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Abstract Bladder volume measurement is critical for early detection and management of lower urinary tract dysfunctions. Current gold standard is invasive, and alternative technologies either require trained personnel or do not offer medical grade information. Here, we report an integrated wearable ultrasonic bladder volume monitoring device for accurate and autonomous continuous monitoring of the bladder volume. The device incorporates flexible and air-backed ultrasonic transducers and miniaturized control electronics with wireless data transmission capability. We demonstrate the real-life application of the device on healthy volunteers with various bladder shapes and sizes with high accuracy. Apart from the lower urinary tract dysfunctions, the proposed technology could also be adapted for various wearable ultrasonic applications.

Objective: We aimed to describe the outcomes and patient satisfaction (PS) rates of transurethral polyacrylamide hydrogel (PAHG) (Bulkamid®) injection for the treatment of female stress urinary incontinence (SUI) in a Turkish cohort. Materials and Methods: Twenty-two patients who underwent injection primarily or secondarily between December 2019 and March 2023 due to SUI or stress-predominant mixed urinary incontinence (MUI) were retrospectively evaluated. All patients underwent an invasive urodynamic study (UDS) before the procedure. The primary outcome was treatment success (TS), defined as no pad use, negative International Continence Society (ICS) uniform cough stress test (CST), and no SUI on International Consultation on Incontinence Questionnaire-Short Form question 6. The secondary outcome was PS. Results: The median age was 61.5 (41-84) years. Six patients had stress-predominant MUI and 15 had SUI. PAHG injection was the primary and secondary treatment in 17 and 4 patients, respectively. ICS uniform CST was positive in all patients. In 8 patients, intrinsic sphincter deficiency (ISD) was detected during UDS. One patient developed transient urinary retention after surgery. At a median follow-up of 17 (1-38) months, the overall TS rate was 85.7%. Success rates in primary vs. secondary setting and pure SUI vs. MUI were 88.2% vs. 75% and 80% vs. 100%, respectively. The overall PS rate was 90%. Satisfaction rates in the primary vs. secondary setting and pure SUI vs. MUI were 93.6% vs. 75% and 85.7% vs. 100%, respectively. TS and PS rates were 100% in all patients with ISD. Conclusion: PAHG injection proved to be a safe and effective minimally invasive treatment for pure stress and stress-predominant MUI in both primary and secondary settings.

Aims:: To present the ICS Teaching Module on Videourodynamics (VUD) and the information as a best practice report. Methods:: This teaching module was developed by the (International Continence Society) ICS Urodynamics Committee to assist ICS members in their clinical practice. A detailed literature search on studies and guidelines published on the clinical role of VUD as well as expert opinions have been considered. A slideshow on VUD has been developed and will be presented to the members of the ICS Urodynamics Committee and will be made available to the ICS membership on the ICS website. Results:: The scientific evidence on the indications, recommended techniques and interpretation of VUD in patients presenting with lower urinary tract symptoms has been summarised. Troubleshooting and optimisation of the imaging as also been described to minimise the radiation exposure to both patient and healthcare professionals. Conclusions:: The scientific evidence on the clinical role, techniques and the indications for VUD is sparse with varying clinical expert opinion. The ICS Urodynamics Committee recommends its use as a second line diagnostic tool for a thorough visualisation of the lower urinary tract anatomy and real time function. This manuscript summarises the evidence and provides practice recommendations on VUD for teaching purposes in the framework of an ICS teaching module.

Aim:: To present the body of evidence behind the International Continence Society (ICS) educational module on “Practice of uroflowmetry in adults” which consists of a PowerPoint® presentation. Methods:: This evidence review has been prepared by a working group instituted by the ICS Urodynamics Committee. The method used included systematic literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results:: A total of 104 articles were included in this systematic review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Evidence analysis was conducted along the following themes: physiology of voiding, pathophysiology of lower urinary tract dysfunction, technique of uroflowmetry, quality check of the uroflowmetry test, interpretation and reporting of uroflowmetry findings. Conclusions:: Uroflowmetry is the most commonly utilized diagnostic test in the evaluation of adults presenting with lower urinary tract symptoms. The practice of uroflowmetry exhibits variations which might lead to inconclusive or inaccurate assessments. The ICS educational module on the Practice of Uroflowmetry in Adults provides up-to-date and evidence-based guidance in an effort to establish standards in the technique, interpretation, and reporting of uroflowmetry.

