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Context The present summary of the European Association of Urology (EAU) guidelines is based on the latest guidelines on male sexual health published in March 2021, with a last comprehensive update in January 2021. Objective To present a summary of the 2021 version of the EAU guidelines on sexual and reproductive health. Evidence acquisition A literature review was performed up to January 2021. The guidelines were updated, and a strength rating for each recommendation was included based on either a systematic review of the evidence or a consensus opinion from the expert panel. Evidence synthesis Late-onset hypogonadism is a clinical condition in the ageing male combining low levels of circulating testosterone and specific symptoms associated with impaired hormone production and/or action. A comprehensive diagnostic and therapeutic work-up, along with screening recommendations and contraindications, is provided. Erectile dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Along with a detailed basic and advanced diagnostic approach, a novel decision-making algorithm for treating ED in order to better tailor therapy to individual patients is provided. The EAU guidelines have adopted the definition of premature ejaculation (PE), which has been developed by the International Society for Sexual Medicine. After the subtype of PE has been defined, patient’s expectations should be discussed thoroughly and pharmacotherapy must be considered as the first-line treatment for patients with lifelong PE, whereas treating the underlying cause must be the initial goal for patients with acquired PE. Haemospermia is defined as the appearance of blood in the ejaculate. Several reasons of haemospermia have been acknowledged; the primary goal over the management work-up is to exclude malignant conditions and treat any other underlying cause. Conclusions The 2021 guidelines on sexual and reproductive health summarise the most recent findings, and advise in terms of diagnosis and treatment of male hypogonadism and sexual dysfunction for their use in clinical practice. These guidelines reflect the multidisciplinary nature of their management. Patient summary Updated European Association of Urology guidelines on sexual and reproductive health are presented, addressing the diagnosis and treatment of the most prevalent conditions in men. Patients must be fully informed of all relevant diagnostic and therapeutic options and, together with their treating physicians, decide on optimal personalised management strategies.

Background: The COVID 19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. Cardiac complications secondary to this infection are common and associated with mortality. This study aimed to evaluate whether subclinical myocardial dysfunction using left ventricular global longitudinal strain (LVGLS) in non-hospitalized mildly symptomatic COVID-19 patients.Methods: In this cross-sectional, single-center study, data were collected from non-hospitalized mildly symptomatic COVID-19 patients between January 01 and February 01, 2021. Fifty (26 male, 24 female) COVID-19 patients and 50 age- and sex-matched healthy volunteers have included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions.Results: The mean age of the COVID-19 patients was 39.55±8.96, 52% of them were male. The most prevalent presenting symptoms were fever (in 34 (68%)), asthenia (in 30 (60%)), loss of appetite (in 21 (42%)), myalgia (in 20 (40%)), and cough (in 13 (26%)). Plasma levels of C-reactive protein (CRP) were significantly higher in the COVID-19 patients than in the controls (10.84±12.44 vs. 4.50±2.81, p < 0.001). There was no significant difference between the groups in terms of standard echocardiography and Doppler parameters (p>0.05). Left ventricular longitudinal strain and strain velocity parameters were significantly decreased in COVID-19 patients compared to healthy individuals. LV-GLS values (-21,72 ± 3,85% vs. -23,11 ± 4,16%; P =0,003) were significantly lower in COVID-19 patients when compared with the healthy controls.Conclusion: Mildly symptomatic COVID-19 patients also have subclinical myocardial dysfunction similar to hospitalized patients. STE has the potential for detecting subclinical LV systolic dysfunction and can provide useful information on the risk stratification in the mildly symptomatic COVID-19 population.

Aktaş, Halil ( Aksaray, Yazar ), Objective: Several studies have investigated different cardiac biomarkers as predictors of the prognosis after percutaneous coronary interventions (PCI) in patients with chronic ischemic heart disease; nevertheless, the results of these studies are conflicting. High sensitive troponin T (Hs-TnT) measurement is a novel and sensitive method. The aim of this study was to investigate if Hs-TnT levels are a predictor of major adverse cardiovascular events (MACE) in the first year after a successful elective PCI in patients with stable angina pectoris (SAP). Material and methods: 100 patients who presented with SAP and underwent successfully elective PCI were included in the study. Patients with elevated troponin I levels (>0.1 ng/mL) before the procedure excluded from the study. Hs-TnT levels were measured before the procedure and at 3-4 hours (h) (early period) and 12-24 hours (late period) after the procedure and Hs-TnT level >14 pg/mL was considered positive. The incidence of MACE during the first year was recorded. Results: Hs-TnT levels were positive in 36% of the patients in the early period and in 54% of the patients in the late period. The incidence rate of MACE for the first year was significantly higher in the patients with positive Hs-TnT levels in the early period but not the late period (36.1% vs. 15.6%; p = 0.026) and logistic regression analysis yielded an odds ratio of 3.36. Conclusion: Hs-TnT levels measured 3-4 h after a successful elective PCI in patients with SAP can predict the incidence of MACE within the first year. Nonetheless, these results must be corroborated by other larger studies.

Cil: Rychle přibývajici informace o koronaviru (COVID-19) se pravidelně siři na webových strankach i na so- cialnich sitich. Zkoumali jsme trendy v zadavani vyhledavacich dotazů na webove strance spolecnosti Google, ktere se týkaly temat kardiovaskularni onemocněni nebo jejich symptomy, jako jsou bolest na hrudi, hypertenze, hyperlipidemie a infarkt myokardu v obdobi pandemie COVID-19, v Turecku a Italii, tedy ve dvou zemich nejvice postižených timto onemocněnim. Metody: K ziskani udajů o vyhledavacich aktivitach uživatelů internetu a o zakladnich typech dotazů ve vyhledavaci Google byl použit nastroj Google Trends™ (GT™). Patrali jsme po nejznamějsich klicových slovech souvisejicich s kardiovaskularnimi onemocněnimi a jejich symptomy, jako jsou bolest na hrudi, infarkt myokardu, srdecni onemocněni, hypertenze a vysoke hodnoty cholesterolu, použitými v obdobi mezi 1. lednem a 5. květnem 2020 v nastroji GT™, přicemž dotazy byly zadavany v turectině a italstině. Výsledky: Zdalo se, že zajem o temata souvisejici s koronavirem v Turecku a Italii roste a po kratke době mirně opada. Mezi lednem a květnem 2020 bylo možno v obou zemich pozorovat větsi trend ve vyhledavani otazek spojených s bolesti na hrudi, hypertenzi, inhibitory angiotenzin konvertujiciho enzymu (ACEI) a umrtim. Intenzita zadavaných dotazů na tema infarkt myokardu se celorocně neměnila, byl vsak pozorovan napadný pokles zajmu o hodnoty cholesterolu. Ukazalo se rovněž, že s přibývajici delkou pandemie se intenzita vyhledavani v obou zemich snižila. Zavěr: Internet lze využit ke studiu chovani lidi podle jejich aktivity při vyhledavani různých otazek souvisejicich s kardiovaskularnimi onemocněnimi a jejich symptomy v době vypuknuti pandemie. Ziskane udaje dokazuji, že uživatele internetu v obou zemich se v průběhu pandemie COVID-19 intenzivně zajimali o otazky kardiovaskularnich onemocněni a s nimi souvisejicimi symptomy. © 2020, CKS.

