Üriner inkontinansı olan genç ve yaşlı kadınlarda noktüri ile ilişkili faktörlerin değerlendirilmesi

Objective: To assess the factors affecting nocturia in young and older women with urinary incontinence (UI).Material and Methods: Women who applied to the urology outpatient clinic with the UI complaint between November 2021-March 2022 were included. Demographic data, anthropometric measurements, medications and comorbidities were recorded. The ICIQ-SF test was applied to evaluate their quality of life. Patients who have been waking up at night with the need to urinate ≥2 were considered to have nocturia.Results: Ninety-two women were included. Two groups were created as patients <60 years (n=47) and ≥60 years (n=45). The body mass index and waist circumference were higher in patients ≥60 years (respectively; p= 0.034, p= <0.001). Using of diuretic and anticholinergic medications was higher than in the younger group (respectively; p= <0.001, p= 0.006). The total number of medications was higher in the older group (p= <0.001). The number of comorbidities and the number of patients with Type 2 Diabetes Mellitus (DM) were higher in the older group (respectively; p= 0.002, p= 0.025). No difference was found in the young group with and without nocturia in terms of anthropometric measurements, medications used, and comorbidities. The number of medications and the number of Type 2 DM patients were significantly higher in the older group with nocturia (respectively; p= 0.04, p= 0.036). Conclusion: Type 2 DM and multiple medication use are risk factors for nocturia in older women with UI. Evaluation and management of these risk factors may contribute to better clinical outcomes.Amaç: Üriner inkontinanslı (Üİ) genç ve yaşlı kadınlarda noktüriyi etkileyen faktörleri değerlendirmek. Gereç ve Yöntemler: Kasım 2021-Mart 2022 tarihleri arasında Üİ şikâyeti ile üroloji polikliniğine başvuran kadınlar çalışmaya dahil edildi. Demografik veriler, antropometrik ölçümler, ilaçlar ve komorbiditeler kaydedildi. Yaşam kalitelerini değerlendirmek için ICIQ-SF testi uygulandı. Geceleri ≥2 idrar yapma ihtiyacı ile uyanan hastalarda noktüri var olarak kabul edildi. Bulgular: Çalışmaya 92 kadın dahil edildi. Hastalar <60 yaş (n=47) ve ≥60 yaş (n=45) olarak 2 gruba ayrıldı. Bel çevresi ve vücut kitle indeksi ≥60 yaş hastalarda daha yüksekti (sırasıyla; p= <0,001, p= 0,034). Kullanılan ilaç sayısı yaşlı grupta daha fazlaydı (p= <0,001). Diüretik ve antikolinerjik ilaç kullanımı yaşlı grupta genç gruba göre daha yüksekti (sırasıyla; p= <0,001, p= 0,006). Tip 2 Diabetes Mellitus'lu (DM) hasta sayısı ve komorbidite sayısı yaşlı grupta daha fazlaydı (sırasıyla; p= 0,002, p= 0,025). Noktürisi olan ve olmayan genç grupta antropometrik ölçümler, kullanılan ilaçlar ve komorbiditeler açısından fark bulunmadı. Noktürisi olan yaşlı grupta ilaç sayısı ve Tip 2 DM olan hasta sayısı noktürisi olmayan yaşlı gruba göre anlamlı olarak daha yüksekti (sırasıyla; p= 0.04, p= 0.036). Sonuç: Çalışmamızın sonuçları, klinisyenlerin özellikle Üİ'li yaşlı kadınlarda noktüri riskini azaltmak için kullanılan ilaç sayısını ve Tip 2 DM varlığını değerlendirmesinin önemini vurgulamaktadır

