Short term effects of home-based bladder training and pelvic floor muscle training in symptoms of urinary incontinence

Aim: The aim of this non-controlled trial Summary was to investigate the effects of a home-based pelvic floor muscle training (PFMT) and bladder training (BT) in urinary incontinence (UI) among women. Patients and methods: The study included 25 individuals who were diagnosed with UI. PFMT which strengthens pelvic floor muscles was described to patients in litotomy position with using digital palpation method. PFMT was given as home-based exercise program for six weeks, 7 days a week and ten times a day. BT was planned according to the symptoms of the patients. Assessments were done at the beginning and at the end of the six weeks exercise program. The outcome measures were UI severity measured by pad test and QoL measured by King's Health Questionnaire. The secondary outcome measure was lower urinary tract symptoms and sexual health measured by Bristol Female Lower Urinary Tract Symptoms Index. Results: Pre- and post-treatment assessments done with pad test showed that there was a statistically significant decrease in the severity of UI (p = 0.002). The difference between pre- and post-treatment QoL scores (p = 0.001) and lower tract symptom scores were also statistically significant (p = 0.000). Conclusions: When PFMT and BT were given together there was a decrease in the symptoms and increases the QoL

Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones

Penile size in term newborn infants

The objective of this study was to establish standard penile size in healthy full-term Turkish newborns and to evaluate the relation between penile and other anthropometric measures. For this prospective study, stretched penile length (SPL) and penile diameter (PD) of live-borns delivered in our hospital between September 2007-December 2008 were measured, and their birthweight, length and head circumference were recorded. Penile versus other anthropometric correlations were determined by Pearson analyses, followed by linear regression. In 1217 full-term subjects, mean SPL was 3.16 +/- 0.39 cm (+/- 2.5 SD=2.19-4.14 cm), and mean PD was 1.21 +/- 0.11 cm (+/- 2.5 SD=0.93-1.49 cm). Linear regression analysis showed a strong correlation of SPL (p=0.0001) to height, and PD to height (p=0.0001) and birthweight (p=0.002). Formulas were calculated for predicted individual values for PL and PD of newborns. In conclusion, there is a correlation between neonatal anthropometric measurements and penile anthropometry. Mean anthropometric differences of various ethnicities may account for the differences in mean SPL and PD among various ethnic populations

Effects of ejaculation on serum prostate-specific antigen levels

Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free and complex prostate-specific antigen (PSA) levels and their effect on biopsy decisions

Effect of ejaculation on Serum Prostate-Specific Antigen concentration

ABSTRACT Abstract Purpose:To evaluate the effect of ejaculation on serum prostate-specific antigen (PSA) concentrations in patients with lower urinary tract symptom (LUTS). Materials and Methods Our study includes 98 men (62 study and 36 control). After three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels. Then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total (tPSA), free (fPSA) and complexed PSA (cPSA) levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation. Results The mean age in study and control groups patients were 59.03±0.99 years, 61.14±1.30 years, respectively. In the study group, changes in tPSA and fPSA levels after ejaculation were found statistically significant while changes in cPSA levels and f/tPSA ratios were not significant (p=0.016, p=0.0003, p=0.176, and p=0.173, respectively). Baseline values showed significant differences with 1st and 5th hours. No significant changes in tPSA, fPSA, cPSA levels and f/tPSA values were found in control group (p=0.223, p=0.224, p=0.444, and p=0.718, respectively). The changes in the number of patients exceeding the cutoff values after ejaculation were not statistically significant for tPSA, cPSA, and f/tPSA ratio. Conclusions In this study, ejaculation increased tPSA and fPSA concentrations but it didn’t have a significant effect on serum cPSA levels and f/tPSA ratios. However, recent ejaculation may affect the biopsy indication at least near cut off PSA values. Further studies are needed to explain the mechanisms of alterations in the concentration of PSA

Penil Entrapment with A Steel Nut and Its Treatment with A Dental Micro Motor

Entrapment or strangulation of the penis is an uncommon condition that requires prompt medical intervention to avoid mechanical and/or vascular injuries. Severe complications such as edema, necrosis, skin infection, penile amputation, and urethral fistula may occur. There is no universally accepted method for treatment, and medical treatment can be delayed due to feelings of humiliation or self-attempt to release the entrapment. Intracavernosal aspiration is a surgical procedure used to evacuate blood from the obstructed corpus cavernosum. This procedure reduces penile size making it easier to remove the ring. However, it does not alleviate the inflammatory idea in the interstitial spaces and penile skin. This paper describes a case study of a 34-year-old male patient who was evaluated in the department of emergency with penile entrapment in a thick steel ring that was placed for prolonged erection. Removing the ring manually was attempted in the emergency department but failed, causing more engorgement in the distal part of the penis. The following admission, the patient was expeditiously transferred to the operating room where the surgical team interposed a wooden tongue depressor between the penile shaft and the ring. Subsequently, a manual hacksaw was used to excise the constriction device. Nevertheless, owing to the substantial diameter of the ring, the hacksaw became fractured and subsequently, a micromotor was employed for the ring removal procedure. Throughout the cutting process involving the micromotor, the ring was continuously cooled with an iced isotonic solution. Within thirty minutes, the ventral and dorsal sides of the steel ring were cut, and it was removed in two pieces

