849), respectively. Logistic regression analysis revealed that the RUSS was an independent predictive factor for SFR (p = 0.028). Conclusion: The results showed that all four scoring systems predict the SFRs for RIRS accurately. However, surgeons should prefer RUSS when all four nomograms are available, except when assessing single renal stones. In that case, S-ReSC should be used for assessment. Three other nomograms except the S.T.O.N.E. scoring system can be suitable for the assessment of lower caliceal stones.

The impact of body mass index on reproductive hormones, testosterone/estradiol ratio and semen parameters.

INTRODUCTION: The aim of this study was to evaluate the relationship between body mass index (BMI) and sperm parameters and reproductive hormone levels in patients with no known risk factors for infertility. MATERIAL AND METHODS: Four hundred patients who met the study's inclusion criteria were divided into three groups according to their BMI values as normal weight (BMI: 18.5-24.9 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥30 kg/m2). Semen parameters, reproductive hormone levels and testosterone/estradiol ratio were compared retrospectively between the groups. RESULTS: There was no significant difference between the groups in terms of age and infertility period. The mean BMI of all the patients was 26.6 ±4.08, and the BMI in the normal, overweight and obese groups were 22.6 ±1.7, 27.4 ±1.3, and 33.4 ±2.9, respectively (p <0.001). There was no significant difference between the groups in terms of serum follicle stimulating hormone, luteinizing hormone, estradiol, prolactin, semen volume, sperm concentration, total sperm count, and progressive and total motility. Serum testosterone (T) level and testosterone/estradiol (T/E2) ratio were significantly higher in the normal BMI group (p <0.001). CONCLUSIONS: Adipose tissue increase was not significantly correlated with change in the semen parameters and it was negatively correlated with T levels and T/E2 ratio.

Evaluation of the influence of subinguinal varicocelectomy procedure on seminal parameters, reproductive hormones and testosterone/estradiol ratio.

OBJECTIVE: Varicocele is the most commonly surgically curable cause of male infertility. However, the mechanisms related to the effect of reducing fertility potential have not been clearly identified. The aim of this study was to investigate the effects of varicocelectomy on semen parameters, reproductive hormones and testosterone / estradiol ratio. Matherial and methods: Fifty seven patients outcomes were evaluated before and 6 months after subinguinal microsurgical varicocelectomy. Semen parameters, reproductice hormones and testosteron/estradiol ratio results of patients were compared retrospectively. RESULTS: The mean age was 26.8 years. Fifty four (94.7%) patients had grade 3 and 3 (5.3%) patients had grade 2 varicocele. There was a significant increase in semen parameters except semen volume. There was a statistically significant increase in serum testosterone levels, but not on testosterone/ estradiol ratio. CONCLUSIONS: According to our results, microsurgical subinguinal varicocelectomy can be recommended for both improving semen parameters and hormonal recovery.

Factors Affecting Retrograde Intrarenal Surgery Success: 6 Years Experience of a Clinic in Central Anatolia.

Background: Urinary system stone disease is an important health problem. It has been reported to have a prevalence of 14.8% in Turkey. The aim of the renal stone removal surgery is to clear the stones with minimal complications. Retrograde intrarenal surgery (RIRS) is a safe method due to the fewer and minor complications. As a clinic in central Anatolia, we aimed at researching the factors affecting RIRS success in our area. Methods: After local ethics committee's approval, the data of the patients who had undergone RIRS between 2014 and 2019 were reviewed. Patients who were <18 years old, had kidney anomalies, and had both ureter and kidney stones were excluded from the study. The patients who were defined as successful were named as Group 1 and the others were named as Group 2. The demographic, intraoperative, and postoperative data of the two groups were compared. Results: There were a total of 416 patients in our study. Group 1 consisted of 332 patients, whereas Group 2 had 84 patients. Opacity was significantly different between the groups (P = .004). Stone size, stone volume, and operation time were significantly higher in Group 2. After logistic regression analysis, we found that stone size, opacity, and operation time affected the success of RIRS significantly (P < .05). There was a reverse relationship with stone size, operation time, and opacity. Conclusions: We believe that in patients who have large lower calix stones and who want effective treatment, percutaneous nephrolithotomy should still be an option for treatment.

