The relationship between smoking and lower urinary tract symptoms: community based study

Benin prostat hiperplazisi (BPH) ve sigara içimi arasındaki ilişkiyi araştıran çalışmalar genellikle kliniğe dayalı çalışmalardır. Bizim çalışmamızın amacı, sigara alışkanlığının BPH ve/veya alt üriner sistem yakınmalarını (AÜSY) etkileyip etkilemediğini topluma dayalı olarak araştırmaktır. Manisa’nın küçük bir ilçesinde yaşayan 40 yaş üzeri 255 erkeğe uluslararası prostat semptom skoru (International prostate symptom score: I-PSS), yaşam kalitesi (YK) ve sigara alışkanlığını belirlemek için formlar doldurtuldu. Ayrıca ultrasonografi (USG) ile prostat volümü (PV) ve artık idrar (Aİ) değerlendirildi. Sigara miktarı arttıkça (paket/yıl) I-PSS, YK ve Aİ değerlerinde artma vardı, ancak Pearson korelasyonu katsayısına göre anlamlı bir bağlantı bulunmadı. BPH prevelansı içenlerde içmeyenlere göre daha yüksekti ancak istatistiksel anlamı yoktu. Çalışmamızda BPH ve sigara alışkanlığı arasında istatistiksel olarak anlamsız bir ilişki bulundu. BPH prevelansına sigara alışkanlığının zayıf bir etkisi olduğu gösterildi. Bu sonuç sigaranın seks steroidleri üzerinde farklı etkiler göstermesine bağlı olabilir.Introduction: The studies, investigated the relationship between smoking and benign prostatic hyperplasia (BPH), are commonly clinically based. We aimed that whether smoking has any effect on BPH and/or lower urinary tract symptoms in a community based fashion. Materials and Methods: The forms of international prostate symptom score (I-PSS), quality of life (QoL) and asking smoking addiction were fulfilled by 255 men over 40 years old living in a small town of Manisa. Meanwhile prostatic volume and post-voiding residual urine volume calculations with ultrasound were evaluated. Results: While the degree of smoking (package/year) increased, I-PSS, QoL and residual urine volume slightly increased, but no correlation found with Pearson co-efficient. Although no statistically significant relation was observed, prevalence of BPH in this population was higher in smoking men than non smoking men. Conclusion: In this study, although no statistically correlation was found between smoking and BPH, it is observed that smoking is slightly effect the prevalence of BPH. It may be speculated that smoking has variable effects on sex steroids

Kas İnvaziv Olmayan Mesane Kanserinde Tedavinin Anjiyogenik (Vasküler Endotelyal Büyüme Faktörü-2 ve Matriks Metaloproteinaz-2) ve Antianjiyogenik (Endostatin ve Trombospondin-1) Faktörler Üzerine Etkisi

