Ilker Sen

The impact of urinary incontinence on female sexual function

Although urinary incontinence is not a life-threatening disorder, it has been shown to have detrimental effects on quality of life in terms of psychological, social, and sexual problems. In this study, investigators explored the effects of different types of urinary incontinence on female sexual function with a reliable and validated questionnaire, the Female Sexual Function Index (FSFI). One hundred fifty-three women with complaints of incontinence were enrolled in the study. An age-matched group of 89 women who had no incontinence or lower urinary tract disorders were enrolled as a control group; all completed the FSFI. Incontinence was classified as urge, stress, and mixed type. Pelvic organ prolapse (POP), if present, was also recorded. FSFI scores were compared between the incontinent and control groups. A multivariate linear regression analysis model was used to explore the effects of patient characteristics on total FSFI domain score. All domain scores of FSFI except lubrication and pain were statistically significant in the incontinence group (for total domain score, P=.005). For FSFI, in terms of types of incontinence, the difference was significant when the group with mixed urinary incontinence was compared with the control group. In multivariate linear regression analysis, age, presence of POP, and mode of delivery were predictors of female sexual function. Mixed urinary incontinence, when compared with other types, had a significant impact on sexual function. When POP was also present, no negative effects were noted in incontinent women.

Evaluation of Sexual Function in Women with Overactive Bladder Syndrome

Introduction: Of late, little data is available concerning factors affecting female sexual function. In the present study, we evaluated the effects of overactive bladder (OAB) syndrome symptoms on female sexual function. Materials and Methods: 40 patients with OAB symptoms and 40 age-matched women as a control group were evaluated using the Female Sexual Function Index (FSFI) for sexual function. According to the presence of urge incontinence, women with OAB were also divided into wet and dry groups. After completion of the forms, groups were compared. Results: Although scores of all domains of FSFI (desire, arousal, lubrication, orgasm, satisfaction, pain and total) in the OAB group were found to be lower than in the control group, only ‘desire’ was found to be significantly different (p = 0.035). The FSFI scores of the OAB-dry and OAB-wet group were similar to each other. Conclusion: The results indicate that there is a trend toward lower sexual function scores in women with OAB compared to controls.

RENAL BRUCELLOMA: A RARE INFECTION OF THE KIDNEY

Abstract  We report a case of renal abscess caused by brucellosis (renal brucelloma) which was treated by surgery. Renal parenchymal involvement of systemic brucellosis is a very rare condition and relapses after medical treatment, such as solid organ abscess including kidney, should be especially considered. In chronic cases, laboratory findings including polymerase chain‐reaction examination is needed for definitive diagnosis.

Renal Tissue Damage After Experimental Pyelonephritis: Role of Antioxidants and Selective Cyclooxygenase-2 Inhibitors

OBJECTIVES To investigate the involvement of oxidative stress in the pathogenesis of acute pyelonephritis, and to evaluate the impact of meloxicam and/or L-carnitine in addition to conventional antibiotic treatment. METHODS A total of 48 Wistar rats were divided into 4 groups according to their treatment, which was started 1 day after inoculation of all rats with Escherichia coli (ATCC 25 922, 10(10) cfu/mL). Group 1 received only antibiotic treatment with ceftriaxone (50 mg/kg, IM). Groups 2 and 3 received L-carnitine (500 mg/kg, IM) and meloxicam (3 mg/kg, IM) in addition to conventional treatment, respectively. Group 4 received combination therapy (L-carnitine and meloxicam) in addition to the first group. Rats were killed 3 and 7 days after E. coli inoculation and underwent nephrectomy. Histologic determination of tubular atrophy, acute and chronic inflammation, interstitial fibrosis and biochemical determination of superoxide dismutase and catalase activity, total thiol content, total antioxidant capacity, and malondialdehyde and protein hydroperoxide levels were measured. RESULTS Interstitial fibrosis (P = .06), chronic inflammation (P = .536), and tubular atrophy (P = 0.094) decreased in group 4 compared with the other groups, but there was a statistically significant decrease only in acute inflammation (P = .015). In addition, if the day of nephrectomy is considered, there was again a significant decrease in acute inflammation on day 7 compared with day 3 in groups 2, 3, and 4 (P = .002). Catalase significantly increased in group 2 (P = .029), group 3 (P = .02), and group 4 (P = .014), and decreased in group 1 (P = .012) in day 7. CONCLUSIONS L-carnitine and meloxicam alleviated oxidative stress, probably by decreasing lipid peroxidation and enforcing antioxidant defense system. Acute renal inflammatory injury can be prevented much more effectively by combination therapy rather than by conventional therapy alone.