Comparison of Safety and Efficiency of General, Spinal and Epidural Anesthesia Methods Used for the Endoscopic Surgical Treatment of Ureteral Stones: Which One is Better To Access The Ureter and Reach The Stone?

PURPOSE: The aim of this study is to evaluate the effects of anesthesia methods on the success of urethral access and stone access achievement in endoscopic treatment of urolithiasis. MATERIALS AND METHODS: In this prospective randomized study, 105 patients who underwent primary ureterorenoscopy (URS) procedure for ureteral stones were evaluated. The patients were randomized into three groups by permuted block randomization according to the applied anesthesia method: General anesthesia (GA): 33 patients, Spinal anesthesia (SA): 31 patients, and Epidural anesthesia (EA): 31 patients. Ten patients, whose ureteral access was not successful, were dropped out. The success of the three anesthesia methods on the success of the ureter access and its effects on surgical outcomes were compared. RESULTS: There was no statistically significant difference among the three groups in terms of the demographic values and preoperative features except the American Society of Anesthesiologists (ASA) status. Dilatation and the access time to stone were statistically significantly longer in SA and EA group compared to the GA group. There was no statistically significant difference among the groups in terms of operation, lithotripsy time, stone-free rate (SFR), and complication rates. The Visual Analog Scale (VAS) scores in the 8th and 24th hours were statistically significantly higher in the GA group. CONCLUSION: In patients who decided to undergo primary ureterorenoscopy procedure, it can be suggested to treat with GA to provide a better relaxation of the ureter if there are no contraindications.

Are There Any Relationships Between Abnormal Seminal Parameters and Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Red Blood Cell Distribution-Platelet Ratio?

Objective The aim of this study is to determine the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and red blood cell distribution width (RDW)/platelet ratio (RPR) values, which are pro-inflammatory markers, with abnormal sperm parameters, and to evaluate their availability as predictive markers. Materials and methods A total of 160 patients, 80 of whom were the control group, formed with match-pair analysis (Group 1), and 80 patients with abnormal sperm analysis, who met the study criteria (Group 2), were included in the study. Complete blood count results were recorded. NLR, PLR, and RPR values were calculated using hematological parameters, and a comparison was made between the two groups. Results The mean age was 31.23 ± 5.1 years in Group 1 and 31.33 ± 6.4 years in Group 2. NLR values were 1.84 ± 0.57-1.87 ± 0.65 (P =0.77), PLR values were 105.42 ± 23.89-111.42 ± 34.54 (P = 0.62) and RPR values were 0.05 ± 0.009-0.05 ± 0.01 (P =0.45), respectively. There was no statistically significant difference between the groups. Conclusions We investigated whether NLR, PLR, and RPR results can be used as a predictive marker on abnormal sperm parameters. We do not recommend the use of these parameters as a predictive marker.

Evaluation of Male Infertility Prevalence with Clinical Outcomes in Middle Anatolian Region.

OBJECTIVE: the aim of this study is to determine the prevalence of male factor infertility with the clinical patterns of patients in our region. MATERIALS AND METHODS: this is a descriptive retrospective study of 406 infertility cases presented at our urology clinic from February 2018 to February 2019. We assessed hormone and physical examination data, semen analysis results, the contribution of male and female factors to infertility, and types of infertility (i.e., primary or secondary). RESULTS: the age of the male patients ranged from 18 to 50 years, with a mean of 30 ± 5 years. Asthenozoospermia was the leading cause of male factor infertility in 77 patients (19%). Male factors as the sole cause of infertility were found in 185 (45.6%) couples. Female factors as the sole cause were found in 32 couples (7.9%). Primary infertility was determined in 314 (77.3%) patients, and 92 (22.7%) had secondary infertility. CONCLUSION: according to our results, the male infertility rate was high among couples reporting infertility. Couples should be informed about the causes of infertility, which may be due factors attributed to either sex.