Amaç: Kas invaziv olmayan mesane kanserinde (KİOMK) tedavinin anjiyogenik [vasküler endotelyal büyüme faktörü-2 (VEGF-2) ve matriks metaloproteinaz-2 (MMP-2)] ve antianjiyogenik [endostatin (ES) and trombospondin-1 (TSP-1)] faktörler üzerine etkilerini araştırmayı amaçladık.Gereç ve Yöntem: KİOMK'li 30 hasta ve aynı yaş grubundaki 30 kontrol çalışmaya dahil edildi. Hastaların kan örnekleri üç defa alınarak yukarıda bahsedilen markerlar enzime bağlı immünosorbent testi yöntemiyle ölçüldü. İlk kan örneği transüretral rezeksiyon-mesane tümörü (TUR-MT) öncesi, ikinci örnek TUR-MT sonrası 20. günde ve son örnek intravezikal immünoterapi sonrası alındı. Hasta ve kontrol grubunun marker ölçüm ortalamaları karşılaştırıldı. Ayrıca hasta grubundan alınan üç ayrı ölçüm de kendi arasında karşılaştırıldı.Bulgular: Hasta grubunun TRU-MT öncesi ortalama VEGF-2 ve MMP-2 değerleri kontrol grubununkinden anlamlı olarak yüksel bulunurken (sırasıyla p=0,04 ve p=0,01), ortalama ES ve TSP-1 değerleri iki grup arasında istatistiksel olarak benzerdi (sırasıyla p=0,95 ve p=0,99). VEGF-2 ve MMP-2 değerlerinin hasta grubunda TUR-MT sonrası anlamlı olarak azaldığı saptanırken (sırasıyla p=0,03 ve p=0,01), bu azalma intravezikal tedavi sonrası devam etmekle birlikte istatistiksel olarak anlamsızdı. Sonuç: KİOMK'li hastalardaki yüksek VEGF-2 ve MMP-2 değerleri TUR-MT sonrası muhtemel kitlenin alınmasına bağlı olarak azalmaktadır. Bu anjiyogenik markerlar KİOMK tedavi sonrası takipte kullanılabilirObjective: We aimed to investigate possible effects of treatment on angiogenic [vascular endothelial growth factor-2 (VEGF-2) and matrix metalloproteinase-2 (MMP-2)] and antiangiogenic [endostatin (ES) and thrombospondin-1 (TSP-1)] factors in non-muscle invasive bladder carcinoma (NMIBC). Materials and Methods: Thirty NMIBC patients and 30 age-matched controls were included in the study. For the above-mentioned markers, peripheral blood samples were drawn at three time points to be studied by enzyme-linked immunosorbent assay: before transurethral resection of bladder tumor (TURBT), at first control (20 days after the operation) and second control (at the end of intravesical immunotherapy). The mean blood levels obtained in the three measurements and those in patients and controls were compared statistically.Results: The mean levels of VEGF-2 and MMP-2 in patients before TURBT were found to be statistically significantly higher than in controls (p=0.04 and p=0.01, respectively), while no significant differences were obtained between the mean ES and TSP-1 levels (p=0.95 and p=0.99, respectively). It was also found that the VEGF-2 and MMP-2 levels were significantly decreased after TURBT (p=0.03 and p=0.01, respectively), but the tendency of these decrease was not found to be statistically significant between the first and second controls. Conclusion: Elevated VEGF-2 and MMP-2 levels in patients with NMIBC were significantly decreased after and probably due to the TURBT, which leads to a conclusion that these angiogenic markers may be used for follow-up of NMIB

The relationship between serum steroid hormon levels and I-PSS, prostatic volume, residual urine: A community based study

