PurposeTo determine the effect of the new β3-agonist (mirabegron), which is used for overactive bladder (OAB) treatment, on central retinal thickness (CRT) and choroidal vascularity. Material and ...MethodsThe 26 eyes of 26 cases using 50 mg tablet mirabegron once per day for OAB were included in this prospective case control study. The CRT, choroidal thickness (ChT), and choroidal vascularity were measured at baseline, week 1 (W1), month 1 (M1), month 2 (M2), and month 3 (M3). Subfoveal ChT measurement included the total subfoveal choroidal thickness (SFCT), and the small and large choroidal vessel layer (SCVL and LCVL) thickness. The total choroidal area (TCA), lumen area (LA), stromal area (SA), stroma/lumen ratio, and choroidal vascularity index (CVI) were measured with the Image-J software. ResultsThe largest SFCT increase compared to baseline was at M1 (26.8 ± 40.8 µm, P = 0.001). The subfoveal SCVL thickness showed a significant decrease at M2 and M3 (-6.0 ± 8.9 µm, P = 0.002; -7.8 ± 13.4 µm, P = 0.046, respectively). LCVL thickness showed a significant increase at W1, M1, and M2, with the largest at M1. CVI showed a significant increase at M1, M2, and M3 (P < 0.05 for all). The TCA, LA, and SA showed a significant increasing trend at all follow-up periods. LA/SA decreased at W1 because of stromal expansion but increased at M3 with more prominent vascular dilatation. CRT values showed no significant change. ConclusionsMirabegron had a significant effect on choroidal thickness. Choroidal vascular response is in the form of narrowing in the choriocapillaris and enlargement in the Haller's layer.
Objectives: The aim of this study was to investigate the impact of the addition of 50 mg daily sildenafil to pentoxifylline-colchicine combination ther-apy on the Peyronie's plaque features in ...patients with the acute phase of Peyronie's disease (PD). Methods: In this retrospective and non-randomized clinical study, patients were divided into 2 groups as group 1; (n = 107) who received colchicine and pentoxyfillin plus 50 mg daily oral sildenafil, and as group 2; (n = 79) who received only colchicine and pentoxyfillin. Patients were compared in terms of degree of curvature, pain in erection and erectile function at the baseline and at 6-month follow up. Pain in erection and erectile func-tion were evaluated by visual Analogue Scale (EF-VAS), and the shortened version of the International Index of Erectile Function (IIEF-5). Improvement in the degree of curvature and change in EF-VAS scores were primary endpoints of the study. Change in IIEF-5 score was the secondary endpoint of the study. Results: The two groups were statistically similar in terms of demographics and baseline features of PD. A statistically signifi-cant reduction in degree of curvature and EF-VAS scores was shown in group 1 compared to group 2.There was also a signifi-cantly higher IIEF-5 score in group 1 compared to group 2. No significant side effects were detected in both groups during treatment period.Conclusions: Adding sildenafil to pentoxifylline-colchicine com-bination treatment seems to improve PD related symptoms in the acute phase PD. PDE5i may contribute to relieve the Peyronie's symptoms in ED patients through their antifibrotic effects.
The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV ...on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA).
Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up.
The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations.
Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.