Hypospadias in Istanbul: Incidence and risk factors

Background: The aim of the present prospective study was to determine the incidence of hypospadias in newborns in one of the busiest teaching hospitals of Istanbul, and to investigate the risk factors

Transrektal ultrasonografi kılavuzluğunda prostat biyopsisi yapılan hastalarda enfektif komplikasyonlar ve rektal floradaki siprofloksasine dirençli Escherichia coli kolonizasyonunun rolü

WOS: 000402553200019PubMed ID: 28717548Objective: In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal flora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal flora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. Material and methods: A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program. Rectal swab samples were taken from all patients prior to biopsy. The presence of complications have been evaluated after a week following the biopsy procedure. Patients with fever were also evaluated. The possible correlation between the presence of ciprofloxacin-resistant bacteria in faecal flora and the risk of urinary tract infection development and the other complications were evaluated. Results: E. coli bacteria were present in all cultures of rectal swab samples obtained from 142 patients prior to prostate biopsy. Of all these patients, while ciprofloxacin-resistant E. coli (CR E. coli) grew in 76 (53.5%) patients; ciprofloxacin susceptible E. coli (CS E. coli) was obtained in 66 (46.5%) patients. In 16 patients (11.3%), infectious complications were observed. While the infective complications were present in the 14.5% of patients with CR E. coli; they were present in the 7.6% of patients with CS E. coli (p=0.295). High fever was observed in nine patients (6.3%). Of these nine patients, although six had CR E. coli growth as detected during culture sensitivity tests; three had CS E. coli growth in their rectal swab culture tests. Sepsis was observed in three (2.1%) of these patients with high fever. Ciprofloxacin-resistant E. coli grew in all of the rectal swab cultures obtained from these patients with sepsis. Conclusion: In the light of our findings we may say that, it will be appropriate to reconsider the ciprofloxacin prophylaxis and prefer to use other prophylactic agents for a certain period of time in populations with higher rates of resistance to this medical agent. Furthermore, it will be appropriate again to obtain rectal swab specimens for culture tests before biopsy procedure in order to perform targeted prophylaxis according to the culture antibiogram test results. This approach will enable us to evaluate the cost-effectiveness of the procedure in detail.Bu çalışmada, kliniğimizde prostat biyopsisi uygulanan hastalarda rektal floradaki bakterilerin siprofloksasine direncini araştırdık. Aynı zamanda fekal florada siprofloksasine dirençli bakterilerin bulunmasının işlem sonrası gelişebilecek enfektif komplikasyon riskine olası etkisini ve bu açıdan profilaktik antibiyotik kullanımının söz konusu enfeksiyöz komplikasyonlar üzerine etkisini değerlendirmeyi amaçladık. Gereç ve yöntemler: Çalışmaya transrektal ultrasonografi kılavuzluğunda prostat biyopsisi yapılan toplam 142 hasta dahil edildi. Biyopsi öncesinde tüm hastalardan rektal sürüntü örneği alındı. Biyopsi yapıldıktan 1 hafta sonra tüm hastalar komplikasyonların varlığı açısından sorgulandı. Ateş yüksekliği olan hastalar ayrıca değerlendirmeye alındı. Fekal florada siprofloksasin dirençli bakteri taşıyıcılığının, prostat biyopsisi sonrası üriner sistem enfeksiyonu ve diğer komplikasyonların gelişimi ile olan ilişkisi değerlendirildi. Bulgular: Prostat biyopsisi yapılan 142 hastanın biyopsi öncesi yapılan rektal sürüntü örneklerinin tamamında E. coli üremesi oldu. Bunların 76 tanesinde (%53,5) siprofloksasine dirençli E. coli (SR E. coli) ürerken 66 tanesinde (%46,5) siprofloksasin duyarlı E. coli (SS E. coli) üredi. Toplam 16 hastada (%11,3) enfektif komplikasyonlar gözlendi. SR E. coli grubunda enfektif komplikasyonlar %14,5 oranında gözlenirken, bu oran SS. E. coli grubunda %7,6 idi (p=0,295). Toplam 9 hastada (%6,3) yüksek ateş gözlendi. Bu hastaların 6 tanesinin rektal sürüntü kültüründe SR E. coli ürerken 3 tanesinin rektal sürüntü kültüründe SS E. coli üremişti. Yüksek ateş gözlenen bu hastaların 3 tanesinde (%2,1) sepsis gözlendi. Sepsis gelişen 3 hastanın da rektal sürüntü kültürlerinde siprofloksasine dirençli E. coli üredi.Sonuç: Kanaatimizce siprofloksasin profilaksisinin yeniden gözden geçirilmesi ve direnç oranı yüksek toplumlarda en azından belli bir süre başka bir profilaksi ajanının kullanılması gerektiğini söyleyebiliriz. Maliyeti ayrıca değerlendirmek şartıyla biyopsi öncesi rektal sürüntü kültürü alınması ve buradaki antibiyogram sonucuna göre hedefe yönelik profilaksi yapılması uygun olacaktır