Objective:Nocturnal enuresis (NE) is one of the most common disorders in pediatric urology, and patients often turn to family physicians (FP) and pediatricians (P) initially. The aim of this study was to understand the awareness, self-confidence and suggestions of physicians regarding the management of NE.Materials and Methods:In this study, 360 FP and family medicine residents (FMR), as well as 280 P and pediatrics residents (PR), were contacted through a cellular phone texting system. A simple multiple-choice questionnaire (Surveymonkey®) consisting of 10 questions was used to gather data. The survey included questions about their experience, training, evaluation, and management of NE.Results:A total of 119 FPs and Ps (18.5%) filled the questionnaire. Thirty (25.21%) of the participants were P, 27 (22.69%) PR, 3 (2.52%) FP and 59 (49.58%) FMR. The rate of physicians who encounter at least 5 children with NE per month is 31.33%. The mean self-confidence in the management of NE was 4.5 out of 10. The self-confidence of pediatricians was significantly higher than that of PR and FMR (p

Duloxetine is the only available agent for the medical treatment of stress urinary incontinence (SUI). In this systematic review, we analyzed the efficacy and safety of duloxetine treatment in women with SUI and stress-predominant mixed urinary incontinence (SPMUI). We searched the literature using OVID MEDLINE, Embase and ULAKBIM (Turkish database) databases for placebo-controlled studies on the use of duloxetine in women with SUI or SPMUI. Data on change in incontinence episode frequency (IEF), decrease in the number of continence pads used, increase in voiding interval (minute) and discontinuation rates due to adverse effects and lack of efficacy (%) were extracted. A total of 12 randomized controlled trials were included. Duloxetine treatment results in an 18% decrease in IEF and 16% decrease in the number of incontinence pads used compared to pre-treatment status. It also increases the time interval between the voids by 18 min. Duloxetine treatment was associated with higher treatment discontinuation rates compared with placebo. The reason for discontinuation was related to the side effects of the treatment rather than lack of efficacy. Duloxetine can be an effective treatment option in women with UI based on high-level evidence supporting its efficacy. Further studies with larger patient populations and longer durations of follow-up are required to assess its safety profile.

Aim: The voiding diary (VD) yields crucial insights into voiding volumes (VV), voiding frequency (VF), and management habits in children with lower urinary tract (LUT) dysfunction. It is recommended to be conducted for a minimum of 2 days. Nevertheless, certain studies have indicated similarities in voided volumes between days in a three-day VD. This study aims to compare VV and VF values across days based on bladder capacity and symptom scores. Materials and Methods: Children who applied to the pediatric urology clinic due to LUT symptoms between 2022 and 2023 were included in the study. Retrospective evaluation was conducted on the records. Children with neurological deficits and incomplete data were excluded from the study. All children were assessed following the guidelines of ICCS and EUA and underwent a 3-day voiding diary. Mean VV and VF values of the whole group for each day were compared and subgroup analyzes were performed in terms of gender, Voiding Dysfunction Symptom Score (VDSS), bladder capacity (BC), and diagnoses. Results: A total of 109 (53 girls (48.6%), 56 boys (51.4%)) children with a median age of 8 (3-17) were included in the study. 77 (70.6%) children were diagnosed with overactive bladder, 8 (7.4%) with dysfunctional voiding, and 24 (22%) with monosymptomatic enuresis nocturne. The mean VVs between days were similar in the whole group (p = 0.759). Moreover, the mean VV of the first day was similar to the average of both the first two days and the three days (p = 0.021, p = 0.490). Also, the maximum and minimum VVs were similar between days (p = 0.942, p = 0.160, respectively). In subgroup analyses based on gender, bladder capacity, and symptom score, mean VV was also found to be similar. VF values were found to be significantly different between days. There was also a difference between VF values in children with VDSS > 8.5 (p = 0.012) and BC/EBC (%) > 65 (p = 0.030). In subgroup analysis for diagnoses, mean and maximum VV and VF were similar between the groups, except for VF (p = 0.026) in OAB. Conclusion: While the voided volumes of children with non-neurogenic LUT dysfunctions appear to be consistent across the days of the VD, variations in VF might arise, especially among children with a VDSS of > 8.5 and normal bladder capacity. As a result, we believe that using a VD spanning at least two days could enhance diagnostic accuracy and help prevent unnecessary treatment.

