Effects of external electrical stimulation added to pelvic floor muscle training in women with stress urinary incontinence: A randomized controlled study.

OBJECTIVE: In this study, the combination of external electrical stimulation (EES) with pelvic floor muscle training (PFMT) was assessed to determine if it yielded better results than PFMT or EES alone for treatment of stress urinary incontinence (SUI). STUDY DESIGN: Fifty-one women with SUI were randomly allocated to EES + PFMT (n = 17), PFMT (n = 17), or EES groups (n = 17) for 8 weeks of treatment. Personal, demographic, and clinical characteristics of the patients were recorded. Outcome measures included self-reported improvement, severity of incontinence, symptom distress, quality of life (QOL), urinary incontinence episodes, pelvic floor muscle strength (PFMS) and endurance (PFME) and dysfunction. All evaluations were made pre- and posttreatment. Data were analyzed using the Chi-square, marginal homogeneity, Kruskal-Wallis, Wilcoxon signed-rank or paired t test and Dunn-Bonferroni post hoc tests. RESULTS: In the 8th week, there were significant changes in self-reported improvement, severity of incontinence, symptom distress score, urinary incontinence episodes, PFMS, PFME, pelvic floor dysfunction and all areas of QoL in all groups (p < 0.05). Combined therapy was not superior to PFMT and EES for overall outcome measures, except for the incontinence impact subdomain of the QoL score (p < 0.05). CONCLUSIONS: Our study supports the idea that PFMT should be preferred as the first line therapy for women with SUI. However, the acceptable EES method can be recommended in addition to PFMT to increase motivation and treatment compliance in patients with insufficient or inaccurate pelvic floor muscle contractions.

Is erectile dysfunction an early clinical symptom of chronic kidney disease?

OBJECTIVES: Erectile dysfunction (ED) is the persistent inability to attain and/or maintain erection sufficient for satisfactory sexual performance. Chronic kidney disease (CKD) is a problem with increasing incidence every day which disrupts quality of life significantly. We aimed to research whether ED is a warning symptom for the early stages of CKD or not. MATERIALS AND METHODS: The records of 639 patients attending Ordu University due to ED were retrospectively investigated. According to International Index of Erectile Function (IIEF) scores and degree of ED, patients were compared in terms of GFR values. RESULTS: In 92.8% of patients, serum creatinine values were within normal limits (<1 mg/dL), while 30.5% of patients were observed to have GFR below 80. While stage 2 CKD was identified in 1% of the control group, this rate was calculated as 8% in the group with severe ED. In stage 1 and stage 2 CKD, IIEF scores were identified to be low by clear degree. CONCLUSIONS: Results confirm that it was identified that the incidence of stage 1 and stage 2 CKD was higher among patients attending with ED compared to the control group. Just as ED may be an early clinical marker of coronary artery disease, it may be early warning symptom for CKD.

Association between the Trp64Arg polymorphism of the ADRB3 gene and overactive bladder.

BACKGROUND: The ß3 -adrenergic receptor (ADRB3) is very important in the regulation of the human detrusor muscle function. The well-known tryptophan64arginine polymorphism of the ADRB3 gene alters the response of the receptor to various stimuli, including adrenalin and noradrenalin, and may increase the susceptibility to develop overactive bladder (OAB). Therefore, this study was performed to determine whether ADRB3 Trp64Arg polymorphism is associated with the pathophysiology of OAB syndrome. METHODS: The study group (n = 150) consists of 72 patients with OAB and 78 controls without OAB. Venous blood samples were taken from all participants to analyze the ADRB3 gene Trp64Arg polymorphism using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assay. We compared the distribution of Trp64Arg polymorphism and symptom severity in both OAB and non-OAB subjects using χ2 test and Mann-Whitney's U test, respectively. RESULTS: The frequency of the 64Arg variant (heterozygous plus homozygous) in OAB and non-OAB subjects was 15.3% and 14.1%, respectively. There was no statistically significant difference between the OAB and non-OAB groups in regard to the distribution frequency of ADRB3 Trp64Arg polymorphism. The total frequency (OAB + non-OAB, 76 women and 74 men) of the Arg64 variant allele was 5.9% and 10.8% in women and in men, respectively. Although the frequency of the Arg64 variant was nearly twofold higher in men compared to women, the difference was not statistically significant. CONCLUSIONS: These results demonstrated that the ADRB3 Trp64Arg polymorphism is not significantly associated with OAB syndrome in a sample of Turkish OAB patients.

