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Objective:The aim of this study was to detect a prostate specific antigen (PSA) cut-off value for metastases, and prevent unnecessary use of Ga-68 prostate specific membrane antigen (PSMA) ligand positron emission tomography/computer tomography (CT) imaging.Materials and Methods:Between January 2016 and October 2017, patients with prostate cancer (PCa) who were staged using Ga-68 PSMA enrolled in this retrospective study. Patients were divided into two groups: group 1 (G1) had Ga-68 PSMA for primary staging, and group 2 (G2) had Ga-68 PSMA for detection of metastases after treatment (secondary staging). PSA cut-off values were calculated for general, bone, lymph node and visceral metastases.Results:A total of 181 patients were included in this study. PSA cut-off was 7.5 ng/mL for overall metastases in general. The PSA cut-offs for overall metastases using initial PSA were 8.98 ng/mL and 6.82 ng/mL for G1 and G2, respectively. For G2 patients the post-treatment PSA cut-off was 0.38 ng/mL. For bone metastases, the PSA cut-offs using initial PSA were 8.98 ng/mL and 10.7 ng/mL for G1 and G2, respectively. For lymph node metastases, the PSA cut-offs using initial PSA were 8.98 ng/mL and 6.71 ng/mL for G1 and G2, respectively. For visceral metastases, the PSA cut-offs using initial PSA were 16.4 ng/mL and 7.08 ng/ mL for G1 and G2, respectively. The same analyses could not be calculated in subgroups of G2 due to small sample size.Conclusion:These cut-off values do not suggest that Ga-68 PSMA is superior to using both CT and bone scintigraphy. It is an expensive test and its use is only reasonable when small lymph node metastases cannot be evaluated in CT.

PURPOSE Diabetes mellitus (DM) is a chronic metabolic disorder that often leads to complications. We aimed to correlate two complications of DM, polyneuropathy and hyperactive bladder syndrome, using noninvasive measures, such as screening tests. METHODS We included 80 female and 40 male type 2 diabetic patients in this prospective study. Diabetic polyneuropathy evaluations were conducted using the Douleur Neuropathique 4 Questions (DN4), and overactive bladder (OAB) evaluations were performed using the Overactive Bladder Questionnaire (OAB-V8). The patients were also evaluated for retinopathy and nephropathy. The diabetic male and female patients with or without OAB were chosen and compared for microvascular complications (polyneuropathy, retinopathy, and nephropathy). RESULTS There were no significant correlations between OAB and retinopathy as well as between OAB and nephropathy among diabetic patients (female patients, P>0.05; male patients, P>0.05 ). However, the patients with OAB were significantly more likely to develop polyneuropathy (female patients, P

The aim of our study was to evaluate whether neutrophil-to-lymphocyte ratio (NLR) is a predictor of disease progression and recurrence in patients with primary non-muscle-invasive bladder cancer (NMIBC). This was a prospective study of 86 patients with newly diagnosed NMIBC. The patients were classified by the number of points assigned by the European Organization for Research and Treatment of Cancer risk tables. The correlation between progression score, recurrence score, age, mean platelet volume, red blood cell distribution width and NLR was assessed statistically. The same parameters were compared between the risk groups. A significant difference in NLR and age values was observed between recurrence and progression risk score groups. The relationships between NLR and recurrence and progression risk scores were no longer significant after correcting for the statistical effect of age on scores. Age was significantly different between groups after adjusting for NLR. Our study revealed that NLR and age were associated with patient age and bladder tumor progression and recurrence risk scores. After correcting for age, the significant relationship with NLR was lost, in contrast to some previous studies. We recommend that patient age should be corrected to avoid misleading results in NLR studies.

The aim of this study was to evaluate inflammation parameters and assess the utility of the neutrophil- lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in patients with nenign prostate hyperplasia BPH. We also aimed to investigate the relationship between inflammatory parameters with α-blocker therapy response, and evaluate the potential association between NLR and the progression of benign prostatic hyperplasia (BPH).We examined 320 consecutive patients (July 2013-December 2013) admitted to our outpatient clinic with symptoms of the lower urinary tract at Bozok University. The mean age was 60 (range, 51-75) years. Complete blood count (CBC), prostate-specific antigen (PSA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Correlations between PSA, CRP, ESR, prostate volume, International Prostate Symptom Score (IPPS), maximum urinary flow rate (Qmax), and NLR were assessed statistically. Patients were divided into two groups: high and low risk of progression.NLR was positively correlated with IPSS (p=0.001, r=0.265), PSA (p=0.001, r=0.194), and negatively correlated with Qmax (p0.001, r=-0.236). High-risk patients a had a higher NLR compared with low-risk patients, based on IPSS (p0.001), PSA (p=0.013), and Qmax (p0.001); however, there were no significant differences between the groups in terms of age (p0.05), and prostate volume (p0.05).NLR can predict BPH progression. We propose that increased inflammation is negatively associated with clinical status in BPH patients and suggest that NLR can give information along with LUTS severity which may be used as a readikly accessible marker for patient follow-up.