Introduction: An increasing number of patients are seeking premature ejaculation (PE) therapy online. Although health care information on the Internet about PE is abundant, the quality of information about its treatment on YouTube, the most visited online video streaming service, is unknown. Aim: The aim of this study was to assess the role of videos pertaining to the treatment of PE through YouTube. Methods: A cross-sectional study was performed through YouTube using the keywords “cure premature ejaculation,” “end premature ejaculation,” “stop premature ejaculation,” or “premature ejaculation treatment.” The videos were sorted as reliable or nonreliable by 2 urologists as they may contain scientifically proven information or not. Nonrelevant, non-English, and silent videos were excluded. Video demographics were analyzed by the quality and source of the video. Main Outcome Measures: A 5-point global quality scale, a 5-point modified reliability (DISCERN) tool, kappa statistic, the intraclass correlation coefficient, and descriptive statistics in the form of proportions and percentages were used. Results: Of the 800 videos, 668 were excluded because they were duplicates (n = 389), irrelevant (n = 49), not in English (n = 284), or had no audio (n = 51). Of the 132 videos, 93 (70%) were described as reliable and 39 (30%) as nonreliable. The kappa statistic for interobserver agreement was 0.832. In the reliable information group, the reliability (2.55 ± 1.03) and quality scores of the contents (2.74 ± 1.06) were statistically higher than those in the nonreliable information group (0.23 ± 0.53 and 1.15 ± 0.48, respectively; P < .05). The majority of the nonreliable information group comprised medical advertisement/for-profit companies (51%) and individuals (41%). There was no significant difference between the reliable and nonreliable information groups in terms of average views (P = .873) and viewed videos per day (P = .538). Clinical Implications: Evaluating videos about the management of PE holds promise for understanding what men are exposed to. Strength & Limitations: The study simultaneously investigated the quality and accuracy of YouTube videos by several aspects using validated instruments. As for limitations, there is no consensus in the literature regarding how to assess health care-related online videos, and the results were not derived from patients’ perceptions. Conclusion: The study highlights data about the treatment of PE on YouTube. Videos with reliable information outnumbered those with nonreliable information. This is the first study to demonstrate that YouTube is an important source of data on PE management. Physicians and health care providers should contribute reliable content, and YouTube should remove deceptive videos before patients watch them Gul M, Diri MA. YouTube as a Source of Information About Premature Ejaculation Treatment. J Sex Med 2019;16:1734–1740.

Various analgesic applications can be used during extracorporeal shock wave lithotripsy (SWL) for pain relief and maximal success rate. Intracutaneous sterile water injection (ISWI) has been shown to be effective in several types of pain, but a gap exists about its use during SWL. In this paper, we aimed to evaluate the effect of ISWI during SWL and compare that with diclofenac sodium injection used commonly to provide ideal patient contentment. Patients with kidney stone were randomized to have either ISWI therapy or intramuscular non-steroid anti-inflammatory drug (diclofenac sodium) injection. Using a syringe, 2–3 ml of sterile water was administered to the triangle area bounded by the 12th costal margin, the iliac crest and the vertebral spine in prone position. Visual analog scale (VAS) was employed to record pain scores of patients. Other parameters including stone size, SWL duration, total shock waves given, used energy and the necessity of rescue analgesia were also noted. A total of 524 patients were recruited, of those 216 patients were treated with ISWI and 308 patients had diclofenac sodium injections. The characteristics of the patients and shockwave therapy did not differ significantly between the two groups. Although the mean VAS scores prior to SWL and at every voltage increment during the procedure did not differ, more patients in the diclofenac sodium injection group required rescue analgesia with significantly greater side effects. ISWI is found to be as effective as the diclofenac sodium injection for pain management during SWL with lower adverse event rates.

Hard flaccid (HF) syndrome is a complex symptom that significantly impacts a man’s sexual and social life. Since there is currently only one case series available in the literature regarding HF syndrome, it has not been recognized as a real medical condition. HF syndrome has mostly been reported in several patient forums and its exact definition, prevalence, etiology, and treatment are unknown. We hereby, aimed to understand the nature of HF syndrome and how it is perceived among men. Online forum sites in the English language were systematically evaluated to perform a descriptive qualitative assessment. “Hard flaccid; forum” term was searched in Google® and data were collected from forum posts. Datasets were analyzed using thematic analysis within a three-month period (September 2018–November 2018) and were combined to triangulate analysis. A total of 12 forum discussions, containing 6150 comments, were analyzed. Themes that arose included: “I would like to ensure that I have HF”; “How did I end up like this?”; “Seeking support for treatment choices – who will help me?”; “How can I cope with this condition?”. Thematic analysis revealed that most HF cases began after a traumatic event. The reported incidence of HF-related symptoms varies considerably. The most commonly associated symptoms of HF are penile semi-hardness in the flaccid state, penile sensory changes, erectile dysfunction, and emotional distress. Although it is not recognized by major medical authorities, many men appear to suffer from symptoms related to HF syndrome. Future basic science and clinical studies must be conducted to understand the exact pathophysiology of HF syndrome and to develop effective therapies. © 2019, The Author(s), under exclusive licence to Springer Nature Limited.

*Gül, Murat ( Aksaray, Yazar ), The objective of our study was to investigate the possible relationship between poor perinatal outcome and foetal cardiac functions in pregnant women with reduced foetal movements (RFM). This cross-sectional study included 126 pregnant women with normal foetal movements (Group 1, Controls) and 42 pregnant women over 32 weeks gestation with RFM (Group 2). Group 2 was further divided into two subgroups according to their perinatal outcome: normal perinatal outcome (Group 2a) and poor perinatal outcome (Group 2b). Cardiotocography, the E/A ratio in both atrioventricular valves, myocardial performance index (MPI) and foetal tricuspid annular plane systolic excursion (f-TAPSE) were evaluated. Foetuses with poor perinatal outcome had a higher MPI (p =.003), higher tricuspid and mitral E/A (p

