Oguz Ekmekcioglu

Prevalence of the Complaint of Ejaculating Prematurely and the Four Premature Ejaculation Syndromes: Results from the Turkish Society of Andrology Sexual Health Survey

INTRODUCTION In addition to the previously known lifelong and acquired premature ejaculation (PE) syndromes, the existence of two more PE syndromes has been suggested: natural variable PE and premature-like ejaculatory dysfunction. However, epidemiological studies investigating the prevalence of these four PE syndromes have yet to be conducted. AIM To determine the prevalence of the complaint of ejaculating prematurely across the four PE syndromes. METHODS This study, conducted between June 2009 and December 2009, was designed as a non-interventional, observational cross-sectional field survey. Participating couples were randomly selected from 17 provinces of Turkey. All participants were asked to complete a questionnaire including data regarding demographics, socioeconomic status, social and cultural factors, medical and sexual history, current medications, and ejaculation time. Subjects with a complaint of ejaculating prematurely were classified as lifelong, acquired, and natural variable PE, or premature-like ejaculatory dysfunction. MAIN OUTCOME MEASURES The main outcome measures were prevalence of complaint of ejaculating prematurely in the general population and across the four PE syndromes. RESULTS A total of 2,593 couples (mean age, 41.9±12.7 years for males and 38.2±12.1 years for females) were enrolled. Five-hundred twelve subjects (20.0%) complained of ejaculating prematurely. Fifty-eight (2.3%), 100 (3.9%), 215 (8.5%), and 131 (5.1%) subjects were classified as lifelong, acquired, and natural variable PE, and premature-like ejaculatory dysfunction, respectively. CONCLUSIONS The prevalence of the complaint of ejaculating prematurely among Turkish men was 20.0%, with the highest PE syndrome being natural variable PE (8.5%) and premature-like ejaculatory dysfunction (5.1%).

THE EFFECTS OF FLUOXETINE ON SEVERAL NEUROPHYSIOLOGICAL VARIABLES IN PATIENTS WITH PREMATURE EJACULATION

PURPOSE Fluoxetine, a selective serotonin re-uptake inhibitor, has been shown to increase the intravaginal latency of patients with premature ejaculation. We demonstrated the effects of fluoxetine on intravaginal latency, penile sensory threshold, and variables of sacral evoked response and cortical somatosensorial evoked potential in patients with premature ejaculation. MATERIALS AND METHODS Of 48 patients 40 who presented to our clinic with premature ejaculation met the study criteria, gave written or oral consent, and were divided randomly in a double-blind fashion into 2 groups of 20 patients. The study group received 20 mg. fluoxetine daily and the control group received placebo for 1 month. The patients were evaluated during visits before and after treatment for intravaginal latency, penile sensory threshold values, and the variables of sacral evoked response and cortical somatosensory evoked potential tests. RESULTS Patient ages, intravaginal latencies, penile sensory threshold values, and amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests in both groups were not significantly different at the beginning of treatment (p >0.05). At the end of treatment intravaginal latencies and penile sensory threshold values were increased in the study group compared to before treatment and the control group (p <0.05). No change was observed in either group for the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests (p >0.05). CONCLUSIONS These findings suggest that fluoxetine is effective treatment for premature ejaculation probably due to its effect of increasing the penile sensory threshold, without changing the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential.

Antioxidative Effect of Royal Jelly in Cisplatin-induced Testes Damage

OBJECTIVES To investigate the antioxidative effect of royal jelly on cisplatin (CP)-induced spermiotoxicity using quantitative, biochemical, and histopathologic approaches. METHODS CP was administered to rats at a single dose of 7 mg/kg i.p. Royal jelly was administered by gavage daily for 10 days at doses of 50 and 100 mg/kg. Traits of reproductive organs, such as sperm characteristics, testicular histologic findings, plasma testosterone levels, and testicular tissue oxidative stress status were determined. RESULTS Royal jelly ameliorated the CP-induced reductions in weights of testes, epididymides, seminal vesicles, and prostate along with epididymal sperm concentration and motility. An increase in testes malondialdehyde concentrations (P <.05) were detected, while significant decreases in superoxide dismutase, catalase, and glutathione-peroxidase levels were noted in CP-alone group compared with control group. The administration of royal jelly to CP-treated rats decreased the malondialdehyde level and increased superoxide dismutase, catalase, and glutathione-peroxidase activities in the samples. CONCLUSIONS The CP-induced changes in histopathologic findings of testis were partially reversed by treatment with royal jelly. The results provide further insight into the mechanisms of CP-induced sperm toxicity and confirm the antioxidant potential of royal jelly.

The protective effect of royal jelly against cisplatin-induced renal oxidative stress in rats

BackgroundThe aim of this study was to investigate the effects of royal jelly on cisplatin-induced nephrotoxicity and oxidative stress in rats.MethodsAdult male Wistar albino rats were randomly divided into eight groups: the control, cisplatin, royal jelly, and royal jelly plus cisplatin groups. Biochemical and histopathological methods were utilized for evaluation of the nephrotoxicity. Blood was collected and analyzed for blood urea nitrogen (BUN), alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol, uric acid, total bilirubin, and total protein levels. The kidney samples were stored for the measurement of malondialdehyde (MDA), glutathione peroxidase (GSHPx), superoxide dismutase (SOD), and catalase (CAT) activities and processed for histopathological examinations.ResultsAdministration of cisplatin to rats induced a marked renal failure, characterized with a significant increase in serum BUN and uric acid concentrations, and they had higher kidney MDA and lower GSH-Px, SOD, and CAT activities. In the groups that were administered RJ in association with CP, improvement was observed in some oxidative stress parameters and certain other biochemical parameters, pre-treatment with RJ being more effective.ConclusionsThe CP-induced changes in histopathologic findings of kidneys were partially reversed by treatment with royal jelly. The results provide further insight into the mechanisms of CP-induced nephrotoxicity and confirm the antioxidant potential of royal jelly.