Objective:To evaluate the impact of coronavirus disease-2019 (COVID-19) lockdown on the sexual lives of couples who live in Turkiye.Materials and Methods:One hundred ninety-three sexually active participants. While sexual functions were evaluated with the international erectile function index-15 in men and the female sexual function index in women, Hamilton anxiety scale (HAM) was used to measure anxiety level. Married people filled out the Marriage adjustment test (MAT) questionnaire. The effects of the quarantine period on the relationship were evaluated with a questionnaire created specifically for this study.Results:Sexual improvement and worsening were observed in 8.8%, and 15%, respectively. It did not change for 76.2%. Sexually deteriorated subjects had a higher HAM score (p=0.003). The MAT score was lower in sexually deteriorated subjects (p=0.004). The rate of sexual worsening was higher in women than in men (28.6% vs. 12%, p=0.02). Women’s HAM scores were higher (p=0.002). The MAT score was also found to be higher in women (p=0.0037). 58% of sexually deteriorated participants did not feel safe at home during the COVID-19 period, whereas all of those sexually improved participants felt safe at home.Conclusion:During the COVID-19 lockdown period, sexual deterioration was detected in 15% of sexually active people. This worsening was associated with the HAM score. Additionally, it was revealed that feeling safe at home is related to sexual life. While the relationship between sexually worsening and the MAT score was significant in men, it was revealed that the level of anxiety in women affected sexual life more significantly.

Objective:: Urinary retention after non-urological surgery is a common morbidity, yet its​ etiology and treatment approaches are still a matter of debate. The primary aims of this study are to evaluate the management of urinary retention after non-urological surgeries, determine the predictors of prognosis, and report follow-up data. Methods:: Patients who were referred to the urology clinic at a single center due to postoperative urinary retention between December 2014 and November 2021 were included. Demographical, clinical, and surgical parameters were recorded. In all patients, a urethral catheter was kept in-situ for at least 5 days after urinary retention. In case of persistent urinary retention after catheter removal, clean intermittent catheterization (CIC) was recommended. Results of the patients who spontaneously regained micturition after conservative treatment and those with persistent urinary retention were compared. Results:: Among 95 patients, the median age was 65 (24–90) years. In 75 patients (78.9%), spontaneous micturition returned with conservative management (Group 1). Twenty patients (21.1%) required CIC due to persistent urinary retention (Group 2). The percentages of males in Group 1 and 2 were 81.3% and 50% respectively (p

Objective:This study aims to investigate the neurourological and urodynamic findings of children with cerebral palsy (CP) that referred for dorsal rhizotomy surgery (DRS).Materials and Methods:All children with CP who were scheduled for selective DRS were assessed with a detailed medical history, physical exam, urinalysis and urodynamic studies to assess bladder function and urinary problems. Urodynamic studies included filling and voiding cystometry, detrusor leak point pressure, external anal sphincter electromyography, flow rate and residual urine volume. All investigations and definitions relied on the standardisation of the International Continence Society.Results:Overall, 24 boys and 10 girls were evaluated. The mean age of boys, and girls and the study group was 6.6 (1.7-9.8), 6.5 (3.5-11.4) and 6.6 (1.7-11.4) years, respectively. The most common complaints of the study group were urinary incontinence (58.8%), encopresis (32.4%) and constipation (17.6%) and 41.2% of patients needed diapers due to these problems. Twenty-five per cent (n=5) of male patients had an undescended testis. The most common clinical conditions at urodynamics, were low bladder compliance (85.3%), detrusor overactivity (67.6%), hyposensitive bladder (52.6%) and low bladder capacity (41.2%).Conclusion:Upper motor neuron lesions, like CP, may present with various urodynamic findings. However, patients with CP are not routinely seen by urologists. Our findings revealed serious neurological problems in children referred for DRS. Therefore, every child with CP who has a DRS plan should undergo a detailed urological examination at least once before the procedure.

Bladder pain syndrome is an important chronic pain syndrome which seriously reduces the patients’ quality of life. It is a diagnosis of exclusion. It is defined as a clinical diagnosis composed of chronic (>6 months) pain/pressure/discomfort that is primarly perceived from the bladder and/or pelvis, and accompanied by urgency and/or frequency of urination. Throughout this paper, the definition, characteristic features, diagnostic tests and attempts, interpretation of the findings and the different treatment algorithms suggested by different organizations will be discussed.

