Complete response to acupuncture therapy in female patients with refractory interstitial cystitis/bladder pain syndrome

Objectives: Interstitial Cystitis/Bladder Pain syndrome (IC/BPS) is a considerable issue in urology and gynecology and unfortunately, the treatment options recommended are not fully efficient. Therefore, in this study we aimed to determine the effectiveness of acupuncture treatment in patients with refractory IC/BPS. Material and methods: 12 refractory IC/BPS female patients received ten sessions of acupuncture twice a week. The visual analog score (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), O’Leary-Saint symptom score (OSS), Patient Health Questionnaire (PHQ9), Pelvic pain and urgency & frequency patient symptom scale tests (PUF) and maximum voided volume (MVV) was completed in 1st, 3rd, 6th and 12th months following the treatment. Results: There was a statistically significant decrease in all of the scores evaluated at first month compared with the baseline. While the change in VAS score in 1, 3, 6 and 12th months were found statistically significant, measurements of ICSI, OSS and PUF scores and MVV values in the 6th and 12th months and ICPI and PHQ scores in the 12th month were not found statistically significant compared to the pre-treatment period. Response to treatment for the first three months after acupuncture application was (100%), but this ratio was measured as 33.3% (4/12) in the sixth month and 16.6% in the 12th month (2/12). Conclusions: The results of this study suggest that acupuncture appears to be an effective, useful, non-invasive method in IC/BPS patients. It can be used as an appropriate treatment method not only in refractory but also in IC patients since it is rather advantageous compared to other treating agents

Evaluation of the Readability of Informed Consent Forms Used for Emergency Procedures

INTRODUCTION: The aim of the study was to evaluate the readability levels of informed consent forms used for patient consent before emergency procedures applied in emergency service in Necmettin Erbakan University Meram Medical Faculty Emergency Service Clinic through readability formula. METHOD: Fifteen informed patient consent forms used for emergency medical applications in Necmettin Erbakan University Meram Medical Faculty Emergency Medicine Department were evaluated. Information text available on the forms was transferred into Microsoft Word program. Average word number, syllable number and words with syllable number of four and above were calculated. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog, Flesch kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. RESULTS: Readability levels of all consent forms were detected at average difficulty level according to Ateşman formula, very difficult according to Flesch-Kincaid formula, difficult according to Gunning fog formula and at high school level according to Bezirci-Yılmaz. CONCLUSIONS: In this study, the readability level of emergency intervention consent forms used in the clinic was detected as hard and required high school or higher education level. The conclusion is that attention should be paid to this subject which is both medically and legally binding for the doctors and verbal and visual support should be provided for informing the patients in addition to consent forms

Is there a difference between the readabilities of informed consent forms used for procedures in the emergency services of state and university hospitals in Turkey?

Aim: The aim of the present study was to evaluate the readability levels of informed consent forms (ICFs) used for procedures in the emergency services of state and university hospitals by comparing through readability formulas. Materials and Methods: ICFs used in emergency medicine clinics in different university and state hospitals in Turkey were collected, and forms that were the same were included in the evaluation only once. A total of 32 ICFs, with 15 from university hospitals and 17 from state hospitals, were evaluated. Average word number, syllable number, and words with syllable number of four and above were calculated. Different formulas were used to determine readability levels. Results: Although the readability of ICFs used in university hospitals was found to be better than those in state hospitals, the readability levels of the ICFs for both groups were detected to have medium difficulty according to the Atesman formula, very difficult according to the Flesch-Kincaid formula, difficult according to the Gunning-Fog formula, and at high school level according to the Bezirci-Yilmaz formula. Conclusion: In conclusion, the readability rates of emergency procedure ICFs in both state hospitals and university hospitals were detected to be rather low according to the present study. The education level of our country and the local environment should be considered while preparing these ICFs

Neonatal bladder-derived mesenchymal stem cells ameliorate bladder dysfunction in diabetic rat models

