Erdal Benli

Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine) solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n = 89) were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n = 87) had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fishers exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p < 0.05). Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy.

The relation of sexual dysfunction to depression and anxiety in patients with Parkinson's disease.

Objective In this study, we aimed to find out whether sexual dysfunction in patients with Parkinson’s Disease (PD) was associated to PD-related disability and whether this relationship was modulated by depressive and anxiety symptoms. Methods Eighty-nine consecutive patients with idiopathic PD who attended to our movement disorders outpatient clinics between January 2011 and June 2014 were included in this study. The diagnosis of PD was confirmed by a movement disorders specialists in Neurology, according to UK Parkinson’s Disease Society Brain Bank Criteria. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr stage (H&Y) was used to establish disease severity. Cognitive function was assessed by the Mini-Mental State Examination. Patients were also administered the Hamilton depression (HAMD) and anxiety (HAMA) rating scales. The sexual functions of the patients were rated by applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). Results The mean age at the time of the study visit was 67.74±9.05. Male/female ratio was 1.87. Mean UPDRS total was 29.06±13.96 and mean UPDRS motor was 17.62±9.07. Mean HAMD score was 13.92±10.86, 58.4% of the patients had minor or major depression; and mean HAMA score was 7.94±6.49, 56.2% of the patients had minor or major anxiety. The mean ASEX score was 18.54±7.27 out of a maximum of 30. ASEX total scores were correlated with age, H&Y stage and HAMA scores. Age and also age at onset were correlated with ASEX subdomains except sexual desire. There was no correlation between disease duration and ASEX subdomains. UPDRS motor score was correlated with erection/lubrication. HAMD was only correlated with orgasm satisfaction. HAMA score was correlated with stimulation and orgasm. Conclusion In patients with PD, there may be a common factor that modulates both depression, anxiety and sexual function. Further studies are needed to clarify the exact relationship.

Is there a difference between Parkinson disease patients and a control group in terms of urinary symptoms and quality of life

BACKGROUND/AIM The aim of this study is to research whether urinary symptoms and disruption of quality of life observed in Parkinson disease patients are different than those of their healthy peers. Additionally, whether these complaints were affected by characteristics such as age at onset of Parkinson disease, sex, disease duration, and severity was investigated. MATERIALS AND METHODS This study comprised a total of 79 individuals, 39 Parkinson patients and a control group of 40 individuals. Parkinson diagnosis was provided by a neurology expert according to the UK Parkinsons Disease Society Brain Bank Criteria. All patients were evaluated by a urologist with the International Prostate Symptom Score (IPSS) and an overactive bladder (OAB) questionnaire. RESULTS Compared with the control group, the Parkinson patient group had statistically significantly higher rates of urological complaints (P < 0.001), irritative symptoms (P < 0.001), voiding symptoms (P < 0.001), OAB score (P < 0.001), IPSS total score (P = 0.007), and treatment requirements (P < 0.001). CONCLUSION Urologic complaints were observed more frequently in the Parkinson patient group compared to the control group. Another important result of this study is that in the Parkinson patient group there was no difference found between urologic complaints in terms of sex.

The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

OBJECTIVE To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. MATERIAL AND METHODS Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. RESULTS The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). CONCLUSIONS According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

The Effect of Tadalafil on Renal Fibrosis Induced by Ureteral Obstruction

Objective: It has been reported that phosphodiesterase-5 (PDE-5) inhibitors improve kidney function during acute and chronic renal failure. This study aimed to determine the possible therapeutic effects of tadalafil, a specific PDE-5 inhibitor, on renal fibrosis induced by unilateral ureteral obstruction (UUO). Methods: Male Sprague-Dawley rats were used and randomly divided into three groups (n = 6) as sham-operated, UUO and tadalafil-treated (10 mg/72 hours, ig) UUO (UUO+T) groups. Unilateral ureteral obstruction was induced by complete ligation of the left ureter and 14 days after surgery creatinine clearance, urinary cyclic guanosine monophosphate (cGMP), renal alpha-smooth muscle actin (α-sma) and transforming growth factor βeta (TGF-β) levels, as well as histologic changes, were observed in all the animals. Results: Unilateral ureteral obstruction-induced renal fibrosis was confirmed by increased α-sma level, collagen deposition, tubular dilation, inflammatory cell infiltration and necrosis. An increased renal TGF-β level and decreased urinary cGMP level was also observed in obstructed animals in addition to reduced creatinine clearance. Tadalafil treatment, which restored the animals’ urinary cGMP level, significantly attenuated the fibrotic changes and TGF-β increase in their kidneys. Conclusion: This study suggests that tadalafil treatment ameliorates renal fibrosis by reducing TGF-β expression and may have important clinical relevance since tadalafil is currently used clinically to treat erectile dysfunction and pulmonary hypertension.

Comparison of response to treatment of unilateral and bilateral varicocelectomy

BACKGROUND/AIM We aimed to compare the results of unilateral and bilateral varicocele surgery. MATERIALS AND METHODS In two referral hospitals, the data of 180 patients who were treated with unilateral and bilateral microscopic varicocelectomy were retrospectively analyzed. Sperm parameters and spontaneous pregnancy rates were compared in patients who underwent bilateral and unilateral microscopic varicocelectomy. RESULTS The mean age was 29.6 (17-46) years. While 82 patients underwent unilateral varicocelectomy (Group I), 98 patients underwent bilaterally varicocelectomy (Group II). Forty (48.8%) spontaneous pregnancies occurred in Group I and 59 (60.2%) in Group II. When we analyzed sperm parameters, the rate of increase in the number of sperm in spermiograms was 17% in Group I and 27.5% in Group II. The rate of increase in sperm mobility was 58.5% and 50% in Group I and II, respectively. The improvement rate in sperm morphology was 46.3% in Group I and 56.1% in Group II. There were no significant differences between all these parameters. CONCLUSION In light of our results, although pregnancy rates seemed to be higher in patients who underwent bilateral varicocelectomy, these results were not statistically significant. Improvement rates in sperm parameters were similar between the patients who underwent unilateral and bilateral varicocelectomy.

