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Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: We have tried to define any criteria between under active bladder (UB) and bladder outlet obstruction (BO) from voiding efficiency (VE) without using pressure flow studies. Material and methods: In male patients uroflowmetry data, post-void residual (PVR) urine data and subsequent pressure flow studies (PFS) were examined retrospectively. Bladder outlet obstruction index (BOI) and bladder contractility index (BCI) were calculated using patients’ PFS values. Patients with BCI < 100 and BOI < 20 were grouped as the UB group and BCI > 100 and BOI > 40 with obstruction were grouped as the BO group. Results: Forty-four patients in UB and 49 in BO groups, totally 93 patients were examined. According to Qmax value there is no statistically significant difference between the two groups (p = 0.38). Average VE was 63.6 ±2.43% and 46.2 ±2.63% for UB and BO groups, respectively, and the difference was statistically significant (p < 0.001). UB can be diagnosed with at least 95% sensitivity and 88% specificity in men. Conclusions: Non-invasive uroflowmetry and VE measurements were also shown to differentiate between UB and BO patients, presenting with identical clinic data, besides PFS. [ABSTRACT FROM AUTHOR]

Background: The purpose of our study is to investigate the roles of IL-18 gene variations in bladder cancer development in Thrace population of Turkey. Methods: This study was carried out with 103 bladder cancer patients and 81 healthy controls. Genotype distributions of IL-18 (-137 G/C) and IL-18 (-607 C/A) gene variations were determined using polymerase chain reaction (PCR) method. Results: The CC homozygous genotype for IL-18 (-607 C/A) gene variation was significantly higher in patients with bladder cancer compared to healthy controls (OR 0.345, 95% Cl 0.186–0.639, p = 0.001). Besides this, allele frequencies of IL-18 (-137 G/C) and IL-18 (-607 C/A) gene variations in patient with bladder cancer and healthy control groups were significantly different from the Hardy–Weinberg distribution (p < 0.05). For IL-18 (-137 G/C) and IL-18 (-607 C/A) gene variations, significant difference was determined between the bladder cancer patient and healthy control groups in terms of GC–CA (OR 0.381, 95% Cl 0.203–0.714, p = 0.002), GC–CC (OR 2.147, 95% Cl 1.013–4.550, p = 0.043), GG–AA (OR 0.431, 95% Cl 0.365–0.509, p = 0.049), and GG–CC (OR 2.476, 95% Cl 1.177–5.208, p = 0.015) haplotypes. Conclusion: In our study, CC genotype of IL-18 (-607 C/A) gene variation was determined as genetic risk factor for bladder cancer development. In bladder cancer patient and healthy control groups, G and C allele frequencies of IL-18 (-137 G/C) gene variation, and C and A allele frequencies of IL-18 (-607 C/A) gene variation were determined significantly different from the Hardy–Weinberg distribution. [ABSTRACT FROM AUTHOR]

Objective: Benign prostatic hyperplasia is one of the biggest problems of aging men. Prostate surgery is now well defined in the case of failure of medical therapy. Robotic simple prostatectomy is a minimally invasive surgical method with an alternative to open simple prostatectomy in large prostate volumes. We present our simple prostatectomy technique with robot, perioperative, and short-term functional result in our clinic. Material and methods: Between January 2017 and January 2021, 42 patients underwent simple robotic prostatectomy were retrospectively evaluated. Preoperative, perioperative, and post-operative clinical data were analyzed. Post-operative continence status, voiding, and erectile functions were evaluated using uroflowmetry and international prostate symptom score (IPSS) at sixth week and third month. Results: The mean age of the patients was 71 (66-78) years. No major complications were observed in any of the patients. Urethral catheters were removed on the fourth post-operative day. Except for one case, all of the cases urinated spontaneously after the catheter was removed. One case could not urinate spontaneously, and urethral catheter was placed again. Three days later, the urethral catheter was removed, and patient urinated spontaneously. None of the patients reported stress urinary incontinence or erectile dysfunction. The mean operative time was 112 minutes, the mean hospital stay was 1.6 days, the mean post-operative IPSS was 6, and the mean post-operative Q max was 24.4mL s-1. Conclusion: Robotic simple prostatectomy may be an effective and safe alternative minimally invasive technique in the treatment of large-volume benign prostatic hyperplasia. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate the efficacy of tamsulosin in the treatment of lower urinary tract symptoms (LUTS) in patients under active surveillance (AS) for low-risk prostate cancer (Pca). Materials and Methods: Patients who underwent prostate biopsy between 2010 and 2014 were evaluated prospectively. Inclusion criteria for AS were PSA level below 10 ng/mL, a tumor in a maximum of two cores, a tumor core percentage below 50%, a clinical stage ≤ T2a and a Gleason score ≤6. Patients under AS with LUTS were included in the study group and patients with benign pathology results with LUTS were included in the control group. International prostate symptom score (IPSS) and uroflowmetry test were used to evaluate LUTS. The maximum flow rate (Qmax) was recorded. All patients received tamsulosin 0.4 mg once daily in a modified-release formulation (Flomax MR®, Astellas, Japan). Transurethral resection prostatectomy (TUR-P) was performed when surgical treatment was necessary for obstruction despite tamsulosin treatment. Results: The study included a total of 91 patients, 41 patients in the AS group and 50 patients in the control group. Patients were assessed after six months. There was a 30% reduction in IPSS in the AS group and 24.5% in the control group (p=0.591). Qmax increased by 20.4% in the AS group and by 20% in the control group (p=0.985). The need for TUR-P was similar between the two groups (14.6% vs 20%, p=0.503) during three-year follow-up. Conclusion: Tamsulosin can be used safely and with high efficacy for LUTS in patients under AS for low-risk Pca. The improvement in IPSS and Qmax, and the need for surgical treatment were similar to the control group. [ABSTRACT FROM AUTHOR]

