Introduction Although shock wave lithotripsy (SWL) is a common noninvasive procedure, it can be very painful and a serious source of anxiety which may affect pain perception. The aim of this study ...was to evaluate the association between patient's anxiety and SWL-related pain. Materials and Methods A total of 54 patients, who underwent the first session of SWL treatment between January and April 2014 due to a single renal pelvic stone with a diameter less than 20 mm, were included in the study. All patients were particularly informed about the procedure and, then, the validated Hospital Anxiety and Depression scale was administered in order to identify the anxiety level before the procedure. All relevant data, such as age, sex, stone size, body mass index (BMI), anxiety score, visual analog scale (VAS) score, skin-to-stone distance, and total energy were recorded. Results The mean age of the study population was 41.11±16.35 years. The mean stone size, anxiety level before procedure, VAS score during SWL, BMI, skin-to-stone distance and energy level were 10.69±4.75 mm (5-20 mm), 5.2±3.87; 6.5±2.46; 25.77±4.16; 7.23±2.10 cm; 56.53±16.74 joule, respectively. Anxiety prior to procedure, energy level and the number of total shock wave had a significant effect on VAS score (p<0.05). Sex, stone size, BMI and skin-to-stone distance did not significantly affect the VAS scores (p>0.05). Conclusion According to our results, reducing patient anxiety, if any, can provide some additional pain control during SWL procedure and can improve patient compliance.
Circumcision in adults: effect on sexual function Şenkul, Temuçİn; İşerİ, Cüneyt; şen, Bülent ...
Urology (Ridgewood, N.J.),
2004, 2004-Jan, 2004-01-00, 20040101, Letnik:
63, Številka:
1
Journal Article
Recenzirano
To evaluate the effects of adult circumcision on sexual function in men circumcised only for religious or cosmetic reasons.
The study group consisted of 42 male patients with a median age of 22.3 ...years (range 19 to 28) referred for circumcision from June 2002 to January 2003. Of the 42 men, 39 desired circumcision for religious reasons. Before circumcision, their sexual performance was evaluated using the Brief Male Sexual Function Inventory (BMSFI) and ejaculatory latency time. The BMSFI evaluation and ejaculatory latency time measurements were repeated after a postoperative interval of at least 12 weeks. The scores in the five main sections of the BMSFI and the ejaculatory latency times before and after circumcision were analyzed.
The differences in the mean BMSFI scores were not statistically significant in any of the five sections. However, the mean ejaculatory latency time was significantly longer after circumcision (
P = 0.02).
Adult circumcision does not adversely affect sexual function. The increase in the ejaculatory latency time can be considered an advantage rather than a complication.
The objective of the study is to investigate the effect of doxazosin, administered to the subjects who underwent SWL due to upper ureteral stones, on therapeutic outcomes. The study enrolled the ...patients with a radio-opaque stone ≥5 mm in upper ureter. Patients were randomized into two groups: the first group underwent SWL following the diagnosis and they were recommended to receive oral hydration. The second group underwent SWL after initiating alpha blocker (doxazosin controlled-release tablet 4 mg/day) and drug therapy was continued until that the patient has been stone free. Parameters of SWL procedure, Steinstrasse, pain score at admission, time to stone passage, the complications developed, the additional procedures that were administered and number of hospital visits done due to pain during the treatment were recorded. A total of 79 patients were enrolled to the study. The subjects evaluated included 35 patients, who received an alpha blocker and 44 patients who did not receive an alpha blocker. For both groups, the level of energy applied per SWL session, the diameter of the stone, the number of hospital visits done due to pain, pain score and the need for analgesia were found to be similar (p > 0.05). The group of doxazosin was more advantageous in terms of stone-free rate, the need for additional procedures and Steinstrasse (p < 0.05). In conclusion, the addition of doxazosin to SWL therapy administered for upper ureteral stones reduces Steinstrasse, and thereby, the need for additional procedures and increases post-treatment stone-free rate. A positive effect of doxazosin on the time to stone passage was not shown.
Objectives: The aim of the present study was to assess and compare pre‐ and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches.
Methods: ...The study included 144 consecutive patients with left‐sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an ‘Assesment Questionnaire for Scrotal Pain’ both before and after the surgery.
Results: The surgery was successful in 101 (83.4%) of the 121 patients available for follow up. Seventy‐four (61.1%) patients reported the complete resolution of pain while 27 patients (22.3%) reported partial resolution. Symptoms worsened in a single case and pain persisted postoperatively in 19 cases (15.7%). There were no statistically significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had external spermatic vein ligation and those who did not, regardless of the surgical approach (inguinal or subinguinal). All patients who reported complete or partial resolution of pain stated that they would recommend surgery to relatives with the same problem.
Conclusions: Varicocelectomy using either inguinal or subinguinal approaches is an effective and reasonable treatment option in this patient group and should include external spermatic vein ligation for a satisfactory outcome.
To review the follow-up data and complications of adult patients who underwent hypospadias surgery.
