Impact of Prostate Needle Biopsy on Erectile Function

Aim:To evaluate the impact of transrectal ultrasonography-guided prostate needle biopsy (TRUS-Bx) on erectile function.Methods:Patients who underwent TRUS-Bx were prospectively examined. The indications for prostate biopsy were elevated prostatespecific antigen (PSA) level and/or abnormal digital rectal examination. All patients were evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) before TRUS-Bx and at one, three and six months after TRUS-Bx. Severity of erectile dysfunction (ED) was classified into five categories according to IIEF-5 scores.Results:Eighty patients were included in the study. The mean age of the patients was 64.7 years and the mean serum PSA level was 10.2 ng/mL. The mean IIEF-5 score was 16.5 prior to TRUS-Bx. Before TRUSBx, ED was reported in 61 patients and mild, mild to moderate, and moderate ED in 23 (28.8%), 21 (26.2%), and 17 (21.2%) patients, respectively. Six months after TRUS-Bx, ED was reported as mild, mild to moderate, moderate and severe in 23 (28.8%), 21 (26.3%), 16 (20%) and one (1.3%) patients, respectively. The differences between before and after prostate biopsy were statistically insignificant (p>0.05).Conclusion:TRUS-Bx does not have a permanent effect on erectile function. It seemed to be a trend toward increasing ED at 1 month and longer follow-up showed that these changes resolved back to baseline

Hypercalciuria in Children with Monosymptomatic Nocturnal Enuresis

Aim: Nocturnal enuresis is a common problem in childhood. We aimed to evaluate the role of urinary calcium excretion in children with monosymptomatic nocturnal enuresis (MNE). Methods: This study included 60 children with MNE and 30 healthy controls. In addition to routine tests, urine density and urinary calcium levels were measured. Hypercalciuria was defined as the excess urinary calcium excretion ≥4mg/kg/day or urinary calcium/creatinine ratio ≥0.21. Results: Urinary calcium excretion was significantly higher in the enuresis group compared with the control group and the prevalence of hypercalciuria was 25% in children with enuresis. In conclusion, our study showed that hypercalciuria is an important finding of nocturnal enuresis. Conclusion: However, further studies are needed to clarify this relationship. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 39-42

Applicability of Distal Hypospadias Surgery in State Hospitals: Retrospective Analysis of 48 Cases

Aim: Hypospadias is one of the most common malformations in the male genital tract and distal hypospadias is the most frequent type. In this study, we aimed to retrospectively analyze medical records of patients who have undergone distal hypospadias surgery between April 2011 and April 2013 in a state hospital. Methods: We retrospectively evaluated hospital records of 48 patients who have been operated for distal hypospadias between April 2011 and April 2013. All patients were operated by a single surgeon (AŞ). Patient age, type of hypospadias, the presence of chordee and history of circumcision were evaluated. In addition, duration of surgery, duration of catheterization, length of hospital stay, and short-term and long-term complications were recorded. Results: The mean age of the patients was 7.38±3.77years. Subcoronal hypospadias was the most frequent type and eight of patients had chordee. A total of 42 patients underwent tubularized incised plate urethroplasty (TIPU) and six patients underwent meatal advancement and glanduloplasty (MAGPI). The mean duration of surgery was 83.41±25.65 minutes. None of the patients had a short-term complication; meatus stenosis developed during long-term follow-up in three patients who were treated by dilatation. Additionally, TIPU was performed in three patients in whom fistulas developed. Conclusion: We aimed to demonstrate that distal hypospadias surgery could be performed with low complication and high success rates in state hospitals by surgeons who receive training in hypospadias surgery. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 195-8

Otozomal dominant polikistik böbrek hastalığında ürogenital kistlerin semen parametreleri üzerine etkisi var mı ?

