Burhan Coskun

Urodynamics findings in transverse myelitis patients with lower urinary tract symptoms: Results from a tertiary referral urodynamic center

To characterize urodynamic findings in patients referred with transverse myelitis (TM) and lower urinary tract symptoms (LUTS), as well as to identify any characteristics predictive of urodynamics findings.

Quality of life after suprapubic catheter placement in patients with neurogenic bladder conditions

To evaluate quality of life in patients with neurogenic bladder (NGB) conditions who have elected to undergo suprapubic catheterization (SPC), as well as assess adverse events (AEs) related to the procedure.

The protective effect of L-arginine, tadalafil, and their combination in rat testes after ischemia and reperfusion injury

INTRODUCTION Nitric oxide (NO) plays an important role in the ischemia and reperfusion process. In this study, we aimed to examine the effect of L-arginine, tadalafil, and their combination for prevention of the ischemia reperfusion injury after testis torsion in rats. METHODS A total of 40 adult, male Sprague-Dawley rats were allocated into five groups. Three hours of left testicular torsion was performed in each group, excluding the control group. While the ischemia reperfusion (I/R) group had no treatment, I/R + Arg group received L-arginine, I/R + Td group received tadalafil and I/R + Arg + Td group received tadalafil and L-arginine 30 minutes before the detorsion. Then the left testis was untwisted for four hours of reperfusion. After bilateral orchiectomy, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue. Spermatogenesis was evaluated with Johnsens score. RESULTS LPx levels of the I/R group were found to be significantly higher than for groups that received drugs for both testes (p<0.001). GSH levels of the combination group were higher than I/R group in ipsilateral testis (p<0.01) and it was significantly higher than other groups for contralateral testis (p<0.001 for I/R group, p<0.01 for I/R + Arg, p<0.05 for I/R + Td). Mean Johnsens score of the I/R group was found to be significantly lower than treatment groups in ipsilateral testis (p<0.001 for I/R + Arg + Td group, p<0.01 for other treatment goups) and contralateral testis (p<0.001). The mean Johnsen score of the combination group was significantly higher than that of other treatment groups in ipsilateral testis (p<0.05) and it was significantly higher than in the I/R + Td group in the contralateral testis (p<0.05). CONCLUSIONS L-arginine, tadalafil, and combination of these two molecules showed protective effect against ischemia/reperfusion injury for both testes after unilateral testis torsion.

Urodynamics for incontinence after midurethral sling removal

We reviewed the role of urodynamics (UDS) in the management of women with incontinence following mid‐urethral sling removal (MUSR).

Efficacy and safety of onabotulinumtoxinA injection in patients with refractory overactive bladder: First multicentric study in Turkish population

To investigate the efficacy and safety of intradetrusor onabotulinumtoxinA (onaBoNT‐A) injection in patients with overactive bladder (OAB) refractory to antimuscarinic treatment.

Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones

Objectives: To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones. Material and Methods: We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy (URS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another. Results: Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications. Conclusions: Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.

Prolapse Recurrence after Transvaginal Mesh Removal

PURPOSE We determined the rate of pelvic organ prolapse recurrence after transvaginal mesh removal. MATERIALS AND METHODS Following institutional review board approval a longitudinally collected database of women undergoing transvaginal mesh removal for complications after transvaginal mesh placement with at least 1 year minimum followup was queried for pelvic organ prolapse recurrence. Recurrent prolapse was defined as greater than stage 1 on examination or the need for reoperation at the site of transvaginal mesh removal. Outcome measures were based on POP-Q (Pelvic Organ Prolapse Quantification System) at the last visit. Patients were grouped into 3 groups, including group 1--recurrent prolapse in the same compartment as transvaginal mesh removal, 2--persistent prolapse and 3--prolapse in a compartment different than transvaginal mesh removal. RESULTS Of 73 women 52 met study inclusion criteria from 2007 to 2013, including 73% who presented with multiple indications for transvaginal mesh removal. The mean interval between insertion and removal was 45 months (range 10 to 165). Overall mean followup after transvaginal mesh removal was 30 months (range 12 to 84). In group 1 (recurrent prolapse) the rate was 15% (6 of 40 patients). Four women underwent surgery for recurrent prolapse at a mean 7 of months (range 5 to 10). Two patients elected observation. The rate of persistent prolapse (group 2) was 23% (12 of 52 patients). Three women underwent prolapse reoperation at a mean of 10 months (range 8 to 12). In group 3 (de novo/different compartment prolapse) the rate was 6% (3 of 52 patients). One woman underwent surgical repair at 52 months. CONCLUSIONS At a mean 2.5-year followup 62% of patients (32 of 52) did not have recurrent or persistent prolapse after transvaginal mesh removal and 85% (44 of 52) did not undergo any further procedure for prolapse. Specifically for pelvic organ prolapse in the same compartment as transvaginal mesh removal 12% of patients had recurrence, of whom 8% underwent prolapse repair.