Purpose: To evaluate the effect of a new mesenchymal stem cell type derived from the neonatal bladder (nMSC-B) on diabetic bladder dysfunction (DBD). Materials and Methods: nMSC-B were harvested from neonatal male Sprague-Dawley rat’s bladder and expand- ed in culture. nMSC-B were transferred to Type-1 diabetic rats which were induced by a single dose 45 mg/kg Streptozocin (STZ). Stem cells were transferred via intraperitoneally (IP) (DM-IP group, n:6) and by direct injec- tion to the detrusor (DM-D group, n:6) at 12th week following diabetes and compared with Phosphate Buffered Saline (PBS) injected diabetic rats (DM-PBS group, n:6) and age-matched PBS injected non-diabetic normal rats (NR-PBS group, n:6). All rats were evaluated histopathologically and functionally four weeks after the stem cell treatment. Results: nMSC-B showed improvement in both voiding function and bladder structure. The maximum voiding pressure (MVP) values in the DM-PBS group were lower compare to DM-IP, DM-D and NR-PBS groups (13.27 ± 0.78 vs 16.27 ± 0.61, 28.59 ± 2.09, 21.54 ± 1.00, respectively, P < .001). There was a significant improvement for MVP values in stem cell-treated groups. Immunohistochemical examination revealed decreased bladder smooth muscle (SM), increased fibrosis and desquamation in urothelia in diabetic groups compared to normal group(P < .001). We detected recovery in the stem cell groups. This recovery was more evident in DM-D group. No statisti- cal difference was observed in SM and fibrosis between DM-D and NR-PBS groups (P = .9). Conclusion: It was shown that nMSCBs provided amelioration of DBD. We think that nMSC-B constitutes an effective treatment method in DBD

An Urethral Stone Mimicking Urinary Tract Infection in a Twenty-six-month-old Boy

A 26-month-old boy, who was misdiagnosed with urinary tract infection, was admitted to our hospital with increasing complaints of uneasiness, vomiting and nausea. On physical examination, a urethral stone was suspected and was confirmed by plain urinary tract x-ray. In children, the clinical features of a urethral stone may be overlooked because children are not able to express their complaints fully. Therefore, a detailed and careful physical examination is of great importance. In this paper, we present the rare case of urethral stone in a child and a review of the literature

Penil doppler ultrasonografi sonrası gelişen priapizmin uluslararası erektil fonksiyon indeks skoru ve ereksiyon sertlik derecesi skoru seviyeleri ile ilişkisi var mı

