Pathological investigation of childhood foreskin: are lichen sclerosus and phimosis common?

WOS: 000369704200014PubMed: 26876402Objective: To evaluate histopathological results of foreskin removed during circumcision in the pediatric age group and the relationship between these and the degree of phimosis. Study Design: Cross-sectional study. Place and Duration of Study: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey, from June to December 2014. Methodology: Male children undergoing planned circumcision were examined for the presence and degree of phimosis which was recorded before the operation. After circumcision, the preputial skin was dermatopathologically investigated. Pathological investigation carefully evaluated findings such as acute inflammation, chronic inflammation, increased pigmentation and atrophy in addition to findings of Lichen Sclerosus (LS) in all specimens. the pathological findings obtained were classified by degree of phimosis and evaluated. Results: the average age of the 140 children was 6.58 +/- 2.35 years. While 61 (43.6%) children did not have phimosis, 79 (56.4%) patients had different degrees of phimosis. Classic LS was not identified in any patient. in a total of 14 (10%) children, early period findings of LS were discovered. the frequency of LS with phimosis was 12.6%, without phimosis was 6.5% (p=0.39). the incidence of histopathologically normal skin in non-phimosis and phimosis groups was 37.7% and 22.7%, respectively. in total, 41 (29.3%) of the 140 cases had totally normal foreskin. Conclusion: Important dermatoses such as LS may be observed in foreskin with or without phimosis. the presence of phimosis may be an aggravating factor in the incidence of these dermatoses

Effects of dietary interventions on 24-hour urine parameters in patients with idiopathic recurrent calcium oxalate stones

AbstractThe aim of this study is to investigate the effects of dietary factors on 24-hour urine parameters in patients with idiopathic recurrent calcium oxalate stones. A total of 108 of idiopathic recurrent calcium oxalate stones were included in the study. A 24-hour urinalysis was performed and metabolic abnormalities were measured for all of the patients. All of the patients were given specialized diets for their 24-hour urine abnormalities. At the end of first month, the same parameters were examined in another 24-hour urinalysis. Hyperoxaluria, hypernatruria, and hypercalciuria were found in 84 (77%), 43 (39.8%), and 38 (35.5%) of the patients, respectively. The differences between the oxalate, sodium, volume, uric acid, and citrate parameters before and after the dietary intervention were significant (p < 0.05). The calcium parameters were not significantly different before and after the intervention. We found that oxalate, sodium, volume, uric acid, and citrate—but not calcium—abnormalities in patients with recurrent calcium oxalate stones can be corrected by diet. The metabolic profiles of idiopathic calcium oxalate stone patients should be evaluated and the appropriate dietary interventions should be implemented to decrease stone recurrence

Intravesical Sodium Chondroitin Sulphate to Treat Overactive Bladder: Preliminary Result

Purpose: This study aimed to verify the efficacy and safety of intravesical treatment with sodium chondroitin sulfate (CS) in patients with overactive bladder (OAB) who are refractory to previous antimuscarinic treatment. Methods: This study was performed between June 2012 and January 2015 and included 31 consecutive women (mean age, 42.10±7.34 years) with OAB who had been previously treated with two types of antimuscarinic drugs. The results of gynecologic and cystoscopic examinations were normal, and OAB comorbidity was absent. Treatment with intravesical instillations containing 40 mL CS (0.2%; 2 mg/mL) was administered for 6 weeks; after weekly treatments, monthly treatments were administered. The OAB-validated 8 (OAB-V8) symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry were evaluated for all the patients. The values obtained before the treatment were statistically compared with those obtained six months after the treatment. Results: The duration of the symptoms was 18.36±6.19 months. A statistically significant improvement of the patients’ conditions was observed in terms of the OAB-V8 symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry after the treatment. Conclusions: Despite the limitations of this study, the outcomes confirmed that CS therapy is safe and effective for the treatment of OAB

The efficacy of udenafil in end-stage renal disease patients undergoing hemodialysis

