The relationship between premature ejaculation and the timing of pre-adult circumcision.

We aimed to investigate the relationship between premature ejaculation and the age when men had been circumcised before adulthood. A total of 2,768 sexually active male patients aged between 18 and 65 years were included in this study. A multicentre study was conducted prospectively with the participation of 20 centres. A survey consisting of 12 questions prepared by the researchers, as well as the validated Turkish versions of the five-item Premature Ejaculation Diagnostic Tool, was administered to all participants. The study included 1,603 participants who met the inclusion criteria. There was no significant difference in the Premature Ejaculation Diagnostic Tool and self-reported ejaculation time between the participants who had been circumcised at different ages during childhood. Remembering circumcision experience with fear or anxiety did not increase the risk of sexual dysfunction compared to the participants who described their experience with happiness or with no particular emotion. There was no significant difference in Premature Ejaculation Diagnostic Tool scores or the self-reported ejaculation time of the participants circumcised at different ages. The age of childhood circumcision, having a fearful or anxious circumcision experience, does not affect the risk of premature ejaculation in adult life.

Nitric oxide and asymmetric dimethyl arginine (ADMA) levels in an experimental hydronephrotic kidney caused by unilateral partial ureteral obstruction.

AIM: Our aim is to measure asymmetric dimethyl arginine and nitric oxide levels in rats with induced unilateral acute ureteral obstruction to research the effects on the kidney. MATERIAL AND METHODS: The study included 21 adolescent (average age 6 weeks) Sprague-Dawley male rats weighing between 240-290g divided at random into 3 groups. Group-1: Control group (n=6): underwent no procedures. Group-2: Sham group (n=6): underwent the same procedures as the experimental group without ureter and psoas muscle dissection. Group-3: Group with induced partial unilateral ureteral obstruction (n=9). All rats were sacrificed after 12 weeks. Superoxide dismutase enzyme activity and nitrite and nitrate salt levels were measured in renal tissue. Plasma nitrite-nitrate and ADMA levels were examined. RESULTS: In the experimental group histopathological changes observed included renal pelvis dilatation, flattened papillae, sclerotic glomerulus and fibrosis. In the experimental group tissue SOD and blood ADMA levels were higher than the control and sham groups (p<0.05) while tissue NO and plasma NO values were lower than in the sham and control groups (p<0.05). CONCLUSION: Oxidative stress and disruption of NO synthesis play an important role in renal function and histopathological changes after obstructive renal disease. To prevent renal complications developing after obstructive nephropathy we believe that a new strategy may be research on reducing ADMA.

Endothelial Dysfunction and Ischemia-Modified Albumin Levels in Males with Diabetic and Nondiabetic Erectile Dysfunction.

In this study, we aimed to determine endothelial dysfunction and ischemia-modified albumin (IMA) levels in patients diagnosed with erectile dysfunction (ED) and to examine the relationship between these and diabetes disease. 86 male patients (46 patients with diabetes, age: 51.5 ± 9.2 and 40 patients with nondiabetes (control group), age: 54.78 ± 12.2) were included in the study. IMA, a new indicator of tissue ischemia and oxidative stress, was checked. Superoxide dismutase (SOD) activity, another oxidative stress indicator, was examined. Endothelin-1 (ET-1), one of the parameters of endothelial dysfunction, was measured. Additionally, endothelial function was evaluated with flow-mediated vasodilatation (FMD). Student's t-test was used for statistical evaluation. p values less than 0.05 were considered statistically significant. SOD activity was significantly lower in the diabetic group than in the control group, and ET-1 was significantly higher (p < 0.001). IMA was found to be significantly higher in the diabetic group than the control group (p < 0.001). FMD was significantly lower in diabetic group compared to the control group (p < 0.002). According to our findings, the co-occurrence of erectile dysfunction and diabetes demonstrates a complex condition that includes endothelial dysfunction, oxidative stress, and tissue ischemia. When the correlation of indicators, which are markers, was examined, the severity of the co-occurrence of diabetes and erectile dysfunction was again demonstrated.

Unexpected severe hepatotoxicity of ciprofloxacine: two case reports.

Ciprofloxacin is a fluoroquinolone antibiotic that has a relatively low rate of occurence of adverse side effects. However, increasing evidences suggest that ciprofloxacin may cause unexpected severe liver damage. Especially, the risk of hepatotoxicity is significantly higher in elderly men receiving drug for a long time. In this article, 2 cases of unexpected severe hepatoxicity of ciprofloxacin are presented.

The Association Between Delayed Graft Function and Renal Resistive Index in Kidney Transplant Recipients.

Background and objectives Delayed graft function (DGF) may increase the risk for kidney graft dysfunction. Renal resistive index (RRI) in Doppler ultrasonography is useful in measuring blood flow changes in kidneys which is indicative of tubulointerstitial damage. Most of the diseases in DGF etiology are related to tubulointerstitium and arteries of the kidneys. In this study, we investigated whether there is a relationship between delayed graft function and renal resistive index in kidney transplant recipients (KTR). Materials and methods Patients who underwent kidney transplantation were included in this retrospective study. KTR were divided into two groups as DGF (+) and DGF (-). Comparison of RRI values of DGF (+) and DGF (-) groups according to the measurements at different times. Results The findings showed that both RRI measurements (post-transplant in the first week and the end of the first year) of the DGF (+) group were higher than DGF (-) group (p=0.001 and p=0.003, respectively). The interaction of measurements and DGF did not have an effect on RRI (p>0.05). Conclusion The value of RRI in the DGF (-) group was lower than DGF (+) group in the first week after kidney transplantation.

Evaluating the Relationship Between Burnout Levels and Compassion Fatigue, Emotional Intelligence, and Communication Skills of Organ Transplant Coordinators.