Objective:To evaluate the clinical risk factors contributing to the development of extended spectrum beta-lactamase (ESBL)- producing asymptomatic bacteriuria in myelodysplastic children performing clean intermittent catheterization (CIC).Materials and Methods:The clinical risk factors for ESBL-producing bacteriuria were retrospectively investigated in 60 myelodysplastic children who had asymptomatic bacteriuria and were performing CIC. A total of 60 children were included in this study, 30 children (17 females, 13 males) with ESBL-positive bacteriuria in urine culture were identified as the study group and 30 age- and gender-matched ESBL-negative children (16 females, 14 males) served as controls. All children had neurogenic bladder due to myelodysplasia and had been used anticholinergics. The two groups were compared in terms of age, gender, presence of constipation and motor deficit, antibiotic prophylaxis, number of hospital admission, ultrasound findings, and presence of renal scarring in dimercapto succinic acid scintigraphy and urodynamic findings.Results:The mean age of the children was 77±50 months in study and 78±69 months in control groups. There was no statistically significant difference in terms of maximum bladder capacity, leak point pressure, constipation status and scarring. In study and control groups, 83% and 46% of children were on antimicrobial prophylaxis, respectively (p=0.007).Conclusion:ESBL-producing bacteriuria was found to be associated with long-term antibiotic prophylaxis. Thus, it was concluded that the use of antibiotics for asymptomatic bacteriuria should be kept to a minimum.

Aging correlates with greater incidence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in the male population where the pathophysiological link remains elusive. The incidence of LUTS and ED correlates with the prevalence of vascular risk factors, implying potential role of arterial disorders in concomitant development of the two conditions. Human studies have revealed lower bladder and prostate blood flow in patients with LUTS suggesting that the severity of LUTS and ED correlates with the severity of vascular disorders. A close link between increased prostatic vascular resistance and greater incidence of LUTS and ED has been documented. Experimental models of atherosclerosis-induced chronic pelvic ischemia (CPI) showed increased contractile reactivity of prostatic and bladder tissues, impairment of penile erectile tissue relaxation, and simultaneous development of detrusor overactivity and ED. In the bladder, short-term ischemia caused overactive contractions while prolonged ischemia provoked degenerative responses and led to underactivity. CPI compromised structural integrity of the bladder, prostatic, and penile erectile tissues. Downstream molecular mechanisms appear to involve cellular stress and survival signaling, receptor modifications, upregulation of cytokines, and impairment of the nitric oxide pathway in cavernosal tissue. These observations may suggest pelvic ischemia as an important contributing factor in LUTS-associated ED. The aim of this narrative review is to discuss the current evidence on CPI as a possible etiologic mechanism underlying LUTS-associated ED.

Oral pharmacotherapy constitutes second-line treatment for overactive bladder (OAB) after lifestyle modifications, bladder retraining, and pelvic floor muscle exercises. Antimuscarinics have an established role in the treatment of OAB. However, antimuscarinics are known to have low persistence rates in clinical practice. Mirabegron is an oral β3-adrenoreceptor agonist which has emerged as an alternative to antimuscarinics for managing OAB. Overall, mirabegron has similar clinical efficacy to antimuscarinics and is superior to placebo. Mirabegron has been generally well tolerated in both interventional and non-interventional studies. Persistence has been shown to be higher with mirabegron than with antimuscarinics in real-world studies. Increased blood pressure is associated with mirabegron and therefore its use is contraindicated in patients with severe uncontrolled hypertension. However, a low rate of treatment cessation due to cardiovascular issues has been noted in clinical trials. Mirabegron’s utility in the elderly patient population has been well supported with promising efficacy and safety outcomes. New data from a prospective placebo-controlled randomized trial in older OAB patients is expected to be published soon. Mirabegron does not interfere with detrusor contractions during the emptying phase of the micturition cycle and hence lacks any significant effect on post-void residual volume. Mirabegron can be combined with antimuscarinics to synergize clinical effectiveness. Overall, mirabegron represents a well-tolerated and effective medical treatment option for OAB. Mirabegron could be used as an alternative to antimuscarinics, especially in patients who do not improve with antimuscarinics and/or experience bothersome side effects for whom anticholinergic load may be a relevant consideration.