WOS:000416270600009PubMed ID: 29201505Objective: The relation between Erection Hardness Score (EHS) and The International Erectile FunctionIndex (IIEF) Questionnaire- Erectile Function Domain Score (IIEF-EF score) used in erectile dysfunction(ED) evaluation and the prevalence of priapism after penile Doppler ultrasonography (PDU) was examined inthis study.Material and methods: A total of 62 patients who had PDU were included in the study. Patients were dividedinto two groups; there were 33 patients in IIEF-EF score 10, EHS 2 group (Group 1) and 29 patients in IIEFEFscore 10, EHS 2 group (Group 2). The two groups separated according to their scores were compared forage, body mass index (BMI), prevalence of priapism, vascular comorbidities and duration of erection.Results: When compared to Group 2, median age, rate of vascular comorbidities rate and BMI were detectedto be higher in Group 1 with IIEF-EF score 10 and EHS 2. But contrary to age and rate of vascular comorbidities(p0.035, p0.049 respectively), higher BMI was detected to be statistically insignificant (p0.093).Duration of erection, IIEF-EF score and number of cases with priapism were significantly higher in Group 2with IIEF-EF score 10 and EHS 2 (p0.001, p0.027, p0.049 respectively).Conclusion: High IIEF-EF and EHS scores, younger ages and lower rates of vascular comorbidities in patientsfrom whom PDU was demanded increase the prevalence of priapism.Amaç: Bu çalışmada erektil disfonksiyon (ED) değerlendirilmesinde kullanılan Uluslararası Erektil Fonksiyonİndeks (IIEF) Formu -Erektil Fonksiyon Alanı Skoru (IIEF-EF Skoru) ve Ereksiyon Sertlik DerecesiSkoru (EHS) seviyeleri ile penil Doppler ultrasonografi (PDU) sonrası priapizm gelişme sıklığı arasında kiilişki değerlendirilmiştir.Gereç ve yöntemler: PDU çekilen toplam 62 hasta çalışmaya dahil edildi. IIEF-EF skoru 10 (ağır), EHS2 grubunda (Grup 1) 33 hasta, IIEF-EF skoru 10 (orta-hafif), EHS 2 grubunda (Grup 2) 29 hasta olacakşekilde hastalar iki gruba ayrıldı. Skorlara göre ayrılan iki grup yaş, vücut kitle indeksi (VKİ), priapizmgörülme sıklığı, eşlik eden vasküler komorbid hastalık ve ereksiyon süresi açısından karşılaştırıldı.Bulgular: IIEF-EF skoru 10 (ağır), EHS 2 olan Grup 1’de yaş ortalamasının, eşlik eden vasküler komorbidhastalık oranının ve VKİ'nin grup 2’ye kıyasla yüksek olduğu tespit edildi. Fakat yaş ve eşlik edenvasküler komorbid hastalık oranının aksine (p0,035, p0,049, sırasıyla) VKİ’nin yüksekliğinin istatikselolarak anlamlı olmadığı saptandı (p0,093). IIEF-EF skoru 10 (orta-hafif), EHS 2 olan Grup 2’de ereksiyonsüresi, IIEF-EF skoru ve priapizm sayısının anlamlı düzeyde yüksek olduğu izlendi (p0,001, p0,027,p0,049, sırasıyla).Sonuç: PDU istenilen hastalarda IIEF-EF ve EHS skorlarının yüksekliği, yaşın daha küçük olması, eşlikeden vasküler komorbid hastalık oranının az olması priapizm gelişme oranını artırmaktadır

Vaccine Therapy for the Prostate Cancer

The aim of using vaccine in the treatment of prostate cancer (Pca) is to activate immune response against malignant cells by overcoming the tolerance triggered by the tumor. Vaccine therapies are effective by using the immune response against cancer. The first oncological vaccine therapy ever published in the literature belongs to Coley dating back to 1893. In that study, it has been demonstrated that inoperable soft tissue sarcomas were regressed by stimulating non-specific immune response with streptococcal toxins. Not every type of cancer is suitable for vaccine therapy. For a vaccine therapy to be implemented, the cancer should have a slow progression, it should be immunogenic, and contain tissue-specific proteins. For that reason, studies regarding urological cancers, most of which are phase 1/2 and phase 3, are focused on the kidneys and the prostate. Although vaccine therapy in oncological diseases dates back to old times, studies have only been intensified recently. In this compilation, we will discuss vaccine therapies that are being used in prostate cancer, which urologists are not so familiar with, in the light of the up-to-date literatur

Ağır Arteriyojenik Erektil Disfonksiyonlu Hastalarda Düşük Dansiteli Linear Şok Dalga Tedavisinin Etkinliği

