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To assess the impact of a diagnosis of bladder cancer on smoking behavior and to analyze the role of the physician in smoking cessation. Nonmuscle-invasive bladder cancer patients completed a phone survey of their smoking habits. They were asked about smoking behavior before and after the diagnosis of cancer and whether they had been informed by their physician about the relation between smoking and bladder cancer. Two hundred-twelve patients responded to the survey. The mean age was 60.03±6.36 years. Ninety-three of the 135 current smokers (68.9%) were advised to quit smoking, whereas nine of 20 nonsmokers (45%) were not commented about the future risks of smoking. The results showed that 13% of the current smokers and 35% of the current nonsmokers were not warned about the relation of bladder cancer with smoking. Statistical significance was not seen in terms of sex, disease stage, and tumor grade at diagnosis. The relation between smoking and bladder cancer has been well established. However, some patients are not informed to quit smoking by their physicians. © 2015, TIP ARASTIRMALARI DERNEGI. All rights reserved.

Purpose: To compare the efficacy of RIRS and PNL in lower pole stones ?2 cm. Materials and and Methods: A total of 109 patients who underwent PNL or RIRS for solitary lower pole stone between April 2009 and December 2012, were retrospectively analyzed. Lower pole stone was diagnosed with CT scan. Stone size was assessed as the longest axis of the stone. All patients were informed about the advantages, disadvantages and probable complications of both PNL and RIRS before the selection of the procedure. Patients decided the surgery type by themselves without being under any influences and written informed consent was obtained from all patients prior to the surgery. Patients were divided into two groups according to the patients' preference of surgery type. Group 1 consisted of 77 patients who underwent PNL and Group 2 consisted of 32 patients treated with RIRS. Stone free statuses, postoperative complications, operative time and hospitalization time were compared in both groups. Results: There was no statistical significance between the two groups in mean age, stone size, stone laterality, mean follow-up periods and mean operative times. In PNL group, stone-free rate was 96.1% at first session and 100% after the additional procedure. In Group 2, stone-free rate was 90.6% at the first procedure and 100% after the additional procedure. The final stone-free rates and operative times were similar in both groups. Conclusions: RIRS should be an effective treatment alternative to PNL in lower pole stones larger than 2 cm, especially in selected patients.

Some in vitro and animal studies have shown endothelial dysfunction in hyperoxaluria models indicating its role in pathogenesis of urolithiasis and relation to CVD. The aim of this study was to investigate endothelial function in patients with urolithiasis in relation to urinary stone risk factors and metabolic parameters. A total of 120 subjects without any known CVD (60 with urolithiasis and 60 healthy subjects) were included into study. Fasting blood and 24-h urine samples were collected to study metabolic parameters (glucose and lipids) and urine stone risk factors (oxalate, citrate, uric acid, and calcium, pH). Endothelial function was assessed as flow-mediated dilation (FMD) at the brachial artery. Age, sex, and body mass index were similar in patients and controls. Of urine stone risk factors, oxalate and citrate were higher in patients than controls. Fasting blood glucose, total LDL cholesterol, and triglyceride were higher, and HDL cholesterol was lower in patients than controls. Although within normal limits systolic blood pressure was higher in patient group, patients with urolithiasis had a lower %FMD than controls. Percent FMD was negatively correlated with urinary oxalate/creatinine ratio (p = 0.019, r = -0.315), calcium/creatinine ratio (p = 0.0001, r = -0.505) age (p

Background: Prostate cancer is one of the most common solid tumors and the second leading cause of the death due to malignancy in men. Caspase 9 (CASP9) is a member of the intrinsic pathway and plays a central role in the apoptosis. Patients and Methods: Genotyping of the CASP9 (rs1052576) polymorphism were performed using real-time polymerase chain reaction for blood samples of prostate cancer patients (n=69) and controls (n=76). Results: There were no significant differences between the groups in the frequency of CASP9 genotypes (χ2=1.363; p=0.506). Patients with CASP9 (rs1052576) CT genotype were 12.8 fold higher in pathological stage of pT2a compared to any other stages of cancer (OR=0.078, 95% CI= 0.009-0.062; p=0.004). Also TT genotype carriers were 11.3 times lower in pathological stage of pT2a (OR=11.33, 95% CI=2.39-53.748; p=0.000). C allele carriers were 11.36 fold higher in pathological stage of pT2a compared to any other stages of cancer (OR=0.088, 95% CI=0.019-0.418; p=0.002). Conclusion: CASP9 (rs1052576) C allele was decreasing the risk for pathological stage of patients with prostate cancer and also CT genotype had positive impact on pathological stage of patients with prostate cancer. CASP9 (rs1052576) TT genotype was seemed to be associated with higher risk of pathological stage. Those results implicated that CASP9 variations could be associated with severity of prostate cancer.