After radical prostatectomy (RP) or radiotherapy (RT) for prostate cancer, erectile dysfunction (ED) is the main complication next to urinary incontinence, affecting quality of life. The pathophysiology of ED after these treatments is believed to include neuropraxia causing reduced oxygenation and structural changes of the tissue in the corpora cavernosa. Next to the option of sparing the nerves during RP, research has been focusing on methods for penile rehabilitation after RP and RT, since it occurs often, even after nerve-sparing techniques were used. In animal studies, the use of phosphodiesterase type 5 inhibitors (PDE5i) after cavernous nerve damage is supported, but results in human studies are contradictory. Non-medical treatment options such as vacuum device therapy, hyperbaric oxygen therapy, yoga, aerobic, or pelvic floor training may be helpful, but evidence is scarce. Clear guidelines for penile rehabilitation are not yet available. However, care and support for ED after RP and RT is highly demanded by a large group of patients, so measures have to be taken even though the evidence is not strong yet. In this systematic review, an overview of the literature for penile rehabilitation and treatment options for ED after RP and RT is provided, using only randomized controlled trials (RCT). ispartof: FRONTIERS IN SURGERY vol:8 ispartof: location:Switzerland status: published

Erectile dysfunction (ED) shares several risk factors with diabetes mellitus (DM), hypertension (HT) and coronary vascular disease (CVD), which were well-associated with seasonal fluctuation with the highest peak in winter. In this study, we aimed to determine whether ED demonstrates seasonal fluctuations with the above-mentioned systemic diseases. Database from a tertiary university hospital between 2010 and 2020 was deciphered to retrieve patients diagnosed with ED. Patients with primary bladder tumour and post-procedural ED constituted the negative control groups from the same study period. International index of erectile function questionnaire (IIEF-15) was used to segregate included patients into mild/moderate and severe ED groups. The probability of detecting DM, HT and CVD in patients with severe ED was significantly higher than that of with mild/moderate ED (p 0.05). More ED symptoms emerged and were diagnosed in the winter seasons even though no statistical significance was observed between patients with mild/moderate and severe ED (p = 0.946, Cramer's V coefficient = 0.19). The seasonal variation of patients with bladder tumour and post-procedural ED groups showed no significant difference (p 0.05, both). ED admissions are associated with higher peaks in the winter seasons. This may help in daily clinical practice to warrant better clinical and epidemiological interpretation of ED.

*Gül, Murat ( Aksaray, Yazar ), Objective To evaluate the mid-term effects of ivabradine on right ventricular functions in patients with heart failure. Methods A prospective study was conducted on 52 patients who had heart failure in normal sinus rhythm (59% male, age: 64.76 +/- 12.49 years). Right ventricular functions were measured at baseline, after one month and one year by conventional and tissue Doppler echocardiography imaging. The parameters, right ventricular (RV) longitudinal strain (LS), RV systolic longitudinal strain rate (LSRs), RV early diastolic longitudinal strain rate, and late diastolic longitudinal strain rate, were evaluated by apical four-chamber grayscale imaging through the free wall of RV in accordance with the automated function imaging protocol. Results During the follow-up, the pulmonary artery systolic pressure (PASP), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI), E peak, and A peak values were similar to the basal values. While comparing the basal values of the global longitudinal systolic strain (GLS), LS, LSRs, longitudinal strain rate diastolic early filling (LSRe), and longitudinal strain rate diastolic late tilling (LSRa), there were no differences in the first month but a significant increase was observed on one-year follow-up (p

*Gül, Murat ( Aksaray, Yazar ) *İnci, Sinan ( Aksaray, Yazar ), Arterial stiffness has been identified as a powerful and independent risk factor for cardiovascular disease. Obesity is associated with an increased risk of aortic stiffness (AS) and adverse cardiovascular events. Herein, we aimed to evaluate the effects of weight loss after laparoscopic sleeve gastrectomy (LSG) on AS in individuals with morbid obesity by using the transthoracic echocardiography (TTE). A total of 53 patients with obesity (17 males, 36 females) who underwent LSG and did not have any known heart disease were included in the study. The AS parameters were measured with TTE. The demographic and echocardiographic data of the patients were studied before, at 1 month and 12 months after surgery. The mean age of the study group was 34.41±11.62, 68% of whom were female. There were no significant differences in terms of the standard echocardiography and Doppler measurements as compared with preoperative values (all p>0.05). When the elastic parameters of the aorta were compared, no significant differences were detected regarding aortic strain (%) ((16.28±4.11) vs (16.68±4.56), p=(0.998)), distensibility (cm2/dyn) ((6.74±1.78) vs (7.03±2.31), p=(0.997)) and Aortic Stiffness Index values ((10.73±3.84) vs (10.63±3.34), p=0.998) between baseline and first month after surgery. In the 12-month follow-up, it was determined that the aortic strain ((16.28±4.11) vs (22.74±5.79), p≤0.001) and distensibility ((6.74±1.78) vs (10.34±3.059), p

*Mutlu, Hüseyin ( Aksaray, Yazar ) *Sert, Ekrem Taha ( Aksaray, Yazar ), Background: There is growing interest in physical medicine treatment options for renal colic. In this study, we aimed to determine whether or not heat-patch treatment with no drug was effective in relieving renal colic. Methods: For this purpose, patients who were diagnosed with renal colic in the emergency department were randomised to have either heat-patch or sham treatment. The Visual Analogue Scale (VAS) scores of renal colic, body temperature (Btemp), and sub-patch skin temperature (Stemp) values were measured at 0, 15, 30, 45, and 60 minutes. In addition, the salvage treatment needs of the groups were compared. Results: The average age of the study group was 30.5 ± 8.3 years and that of the sham group was 31.0 ± 8.2 years (P =.75). According to the baseline VAS score of the patients, 15, 30, 45, and 60 minutes VAS scores significantly decreased in the heat-patch group (P

Incidentalni echokardiograficke nalezy u asymptomatických pacientů mohou při rozhodovani v klinicke praxi představovat problem. Regurgitace mitralni chlopně je castou srdecni vadou a hlavni přicinou rozvoje městnaveho srdecniho selhani a umrti. Přes řadu možnosti lecby se v připadě vhodných anatomických poměrů dava přednost plastice mitralni chlopně. Transapikalni metoda plastiky mitralni chlopně s implantaci umělých slasinek představuje novou a minimalně invazivni metodu pro pacienty s degenerativnim postiženim mitralni chlopně. Je prokazano, že tento výkon je bezpecný, ucinný a ma vynikajici dlouhodobe výsledky. I když se tato metoda při plastice srdecni chlopně použiva casto, v připadě mitralni chlopně se tento výkon provadi vzacně. V tomto clanku popisujeme připad asymptomatickeho pacienta s kombinaci plastiky mitralni a trikuspidalni chlopně s použitim umělých slasinek. © 2021, CKS.