COVID-19 and urology: A bibliometric analysis of the literature

Aim The aims of this research were to analyse the urological literature published during the COVID-19 pandemic and to guide future research. Material and methods Between 2019 and 2021, the Web of Science (WoS) All Databases collection was searched for publications related to COVID-19 and Urology. The keywords used during this search were coronavirus-19, COVID-19, SARS-CoV-2, novel coronavirus, 2019-nCoV, pandemic and/or urology. The top 50 cited (T50) publications were also identified and summarized. Exported Microsoft Excel files, Visualization of Similarities viewer (VOSviewer) software and descriptive assessment were used for bibliometric and statistical analyses of the publications. Results In total, 582 publications related to COVID-19 and urology were identified. In these publications, the most active author, journal, country and organisation were Francesco Porpiglia, European Urology, the United States of America (USA) and La Paz University Hospital, respectively. The most commonly used keywords were telemedicine-telehealth, SARS-CoV-2, coronavirus, pandemic, residency, testicle, semen, kidney transplantation, endourology and surgery. The most worrying issues in the articles are the negative impact of COVID-19 on resident training and permanent damage to urological organs. Conclusions We analysed all the articles related to COVID-19 and urology published to date in the WoS All Databases collection. The most commonly published articles were based on clinical and outpatient practice, telemedicine, residency training, transplantation, and testicles. The long-term adverse effects of the pandemic on urology practice and especially urological organs will need to be assessed further in future research

Türk popülasyonunda oligozoospermi ve azospermi hastalarında infertilitenin genetik nedenleri

Objective: Advances in the science of genet- ics and the development of assisted reproductive techniques focus on the genetic causes of infer- tility. The aim of this research is to reveal genetic abnormalities in terms of sex chromosome aneu- ploidy and Y chromosome microdeletions. Material and Methods: A total of 350 patients with azoospermia or severe oligozoospermia were selected. After general examination of the patients and laboratory investigations were performed, cartoypes and Y chromosome microdeletions were examined. Results: A total of 225 infertile men with non-obstructive azoospermia (NOA) and 125 in- fertile men with oligozoospermia were enrolled into the study. The overall cytogenetic anomaly rate was 16%. Chromosomal changes were detected in 32 of 350 (9.1%) cases. The most common genetic anomaly was 47, XXY (Klinefelter syndrome) and the incidence was 11.5% in NOA group. This rate was 3.2% in oligozoospermia group. Y chromosome microdeletions were detected in 24 (6.8%) patients and similarly, it was observed more frequently in the NOA group than in the oligozoospermia group. Conclusion: The incidence of genetic causes have been increasing with the severity of infertil- ity. As a result, genetic screening and appropriate genetic counseling are needed before the use of assisted reproductive techniques.Amaç: Genetik bilimindeki ilerlemeler ve yardımcı üreme tekniklerindeki gelişmeler, infer- tilitenin genetik nedenlerine odaklanmamızı sağ- lamaktadır. Bu çalışmada, sex kromozomu anöplo- idisi ve Y kromozom mikrodelesyonları açısından genetik anormallikleriaraştırmayı amaçladık. Gereç ve Yöntemler: Azospermi veya şiddet- li oligozoospermi (≤ 5 milyon spermatozoa/ml) olan toplam 350 hasta analiz edildi. Hastalar genel muayene ve laboratuvar değerlendirmesi sonrası, karyotip ve Y kromozom mikrodelesyonu açısın- dan değerlendirildi. Bulgular: Non-obstrüktif azospermi (NOA) olan toplam 225 infertil erkek ve oligozoospermi olan 125 infertil erkek çalışmaya dahil edildi. Ge- nel sitogenetik anomali oranı% 16 idi. Üç yüz elli vakanın 32’sinde (% 9,1) kromozom değişiklikleri tespit edildi. En sık görülen genetik anomali 47, XXY (Klinefelter sendromu KS) idi ve insidansı NOA grubunda % 11.5 ve oligozoospermi gru- bunda % 3,2 idi. Y kromozom mikrodelesyonu 24 (% 6.8) hastada tespit edildi ve benzer şekilde NOA grubunda oligozoospermi grubuna göre daha sık görüldü (% 9.3 vs % 2.4, sırasıyla). Sonuç: İnfertilitenin şiddeti ile birlikte gene- tik nedenlerin görülme sıklığı artmaktadır. Sonuç olarak, yardımcı üreme tekniklerinin kullanılma- sından önce genetik tarama ve uygun genetik da- nışmanlığa ihtiyaç duyulmaktadır

Üreter taşı hastalarında postüreteroskopik lezyon skalası ile emilen irrigasyon sıvısı arasında bağlantı var mı?