Purpose The aim of the study was to evaluate the efficacy and safety of bilateral single-session retrograde intrarenal surgery in the treatment of bilateral renal stones. Materials and Methods From December 2008 to February 2012, 42 patients who had undergone bilateral single-session retrograde intrarenal surgery (RIRS) and laser lithotripsy were included in the study. The procedures were performed in the lithotomy position on an endoscopy table under general anesthesia, beginning on the side in which the stone size was smaller. Plain abdominal radiography, intravenous urograms (IVU), renal ultrasonography (USG) and / or non-contrast tomography (CT) scans were conducted for all patients. The success rate was defined as patients who were stone-free or only had residual fragment less than 4 mm. Results A total of 42 patients (28 male, 14 female) with a mean age 39.2 ± 14.2 were included in the present study. The mean stone size was 24.09 ± 6.37 mm with a mean operative time of 51.08 ± 15.22 minutes. The stone-free rates (SFR) were 92.8% and 97.6% after the first and second procedures, respectively. The average hospital stay was 1.37 ± 0.72 days. In two patients (4.7%), minor complications (Clavien I or II) were observed, whereas no major complications (Clavien III-V) or blood transfusions were noted in the studied group. Conclusions Bilateral single-session RIRS and laser lithotripsy can be performed safely and effectively with a high success rate and low complication rate in patients with bilateral renal stones.

The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi ?10 mm. 92 patients having single radio-opaque proximal ureteral stone ?10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified according to stone diameters

End-stage renal disease (ESRD) affects sexual function. The etiology of sexual dysfunction in ESRD is multifactorial and hypogonadism is not uncommon. In a cohort of 96 men with ESRD, scores on International Index of Erectile Function (IIEF) correlated with bioavailable testosterone (T; P0.01). We further evaluated the effects of administration of T on ED in hypogonadal men on hemodialysis. Nine men with ED and hypogonadism (baseline bioavailable T 3.82 nmol l 1), received 5 g T-gel (1% (10 mg g 1) per day treatment for 6 months. The IIEF and frequency of sexual intercourse per week were used to assess treatment efficacy. T administration significantly increased serum T levels to the normal range, and was associated with statistically significant improvements of the scores of the IIEF domains (erectile function from 7.68.0 to 12.87.8; intercourse satisfaction from 3.44.5 to 4.83.1; orgasmic function from 4.83.1 to 3.42.9; sexual desire from 3.42.9 to 4.40.6; overall sexual satisfaction from 2.61.3 to 3.81.0). But scores of the IIEF did not normalize. Frequency of weekly sexual intercourse increased from 0.40.4 to 1.10.8 (P0.05) after 6 months. There were no adverse effects. We conclude that restoring T levels to normal in men with ESRD improved scores on the IIEF and frequency of weekly sexual intercourse. © 2010 Nature Publishing Group All rights reserved.

Objectives: To evaluate the possible role of being overweight on stone-forming risk factors in children. Methods: A total of 94 children (43 boys and 51 girls, male/female ratio 1:1.8) who were taking no medication or dietary modifications before treatment were included in the study. After a detailed stone disease history, the systolic and diastolic blood pressures were precisely measured and recorded for all patients. The body mass index, 24-hour urine values, and serum stone-forming risk parameters were evaluated in 44 overweight (17 boys and 27 girls; group 1) and 50 normal (26 boys and 24 girls; group 2) children. The results of each group were compared using the Wilcoxon rank sum test. Results: The evaluation of the stone-forming risk factors in both groups revealed that the overweight status might be responsible for the increased excretion of these substances in such children. Most of the children in group 1 demonstrated hypocitraturia and hyperoxaluria (9/44, 20.5%) compared with the patients in group 2. Although the mean urinary oxalate level was 0.74 ± 0.81 mg/kg/24 h for boys and 0.69 ± 0.72 mg/kg/24 h for girls in group 1, relatively lower values were noted in group 2 (0.42 ± 0.52 and 0.45 ± 0.57 mg/kg/24 h for the boys and girls, respectively). Similarly, the children in group 1 had elevated mean urinary calcium and lower citrate excretion compared with the group 2 patients. Conclusions: Overweight status in children might be associated with an elevated risk of stone formation in both sexes owing to the alterations in urine composition. Obese children could be more prone to stone formation, and they should be evaluated and followed up for this aspect. Crown Copyright © 2009.