Can transurethral thermotherapy save elderly patients with benign prostatic obstruction and high ASA score?

INTRODUCTION: The Aim of this study was to investigate the efficacy of the new bipolar radiofrequency prostate thermotherapy method for those with high potential surgical risk and also for patients with a chronic catheter. MATERIAL AND METHODS: 103 patients attending our clinic due to BPO and related complaints with high ASA score had outcomes after the procedure recorded prospectively and investigated retrospectively. Qmax, prostate volume, IPSS score, quality of life score, and presence of catheters were recorded before the procedure and analyzed with the outcomes after the procedure. RESULTS: The ASA scores were calculated as 3.0 ± 1.0 (IQR). Before the procedure, Qmax values (mean (SD)) were 5.11 ± 5.37 ml/s, while in the 6th month after the procedure Qmax values were identified as 10.45 ± 3.8 ml/s (p < 0.001). Of 53 patients (55.2%) with chronic catheters who could not be operated, 30 (61.2%) no longer required urinary catheter. CONCLUSION: Bipolar RF thermotherapy appears to be an effective method for patients with BPO who cannot be operated. Due to the surgical risks of patients dependent on the catheter in spite of receiving medical treatment, it is a good alternative to remove catheter dependence. It may be one of the methods that should be remembered, especially in this patient group.

Polygamy, sexual behavior in a population under risk for prostate cancer diagnostic: an observational study from the Black Sea Region in Turkey.

AIM: Although prostate cancer (PCa) is the most common cancer type in men, a replaceable risk factor has not yet been established. In our study, we assessed the relationship between the number of sexual partners, age of first sexual experience and age of first masturbation and prostate cancer incidence. MATERIALS AND METHODS: In Ordu University Department of Urology between January 2013 and September 2016, in PSA elevation and rectal examination, patients with prostate biopsy were evaluated due to nodule palpation in the prostate. At younger ages and at present, their first masturbation ages, first sexual debut ages, and total sexual partner numbers were recorded. The correlation between the obtained data and PCa frequency was evaluated. RESULTS: The study included 146 patients with PCa identified on biopsy and 171 patients with benign biopsy results who answered the questions. 66.7% of the ones whose biopsy results were benign and 40.6% of cancer suspects had only one sexual partner. The median number of sexual partners was 1±4 (1-100) in the benign group and 2±6 (1-500) in the malignant group (p=0.039). There was a negative correlation between age of first sexual debut and number of partners (r: -0,479; p<0.001). CONCLUSION: In our study, it appears that there may be an association between the number of sexual partners and prostate cancer in the patient group with PSA level above 4ng/mL. Avoidance of sexual promiscuity or participation in protected sex may be beneficial to protect against prostate cancer.

Early term effect of ureterorenoscopy (URS) on the Kidney: research measuring NGAL, KIM-1, FABP and CYS C levels in urine.

AIM: URS is a very commonly used procedure for treatment of ureter stones. Increased hydrostatic pressure in the collecting system linked to fluids used during the procedure may cause harmful effects on the kidney. The aim of this study is to determine whether the URS procedure has a negative effect on the kidney by investigating NGAL, KIM-1, FABP and Cys C levels in urine. MATERIAL AND METHODS: This study included 30 patients undergoing ureterorenoscopy (URS) for ureter stones. Urine samples were collected 5 times; before the URS procedure (control) and at 1, 3, 5 and 12 hours following the procedure. NGAL, KIM-1, FBAP and Cys C levels were measured in urine and compared with the control values. RESULTS: The NGAL levels in urine before the procedure and at 1, 3, 5 and 12 hours after the procedure were 34.59±35.34; 62.72±142.32; 47.15±104.48; 45.23±163.16 and 44.99±60.79ng/mL, respectively (p=0.001). Similarly, the urinary KIM-1, FABP and Cys C levels were found to increase compared to control values; however this increase did not reach statistical significance (p >0.05). CONCLUSIONS: After the URS procedure, there were important changes in NGAL, FABP, KIM-1 and Cys C levels. These changes reached statistical significance for NGAL, but did not reach significance for the other parameters. In conclusion, the URS procedure significantly affects the kidney; however, this effect disappears over time.