WOS:000419241900006Amaç: Bu çalışmanın amacı, şiddetli arteriyojenik erektil disfonksiyona (ED) sahip hastalarda, fosfodiesteraz tip 5 (PDESİ) inhibitörünün (Tadalafil 5 mg) günlük kullanımı ile kombine edilen düşük dansiteli lineer şok dalga tedavisini (LI-ESWT), sadece PDESİ'nin günlük kullanımı ile kıyaslayarak LI-ESWT'nin etkinliğini değerlendirmektir.Gereç ve Yöntem: Toplam 23 hasta çalışmaya dahil edildi. Bu hastalar LI-ESWT tadalafil 5 mg tedavisi (n10) uygulanan, sadece tadalafil 5 mg tedavisi uygulanan (n13) hastalar şeklinde iki gruba ayrıldı. LI-ESWT, 4 hafta boyunca haftada bir kez uygulandı. Her iki gruptaki hastalara da günde bir defa tadalafil 5 mg tedavisi oral olarak başlandı ve tedaviye her iki grupta 3 ay devam edildi. Tedavi öncesi ve sonrası 1. ay ve 3. ayda hastalar Uluslararası Erektil Fonksiyon İndeks Formu-Erektil Fonksiyon Alanı Skoru (IIEF-EF) ve Ereksiyon Sertlik Derecesi Skoru (ESDS) seviyeleri ve Seksüel İlişki Profili (SEP) 2 ve 3 ile değerlendirildi. Bulgular: Tedavi öncesi ve tedavi sonrası 1. ve 3. ayda ölçülen IIEF-EF skorları arasında istatiksel anlamlı fark saptanmadı (p0,091; p0,198). Üçüncü ay sonunda LI-ESWT tadalafil 5 mg grubunda IIEF-EF skoru 4 puan, Tadalafil 5 mg grubunda 3,2 puan artış gösterdi. İki grup arasında 1. ve 3. ayda ölçülen ESDS, SEP2 ve SEP3 pozitif hasta oranları arasında istatistiksel olarak anlamlı fark saptanmadı.Sonuç: LI-ESWT, ED tedavisinde kolay uygulanabilir, belirgin yan etkisi olamayan ve sonuçlar üzerinde pozitif etkisi olan bir uygulamadır. Fakat ağır arteriyojenik ED mevcut hastalarda etkin bir tedavi yöntemi değildirObjective: The aim of this study was to evaluate the efficacy of low-intensity linear shockwave treatment (LI-ESWT) in patients with severe arteriogenic erectile dysfunction (ED) by comparing LI-ESWT combined with daily use of phosphodiesterase type 5 inhibitors (PDE5i) with the daily use of PDE5i alone.Materials and Methods: A total of 23 patients were included in the study. The patients were separated into two groups: LI-ESWT tadalafil 5 mg (n10) group and tadalafil 5 mg only group (n13). LI-ESWT was applied once a week for four weeks. Oral tadalafil 5 mg once a day was started and continued for three months in both groups. The patients were evaluated with the International Erectile Function Index Questionnaire Erectile Function Domain (IIEF-EF), Erection Hardness Score (EHS) and Sexual Encounter Profile (SEP) 2 and 3 before treatment and the 1 and 3 months after treatment. Results: No statistically significant difference was detected among IIEF-EF scores measured before and 1 and 3 months after treatment (p0.091, p0.198). At the end of the third month, IIEF score increased 4 points in LI-ESWT tadalafil 5 mg group and 3.2 points in tadalafil 5 mg only group. No statistically significant difference was detected in EHS, and the rate of positive responses to SEP2 and SEP3 questions at the 1st and 3rd months between the groups.Conclusion: LI-ESWT is easily applicable without any significant side effects and it has positive effects on the outcomes, however, it is not an effective treatment method in patients with severe arteriogenic E

A new approach in ureteral access sheath locating in retrograde intrarenal surgery (RIRS) by endovisional technique

Objective: To compare the results of patients who underwent retrograde intrarenal surgery (RIRS) using endovisional technique for ureteral sheat locating with control group in which endovisional technique was not applied. Material and Methods: Of the 41 patients who underwent RIRS treatment for kidney stone, between March 2014- August 2015, 19 patients treated with endovisional technique formed the study group and remaining 22 patients formed the control group. Patients were evaluated for age and gender, baseline and post procedural creatinine level, duration of operation, fluoroscopy and hospitalization time, size and localization of the stone, presence of multiple stones, previous shock wave lithotripsy (SWL) procedure, double J catheter requirement, complication rate, residual stone rate and absence of stone ratio. Results: There was no statistically significant difference between age, gender, location of the stone, previous SWL procedure, presence of multiple stones, baseline and postprocedural creatinine level, absence of stone ratio, double J catheter requirement and hospitalization duration between the groups. The duration of operation and fluoroscopy of the patients were significantly shorter than the control group (p = 0.036 and p &lt; 0.001, respectively). The complication rates of the endovisional technique group was significantly lower than that of the control group (p = 0.032). Conclusion: Endovisional technique is considered to be an appropriate and useful technique in order to locate the sheath safely in patients who has difficulty in ureteral access sheath locating and to decrease the duration of operation and fluoroscopy