Comparative analysis of re-entry malecot and nelaton catheters after standard percutaneous nephrolithotomy in adult patients: a cross-sectional study.

Drainage catheters are used almost routinely to provide urinary drainage, prevent extravasation of urine, and create tamponade against bleeding after percutaneous nephrolithotomy (PNL). In the literature, there is no standardized approach to determining which type of catheter is superior. In this context, we aimed to comparatively analyze two different types of catheters (re-entry malecot catheter and nelaton catheter) in terms of success and complications, which we use for drainage after a PNL operation and which have very different costs. Patients who underwent PNL for kidney stones between January 2018 and October 2022 were included in the study. The data of a total of 148 patients who had a 16-F reentry malecot nephrostomy catheter or a 16-F nelaton catheter were analyzed. In addition to the demographic characteristics of the patients, stone characteristics, operative data, hospitalization time, analgesia requirement, hemoglobin exchange, amount of blood transfusion, and postoperative data (success and complications) were comparatively evaluated. The current unit price for a reentry malecot and a nelaton catheter is 4.7 United States dollars (USD) and 0.11 USD, respectively. There were a total of 148 patients in the study, 63 of whom were nelaton catheters and 85 were reentry malecots, and the mean age was 39.95 ± 13.28 years. There was no statistically significant difference between preoperative stone sizes and residual stone rates according to the groups. In addition, there was no statistically significant difference between the groups in terms of access site and stone localization. There was no significant difference between the groups in terms of complication rates according to the Clavien-Dindo classification, Hb levels, blood transfusion rates, operation times, or hospitalization times. In conclusion, if a second procedure is planned, a reentry malecot catheter may be preferred. Apart from this situation, nelaton catheters should be preferred because they are similar to reentry catheters in terms of effectiveness, and side effects and are more economical than reentry catheters in terms of cost.

Effects of knee prosthetic surgery on overactive bladder symptoms and incontinence in women.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) and overactive bladder (OAB) are common conditions worldwide. These conditions significantly affect the quality of life (QoL) of patients with limited mobility. Total knee arthroplasty (TKA) is one of the most commonly performed orthopedic procedures, resulting in pain relief, as well as improved function and QoL. This study was aimed at evaluating changes in patients' mobility as a result of TKA surgery and the effect of these changes on their OAB and UI symptoms. METHODS: A total of 49 female patients with stage IV osteoarthrosis were included in the study. The International Consultation on Incontinence Question-Short Form (ICIQ-SF), Overactive Bladder-Validated 8 (OAB-V8), Visual Analog Scale (VAS), and Oxford Knee Score (OKS) forms were completed pre-operatively and at the 6th post-operative month. Both knee flexion angles were measured, and the post-void residual urine volume (PVR) was recorded. RESULTS: A statistically significant (p<0.001) decrease was observed in the ICIQ-SF, VAS, OKS, and OAB-V8 scores in the post-operative period compared with the pre-operative values. No statistically significant change was detected in PVR (p=0.103). There was a statistically significant increase in the flexion angle (p<0.001). CONCLUSIONS: After knee arthroplasty, there was a noticeable improvement in the OAB symptoms and UI complaints of the patients. Therefore, we consider that increasing mobility after TKA will positively affect OAB/UI in female patients.

The Impact of COVID-19 Pandemic on Urological Emergencies, 8 Months Results of a Multicenter Retrospective Study From Turkey.

Objectives: We aimed to reveal the change of urological emergencies during the COVID-19 pandemic compared to the same period of the previous year. Methods: The number of admissions to the emergency department (ED), admissions to the urology outpatient clinic, emergency urological consultations, and urological and emergency urological surgeries during the periods April-November-2019 and April-November-2020 were recorded. The data of the COVID-19 period were compared with the previous year. Results: While the number of admissions to the urological outpatient clinic was 160,447 during the COVID period, it was 351,809 during the non-COVID period. The number of admissions to the ED decreased from 3.2 million to 2.4. The number of admissions to the urology outpatient clinic significantly decreased by 54% during the pandemic (p=0.001). Percutaneous cystostomy performed due to acute urinary obstruction decreased by 27.96%, double J stent, nephrostomy decreased by 16.61%, and ureterorenoscopy decreased by 12.26%. Urogenital trauma also decreased. On the contrary, surgical procedures performed due to penile fracture, gross hematuria, Fournier gangrene, and testicular torsion increased. Conclusion: During the COVID-19 pandemic, a significant decrease was observed in non-COVID patients' admissions to the emergency and urology department, and in urologic surgeries.

A survey analysis of knowledge levels of urologists about radiation safety and fluoroscopy use.

AIMS: To evaluate the awareness of the use of fluoroscopy in endourological procedures, as well as the theoretical and practical applications of preventive measures. MATERIAL AND METHOD: Between May 2018 and April 2019, a 26-question survey prepared using Google Docs was sent to urologists via email. Personal information, radiation training and behaviours related to radiation and fluoroscopy usage, and the use of protective equipment were queried. RESULTS: A total of 226 participants fully completed and returned the email survey. Of the 226 participants, 78 (34.5%) were academics, 44 (19.4%) were residents while 104 (46.1%) were experts. More than 60% of the participants stated that they participated in the operation requiring less than five fluoroscopy use per week. The majority of operations requiring fluoroscopy consisted of endourological procedures. The lead apron was used by 93% of the participants, but the use of protective glasses and gloves was very low (3.5%). The majority of academicians, experts and residents did not use dosimeters (76.9%, 82.7% and 81.8%, respectively). More than 50% of the participants did not have literature information about the harmful effects of radiation with the use of fluoroscopy. The most common complaints on the day of fluoroscopy were fatigue and headache. CONCLUSION: The lack of information regarding the radiation protection measures and harmful effects of radiation is common among urologists in Turkey. Therefore, systematic training programs on fluoroscopy use and radiation exposure should be provided during urology residency.

