Overactive bladder negatively affects erectile function and promotes premature ejaculation: findings from large representative population-level study.

PURPOSE: The effect of overactive bladder (OAB) on sexual health has been evaluated extensively for women but much less for men. Therefore, the aim of this study was to evaluate the relationship between OAB and men's sexual activity and the effect of OAB on erectile dysfunction (ED) and premature ejaculation (PE) in a large representative cohort of men at the population level. METHODS: This study was based on computer-assisted web interviews that used validated questionnaires. The most recent census and the sample size estimation calculations were employed to produce a population-representative pool. RESULTS: The study included 3001 men, representative of the population in terms of age and place of residence. The frequency of sexual intercourse was higher for respondents without OAB symptoms compared with persons who had OAB (p = 0.001), but there was no association between OAB symptoms and number of sexual partners (p = 0.754). Regression models did not confirm the effect of OAB on sexual activity (odds ratio 0.993, CI 0.974-1.013, p = 0.511). Both ED and PE were more prevalent in respondents with OAB symptoms compared with persons who lacked those symptoms (p < 0.001). Importantly, the effect of OAB on ED or PE was independent of age, comorbidities, and lifestyle habits (regression coefficients of 0.13 and 0.158 for ED and PE, respectively). CONCLUSION: Overactive bladder did not significantly affect men's sexual activity, but it significantly correlated with ED and PE. Our results suggest a need in daily clinical practice to screen for OAB symptoms for persons who report ED or PE.

The effect of long-term COVID-19 on aetiological factors related to nocturia.

AIMS AND OBJECTIVES: This study was conducted to examine the possible aetiology of nocturia in patients with long-term COVID-19. BACKGROUND: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID-19, 10-14 weeks after the illness. DESIGN: A descriptive design. METHODS: The study consisted of 70 patients who had experienced COVID-19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. RESULTS: When the nocturia effects of long-term COVID-19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p < .05). According to post-hoc analysis, the mean age of patients with a dominant cardio-metabolic factor was found to be significantly younger (p < .05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p < .05). CONCLUSIONS: It was found that the urinary tract aetiological factor was dominant in patients with long-term COVID-19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. RELEVANCE TO CLINICAL PRACTICE: Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post-COVID-19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. PATIENT OR PUBLIC CONTRIBUTION: The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID-19 infection.

The effect of vitamin D replacement in patients with lower urinary tract complaint/erectile dysfunction resistant to Tadalafil 5 mg treatment: A pilot clinical study.

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.

Is there a relationship between mean platelet volume and response to treatment with daily tadalafil in patients with erectile dysfunction?

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 3 10.05 fL was associated with 66% sensitivity and 75,4% specificity for no response to 5 mg daily tadalafil treatment (Area under curve = 76.9% [95% CI 68.2%-85.6%; p < 0.001]). Initial IIEF-EF score, fasting blood glucose, and MPV level was independently associated with the response to the tadalafil treatment. This is the only study to evaluate the value of MPV level on the therapeutic response of ED to tadalafil. Strict inclusion criteria were applied to the cohort. However, the diagnose of vascular ED has been made by clinical evaluation and retrospective design of the study were the limitations of the study. The results of our study suggest that MPV might be used to predict the result of 5 mg daily tadalafil treatment in selected ED patients as a fast and cost-effective test.

The impact of myasthenia gravis on lower urinary tract functions.

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.

Relation of glycated hemoglobin and vitamin D deficiency with erectile dysfunction in patients with type 2 diabetes mellitus.

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.

The Effect on Pain and Anxiety of Hot Pad Applied to Patients During Transrectal Prostate Biopsy.

AIM: The aim of the study was to evaluate the effect of the application of a heating pad on the sacral region on pain and anxiety during a transrectal prostate biopsy. DESIGN: This was a quasi-experimental study. METHODS: The quasi-experimental study was conducted in the Urology Outpatient Clinic of a Training and Research Hospital in Istanbul. A total of 40 males were nonrandomly divided into two groups: experimental group (n = 20) and control group (n = 20). A heating pad (40-45°C) was applied to the sacral region of the patients in the experimental group during transrectal prostate biopsy. Data were collected using the Beck Anxiety Inventory (BAI) and visual analogue scale (VAS). RESULTS: It was detected that the mean scores of the BAI were significantly lower in the experimental group compared with the control group (p < .001). The scores of the VAS were significantly lower in the experimental group compared with the control (p = .016). CONCLUSION: Applying a heating pad to the sacral region during a transrectal prostate biopsy is an effective non-pharmacologic method to increase patient comfort and reduce pain and anxiety.

The correlation between atherogenic indexes and erectile dysfunction.