Objective: To analyze the parameters that are believed to impact the success rate in patients undergoing percutaneous nephrolithotomy and to determine the factors that have a significant effect. ...Materials and Methods: Success rates of 508 patients who underwent percutaneous nephrolithotomy were determined over a five-year period. Evaluation was performed with the medical history, non-contrast computerized tomography, and clinical research form in the first, third, and sixth months postoperatively. Patient characteristics, stone characteristics, and operation details were analyzed, and their effects on success were investigated. In the evaluation of the success rate, the results of the first month, were considered. Results: No significant difference was shown between the successful and unsuccessful groups in terms of demographic features. Morbidities such as body mass index, hypertension, diabetes mellitus, hyperlipidemia, and heart disease had no effect on success. Solitary kidney or congenital renal anomaly, degree of hydronephrosis, and high preoperative serum urea creatinine levels did not have a significant impact on the success rate. Significant effects of parameters such as stone volume greater than 15 cm.sup.2, complex stones, infection and cystine stones, intraoperative complication rate, and operation time on success were investigated (p<0.001, p=0.038, p=0.014, p=0.010, p=0.022, p=0.030, respectively). Success rates decreased statistically in cases with accompanying macroscopic hematuria (p=0.032). Previous surgery, extracorporeal shock wave lithotripsy history, and multifocal access had no effect however surgical experience increased the success rate (p=0.036). Conclusion: The success rates in percutaneous nephrolithotomy can be enhanced by examining the factors that may have an impact and taking necessary precautions relevant to these factors. Keywords: Percutan nephrolithotomy, success rate, predictive
We aimed to determine the effect on choroidal thickness of daily 5 mg tadalafil use in patients with erectile dysfunction (ED) and to evaluate agreement between short form of International Index of ...Erectile Function (IIEF 1–5, 15) scores and choroidal thickness during follow‐up. Enhanced depth imaging spectral domain–optical coherence tomography (EDI‐OCT) was used to measure full choroidal thickness in the subfoveal area, choroidal thickness (CT) and small‐choroidal‐vessel‐layer (SCVL) thickness. Thirty of the 45 patients included complete their follow‐ups and exhibited medication continuity. Patients were divided into two groups, five (16.7%) with ED at any level at third‐month follow‐up, and 25 (83.3%) with no ED, and subgroup analysis was then performed. Median changes in SCVL thickness at first‐ and sixth‐month follow‐ups were 20.5 µm versus 9.0 μm (p = .001) and 23.5 µm versus 12.5 µm (p = .005) in patients without and with ED respectively. The SCVL thickness increased by 20 μm compared with the baseline level, indicating an improvement in the patient's complaints of erectile dysfunction. The level of increase in SCVL thickness can be a useful and objective guide to clinicians if they cannot be present when the IIEF questionnaire is administered.
In the present study, we compared the retroperitoneal high ligation with subinguinal varicocelectomy on the treatment of painful varicocele. A total of 90 patients who underwent retroperitoneal high ...ligation (n = 45) and subinguinal varicocelectomy (n = 45) for painful varicocele were included in this prospective study. Varicocele in all patients was diagnosed with by physical examination and coloured Doppler ultrasonography. All the patients underwent a conservative treatment for pain for 4 weeks. Patient ages, varicocele grades, preoperative pain scores, postoperative pain scores at 6 months, duration of surgeries, complications and recurrences were recorded. Complete success rate for chronic scrotal pain was found to be 80% in retroperitoneal varicocelectomy group and 71% in subinguinal varicocelectomy group. Partial success rate was 11% for retroperitoneal varicocelectomy group and 18% for subinguinal ligation group. There was no significant difference between two groups in terms of pain and complications. However, the operation time was significantly lower in the Palomo group. Although microsurgical subinguinal varicocelectomy is the current approach for the treatment of varicocele, retroperitoneal high ligation can achieve the same pain resolution with shorter operative duration compared to loupe‐assisted subinguinal varicocelectomy.
We aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with ...renal cell carcinoma. We retrospectively analyzed 127 patients’ data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR.
P
values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR.
P
values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively.
Objective Standardization is important for the assessment of technical difficulty and complications in laparoscopic urology surgery. In this study, our laparoscopic operations and complications were ...evaluated retrospectively by using the European Scoring System and Clavien classification system. Materials and Methods We evaluated a total of 228 laparoscopic urologiy procedures performed between 2002 and 2007. The first 114 cases were named as group 1 and the second 114 cases as group 2. Both of the groups were classified regarding technical difficulty according to the European Scoring System. Complications were divided into two groups: major and minor. Postoperative complications were evaluated by the Clavien classification system. Results The rate of difficult operations was 24.5% and 56.1% in group 1 and group 2, respectively. In group 1, major and total complications were more common in difficult operations than in easy operations (p=0.045, p=0.006). Minor complications were similar (p=0.064). In group 2, complication rates were similar for both difficult and easy operations. (p=0.694, p=0.509, p=0.273). Complication rates per case was 0.21 (0-3) in group 1 and 0.19 (0-3) in group 2 and there was no significant difference between the two groups (p=0.790). Postoperative complications were classified using the Clavien classification system. 17% (n=4/23) of 23 complication was grade 1, 48% (n=ll/23) was grade 2, 26% (n=6/23) was grade 3a, 9% (n=2/23) was grade 3b. There were no grade 4 and 5 complications. 3% of the cases were converted to open surgery and no statistically difference was found between the groups (p=0.446). Conclusion We assume that the European Scoring System and the Clavien classification system are important in the assessment of difficulty of the cases and standardization of the analysis of postoperative complications.