Purpose. To evaluate the results of patient symptoms and radiologic outcomes of cystoretroperitoneal shunt (CRS) technique in the treatment of symptomatic simple renal cysts.Patients and Methods. In a prospective study, 37 patients with a simple renal cyst were treated with ultrasound-guided percutaneous CRS-catheter. Radiological success was indicated as no recurrence of the cyst or a reduction in cyst volume by at least half.Results. CRS technique was performed successfully in 36 patients with a simple renal cyst. The mean size of all cysts decreased from 8.8 cm (range 7 to 14) to 1.7 cm (range 0 to 9; ). Symptomatic success (pain relief) was achieved in 29/36 (80.5%) of patients, and radiographic success was achieved in 23/36 (63.8%) of patients, with a median follow-up of 16 months (range 6 to 24).Conclusion. Ultrasound-guided percutaneous CRS technique for simple renal cysts is fast, safe, effective, and inexpensive.

Introduction Premature ejaculation (PE) is the most common male sexual dysfunction. Monosymp tomatic enuresis (ME) is nocturnal bed wetting, without any daytime symptoms. Recent clinical stud ies report an association between lifelong PE and ME. The purpose of this study was to compare the intravaginal ejaculatory time (IELT) between lifelong PE in men with and without ME. The goal was to determine if there is an association between the severity of ME and of IELT. Material and methods A total of 137 men with lifelong PE were included in this study. Subjects were asked if they had childhood ME. The characteristics and mean IELTs of patients with and without ME were compared using the student’s t–test, and the correlation between severity of ME and IELT was assessed with trend test. Results Of the 137 lifelong PE patients, 57 reported ME. There was a strong negative correlation in patients with ME between the severity of enuresis and IELT, with IELT being shorter in patients with severe ME. Conclusions A strong correlation between IELT and the severity of ME suggests a common underlying mechanism. Further studies are required to confirm these findings and elucidate the exact pathophysiology.

Background: Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms. Methods: This was a prospective randomised study including 60 patients (American Society of Anesthesiologists class I and II) who were scheduled to undergo TURP. The patients were divided into two equally sized groups (group M: morphine, group C: control). A standartized anesthesia method was used. Group M patients received morphine 0.04 mg/kg intravenous (iv) in 100 ml of normal saline followed by an infusion of morphine for 24 h (0.01 mg/kg/h); group C patients received 100 ml normal saline 20 min before the expected extubation time, followed by a normal saline infusion which looked identical to that of the morphine infusion. The incidences and severity of LUT discomfort, postoperative pain, sedation level, postoperative nausea and vomiting (PONV) and respiratory depression were recorded at 0, 1, 2, 6, 12 and 24 h postoperatively. Results: The incidence of LUT discomfort was lower in group M patients at all time points during the study (p < 0.05) except for 2 h postoperatively, and the severity of LUT discomfort was also lower this group at 0, 12 and 24 h postoperatively (p = 0.001, p = 0.04 and p = 0.02, respectively). Pain (numeric rating scale) scores were lower in group M patients at 0 (p = 0.003) and 6 h (p < 0.001). The need for rescue analgesic was lower in group M patients (19 patients in group C, 10 patients in group M; p = 0.04). The incidence of PONV was higher in group M patients (p = 0.03). The incidence of pruritus, respiratory depression and over-sedation were similar among the groups. Conclusion: Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting. © 2013 Japanese Society of Anesthesiologists.