WOS: 000374928100006OBJECTIVE: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disease with cysts in many organs including the urogenital tract. The aim of the study was to evaluate the relationship between urogenital cysts, semen pathologies and infertility in ADPKD. MATERIAL and METHODS: Male ADPKD patients aged 18-60 with creatinine clearance years higher than 60 ml/min were included. All patients had magnetic resonance imaging of the urinary system and pelvis, scrotal Doppler ultrasonography and sperm analysis. The results were compared with those of a healthy control group. RESULTS: 27 patients and 17 volunteers were included. Seminal vesicle and prostate cysts were detected in four (15%) and six (22%) patients, respectively. Five of the 23 married patients (21%) had infertility and this rate was higher than in the control group (p=0.044). The ratio of sperms with normal morphology and progressive motility was lower, and the rate of hypospermia, oligozoospermia, azospermia, asthenozoospermia and teratozoospermia were higher in the patient group. There was no significant difference between patients with/without urogenital cysts regarding seminal pathologies. CONCLUSION: Seminal abnormalities and infertility are more frequent in patients with ADPKD. Defects in spermatogenesis and sperm motility may be related to urogenital cysts as well as ciliary pathologies. There is a need for further studies evaluating the role of urogenital cysts in semen pathologies.AMAÇ: Otozomal dominant polikistik böbrek hastalığı (ODPBH) ürogenital sistemle birlikte birçok organda kist oluşumuna neden olabilen sistemik bir hastalıktır. Çalışmada, ODPBH olan bireylerde ürogenital kistler ile semen patolojileri ve infertilite ilişkisi değerlendirilmiştir. GEREÇ ve YÖNTEMLER: Çalışmaya 18-60 yaşları arasında, kreatinin klirensi 60 ml/dakika/1.73 m2’nin üzerinde, ODPBH olan erkekler dahil edildi. Tüm hastalara üriner sistem ve pelvik manyetik rezonans(MR) inceleme, skrotal Doppler ultrasonografi ve semen analizi yapıldı. Sonuçlar sağlıklı kontrol grubu ile karşılaştırıldı. BULGULAR: Yirmiyedi hasta ve 17 gönüllü çalışmaya dahil edildi. Seminal vezikül kisti 4(%15), prostat kisti 6 (%22) hastada tespit edildi. Kontrol grubundan daha sık olarak, evli olan 23 hastanın 5’inde (%21) infertilite mevcuttu (p=0.044). Normal morfolojili sperm oranları ve ileri motilite daha düşük, hipospermi, oligozoospermi, azospermi, asthenozoospermi ve teratozoospermi oranları hasta grubunda daha yüksekti. Ürogenital kisti olan/olmayan hastalarda semen patolojileri açısından anlamlı fark yoktu. SONUÇ: Seminal anormallikler ve infertilite ODPBH olanlarda daha sıktır. Spermatogenez ve sperm motilite defektleri siliar patolojiler gibi urogenital kistlerle ilişkili olabilir. Ürogenital kistlerin semen patolojilerindeki rolünü değerlendirmek için ileri çalışmalara ihtiyaç vardır

Percutaneous Nephrolithotomy: Our Results of a Single-Centre Analysis in 2300 Cases

Aim: In this study, we evaluated the results of 2300 patients who underwent percutaneous nephrolithotomy (PNL) between March 2002 and April 2013. Methods: In our clinic, a total of 2300 PNL operations were performed between March 2002 - April 2013. Demographic characteristics (age, gender), body mass index, stone features (side, size, location), clinical characteristics of the urinary tract (renal anomaly, previous surgery, previous extracorporeal shock wave lithotripsy), operation parameters (duration of the intervention and fluoroscopy, number of access, location of access, transfusion, complications), post-operative data (length of hospital stay, transfusion, complications, stone-free) were recorded on PNL forms. The data were analyzed retrospectively. Results: Of all the PNL operations, 1225 (53.2%) were left-sided, 1074 (46.6%) were right-sided and 1 was bilateral. The mean age of the subjects was 43.5 (7-83) years and the mean body mass index was 26.6 kg/m2 (12-51). A total of 46 (2%) cases had renal anomalies. There were 16 patients with horseshoe kidney. More than one accesses was performed in 18.6% of the patient and intercostal access was done in 9.8%. Perioperative and post-operative transfusion rates were 1.4% and 2.9%, respectively. The mean stone size was 7.5±4.1 cm2. Stone-free (SF) rate was 65.1% and success rate was 78.5%. Conclusion: With increasing experience and advances in endourology, PNL is being widely performed with low morbidity and high success in our country as in the world. (The Me­di­cal Bul­le­tin of Ha­se­ki 2013; 51: 19-24