The effect of tadalafil therapy on kidney damage caused by sepsis in a polymicrobial septic model induced in rats: a biochemical and histopathological study.

INTRODUCTION: Sepsis is an inflammatory reaction to bacteria involving the whole body and is a significant cause of mortality and economic costs. The purpose of this research was to determine whether tadalafil exhibits a preventive effect on sepsis in a septic model induced in rats with cecal ligation and puncture (CLP). MATERIALS AND METHODS: Rats were randomly separated into groups, 10 rats in each: (i) a sham (control) group, (ii) an untreated sepsis group, (iii) a sepsis group treated with 5mg/kg tadalafil and (iv) a sepsis group treated with 10mg/kg tadalafil. A polymicrobial sepsis model was induced in rats using CLP. Rats were sacrificed after 16h, and blood and kidney tissues were collected for biochemical and histopathological study. RESULTS: Levels of the inflammatory parameter IL-6 decreased significantly in the sepsis groups receiving tadalafil in comparison with the untreated sepsis group (p < 0.05). In terms of histopathology, inflammation scores investigated in kidney tissues decreased significantly in the sepsis groups receiving tadalafil compared to the untreated sepsis group (p < 0.05). In addition, levels of creatinine and cystatin C measured in septic rats receiving tadalafil were lower by a clear degree than in septic rats (p < 0.05). CONCLUSION: In this study, tadalafil exhibited a preventive effect for sepsis-related damage by suppressing inflammation in serum and kidney tissue of septic rats in a polymicrobial sepsis model induced with CLP.

Comparison of preventive analgesia techniques in circumcision cases: Dorsal penile nerve block, caudal block, or subcutaneous morphine?

OBJECTIVE: To compare 3 different techniques of preventive analgesia before circumcision operations in male children between 6-12 years of age. Our objective was to investigate the duration and quality of postoperative analgesia in patients, who were subject to caudal block technique, dorsal penile nerve block or who were administered subcutaneous morphine. METHODS: The prospective, randomised, single-blind study was conducted at Ordu University Training and Research Hospital, Ordu, Turkey, from January 1 to June 30, 2015, and comprised boys aged 6-12 years, who were scheduled to undergo circumcision operation. All patients were under general anaesthesia by means of laryngeal masks. The patients were randomised into 3 equal groups. The patients in Group C received caudal block with bupivacaine 0.25% in a total volume of 0.50 ml/kg in lateral position. Those in Group M received injections of 100 mcg/kg of subcutaneous morphine into the deltoid muscle. Patients in Group DP were subjected to dorsal penile nerve block with 1 mg/kg of bupivacaine 0.25%. Intraoperative haemodynamic data, pain and sedation scores, according to Children's Hospital of Eastern Ontorio Pain Scale and Ramsay Sedation Scale, were recorded at postoperative 1st, 6th and 24th hours in all cases. RESULTS: The 60 subjects in the study were divided into 3 groups of 20(33.3%) each. The overall mean age was 7.75±8.12 years. At 1 hour after surgery; 8(40%) cases in Group M, 5(25%) cases in Group DP, and all the 20(100%) cases in Group C had a pain score <6 (p<0.05). When the scores were analysed 12 hours post-operatively, 5(25%) cases in Group M and 10(50%) cases in Group DP had a pain score >6, while the pain scores of all the 20(100%) cases in Group C were <6 (p<0.01). Among the groups, there was no statistically significant difference regarding the sedation scores (p>0.05). CONCLUSIONS: Using the three methods, analgesia lasted until 12 hours postoperatively, being more evident in the caudal block group, minimising postoperative stress in children and parents.

Are erectile functions affected by AB0 blood group?

