Fikret Halis

The effects of three phosphodiesterase type 5 inhibitors on ejaculation latency time in lifelong premature ejaculators: a double-blind laboratory setting study

Study Type – Therapy (RCT)
Level of Evidence 1b

Childhood Enuresis is Associated with Shorter Intravaginal Ejaculatory Latency Time in Healthy Men

PURPOSE In our previous study we showed that there was a significant increase in the prevalence of monosymptomatic enuresis among lifelong premature ejaculators. In this study we compared the intravaginal ejaculatory latency time of men with and without a history of monosymptomatic enuresis, and determined the association between the severity and duration of monosymptomatic enuresis and intravaginal ejaculatory latency time in healthy men. MATERIALS AND METHODS Between March and September 2012 we designed a prospective study in 49 healthy men who had a history of monosymptomatic enuresis and in age matched 49 control cases without a history of monosymptomatic enuresis. All subjects were asked about their history of monosymptomatic enuresis. Each subject was then evaluated using the premature ejaculation diagnostic tool and asked to measure their intravaginal ejaculatory latency times with their female sexual partner using a calibrated stopwatch. RESULTS Men with a history of monosymptomatic enuresis and control cases had a mean age of 33.6 (SD 4.7, range 25 to 43) and 33.8 (SD 5.4, range 25 to 48) years, respectively (p = 0.97). Mean/median intravaginal ejaculatory latency times of men with and without a history of monosymptomatic enuresis were 196.9/126.2 and 426.6/343.2 seconds, respectively (p <0.001). Mean/median premature ejaculation diagnostic tool scores of men with and without a history of monosymptomatic enuresis were 7.1/6 and 2.3/2, respectively (p <0.001). In correlation matrix analysis, intravaginal ejaculatory latency times and premature ejaculation diagnostic tool scores were correlated significantly with monosymptomatic enuresis history, duration and severity (p <0.001). CONCLUSIONS We found that intravaginal ejaculatory latency time in men with a history of monosymptomatic enuresis is significantly shorter than that of controls. We have also shown that there is a strong negative correlation between having a history of monosymptomatic enuresis and intravaginal ejaculatory latency time.

Value of preoperative stone scoring systems in predicting the results of percutaneous nephrolithotomy.

Introduction Guys Stone Score and S.T.O.N.E. Nephrolithometry nomograms have been introduced for systematic and quantitative assessment of kidney stones. The aim of this study was to reveal the value of two scorings systems, Guy and S.T.O.N.E, most frequently used for predicting postoperative stone-free status prior to Percutaneous Nephrolithotomy (PCNL), in the prediction of postoperative results of PCNL. Material and methods We retrospectively examined patients who underwent PCNL. Preoperative abdominopelvic computerized tomography images of these patients were reviewed and scored according to the Guy and S.T.O.N.E. systems. The relationship between the Guy and S.T.O.N.E. scores, and their postoperative stone-free status, complications based on Clavien system, operation time, fluoroscopy time and period of hospitalization was compared. Results We identified a total of 102 patients who underwent PCNL between 2010 and 2014, having met the inclusion criteria. The relationships between the total S.T.O.N.E score and Clavien score (p <0.001); time of operation (p = 0.012) and stone-free status (p <0.001); Guy stone score and Clavien score (p <0.001); and period of hospitalization (p <0.001) and time of operation (p <0.001) were found to be statistically significant. There was no statistically significant relationship between Guy score and stone-free status and no statistically significant relationship was found between fluoroscopy time and both stone scoring systems. Conclusions Guy and S.T.O.N.E. scoring systems may be used as effective instruments particularly for predicting postoperative complications.