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 (n = 134) consisted of patients with moderate and mild ED (IIEF-EF: 17-30), the second group (n = 119) consisted of patients with severe ED. In addition to the mean values of lipid parameters; CRI-1 (total cholesterol/HDL), CRI-2 (LDL/HDL) AIP (log10(triglycerides/HDL), and AC (non-HDL/HDL) were calculated. The mean age was 44.02 ± 10.41 (24-70), and the mean BMI was 27.80 ± 4.12 (18.52 ± 41.97). However, CRI-1 and AIP values were found to be higher in the severe ED group compared to the mild ED group (CRI-1: 4.50 ± 1.47, 4.88 ± 1.30; p = .039; AIP: 0.489 ± 0.315, 0.617 ± 0.283; p = .007). Our results demonstrated that CR-1 and AIP have a positive correlation with the severity of ED. Moreover, we can suggest that patients with higher CR-1 and AIP values are likely to have more severe ED in the future.

The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels.

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, patients who applied to the andrology outpatient clinic with an ED complaint were retrospectively reviewed. Patients with diabetes, hypertension, hyperlipidemia, malignancy, late-onset hypogonadism and smokers were not included in the study. The International Erectile Function Index-Erectile Function (IIEF-EF) questionnaire was used to assess the levels of erectile function. According to this scoring system, patients were divided into two groups. IIEF score: between 17 and 25 = mild ED (Group 1) and IIEF score between 16 and 0 = moderate-severe ED (Group 2). Blood samples of the patients were taken from antecubital vein and MPV and 25-hydroxyvitamin D [25(OH)D] levels were evaluated.Results: Ninety patients were included in the study (Group 1: n = 41, Group 2: n = 49). The mean age of the patients was 41.07 ± 8.56 and the mean body mass index (BMI) was 27.59 ± 3.91. 25(OH)D levels were found to be statistically lower in Group 2 (18.85 ± 6.09; 13.98 ± 7.10; p = .001). MPV levels were found to be statistically higher in Group 2 (10.05 ± 0.81; 10.78 ± 1.16; p = .001). Correlation between IIEF-EF scores and 25(OH)D levels was positive (p = .03, r = 0.22). There was negative correlation between IIEF-EF scores and MPV and between 25(OH)D levels and MPV levels [p = .003 for IIEF-EF/MPV, p = .04, r = -0.23 for 25(OH)D/MPV].Conclusion: There is a significant positive correlation between ED severity and 25(OH)D levels and there is a significant negative correlation between ED severity and MPV levels.

Comprehensive examination of haematological parameters of patients operated due to testicular torsion.

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 < .01). We found a significant difference in terms of neutrophil, lymphocyte, monocyte counts and neutrophil-lymphocyte ratio between patients with testicular torsion and controls. We also found that the monocytes count and symptom duration differed significantly between the detorsion group and the orchiectomy group. It is obvious that there is contradictory information according to the studies in the literature. We can say that the duration of symptoms and the number of monocytes are predictors of testicular viability.

The relationship between testosterone levels and Peyronie's disease.

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.

Acute effect of microdissection testicular sperm extraction on blood total testosterone and luteinising hormone levels.

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.

The effects of bladder training on bladder functions after transurethral resection of prostate.

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.

Are There Differences in Brain Morphology in Patients with Lifelong Premature Ejaculation?

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. Atalay HA, Sonkaya AR, Ozbir S, et al. Are There Differences in Brain Morphology in Patients with Lifelong Premature Ejaculation? J Sex Med 2019;16:992-998.

Turkish validation of the overactive bladder symptom score (OABSS) and evaluation of mirabegron treatment response.

INTRODUCTION AND HYPOTHESIS: 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. METHODS: 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. RESULTS: 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 < 0.001). CONCLUSION: The Turkish version of the OABSS has been approved as a valid and reliable tool for evaluating OAB. Mirabegron used daily improved the symptoms of OAB in patients.

Recurrent, Giant Renal Angiomyolipoma Treated with Selective Arterial Embolization: A Case Report.

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.

The Effect of Platelet-Rich Plasma on Peyronie's Disease in Rat Model.

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.

The Predictive Value of Ischemia-Modified Albumin in Renal Ischemia-Reperfusion Injury.

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.

Is high levels of vitamin D a new risk factor for Peyronie's disease?

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-ß1 is one of the most fibrogenic cytokines. Increasing serum vitamin D levels is considered that induce expression of TGF-ß1. Serum vitamin D levels and TGF-ß1 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.

Factors affecting fluoroscopy time during percutaneous nephrolithotomy: Impact of stone volume distribution in renal collecting system.

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 fl uoroscopy 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 fl uoroscopy time was significantly associated with the ASV-to-RCSV ratio (p<0.001, r=0.614). The single tract was used in 77 ( 75.5%) cases while multiple tracts were used in 25 (24.5%) cases. Fluoroscopy time was significantly associated with multiple access (p<0.001, r=0.689). On univariate linear regression analysis, longer fluoroscopy time was related with increased stone size, increased stone volume, increased number of access, increased calyx number with stone, increased ASV-to-RCSV, increased operative time and decreased stone essence. On multivariate linear regression analysis, the number of access and the ASV-to-RCSV were independent predictors of fluoroscopy time during percutaneous nephrolithotomy. CONCLUSIONS: The distribution of the stone burden volume in the pelvicalyceal system is a significant predictor for prolonged fluoroscopy time during percutaneous nephrolithotomy. Measures to decrease FT could be benefi cial in patients with a high ASV-to-RCSV ratio for precise preoperative planning.