Efficacy and tolerability of mirabegron in female patients with overactive bladder symptoms after surgical treatment for stress urinary incontinence

ABSTRACT Purpose To evaluate the efficacy and tolerability of mirabegron in females with overactive bladder (OAB) symptoms after surgical treatment for stress urinary incontinence (SUI). Materials and Methods The study was conducted with a prospective, randomized and double-blinded design. 62 patients over the age of 40 who met the inclusion-exclusion criterias of the study were enrolled and randomly divided into two groups as Group A (mirabegron 50mg) and B (solifenacin 5mg). Patients were compared based on efficacy of treatment [Patient Perception of Bladder Condition (PPBC) scale and micturition diaries], safety of treatment (heart rate, systolic and diastolic blood pressure, adverse events), number of micturitions per day, patient's satisfaction status after treatment [Visual Analog Scale(VAS)] and quality of life. Results The mean age of the population was 48.2±3.8 years and the duration of OAB symptoms was 5.9±2.9 months. Baseline values for the mean number of micturitions, volume voided in each micturition, nocturia episodes, urgency and urgency incontinence episodes were 15.3±0.34, 128±3.88mL, 3.96±1.67, 5.72±1.35 and 4.22±0.69, respectively. After treatment, values for these parameters were 11.7±0.29, 164.7±2.9mL, 2.25±0.6, 3.38±0.71, 2.31±0.49 respectively. Quality of life score, symptom bother score, VAS for treatment satisfaction score, PPBC score after treatment were 66.1±0.85, 43.7±0.77, 4.78±0.14, 4.78±0.14, respectively. There were no significant differences between two groups on any parameter. However, mirabegron showed better tolerability than solifenacin, particularly after 6 months. Conclusion Mirabegron is safe, effective and tolerable in the long-term treatment of females with OAB symptoms after surgery for stress urinary incontinence.

Efficacy and tolerability of mirabegron in female patients with overactive bladder symptoms after surgical treatment for stress urinary incontinence.

PURPOSE: To evaluate the efficacy and tolerability of mirabegron in females with overactive bladder (OAB) symptoms after surgical treatment for stress urinary incontinence (SUI). MATERIALS AND METHODS: The study was conducted with a prospective, randomized and double-blinded design. 62 patients over the age of 40 who met the inclusion-exclusion criterias of the study were enrolled and randomly divided into two groups as Group A (mirabegron 50mg) and B (solifenacin 5mg). Patients were compared based on efficacy of treatment [Patient Perception of Bladder Condition (PPBC) scale and micturition diaries], safety of treatment (heart rate, systolic and diastolic blood pressure, adverse events), number of micturitions per day, patient's satisfaction status after treatment [Visual Analog Scale(VAS)] and quality of life. RESULTS: The mean age of the population was 48.2±3.8 years and the duration of OAB symptoms was 5.9±2.9 months. Baseline values for the mean number of micturitions, volume voided in each micturition, nocturia episodes, urgency and urgency incontinence episodes were 15.3±0.34, 128±3.88mL, 3.96±1.67, 5.72±1.35 and 4.22±0.69, respectively. After treatment, values for these parameters were 11.7±0.29, 164.7±2.9mL, 2.25±0.6, 3.38±0.71, 2.31±0.49 respectively. Quality of life score, symptom bother score, VAS for treatment satisfaction score, PPBC score after treatment were 66.1±0.85, 43.7±0.77, 4.78±0.14, 4.78±0.14, respectively. There were no significant differences between two groups on any parameter. However, mirabegron showed better tolerability than solifenacin, particularly after 6 months. CONCLUSION: Mirabegron is safe, effective and tolerable in the long-term treatment of females with OAB symptoms after surgery for stress urinary incontinence.

Do body mass index, hormone profile and testicular volume effect sperm retrieval rates of microsurgical sperm extraction in the patients with nonobstructive azoospermia?

OBJECTIVE: We aimed to evaluate the effect of body mass index (BMI), follicle stimulating hormone (FSH), and luteinizing hormone (LH) levels and the mean testicular volume on sperm retrieval rates in microsurgical sperm extraction (microTESE) in the patients with nonobstructive azoospermia (NOA). MATERIAL AND METHODS: The data of 282 infertile patients with NOA were analysed retrospectively. The patients with normal karyotype and no Y microdeletions were included in the study. The patients were classified according to their BMI scores and the medical history, physical examination and hormonal parameters were evaluated. The overall data were processed statistically with chi-square and logistic regression analysis and the relation between preoperative findings and sperm retrieval rates was investigated. RESULTS: The sperm retrieval rate of 282 patients after microTESE was found as 41.1%. There was no statistically significant difference in sperm retrieval rates among the subgroups classified according to BMI. FSH and LH levels and the mean testicular volume and pathologic findings were significantly correlated with sperm retrieval rates. CONCLUSION: Finally significant correlation was determined between sperm retrieval rates and FSH, and LH levels and testicular volumes but no statistically significant difference was found in sperm retrieval rates among BMI groups.