Introduction
Interstitial cystitis/bladder pain syndrome (IC/BPS) has a negative impact on female sexual function. We aimed to evaluate the effect of intravesical botulinum toxin‐A (BTX‐A) injection ...on the improvement of sexual dysfunction and urinary symptoms using the multi‐domain female sexual function Index (FSFI), interstitial cystitis symptom index (ICSI), and interstitial cystitis problem index (ICPI).
Material and Method
The data of the 23 patients (study group) who received intravesical BTX‐A with the diagnosis of IC/BPS were reviewed. Twenty‐three age‐matched healthy, sexually active women were determined as the control group. Patients received 100 U BTX‐A submucosally injections, including the trigone. One hundred units of BTX‐A were diluted to 20 cc 0.9% saline, and 1 cc was then applied submucosally on 20 different points of the bladder wall (5 U/1 mL per site). The study group was asked to fill out FSFI, ICSI, and ICPI, as well as the visual analog scale (VAS) and bladder diary before and 3 months after the treatment. Patients in the control group completed the same questionnaires once. The pre‐ and post‐treatment questionnaire scores were compared in the study group. The study group's data were also compared to the control group.
Results
Compared to the pretreatment period, the study group showed statistically significant improvement in the total FSFI score and each domain of the FSFI after BTX‐A injection. The mean total FSFI score and three domains of FSFI (desire, lubrication, pain) reached to the score of the control group following BTX‐A injection. Statistically significant improvements were also shown in scores of ICSI, ICPI, and VAS. (p < 0.05).
Conclusion
IC/BPS is associated with a very high incidence of sexual dysfunction. Intravesical BTX‐A injection may provide significant improvement in sexual dysfunction in women with IC/BPS.
Purpose
We aimed to assess the success rates and functional outcomes of ReDo buccal mucosal graft urethroplasty (BMGU) following failed primary BMGU and evaluate the oral morbidity and changes in ...quality of life (QoL) after this surgery.
Materials and methods
Data of the patients with recurrent anterior urethral stricture who underwent ReDo BMGU after failed primary BMGU were retrospectively reviewed. The collected data included the results of the urethral stricture surgery patient-reported outcome measure-lower urinary tract symptoms (USS-PROM-LUTS) and euro-quality of life visual analog scale (EQ-VAS) questionnaires performed preoperatively before and one year after surgery. The cohort was divided into two groups according to procedural success, and these groups were compared.
Results
Thirty-two men patients were included. Among these, twenty-seven (84.3%) cases were considered successful following ReDo BMGU. The pre-ReDo BMGU mean stricture length was significantly longer in the failure group (2.3 ± 0.6 vs. 4.4 ± 1.2 cm,
p
= 0.001). Except for one patient with persistent oral numbness, no severe complication was reported postoperatively in the first year. The mean USS-PROM-LUTS score decreased significantly, while the mean LUTS-related quality of life score increased significantly following ReDo BMGU (
p
< 0.001,
p
< 0.001). In addition, the mean total EQ-VAS score increased significantly from 62.75 to 78.45, indicating remarkable improvement (
p
< 0.001).
Conclusions
Although less favorable outcomes can be anticipated in ReDo BMGU due to extensive scar tissue formation and reduced vascularity, high success and patient satisfaction rates and low oral morbidity rates were detected in ReDo BMGU cases.
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