Faruk Kucukdurmaz

Prevalence and correlates of female sexual dysfunction among Turkish pregnant women.

OBJECTIVEnThe aim of the present study was to determine the prevalence and associated factors of female sexual dysfunction together with the concerns of women about sexuality during pregnancy.nnnMATERIAL AND METHODSnA total of 207 healthy, sexually active pregnant women were enrolled in the study. Demographic data of all participants were noted and sexual functions were evaluated by Female Sexual Function Index (FSFI). Each FSFI domain score was calculated and mean scores were noted. Concerns of women about sexuality were also investigated.nnnRESULTSnMean age of participant women was 27.0±5.9 (range 15-44) years. Prevalence of sexual dysfunction was found to be 87% in study population. Mean FSFI score was 18.6±1.21. The rate of sexual dysfunction was higher in the first (87%) and third (92.6%) trimesters when compared to the second (80.6%) trimester (p=0.243). Among demographic variables, education levels of partners and preconceptional sexual dysfunction were found to be significantly related to FSD. The most common concerns of women about sexual relationship have been reported as the fear of having pain (35%), risk of abortion (21.3%) and religious factors (10%).nnnCONCLUSIONnPrevalence of sexual dysfunction is relatively high among pregnant women. Educational levels and preconceptional sexual functions were found to have an impact on this high rate. Accurate counseling of partners about sexuality during pregnancy may help to reduce misbeliefs, concerns and, thereby, decrease this high rate of female sexual dysfunction.

A Comparison of Sexual Function, Psychological Status, and Sociodemographic Characteristics of Turkish Men within Polygamous and Monogamous Marriages.

BACKGROUNDnA limited number of studies within the literature have entailed objective evaluations of psychological, sexual, and emotional features of women within polygamous marriages. However, there is a lack of studies reporting these features among polygamous and monogamous men.nnnAIMSnThe aim of this study was to investigate sociodemographic characteristics, sexual function, and psychological status of polygamously and monogamously married men.nnnSTUDY DESIGNnCross-sectional study.nnnMETHODSnThe study sample comprised two groups: 35 polygamous and 45 monogamous men in Kahramanmaraş Province, Turkey. Door-to-door surveys covered sociodemographic factors and adopted Beck Depression Inventory (BDI), and International Index of Erectile Function - Erectile Function Domain (IIEF-EFD) scales.nnnRESULTSnPolygamous men showed considerably higher IIEF-EFD scores (p<0.05). While the median score of IIEF-EFD was 25.0 for polygamous men, it was 22.0 for monogamous men. A comparison of the two groups revealed that polygamous men had lower BDI scores. However, the difference between the groups was statistically non-significant (p>0.05). Odds ratios and 95% confidence intervals of monogamous men for erectile dysfunction and depression were 14.4 (95% CI: 3.1-67.5) and 7.4 (95% CI: 0.9-61.9), respectively. The main reasons for multiple marriages reported by polygamous men, in descending order, were: 1) decreased satisfaction of sexual desires by a wife (37.1%); 2) falling in love with the second wife (22.8%); and 3) incompatibility with the first wife (17.1%). However, 62.9% of them responded negatively to the question: Would you recommend polygamous marriage to other men?nnnCONCLUSIONnOur results showed that polygamous men had higher erectile function and lower depression scores than monogamous men. Further studies investigating the effects of polygamy on mens psychosexual function are warranted. Additionally, studies that address the perspectives of offspring and womens expectations within polygamous marriages should be conducted.

Surgical Treatment of Erectile Dysfunction

Erectile dysfunction (ED) is defined as the consistent or recurrent inability of a man to attain and/or maintain penile erection sufficient for sexual activity. According to current guidelines, a 3-month symptom duration is accepted to establish the diagnosis except for some cases of trauma or surgically induced ED (Lewis R 2010). ED affects physical and psychosocial health and has a significant impact on the quality of life (QoL) of sufferers and their partners and families. Epidemiologic studies for ED estimate the prevalence of ED ranging between 20-30 % among men aged between 40-80 years (Laumannn et al 2005, Lewis R 2010). These differences in reported incidences are probably due to variations in the methodology and the age and socioeconomic status of the study populations.