Objective: Post-Ureteroscopic Lesion Scale (PULS) is used to classify ureteral wall injury that occurs during ureteroscopy. In this study we presented the preliminary results of absorbed irrigation fluid volumes according to PULS grades. Material and Methods: Forty-four patients to whom 7F semirigid ureteoscopy was performed due to ureteral stone were included in the study. All patients received general anesthesia. Izotonic containing 1% ethanol was used as irrigation fluid. Ethanol concentration in venous blood was commenced to be measured at the start of irrigation use and was carried on at 15-minute intervals including the post-operative period in the recovery room. Absorbed fluid volume was calculated by using blood ethanol concentrations. Irrigation time, stone size and PULS grade were recorded. Results: Mean operation time was found to be 44.2 ± 19.9 minutes. Mean stone size was measured to be 12.7± 6 mm and mean irrigation fluid amount used was 1371±1262 ml. PULS grade of 0 was seen in 26 patients and that of 1 or more was seen in 18 patients. No patient had a PULS grade of 3 or 4. Mean absorbed fluid volume was measured to be 58 ± 50,6 ml. No significant correlation was found between PULS grade and mean absorbed fluid volume. Conclusion: Fluid absorption during URS is not correlated with the PULS grade. Semirigid URS is a safe treatment option for ureteral stone disease in terms of the level of irrigation fluid being absorbed.Amaç: Üreteroskopi esnasında üreter duvarında oluşan hasarı sınıflandırmak için Post-Üreteroskopik Lezyon Skalası (PULS) kullanılmaktadır. Bu çalışmada PULS derecelerine göre absorbe edilen irrigasyon sıvı hacimlerinin ön sonuçlarını sunduk. Gereç ve Yöntemler: Bu çalışmaya üreter taşı nedeniyle 7 F semirijid üreteroskopi uygulanan 44 hasta dahil edildi. Tüm hastalara genel anestezi uygulandı. %1 etanol içeren izotonik irrigasyon sıvısı olarak kullanıldı. Venöz kan etanol konsantrasyonları irrigasyon kullanılmaya başlaması ile ölçülmeye başlandı, operasyon sonrası derlenme odasını kapsayacak şekilde 15 dakika arayla periyodik ölçüldü. Absorbe edilen sıvı hacmi kan etanol konsantrasyonları kullanılarak hesaplandı. İrrigasyon süresi, taş boyutu, PULS derecesi kaydedildi.Bulgular: Ortalama operasyon süresi 44.2 ± 19.9 dakika olarak saptandı. Ortalama taş hacmi 12.7± 6 mm ve ortalama kullanılan irrigasyon sıvı miktarı 1371±1262 mL olarak ölçüldü. Hastaların 26’sınde PULS derecesi 0 iken 18’inde 1 veya üzerindeydi üzerindeydi. Hiçbir hastada PULS derecesi 3 veya 4 olmadı. Ortalama absorbe edilen sıvı hacmi 58 ± 50,6 mL olarak hesaplandı. PULS derecesi ile ortalama absorbe edilen sıvı miktarı arasında istatistiksel anlamlı fark saptanmadı.Sonuç: URS esnasında oluşan PULS derecesi 1-2 olan veya düşük dereceli submukozal üreter lezyonlarıyla sıvı emilimi korele bulunmamıştır. Semirijid URS, üreter taşı hastalığı tedavisinde irrigasyon sıvısının emilimi açısından güvenli bir yöntemdir

Risk factors affecting success of urethroplasty in male patients – Single center results