Pain during sexual activity and ejaculation are the unspoken long-term complications of groin hernia repair. Laparoscopic surgical techniques are associated with decreased post-operative pain and earlier return to daily activities, but its effect on these complications is unclear. This study aims to investigate the effect of transabdominal preperitoneal repair (TAPP) on de-novo pain during sexual intercourse and ejaculation and to compare with open repair. For this reason, two groups were determined according to the surgical technique: the Lichtenstein repair and the TAPP groups and a questionnaire was sent to the patients a minimum of 6 months following the surgery. A total of 317 patients included, as 115 in TAPP and 202 in Lichtenstein repair group. No significant difference was observed concerning pre-operative pain during sexual activity and ejaculation in both groups (p = .75, p = .56). Following the surgery, the number of patients experiencing painful sexual activity was significantly higher in the Lichtenstein repair group compared to the TAPP group (19.3% vs. 11.3%, respectively, p = .03). The post-operative painful ejaculation rate was also significantly lower for the TAPP group (p = .04). The lower rates of post-operative dysejaculation and pain during sexual activity can be achieved with the advantage of laparoscopic surgery.

Objective To investigate the clinical value of preoperative De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) (DRR) in patients with transitional cell bladder cancer (TCBC) at initial diagnosis. The secondary objective was to investigate the status of systemic inflammatory parameters, such as neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR) and platelet-monocyte ratio (PMR). Materials and methods The records of patients with primary TCBC who underwent transurethral resection were retrospectively evaluated. The relationship of DRR and systemic inflammatory parameters with clinicopathological findings, recurrence and progression status was evaluated separately. Results There was no significant difference in the DRR according to the clinicopathological findings, recurrence and progression. Significant differences were found between the NLR and the patient groups for tumour diameter, tumour stage, tumour grade and progression. In univariate analysis, the LMR was found to be associated with progression, and also the PLR and LMR were found to be associated with recurrence. Decrease in LMR and increase in LMR score demonstrated by multiple analysis was shown as independent predictors of progression and recurrence development. Conclusions This paper shows a positive correlation between poor prognosis in TCBC and the systemic inflammatory markers, namely NLR, LMR, PLR and PMR, but not DRR.

*Gül, Murat ( Aksaray, Yazar ) *İnci, Sinan ( Aksaray, Yazar ) *Özkan, Namık ( Aksaray, Yazar ), Background Obese patients have an increased risk of arrhythmias and sudden death, even in the absence of structural heart disease and cardiac dysfunction. This study aimed to determine whether weight loss by bariatric surgery has an effect on arrhythmia-related electrocardiographic (ECG) variables in morbidly obese patients. Methods In this prospective study, the data of 48 patients were analyzed. All ECG variables that have the potential to predict ventricular arrhythmia were evaluated before surgery, and were compared with the 1-month and 6-month follow-up results. Results The mean body mass index was 45.74 +/- 5.60 kg/m(2) before surgery. There was a statistically significant decline in body mass index in the first and sixth month after surgery (39.26 +/- 5.00 kg/m(2) and 31.71 +/- 4.49 kg/m(2), respectively; p < 0.001). Furthermore, notable reduction was found in terms of heart rate measurements-QTc-d, JTc, JTc-d, Tp-e, TP-e/QT, TP-e/QTc-in the first month and sixth month compared with baseline (p < 0.001 for all comparisons). Several ECG variables, such as heart rate (r = 0.369, p = 0.001), QTc-d (r = 0.449, p = 0.001), JTc-d (r = 0.324, p = 0.002), Tp-e (r = 0.592, p = 0.001), Tp-e/QTc (r = 0.543, p = 0.001), Tp-e/JTc (r = 0.515, p = 0.001), exhibited a positive and significant correlation with weigh loss. Moreover, a negative and weakly significant correlation was found between the index of cardiac electrophysiological balance (r = -0.239, p = 0.004) and body mass index. Conclusion Substantial weight loss following laparoscopic sleeve gastrectomy in obese patients is accompanied by a significant improvement in ventricular repolarization. Therefore, this effect may lead to a decrease in the incidence of lethal ventricular arrhythmia and sudden cardiac death.

Purpose: To evaluate the awareness of the use of fluoroscopy in endourological procedures, as well as the theoretical and practical applications of preventive measures. Material and Method: Between May 2018 - April 2019, a 26-question survey prepared using Google Docs was sent to urologists via e-mail. Personal information, radiation training and behaviors related to radiation and fluoroscopy usage, and the use of protective equipment were queried. Results: A total of 226 participants fully completed and returned the email survey. Of the 226 participants 78 (34,5%) were academics, 44 (19,4%) were residents while 104 (46.1%) were experts. More than 60% of the participants stated that they participated in the operation requiring less than five fluoroscopy-use per week. The majority of operations requiring fluoroscopy consisted of endourological procedures. The lead apron was used by 93% of the participants, but the use of protective glasses and gloves was very low (3.5%). The majority of academicians, experts and residents did not use dosimeters (76.9%, 82,7 and 81,8%, respectively). More than 50% of the participants did not have literature information about the harmful effects of radiation due to the use of fluoroscopy. The most common complaints on the day of fluoroscopy were fatigue and headache. Conclusion: The lack of information regarding the radiation protection measures and harmful effects of radiation are common among urologists in Turkey. Therefore, systematic training programs on fluoroscopy use and radiation exposure should be provided during urology residency. Keywords: Urologist, fluoroscopy, radiation, radiation protection

Background: Ureteral stone disease may be an emergent condition if the appropriate management is not performed in a timely manner. As the coronavirus disease 2019 (COVID-19) continues to spread globally, isolation and restriction orders taken by the governments have become the cores to control the pandemic. In this study, we, therefore, aimed to investigate the ureteral stone presentations in a high-volume university hospital during the COVID-19 restriction order period. Materials and Methods: The data of 149 patients who were hospitalized due to ureteral stone both during the COVID-19 pandemic restriction period and the corresponding period (non-COVID-19) of the previous year were collected and analyzed retrospectively. Unpaired Student's t-test was used to compare continuous variables. The categorical data were assessed using Chi-square and Fisher's exact tests. Results: Of 149 patients, 35 were hospitalized in the COVID-19 restrictions period. While the mean age and the stone characteristics of the two groups did not differ significantly, serum creatinine levels (1.9 ± 1.85 vs 1.15 ± 0.64) and the white blood cell counts (12.45 ± 6.54 vs 8.21 ± 4.15) at hospital admission were significantly higher in the COVID-19 restrictions group (p = 0.034 and p = 0.005, respectively). According to the priority classification recommendations of the European Urology Guidelines Office Rapid Reaction Group for urolithiasis applicable during the COVID-19 pandemic, a significant difference was observed between the two periods (X2 = 9.907, p = 0.019). In particular, the rate of emergency cases was found more than threefold in the COVID-19 period. Although there was no significant difference in terms of the grade of hydronephrosis at hospital admission between the two groups, the rates of grade 3 and 4 hydronephrosis were higher in the COVID-period group (1.8- and 3.3-fold, respectively). Conclusion: The rate of complicated ureteral stone disease significantly increased during the COVID-19 restrictions period. Urologists should prioritize the patients most in need of urgent care during COVID-19-like biosocial crisis.