Objective: We aimed to review the approaches of urologist and gynecologist in the management of overactive bladder (OAB). Material and methods: A questionnaire consisting of 12 items were answered by 375 urologist and 46 gynecologist. The differences between frequency of encountering OAB, their viewpoints concerning conservative treatment, and their experience related to anticholinergic drug use and the management of refractory OAB were compared. Results: The majority of the urologists, and gynecologists responded to the question "How often do you encounter OAB patients in your daily practice?" as 'in 10-25, and 50% of our patients', respectively (<0.001). The most common complaint consulted to urologists, and gynecologists were urge incontinence (51.1% vs. 64.8). The frequency of using questionnaire and voiding diary was similar in both specialties (23.9% vs. 25.1%, p=0.892). It was observed that 38.6% of the urologists, and 50% of the gynecologists had recommended conservative treatment as a first-line treatment of overactive bladder (p=0.049). The low sociocultural level was the most important obstacle confronting application of conservative treatment methods (54.3% vs. 37%, p=0.012). The survey participants indicated that the most important factor which affected their decision to select an anticholinergic agent as the first-line treatment of overactive bladder was higher effectiveness of these drugs (urologists; 55.7%, and gynecologists 64%, p=0.371). The patients who started to receive anticholinergic drugs most frequently complained both to their urologists, and/or gynecologists about dry mouth (76.3 vs. 74.5%). Based on the responses of the urologists, and gynecologists, the most frequent reason of anticholinergic drug withdrawal was patients' inability to tolerate side effects of these drugs (48% vs. 47.8%, p=0.697). The participants indicated that in case of unsatisfactory response to one anticholinergic agent, swithching rate to another anticholinergic drug was 56.9% among urologists vs. 59.6%, among gynecologists. In addition, 36.9% of urologists and 38.5% of gynecologists recommended another pharmaceutical form of the drug with a higher dose to their patients (p=0.279). Similar number of physicians indicated that the prescribed anticholinergic drug should be continued for at least 3 months and in case of unresponsiveness patient could be considered refractory. Majority of urologists (68.8%), and gynecologists (56.5%) chose to perform urodynamic tests in patients who are unresponsive to anticholinergic treatment, (p=0.093). Conclusion: The attitudes of urologist and gynecologist for diagnosis and treatment of OAB are mostly correlating with current guideline practices with few exceptions. Urologists tend to use bladder diaries or questionnaires less frequently whereas, gynecologists refer to urodynamic studies in patients with refractory OAB less than the urologists do. However, irrespective of the clinical speciality, conservative treatment modalities are rarely administered. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional study.Objectives:Our aim was to compare the effects of repeated cystometric measurements in spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO) who use indwelling catheters (IDC) or intermittent catheterization (IC).Setting:Turkey.Methods:A total of 20 SCI patients with NDO, 9 patients on IC and 11 on IDC for at least two consecutive months were included. After emptying the bladder, first involuntary detrusor contraction volume (1stIDCV), cystometric bladder capacity (CC), bladder compliance and maximum detrusor pressure (MPdet) were assessed by filling it with sterile physiological saline at room temperature at a continuous rate of 30 ml min−1. The bladder was re-emptied after the process and a second filling cystometry was performed in the same way.Results:When all study population were taken into account, 1stIDCV and CC measures were significantly increased in the second cystometry compared with the first cystometry (P=0.001 and P=0.022, respectively), whereas there was no statistically significant difference on bladder compliance and MPdet measures between the first and the repeated cystometry. There was no statistically significant difference on 1stIDCV, CC and bladder compliance measures between the first and the repeated cystometries for IC group, whereas there was statistically significant increase on these measures in the IDC group (P=0.003, P=0.008 and P=0.022, respectively). In addition there was no statistically significant difference on MPdet measures between the first and the repeated cystometries for both the urine drainage methods. When IC and IDC groups were compared according to mean values of differences in 1stIDCV, CC and bladder compliance measures between the two cystometries, the IDC group had a statistically significant increase in all parameters when compared with the IC group in the second cystometry performed (P=0.001, P=0.003 and P=0.048, respectively).Conclusion:Repeated cystometric measurements in SCI patients with NDO lead to an increase in 1stIDCV and CC. However, when the type of urine drainage method is taken into account, although repeated filling cystometry leads to an increase in 1stIDCV, MCC and bladder compliance in patients with IDC, it does not cause a difference in patients on IC. [ABSTRACT FROM AUTHOR]