Objectives To evaluate the causes of emergent stent placement during the postoperative early period after uncomplicated ureteroscopy in 23 patients. Methods Of 276 uncomplicated ureteroscopy procedures performed for the management of ureteral calculi, double-J stent placement was necessary on an emergent basis in 23 patients because of intolerable colic pain and extreme patient discomfort. All stents were inserted within 24 hours after the procedure. Results Of the 23 patients requiring emergent stent placement, 14 were men and 9 were women. The stones had been located in the lower ureter in 11, mid-ureter in 6, and upper ureter in 6 patients. All patients had undergone an uncomplicated procedure with no complication evident either during or immediately after ureteroscopic stone management. The intraoperative findings for the 23 patients revealed extensive edema formation, unrecognized small stones embedded in the edematous ureteral wall, unpassed small fragments gathered at the orifice, obstructing blood clots, and kinking of the ureter. A retrospective evaluation of the operative CD recordings and radiographic findings clearly showed that a longer operative time, repeated access, management of a large stone, impacted calculi with ureteral wall edema, a mildly narrowed ureteral segment, ignored caliceal small calculi, and a recent history of urinary tract infection contributed to the need for postoperative intervention. Conclusions Ureteral catheterization, at least in the form of overnight stent placement, might prevent the formation of transient ureteral obstruction, with resultant postoperative patient discomfort and colic pain evident in selected cases. © 2011 Elsevier Inc.

Objective: To evaluate the natural course of the stone disease in pediatric patients from different perspectives among which the spontaneous passage and stone recurrence rates evaluated during the follow-up. Materials and methods: A total of 142 children referring with primary urinary stone disease were evaluated and followed. All children in the study were divided into two groups with respect to the age (Group 1: 0-5 years and Group 2: 6-15 years). Children were followed with respect to spontaneous passage rates, recurrence-regrowth rates, physical as well as the renal growth rates. Results: Stone recurrence has been noted in 44% of patients in group 1, this value was 31% in group 2. Children with at least one identifiable metabolic abnormality tended to have higher recurrence rates than the others despite conservative measures. The average stone recurrence rate in children without any metabolic abnormality was 14% and nearly 50% in children with an identifiable metabolic abnormality. Conclusions: We may emphasize that due to the high recurrence and re-growth rates, all children with urinary stone disease should be followed closely with regular visits. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of pre-existing calculi. © 2010 Springer Science+Business Media, B.V.

Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone risk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors. © 2011 Springer-Verlag.

The aim of this study was to evaluate the possible relationship between varicocele and saphenofemoral insufficiency in patients diagnosed with primary varicocele. A total of 70 patients with the primary diagnosis of varicocele were included into the study. A total of 30 age-matched healthy adults were also included in the study as a control group. Varicocele was diagnosed by palpation and observation of each spermatic cord in standing position before and during a valsalva maneuver. Additionally, scrotal Doppler and lower extremity venous Doppler ultrasonography were performed. Patients who were with spermatic varicose vein larger than 3.0 mm were included in the study group as a varicocele patient. At the lower extremity venous Doppler ultrasonography, a retrograde flow lasting longer than 0.5 seconds during normal breathing or at the valsalva maneuver was considered to be meaningful for saphenofemoral junction insufficiency. Thirty-six (51.35%) patients had insufficiency in saphenofemoral junction in the study group (6 [8.5%] bilateral, 30 [42.85%] unilateral) whereas 8 (26.6%) had insufficiency in the control group (2 [6.6%] bilateral, 6 [20%] unilateral insufficiency). The patients with primary varicocele had a statistically significant (P 5 .02) higher rate of venous insufficiency in their saphenofemoral junctions when compared with the control group. In the present study, the rate of saphenofemoral insufficiency has been found to be statistically higher in patients with primary varicocele compared with healthy men. Depending on the common presence of valvular insufficiency, we believe that the presence of varicocele should be investigated in the young population suffering from saphenofemoral junction insufficiency.

