Intravesical Migration of an Intrauterine Device

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Is there a relationship between severity of coronary artery disease and severity of erectile dysfunction?

Introduction The correlation between erectile dysfunction (ED) and coronary artery disease has been emphasized and ED has been recognized as a potential independent risk factor and/or predictor of coronary artery disease (CAD). We evaluated the association between the number of occluded coronary arteries in myocardial infarction (MI) patients with the severity of ED, and investigated the influence of related risk factors in our study group. Materials and Methods 183 male patients who underwent coronary angiography because of acute MI from November 2009 to May 2011 were included. Following the stabilization of patients after the treatment, each patient was evaluated for erectile functionality. Risk factors such as age, diabetes, smoking, waist circumference, hypertension, and hematologic parameters were recorded. Results Among 183 patients with a mean age of 55.2 years who underwent coronary angiography due to acute MI, 100 (54.64%) had ED, while the ED rate was 45.36% (44/97) in cases of single-vessel disease, 64.5% (31/48) in cases of two-vessel disease, and 65.7% (25/38) in cases of three-vessel disease. The mean IIEF score was 24.2 ± 4.3, 20.4 ± 4.9 and 20.5 ± 4.2 for single or two or three-vessel disease, respectively. The presence of hypertension aggravated ED only in patients with three-vessel disease and increased total and LDL cholesterol levels in patients with single-vessel or two-vessel disease were accompanied by significantly decreasing IIEF scores. Conclusion The severity of ED correlated with the number of occluded vessels documented by coronary angiography, in male patients with acute myocardial infarction. In addition, the presence of hypertension had a significant influence over erectile function only in patients with three-vessel occlusion

Evaluation of Similar Genetic Pathophysiology Underlying Diabetes Mellitus and Peyronie’s Disease: WNT-2 and TGF Beta-1 Genes

Aim: Some recent studies on PD have focused on the WNT-2 and TGF-β1 gene loci, but its genetic basis is still not clearly known. In this context, we aimed to evaluate the presence of WNT-2 and TGF-β1 gene expression and genetic similarity between patients with Peyronie’s disease (PD) and comorbidities, especially diabetes mellitus (DM). Methods: Between May 2020 and April 2021, 57 patients diagnosed with PD were included in this cross-sectional study. The presence of comorbidities [Dupuytren’s contracture (DC), DM, hypertension (HT), dyslipidemia, and erectile dysfunction (ED)] was recorded. For genetic analysis, the WNT-2 and TGF-β1 genes were analyzed in the patients’ serum. Results: The mean age was found to be 50.2. 45.6% of the patients had DM, 19.1% had HT, 14% had dyslipidemia, 5.3% had DC, and 40.4% had ED. TGF-β1 gene expression was found to be increased in all patients; WNT-2 gene expression was found to be increased in 80.7%. When subtypes of the TGF-β1 and WNT-2 gene expression were analyzed, 52.6% of patients with WNT-2 gene expression and 95.5% of patients with TGF-β1 gene expression were found to be homozygous, and the others were found to be heterozygous. Patients with DM and PD had significantly higher homozygous WNT-2 gene expression (p=0.03). No significant relationship was found between other comorbidities and these genes. Conclusion: Homozygous WNT-2 gene expression was found to be increased in PD with DM. These data could be used to explain the genetic pathophysiology of PD in diabetic patients

Prostate-specific antigen reduction after empiric antibiotic treatment does not rule out biopsy in patients with lower urinary tract symptoms: prospective, controlled, single-center study

Background: To evaluate men, with lower urinary tract symptoms and newly elevated serum prostate specific antigen (PSA) to determine whether a three-week course of ciprofloxacin antibiotics lowers serum PSA levels and affects recommendations for prostate biopsy. Methods: A prospective, controlled, single-center prospective trial of 177 men with a newly elevated PSA and lower urinary tract symptoms was conducted. Patients were randomized to three weeks of ciprofloxacin or observation. After three weeks, patients PSA levels and derivatives were repeated. At the end of 3 weeks, all patients underwent TRUS guided systematic 12-core prostate biopsies regardless of the final PSA value. Results: Of 177 men who completed the study, 88 were in the treatment and 89 in the observation group. 46.5% of treatment and %18 of control groups patients PSA levels had decreased after 3 weeks and a significant PSA reduction was observed in the treatment group compare to control group (p: 0.035) but no significant prostate cancer detection rates were observed between the groups (p: 0.418). Also, in the treatment group prostate cancer detection rate was significantly higher in patients whom PSA levels were decreased (p: 0.011). Conclusion: This study has shown that, use empirical antibiotic treatment decreased the PSA levels but did not have any effect on prostate cancer detection. In addition, prostate cancer detection rates were found to be higher in patients with reduced PSA levels after treatment. Therefore, it may not be safe to rule out biopsies in patients who achieve a satisfactory PSA response to antibiotics

Impact of Three-Dimensional Printed Pelvicaliceal System Models on Residents' Understanding of Pelvicaliceal System Anatomy Before Percutaneous Nephrolithotripsy Surgery: A Pilot Study

Objective: To investigate the impact of three-dimensional (3D) printed pelvicaliceal system models on residents' understanding of pelvicaliceal system anatomy before percutaneous nephrolithotripsy (PCNL). Materials and Methods: Patients with unilateral complex renal stones indicating PCNL were selected. Usable data of patients were obtained from CT-scans in Digital Imaging and Communications in Medicine (DICOM) format. Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicaliceal systems (PCSs). All DICOM-formatted files were converted to the stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of PCSs. A questionnaire was designed so that residents could assess the 3D models' effects on their understanding of the anatomy of the pelvicaliceal system before PCNL (Fig. 3). Results: Five patients' anatomically accurate models of the human renal collecting system were effectively generated (Figs. 1 and 2). After presentation of the 3D models, residents were 86% and 88% better at determining the number of anterior and posterior calices, respectively, 60% better at understanding stone location, and 64% better at determining optimal entry calix into the collecting system (Fig. 5). Conclusion: Generating kidney models of PCSs using 3D printing technology is feasible, and the models were accepted by residents as aids in surgical planning and understanding of pelvicaliceal system anatomy before PCNL

Impact of poor glycemic control of type 2 diabetes mellitus on serum prostate-specific antigen concentrations in men

Background: To evaluate the impact of poor glycemic control of type 2 diabetes mellitus (T2DM) on serum prostate-specific antigen (PSA) concentrations in men