ABSTRACT Overactive bladder syndrome ( OAB) is a chronic condition that requires long-term management. Patient education may have role in decreasing the unfavourable effects of long-term treatment of OAB. The aim of the study was to evaluate the effect of detailed patient education on the patients' persistence with antimuscarinic treatment for OAB. A total of 140 patients with the diagnosis of OAB were included in this study. Patients were randomly divided into two groups. Patients in Group 1 were given information by the same urology doctor about the disease and treatment. Patients in Group 2 were given information by a urology nurse. Patients were recalled in the first, third and sixth months of treatment. The treatment persistency was evaluated in the whole study population and between the groups. The persistency rates of the whole group were 88·6% in the first month, 65·7% in the third month and 45·7% in the sixth month. At the end of the sixth month, 42·8% of males and 47·1% of females were taking antimuscarinics ( p = 0·580). The persistence rate of Groups 1 and 2 were 82·8 and 94·3% at the first month. ( p = 0·034). It decreased to 31·4% in the first and 60% in the second group at the sixth month ( p = 0·001). The persistence rate of antimuscarinic treatment is low. Patient education is simple and effective way of increasing persistence. Clinicians must pay attention to inform their patients about the disease and possible side effects of treatment. An educated health provider may be very helpful in educating patients for OAB. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the risk factors in women with urodynamic stress urinary incontinence (USTIC) at a Turkish tertiary referral center.Materials and Methods: The urodynamic records of 3038 consecutive women were analyzed between 1990 and 2011. The patients who had etiological factor of neurologic disease were excluded. There were 1187 women who had USTIC after urodynamic investigation and 274 women who had no incontinence symptoms were included in the study. Multivariate analyses were done using logistic regression test to determine the risk factors for USTIC.Results: The mean age was 50.1 years (range, 86-18). Increased age, vaginal delivery, cesarean section, anterior prolapse existence in physical examination, previous anti-incontinence surgery, and previous pelvic organ prolapse surgery was found to be significant risk factors for USTIC at multivariate analyses.Conclusion: There are risk factors for women to have USTIC. Increased age, having vaginal delivery, having cesarean section, anterior prolapse, previous anti-incontinence surgery and previous prolapse surgery were found to be risk factors for women to have USTIC at this study. [ABSTRACT FROM AUTHOR]

Objectives: Examination of relations between urinary dysfunction and Functional Independence Measurement (FIM) values and other clinical factors. Materials and methods: Twenty-nine patients with TBI were included in the study. Patients' demographic values, lower urinary tract symptoms (LUTS) and urinary drainage methods were recorded. Functional assessment was performed using FIM. Urodynamic studies were carried out and maximum cystometric capacity (MCC), storage and voiding function, type of detrusor, urodynamic abnormality and post-void residual urine volume values were investigated. Results: Total FIM and FIM sphincter control sub-group scores were significantly lower in patients with storage dysfunction and urodynamic abnormality than patients without storage dysfunction and urodynamic abnormality ( p < 0.05). In tetraparetic patients, frequency of storage dysfunction was significantly higher than hemiparetic patients ( p < 0.05). Urodynamic abnormality was detected in five of nine patients with LUTS and in 12 of 20 patients without LUTS. There was no significant correlation between LUTS and urodynamic abnormality ( p > 0.05). Conclusions: Storage dysfunction and urodynamic abnormality is associated with poorly functional outcomes in TBI patients. There is a direct correlation between motor deficit and urodynamic abnormality. All of the TBI patients with or without LUTS should be evaluated neuro-urologically; urodynamic evaluation and treatment should be arranged if needed. [ABSTRACT FROM AUTHOR]