Amaç: Bu çalışmada kliniğimizde üretroplasti yapılan erkek hastalar incelenerek olguların sonuçları ve üret- roplasti başarısı üzerine etkili risk faktörleri araştırıldı. Materyal ve metod: Bu retrospektif çalışmada, üretra darlığı olan erkek hastalarda tek cerrah tarafından uygulanan farklı üretroplasti tekniklerini takiben tedavi başarısını etkileyen faktörleri belirlemek için tek değişkenli ve çok değişkenli analizler kullanılmıştır. Bulgular: 102 erkek hastada gerçekleştirilen üretroplasti vakalarında ortalama yaş 49 yıl, ortalama darlık uzunluğu 3,9 cm ve başarı oranı % 84 olarak belirlendi. Çok değişkenli analiz sonuçlarına göre diyabetes mellitus (DM) varlığı, önceden geçirilmiş üretratomi interna (İÜ) sayısı ve darlık uzunluğu üretroplasti başarısını öngören faktörler olarak tanımlandı. (OR 1.257; 95% CI 0.073-0.909; p=0.035, OR 5.343; 95% CI 2.233-12.782; p=0.005 ve OR 8.683;% 95 CI 2.950-25.561; p=0.025) Sonuç: Üretroplasti, üretra darlığı tedavisinde altın standart bir cerrahi prosedür olmakla beraber DM varlığı, birden çok İÜ öyküsü ve uzun darlıklar tedavi başarısızlığı ile ilişkilidir. Üretroplasti teknikleri birden çok faktör ile değerlendirilmeli ve deneyimli merkezlerde gerçekleştirilmelidir.Background: In this study, male patients who underwent urethroplasty in our clinic were examined, and the outcome of the cases and the risk factors affecting the success of urethroplasty were investigated. Materials and Methods: In this retrospective study, univariate and multivariate analyzes were used to de- termine the factors affecting treatment success following different urethroplasty techniques performed by a single surgeon in male patients with urethral stricture. Results: In the urethroplasty cases performed in 102 male patients, the mean age was 49 years, the mean stenosis length was 3.9 cm, and the success rate was 84%. According to the results of the multivariate analysis, the presence of diabetes mellitus (DM), the number of previous urethratomy interna (IU) and the length of the stenosis were defined as the factors predicting the success of urethroplasty. (OR 1.257; 95% CI 0.073-0.909; p=0.035, OR 5.343; 95% CI 2.233-12.782; p=0.005 and OR 8.683; 95% CI 2.950-25.561; p=0.025) Conclusions: Although urethroplasty is the gold standard surgical procedure in the treatment of urethral strictures, the presence of DM, multiple IU history, and long strictures are associated with treatment fail- ure. Urethroplasty techniques should be evaluated with multiple factors and performed in experienced centers

A new safe and ergonomic manipulation tool for the flank-free supine position: "U-Pad"

Introduction: One of the most important problems in the supine percutaneous approach to the kidney is the narrow surgical surface area (SSA) in the lumbar region. Herein, the spatial and angular geometric advantages of the U-shaped lumbar pad (U-Pad) used as a new positioning tool for safety and ergonomics in the supine percutaneous approach have been revealed.Materials and Methods: Data of patients who underwent endoscopic combined intrarenal surgery (ECIRS) using the U-Pad for kidney stones between March and September 2021 were prospectively collected. The demographic, preoperative, operative, and postoperative data of patients have been saved. The patients were positioned first with the standard gel pad (group 1) and then with the U-Pad (group 2). Both SSA (X and X+Y, cm(2)) and angular degree (alpha and beta,degrees) calculations were compared. Fluoroscopy images with the same settings (97 kV/3.00 mA) were visually compared. In geometric data, trapezoidal area formula [(upper base + lower base) x height/2] and goniometer were used to compare with paired t-test.Results: ECIRS was performed on 17 patients, 13 men and 4 women, with a median age of 39 (range 32-47). The median body mass index was 26.2 (23.5-29.1). Stone localization and features were recorded. The median SSA was calculated as 35.7 cm(2) in group 1 and 97.3 cm(2) in group 2, and it was calculated that the total SSA increased to 272.5% with a median of 61.6 cm(2) extra surgical area. Similarly, the downward manipulation angle was 32 degrees (alpha degrees) in group 1, whereas it was 60.6 degrees (beta degrees) in group 2, and the median extra motion angle was calculated as 28.6 degrees (89.3%).Conclusion: The U-Pad is a safe and rapid tool in the supine percutaneous approach to the kidney, providing at least two times the extra SSA and manipulation angle

Comparison of before and after COVID-19 urology practices of a pandemic hospital

Objective: The aim of this study is to compare the effects of COVID-19 on urology practice using pre- and post-pandemic data of a pandemic hospital.Material and methods: March 11 is considered as the beginning of COVID-19 and, changes in the number of the outpatient clinic examinations, non-surgical procedures, and surgery in the 8-week period before and during the pandemic were evaluated by weeks. Age, gender, and comorbid diseases of the operated patients were compared statistically. The symptoms, complaints, mortality, and morbidity conditions of the patients were recorded by contacting them. Descriptive data and chi-square test were used.Results: The number of COVID-19 cases has been reported as 8,916 for the hospital, 88,412 for the city and 150,593 for the country. The mean age of the operated patients before and after 11 March was 51 and 47, and comorbidities were 79 and 40, respectively, and there was no statistically significant difference(p<0.05). The number of patients examined was 2,309 and 868, the number of operated patients 173 and 94, the number of patients undergoing non-surgical procedures were 371 and 174, respectively. The names and numbers of surgical and non-surgical procedures are listed according to European Association of Urology (EAU) priority classification. In follow-up, no complication because of COVID-19 was observed in any patient.Conclusion: Our study showed that, although the numbers have decreased, similar operations can be performed in daily urology practice without any contamination and mortality during the pandemic compared to the prepandemic period, by taking precautions and following the algorithms

Recurrent bladder cystitis: Who takes the role?