Objectives: To evaluate the efficacy of semirigid ureteroscopy in the management of ureteral stones located in different parts of the ureter. Methods: 1,503 patients were treated with semirigid ureteroscopy. All ureteral stones were either removed only by a basket catheter or disintegrated by pneumatic lithotripsy. Success rates, auxiliary procedures, complication rates and operation time were comparatively evaluated according to stone location. Results: Overall, mean stone size and age were 12.1 ± 3.7 mm and 43.2 ± 9.72 years, respectively. While 1,416 patients (94.2%) were completely stone-free, the procedure was unsuccessful in 87 cases (5.8%). The success rate was relatively low in the proximal ureter (71.7%) when compared with the mid (94.8%) and distal ureter (98.9%) (p = 0.021). Mean operation time was 25.4 ± 11.7 min. Longer duration of operation and higher complication rate were found in proximal ureteral calculi. Stone migration to the kidney and hematuria were the main reasons of failure in the proximal ureter and ureteral stenting was needed for 56.4% of patients with upper ureteral stone. Conclusions: Semirigid ureteroscopy can be the treatment of choice in lower and midureteral stones. However, it is an invasive and less successful treatment modality for proximal ureteral stones with relatively high complication rates.

WOS: 000282160600049, PubMed: 20074725, Objective: To compare the factors affecting sexual function in premenopausal women with type 2 diabetes using the female sexual function index (FSFI). Design: Cross-sectional study. Setting: Premenopausal women with type 2 diabetes and healthy volunteers in an academic research environment. Patient(s): Sixty-two type 2 diabetic women were compared with 50 controls. The FSFI scores of the patients were compared according to age, duration of diabetes, marriage, socioeconomic status, parity, menstruation regularity, body mass index (BMI), and smoking. Intervention(s): None. Main Outcome Measure(s): Female sexual function index scores. Result(s): The mean FSFI score in diabetics was lower than in controls. Menstrual irregularity and duration of diabetes affected female sexual function unlike age, BMI, socioeconomic status, duration of marriage, or parity. Regularly menstruating women had higher FSFI scores (27.1 +/- 6.7) than irregularly menstruating women (20.7 +/- 7.4). Type 2 diabetics were divided into three groups according to duration of diabetes. The women having diabetes longer than 10 years had the worse sexual function. Also, smoking affected inversely female sexual well being. Conclusion(s): Menstrual disturbance, smoking, and longer duration of diabetes (more than 10 years) impair FSFI scores in premenopausal women with type 2 diabetes. (Fertil Steril (R) 2010;94:1840-3. (C)2010 by American Society for Reproductive Medicine.)

Purpose: The pathogenesis of kidney stones remains elusive. There is some evidence that hyperoxaluria may effect vascular endothelium and many studies link renal stones to atherosclerosis. Also, renal vascular endothelial cells regulate proximal tubular epithelial cell function. We determined the effect of hyperoxaluria on plasma and tissue levels of asymmetrical dimethylarginine. The secondary aim was to determine the effect of verapamil on asymmetrical dimethylarginine. Materials and Methods: A total of 42 Sprague-Dawley rats were included in the study. In groups 1A, 1B and 1C hyperoxaluria was induced with ethylene glycol for 2 weeks. Groups 2A, 2B and 2C received ethylene glycol for 14 days and verapamil for 28 days. Control group 3 received no specific medication but distilled water. Blood samples were obtained at 24 hours and at study end, and kidney samples were obtained at 24 hours, and 7 and 28 days for histopathological evaluation. Results: Plasma asymmetrical dimethylarginine increased early in the hyperoxaluric group (p = 0.0002). The effect was retained at the end of the study period (p = 0.01). There was no increase in asymmetrical dimethylarginine in the verapamil group on short-term and long-term followup. Hyperoxaluria induced a significantly dense staining pattern in renal tissue asymmetrical dimethylarginine vs controls (p = 0.01). Asymmetrical dimethylarginine staining did not differ in the control and verapamil groups. Conclusions: Increased systemic and local tissue asymmetrical dimethylarginine may help explain the pathogenetic mechanisms of hyperoxaluria induced disorders such as nephrolithiasis and atherosclerosis. © 2010 American Urological Association.