Study design:Retrospective study.Objectives:To analyze the neurogenic bladder characteristics and treatment approaches in patients with upper and lower cervical spinal cord injury (SCI) in order to make proper and reasonable decisions to the relevant patients.Setting:Rehabilitation center in Ankara, Turkey.Method:Ninety patients with cervical SCI were included. The urodynamic analyses of the patients were conducted retrospectively by using the urodynamic laboratory records. The patients were divided into two groups as the upper cervical SCI (UCSCI) group (C1-C5) and lower cervical SCI (LCSCI) group (C6-C8).Results:In this study, 82 male (91.1%) and 8 (8.9%) female patients were included. There were 51 UCSCI patients with the mean age of 34.2±16.1 years and 39 LCSCI patients with the mean age of 30.4±12.5 years. Detrusor overactivity and preservation of the bladder-filling sensation were significantly more frequent in the UCSCI group than in the LCSCI group (P=0.048, P=0.000 respectively). Moreover, there were statistically significant differences between the groups regarding the bladder-emptying methods, residual volume and the frequency of anticholinergic and alpha blocker use (all P<0.05). No significant difference was found between the groups regarding the frequency of autonomic dysreflexia, detrusor hypocompliancy and the bladder-storage and -emptying disorders (all P>0.05).Conclusion:Our results demonstrate that there are differences in the upper and lower SCI cases in terms of neurogenic bladder characteristics and treatment approaches. [ABSTRACT FROM AUTHOR]

Objective: In our study, we aimed to compare the cystometric and clinic results of patients who underwent augmentation cystoplasty for the treatment of a contracted bladder, according to etiological factors such as chronic tuberculosis cystitis (CTC) and spinal cord injuries (SCIs). Materials and methods: We retrospectively evaluated 26 patients with a contracted bladder due to CTC and SCI who underwent bladder augmentation in our clinic. The contracted bladder etiologies were SCI in 16 of patients (61.5%) and TBC in the remaining 10 patients (38.4%). The patients were evaluated preoperatively and postoperatively. Results: The mean follow-up periods for patients with SCI and CTC were 98.5±31.3 and 83.2±35.3 months, respectively (p>0.05). Patients with SCI and CTC did not significantly differ with respect to the preoperative and postoperative mean bladder capacities or intravesical pressures. As additional postoperative treatments, Clean Intermittent Self-Catheterization (CISC) was performed in 5 (31.2%) SCI patients, and anticholinergic treatment was administered to 3 SCI patients (18.7%). Anticholinergic treatment was used postoperatively in only one patient with CTC (10%). Conclusion: Augmentation cystoplasty is a useful treatment for patients with SCI and CTC. The postoperative urodynamic studies in these patients were similar. However, the requirement for additional treatments in patients with SCI, including anticholinergic agents and CISC, is more frequent than in patients with CTC in the postoperative period. Therefore, patients with SCI should be warned about additional postoperative treatments before augmentation cystoplasty, and CISC should be taught to these patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine the role of sonographic bladder wall thickness measurement in children with lower urinary system dysfunction. Material and methods: In this study, we reviewed 114 pediatric patients who underwent urodynamic studies for lower urinary system dysfunction between 2007-2009 at Istanbul University Cerrahpasa Medical Faculty. The patients were classified according to instable detrusor contractions and bladder wall thicknesses. Informed consent form was obtained from their parents. Results: Our study groups consisted with anatomical reasons (n=13), neurological problems (n=40) and idiopathic group (n=61). Urodynamic study detected unstable detrusor contractions in 66 patients while it did not determine contraction in 48 patients. Ultrasonography in 22 patients with unstable detrusor contraction (22/66) of bladder wall thickness was thin. In 44 patients (44/66) bladder wall thickness was detected thick. Conclusions: Our study suggests that the measurement of bladder wall thickness alone can not diagnose lower urinary system dysfunction correctly and can not replace urodynamic studies. Sonography and urodynamic studies are complementary rather than alternative modalities in evaluation and management of children with lower urinary system dysfunction. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To validate the Turkish translated version of short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Study design: After the test–retest reliability and internal consistency were established in a pilot study, 270 patients were enrolled and general and subscale scores of the questionnaire were calculated. All participants underwent the International Continence Society (ICS) prolapse score (POP-Q) and urodynamic assessment. Main scores and scores of Prolapse Quality of Life questionnaire (PQoL) and Incontinence Impact Questionnaire (IIQ-7) were compared between patients with incontinence±prolapse and asymptomatic women. Results: 62.24% of the participants showed urodynamic abnormality and/or leakage with or without prolapse. 28.91% had prolapse stage 3 or higher diagnosed by the POP-Q system. PISQ-12 showed a high internal consistency (Cronbach''s alpha was 0.89). For test–retest reliability Spearman''s rho was 0.72–0.79 for all domains. The mean scores of PISQ-12 were significantly better in asymptomatic women compared with the incontinence±prolapse group. Sexual function was negatively affected by prolapse and/or incontinence as assessed with PQoL and IIQ-7 questionnaires. Conclusion: The Turkish translated version of the PISQ-12 is a reliable, consistent and valid instrument to evaluate sexual functioning in women with urinary incontinence and/or pelvic organ prolapse. It is easy to understand that it may be easily administered and self-completed by the women. [Copyright &y& Elsevier]