Objective:To investigate the prevalence of voiding dysfunction (VD) and nocturnal enuresis (NE) in Turkish primary school children using a previously validated Dysfunctional Voiding Scoring System (DVSS) questionnaire and a self-administered questionnaire.Materials and Methods:The previously validated DVSS questionnaire was completed by the parents of 3015 randomly selected children. Another questionnaire was also administered for studying VD and NE rates, demographic characteristics, and learning or behavioral problems of children.Results:Of all children, 6.6% (n=199) had a score suggesting VD and 6.1% (n=185) had NE. No significant differences were found between children with and without VD in terms of age, gender, and fluid intake. Children with VD had significantly high rates of constipation (19.7% vs 5.2%; p

Objective: Predictive factors that could affect the cure and complication rates of midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI) were investigated. Materials and Methods: A total of 594 women (outside-in transobturator in 285, inside-out transobturator in 91, and retropubic in 218) with SUI and who had undergone MUS were evaluated. The median age was 53.9 (27-82) years. Univariate analyses were done using chi-square test, Student’s t-test and the Mann-Whitney U test. Multivariate analyses were done using logistic regression analysis to determine predictive factors affecting cure and complication rates. Results: The mean follow-up time was 48 months. The subjective cure rate was 84% and complication rate was 11.2%. On univariate and multivariate analyses, the cure rate was found to be increased in younger patients [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.95-0.99, p=0.038] and in patients with pure SUI (OR: 2.17, 95% CI: 1.31-3.60, p=0.002). The type of surgery was the only statistically significant parameter affecting the complication rate, which was significantly higher in retropubic MUS procedure (OR: 6.28, 95% CI: 3.51-11.22, p

Objective: The aim of this study was to determine the significance of contralateral testis size in predicting monorchism in pediatric patients with unilateral undescended testis. Materials and Methods: The data of patients who underwent surgical operation by a single pediatric urologist for undescended testis between 2013 and 2016 was evaluated retrospectively. The patients were grouped as having monorchism (M), nonpalpable intra-abdominal testis (NPIAT), and palpable undescended testis (PUDT). The dimensions of the testes were measured ultrasonographically and recorded before operation. Patients with nonpalpable testis underwent diagnostic laparoscopy and patients with PUDT underwent inguinal orchiopexy. Results: A total of 57 children with a mean age of 31 (11-60) months were evaluated. Of the children, 12 had M, 9 had NPIAT and 36 had PUDT with a similar mean age (p>0.05). The size of the descended testis was found to be significantly small in NPIAT* and PUDT** groups compared to the M group (*p0.05). Conclusion: The size of the testis in the scrotum might help to localize the position of the undescended testis.

Objective: This study aims to validate the “Marmara post-prostatectomy incontinence symptom score (M-PPISS)” designed for the assessment of post-prostatectomy incontinence (PPI). Materials and Methods: The questionnaire consists of 3 sections including 8 questions (4 questions examining the type and degree of PPI, 3 questions examining the effect of PPI on quality of life (QoL) and 1 question examining bladder emptying) and an analogue scale to assess the impact of PPI on the QoL. The questionnaire was completed by 106 patients, who underwent radical prostatectomy (RP) in our clinic between 2007 and 2015, at the end of the first week, first month and at 3-month intervals up to one year after RP. Results: The mean score of 106 patients at the end of the first week after the operation was 6.57 (minimum: 0, maximum: 24). The internal consistency coefficient measured for our questionnaire was found to be higher (Cronbach’s alpha: 0.887). When an item was deleted, Cronbach’s alpha was not lower than 0.85 for any value. According to the 27% rule, p value was calculated as 0.0001. In the numerical evaluation of total score and the analogue scale considering QoL (satisfaction and dissatisfaction); patients with a total score of 0-4 were accepted as “satisfied with QoL”, while patients with a total score of ≥5 were included in the dissatisfied group (cut-off value: 5). Conclusion: The M-PPISS was found to be a reliable and valid instrument in the evaluation of urinary incontinence after RP.