İleri yaş erkeklerde en sık görülen hastalıklardan biri olan benin prostat hipertrofisinin histolojik ve klinik gelişiminde endokrinolojik etki önde gelen etkenlerden biri olarak değerlendirilmektedir. Çalışmamızda bir yerleşkedeki 40 yaş üstü bireylerde uluslararası prostat semptom skoru (I-PSS), artık idrar (Aİ) ve prostat ağırlığı (PA) kriterleri kullanılarak BPH insidansının steroid hormon düzeyleri ile bağıntısı incelendi. Bireylerin total ve serbest testosteron (sırasıyla tT, fT), estradiol (E2), dihidroepiandosteron sülfat (DHEAS), seks hormon bağlayıcı globulin (SHBG), follikül uyarıcı hormon (FSH) ve lüteinizan hormon (LH) düzeylerine bakıldı. Uluslararası prostat semptom skoru (I-PSS) ve yaşam kalitesi (QoL) eşliğinde anamnezleri değerlendirildi. Ortalama FSH, LH, DHEAS, SHBG, E2, tT ve fT değerleri sırasıyla idi. Pearson korelasyon katsayısı ile yaş, total I-PSS, QoL, Aİ ve PA birbiriyle pozitif doğru orantılı idi (p<0.05). Ayrıca yaş arttıkça FSH (r=0.2979) ve SHBG (r=0.3642) anlamlı olarak artarken; DHEAS (r=-0.4792) ve fT (r=-0.3306) ise anlamlı olarak azalmaktaydı (p<0.05). Yaş ile E2, LH, tT ve SHBG (seks hormon bağlayıcı globulin) arasında istatistiksel olarak anlamlı bir bağıntı bulunmadı. I-PSS değeri 7’den büyük tüm bireyler BPH olarak kabul edildiğinde; BPH olanların fT değerleri anlamlı olarak daha düşük (14/12.3, p=0.009), SHBG değerleri ise daha yüksek (52.5/64.8, p=0.029) bulundu. BPH tanısını I-PSS, PA ve Aİ kriterlerinin çeşitli kombinasyonları ile yaptığımızda, serum steroid hormon değerleri ile BPH arasında anlamlı bir bulguya rastlanmadı. I-PSS değeri yüksek olan bireylerde fT düzeyinin anlamlı olarak daha düşük bulunduIntroduction: It is evaluated that endocrinolgical effect is the most reliable factor for development of histological and clinical BPH which is the common disease in older males. Materials and Methods: In our study, we investigated the relationship between BPH incidence and steroid hormone levels by using the criteria of I-PSS, residual urine and prostatic volume in the men over 40 in a rural town. Total and free testosterone, estradiol, dihidroepiandosteron sulfate, sex hormone binding globulin, FSH and LH levels were analyzed. I-PSS and quality of life scores were evaluated. Results: Mean FSH, LH, DHEAS, SHBG, E2, tT and fT levels were 11.03&plusmn;11.06 mIU/ml (0.9-83.7), 9.26&plusmn;18.7 mIU/ml (0.7-200), 114, 86&plusmn;68.3 pg/dl (30-417), 55.28&plusmn;31.4 nmol/L (2-180), 23.03&plusmn;9.05 pg/mL (20- 46.1), 3.9&plusmn;1.82 ng/dl (0.2-16) and 13.7&plusmn;4.7 pg/mL (0.6-31.6). Mean I-PSS, QoL, residual urine and prostatic volume were 4.7&plusmn;5.9 (0-30), 0.7&plusmn;1.3 (0-6), 21.5&plusmn;30.7 (0-295) ml and 24.4&plusmn;11.4 (9-82) gr. respectively. With Pearson correlation system; age, I-PSS, QoL, residual urine and prostatic volume were well correlated with each other (p&lt;0.05). While age increased, FSH and SHBG increased significantly (r=0.2979 and r=0.3642). On the other hand, DHEAS (r=-0.4792) and fT (r=-0.3306) decreased, while age increased. There was no correlation between E2, LH, tT, SHBG and age. When it is accepted as all the men with their I-PSS over 7 has BPH; fT levels were statistically lower (14/12.3, p=0.009) and their SHBG levels were higher than those without BPH (52.5/64.8, p=0.029). Conclusion: If the diagnosis of BPH is determined with the different combination of I-PSS, residual urine and prostatic volume, no significant data was revealed between serum steroid hormone levels and BPH. fT levels were significantly lower in men with high I-PSS than those with low I-PSS