A HindIII polymorphism of fibronectin gene is associated with nephrolithiasis.

OBJECTIVES To evaluate the association between fibronectin gene (FN1) polymorphisms and calcium oxalate nephrolithiasis as a genetic risk factor. METHODS Genomic DNA of 143 patients with calcium oxalate nephrolithiasis and 154 healthy controls were screened for polymorphisms (HaeIII b, MspI, and HindIII) of the FN1 gene, using polymerase chain reaction-restriction fragments length polymorphism method. Allele and genotype frequencies were compared between the groups. RESULTS Although the observed differences between distribution of genotypes of AA, AB, and BB (for HaeIII b), as well as CC, CD, and DD (MspI) were not significant, FF genotype for HindIII showed significant difference when compared with both EF and EE + EF genotype (P = .00202 and P = .00203, respectively). CONCLUSIONS The results of our study revealed that HindIII polymorphism of the FN1 gene is highly associated with calcium oxalate stone disease. This association makes FN a good candidate for further studies about the etiology of stone disease, and in the future it could be a candidate marker for evaluating the genetic risks in patients with nephrolithiasis.

False Positive 18F-FDG PET Scan in Adrenal Oncocytoma

18F-FDG whole-body positron emulsion tomography (18F-FDG PET) has become an established imaging modality for a variety of cancers. Today, 18F-FDG PET is utilized to differentiate benign from malignant non-functioning adrenal masses. In this report, a 25-year-old woman presented with a 2-month history of left flank pain. Abdominal CT revealed a left 6.5 × 4.5 cm adrenal mass with regular margins and focal calcification. To make a differential diagnosis, 18F-FDG PET was performed. Preoperative laboratory studies showed that the mass was non-functioning. A left adrenalectomy was performed through a left subcostal incision. The final pathologic evaluation revealed adrenal oncocytoma. We present the disassociation between preoperative 18F-FDG PET and pathologic findings of a benign adrenocortical oncocytoma.

Prolapse of a simple ureterocele presenting as a vulval mass in a woman

Abstract  A 48‐year‐old woman presented with a large vulval mass after prolapse of a ureterocele. Her past excretory urogram showed a filling defect (cobra head appearance) in the bladder related to a single‐system ureterocele on the left. The mass was manually reduced back through to the urethra under sedation and a urethral catheter was inserted. The anterior wall of the ureterocele was resected transurethrally for definitive treatment.

Papillary adenoma of the prostatic urethra: Report of two cases

Abstract Papillary adenoma of the prostatic urethra is a rare cause of hematuria, hemospermia and lower urinary tract obstruction, especially in young adults. We report two cases of papillary adenoma and their endoscopic views. One of the patients had a lesion located on the verumontanum and presented with hematuria, hemospermia and symptoms of lower urinary tract obstruction. The other patient had papillary lesions located in the paramontanal gutter and presented with persistent painless hematuria. The origin of both lesions was proven to be prostatic epithelial differentiation using immunohistochemical identification of prostate‐specific antigen. Papillary adenoma is believed to be benign, therefore, both lesions were carefully excised and fulgurated transurethrally.

Simple dorsal plication near the 12 o’clock position for the correction of congenital ventral penile curvature

Abstract  Fourteen patients with congenital penile curvature without hypospadias were treated with a modified Essed dorsal plication method between 1998 and 2002 in our clinic. Patient age ranged between 20 and 25 years (mean 22.2). Eight cases (57.1%) had ventral curvature only and six had an additional lateral curvature. There were no significant postoperative complications. One (7.1%) patient had early suture breakage on the 21st postoperative day during erection and underwent re‐operation after 9 months. After a mean follow‐up period of 23.2 months (range 3–46) all patients were satisfied with the procedure except for one patient (7.1%) who had a residual curvature of 20°. Four cases (28.6%) had minimal shortening of the penis. The overall satisfaction rate with the procedure was 93%. Simple dorsal plication near the 12 o’clock position is a minimally invasive and effective method for the treatment of congenital ventral penile curvature.