The effect of trimetazidine on renal oxidative stress in partialand complete ureteral obstructions in a rat model

BACKGROUND/AIM Renal oxidative stress occurs in ureteral obstructions. The purpose of this study was to investigate the effect of the antioxidant and antiischemic agent trimetazidine (TMZ) on oxidative stress following ureteral obstruction. MATERIALS AND METHODS Ten groups were established. Sham groups were checked as controls after 1 and 3 weeks. The other 8 groups had partial or complete ureteral obstruction while receiving or not receiving trimetazidine (TMZ) at 5 mg/kg daily and were evaluated after either 1 week or 3 weeks. Creatinine and cystatin C measurements were performed in the serum. Malondialdehyde, myeloperoxidase, catalase, and glutathione peroxidase activity were measured in renal tissue and serum. RESULTS In the 1-week groups, tissue malondialdehyde, serum myeloperoxidase, and glutathione peroxidase activity increased significantly with obstruction and TMZ use compared to the control group (P < 0.005). In the 3-week TMZ group, cystatin C, tissue malondialdehyde, serum and tissue myeloperoxidase, and tissue glutathione peroxidase differed significantly (P < 0.05). There was no significant difference in all parameters after 3 weeks of partial obstruction (P > 0.05), with only serum malondialdehyde being significantly elevated (P < 0.05). CONCLUSION TMZ did not exhibit a renal oxidative stress-lowering effect in obstruction. It causes mild impairment of renal functions in obstruction. Patients using TMZ must be closely monitored in terms of kidney function in the event of any ureteral obstruction.

Assessment of Two-Years Bladder Biopsy and Cystectomy Outcomes

Objective: To evaluate the outcome of bladder biopsy and resection evaluated in pathology department in 2014-2015. Material and methods: A total of 78 cases from 2014 to 2015 were included in this study. Reports of the cases were removed from the archive and the age, gender, diagnosis and prognostic parameters of the cases were recorded. The distribution of cases according to age and gender was evaluated. Results: 65 of the cases were male, 13 of the cases were female. The average age of cases is between 39 and 90. Twenty-one cases were cystitis and squamous metaplasia. The mean age of benign lesions is between 41 and 85. Five cases of dysplastic lesions were observed. The average age is 61.6 and all of them are male. 52 of the cases were malignant. 49 of the cases were male, 3 of the cases were female. 19 cases of non-invasive papillary urothelial carcinoma, 1 case of low malignant potential urothelial neoplasm, 2 of the prostate adenocarcinoma metastasis, 30 of invasive carcinoma. 20 of the cases were pT1, 9 of the cases were pT2, 1 of the case was pT4 and 19 of the cases were pTa. The mean age was 64.5. Invasive tumors are all male. The mean age was 74.6. Conclusion: In this study, tumors and non-tumoral lesions were seen spreading to a wide range of age in bladder. Benign and malignant lesions were observed in males. Benign lesions were more common in females than malignant lesions in females.

Comparison of serum acetyl hydrolase (PAF-AH) and paraoxonase 1 (PON1) values between prostate cancer patients and a control group

The aim of the study was to measure platelet‐activating factor acetyl hydrolase (PAF‐AH) and paraoxonase (PON1) enzyme activity levels in patients with high Psa values to compare with healthy peers and also to determine the efficacy of these parameters in predicting pathologic results of patients with high Psa values. This study included 66 patients with Psa value > 4 ng/dl (Group 1) and 44 patients with Psa <4 ng/dl (Group 2) for a total of 110 patients. Parameters measured in serum of PON1, PAF‐AH, and MDA were compared between the groups. Additionally the same parameters were compared between patients with prostate biopsy performed due to high Psa and diagnosed with cancer and the control group with normal Psa values. The PAF‐AH activity in Group 1 was 125.17 ± 8.64 and in Group 2 was 120.08 ± 9.23 U/ml (p = 0.003). The PON1 activity was 63.12 ± 6.74 and 65.91 ± 7.77 U/ml in the groups, respectively (p = 0.04). Additionally, there were significant differences identified between the control group and PCa diagnosis group in terms of PAF‐AH and PON1 activities (p = 0.004 and p = 0.02, respectively). The enzyme activity of PAF‐AH and PON1 measured in serum of patients with high Psa value and patients with diagnosis of prostate cancer (PCa) were identified to have changed by a significant amount compared to healthy peers with normal Psa value. It was concluded that these parameters may be beneficial markers for use in assessment of patients with high Psa value.

Evaluation of sexual dysfunction in Parkinson’s disease between two different regions of Turkey

OBJECTIVE In this study, we aimed to evaluate sexual dysfunction (SD) between two different regions of Turkey in patients with Parkinsons Disease (PD). PATIENTS AND METHODS Forty-three PD patients in Ordu and 71 patients in Istanbul were included. The Unified PD Rating Scale and Hoehn and Yahr Stage (HYS) scale were used to assess disease severity. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). The sexual functions of the patients were evaluated with applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). RESULTS Mean age of patients in Istanbul was 67.25±8.34years and mean age of patients in Ordu was 67.98±8.93 (p=0.66). There was 87.33% SD in Istanbul group and 95.35% in Ordu group (p=0.20) respectively. In terms of ASEX score, no difference was found between the Istanbul and Ordu groups. ASEX scores were significantly higher in females in both groups. CONCLUSION In this study, we have found that living in the different regions of our country does not have an impact on sexual function in PD patients.