Objective: The aim of this study was to determine the effectiveness of the voiding dysfunction symptom score (VDSS) in evaluation of children with nocturnal enuresis. Materials and Methods: Four hundred children with nocturnal enuresis were included in the study. They were evaluated with VDSS, physical examination, urinalysis and 2-day voiding diary. All children with nocturnal enuresis symptoms were treated with desmopressin and/or urotherapy. However, children with overactive bladder symptoms were also treated with anticholinergics. Treatment success and change in VDSS were compared and assessed between different treatment methods. Results: Two hundred forty-five children (61.25%) were male and 155 (38.75%) were female. The mean age was 7.6±3.0 years (range: 5-18). The mean VDSS was 9.2±6.3. 35% of children with nocturnal enuresis had concomitant daytime symptoms. 126 children (31.5%) had a VDSS of nine or above and majority of these children were treated with anticholinergic therapy. VDSS questionnaire could not help determine treatment success in children with non-monosymptomatic nocturnal enuresis. However, children treated with urotherapy and desmopressine showed significant difference in VDSSs according to their treatment response. Conclusion: VDSS has shown to decrease after treatment in children with mono-symptomatic nocturnal enuresis. The treatment strategies should be checked and modified if VDSS does not decrease after proper therapy as this would increase the success of treatment.

A 17-year-old boy presented with 15 mm swelling on the left side of his urethral meatus. He did not report any voiding symptoms. He was seeking medical treatment due to cosmetic concerns. Parameatal urethral cysts are benign conditions that are rarely reported in the literature. We performed complete excision of the cyst as previously suggested by some authors. On postoperative follow-up, there were no findings of voiding difficulty and cosmetic problem.

Objective Nuclear imaging techniques such as 99mTc-dimercaptosuccinic acid (DMSA) and 99mTc-mercaptoacetyltriglycine (MAG-3) are widely used for the diagnosis and follow-up of urinary tract obstructions. Both imaging techniques provide the differential renal function (DRF) in slightly different ways. The aim of this study was to assess the MAG-3 scan as an adjunct or alternative to DMSA for evaluating DRF in children with hydronephrosis. Materials and Methods Eighty-one patients with hydronephrosis were enrolled in this study. Patient age, sex, anteroposterior renal pelvis diameter (RPD) at the time of diagnosis, parenchymal thickness and the DRF percentage found by both DMSA and MAG-3 were recorded. DMSA scintigraphy was used for detecting renal scars and estimating DRF. MAG-3 scintigraphy was used for evaluation of renal clearance, the collecting system’s outflow pattern and estimating DRF. Results A total of 102 renal units (38 left, 22 right and 21 bilateral) were evaluated. High correlation rates were found when we compared both tests’ DRF values according to antero-posterior renal pelvic diameter and patient age (p>0.05). In all groups compared in the present study, both tests demonstrated very similar results and DRF values. Statistical analysis of cut-offs (45%, 40%, 10%) were also similar in both methods (p>0.05, kappa >0.7, r=0.926 Pearson). Conclusion DMSA and MAG-3 are tests that are of assistance in the evaluation of hydronephrosis. Compared to DMSA, MAG-3 also provides valuable information to evaluate DRF values in hydronephrotic renal unit (RU). Avoiding unnecessary DMSA imaging will save time and cost and prevent over-radiation of the pediatric population.

Objective “Traditional subureteral transurethral injection” (STING) and “Double hydrodistention-implantation” (Double-HIT) injection techniques for vesicoureteral reflux (VUR) treatment are a less invasive, yet very effective options. The influence of injection techniques in treatment success is not adequately searched in children with overactive bladder syndrome (OAB). The objective of this study to compare the short-term success rates of STING and Double-HIT techniques in children with OAB-VUR complex. Materials and Methods Children who underwent endoscopic injection for VUR between 2010 and 2013 were retrospectively evaluated. Patients were grouped into two groups according to the surgical techniques (STING or Double-HIT). Success of the treatment was defined with a negative voiding cystourethrogram at the 6th postoperative week. Patients were evaluated according to sex, age, pre- and postoperative reflux grades, laterality, type and volume of bulking agent and presence of OAB. Results Both groups were similar in terms of sex, age, lower urinary tract dysfunction, reflux grade and success rates. Surgical technique, score of pediatric lower urinary tract symptom questionnaire, age, sex, laterality of reflux and type of the bulking agent found to have no effect on the overall success rates (p>0.05). Presence of OAB and/or a high grade reflux were identified as statistically significant predictive factors that could affect the treatment results. Conclusion The short-term surgical success of the double-HIT and STING techniques showed no difference in children with OAB. The presence of a high grade reflux and/or OAB seemed to be the main factors for overall success in endoscopic VUR surgery.