Primary Large-Cell Undifferentiated Carcinoma of the Ureter.

OBJECTIVE: To report the first case in the literature of a primary large-cell undifferentiated carcinoma (LCUC) of the ureter with a very aggressive behavior and dismal prognosis. CLINICAL PRESENTATION AND INTERVENTION: A 60-year-old woman with a history of intermittent macroscopic hematuria and mild to moderate right flank pain was admitted to the Department of Urology. Tissue biopsies and cytological samples were taken. Pathologic examination was consistent with LCUC. CONCLUSION: LCUC of the ureter is an aggressive tumor with a high proliferation index. Patients might be diagnosed at an advanced stage. LCUC must be considered in the differential diagnosis of urinary tract pathologies.

Fosfomycin in the treatment of extended spectrum beta-lactamase-producing Enterobacteriaceae- related urinary tract infections.

INTRODUCTION: We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem particularly in patients who we would like to treat on an outpatient basis. METHODOLOGY: We retrospectively analyzed the medical records of all patients who admitted to infectious disease outpatient clinic with complaints of dysuria and frequency and received FT for lower UTI between May 2016 and May 2017. RESULTS: A total of 48 patients, 19 females (39.6%) and 29 males (60.4%), with a mean age of 62.5 (ranging from 27 to 85) years were included the study. 26 (76.4%) of patients with a history of urinary operation or intervention had also a history of antibiotic use within the past 3 months. The isolated pathogens included Escherichia Coli (n = 32), Klebsiella spp. (n = 12), Enterobacter spp. (n = 4). The overall microbiological response after treatment was 70.8% (34/48) and the clinical response was 75% (36/48). Clinical and microbiological response rates of patients with and without urinary operation/intervention, diabetes mellitus, history of antibiotic use and malignancy were found similar (p > 0.05). However, patients with a urinary stone disease history had significantly higher response rates than those without a urinary stone disease history (P = 0.042). CONCLUSION: Oral fosfomycin tromethamine might be the treatment of choice in ESBL-producing enterobactericea related UTIs especially caused by Escherichia Coli.

Does the New Proposal for Prostate Cancer Grading Correlate With CAPRA Score?

PURPOSE: To determine if there is a correlation between the newly proposed Gleason grading system by the International Society of Urological Pathology and the Cancer of the Prostate Risk Assessment (CAPRA) score. MATERIAL AND METHODS: The records of all patients that underwent radical prostatectomy at our hospital between 2007 and 2013 were retrospectively reviewed. The study parameters included patient demographics, the percentage of pre-operative prostate biopsies positive for PCa, biopsy Gleason Score (GS), and pre- and post-operative PSA values. RESULT: The study included 146 patients with complete medical records and follow-up data. Mean age of the patientswas 66.6 ± 6.08 years. According to the newly proposed Gleason grading system, 97 (66.4%) patients were grade 1, 20 (13.7%) were grade 2, 8 (5.5%) were grade 3, 11 (7.5%) were grade 4, and 10 (6.8%) were grade 5. The distribution of CAPRA scores was as follows: 1: n = 43 (29.5%); 2: n = 53 (36.3%); 3: n = 22 (15.1%); 4: n = 14 (9.6%); 5: n = 8 (5.5%); 6: n = 4 (2.7%); 7: n = 1 (0.7%); 8: n = 1 (0.7%). Correlation analysis showed that theCAPRA score was significantly correlated with GS based on the newly proposed Gleason grading system (CorrelationCoefficient=0.361, P < 0.001). CONCLUSION: As a strong correlation was noted between these 2 independent grading systems, we think clinicians that seek to predict the prognosis in PCa patients should take into consideration both the newly proposed ISUP grading system and the CAPRA score.

Prediction of stone-free status after single-session retrograde intrarenal surgery for renal stones.