Background/aim: To evaluate the predictability of vardenafil success in patients with erectile dysfunction (ED) by using cardiological tests. Materials and methods: Patients diagnosed with ED who did not benefit from lifestyle changes (n = 68) were evaluated with an abridged 5-item version of the International Index of Erectile Function (IIEF-5). The pretreatment and posttreatment IIEF-5 scores were compared with pretreatment data obtained from cardiological examinations. Results: When pretreatment scores were compared with test parameters, mitral flow E/A ratio and tissue Doppler imaging (TDI) E?/A?, exercise test duration, exercise capacity in MET, and percentage of maximum heart rate were found to be statistically significant. Furthermore, there was a significant negative correlation between mitral flow E/A ratio, TDI E?/A?, exercise test duration, exercise capacity in MET, and the difference in post- and pretreatment IIEF-5 scores. Conclusion: As a diastolic function indicator, TDI E?/A? positively correlates with pretreatment IIEF-5 scores and negatively correlates with the beneficial effect of vardenafil treatment. As a result, the cardiological status of the patient correlates with individual IIEF-5 scores, and it seems to be useful in predicting vardenafil success.

The objective of this study was to report our pathological findings in nephrectomy specimens from patients treated for non-functioning hydronephrotic kidney due to renal pelvic stone disease. A total of 97 patients who underwent nephrectomy for non-functioning hydronephrotic kidneys between January, 2011 and June, 2014 were retrospectively reviewed. A non-functioning kidney was defined as one having paper-thin parenchyma on urinary ultrasound or computed tomography, exhibiting no contrast visualization in the collecting duct system on intravenous urography and having a split renal function of

To evaluate the treatment success rate of flexible ureterorenoscopy (URS) for opaque and non-opaque renal stones.Ninety-four patients, who underwent flexible URS for renal stones between October 2012 and January 2014, were included. The patients were divided into two groups according to stone radiolucency. The patients were evaluated with preoperative and postoperative (at the weeks 4) computed tomography. Success of the treatment was defined as stone-free status and residual fragmentslt; 4 mm.Success of the treatment was observed in 79 (84%) patients. Sex, stone size, and stone location were factors affecting treatment success. Seventy-five (79.8%) patients had opaque stones, and 19 (20.2%) had non-opaque stones. The treatment success rates for opaque and non-opaque stones were 86.6% and 73.6%, respectively (P = .167). Flexible URS was a successful modality with acceptable morbidity to treat renal stones.These results show that radiolucent and opaque stones can be effectively treated by flexible URS.nbsp

Background: The aims of this study were to investigate the utility of red blood cell distribution width (RDW) as a simple and readily available marker in prostate cancer, as well as to evaluate RDW as a predictor of progression in prostate cancer patients. Materials and Methods: We evaluated 62 newly diagnosed prostate cancer patients who underwent transrectal ultrasound (TRUS)-guided biopsy and 62 healthy controls of mean age 64 (range, 45–75) years at the Urology Clinic of Bozok University Hospital. Data collection was performed using our laboratory information system database to retrieve findings regarding RDW, hemoglobin, prostatespecific antigen (PSA), and age. The RDW values were compared between the healthy control group and prostate cancer patients. A high risk of progression as defined as a Gleason score (GS) >6, total number of cores positive for cancer >33%, each core containing >50% cancer cells, and a prostate-specific antigen (PSA) level >10 ng/ mL. Patients were classified according to risk of progression, as well as divided into subgroups according to the RDW quartile. Results: The mean RDW value of prostate cancer patients was 14.6, compared with 13.7 in the healthy control group (p=0.001). A higher RDW was associated with an increased risk of progression, whereas a lower RDW value was correlated with a low risk of progression. Conclusions: RDW is an easily derived measure that might, in combination with other markers, help predict prostate cancer risk and progression. We suggest that RDW may be used in combination with other parameters in the assessment of prostate cancer.

Objective: Folate, vitamin B12 and iron are important vitamin and minerals which play role in the development of nervous system. The aim of this study was looking at the presence of folate, vitamin B12 and iron deficiency among patients with Primary nocturnal enuresis (PNE) and possible relation between the delay of central nervous system (CNS) development, PNE and folate, vitamin B12 and iron states. Methods: Consecutively applied forty patients with PNE (23 girls and 17 boys) and otherwise normal thirty control subjects (17 girls and 13 boys) were included in the study. Average ages (in range) of PNE and the control group were 9.2(6-12) years and 9.3 (6-12) years accordingly. Age, height, weight, complete blood count, blood vitamin B12, folate, ferritin and iron values of both groups were recorded and compared to each other. Results: Average vitamin B12 and folate levels of patients with PNE were significantly and statistically lower compared to those of the control group. Average blood iron of patients with PNE was significantly higher than that of the control group and also average ferritin level of the PNE group was detected to be higher than the control group but this relation was statistically insignificant. Conclusion: Primary nocturnal enuresis is related to the delay in CNS maturation so it was thought that low vitamin B12 and folate which were found in patients with PNE may have role in the delay of CNS maturation. Additionally, further studies are needed to investigate the role of vitamin B12 and folate either alone or as combination in treatment of patients with PNE who have low vitamin B12and folate level.