Losartan treatment significantly attenuates the fibrotic changes in the corpus cavernosum of castrated rats

INTRODUCTION AND OBJECTIVESnThe aim of this study is to evaluate the effects of castration and subsequent losartan administration on the fibrosis-related parameters in the corpora cavernosa of castrated rats.nnnMATERIAL AND METHODSnTwenty-four male rats were divided into four equal groups. Group 1:sham surgery plus vehicle (0.9% NaCl) (control:con), group 2:sham surgery plus losartan (con+los), group 3: castration plus vehicle (castration:cast) and group 4:castration plus losartan (cast+los). After four weeks of oral losartan treatment, corporal levels of transforming growth factor-beta (TGF-β), thrombospondin-1 (TSP-1), alpha-actin, beta-actin and fibronectin were investigated by ELISA kits. Changes in the collagen and smooth muscle content were evaluated by histological analysis with Masson trichrome staining.nnnRESULTSnInitial and post-treatment body weights of rats were similar among groups. Castration significantly increased the expression of TGF-β, TSP-1 and fibronectin and resulted in a significant decrease in alpha-actin levels in the corpora cavernosa. Administration of losartan reduced the levels of TGF-β, TSP-1 and fibronectin in castrated rats. Alpha actin levels also increased after losartan treatment. Beta-actin levels were not significantly different among 4 groups. The levels of all markers were similar in group 1 and 2. Rate of fibrosis was significantly higher in castrated rats and treatment with losartan reduced this rate.nnnCONCLUSIONnCastration increased the expression of fibrosis-related markers in the corpora cavernosa of rats. Administration of losartan significantly attenuated those changes and exerted an antifibrotic effect.

Comparison Of Ureteroscopy And Percutaneous Nephrolithotomy For Renal Pelvic Stones Over 2 Cm

DOI: 10.4328/JCAM.5404 Received: 26.09.2017 Accepted: 16.11.2017 Published Online:16.11.2017 Printed: 01.01.2018 J Clin Anal Med 2018;9(1): 42-6 Corresponding Author: Faruk Kucukdurmaz; Department of Urology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey. GSM: +905335409307 E-Mail:farukdr@hotmail.com Abstract Aim: Advances in the technology of ureteroscopes and lithotriptors have led to the implementation of retrograde intrarenal surgery (RIRS) in the treatment of renal Stones. This study aimed to compare the outcomes and complications of semirigid ureterorenoscopy (s-URS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal pelvic stones larger than 2 cm, retrospectively. Material and Method: Between January 2014 and July 2016, 90 patients with single renal pelvic stones of more than 2 cm were treated by PCNL (group 1) or s-URS (group 2). Group 1 had 44; group 2 had 46 patients. Demographic features of patients such as age, gender, body mass index (BMI) as well as stone size were compared. Perioperative course and postoperative outcomes such as stone-free and complication rates were also evaluated. Patients assessed by plain abdominal radiography 24 hours after surgery and non-contrast computed tomography at 3rd months, postoperatively. Clinical success was defined as stone-free status. Results: Mean ages of patients in group 1 and 2 were 40.29±19.78 and 38.41±23.26 year, respectively (p=0.681). Two groups were comparable in terms of gender, BMI, grade of hydronephrosis. Mean stone sizes were also similar. The mean operation, fluoroscopy and hospitalization times were shorter in group 2. After first sessions, mean stone-free rates for PCNL and s-URS were 81.8% and 60.8%, respectively (p=0.037). In the s-URS group,11 patients underwent f-URS due to stone migration into lower calix, and 7 of them became stone-free after those procedures. At 3rd months follow-up, those rates were determined as 84.1% and 76%, respectively. Discussion: Although s-URS is not superior to PCNL in the treatment of large renal pelvic stones, it can be used to reach renal pelvis and fragment those stones in selected cases.