*Mutlu, Hüseyin ( Aksaray, Yazar ) *Gül, Murat ( Aksaray, Yazar ), Background Netrin-1 is a recently discovered diagnostic biomarker that indicates atherosclerosis, angiogenesis, and ischemia-reperfusion damage. There arc no human studies about Netrin-1 in acute coronary syndrome (ACS). The purpose of the present study was to investigate Netrin-1 levels in the early diagnosis and successful reperfusion of ACS. Method The study was conducted with 188 patients diagnosed with ACS and 50 healthy subjects at the emergency unit in a prospective design. Blood samples were collected from the patient group at initial admission and after angiography. The control group consisted of healthy adult subjects without any disease. Netrin-1 levels were studied in both groups. Results The Netrin-1 levels of the patient group at the time of admission were found to be higher than of the control group (p

BACKGROUND Although the prognosis of childhood cancer survivors has increased dramatically during recent years, chemotherapy and radiation treatments for cancer and other conditions may lead to permanent infertility in prepubertal boys. Recent developments have shown that spermatogonial stem cell (SSC) transplantation may be a hope for restoring fertility in adult survivors of childhood cancers. For this reason, several centres around the world are collecting and cryopreserving testicular tissue or cells anticipating that, in the near future, some patients will return for SSC transplantation. This review summarizes the current knowledge and utility of SSC transplantation techniques. OBJECTIVE AND RATIONALE The aim of this narrative review is to provide an overview of the currently used experimental injection techniques for SSC transplantation in animal and human testes. This is crucial in understanding and determining the role of the different techniques necessary for successful transplantation. SEARCH METHODS A comprehensive review of peer-reviewed publications on this topic was performed using the PubMed and Google Scholar databases. The search was limited to English language work and studies between 1994 (from the first study on SSC transplantation) and April 2019. Key search terms included mouse, rat, boar, ram, dog, sheep, goat, cattle, monkey, human, cadaver, testes, SSC transplantation, injection and technique. OUTCOMES This review provides an extensive clinical overview of the current research in the field of human SSC transplantation. Rete testis injection with ultrasonography guidance currently seems the most promising injection technique thus far; however, the ability to draw clear conclusions is limited due to long ischemia time of cadaver testis, the relatively decreased volume of the testis, the diminishing size of seminiferous tubules, a lack of intratesticular pressure and leakage into the interstitium during the injection on human cadaver testis. Current evidence does not support improved outcomes from multiple infusions through the rete testes. Overall, further optimization is required to increase the efficiency and safety of the infusion method. WIDER IMPLICATIONS Identifying a favourable injection method for SSC transplantation will provide insight into the mechanisms of successful assisted human reproduction. Future research could focus on reducing leakage and establishing the optimal infusion cell concentrations and pressure.

Akaras, Nurhan ( Aksaray, Yazar ), We aimed to determine the possible effects of the antioxidant agent (1 → 3)-β-D-glucan on bortezomib-induced rat testis damage. We used five groups of rats; control, (1 → 3)-β-D-glucan (75 mg/kg), bortezomib group, bortezomib + (1 → 3)-β-D-glucan groups (injection of (1 → 3)-β-D-glucan after bortezomib and sacrificed at 48th or 72nd h). The effects of these substances were assessed by measuring the levels of the antioxidant enzymes and LPO, and by performing immunohistochemical analysis with NF-κB. The histology of testis was evaluated using aniline blue staining. (1 → 3)-β-D-glucan leads to significant reductions in the levels of antioxidant enzymes and increased levels of LPO in testes. Moreover, it increased the NF-κB immunopositivity significantly in testis, especially in Bortezomib + (1 → 3)-β-D-glucan group at 48th h. The histological changes were observed in the bortezomib and/or (1 → 3)-β-D-glucan groups. Our results demonstrated that testis damage caused by the treatment with bortezomib was not eliminated by (1 → 3)-β-D-glucan and shockingly it increased the damage. Practical applications: The testis damage caused by the treatment with bortezomib was not eliminated by (1 → 3)-β-D-glucan and as a result, β-1,3-(D)-glucan enhanced the toxicity by leading a decrease in the levels of GSH, SOD, and CAT, thus caused an elevation in the immunoreactivity of NF-κB and altered the histopathological changes by enhancing the toxic effects of bortezomib. The findings of the previous studies about the antioxidative activity of (1 → 3)-β-D-glucan are controversial. So, it is necessary to consider the cytotoxicity of (1 → 3)-β-D-glucan in testis tissue. Thus, more studies on testis tissue are necessary to confirm that (1 → 3)-β-D-glucan is safe as an antioxidant.

Diri, Mehmet Akif ( Aksaray,Yazar ), This study aims to evaluate the safety and efficacy of the new bipolar radiofrequency thermotherapy device (TEMPRO) in treating patients with benign prostate hyperplasia (BPH). Between December 2017 and November 2018, 72 male patients with BPH were included. All patients completed the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires. Physical examinations were performed, and prostate volume, prostatic urethral length and post-voiding residual urine (PVR) were measured using ultrasound. Uroflowmetry was used to calculate the maximum flow rate of urination (Qmax). Bipolar radiofrequency thermotherapy was applied with TEMPRO system containing a 16Fr applicator. All patients were re-evaluated at 6 months post-operatively. The mean age of the patients was 63.22 ± 6.68 years. All patients were treated with local anaesthesia, and three patients were unable to complete the procedure. The median (IQR) visual analogue scale score was 1 (0–3) at 6 hr post-operatively. After 6 months, significant improvements were observed in the IPSS, QoL, Qmax and PVR values of the patients (p 70 ml. Due to its low rate of complication, the TEMPRO© treatment is effective in treating BPH, especially among aged patients and those with serious symptoms.

As the COVID-19 spread globally, social distancing, self-isolation/quarantine, and national lockdowns have become crucial to control the pandemic. However, these measures may also lead to increases in social isolation, loneliness, and stress, which can alter the consumption of pornography habits. The aim of the study was thus to explore the interest pattern in pornography and coronavirus-themed pornography during the COVID-19 outbreak. Google Trends® was employed to determine the most popular porn websites (Porn, XNXX, PornHub, xVideos, and xHamster), and coronavirus-themed pornography worldwide and in six nations with different COVID-19 outbreak and self-isolation recommendations. We analyzed every search trend on Google® from January 9, 2020 to May 25, 2020 using "joint point regression analysis". Comparisons of week relative search volume (WRSV) and temporal patterns were analyzed to assess the change of interest in search terms during nations lockdowns. Paired t-test was used to compare WRSV values among the porn websites during the national lockdowns and the equivalent timespan of the weeks in the previous 4 years. The research trend of almost every keyword increased with significant inflection points for those nations with a straight "stay at home orders" (China, Italy, Spain, and France). "PornHub" and "Porn" showed the highest increase of interest worldwide with an average weekend percentage change (AWPC) of 4.9 and 3.8, respectively. The mean WRSV for keywords in USA and Sweden did not show a similar increase as the other nations. The WRSV percentage change with the historical data had a peak during the straight nations' lockdowns (p < 0.01). All the nations had a significant increase in WRSV coronavirus-themed pornography for each keyword (p < 0.01) with an AWPC, ranging worldwide between 18.5 and 61.8 (p < 0.01), after the beginning of self-quarantine. As strengths this study uses a big data technology to collect worldwide trend of interest, however, data are anonymous and do not allow analysis of subpopulation groups. In conclusion, we demonstrated an increased interest in pornography and coronavirus-themed pornography after the outbreak of COVID-19 in nations with a straight "stay at home orders".