OBJECTIVE: To determine the possible factors effecting stone-free status (SFS) after single-session retrograde intrarenal surgery (RIRS) for renal stones. MATERIAL AND METHODS: We retrospectively analyzed the charts of 100 consecutive patients who underwent RIRS. Unilateral procedures performed for single renal stones were included in the study. The studied parameters included patient demographics, stone characteristics (size, volume, location and attenuation according to Hounsfield unit [HU]), operation time, presence of preoperative double-J stent (DJS), use of ureteral access sheath (UAS) and SFS. RESULTS: The study population consisted of 100 patients where 43 of them were stone free and remaining 57 had residual stones. The mean age of the patients was 47.2±13.4 years. The mean stone size (largest dimension), stone attenuation and stone volume were 14.8±5.8 mm, 1010±416 HU and 937±929 mm3, respectively. The mean operative time was 60.8±24.2 minutes. Mean stone size, volume and HU were higher in the RS group compared to SF group but without any statistically significant difference, 15.2±6.1 vs. 14.2±5.3 mm, 1056±1037 mm3 vs. 780±745 mm3 and 1061±374 HU vs. 942±462 HU, respectively (p=0.490, p=0.135 and p=0.226). In multivariate regression analysis stone location and UAS use were found to be the significant predictors of SFS. Patients with lower pole stones are 2.25 times likely to have residual stones after RIRS compared to patient's having stones at other localizations (p<0.001). CONCLUSION: Stone volume could be a more reliable parameter than stone size in predicting RIRS success. Lower pole stone location and UAS use could be considered the most significant predictors of SFS after single session RIRS for single renal stones.

The effect of CO2 pneumoperitoneum on serum prostate-specific antigen levels in patients undergoing laparoscopic cholecystectomy.

BACKGROUND: Recently, several studies have shown an elevation of serum prostate-specific antigen (PSA) levels after the events associated with presumed pelvic ischemia. Although it has been shown that CO2 pneumoperitoneum during laparoscopic surgery causes splanchnic ischemia, no study has investigated the PSA levels after this procedure. This study aimed to evaluate the effects of CO2 pneumoperitoneum on serum total PSA (tPSA) and free PSA (fPSA) levels in patients undergoing laparoscopic cholecystectomy. METHODS: This study involved 30 men who underwent elective laparoscopic cholecystectomy. Serum tPSA and fPSA levels and f/tPSA ratios were determined the day before surgery (baseline), immediately before insufflation, after desufflation, and 24 hours and 7 days after surgery. RESULTS: Serum tPSA and fPSA values after desufflation and 24 hours after surgery were significantly higher than the values before insufflation and at baseline (P<0.01), whereas the f/tPSA ratio did not change (P>0.05). PSA levels decreased to baseline levels after 7 days. CONCLUSIONS: Our study showed that CO2 pneumoperitoneum during laparoscopic surgery can cause a rise in serum tPSA and fPSA levels. We think that CO2 pneumoperitoneum during laparoscopic surgery should be added to list of the events in which PSA measurements must be interpreted with caution.

Lower urinary tract symptoms, prostate volume, uroflowmetry, residual urine volume and bladder wall thickness in Turkish men: a comparative analysis.

AIM: To evaluate the association between lower urinary tract symptoms (LUTS) severity and bladder wall thickness (BWT). MATERIALS AND METHODS: The study included 155 patients referred to outpatient clinics for LUTS. Patients were divided into three groups due to their IPSS. Group A included the patients with mild symptoms, group B included patients with moderate symptoms and group C included patients with severe symptoms. The patients were again divided into two groups due to their uroflowmetry results. Group 1 included the patients whose Q (max) 10 ml/s. RESULTS: The mean BWT was 4.14 + 1.03 mm (from 3 to 9 mm). Although there was no difference between the IPSS groups in BWT (P = 0.325), it was statistically significant between uroflowmetry study groups (P < 0.01). CONCLUSIONS: BWT seems to be significantly increased in men who have Q (max) values smaller than 10 ml/s.

A distal protruding ureteral polyp looking like a bladder mass.

A 34-year-old female patient with a right lumbar and back pain during micturition is presented. Ultrasonography and intravenous urogram both supported a possible bladder mass. Finally, a ureteral polyp was diagnosed on cystoscopy and resected by the ureteroscopic approach.