AIM: The aim of this study was to investigate whether there is a relationship between erectile dysfunction (ED), thought to be a vascular disease, and AB0 blood group. MATERIAL AND METHOD: The study included 350 people abiding by the study criteria who applied to our clinic from April 2012-April 2015. The patients were divided into two groups including those with ED (Group 1) and those without (Group 2). Age, blood group, IIEF-5 score and presence of additional diseases were recorded. Erectile functions were analyzed according to blood group. RESULTS: There was no difference between the mean age of 111 patients with ED and that of 239 patients without ED included in the study (p = 0.284). There was no difference between patients in the two groups in terms of smoking, alcohol use, hypertension and diabetes (p > 0.05). Among patients in the ED group, the mean IIEF-5 score according to blood group was 19.8 ± 5.04 in the 0 blood group, 16.5 ± 5.2 in the A blood group, 17.2 ± 5.3 in the B blood group and 13.3 ± 3.02 in the AB blood group. The IIEF-5 scores of individuals in the 0 blood group were significantly high compared to individuals in other blood groups (p = 0.004). Logistic regression analysis found that compared to the 0 blood group, the erectile dysfunction risk was 3.9 times greater for the A blood group, 3.5 times greater for the B blood group and 4.7 times greater for the AB blood group (p = 0.001) (Table 3). CONCLUSION: The risk of erectile dysfunction was significantly increased for individuals in the A, B and AB blood groups compared to individuals in the 0 blood group.

Correlation between erectile dysfunction and serum B12 levels: a 136-case cross-sectional analysis.

BACKGROUND: Erectile dysfunction (ED) involves the inability to initiate or sustain penile erection with sufficient hardness to ensure satisfying sexual relations. Many causes are blamed in the etiology. OBJECTIVES: In this study, the correlation between serum vitamin B12 (vit B12) levels with ED was researched in a homogeneous case group after exclusion of all other predisposing conditions causing ED. METHODS: The study included male patients attending the urology clinic from 2015 to 2022. Patients were prospectively registered to the study. Cases were divided into two groups as low and normal according to vit B12 levels. In the study, vit B12 levels ≤200 mg/dL were accepted as low. The Sexual Health Inventory for Men-5 (SHIM-5) was used to assess the erectile function. The SHIM-5 scores for the groups were compared. All patients with comorbid diseases, medication use, or previous surgical history predisposing toward ED and organic and/or psychogenic causes for ED were excluded from the study. RESULTS: The study included 136 patients abiding by the study criteria among 957 patients. The mean age of cases was 63.35 ± 7.83 years. Mean vit B12 value was 320.74 ± 184.74 mg/dL and 32 cases (23.5%) had inadequate vit B12 (< 200 mg/dL). The mean SHIM-5 value in the group was 15.48 ± 6.71. In the inadequate vit B12 and normal vit B12 groups, the mean SHIM-5 values were 15.30 ± 6.85 and 16.06 ± 6.28, respectively, with no significant difference between the two groups (t = 0.562, p = 0.575). Vit B12 deficiency was identified in 26.7% of patients with sexual desire disorder (SDD) (n = 90) and 17.4% of those without SDD (X2 = 1.46, p = 0.228). DISCUSSION: Contrary to the general trend in the literature, we found no significant correlation between vit B12 levels and ED. CONCLUSION: There is a need for prospective randomized controlled studies for detailed analysis of the correlation between erectile dysfunction and vit B12.

Comparison of Serum Gamma Glutamyl Transferase Levels between Prostate Cancer Patients and Their Healthy Peers.