Comparison of patient satisfaction rates for the malleable and two piece-inflatable penile prostheses

OBJECTIVE To compare patient/partner satisfaction with AMS 600-650 and AMS Ambicore penile implants (American Medical Systems, Minneapolis, USA) in patients with erectile dysfunction. MATERIAL AND METHODS The modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires at six months after implantation of 46 patients who underwent AMS 600-650 (n=23) or Ambicore placement (n=23) between 1/1/2008 and 1/1/2013 were analyzed. RESULTS The percentages of patients with AMS 600-650 who reported to be satisfied, very satisfied and neither satisfied nor dissatisfied with their prostheses were 34.78% (n=8), 30.43% (n=7) and 34.78% (n=8), respectively. For patients with AMS Ambicore, these percentages were 73.91% (n=17), 13.04% (n=3) and 13.04% (n=3), respectively. These overall satisfaction rates were significantly different between patients with AMS 600-650 and Ambicore (p=0.013). For patients with AMS 600-650, the percentages of patients who reported to be very likely, neither likely nor unlikely, or very unlikely to continue using their prosthesis were 30.43% (n=7), 34.78% (n=8), and 34.78% (n=8) while for patients with AMS Ambicore, these percentages were 65.21%, 21.33%, and 13.04%, respectively. These percentages were different between patients with AMS 600-650 and Ambicore (p=0.018). CONCLUSION The two-piece inflatable penile prosthesis was found to be more successful in overall satisfaction and more likely for continued use when compared to the malleable penile prosthesis.

Management of the complications of pubovaginal sling surgery

Objective. To present complications of pubovaginal sling surgery (PVS) and their managements. Methods. A total of 21 patients who underwent PVS in 4 different tertiary refferal centers between June 2014 and May 2016 were reviewed retrospectively. Demographic characteristics of the patients, previous 6 history, daily pad use, Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ) were recorded. Also, the management of the complications were stated. Results. The mean age of the patients were 54.9±12.32 (range, 36-76) years. Six (28.5%) patients had a history of previous incontinence surgery and 15 (71.4%) patients were n aive . There were no intraoperative complications. The mean daily pad use was decreased from 4.04±0.95 to 0.95±0.86 ( p =0.0001). While mean preoperative UDI-6 scores were decreased from 6.66±2.09 to 2.09±1.22 ( p =0.0001) at postoperative sixth month ; preoperative mean IIQ-7 scores decreased from 16.8±1.16 to 5.09±4.21 ( p =0.0001) at postoperative sixth month. One (4.76%) patient had abdominal hernia at postoperative 2 nd year, three (14.28%) patients had an increased post-micturational residual (150-200ml) and two (9.52%) patients had urinary retention. Conclusion. Although the efficiency of PVS is high; one should aware of complications. The successful management of the complications will increase efficiency and patient satisfaction.

MP75-11 LONG-TERM OUTCOME OF UTERINE SPARING PROCEDURE AS PART OF ANTERIOR VAGINAL WALL SUSPENSION.

and QoL consistently improved post-operatively, and remained stable over time (Table 1). VCUG findings also improved for urethral support and cystocele reduction. Additional therapy with sling (4) or injectable agents (8) was required in 12 (6%) women at a median of 3.8 (1.2-10.3) years. CONCLUSIONS: The AVWS procedure can durably correct SUI by restoration of anatomical support to the bladder neck and bladder base. Reference: 1. Wilson TS, Zimmern PE: Anterior Vaginal Wall Suspension, Female Urology, Urogynecology, and Voiding Dysfunction, Vasavada, Appell, Sand, and Raz, Section I, Chapter 17, 283-290, Marcel Dekker, 2005