Plicni embolie a infarkt myokardu s elevacemi useku ST jsou castou přicinou akutniho postiženi kardiovaskularniho systemu, ktere může rychle vest ke zhorseni hemodynamiky pacienta. Sedmdesatileta žena byla přivezena na odděleni akutniho přijmu se srdecni zastavou. EKG vysetřeni prokazalo sinusový rytmus s blokadou praveho Tawarova ramenka s elevacemi useku ST v inferolateralnich svodech. Podle koronarogramu byla přicinou neobstrukcni ischemicka choroba srdecni s několika platy. CT angiografie plic prokazala subtotalni uzavěr leve plicni tepny a cetne defekty plněni v obou distalnich segmentech plic. Tato kazuistika upozorňuje na nutnost podezřeni na akutni plicni embolii u každeho pacienta s infarktem myokardu s elevacemi useku ST a nepostiženými koronarnimi tepnami. © 2020, CKS.

Diri, Mehmet Akif ( Aksaray, Yazar ), Toxic insult to the gonads by chemotherapy or radiotherapy can lead to permanent infertility. It’s an important health concern because each year more than 4000 male patients are at risk of azoospermia in the United States due to gonadotoxicity of the regimens used. There are also several benign/genetic diseases whose natural course can result in infertility without gonadotoxic therapy. Considering the fact that most of these people are cured and survive with the advent of modern medicine, infertility is related to serious psychological and relationship implications and parenthood is a significant issue for those patients. Semen cryopreservation option is available for postpubertal adolescent and adult men, while children do not have this storing option since they do not have mature spermatozoa. However, their testes contain spermatogonial stem cells (SSCs), which are initiators of spermatogenesis. Promising findings in animal studies and human cell lines have encouraged scientists that SSCs may be hope for restoring fertility option of patients who cannot produce functional sperm and who have no other choice to preserve their future fertility. For this reason, several centers around the world already began to collect and cryopreserve testicular tissue or cells with anticipation that SSC-based therapies will be available in the near future; however, an optimal transplantation design in humans is yet to be developed. Here we propose an allogeneic testicular stem cell transplantation with an encapsulation device to restore fertility in patients with infertility. We endeavor to discuss the reliability of this method with the current literature and bring the evidence on its feasibility.

WOS: 000442902500007, Background: Smoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI. Objective: To assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial (RA) versus femoral approach (FA). Methods: Our population is represented by 138 STEMI patients undergoing pPCI by FA or RA. The smoking cessation rates and QOL scores were evaluated. Results: Patients at RA group (46 patients, 57 +/- 9 years, 87% male) had a higher European Quality of Life-5 Dimensions (EQ-5D) index score at post-PCI first week compared to FA group (92 patients, 57 +/- 8 years, 75% male) [FA: median 0.81 (0.22) vs. RA: 1 (0.22), p = 0.042], although it was similar at baseline [FA: median 1 (0) vs. RA: 1 (0), p = 0.992]. Total hospital length of stay [RA: median 3 (1) day vs. FA: 4 (1), p < 0.001] was significantly reduced in the RA group. Whereas the smoking cessation rates at 1-year post-discharge were 41% in RA group, it was 67% in FA group (p = 0.003). Female sex, pain-to-door time and RA during p-PCI were independent predictors of continued smoking after STEMI. Conclusion: This study shows that the smoking cessation was lower in RA group compared to FA group. The more comfortable conditions of STEMI management related to RA may cause a lower awareness of the disease severity and lower motivation to quit smoking. Therefore, it is important to inquire about smoking status at each clinical encounter, particularly in patients undergoing pPCI by the radial approach. (c) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.

*Gül, Murat ( Aksaray, Yazar ), Background: Gonadotoxic treatment of malignant diseases as well as some nonmalignant conditions such as cryptorchidism in young boys may result in infertility and failure to father children later in life. As a fertility preserving strategy, several centers collect testicular biopsies to cryopreserve spermatogonial stem cells (SSCs) worldwide. One of the most promising therapeutic strategies is to transplant SSCs back into the seminiferous tubules to initiate endogenous spermatogenesis. However, to obtain sufficient numbers of SSC to warrant transplantation, in vitro propagation of cells is needed together with proper validation of their stem cell identity. Materials and Methods: A minute amount of testicular biopsies (between 5 mg and 10 mg) were processed by mechanical and enzymatic digestion. SSCs were enriched by differential plating method in StemPro-34 medium supplemented with several growth factors. SSC-like cell clusters (SSCLCs) were passaged five times. SSCLCs were identified by immunohistochemical and immunofluorescence staining, using protein expression patterns in testis biopsies as reference. Quantitative polymerase chain reaction analysis of SSC markers LIN-28 homolog A (LIN28A), G antigen 1 (GAGE1), promyelocytic leukemia zinc finger protein (PLZF), integrin alpha 6 (ITGA6), ubiquitin carboxy-terminal hydrolase L1 (UCHL1) and integrin beta 1 (ITGB1) were also used to validate the SSC-like cell identity. Results: Proliferation of SSCLCs was achieved. The presence of SSCs in SSCLCs was confirmed by positive immunostaining of LIN28, UCHL1 and quantitative polymerase chain reaction for LIN28A, UCHL1, PLZF, ITGA6, and ITGB1, respectively. Conclusion: This study has demonstrated that SSCs from infant boys possess the capacity for in vitro proliferation and advance a fertility preservation strategy for prepubertal boys who may otherwise lose their fertility.