Background: Prostate cancer (PCa) is the most common cancer affecting men, apart from cutaneous cancers. Serum prostate specific antigen (PSA) levels are frequently used to predict prostate cancer diagnosis. However, many causes (e.g., prostatitis, benign prostate obstruction, urethral catheterization) may cause elevated PSA, in addition to PCa. We aimed to investigate the gamma glutamyl transferase (GGT) levels, a serum biomarker not affected by situations other than cancer causing elevated PSA. Methods: The study evaluated male patients with prostate biopsy due to high serum PSA levels and/or abnormal digital rectal examination (DRE) examined in Ordu University Education and Research Hospital, Ordu/Turkey urology clinic from April 2019 to April 2021. The patient group in the study included 261 men with PCa diagnosis and the control group included 245 healthy men with normal PSA levels, and no PCa and/or benign prostate obstruction (BPO). The two groups were compared in terms of serum GGT levels. Results: GGT was significantly low in the PCa group and might be a predictor in terms of PCa (P=0.000). In the malignant (PCa) group, the GGT cut-off value was identified as 21.5 (sensitivity 68.6%, specificity 54.4%). Conclusion: Serum GGT levels might assist in diagnosis of PCa. However, diagnostic power is weak due to low specificity. There is a need for studies investigating the efficacy of GGT levels for prediction of PCa diagnosis and assessing other parameters alongside GGT.

Does isotretinoin affect spermatogenesis in the long term? A rat model.

OBJECTIVES: Spermatogenesis, in which cell regeneration continues, can be affected by environmental, chemical, psychological factors or various diseases. There is conflicting information in the literature about the effect of isotretinoin, which is widely used in acne treatment, on testes and spermatogenesis. Therefore, we planned a rat study to evaluate the long-term efficacy of oral isotretinoin on testicular tissues and spermatogenesis. MATERIALS AND METHODS: The Group 1 (n = 6) 7.5 mg/kg/day and the Group 2 (n = 6) received isotretinoin at a dose of 30 mg/kg/day dissolved in sunflower oil, the Sham Group (n = 6) received only sunflower oil by gavage, and the control group (n = 6) received standard feed and water for four weeks. After the 4th week, all animals were fed with standard feed and water and followed for the next four weeks. At the end of the 8th week, all animals were sacrificed under deep anesthesia. Seminiferous tubule diameters, epithelial thickness, apoptotic index, sperm number and motility recorded Results: Sperm count, motility, vitality, diameter of seminiferous tubule and germinal epithelium thickness were decreased and apoptotic index increased in the groups received isotretinoin. There was no significant difference between the groups in terms of testosterone levels. CONCLUSIONS: We consider that further comprehensive studies, including human clinical trials, should be conducted to examine the negative effects of isotretinoin on spermatogenesis in the long term especially when there is a need using isotretinoin in men for various reasons and to eliminate the contradictions in the literature in this regard.

Retroperitoneal laparoscopic pyelolithotomy in an ectopic pelvic kidney.

BACKGROUND AND OBJECTIVES: Retroperitoneal laparoscopic pyelolithotomy was performed in an ectopic pelvic kidney with renal pelvis calculi. METHODS AND RESULTS: Laparoscopic pyelolithotomy was successfully performed in an ectopic pelvic kidney by using the retroperitoneal route. The total operation time was 130 minutes, and the estimated blood loss was < 50 mL. The patient was discharged on the second postoperative day without any complications. CONCLUSION: Laparoscopic pyelolithotomy is an effective treatment option for management of stones in the pelvis of an ectopic pelvic kidney. The retroperitoneal route may help to avoid intraoperative and postoperative complications.

Bipolar radiofrequency thermotherapy vs. transurethral resection of the prostate: Effect on nocturia as a result of benign prostatic obstruction.

INTRODUCTION: The purpose of this study was to investigate and compare the effects of radiofrequency thermotherapy (RF) thermotherapy and transurethral resection of the prostate (TURP) on nocturia and associated quality of life in patients diagnosed with benign prostatic obstruction (BPO) under medical treatment who have complaints of persistent nocturia. METHODS: The results of patients who underwent RF thermotherapy and TURP procedures between February 2019 and February 2022 were examined, and their three-month results were compared based on their uroflowmetry values, International Prostate Symptom Score (IPSS) values, nocturia frequency, and Nocturia Quality of Life Questionnaire scores. RESULTS: While the frequency of nocturia in the RF thermotherapy group that was 4.5±1.6 before the procedure decreased to 2.3±1.4 after the procedure (p=0.002), this value in the TURP group decreased from 5.1±2.42 to 3.9±2.1 (p=0.044). RF thermotherapy was found to be more effective than TURP (p<0.005). Significantly, more noticeable improvements were observed in most nocturia-related next-day complaints and nocturia-related concerns in the RF thermotherapy group than the TURP group. CONCLUSIONS: It was observed that RF thermotherapy had a more acceptable effect on obstructive complaints in comparison to TURP, and it could be more effective on nocturia and associated quality of life. RF ablation treatment may be offered as an appropriate option to treat nocturia complaints in suitable patients.