AIM: The aim was to determine the effects of compassion fatigue, emotional intelligence levels, and communication skills of organ transplant coordinators on burnout. METHODS: This descriptive correlational study included 104 organ transplant coordinators. Data were collected via a survey that consisted of demographic information, the Copenhagen Burnout Inventory, the Emotional Intelligence Scale, and the Compassion Fatigue Scale. FINDINGS: A positive relationship was reported between burnout (mean, 39.42 [SD, 19.54]) and compassion fatigue (mean, 2.26 [SD, 0.86]) measurements of the organ transplant coordinators (r = 0.432) and a negative and significant relationship existed between burnout and emotional intelligence (mean, 3.53 [SD, 0.58]) measurements (r = -0.372). However, no correlation was found between communication skills (mean, 4.27 [SD, 0.52]) and burnout (r = -0.184; P > .05) except a negative correlation with client-related burnout measurements (r = -0.222; P < .05). As a result of the 2-step regression analysis, the regression-squared value predicted the joint effect of compassion fatigue and emotional intelligence on burnout (R2 = .285). CONCLUSIONS: Organ transplant coordinators reported moderate levels of burnout and compassion fatigue and high levels of emotional intelligence and communication skills. Compassion fatigue caused burnout, while emotional intelligence decreased. Additionally, transplant coordinators' communication skills were related to client-related burnout.

A Rare Complication of Amplatz Sheath: Amplatz Sheath Rupture During Percutaneous Nephrolithotomy.

Introduction: Amplatz sheaths are hollow tubes that serve as the portal for the insertion of the nephroscope during percutaneous nephrolithotomy (PCNL). Breakage of this tube during the procedure is rare, but when it does occur it should be recognized and addressed promptly. Case Presentation: A 46-year-old Caucasian male patient was scheduled for PCNL. The Amplatz sheath was inserted in the usual manner over a balloon dilator and nephroscopy was performed. Profuse bleeding was encountered early. Upon meticulous endoscopic navigation, the broken Amplatz tube was recognized and replaced. This allowed us to identify and remove the fragment of the Amplatz tube, followed by stone fragmentation and removal. Conclusion: Our experience highlights the importance of recognizing this rare complication of a broken Amplatz sheath that should be managed promptly and effectively through endoscopic means without the need to abort the planned PCNL.

Alterations in iris structure and pupil size related to alpha-1 adrenergic receptor antagonists use: implications for floppy iris syndrome.

PURPOSE: To evaluate structural alterations of iris and pupil diameters (PDs) in patients using systemic α-1-adrenergic receptor antagonists (α-1ARAs), which are associated with intraoperative floppy iris syndrome (IFIS). METHODS: Eighty-eight eyes of 49 male were evaluated prospectively. Patients were assigned to 2 different groups. Study group included 23 patients taking any systemic α-1ARAs treatment, and control group included 26 patients not taking any systemic α-1ARAs treatment. All patients underwent anterior segment optical coherence tomography to evaluate iris thickness at the dilator muscle region (DMR) and at the sphincter muscle region (SMR). The PD was measured using a computerized infrared pupillometer under scotopic and photopic illumination. RESULTS: The study group included 46 eyes of 23 patients and the control group included 42 eyes of 26 patients. Most treated patients were on tamsulosin (16/23). Mean age was similar in the study and control groups (61.9±7.1 vs. 60.3±8, 2 years, nonsignificant). DMR (506.5±89.4 vs. 503.6±83.5 µm), SMR (507.8±78.1 vs. 522.1±96.4 µm) and the DMR/SMR ratio (1.0±0.15 vs. 0.99±0.23 µm) was similar in the study and control groups and these differences were nonsignificant. Scotopic PDs were also similar in both groups (3.99±1.11 vs. 3.74±1.35, nonsignificant). A significantly reduced photopic PD (2.89±0.55 vs. 3.62±0.64, P<0.001) and an increased scotopic/photopic PD (1.42±0.44 vs. 1.02±0.30, P<0.001) were found in the study group. CONCLUSIONS: Evaluating PD alterations might be more useful than evaluating iris structural alterations in predicting IFIS. There is still a need for a reliable method that will determine the possibility of IFIS.

Nitric oxide and asymmetric dimethyl arginine (ADMA) levels in an experimental hydronephrotic kidney caused by unilateral partial ureteral obstruction

ABSTRACT Aim Our aim is to measure asymmetric dimethyl arginine and nitric oxide levels in rats with induced unilateral acute ureteral obstruction to research the effects on the kidney. Material and Methods The study included 21 adolescent (average age 6 weeks) Sprague-Dawley male rats weighing between 240-290g divided at random into 3 groups. Group-1: Control group (n=6): underwent no procedures. Group-2: Sham group (n=6): underwent the same procedures as the experimental group without ureter and psoas muscle dissection. Group-3: Group with induced partial unilateral ureteral obstruction (n=9). All rats were sacrificed after 12 weeks. Superoxide dismutase enzyme activity and nitrite and nitrate salt levels were measured in renal tissue. Plasma nitrite-nitrate and ADMA levels were examined. Results In the experimental group histopathological changes observed included renal pelvis dilatation, flattened papillae, sclerotic glomerulus and fibrosis. In the experimental group tissue SOD and blood ADMA levels were higher than the control and sham groups (p<0.05) while tissue NO and plasma NO values were lower than in the sham and control groups (p<0.05). Conclusion Oxidative stress and disruption of NO synthesis play an important role in renal function and histopathological changes after obstructive renal disease. To prevent renal complications developing after obstructive nephropathy we believe that a new strategy may be research on reducing ADMA.