Objectives: To analyze the neurogenic bladder characteristics and the treatment approaches in patients with multiple sclerosis (MS) to facilitate proper and reasonable decisions in relevant patients., Design: Retrospective study., Setting: Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey., Participants: Seventy-five patients diagnosed with MS between 2002 and 2015 were included in the study., Intervention: Urodynamic examination., Outcome Measure: The detrusor type, detrusor compliance, sense of bladder fullness, storage disorder, emptying disorder, voided volume, post-void residual volume, urine culture, emptying method, and medical treatments were recorded., Results: The study included 53 females and 22 males with a mean age of 36 ± 10.1 years. Urodynamic examinations indicated that 74.7% of the patients had detrusor overactivity, 74.7% had detrusor hypocompliance, 77.3% had storage dysfunction, and 81.3% had emptying dysfunction. An anticholinergic medication was recommended to 74.7% of the patients, while alpha-adrenergic receptor blockers were recommended to 69.3%. The detrusor hypocompliance was more common in the group with a disease duration of ≥10 years (p = 0.045). The use of external collector systems was more common, and urine culture was more frequently positive for infections in the female patients (p = 0.001 and p = 0.049, respectively). The frequency of normal bladder-filling sensation was higher in women (p = 0.01). The frequencies of detrusor overactivity and storage and emptying disorders, voided and postvoid volumes (mL), and bladder emptying methods were not significantly different among the subgroups (p > 0.05)., Conclusion: The study revealed a significant neurogenic bladder dysfunction and an inadequate management of this dysfunction in MS patients. Considering that the symptoms may progress over time, the urinary systems of MS patients should be evaluated periodically, and necessary modifications should be made in their treatments., (Copyright © 2021. Published by Elsevier B.V.)

Aims: The Paediatric Urology Guidelines Panel reports initial experience with patient involvement in spina bifida patient groups to gather information on their awareness of the guidelines and reflection of guideline recommendations., Methods: The survey was delivered to spina bifida patients/parents via the national society groups in Turkey, Germany, and The Netherlands. Questions included demographic features, medical status, awareness, and agreement on the recommendations given in the guidelines and future expectations., Results: A total of 291 patients from 3 countries responded to the survey. Mean age was 13.9 ± 12.2 years, male/female ratio 138/151, 75% of all surveys were completed by the caregivers. The medication was taken by 78% of patients (64% anticholinergics). Complete dryness rates for urine and stool were 24% and 47%, respectively. The agreement rates on the recommendations regarding urodynamics, intermittent catheterization, anticholinergics drug use, bowel management, and life-long follow-up were 97%, 82%, 91%, 77%, and 98%, respectively. Only 8% of responders were aware of the European Association of Urology/European Society for Pediatric Urology guidelines. The priorities of patients for future expectations were as the following: quality of life (QoL), surgical techniques, development of new medications and sexuality/fertility issues. Male spina bifida patients preferred new medications and sex/fertility issues more, whereas females favored QoL issues improvement more., Conclusions: Although the native language of the involved patients was different from English, awareness of guidelines was 8%. The general approval of the recommendations given in the guidelines is quite high. The national society groups showed a great interest to get involved in the creation of the guidelines to improve health care for spina bifida patients., (© 2019 Wiley Periodicals, Inc.)

Objective: To investigate the effect of repeating uroflowmetry test on results of patients with or without lower urinary tract symptoms., Methods: The prospective study was conducted at the Department of Urology, Ankara Training and Research Hospital, Turkey, from August to December 2012, and comprised 79 consecutive male patients with or without infravesical obstruction symptoms. All patients underwent uroflowmetry testing thrice on different occasions. The urinary maximum flow rate, average flow rate, voided volume (> or = 150 ml), voiding time, flow time and time to void values were evaluated. SPSS 16 was used for statistical analysis., Results: The overall mean of maximum flow rate was 11.4 +/- 1.69, 12.4 +/- 1.47 and 13.7 +/- 1.44 ml/sec at the first, second and third repetition respectively (p > 0.05). The mean percentage difference in maximum flow was +8% higher between the first and second attempt, and +4% higher between the second and third attempt. The mean average flow rate, the mean voiding time and the mean flow time values were also found to have insignificantly improved. The mean voided volumes of the patients were 201 +/- 48, 209 +/- 57 and 248 +/- 61 ml, respectively (p > 0.05). The time to void decreased significantly in the second and third attempts (p < 0.01)., Conclusion: Repeating uroflowmetry exhibits a minor improvement in maximum and average flow rates, and voided values in men, while a significant decrease was noted in time to void.