Objectives The effect of verapamil on tubular ischemia that is demonstrated by HIF-1a positivity in tubular cells following hyperoxaluria was evaluated in a rabbit model. Methods Thirty-six healthy male rabbits were randomly divided into three groups. Animals in the hyperoxaluric group were fed with 0.75% ethylene glycol. The verapamil group was fed identically to the hyperoxaluric group. Additionally, the verapamil group received verapamil orally (0.1 mg/kg). The control group received no special diet. Six animals in each group were killed on the 7th day of the experiment and the remaining six at the 28th day. Kidneys of the rabbits were examined by histopathologic and immunohistochemical analysis to detect the presence and degree of HIF-1a positivity. Results On the 7th day analysis, severe and moderate degree staining for HIF-1a in hyperoxaluric group were shown in four and two, respectively. In the verapamil group, however, three of six specimens showed nuclear staining (moderate in two and severe in one). Two of six specimens in the control group had minimal staining. The 28th day evaluation showed that two of the hyperoxaluric group had minimal degree nuclear staining but not in the remaining four. No staining was shown in the verapamil and control group animals. Conclusions Hyperoxaluria-related ischemia formation may be responsible for subsequent alterations in renal tubules. As a protective agent, verapamil was found to limit the presence of hypoxic changes as documented by HIF-1 alpha positivity in this study. These data also support the presence ischemic insult after hyperoxaluria induction in animal model. © Springer Science+Business Media, B.V. 2009.

Objectives: To evaluate the therapeutic effect of papaverine hydrochloride in the treatment of patients with renal colic pain unresponsive to conventional treatment. Methods: From March 2007 to January 2008, a total of 561 patients with severe renal colic pain due to a ureteral stone were treated with conventional agents (hyoscine-N-butylbromide and diclofenac sodium) in the emergency and urology departments. Of these 561 patients, 110, with no response to the treatment and persistent severe pain, were randomized into 3 groups for additional treatment. The patients in group 1 (n = 37) received intravenous hyoscine-N-butylbromide, those in group 2 (n = 37) received papaverine hydrochloride, and those in group 3 (n = 36) received pethidine. Before and after treatment, all patients completed a visual analog scale (VAS) questionnaire, with a scale of 0 (no pain) to 10 (maximal complaint), to measure their subjective pain. The mean VAS score of each group was compared with that of the other groups. Results: The pretreatment mean VAS scores of all 3 groups were not significantly different statistically from each other (4.02 ± 1.20, 4.36 ± 1.97, and 4.27 ± 1.50; P > .05). However, after treatment, the mean VAS scores of the patients treated with papaverine (0.93 ± 0.29) and pethidine (0.81 ± 0.38) were significantly different from those of the hycosine group (3.67 ± 2.21; P < .001). However, the mean VAS scores of groups 2 and 3 were comparable (P = .67). Unlike opioids, no papaverine-related severe side effects were observed. Conclusions: Our results indicate that papaverine hydrochloride can used in an effective manner in the management of renal colic pain in patients unresponsive to commonly used conventional agents. © 2008 Elsevier Inc. All rights reserved.

The aim of this study was to evaluate the possible effect of a positive family history on the age at the onset of urinary stone disease and the frequency of subsequent symptomatic episodes relating to the disease. Between March 2006 and April 2009, patients with either a newly diagnosed or a previously documented stone disease were included in the study program. They were required to fill in a questionnaire and divided into two groups according to the positive family history of stone disease; group I comprised patients with a family history for urinary calculi and group II those without. Depending on the data obtained from questionnaires, all patients were evaluated in detail with respect to the age at the onset of the stone disease, stone passage and interventions over time, time to first recurrence (time interval between the onset of the disease and the first recurrence), number of total stone episodes and recurrence intervals. 1,595 patients suffering from urolithiasis with the mean age of 41.7 (14-69 years) were evaluated with respect to their past history of the disease. There were 437 patients in group I and 1,158 in group II. There was no statistically significant difierence between the mean age value of two groups (P = 0.09). When both genders in group I were analyzed separately, female patients tended to have higher rate of family history positivity than males. Comparative evaluation of the age at the onset of the disease between the two groups did reveal that stone formation occured at younger ages in patients with positive family history [P = 0.01 (males), P = 0.01 (females)] and the mean age of onset of the disease was lower in males than females in group I (P = 0.01). Patients in group I had relatively more stone episodes from the onset of the disease [P < 0.01 (2-4 episodes), P < 0.01 (?5 episodes)]. Male patients were associated with higher number of stone episodes (P = 0.01). Mean time interval between recurrences was noted to be significantly shorter in group I patients when compared with patients in group II [P < 0.01 (males), P = 0.02 (females)]. In conclusion, our results showed that urinary stone formation may occur at younger ages and that the frequency of symptom episodes may be higher in patients with a positive family history. We believe that the positive family history for urinary stone disease could give us valuable information concerning the onset as well as the severity of the disease. © The Author(s) 2009.