Purpose In this review, we discuss how the approach should be throughout the symptomatic and diagnostic process of recurrent bladder cystitis. Methods and results The available literature regarding recurrent bladder cystitis in the PubMed database has been reviewed. While urinary tract infections (UTIs) are amongst the most commonly seen diseases in society, the probability of having a UTI in women within a year is 15%. Within a lifetime, it is above 50%. In addition to the related comorbidities and decreased quality of life, the resulting cost constitutes a serious burden on national economies. Recurrent UTI (rUTI) refers to a group of patients who have suffered from a UTI at least three times in the last 12 months or at least two times during the previous 6 months and have diminished quality of life. During this chronic and bothersome process, it is also complicated as to who is going to make the diagnosis of patients and by whom treatment or follow-up will be provided. Conclusion Although there is no clear answer to this issue in the literature, the urologist might be the moderator of this chronic process as the physician who most frequently faces this condition in daily practice, is most aware of the uroanatomy as well as the pathophysiology and performs relevant operations in cases of necessity. At this point, rather than limiting the evaluation and treatment to a single specialty, it is crucial to solve the problem by using a multidisciplinary approach

Development of a prospective data registry system for retrograde intrarenal surgery in renal stones: Turkish academy of urology prospective study group (ACUP study)

OBJECTIVE:We aimed to report the development of a prospective data registry by generating a retrograde intrarenal surgery (RIRS)-specific electronic case report form (eCRF), which can be used by multiple centers in Turkey.MATERIAL AND METHODS:The Stone Disease Study Group of Turkish Urology Academy developed a template for the necessary data to be collected, which was then implemented within a dedicated server. Urologists from different universities, research and training centers, and private hospitals were invited to participate in this data registry. Each urologist was provided with a unique username and password after they agreed to participate in the study.RESULTS:In March 2015, the development of the eCRF was completed, and the server was opened for data input in April 2015. We started a prospective clinical data registry for all patients undergoing RIRS for renal stone(s) in 15 participating hospitals. Until the end of June 2016, 1112 RIRSs on 1264 patients have been included in the dataset.CONCLUSION:The easy-to-use eCRF specifically developed for RIRS was first of its kind in Turkey. This prospective data registry harvests important data that will be used to identify real-world demographic, clinical and operative data of patients with renal stone who undergo RIRS in various urology departments throughout Turkey. The results of this dataset will be presented in various papers.Turkish Association of Urolog

Analysis of patients undergoing urological intervention amid the COVID-19: Experience from the pandemic hospital

Purpose It is reported that surgical procedures performed during the COVID-19 pandemic are accompanied by high complications and risks. In this study, the urological interventions applied with appropriate infrastructure and protocols during the pandemic in the pandemic hospital that is carrying out the COVID-19 struggle are analyzed. Methods Urological interventions were reviewed in the 5-week period between March 11 and April 16. The distribution of outpatient and interventional procedures was determined by weeks concurrently along with the COVID-19 patient workload, and data in the country, subgroups were further analyzed. Patients intervened were divided into four groups as Emergency, High, Intermediate, and Low Priority cases according to the EAU recommendations. The COVID-19-related findings were recorded; staff and patient effects were reported. Results Of the 160 interventions, 65 were minimally invasive or open surgical intervention, 95 were non-surgical outpatient intervention, and the outpatient admission was 777. According to the priority level, 33 cases had emergency and high priority, 32 intermediate and low priority. COVID-19 quarantine and follow-up were performed at least 1 week in 22 (33.8%) operated patients at the last week, 43 (66.2%) patients who were operated in the previous 4 weeks followed up at least 2 weeks. No postoperative complications were encountered in any patient due to COVID-19 during the postoperative period. Conclusion In the COVID-19 pandemic, precautions, isolation, and algorithms are required to avoid disruption in the intervention and follow-up of urology patients; priority urological interventions should not be disrupted in the presence of necessary experience and infrastructure