Akut renal kolik tedavisinde lornoksikam’ın etkinliğinin değerlendirilmesi

Amaç:Akut üriner obstrüksiyonla ilişkili renal koliğin analjezisini sağlamak için farklı ajanlar kullanılmıştır.Bu konuda sıklıkla prostaglandin sentez inhibitörleri kullanılır.Çalışmamızda renal kolik tedavisinde yukarıda adı geçen gruba dahil olan lornoksikamın analjezik etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Renal kolik nedeniyle acil servise gelen hastalar iki gruba ayrıldı. Herhangibir tedaviden önce hastalar 0 ile 10 arasında renkleri koyulaşarak skorlanan visüel analog ağrı skorlaması ile değerlendirildi.Birinci gruba 8 mg lornoksikam, ikinci gruba 75 mg IM diklofenak sodyum enjekte edildi.Tedaviyi takiben bütün hastalardaki ağrı 15, 30 ve 60. dakikalarda tekrar yüzeyel analog skala ile değerlendirildi. Sonuçlar:Başlangıçta temel değerlendirme için 213 hasta seçildi bunların seçilme kriterlerine sahip 129 u da çalışamaya dahildi.Tedavi öncesi grup 2nin ortalama ağrı skoru (S0) 6.10 iken birinci grubun skoru (S0) 6.04 bulundu (p=0,868). Hastaların 15, 30 ve 60. dakikalarda (S15, S30, S60 ) ortalama ağrı skorları birinci grupta sırasıyla 1.46, 0.84 ve 0.63 ikinci grupta bu değerler sırasıyla 3.75, 1.96 ve 1.50 bulundu ki bu değerler arasındaki fark istatistiksel olarak anlamlı bulundu ( S15 : p<0.001, S30 : p=0,001, S60 : p=0,01). Karar: Lornoksikam akut renal koliğin tedavisinde hastalar tarafından iyi tolere edilen kısa zamanda etkili bir analjezi sağlar.Lornoksikam renal koliğin tedavisinde iyi bir alternatif olabilir.Purpose: In order to provide analgesia in renal colic, related to acute urinary obstruction, many different agents are used. Use of prostaglandin synthesis inhibitors is very common for this purpose. In our study, we aim to evaluate the analgesic effect of lornoxicam, included in above mentioned group, in renal colic treatment. Materials and Methods: The patients, who were taken to emergency room due to renal colic, were assigned into two group. Before any treatment, they were evaluated with visual analog pain scale, using darkening color scores between 0 to 10. Group 1: 8mg injectable lornoxicam was administrated, Grup 2: 75mg diclofenac sodium I.M was injected. Following treatment, at 15, 30, and 60th minutes, all patients were reevaluated for pain by using visual analog scale. Results: Initially, 213 patients were recruited for baseline evaluation and 129 of them, were included in the study. Before treatment, mean pain scores of the patients in Group 2 were found to be (S0) 6.10, whereas before treatment mean pain scores of the patients in Group 1 were found to be (S0) 6.04, (p=0.868). While means of pain scores (S15, S30, S60) at 15, 30, and 60th were found as 1.46, 0.84, and 0.63 respectively in Group 1, in Group 2, these values were found 3.75, 1.96, and 1.50 respectively and it was found that there was a statistically significant difference between the values (S15: p&lt;0.001, S30: p=0.001, S60: p=0.01). Conclusions: Lornoxicam provides an effective analgesia within a short time in acute renal colic treatment and can be tolerated well by the patients. Lornoxicam may be one of the good alternatives for renal colic treatmen

Renal oncocytoma: A case report

Renal onkositom, tüm böbrek tümörlerinin %3-5’ini oluşturan, oldukça nadir bir tümördür. Sıklıkla asemptomatiktir ve ortalama boyut 6 cm dir. Burada, 13 cm büyüklüğünde renal onkositom tanısı almış olgu sunulmuştur.Renal oncocytoma, which is diagnosed 3-5% of all renal tumors, is rare tumor. Most renal oncocitomas are asymptomatic and median size 6 cm. Here we present a case with renal oncocytoma, which size was 13 cm

Renal oncocytoma: A case report

Renal onkositom, tüm böbrek tümörlerinin %3-5’ini oluşturan, oldukça nadir bir tümördür. Sıklıkla asemptomatiktir ve ortalama boyut 6 cm dir. Burada, 13 cm büyüklüğünde renal onkositom tanısı almış olgu sunulmuştur.Renal oncocytoma, which is diagnosed 3-5% of all renal tumors, is rare tumor. Most renal oncocitomas are asymptomatic and median size 6 cm. Here we present a case with renal oncocytoma, which size was 13 cm

Is there a difference on uroflowmetry between sitting or standing position?

Üroflovmetri günümüz ürolojisinde işeme fonksiyonunun değerlendirilmesinde sık kullanılan bir yöntemdir. Biz çalışmamızda ayakta ve oturarak yapılan üroflovmetri parametreleri arasında fark olup olmadığını incelemeyi amaçladık. Çalışmamıza yaşları 23 ile 47 olan 25 sağlıklı erkeği dahil ettik. Tümünde tam fizik muayene ve rutin idrar incelemesi yapıldı, herhangi bir patoloji saptanmadı. Daha sonra altı adet üroflovmetri parametresi ayakta ve oturarak değerlendirildi. Bu parametreler maksimum akım hızı (Qmax), ortalama akım hızı (Qave), Maksimum akıma ulaşma zamanı (T to Qmax), total işeme zamanı (V time), akım zamanı (T flow) ve işenen idrar miktarıydı (V vol). Yaş ortalaması 30.24±5.58 (23¬47) idi. Analiz edilen üroflovmetrik parametrelerden sadece işeme zamanı açısından anlamlı bir fark saptandı. Ayakta ve oturarak miksiyon yapma, işeme zamanı haricinde diğer parametrelerde herhangi bir fark yapmamaktaydı. Bu çalışma ile üroflow incelemelerinin pozisyonla ilgisi olmadığı kanısına varılmıştır.Uroflow metry is frequently used in urology practice. In this present study, we aimed to determine whether there is a difference on uroflowmetric parameters between sitting and standing position or not. We included 25 healthy men who are 23 to 47 years old. Physical examination and routine urinanalysis revealed no abnormality. Six uroflowmetric parameters were evaluated during sitting and standing. They were maximal flow rate (Qrnax), average flow rate (Qave), time to Qmax (T to Qmax), total voiding time (Vtime), flow time (Tflow) and voided urine volume (Vvol). Mean age was 30.24±5.58 (23-47). There is a statistically difference in only voided time between sitting and standing position. .-\11 parameters were same exce pt voiding time in sitting and standing position. It is concluded that patients' position have no effect on urol1owmetric parameters