Retroperitoneoscopic ureterolithotomy for the treatment of ureteral calculi.

Introduction: Most upper or middle ureteral stones are treated with shock wave lithotripsy or endoscopic techniques. In rare cases the ureteral stones are treated with open surgery after failure of first-line treatments. Retroperitoneoscopy is a minimally invasive alternative to open surgery. Patients and Methods: Between May 1995 and January 2001, twenty-one patients underwent retroperitoneoscopic ureterolithotomy. The stones in upper and middle ureter were large and impacted (5 patients) or not fragmented after shock wave lithotripsy (16 patients). A balloon dissector was placed and infiltrated with 800 ml air in the retroperitoneal space. Three 10-mm trocars were used. The pressure was kept at 15 mm Hg by carbon dioxide insufflation. The stones were extracted from the ureter using a laparoscopic stylet. Results: The stones in 17 patients were successfully removed in a median operating time of 105 (min–max 45–190) min. Urine extravasation in all cases and pnomoscrotum in 2 cases were observed as postoperative complications. The median hospital stay was 6 (min–max 3–22) days with minimal analgesic requirement. Conclusion: Retroperitoneoscopic ureterolithotomy is a useful and effective alternative treatment technique to open surgery when first-line treatments have failed or are unlikely to be effective.

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

Big bladder stones around an intravesical migrated intrauterine device

Spontaneous migration of the intrauterinedevices into the bladder and secondary stoneformation are rare complications. A 33-year-old women in whom a copper T intrauterinedevice had been placed two years previously, presented complaining of irritative lowerurinary tract symptoms. Intravesical migrationof intrauterine device and big stones around itwere confirmed by radiography and cystoscopy.The stones were fragmented by usingelectrohydraulic lithotriptor. And then allfragments of the stones and IUD werecystoscopically removed by a grasping forcepswithout any complication.

Can Neutrophil-Lymphocyte Ratio and Lymph Node Density Be Used as Prognostic Factors in Patients Undergoing Radical Cystectomy?

Objective. To assessment the role of preoperative neutrophil-lymphocyte ratio and postoperative lymph node density in predicting prognosis in patients undergoing radical cystectomy for bladder cancer. Material and Methods. Preoperatively, neutrophil and lymphocyte counts as well as neutrophil-lymphocyte ratios were recorded in 201 patients who underwent radical cystectomy for bladder cancer. Patients with an infection were excluded. Based on the pathology reports, the number of positive lymph nodes was divided by the total number of lymph nodes to calculate lymph node density. Results. The mean follow-up duration was 37.22 ± 35.922 months in patients without lymph node involvement and 27.75 ± 31.501 months in those with lymph node involvement (P = 0.015). Median lymph node density was 17% (4–80) in patients with lymph node involvement. There was no difference according to lymph node density lower than 17% and greater than 17% (P = 0.336). There was no significant difference between patients with an NLR below or above 2.5 in terms of overall survival (P = 0.702). Pathological T stage was associated with survival (P = 0.004). Conclusion. In patients undergoing RC for bladder cancer, lymph node density and preoperative NLR were not found to be independent predictors of prognosis.

Association of left varicocoele with height, body mass index and sperm counts in infertile men

The aim of this study was to evaluate interrelation of left varicocoele with height, body mass index (BMI) and sperm counts. We retrospectively evaluated the data of all patients who consulted for infertility at a tertiary academic referral centre from 2000 to 2010. Patients height, weight, BMI, semen analysis, presence or absence of varicocoele and varicocoele side and grade were evaluated. In statistical evaluations chi‐square, students t, Mann–Whitney U, anova and logistic regression analyses were performed. In anova analyses, Bonferroni post hoc test was performed when needed. The data of 1842 among 2780 men, presenting for infertility, were included in the study. There were 587 men (31.9%) with left varicocoele and 1255 (68.1%) men without varicocoele. Two hundred and seventy‐two men (14.8%) had grade I or II, and 315 men (17.1%) had grade III varicocoeles. Mean height was 174.3 ± 6.7 and 172.5 ± 7.0 cm in men with and without varicocoele respectively (p < 0.001). The mean BMI of cases without varicocoeles (25.8 kg/m2) was greater than varicocoele group (24.9 kg/m2) (p < 0.001). Percentage of varicocoele was the highest in moderately oligozoospermic males and significantly higher than the men with normal sperm count. As the height increased, the probability of having varicocoele increased, and the inverse is true for BMI. If varicocoeles are a progressive lesion, perhaps taller men with varicocoeles should be followed more closely to evaluate their fertility and androgenic status.

Does pleurodesis for pleural effusions give bright ideas about the agents for hydrocele sclerotherapy

Objective: Evaluation of the effectiveness of rifampicin and some agents used in the pleurodesis of pleural effusions, such as autologous blood and purified mineral talc.Patients and methods: A total of 56 hydroceles were treated by sclerotherapy, in a random fashion, using purified mineral talc, rifampicin and autologous blood as sclerosant agents. The control group of patients were handled with aspiration only.Results: The cohort of patients in the blood group had a success rate comparable to the control group (p > 0.05). the rifampicin group did better than both control and blood groups (p < 0.05) but not better than the talc group (p < 0.01). Success rate was highest in the talc group of patients who needed no re-sclerotherapy procedures.Conclusion: Purified mineral talc was shown to be potentially the best sclerosant for the sclerotherapy of hydroceles and epididymal cysts.