Objective: The aim of this study was to evaluate the safety and efficacy of retropubic (RP) or transobturator (TO) midurethral slings (MUS) in a prospective randomized cohort of Turkish women., Patients and Methods: A total of 54 women with urodynamic stress urinary incontinence (SUI) were randomized to undergo either RP or TO MUS between August 2006 and February 2013 in a tertiary referral center by a single surgeon. All patients had history, physical examination, urodynamic evaluation and quality of life assessments. The validated Turkish versions of the SEAPI, ICIQ-SF and OAB-V8 questionnaires were used. The Advantage® RP and the Obtryx® TO MUS Systems were used for all RP and TO procedures., Results: Twenty-seven patients were randomized to each group. The median follow-up was 48.5 ± 21.8 months. The median hospital stay was 24.0 ± 4.8 h and median operative time was 35.0 ± 19.9 min. The overall objective and subjective cure rates were 92.6 and 79.6%, respectively. The quality of life of all patients significantly increased after the operation compared to their preoperative status. Patients with a poorer subjective cure rate were those with mixed urinary incontinence, whose preoperative SEAPI and OAB-V8 scores were significantly higher., Conclusion: MUS surgery is highly effective and could safely be performed in a cohort of Turkish women with SUI in subspecialty centers by experienced surgeons. There is no significant difference between RP or TO applications in terms of safety and efficacy. Further studies with long-term follow-up data are required.

Objective: To evaluate the efficacy and outcomes of PlasmaKinetic™ urethrotomy against cold knife direct vision internal urethrotomy in terms of recurrence rates., Patients and Methods: A total of 136 male patients with urethral strictures were enrolled into the study. The patients were allocated to cold knife or PlasmaKinetic urethrotomy groups sequentially by using computer-generated numbers. Group A (PlasmaKinetic) and group B (cold knife) included 70 and 66 patients, respectively. All patients were reevaluated at the 3rd, 9th and 18th month postoperatively with uroflowmetry., Results: Group A patients had a postoperative 3rd-month maximum flow rate value of 16.09 ml/s, whereas this same parameter was 15.15 ml/s in group B (p < 0.05). The urethral stricture recurrence rate up to the 9-month period was statistically significant for group A (14%) compared with group B (30%). When we compared the recurrence rates of these groups from postoperative day 1 up to the 18th month, the results were 37% for group A and 33% for group B (p > 0.05)., Conclusion: PlasmaKinetic urethrotomy provides a better recurrence-free rate during the early period compared with conventional cold knife therapy. Nevertheless, the outcome of the stricture did not change and fibrotic tissue reformed between the 9th and the 18th month.

The aim of this study was to identify mutations in three different genes, the arginine-vasopressin-neurophysin II (AVP-NPII) gene, the arginine-vasopressin receptor 2 (AVPR2) gene, and the vasopressin-sensitive water channel aquaporin-2 (AQP2) gene in Turkish patients affected by central diabetes insipidus or nephrogenic diabetes insipidus. This study included 15 patients from unrelated families. Prospective clinical data were collected for all patients including the patients underwent a water deprivation-desmopressin test. The coding regions of the AVPR2, AQP2, and AVP-NPII genes were amplified by polymerase chain reaction and submitted to direct sequence analysis. Of the 15 patients with diabetes insipidus referred to Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, eight patients have AVPR2 mutations, five patients have AQP2 mutations and two patients have AVP-NPII mutations. Of the patients, which have AVPR2 mutations, one is compound heterozygous for AVPR2 gene. Seven of these mutations are novel. Comparison of the clinical outcomes of these mutations may facilitate in understanding the functions of AVP-NPII, AQP2, and AVPR2 genes in future studies.