Effects of Treatment on Angiogenic (Vascular Endothelial Growth Factor-2 and Matrix Metalloproteinase-2) and Antiangiogenic (Endostatin and Thrombospondin-1) Factors in Non-muscle Invasive Bladder Carcinoma

Objective: We aimed to investigate possible effects of treatment on angiogenic [vascular endothelial growth factor-2 (VEGF-2) and matrix metalloproteinase-2 (MMP-2)] and antiangiogenic [endostatin (ES) and thrombospondin-1 (TSP-1)] factors in non-muscle invasive bladder carcinoma (NMIBC). Materials and Methods: Thirty NMIBC patients and 30 age-matched controls were included in the study. For the above-mentioned markers, peripheral blood samples were drawn at three time points to be studied by enzyme-linked immunosorbent assay: before transurethral resection of bladder tumor (TURBT), at first control (20 days after the operation) and second control (at the end of intravesical immunotherapy). The mean blood levels obtained in the three measurements and those in patients and controls were compared statistically. Results: The mean levels of VEGF-2 and MMP-2 in patients before TURBT were found to be statistically significantly higher than in controls (p=0.04 and p=0.01, respectively), while no significant differences were obtained between the mean ES and TSP-1 levels (p=0.95 and p=0.99, respectively). It was also found that the VEGF-2 and MMP-2 levels were significantly decreased after TURBT (p=0.03 and p=0.01, respectively), but the tendency of these decrease was not found to be statistically significant between the first and second controls. Conclusion: Elevated VEGF-2 and MMP-2 levels in patients with NMIBC were significantly decreased after and probably due to the TURBT, which leads to a conclusion that these angiogenic markers may be used for follow-up of NMIBC

Assessment of Lower Urinary Tract Symptoms and Sexual Function in Women with Metabolic Syndrome

Objective To assess lower urinary tract symptoms and sexual function in premenopausal women with metabolic syndrome (MetS). Materials and Methods A total of 34 premenopausal patients over 18 years of age with MetS and who were admitted to our endocrinology clinic between September 2013 and April 2014 were included. Control group was consisted of 30 healthy controls chosen from the staff of the hospital. The sexual function, lower urinary tract symptoms and quality of life of the participants were evaluated by using Index of Female Sexual Function (IFSF), Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7), respectively. The scores of the patients were statistically compared with those of controls. Results The mean ages of the patient and control groups were 40.50±5.12 years and 38.17±2.12 years, respectively (p=0.09). The mean IFSF-total and all of the IFSF sub scales (except pain) in the patient group were significantly lower than those of the control group. The mean UDI-6 score of the patients was significantly higher than the controls (p=0.001). The mean IIQ-7 scores of the patients was higher than controls, however this increase was not statistically significant (p=0.11). Conclusion These findings showed that MetS affected adversely the sexual function of premenopausal women due to the fact that IFSF scores were found to be lower in women with MetS as compared to healthy controls. Moreover, IFSF score under the threshold values in patients showed that patients with MetS had sexual function disorder. These lower urinary tract symptoms in the patients with MetS did not affect the quality of life although the severity of lower urinary tract symptoms of patients with MetS was significantly worse than that in control group