Comparison of Sexual Behavior and Inflammatory Parameters in Prostate Cancer Patients with Control Group: Prospective Controlled Study.

PURPOSE: In spite of extraordinary developments in diagnostic and treatment methods for prostate cancer (PCa), the reason for this disease is not known. Our study aimed to compare men in the PCa group with a control group in terms of sexual behavior like partner numbers and ejaculation frequency, and inflammatory parameters examined in serum. MATERIAL AND METHODS: This study was performed prospectively between 2013 and April 2020 and the record system was kept by a single doctor. Patients were prospectively recorded by a single person. Patients with diagnosis of PCa were compared with a control group in terms of sexual behavior and in terms of inflammatory parameters like neutrophil lymphocyte ratio (NLR, neutrophil count/lymphocyte count), systemic inflammatory index (SII, neutrophil count x platelet count/lymphocyte count). RESULTS: In this study, median marriage age was 18 ± 6 years in the control group and 20 ± 2.97 in the PCa group (P = .001). The median lifelong partner number was observed to be 1 ± 1 in the control group and 1 ± 9 in the PCa group (median ± IQR). Additionally, lifelong median ejaculation frequency was determined as 12 ± 5 for controls and 10 ± 4 for the PCa group. Inflammatory markers examined in serum and SII scores were observed to be statistically significantly increased in the cancer group. CONCLUSION: The sexual behavior and inflammatory parameters among patients with PCa diagnosis were identified to be significantly high compared to the control group and appear to be possible correctable risk factors. Informing men about sexual behavior from an early age and taking precautions for people at risk in the early period may be protective against this disease.

Effect of Transurethral Thermotherapy on Storage Symptoms Associated with Lower Urinary System Complaints in Elderly.

BACKGROUND: Storage symptoms are pathology with increasing frequency and importance among elderly men. The efficacy and advantages of the new bipolar radiofrequency prostate thermotherapy method were investigated for storage symptoms in elderly. METHODS: The outcomes for 150 elderly patients with significant storage symptoms accompanying voiding symptoms were investigated. The patients' Qmax (maximum urinary flow rate), prostate volumes, OAB-V8 (overactivebladder-Validated 8) and quality of life scores were questioned before the procedure and 1st month and 6th month. RESULTS: OAB-V8 total score had mean value of 26.3, with values identified as 16.2 (p < 0.001) at the end of the 1st month and 13.9 (p = 0.001) at the end of the 6th month. There were significant reductions in daytime frequent urination, uncomfortable urgency and sudden feeling of urgency complaints (p < 0.001). Thirty-five patients had significant fall in urgency with incontinence (p = 0.016). CONCLUSIONS: The bipolar radiofrequency thermotherapy method provides significant improvement of storage symptoms in elderly men. It is thought that this method has advantages in terms of its effects on storage and voiding symptoms in the elderly.

Effect of targeted prophylaxis with rectal swab on complications after prostate biopsy: prospective randomized study.

BACKGROUND: For diagnosis of prostate cancer, prostate biopsy accompanied by TRUS is the current method applied today. AIM: The aim of this study was to compare targeted antibiotic prophylaxis, chosen according to rectal swab results before the procedure, with routinely administered prophylaxis and to investigate the effect on infective complications. METHODS: The study included 140 patients with 12-quadrant prostate biopsy accompanied by TRUS in our hospital from 2018 to 2020. The first group had antibiotherapy prophylaxis administered according to the results of rectal swabs before the procedure. The second group had routine ciprofloxacin prophylaxis administered. Patients were followed prospectively for 1 month after the procedure. RESULTS: When the mean age, systemic diseases and distribution in both groups are examined, there was no significant difference observed. Fever (> 38.5 °C) was observed in 3 patients in the rectal swab group (4.3%), while it was identified in 10 people in the control group (14.1%) (p = 0.047). Major complications were observed in 3 people in the rectal swab group (4.3%) and in 7 people in the control group (9.9%) (p = 0.012). CONCLUSIONS: The results of the study identified that routine administration of targeted antibiotic prophylaxis may be more effective in preventing infective complications compared to standard prophylaxis. Targeted prophylaxis is recommended for risky patients in the guidelines. However, the lack of difference between the groups in terms of age and comorbidities supports the need to administer targeted prophylaxis not just to risky patients but as well as routine practice.