Objective: Urinary incontinence (UI) may affect a woman's physical and psychological well-being in different aspects. The aim of this study was to compare the effects of urinary stress incontinence (USI), detrusor overactivity (DO) and mixed urinary incontinence (MUI) on sexual function., Study Design: One-hundred and seventy urinary incontinent, sexually active women were included in this cross-sectional study. After urodynamic evaluation, participants were divided into three subgroups as USI (n=61), DO (n=55) and MUI (n=54). Patients were matched according to age, parity and body mass index (BMI), rendering the sample size to 41 patients in each group. Turkish version short form of the Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire (PISQ-12) was filled out by each of the participants. Totally, 52 patients were excluded from the study (47 could not be matched and 5 incomplete questionnaire). Demographic characteristics of the participants, total and three domain scores of PISQ-12 were compared among three UI subgroups., Results: The study group was consisted of 38 (32.2%) DO, 41 (34.7%) USI and 39 (33.1%) MUI patients. Demographic characteristics of the patients were similar in three subgroups. Patients with a diagnosis of MUI had significantly lower mean PISQ-12 scores than the ones with USI and DO whereas patients with USI had lower mean PISQ-12 scores than patients with DO., Conclusion: Although urinary stress incontinence effects sexual function more than detrusor overactivity in terms of PISQ-12 scores, mixed urinary incontinence has the greatest impact on sexual function when compared with urinary stress incontinence and detrusor overactivity., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objectives: A prospective randomized study was conducted to evaluate the safety and effectiveness of bipolar plasma vaporization with a novel electrode that produces vaporization of the tissue (transurethral vaporization of the prostate, TUVP) immersed in isotonic saline compared to the standard transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH)., Patients and Methods: From February 2009 to February 2010, 90 patients with BPH were randomized into two groups, and underwent conventional TURP (group 1) or TUVP (group 2) utilizing bipolar plasma vaporization with an innovative electrode (Olympus Winter & Ibe GmbH, Hamburg, Germany). International Prostate Symptom Scores (IPSS), transrectal ultrasonographic findings, maximal urine flow rates (Qmax), and postvoiding residual urine (PVRU) volumes of all cases were evaluated preoperatively and 1 month, 3 months, and 1 year postoperatively. Preoperative and postoperative serum hemoglobin, hematocrit and sodium concentrations of all patients were measured. All patients included in the study were monitored for 1 year., Results: In patients in group 1 (n = 47; mean age: 64.7 ± 7.3 years) TURP was performed. The patients in group 2 (n = 43; mean age: 65.4 ± 8.9 years) underwent bipolar TUVP. Cases in the two study groups matched for demographic characteristics and clinical parameters were assessed. The evaluation of IPSS scores, PVRU, Qmax, and prostatic volumes of the patients 1 month, 3 months, and 1 year postoperatively did not reveal any significant differences between the two groups. In group 2 (TUVP), postoperative catheter indwelling times were significantly shorter, and Na serum concentrations were also markedly lower (p < 0.005)., Conclusion: We detected similar effectiveness and morbidity rates in both groups. Bipolar TUVP has advantages such as shorter catheter indwelling times and hospital stays, and fewer bleeding episodes without any risk of transurethral resection syndrome. We believe that TUVP might be an alternative to TURP which is currently the 'gold standard' treatment in BPH., (Copyright © 2011 S. Karger AG, Basel.)

The purpose of this article is to investigate the efficacy of intravesical oxybutynin hydrochloride (OH) to treat patients with overactive detrusors who are unresponsive to oral anticholinergic therapy alone. Twenty-five patients who were treated with oral OH for overactive detrusor (but who did not respond to treatment and were using indwelling urethral catheters) were given intravesical OH without changing oral treatment. Pre- and posttreatment bladder capacities were compared in urodynamic studies. The study showed that positive clinical results can be achieved with combined oral and intravesical OH treatments in patients with overactive detrusors who had indwelling urethral catheters because of severely reduced bladder capacity. However, a significant number of patients discontinued this treatment because of infection and difficulty in performing the procedure. Clinicians and rehabilitation nurses should provide education and support to eliminate these problems. In addition, the development of single-use standard sterile OH preparations for intravesical applications may increase the efficacy of the method.

Background: Laparoscopic extraperitoneal adenomectomy is occasionally performed for symptomatic large-volume benign prostatic hyperplasia. Two different multichannel ports were used during operations. We describe the technique of single-port extraperitoneal transvesical adenomectomy and present the initial operative experience., Methods: Three patients in whom an open adenomectomy was indicated underwent single-port extraperitoneal transvesical adenomectomy. Following preparation of the extraperitoneal space via an umbilical incision, a multichannel port was inserted. A transverse cystotomy adjacent to the prostatovesical junction, incision of mucosa overlying the adenoma, subcapsular plane development, prostatic adenomectomy and cystotomy repair were performed as the standard steps of the laparoscopic procedure., Results: All cases were completed without conversion to standard laparoscopy. Mean operative time was 105 min. Mean blood loss was 190 ml. Hospital stay was 4 days and catheter duration was 6 days for all patients. No intraoperative or postoperative complication occurred., Conclusions: Single-port extraperitoneal transvesical adenomectomy for large benign prostate hyperplasia is feasible with excellent cosmetic results and minimal morbidity., (Copyright © 2010 S. Karger AG, Basel.)