Comparison of Two Different Methods Used for Semen Evaluation: Analysis of Semen Samples from 1,055 Men

The aim of this study was to evaluate whether there is a difference between gravimetrically and volumetrically measured semen samples and to assess the impact of semen volume, density, and sperm count on the discrepancy between gravimetric and volumetric methods. This study was designed in an andrology laboratory setting and performed on semen samples of 1,055 men receiving infertility treatment. Semen volume was calculated by gravimetric and volumetric methods. The total sperm count, semen density and sperm viability were also examined according to recent version of World Health Organization manual. The median values for gravimetric and volumetric measurements were 3.44 g and 2.96 ml respectively. The numeric difference in semen volume between 2 methods was 0.48. The mean density of samples was 1.01 ± 0.46 g/ml (range 0.90-2.0 g/ml). The numeric difference between 2 methods gets higher as semen volume increases (p < 0.001). Gravimetric and volumetric semen volume measurements were strongly correlated for all samples and for each subgroup of semen volume, semen density and sperm count, with minimum correlation coefficient of 0.895 (p < 0.001). In conclusion, the gravimetric measurement provides higher results than volumetric one and numeric differences between 2 methods increase as semen volume increases. However, further studies are needed to offer the use of gravimetrical method, which was thought to minimize laboratory errors, particularly for a high amount of semen samples.

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

OBJECTIVEnThe aim of the present study was to investigate the diagnostic value of strain elastography (SE) of testicular tissues in infertile population. We also evaluated the correlation between SE results with semen parameters and hormone profiles of the patients.nnnMATERIAL AND METHODSnA total of 61 patients and 122 testes were evaluated. Patients who were evaluated in an andrology outpatient clinic with the diagnosis of infertility and referred to radiology department for investigation of reproductive organs between June 2015 and January 2016 were included. Patients were divided into two groups according to semen analyses results as normal (Group 1) and abnormal (Group 2). Hormone profiles, semen analyses, B-mode, coloured Doppler ultrasonography and sonoelastography examinations were performed for each patient. Measurements of testicular volumes, resistive indices (RI) in intraparenchymal arteries, strain, strain ratio (SR) and presence of varicocele were recorded.nnnRESULTSnMean age of participants was 33.7±6.3 years. Mean testicular volumes (Group 1, 19.41±4.8 mL, and Group 2, 17.64±3.62 mL) were significantly different between groups (p=0.023). Mean SRs were also different between Groups 1 and 2 (0.12±0.08 vs. 0.22±0.18, p<0.001). Testicular volumes were directly proportional with SRs in Group 1. Strain values had inverse relationship with sperm concentration and total motile sperm counts in Group 2 (p=0.01). SRs were found to be positively correlated with RI and sperm morphology in Group 2 (p<0.05). Although FSH values showed significant difference among groups, any correlation between FSH and elastographic parameters could not be displayed.nnnCONCLUSIONnStrain elastography results were found to be significantly different in patients with abnormal sperm counts. This technique may provide promising results, however, further large scale studies may help to clarify the value of this imaging modality in the assessment of male infertility.

Role of Contrast Enhancement and Corrected Attenuation Values of Renal Tumors in Predicting Renal Cell Carcinoma (RCC) Subtypes: Protocol for a Triphasic Multi-Slice Computed Tomography (CT) Procedure

Summary Background To distinguish RCC subtypes based on contrast enhancement features of CT images. Material/Methods In total, 59 lesions from 57 patients were included. All patients underwent multi-slice CT imaging with a triphasic protocol, which included non-contrast, corticomedullary, nephrographic and urographic phases. Contrast enhancement features of renal masses were evaluated in terms of CT attenuation values (AV) and differences in contrast density; the aorta or renal parenchyma were evaluated based on corrected or relative values. Results Clear cell RCC (ccRCC) showed more intense contrast enhancement than other RCC subtypes. When differentiating ccRCC from other RCC subtypes, a cut-off AV of 86–89 HU, aorta-based corrected AV of 89–95 HU and renal parenchyma-based corrected AV of 87–95 HU showed a diagnostic accuracy of 81–86%, 86–88% and 74–78%, respectively, in the corticomedullary phase. Furthermore, a cutoff of 2.42–2.72 for the relative contrast enhancement ratio, a cutoff of 2.59–2.74 for the aorta-based corrected relative contrast enhancement ratio and a cutoff of 2.63–2.76 for the renal parenchyma-based attenuation ratio showed a diagnostic accuracy of 83–88%, 88–90% and 81%, respectively. Conclusions The most reliable parameters for differentiating ccRCC from other RCC subtypes are aorta-based corrected AV and aorta-based corrected relative contrast enhancement values in the corticomedullary phase.