The effects of phosphodiesterase type 5 inhibitors on penile rigidity variables during a period with no sexual stimulation: a laboratory setting double‐blind study

Study Type – Therapy (RCT)
Level of Evidence 1b

Flouroscopy-free technique is safe and feasible in retrograde intrarenal surgery for renal stones

OBJECTIVE The aim of this study was to present outcomes of our patients who had undergone retrograde intrarenal surgery (RIRS) with fluoroscopy-free technique and evaluate the efficacy and safety of the technique. MATERIAL AND METHODS Between January 2013 and June 2015 the outcomes of 93 patients who had undergone RIRS with fluoroscopy-free technique were retrospectively evaluated. Our RIRS technique involved preoperative assessment of ureter by semi-rigid ureteroscope, inserting guidewire through semi-rigid ureteroscope, inserting ureteral access sheath over the guidewire with the visiual guidance of semi-rigid ureteroscope, passing flexible ureteroscope through the sheath, dusting the stone with holmium laser, rechecking the ureter with semi-rigid ureteroscope and inserting double J stent through semi-rigid ureteroscope. Low-dose computerized tomography scan was performed to all patients in postoperative first month and the results were classified as stone-free (absence of any fragment), clinically insignificant residual fragments (CIRF) (≤4 mm) and residual stone. RESULTS Study population consisted of 62 (66.6%) male and 31 (33.3%) female patients with a mean age of 47.8±14 (range 14-93) years. Mean stone size was 14.7±5 (7-32) mm. Median operative time was 72 (30-125) minutes. Stone-free rate was achieved in 65 (69.9%) patients while CIRF was achieved in 13 (13.9%) and residual stones were detected in 15 (16.1%) patients. Five patients (5.37%) had minor complications, including hematuria and fever. No major complications were observed. CONCLUSION Fluoroscopy-free technique is effective and safe technique in management of renal stone. Furthermore fluoroscopy-free technique can protect the surgeon from the negative effects of radiation.

Effect of the Oxidant-Antioxidant System in Seminal Plasma on Varicocele and Idiopathic Infertility in Male Humans

BACKGROUND The aim of this study was to investigate seminal oxidant-antioxidant activity in idiopathic and varicocele infertility in men. METHODS Total anti-oxidant capacity (TAC), total oxidant status (TOS), paraoxonase (PON1), aryl esterase (ARE), and total thiol levels (TTL) were measured in seminal plasma with an autoanalyzer. The TOS/TAC ratio was determined as the oxidative stress index (OSI). A histopathological evaluation of the sperm was performed in the andrology laboratory of the hospital. Number, motility, morphology, volume, pH, and leukocytes were evaluated in all samples according to World Health Organization criteria. The three study groups were as follows: G1, males with idiopathic infertility; G2, males with varicocele infertility; and G3, normal healthy males (had fathered a child in the last 2 years). Each group was composed of 36 men (age, 25 - 40 years). The Rel Assay Diagnostics kit was used to determine the levels of the parameters. The study was conducted according to the principles of the declaration of Helsinki and was approved by Sakarya University Medicine Faculty Ethic Committee (e.n: 16214662/050.01.04/07). Statistical significance was assumed if p < 0.05. All statistical evaluations were performed using SPSS (version 20.0 for Windows; SPSS, Inc., Chicago, IL, USA). RESULTS No differences were detected between the mean values of antioxidant parameters among the three groups (Kruskal-Wallis test). The p-values of the test parameters (TAC, TOS, PON1, ARE, TTL, OSI) are respectively: 0.494, 0.548, 0.068, 0.151, 0.202, 0.873. The antioxidant parameters of all subjects were compared using the MannWhitney U-test in both groups as fertile (G3) and infertile (G1 + G2). The PON1 levels in infertile subjects were significantly higher than those in fertile subjects. There was a statistically significant difference (p = 0.042). The other antioxidant parameters had no statistically significant difference (p > 0.05). The ARE was not performed in group 3 (control) due to a methodological problem. CONCLUSIONS PON1 levels in infertile subjects were significantly higher than those of fertile subjects.

Intrathoracic Kidney after Blunt Abdominal Trauma: A Case Report and Review of the Literature

Abdominal trauma is responsible for most genitourinary injuries. The incidence of renal artery injury and intrathoracic kidney is quite low in patients who present with blunt trauma experiencing damage. There are four defined etiologies for intrathoracic kidney, which include real intrathoracic ectopic kidney, eventration of the diaphragm, congenital diaphragmatic herniation, and traumatic diaphragmatic rupture. The traumatic intrathoracic kidney is an extremely rare case. We presented intrathoracic kidney case after traumatic posterior diaphragmatic rupture.