*Gül, Murat ( Aksaray, Yazar ), Introduction: Treatment options for erectile dysfunction (ED) have evolved over the last two decades, particularly after the introduction of phosphodiesterase type-5 inhibitors (PDE5Is). The path, however, has not been straightforward with issues raised regarding safety and toxicity following ED treatments. Areas covered: A literature review was conducted on current evidence related to the safety of PDE5Is, intracavernosal injections and various older forms of oral therapies. Relevant trials were identified through a literature search of PubMed from 1980 to 2019. Expert opinion: PDE5Is are now recommended as the first line therapy for the treatment of ED due to their efficacy and tolerable side effects. Comparison of the various PDE5Is on safety has not been supported by prime evidence, and consequently, the negative aspects of each inhibitor appear the same as defined in the literature. Other means of therapies for ED are still in the running, and these also present a different range of side effects. While intracavernosal injections have potential to cause priapism and penile fibrosis, intraurethral alprostadil may result in more systematic side effects. Alternative topical ED therapies are generally limited with their local side effects

*Diri, Mehmet Akif ( Aksaray, Yazar ) *Çetinkaya, Funda ( Aksaray, Yazar ), Introduction: To assess the influence of music therapy on perceived anxiety and pain during outpatient urodynamic study (UDS) in a prospective, randomized fashion. Methods: Between January and December 2018, a total of 70 patients were randomized to either have music therapy (study) or not have (control) in a 1:1 ratio. To the study group, Sufi music was delivered at low tempo. All participants performed the State-Trait Anxiety Inventory evaluation after the procedure and assessed their degree of pain, satisfaction, and willingness to undergo an additional or repeat procedure using the Visual Analog Scale. Results: Patient demographic and baseline characteristics were found to be similar between the 2 groups. Though music did not significantly alleviate pain (4.6 ± 1.2 vs. 4.4 ± 1.7; p = 0.76) and anxiety (47.7 ± 7.75 vs. 46.4 ± 6.5; p = 0.36), it had a positive impact on the patient's willingness to repeat UDS (3.4 ± 1.4 vs. 6.1 ± 1.3; p = 0.005) and provided overall satisfaction (4.6 ± 0.61 vs. 7.2 ± 1.33; p = 0.004). Conclusions: Music is a practical, harmless, and inexpensive non-pharmacological option that can be adopted during medical and surgical procedures, although according to this present study, listening to music during UDS had no effect on pain and anxiety levels.

Gül, Murat ( Aksaray, Yazar ), Premature ejaculation (PE) is the most common sexual dysfunction among men worldwide1 . The exact pathophysiology of PE is unknown, and current treatment modalities are inadequate . Dapoxetine, a short-acting selective serotonin reuptake inhibitor, is the only medication approved in Europe, but it has not yet been approved in the USA owing to its limited efficacy and several safety concerns . Thus, the search for an efficacious and safe treatment for PE is ongoing

*Çayır, S. ( Aksaray, Yazar ) *Gül, Murat ( Aksaray, Yazar ), Objective To investigate the effects of surgical treatment for nasal obstruction on sexual functions, regardless of the condition causing the nasal obstruction. Methods Of 238 patients identified with nasal obstruction, 57 complained of erectile dysfunction and were included in the analysis. Patients underwent septoplasty, functional endoscopic sinus surgery, concha bullosa excision or radiofrequency ablation of the inferior turbinates, depending on their obstruction-causing disease. Pre- and post-operative evaluation of perceived nasal obstruction was performed using the Nasal Obstruction Symptom Evaluation questionnaire. Pre- and post-operative assessment of sexual functions was performed using the International Index of Erectile Function. Results Mean post-operative scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall sexual satisfaction were significantly higher compared to the pre-operative scores (p = 0.022, p = 0.036, p = 0.033, p = 0.016 and p = 0.029, respectively). Conclusion Surgical treatment of nasal obstruction by septoplasty, endoscopic sinus surgery, concha bullosa excision or radiofrequency can significantly improve sexual performance.

Cardiomyopathy is a disease of the heart muscle resulting from genetic defects, cardiac myocyte injury, or infiltration of the myocardium. Cardiomyopathies are traditionally defined as dilated, restrictive, and hypertrophic cardiomyopathy. Today, the genetic basis of most diseases has been clearly defined and has influenced the approach to familial diseases such as cardiomyopathies. Traditional definitions of cardiomyopathies, such as those by the American Heart Association and the European Society of Cardiology, do not consider the genetic basis of cardiomyopathies. In 2013, the World Heart Federation added the genetic basis of cardiomyopathies and proposed a descriptive genotype-phenotype nosology system termed "MOGE(S)." The MOGE(S) system resembles the TNM classification system for malignancy, and therefore it can be useful for the diagnosis, management, and treatment of cardiomyopathies in a similar manner to cancer management.

WOS: 000407745600013 PubMed: 28372306 BACKGROUND: Unvalidated Turkish adaptations of existing low back pain disability scales are often used. OBJECTIVE: To evaluate the validity and the reliability of the Turkish version of Aberdeen Low Back Pain Scale (ALBP). METHODS: The cross-cultural adaptation was performed in accordance with recently published guidelines. The Turkish version was administered to 120 patients. Test-retest and internal consistency were evaluated for reliability. Construct validity and criterion validity were measured. Responsiveness of the questionnaire towards changes by the treatment were assessed. All questionnaires were administered at admission, 1 day later, at the end of treatment, and a month after the end of treatment. Patients were assessed with Ostwestry (OLBP), physical and mental component of SF-36(PCSSF-36, MCSSF-36), Beck Depression Inventory (BDI), Schober test and visual analog scale for pain (VAS). RESULTS: Retest scores were significant and high (Internal Correlation Coefficent: 0.963). For internal consistency, Cronbach's alpha was 0.889. For construct validity, Spearman's Correlation Coefficent was 0.882. For criterion validity of ALBP, correlations were found significant and acceptable for OLBP, PCSSF-36, MCSSF-36, BDI, and VASactivity (p(

WOS: 000393176900009, PubMed: 28180198, Aim: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. Patients and methods: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. Results: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p, Selcuk University Coordinatorship of Scientific Research Projects (BAP) [13401053], We would like to thank Mr. M. Bora Erdogdu for his valuable help with the statistical analysis. This project was funded by the Selcuk University Coordinatorship of Scientific Research Projects (BAP) (grant number 13401053).

Aims To investigate the effect of the bladder sensation grade on uroflowmetry parameters. Methods Fifty healthy volunteering young men were enrolled in the present study. In total, three uroflowmetry evaluations were made. Qmax, Qave, VV, and PVR urine was obtained three times in three described bladder sensation grades, nearly at the same time of the day. Results The mean age of the participants in the present study is 29.08 ± 3.8 years. The mean Qmax values of the volunteers were 17.4 ± 4.8 ml/s, 24.1 ± 6.0 ml/s, and 29.6 ± 6.5 ml/s in the first, second, and third, voiding desire grades, respectively. The mean Qave values were 9.9 ± 2.1 ml/s, 12.9 ± 2.9 ml/s, and 15.9 ± 4.0 ml/s for each of the voiding desire grades mentioned. A statistically significant difference was obvious for all three bladder sensation grades in terms of Qmax and Qave values (P = 0.000). However, no statistically significant difference was seen regarding the PVR urine volumes. The mean voided volume in the first, second and third uroflowmetry were 140 ± 42 ml, 245 ± 64 ml, and 449 ± 105 ml, respectively. The highest Qmax and Qave values were obtained when the desire to void was urgent. Conclusions The findings of the study show that, uroflowmetry evaluations are to be made if the patients have a strong desire to void. Only thus the highest Qmax values can be obtained; yet, the degree of perceived bladder sensation does not have a statistically significant impact on PVR quantity. Neurourol. Urodynam. 9999:XX–XX, 2015. © 2015 Wiley Periodicals, Inc.