Effect of bladder dysfunction on development of depression and anxiety in Parkinson's disease.

OBJECTIVES: Parkinson's disease (PD) often presents with movement disorder. However, besides motor complaints, there are many complaints such as anxiety, depression, urinary complaints and constipation. The aim of this study was to investigate whether neurogenic lower urinary dysfunction (NLUD), which is frequently seen in PD, has an effect on the development of anxiety and depression in these patients. MATERIALS AND METHODS: The study included 32 males (66.6%) and 16 females (33.3%); in total 48 subjects were registered. For the diagnosis and severity of PD, the UK Parkinson's Disease Society Brain Bank Criteria, Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn-Yahr scale were used. Urological evaluation was performed using history, physical examination, laboratory tests and standard forms such as IPSS and OAB-V8. RESULTS: There was no difference between the genders in terms of duration, severity and NLUD (p > 0.05). The incidence of anxiety and depression in PD patients was 62.8% and 72.1%, respectively. The prevalence of NLUD was 67.4% and depression and anxiety was found to increase (1.06 and 1.28 times, respectively) in relation to NLUD. In particular, there was a relationship between storage lower urinary tract symptoms and anxiety and depression development (p < 0.05). CONCLUSIONS: As expected, it was found that the incidence of NLUD, anxiety and depression was increased in PD. In addition, NLUD was found to be a risk factor for the development of anxiety and depression. Therefore, it is concluded that NLUD, which can potentially cause important complications, as well as motor complaints, should be closely monitored and treated in PD patients.

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life. AIM: To investigate whether there have been variations in the presentations of male patients with sexual and reproductive health problems to the outpatient urology clinics during the COVID-19 pandemic and to understand the underlying factors for these variations, if any. METHODS: Male patients aged ≥18 years who presented to the outpatient urology clinics in 12 centers across Turkey from February 1, 2020 to June 1, 2020 were retrospectively evaluated. The patients were divided into 2 groups: those who presented to the outpatient clinic from February 1, 2020 to March 11, 2020 comprised the "pre-COVID-19 pandemic period" group, whereas those who presented to the outpatient clinic from March 12, 2020 to June 1, 2020 comprised the "COVID-19 pandemic period" group and compared with each other. MAIN OUTCOME MEASURES: The main outcome of this study was the number and diagnose of patients presented to urology outpatient clinics. RESULTS: Andrological problems were detected in 721 of 4,955 male patients included in the study. During the COVID-19 pandemic period, there was a significant increase in andrological diagnosis in these patients compared with the pre-COVID-19 pandemic period (n = 293 [17%] vs n = 428 [13.2%], P < .001, respectively). Similarly, there was a statistically significant increase in the number of patients diagnosed with male reproductive or sexual health problems during the COVID-19 pandemic period (n = 107 [6.2%] vs n = 149 [4.6%], P = .016 and n = 186 [10.8%] vs n = 279 [8.6%], P = .013, respectively). The number of patients diagnosed with erectile dysfunction during the pandemic was also significantly higher than the pre-COVID-19 pandemic period (n = 150 [8.7%] vs n = 214 [6.6%], P = .008). CONCLUSION: Presentations to the outpatient urology clinics owing to andrological problems markedly increased during the pandemic period. Although these problems are of multifactorial origin, psychogenic factors are also considered to significantly trigger these problems.MB Duran, O Yildirim, Y Kizilkan, et al. Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study. Sex Med 2020;XX:XXX-XXX.