Aim: The purpose of this study was to compare the effectiveness of handmade transobturator tape (TOT) devices (tailored polypropylene mesh by the surgeon during the operation) with commercially available ones. Materials and methods: We included 78 consecutive women with the complaint of pure stress urinary incontinence recalcitrant to lifestyle modifications, pelvic floor muscle training, and medical treatment. The patients underwent TOT procedures either with a commercially available product (I-Stop, CL Medical, Lyon, France) (group 1) or with a device prepared during the operation with polypropylene mesh of 35 × 2 cm in size (Prolen®, Ethicon Inc., Somerville, New Jersey, USA) (group 2). The patients were followed for at least 18 months and cure was defined as the absence of any episodes of involuntary urine leakage during stressful activities and/or the stress cough test. Results: Thirty-two (group 1) and 46 (group 2) patients underwent TOT surgery. Mean operation time was slightly shorter in group 1 compared to group 2 (20.53 ± 4.88 vs. 22.93 ± 4.84, P = 0.035); however, mean duration of the indwelling catheter was less than 1 day in both groups (P = 0.444). None of the patients had incontinence or urinary retention postoperatively. The cure rates in groups 1 and 2 were not significantly different at the end of the 1st (87.5% vs. 87%, P = 0.944) and 2nd (78.1% vs. 80.4%, P = 0.804) postoperative years. Conclusion: TOT procedures performed with polypropylene mesh and No. 1 silk line are as effective and safe as commercially available TOT devices.

Though the penile tourniquet syndrome is rarely seen, it is a disease which causes complications from a simple edema to severe necrosis and amputation. Whether simple or complicated, the penile strangulation that is the causative factor, except babies, whom are usually questionable. Our aim is to investigate the relation between perpetrators and location of disease in the penile tourniquet syndrome.

Congenital bladder diverticula are strongly associated with vesicoureteral reflux (VUR), and are mostly present in childhood. The most common symptom is urinary tract infection at the time of admission. The diverticulum is usually solitary and its locationis near the ureteral orifice, which is probably the main cause of VUR. We report a woman who presented with a vaginal mass located on the right inferior part of the external urethral meatus. The patient had a history of recurrent urinary tract infection and right nephrectomy due to VUR nephropathy. We examined her with cystography, computerized tomography, and cystoscopy. The cystoscopic examination was very diagnostic in our patient. The patient underwent diverticulectomy, and after 6 months of follow-up, her complaints had completely disappeared.

Penile tourniquet syndrome (PTS), a rare urologic emergency, may lead to undesirable results including necrosis and amputation of penis, if not diagnosed and treated appropriately. Sometimes these injuries may be accepted as a forensic case. Miscellaneous objects used for strangulation can be metallic or nonmetallic. Of all ages, the most vulnerable period is infancy. Telogen effluvium is the most common cause of PTS in infants who are 0–6 years old. In the literature, telogen effluvium as a reason of PTS was not found except for this age group. Therefore, we aimed to present a boy who is 8 years old diagnosed as PTS because of his mother’s hair coil.

This experimental study was designed to investigate whether midazolam has antioxidant effects in reperfused rat kidneys following ischemia. Twenty Wistar Albino rats were included in the study. Rats were anesthetized with the mixture of ketamine 90 mg/kg and xylazine 10 mg/kg administered intraperitoneally. Following anesthesia, the rats were divided into two groups. The first group was considered as the control group, whereas the second group received additional midazolam 3.5 mg/kg intraperitoneally. The left kidney was approached via a transabdominal incision and the left renal artery was dissected. Left renal ischemia was created by clamping the left renal artery for 45 minutes. Following the ischemia period, the kidney was reperfused for one hour. Both kidneys were then removed. Half of the left kidneys were immediately immersed in liquid nitrogen for transportation and then frozen at -70 C until measurements of tissue malondialdehyde (MDA) and glutathione (GSH) levels. The remaining halves of the left kidneys and right kidneys were fixed in 10% formalin. The changes which developed during the ischemia-reperfusion period in the left kidney were investigated by histopathological examination and compared with those of the normal contralateral kidney. When compared with the control group, tissue MDA and GSH levels were similar in the midazolam group (p0.05). Tubular damage with tubulitis and focal interstitial inflammatory infiltration were observed in histopathological examinations of reperfused left kidneys of the control group. There was PMNL infiltration only in perirenal fat tissue of the midazolam group. Right kidneys were histopathologically normal in both groups. We concluded that within this dosage midazolam does not have any antioxidant effect in reperfused rat kidneys following ischemia.