Objective Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is a standard diagnostic modality for detecting prostate cancer (PCa). Pain during biopsy is the most important problem that still needs a solution. The purpose of this study was to compare 3 pain control techniques and to investigate the relationship between the level of pain and histopathological findings. Materials and Methods 139 patients underwent prostate biopsy utilizing 3 analgesic techniques; 1- using lidocain gel (group 1), 2- pethidine+diazepam (group 2) and 3- periprostatic nerve block (group 3). Pain level, the tolerability and repetition of the procedure were questioned. The pathological findings were recorded. Results There was a statistically significant difference between group 1 and the others with regard to tolerability and repeating the procedure. The pain score during biopsy in group 1 was greater than in the other groups and those in group 2 was higher than in group 3. The mean pain score during probe insertion in group 2 was lower than in groups 1 and 3. The mean pain score taken during the biopsy was higher than that during probe insertion in group 2. However, the mean pain score during probeinsertion in group 3 was not different from that in group 1. There was no significant difference in pathological results between group 1 and groups 2 and 3. Pain scores in patients with chronic prostatitis were statistically higher than those in patients with benign prostatic hyperplasia (BPH) and Pca in groups 2 and 3 (p

Objective The aim of this study is to constitute and validate a symptom questionnaire to be used in the diagnosis and follow up of patients with OAB that complies with the specific needs of the Turkish society and that allows the assessment of both disease symptoms and their effects on quality of life. Materials and Methods A total of 78 OAB patients and 90 control patients were included in this study between January 2007 and June 2007. All included patients underwent urine analysis/culture, blood creatinine levels, 3-day voiding dairy, urinary ultrasonography and plain abdominal graphy evaluations. Results Among 168 patients included 99 (58, 95) were males and 69 (41,1%) were females. Mean age was 47,3 (±17, 2) years. Cronbach alpha value which is a determinant of internal consistency was 0.92 for M-OAB questionnaire. The Spearman correlation co- efficient for total score was found to be 0.98 (p=0.001) in the test- retest analysis. The highest sensitivity (97%) and specificity (94%) values for the M-OAB questionnaire to make a diagnosis of OAB were obtained with a cut off value of 12.5 for the total score. Conclusion This study shows the development of a reliable and valid OAB specific symptom and quality of assessment tool that is short and easily applicable in the daily clinical practice. This questionnaire can provide the clinicians with practical comfort and a standardized quantification of the patient symptoms.

Abstract  The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p  [ABSTRACT FROM AUTHOR]

Previously we showed that ischemia alters bladder smooth muscle contractility in the rabbit. This study investigates the role of urothelium and eicosanoid-release in ischemic bladder smooth muscle instability. Male New Zealand white rabbits were divided into treated (n = 12) and age-matched control (n = 10) groups. The treated group underwent balloon endothelial injury of the iliac arteries, and then received 4 weeks of cholesterol diet, followed by 4 weeks of regular diet. The control group received a regular diet for 8 weeks. After 8 weeks, blood flow for both the iliac arteries and the bladder as well as bladder oxygen tension were recorded. In one-half of each ischemic and control bladder, the urothelium was removed. Bladder tissues were processed for organ bath and enzyme-immunoassay (EIA) of prostaglandins (PGs) and leukotrienes (LTs). A significant decrease in iliac arterial blood flow, bladder wall blood flow, and bladder oxygen tension was found in the treated group. Bladder ischemia increased the frequency and amplitude of baseline spontaneous smooth muscle contractility. Ischemic tissues with urothelium (Uro+) demonstrated significant increases in the contractile response to electrical field stimulation (EFS) and carbachol relative to control Uro+ tissues. Urothelial removal increased smooth muscle contraction in the control tissues but had no significant effect in the ischemic/hypoxic tissues. Contraction of control tissues without urothelium (Uro-) was similar to contraction of ischemic Uro+ tissues. Contractions of ischemic Uro+ and control Uro- tissues were unchanged after treatment with the cyclooxygenase (COX) inhibitor indomethacin, while they were significantly reduced by the 5-lipoxygenase (5-LO) inhibitor NDGA. EIA showed no change in PGs release from the ischemic urothelium, but significant increase in PGF2-α and thromboxane A2 release from the ischemic suburothelial tissue. Ischemia increased the release of LTB4, LTC4, and LTE4 from both urothelium and suburothelial tissue. Our studies suggest loss of urothelial-mediated tone and LTs-mediated smooth muscle instability in the chronically ischemic/hypoxic bladder. Neurourol. Urodynam. 23:258–264, 2004. Published 2004 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]