The records of 88 male patients with an average age of 21.9 years (range 20 to 27) who were ...operated on for hypospadias from 1996 to 2001 were reviewed in two groups: primary cases and all others (at least one unsuccessful attempt to correct the hypospadias). The primary cases consisted of 48 anterior, 9 middle, and 2 proximal hypospadias; the second group consisted of 16 urethrocutaneal fistula, 8 hypospadias, and 5 cripple cases.
The complication rate was 10.1% for the first group and 27.5% for the second group. After the second intervention in groups 1 and 2, the overall success rate was 100% and 89.6%, respectively.
Adult hypospadias is repaired with the techniques used in pediatric cases. However, the postoperative complication rate is higher, and these patients more often require multiple interventions.
We wanted to evaluate the therapeutic effect of intravesical heparin and peripheral neuromodulation on patients with interstitial cystitis.
From March 2002 to August 2003, 8 female and 2 male ...subjects conform to the NIDDK criteria and not responsive to the previous conventional treatments were included in the study. Wisconsin pain scores, maximal cystometric capacities, and night and day voiding frequencies were determined and these studies were repeated in the 2nd and 12th months of the treatment with 10,000 units intravesical heparin and peripheral neuromodulation. Frequency of the treatment was once a week during first 8 weeks, once in 2 weeks in the following 8 weeks, and once in 3 weeks four times. Then, it was decreased to once a month.
The mean follow-up period was 13 months (12-16 months). Day and night voiding frequency were significantly better in the 2nd and 12th months, when compared to pretreatment values. The Wisconsin pain scores were 62.5 +/- 13.9% and 62.8 +/- 15.2% in the 2nd and the 12th months, respectively. The average increase in the maximum cystometric capacity was 54.8 +/- 27.4% and 52.5 +/- 31.6% in the 2nd and the 12th months, respectively.
Intravesical heparin and peripheral neuromodulation combination seems to be an alternative for patients with interstitial cystitis not responsive to other treatments.
Urologic surgery performed in the lithotomy position sometimes results in the serious complications of rhabdomyolysis and acute renal failure. Patients in which this occurs are almost always found to ...have compartmental syndromes. The two patients we present herein did not show any sign of a compartmental syndrome, but both were obese and underwent surgery for more than 6 h. The possible mechanism of rhabdomyolysis without compartmental syndrome (without local signs and symptoms of muscle damage) is discussed, and rhabdomyolysis and urologic surgery are reviewed.
Objectives
Our aim was to examine correlation between Post‐void residual urine (PVR) after uroflowmetry and random PVR.
Methods
Male patients reporting to the Urology outpatient clinic with LUTS were ...selected. Patients' age, prostate volume, bladder capacity, voided volume, maximum flow rate, average flow rate, random PVR and PVR after uroflowmetry were recorded. We evaluated the correlations between these parameters. Also we assessed if there was a difference between random PVR and PVR after uroflowmetry. We divided PVR after uroflowmetry and random PVR into three groups: Group 1: 0–50 mL, Group 2: 51–100 mL and Group 3: >100 mL. Also we divided the patients into two groups according to bladder capacity as Group 1: ≤400 mL and Group 2: >400 mL. We compared these groups to determine whether a significant difference.
Results
Seventy‐seven patients applying to the urology outpatient clinic were assessed between 2013 and 2014. PVR after uroflowmetry was significantly higher than random PVR (P < 0.001). When we divided PVR after uroflowmetry and random PVR into three groups there was a significant difference between the groups (P = 0.02). When we divided the patients into two groups according to bladder capacity as Group 1: ≤400 mL and Group 2: >400 mL, PVR after uroflowmetry was different, but random PVR was similar (P < 0.001, P = 0.72).
Conclusions
PVR after uroflowmetry seems to be incorrectly high in patients whose bladder capacity is above 400 mL.
Objective To investigate the differences between the results of percutaneous nephrolithotomy (PCNL) for stone relapse in patients who previously underwent open surgery for renal stones and those in ...patients undergoing surgery for the first time. Materials and Methods Patients who underwent PCNL for renal stones bigger than 2 cm between the years 2009 and 2012 were evaluated. Stone size, length of the procedure, number of access, period of catheterization, length of hospital stay, complications, and stone-free rates were evaluated. Results A total of 64 patients included in the study. Twenty-seven had previously undergone open surgery for renal stones (group 1) and 37 underwent surgery for the first time (group 2). There was no significant difference between the groups in age and stone size. Seven (25.9%) patients in group 1 and 6 (18.2%) patients in group 2 had more than one access (p=0.628). In group 1; 2 patients (7.4%) had grade 2 and 3 patients (11.1%) had grade 3 complications. In group 2; 4 patients (10.8%) had grade 2 and 7 patients (18.9%) had grade 3 complications. The stone-free rate was 14 (51.8%) in group 1 and 23 (62.2%) in group 2. The rate of clinically insignificant residual stones was 8 (29.6%) in group 1 and 5 (13.5%) in group 2. The success rate of PCNL procedure in group 1 was 81.5% and 75.7% in group 2 (p=0.161). Conclusion PCNL is a good option for patients who had a previous open surgery for renal stones as well as for patients undergoing surgery for the first time.
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