Management of urinary tract infection with intravesical amikacin may increase the risk of bladder oxidative stress in children with neurogenic bladder

IntroductionWe evaluated the bladder oxidative stress in neurogenic bladder children treated with intravesical amikacin for recurrent UTI and whether urinary isoprostane f2 alpha (F2-IsoP) is a good biomarker in this particular condition.MethodsThis prospectively designed controlled study was approved by the Adnan Menderes University institutional ethics committee (Adnan Menderes University, 2015/649). Between January 2016 and January 2017, twenty-six children with meningomyelocele who had been doing CIC were recruited. Serum and urine samples were collected during urinary tract infection (UTI) (group 1) and after management of UTI with intravesical amikacin (group 2) besides standard oral antibiotic treatment. While oxidative stress parameters SOD, GSH, GPX, MDA, F2-IsoP and NO were analyzed in the serum samples, only F2-IsoP was analyzed in the urine. All data were compared with 23 normal healthy control children (group 3).ResultsMedian age, CIC duration and number of CIC per day of patients’ group were 84 (60–147) months, 60 (30–90) months and 4 (4–6), respectively. Male-to-female ratio was 1:16. There was no statistical difference between groups in terms of serum oxidative stress parameters (pxa0>xa00.05). However, statistically significant urine F2-IsoP changes exist between groups (pxa0=xa00.011) (Fig.xa01). But there were no correlations between urine F2-IsoP and disease clinical data such as CIC duration or number of CIC per day. Serum glutathione levels in group 2 were higher than group 1 and 3, as well (pxa0=xa00.023, Kruskal–Wallis test).Fig.xa01Comparison of median urinary isoprostane f2 alpha levelsConclusionHigher urine F2-IsoP levels after management of UTI with intravesical amikacin may reflect increased lipid peroxidation and oxidative stress in children with NB. This detrimental effect on bladder should be considered in the long-term treatment period.

Evaluation of serum prolidase activity and oxidative stress markers in men with BPH and prostate cancer

BackgroundProstate cancer (PCa) and benign prostatic hyperplasia (BPH) are diseases of elderly men and are related to increased oxidative stress (OS). Although prolidase has a role in collagen metabolism, it is also used to evaluate OS in many diseases. However, there is a lack of data about serum prolidase activity (SPA) in prostate cancer. The aim of this study was to evaluate and compare SPA levels in males with BPH and PCa.MethodsEvaluation was made of a total of 81 men who underwent transrectal ultrasound guided prostate biopsy for a definitive diagnosis due to high PSA levels. Patients were separated into 2 groups as BPH and PCa patients. Pre-biopsy malondialdehyde (MDA), superoxide dismutase (SOD), PSA levels and serum prolidase activities (SPA) were compared between the groups and the correlations of SPA with the other parameters were also investigated in both groups.ResultsBPH was diagnosed in 51 patients and PCa in 30. The mean age of patients was similar in both groups as 63.25u2009±u20095.81xa0years in the BPH group 65.30u2009±u20097.35xa0years in the PCa group(p:0.081). The median MDA and SOD levels were insignificantly increased in the PCa patients. SPA values were similar in BPH and PCa patients. SPA did not correlate with age, PSA, MDA or SOD levels in either group.ConclusionsOur study results revealed that serum prolidase activity is similar in BPH and PCa cases and is not correlated with MDA, SOD or PSA levels.