Urethral stricture is one of the most bothersome urologic disease among urologists and has a substantial impact on quality of life and healthcare costs. Although it can be cured with internal urethrotomy easily, post-surgery stricture recurrence is challenging. Several adjuvant therapies have been used in conjunction with internal urethrotomy but none of them are used routinely because the pathophysiology of the disease is still obscure. Fibrosis is the most accused hypothesis for the action. Platelet-rich plasma (PRP) is an autologous blood product containing a high concentration of platelets that is being used for a very wide range of clinical healing applications. It comprises a concentration of fundamental protein growth factors shown to be actively excreted by platelets to initiate accurate wound healing. Although PRP can play a critical role in wound healing and has been used in fibrotic diseases successfully, it has some deleterious cytokines such as transforming growth factor β1 (TGF β1) which can also cause fibrosis. The new hypothesis is that the subcutaneous injection of neutralized platelet-rich plasma with TGFβ1 antibody at the planned urethrotomy site may prevent recurrence and provide superior healing and long-term results.

WOS: 000384827400006, PubMed: 27621918, Introduction: Eosinophilic cystitis (EC) is a rare and poorly understood inflammatory condition, characterized by eosinophilic infiltration of all layers of the bladder wall, which mimics bladder tumors. EC may present with symptoms such as increased urination frequency, dysuria, gross/microscopic hematuria, suprapubic pain and urinary retention. Case Presentation: We present a 17-year-old male patient, who was continent night and day in his childhood, and was admitted to our clinic for complaints of hematuria and nocturnal enuresis for the past six months. His history and physical examination were unremarkable, and routine hematological and biochemical tests were normal. Cystoscopy revealed a 4 x 3 cm erythematous, polypoidal, solid lesion on the bladder dome. Histopathological examination of the lesion revealed transitional epithelium with stromaledema, where diffuse, dense infiltration of lamina propria by eosinophils and lymphocytes was also seen. According to these findings, a histopathological diagnosis of EC was made, and the patient was treated with corticosteroids, antimicrobial agents and antihistamines. His symptoms dramatically improved and nocturnal enuresis also recovered after treatment. Conclusions: Although it is a rare entity, EC should be kept in mind in the differential diagnosis of patients presenting with dysuria, hematuria and any kind of acquired voiding dysfunction, including frequency, pollakiuria and incontinence.

We aimed to evaluate the accuracy of determining stone composition with dual-source (DS) dual-energy (DE) computed tomography (CT). A total of 142 patients, diagnosed with urolithiasis and had complete medical records, were included in the study. The number, dimensions, location and CT density of the stones, and dose-length products and effective radiation dose were recorded for every patient. Stone compositions determined with DECT by two radiologists separately were compared with crystallography method. Among 138 stones with a crystallographic result out of 187 stones evaluated, 58 calcium oxalate, 42 hydroxyapatite, 24 uric acid and 10 cystine stones were detected. DECT showed a sensitivity and negative predictive value of 68.67 and 67.5 % for calcium oxalate. Moreover, DECT was found to be very useful in predicting hydroxyapatite and cystine stones with a 100 % sensitivity and negative predictive value. Cohen kappa correlation test showed a substantial agreement (κ = 0.682) between crystallographic analysis and prediction with DECT-analysis, which was statistically significant (p

WOS: 000392860500007, PubMed: 28127450, Introduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors.

Caseoma (caseous calcification of mitral annulus) is rare variant of common echocardiographic finding. Chronic caseous degeneration in the internal material of mitral annular calcification is the underlying mechanism of this condition. On the echocardiographic evaluation, the calcification is around the mass with central echolucent area, typically located at the base of the posterior leaflet. This echocardiographic finding can be mistaken for cardiac tumors, vegetations or abscesses.

Oxidative stress is the most common factor leading to infertility in men with varicocele. Reactive oxygen species and other markers of oxidative stress are measured to predict the extent of oxidative stress. Thiol groups are important antioxidants and essential molecules protecting organism against the harmful effects of reactive oxygen species. Thiol-disulphide homoeostasis is a unique, easy and new method to demonstrate oxidative stress. The aim of this study was to determine thiol-disulphide homoeostasis as an oxidative stress marker in infertile men with varicocele. The hormonal profile and parameters of thiol-disulphide homoeostasis were studied in 46 infertile men with varicocele, 70 fertile men with varicocele and 37 fertile controls. Infertile men with varicocele had significantly higher disulphide concentrations and disulphide/native thiol, disulphide/total thiol and native/total thiol ratios than those of fertile men with varicocele and fertile controls. According to these results, the blood plasma of patients with varicocele contains excessive oxidative stress, even in men with normospermia, and therefore, thiol-disulphide homoeostasis may be useful as an oxidative stress marker in men with varicocele.

WOS: 000392042000013 PubMed: 27560528 AIM: To evaluate the validity and reliability of Turkish version of Extended Aberdeen Spine Pain Scale (EASP). MATERIAL and METHODS: After cultural adaptation, the questionnaire was administered to 120 patients. Test-retest reliability, internal consistency, construct and criterion validity and responsiveness to treatment were measured. All questionnaires were administered at baseline, 1 day later and at the end of treatment. Patients were assessed with Physical and Mental Component scores of SF-36 (SF-36PCS, SF-36MCS), Beck Depression Inventory (BDI) and Visual Analog Scale for pain (VAS). RESULTS: Retest scores were significant (ICC: 0.878). For internal consistency, Cronbach's alpha was 0.908, which means all parts of the questionnaire are highly homogenous. For construct validity, Spearman's Correlation Coefficient was 0.907, which means that items of the questionnaire behaved as expected. For criterion validity of EASP, Spearman's rho correlations with SF36PCS (-0.999), SF-36MCS (-0.367), BDI (0.350), VASactivity (0.429), VASrest (0.399) and VASsleep (0.308) were found significant (p=0.000). According to responsiveness, EASP, SF-36PCS, VASactivity, VASrest, VASsleep showed significant improvement after the treatment (p=0.000). CONCLUSION: The Turkish version of EASP seems reliable, valid, and responsive. Because of its usefulness for evaluating the whole spine as a functional unit, the EASP can be recommended for clinical trials.