WOS: 000371797700004PubMed: 26727286Introduction Erectile dysfunction (ED) is frequently observed in end-stage renal disease (ESRD) patients on hemodialysis (HD) compared to non-uremic patients. This situation causes severe psychogenic problems in patients and disrupts the quality of life. Different phosphodiesterase type 5 (PDE-5) inhibitors have been used, and efficacies revealed, for the treatment of ED in HD patients; however, there are no studies related to udenafil use or results for HD patients. This study retrospectively evaluated the efficacy and reliability of udenafil for HD patients. Materials and methods the laboratory findings, side effects after treatment, and International Index of Erectile Function (IIEF) scores before and after treatment were compared and evaluated for HD patients who applied to our urology clinic with ED complaints and were treated with udenafil. Results the results showed that in the HD patient group with ED, apart from ED, there were severe rates of other sexual dysfunction. in our patient group, there was a statistically significant improvement in all scores for erectile function (p=0.033), orgasmic function (p<0.001), sexual desire (p<0.001), relationship satisfaction (p<0.001), and general satisfaction (p<0.001) after treatment. the reported side effects were headache in one patient and dyspepsia in one patient. Conclusion We concluded that udenafil is an effective and reliable treatment approach for HD patients; however, our results require support from prospective randomized crossover studies with sildenafil

Incidence of bacterial colonisation after indwelling of double-J ureteral stent

Objective: To determine the bacterial colonisation after double-J stent use and the risk factors for bacteriuria linked to the stent. Materials and Methods: A total of 102 patients (61 men and 41 women, mean age 47.5 ± 14.16) were examined. The stents were removed under aseptic conditions, and a urine culture was obtained before the removal of the stents. After the stents were removed, the upper, central and lower sections were separated, and washing water was sent through the stent. Results: Bacterial colonisation was found in 29.4% (30 of 102) of the stents. The most frequently observed microorganisms were determined as staphylococcus, coagulase negative (8 of 30) and E. coli (5 of 30). The washing fluid used to clean the interior of the catheter produced pathogens in 8 patients (7.8%), and these pathogens were observed to be the same microorganisms that colonised the outside of the stent. There was no statistical difference between the patients with colonisation and those without in terms of age, gender, duration of stenting and reason for stent insertion. Conclusions: Though stent colonisation does not always entail symptomatic urinary tract infections, as shown in our study, the pathogens in the urine culture are the same as those colonising the stent, confirming the reality that colonisation is the main factor in these events. Additionally, according to our study, significant colonisation may be found in the first 3 weeks, contrary to the literature, causing us to consider that urinary tract infections may develop even in the early period

Preputial bacterial colonisation in uncircumcised male children: Is it related to phimosis?

atilla, aynur/0000-0001-8027-1991WOS: 000371182900017PubMed: 26968283Objective: To evaluate the presence of uropathogens in the periurethral skin and the effect of phimosis on bacterial colonisation. Methods: the observational cohort study was conducted in Samsun Research and Training Hospital, Samsun, Turkey from June to December, 2014, and comprised patients undergoing circumcision. Before circumcision, all children were examined in the operating room and the presence of phimosis was recorded. All patients had circumcision performed by the same surgical team under general anaesthesia. Before the procedure, samples were taken from preputial skin of all patients by swab before cleansing with polyvidone-iodine. the samples were inoculated on 5% sheep blood agar and eosin-methylene blue agar. Results: the median age of the 117 children was 5 years (range: 1-12). of the total, 19(16.2%) children had complete phimosis, and 72(61.5%) had partial phimosis. in all,91(77.7%) children had phimosis and 26(22.3%) had no phimosis. of the 91 patients with different degrees of phimosis, 52(57.1%) had clinically significant uropathogenic bacterial colonisation >= 100,000 colony-forming units per millilitre [cfu/ml]). of the 26 patients without phimosis, 13(50%) had clinically significant colonisation. Thus, there was no effect of the presence of phimosis on bacteria colonisation (p=0.655). Conclusions: Important uropathogens colonise the preputium in uncircumcised male children. There was no effect of phimosis on colonisation