Aim: The purpose of this study is to determine the prevalence of urinary incontinence in the 12-month postpartum period and the risk factors related to this condition., Methods: The research is a cross-sectional study of 1,749 first-year postpartum women living in the metropolis of Konya and presenting at seven city health centers. The statistical methods used were the chi(2), the Student's t test and logistic regression analysis., Results: Of the women in the study who were in their 12-month postpartum periods, 19.5% were experiencing varying degrees of urinary incontinence. While 42.2% of the women suffered from stress incontinence, 10.3% had urge incontinence, 47.5% complained of a mixed type of urinary incontinence, 7.3% reported leakage of urine during sexual intercourse and 14.4% reported the need to use protective pads. It was found that 12.3% of the women were performing pelvic floor muscle exercises and only 15.2% had consulted their doctors about urinary incontinence., Conclusion: It was seen that urinary incontinence is a serious health problem in the postpartum period, that it disrupts a woman's daily activities, affects her sex life but that despite this, women do not receive needed medical assistance., (2008 S. Karger AG, Basel.)

Background: The purpose of the present paper was to investigate the effects of vitamin A supplementation on recurrent lower urinary tract infections (RUTI)., Methods: Twenty-four patients with non-complicated RUTI were included in a placebo-controlled, double-blinded study. Twelve patients received a single dose of 200,000 IU vitamin A in addition to antimicrobial therapy. Patient and control groups (each containing 12 patients) were followed for up to 1 year and were evaluated for eradication and frequency of lower urinary tract infections (UTI). Serum levels of vitamin A and beta-carotene were determined periodically., Results: During the first 6 months follow-up period the infection rate of the vitamin A-supplemented group reduced from 3.58 to 0.75 per 6 months, and in the subsequent 6 months the infection rate was 1.75 per 6 months. These values were calculated as 2.75, 2.83 and 2.66, respectively, in the placebo group., Conclusion: Vitamin A supplementation may have an adjuvant effect on the treatment of RUTI.

Aim: To validate the Turkish versions of the IIQ-7 and UDI-6 for use in Turkish-speaking populations., Methods: After establishing the test-retest reliability and internal consistency in a pilot study, 302 patients were enrolled in the study and general and subscale scores of the questionnaires were calculated. All participants underwent an urodynamic assessment., Results: Both instruments showed a high internal consistency (Cronbach's alpha for the IIQ-7 and UDI-6 was 0.87 and 0.74, respectively) and test-retest reliability (Spearman's rho was 0.99 for both of the scales (P < 0.001). 55.6% of the participants showed urodynamic abnormality and/or leakage. 39.7% had urodynamic stress incontinence (USI) and 15.9% had detrussor overactivity (DOA) +/- USI. The mean scores of each IIQ-7 and UDI-6 were significantly higher in the USI, and DOA +/- USI groups compared with normal women. Women with DOA +/- USI scored highest in the IIQ-7 and UDI-6. The irritative subscale scores of the 1st and 2nd items of the UDI-6 were significantly higher in the DOA +/- USI group. The stress subscale scores of 3rd and 4th items of UDI-6 were significantly higher in the USI group. Women with postvoid residual (PVR) urine values greater than 50 ml had significantly higher obstructive subscale scores compared to the ones who had less residual volumes., Conclusions: The Turkish translated versions of the IIQ-7 and UDI-6 are reliable, consistent and valid instruments for assessing symptom severity and the impact on QOL in Turkish speaking women with urinary incontinence., (Copyright 2006 Wiley-Liss, Inc.)

Unlabelled: The lower urinary tract reconstruction with an ileal neobladder in woman is not very often but has been recently introduced centers. We report 8 female patients with ileal orthotopic neobladders after cystectomy., Patients and Methods: Between 1995 to 1999, 7 female patients with organ confined invasive bladder cancer and 1 female patient with severely contracted bladder secondary to tuberculosis were operated. While standard radical cystectomy was done in 7 patients with bladder cancer, only simple cystectomy was performed in patient with contracted bladder. Detubularized ileal W-neobladder with antirefluxive ureteroileal reimplantation were used as a procedure and reservoirs are connected to the proximal urethra in all patients. Cystoscopy and biopsy was done routinely in the bladder neck and there were no tumour and CIS in any patient., Results: The mean age was 65.4 years (53-70) and the mean postoperative follow-up time was 31.8 months (6-48). There was no perioperative or early postoperative (first one month) mortality. Early postoperative complications included acute renal failure in I patient (12.5%), deep vein thrombosis in 1 patient (12.5%) and leakage from the pouch in 2 patients (25%). In one patient (12.5%), ileo-pouchal fistula was seen in sixth month and reoperated. Although there was not hypercontinence. one patient (12.5%) had totally incontinence. All other patients had normal micturition and no residual urine. Urethral recurrence was not seen in this postoperative follow-up period but pelvic recurrence and then distant metastases were found in one case (12.5%)., Conclusions: The results of ileal orthotopic neobladder after radical or simple cystectomy in appropriate female patients are satisfactory. But certainly, we need the more experiences and studies about this subject.