An unusual complication of clean intermittent self-catheterization; urethral, glandular cavernosal tissue loss

Temiz aralıklı kateterizaston (TAK), çesitli mesane disfonksiyonlarında, bireylere özgü bir programla mesanenin bosaltılması için rutin olarak uzun yıllardır kullanılan bir tedavi metodudur. Üriner sistem enfeksiyonu TAK yapan hastalarda en sık görülen komplikasyondur. Daimi kateterizasyona göre bariz avantajları olmasına ragmen bu yöntemde, tekrarlayan üretral kateterizasyonlar sebebi ile üretra darlıgı ve üretral yanlıs yol gibi bir takım üretral komplikasyonlar gelisebilmektedir. Bu komplikasyonların (üretra darlıgı ve üretral yanlıs yol)prevelansı TAK'un uzun süre yapılmasıyla artmaktadır. Daha önce literatürde karsılasılmayan bir TAK komplikasyonuna sahip, parsiyel penil doku ve penil üretra kaybı olan bir hastanın olgu sunumu yapıldı ve TAK'a baglı gelisebilecek olan üretral patolojiler gözden geçirildi.Clean intermittent self -catheterization (CISC) is a treatment method that is used routinely in individualized programmes for bladder evacuation in various bladder disorders. Urinary tract infection is the most frequent complication in patients performing CISC Although this method has significant advantages to indwelling catheters (IDC), because of repeatedly urethral catheterization, some complications like urethral stricture and urethral false passage may develop and the prevalence of urethral strictures and false passages increases with longer use of CISC. A case report of a patient, who lost urethral tissue and penile urethra due to CISC, a complication not reported previously in the literature is presented and CISC dependent urethral pathologies are reviewed

The Frequency of Fibromyalgia Syndrome in Patients with Polycystic Ovary Syndrome

Objectives: Polycystic ovary syndrome [PCOS] is one of the most common reproductive abnormalities and is characterized by hyperandrogenemia. We aimed to assess the frequency of fibromyalgia syndrome [FMS] and psychological distress in patients with PCOS. Methods: Forty patients with PCOS and 39 age-matched healthy controls were included in the study as PCOS and healthy normal control [HNC] groups. The diagnosis of FMS was based on the American College of Rheumatology criteria of 1990, and the diagnosis of PCOS was based on the Rotterdam criteria of 2003. All participants completed the questionnaires to gather information including demographic features, FMS-related symptoms, and the psychological status. Patients with PCOS were divided into two subgroups according to coexistence of FMS [PCOS only and PCOS + FMS]. Results: The mean age of PCOS and HNC groups were 23.97 +/- 6.01 and 26.15 +/- 5.45 years, respectively [P > 0.05]. The frequency of FMS in PCOS and HNC groups was 32.5 percent and 7.7 percent, respectively [P < 0.05]. Except constipation and paresthesia, the presence of FMS-related symptoms in the PCOS + FMS subgroup were higher than those of the PCOS only subgroup and HNC group. There were no differences in depression scores between the PCOS only and PCOS + FMS subgroups, but there were differences in anxiety scores. Conclusion: The frequency of FMS was found to be increased in PCOS. Anxiety risk was also found to be increased, particularly in patients with PCOS and concomitant FMS

Evaluation of hand functions in women with polycystic ovary syndrome

Objectives. Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenemia and androgen levels are associated with muscle size and strength; thus we aimed to investigate the hand functions of women with PCOS. Methods. Thirty-seven patients with PCOS and 35 age-matched healthy women were included in the study as PCOS and control groups. Age, body mass index, dominant hand, physical activity level, lean/fat mass ratio, percentage of body fat, Beck Depression Inventory (BDI) score and Duruoz Hand Index (DHI) score were recorded. Hand grip and pinch strengths were tested in the dominant hand using a hand dynamometer and a pinch meter, respectively. Manuel dexterity was tested by the grooved pegboard test. Serum concentrations of total testosterone, estradiol, dehydroepiandrosterone sulfate, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone and progesterone were measured. Results. Patients with PCOS had high total testosterone levels (p0.001). There were no differences between groups in all of the hand strengths or dexterity. No correlations between hand parameters and hormones were found. DHI and BDI scores were high in the PCOS group (p=0.002 and 0.039, respectively). There was a correlation between DHI and BDI scores. Depressive patients had higher BMI (p=0.021) and body fat percentage (p=0.05) than non-depressive patients in the PCOS group. Conclusion. Hand strength and dexterity did not change in patients with PCOS. Depression risk increased especially in the patients with high BMI and affected hand functional status in PCOS

Chromosomal aberrations in benign prostatic hyperplasia patients

Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A total of 54 patients diagnosed with clinical BPH underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate-specific antigen (PSA) measurement and ultrasonographic measurement of prostate volume. Prostate cancer was detected in one patient, who was then excluded from the study. We performed conventional cytogenetic analyses of short-term cultures of 53 peripheral blood samples obtained from the BPH patients. Results: The mean (±standard deviation) age of the 53 patients was 67.8±9.4 years. The mean PSA value of the patients was 5.8±7.0 ng/mL. The mean prostate volume was 53.6±22.9 mL. Chromosomal abnormalities were noted in 5 of the 53 cases (9.4%). Loss of the Y chromosome was the most frequent chromosomal abnormality and was observed in three patients (5.7%). There was no statistically significant relationship among age, PSA, prostate volume, and chromosomal changes. Conclusions: Loss of the Y chromosome was the main chromosomal abnormality found in our study. However, this coexistence did not reach a significant level. Our study concluded that loss of the Y chromosome cannot be considered relevant for the diagnosis of BPH as it is for prostate cancer. Because BPH usually occurs in aging men, loss of the Y chromosome in BPH patients may instead be related to the aging process

Cancer detection rates of different prostate biopsy regimens in patients with renal failure

We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age-specific PSA levels up to 20 ng/mL in patients with renal failure

Ciprofloxacin-Ceftriaxone Combination Prophylaxis for Prostate Biopsy; Infective Complications

Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone) combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3%) 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended-spectrum beta-lactamase-producing (ESBL) Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy