Mentalization and emotion regulation abilities in parents of children with nocturnal enuresis and its relationship with perceived caregiver burden.

OBJECTIVE: Various psychological factors play a role in the development of nocturnal enuresis (NE) which causes significant distress both on children and their parents. However, current studies cannot attribute a role to the psychiatric conditions that cause or result from NE. This study aims to reveal some psychiatric parameters related to the parents of patients with NE which may play a role in the etiopathogenesis of NE. METHODS: Seventy-nine parents of primary 53 NE children and 78 parents of 44 healthy children were enrolled to the study. Parents of children with daytime voiding symptoms, additional comorbidity, or secondary enuresis were excluded from the study. Age- and sex-matched parents of healthy children with the absence of voiding symptoms were included as the control group. Parental Reflective Functioning (RF) Questionnaire, Interpersonal Emotion Regulation (ER) Questionnaire, and Zarit Caregiver Burden Scale were recorded to measure psychiatric conditions. RESULTS: Parents of children with NE showed significantly poorer RF and ER abilities compared to the control group. Moreover, the perceived caregiver burden was also significantly higher in parents of NE patients. Correlation analyses also showed that RF and ER are negatively correlated with caregiver burden. CONCLUSION: This study revealed that the parents of primary NE patients may have difficulty mentalizing and ER in interpersonal relationships. These difficulties may be a cause or a consequence of the NE. In addition, our findings showed that parents of NE patients perceive more caregiving burden. Therefore, it may be advisable for parents of NE patients to seek psychological counseling.

Value of neutrophil-to-lymphocyte ratio in predicting surgical intervention for hydronephrosis during pregnancy.

BACKGROUND: We aimed to examine the hematological parameters of pregnant patients with ureteral stones that require intervention. METHODS: Medical data of patients presenting to urology department between October 2018 and December 2020 were retrospectively analyzed. Patients with flank pain associated with hydronephrosis were included in the study and divided into two groups according to whether an intervention was performed or not (Group-1, Group-2). Ureterorenoscopy (URS) or ureteral stent placement was performed as intervention. Demographic data, complete blood count (CBC), urine analysis, and ultrasonographic findings were collected. Gestational age (week), number of pregnancies, maternal age (years), Anteroposterior pelvis diameter (mm), VAS (Visual Analog Scale) (range 1-10) and mean platelet volume (MPV) were collected from the patient file. Inflammatory markers including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were computed. RESULTS: About 35 patients were included in Group-1 and 52 patients in Group-2. Ureterorenoscopy was performed in 21/35 (60%) patients, and ureteral stents were placed in 14/35 (40%) patients. None of the patients experienced complications. There was no statistical difference between these two groups in terms of maternal age, gestational age, number of pregnancies, pelvis diameter, PLR, and MPV. VAS and NLR were statistically higher in group-1 (p < 0.05). According to the Receiver operating characteristic curve analysis performed for the prediction of ureteral stone presence, the best cut-off point for the NLR 4.153 (sensitivity 80%, specificity 80.6%, area under curve (AUC): 0.824). CONCLUSIONS: We think that NLR can be used to determine the group that needs to be intervented due to ureteral stones in patients with symptomatic hydronephrosis during pregnancy.

Insecure attachment and its relationship with negative self perception in children with nocturnal enuresis.

BACKGROUND: Nocturnal Enuresis (NE) is considered as a multifactorial condition with a specific focus on psychological functioning regarding etiology. Various studies show that children with NE suffer from different types of self-esteem problems and insecure attachment styles. Nevertheless the relationship between these two psychological functions has not been adequately studied. OBJECTIVE: Main objective of the current study is to evaluate self-perception and attachment profiles of enuretic children in relation with various sociodemographic parameters. DESIGN: 41 children with nocturnal enuresis and 40 age and sex matched healthy controls were compared in means of attachment using Kern's Security Scale and self-perception using Self-Perception Profile for Children measures. RESULTS: Our results show that enuretic children suffer significantly more insecure attachment styles and negative self perception issues. Moreover enuretic children varied from healthy controls in means of number of siblings and birth rank. DISCUSSION: Current study suggests that enuretic children should be evaluated for possible psychological difficulties like insecure attachment and self-esteem issues and proper interventions in these areas should be considered. Lower self-esteem as a well-known phenomenon in enuresis research may be addressed in relation with insecure attachment. Nevertheless our study have certain limitation; the possible psychiatric comorbidities from both study groups were excluded only with anamneses. Further the male dominance of the gender of the participants can be seen as a limitation. CONCLUSION: The possible relationship between negative self perception and insecure attachment may serve as an important focus in means of etiology and interventions in NE.

Sperm concentration and semen volume increase after smoking cessation in infertile men.

Smoking has negative reproductive consequences. This study investigated the effect of smoking cessation on the main semen parameters. We included 90 participants who applied to our infertility clinic and smoked at least 20 cigarettes a day for at least 1 year. Of the 90 participants, 48 were in the study group and 42 were in the control group. Semen analysis was performed before and at least 3 months after quitting smoking in the study group. Semen analysis was repeated at baseline and at least 3 months later in the control group. Semen parameters such as volume, sperm concentration, total sperm count, morphology, and motility were evaluated according to the World Health Organization criteria. Patient characteristics as well as the duration of the smoking period, the number of cigarettes smoked per day and the time elapsed since smoking cessation were recorded. The mean age of the participants was 34.69 ± 5.3 years, and the duration of infertility was 34.12 ± 12.1 months (n = 90). The number of cigarettes smoked per day was 30.14 ± 6.69, and the smoking time was 8.31 ± 3.53 years. The average time to quit smoking was 104.2 ± 11.51 days (n = 48). A significant increase in semen volume, sperm concentration and total sperm count was observed 3 months after smoking cessation (2.48 ± 0.79 ml vs. 2.90 ± 0.77 ml, p = 0.002; 18.45 × 106/ml ± 8.56 vs. 22.64 × 106/ml ± 11.69, p = 0.001; 45.04 ± 24.38 × 106 vs. 65.1 ± 34.9 × 106, p < 0.001, respectively). This study showed that smoking cessation had a positive effect on sperm concentration, semen volume, and total sperm count. Although smoking cessation contributed positively to sperm motility and morphology, the difference was not statistically significant.

The efficacy and reliability of VI-RADS in determining candidates for repeated transurethral resection in patients with high-risk non-muscle invasive bladder cancer.

OBJECTIVE: Our study aims to evaluate the efficiency and reliability of Vesical Imaging Reporting Data System (VI-RADS) in prospectively identifying the patients to undergo RE-TURBT in the management of patients with high-risk non-muscle invasive Bladder Cancer(HR-NMIBC).The secondary objective was to evaluate the performance of the VI-RADS scoring system in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle invasive bladder cancer(NMIBC) prospectively. METHODS: The study included 330 patients who underwent transurethral resection of bladder tumour(TURBT) for Bladder Cancer (BC) in our clinic. All patients underwent multiparametric-magnetic resonance imaging (Mp-MRI) before the operation and VI-RADS scoring was administered. The cut-off value of VI-RADS was accepted as three and above. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the differentiation between NMIBC and MIBC distinction in all patients. Receiver operating characteristic (ROC) analysis was performed to evaluate the performance of the VI-RADS scoring system. In the second phase of the study, patients with MIBC and low-risk NMIBC (LR-NMBIC) were excluded and 158 patients with HR-NMIBC were included, and their sensitivity, specificity, PPV and NPV values were measured. ROC analysis was performed. RESULTS: In all patients, sensitivity, specificity, PPV and NPV values of the VI-RADS scoring in the differentiation of MIBC and NMIBC were 91.3, 91.8, 81.7 and 96.3 respectively. The AUC value was 0.934 (95%CI: 0.903-0.964). Sensitivity, specificity, PPV and NPV values were found to be 87, 91.8, 74.1, 95.2 in the evaluation specifically made for patients with HR-NMIBC. The AUC value was 0.900 (95% CI:0.843-0.957). Inter-reader agreement was excellent (Ƙ = 0.90, 95% CI:0.71-0.95). CONCLUSIONS: The VI-RADS scoring system is an effective and reliable method in determining the patients who will undergo RE-TURBT and in differentiating MIBC and NMIBC.

The correlation between atherogenic indexes and erectile dysfunction.

Aside from the ordinary plasma lipid level measurements, the ratios based on individual plasma lipid levels such as atherogenic index of plasma (AIP), Castelli's risk index 1/2 (CRI-1/2), and atherogenic coefficient (AC) are the novel parameters to evaluate the patients with a high risk of CVD. In this study, we aim to evaluate the relationship between AIP, AC, and CRI-1/2 with increased risk of ED. Between April 2018 and February 2019, 253 patients, who were diagnosed as a vasculogenic ED in our clinic, were enrolled in the study. While the first group (n = 134) consisted of patients with moderate and mild ED (IIEF-EF: 17-30), the second group (n = 119) consisted of patients with severe ED. In addition to the mean values of lipid parameters; CRI-1 (total cholesterol/HDL), CRI-2 (LDL/HDL) AIP (log10(triglycerides/HDL), and AC (non-HDL/HDL) were calculated. The mean age was 44.02 ± 10.41 (24-70), and the mean BMI was 27.80 ± 4.12 (18.52 ± 41.97). However, CRI-1 and AIP values were found to be higher in the severe ED group compared to the mild ED group (CRI-1: 4.50 ± 1.47, 4.88 ± 1.30; p = .039; AIP: 0.489 ± 0.315, 0.617 ± 0.283; p = .007). Our results demonstrated that CR-1 and AIP have a positive correlation with the severity of ED. Moreover, we can suggest that patients with higher CR-1 and AIP values are likely to have more severe ED in the future.

Turkish validation of the overactive bladder symptom score (OABSS) and evaluation of mirabegron treatment response.

INTRODUCTION AND HYPOTHESIS: Overactive bladder (OAB) is a syndrome with symptoms such as urinary frequency, urinary urgency and urge incontinence. The aim of this study is to assess the validity and reliability of the Turkish overactive bladder symptom score (OABSS) and to evaluate the results of mirabegron treatment with OABSS. METHODS: The study was carried out with 117 patients who applied to the urology outpatient clinic between June 2018-January 2019. OABSS Turkish validation was developed from the English version. Demographic data of the patients were recorded. The OABSS, overactive bladder questionnaire (OAB-v8) and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were filled out by the patients. The patients were asked to fill in these questionnaires after 2 weeks. Patients receiving mirabegon treatment were evaluated with the same questionnaires and bladder diaries after 8 weeks. RESULTS: A total of 117 OAB patients, including 82 OAB-wet and 35-OAB dry, were included in the study. The mean age of the patients was 46.79 ± 14.26 (18-78) years, and the mean duration of OAB complaint was 32.28 ± 32.21 months. The mean score of the OABSS is 9.9 ± 3.14. The results of the reliability assessment showed that the intraclass correlation coefficient of the total OABSS score was 0.71 (weighted coefficients of individual item points, 0.635-0.831), and the Cronbach α was 0.736. In the validity analysis, the OABSS total score was highly correlated with that belonging to other questionnaire forms (OAB-v8, ICIQ-SF and bladder diary). After the treatment with mirabegron, mean OABSS scores of the patients improved significantly from baseline to the 8th week (p < 0.001). CONCLUSION: The Turkish version of the OABSS has been approved as a valid and reliable tool for evaluating OAB. Mirabegron used daily improved the symptoms of OAB in patients.

Stone volume measuring methods: Should the CT based three-dimensional-reconstructed algorithm be proposed as the gold standard? What did the three-dimensional printed models show us? / Métodos de medida del volumen del cálculo: ¿Debería proponerse el algoritmo de reconstrucción 3D basado en TAC como el patrón de referencia? ¿Qué nos han enseñado los modelos de impresión 3D?

OBJECTIVES: We researched to detect the optimal method for evaluating stone volume, by comparing the ellipsoid formula and 3D reconstructed volume to gold standard of water displacement volume using 3D printed models. METHODS: We retrospectively analyzed out patient database and evaluated 27 patients who had percutaneous nephrolithotripsy. From the DICOM data of patient's preoperative CT images, stone structures were obtained using an image identification system. All DICOM files were saved in the stereolithography file format and a 3D printed model was created. True stone volume was found by water displacement method using this model and this volume compared with ellipsoid formula and 3D-reconstructed volume. RESULTS: Stone volume on water displacement ranged from 0.38-29.8cm3 with a median of 17.5cm3, stone volume on ellipsoid formula ranged from 0.46-34.7cm3 with a median of 19.6cm3 and stone volume on CT based 3D-reconstructed ranged from 0.48-31.8cm3 with a median of 18.9cm3. There was a significant difference between ellipsoid formula and water displacement ( p <   0.0001 ); however, there was no difference between 3D-reconstructed volume and water displacement ( p = 0.051 ). CONCLUSION: Stone volume calculation using CT based 3D-reconstructed algorithm improves the accuracy of stone volume estimation and this measurement is superior to ellipsoid formula.

OBJETIVOS: Realizamos una investigación para detectar el método óptimo de evaluación del volumen del cálculo comparando la fórmula del elipsoide y la reconstrucción 3D del volumen con el patrón de referencia, el volumen de agua desplazado utilizando modelos de impresión 3D. MÉTODOS: Analizamos retrospectivamente la base de datos de pacientes y evaluamos 27 que fueron sometidos a nefrolitotricia percutánea. Desde los datos del DICOM de las imágenes del TAC preoperatorio se obtuvieron las estructuras de los cálculos utilizando un sistema de identificación de imagen. Todos los archivos DICOM fueron guardados en un formato estereolitográfico y se creó un modelo 3D impreso. El volumen verdadero de la litiasis fue hallado mediante el método del desplazamiento de agua utilizando este modelo y se comparó con la fórmula del elipsoide y el volumen de reconstrucción 3D. RESULTADOS: El volumen del cálculo con el desplazamiento de agua osciló entre 0,38-29,8 cm3 con una mediana de 17,5 cm3. Con la fórmula del elipsoide, el volumen tenía un rango entre 0,46-34,7 cm3 con una mediana de 19,6 cm3 y con la reconstrucción 3D basada en TAC el rango fue de 0,48-31,8 cm3 con una mediana de 19,6 cm3. Había una diferencia significativa entre la fórmula del elipsoide y el desplazamiento de agua ( p < 0,0001 ); sin embargo, no había diferencias entre el volumen por reconstrucción 3D y el desplazamiento de agua ( p = 0,051 ). CONCLUSION: El cálculo del volumen de la litiasis utilizando algoritmos de reconstrucción 3D basada en TAC mejora la precisión de la estimación del volumen de la litiasis y esta medida es superior a la fórmula del elipsoide.

Low serum vitamin D is associated with an increased likelihood of acquired premature ejaculation

Abstract Purpose: To investigate the relationship between 25-hydroxyvitamin D (25 (OH) D) levels and acquired premature ejaculation (PE). Materials and Methods: A total of 97 patients with acquired PE and 64 healthy men as a control group selected from volunteers without PE attending our Andrology Outpatient Clinic between November 2016 and April 2017 were included the study. All patients were considered to have acquired PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine Committee. Premature ejaculation diagnostic tool questionnaires were used to assessment of PE and all participants were instructed to record intravaginal ejaculatory latency time. Vitamin D levels were evaluated in all participants using high performance liquid chromatography method included in the study. Results: Compared to men without PE, the patients with acquired PE had significantly lower 25 (OH) D levels (12.0 ± 4.5 ng/mL vs. 18.2 ± 7.4 ng/mL, p < 0.001). In the logistic regression analysis, 25 (OH) D was found to be an independent risk factor for acquired PE, with estimated odds ratios (95% CI) of 0.639 (0.460-0.887, p = 0.007) and the area under curve of the ROC curve of 25 (OH) D diagnosing acquired PE was 0.770 (95% CI: 0.695 to 0.844, p < 0.001). The best cut-off value was 16 ng/mL with a sensitivity of 60.9%, specificity of 83.5%, PPV of 70.9%, and NPV of 76.4% to indicate acquired PE. Conclusions: This study demonstrates that lower vitamin D levels are associated with the acquired PE. The result of our study showed that the role of serum vitamin D levels should be investigate in the etiology of acquired PE. Perhaps supplementation of vitamin D in men with acquired PE will ameliorate the sexual health of these patients.

Low serum vitamin D is associated with an increased likelihood of acquired premature ejaculation.

PURPOSE: To investigate the relationship between 25-hydroxyvitamin D (25 (OH) D) levels and acquired premature ejaculation (PE). MATERIALS AND METHODS: A total of 97 patients with acquired PE and 64 healthy men as a control group selected from volunteers without PE attending our Andrology Outpatient Clinic between November 2016 and April 2017 were included the study. All patients were considered to have acquired PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine Committee. Premature ejaculation diagnostic tool questionnaires were used to assessment of PE and all participants were instructed to record intravaginal ejaculatory latency time. Vitamin D levels were evaluated in all participants using high performance liquid chromatography method included in the study. RESULTS: Compared to men without PE, the patients with acquired PE had significantly lower 25 (OH) D levels (12.0 ± 4.5 ng/mL vs. 18.2 ± 7.4 ng/mL, p < 0.001). In the logistic regression analysis, 25 (OH) D was found to be an independent risk factor for acquired PE, with estimated odds ratios (95% CI) of 0.639 (0.460-0.887, p = 0.007) and the area under curve of the ROC curve of 25 (OH) D diagnosing acquired PE was 0.770 (95% CI: 0.695 to 0.844, p < 0.001). The best cut-off value was 16 ng/mL with a sensitivity of 60.9%, specificity of 83.5%, PPV of 70.9%, and NPV of 76.4% to indicate acquired PE. CONCLUSIONS: This study demonstrates that lower vitamin D levels are associated with the acquired PE. The result of our study showed that the role of serum vitamin D levels should be investigate in the etiology of acquired PE. Perhaps supplementation of vitamin D in men with acquired PE will ameliorate the sexual health of these patients.

The effect of overactive bladder treatment with anticholinergics on female sexual function in women: a prospective observational study.

PURPOSE: The aim of the study was to determine the effect of anticholinergics used for overactive bladder treatment on the sexual function of women. METHODS: Between January 2016 and August 2018, over 18 years old, 216 sexual active women with OAB and 165 healthy women as control group were prospectively enrolled in the study. Five different anticholinergics were used for the treatment. Female Sexual Function Index (FSFI), eight-item overactive bladder awareness tool (OAB-V8), and Beck Depression Inventory form were completed before and after 3 months. Baseline and post-treatment scores were compared with a control group of age-matched healthy women. RESULTS: Patients with OAB reported at baseline significantly worse sexual function in all FSFI domains compared to healthy control group (21.47 ± 3.22 vs. 26.79 ± 5.56, p < 0.01). Three months after treatment, over 85% of participants reported clinically relevant improvements in sexual function, with statistically significant changes in mean FSFI scores. CONCLUSIONS: Treatment of OAB with anticholinergics can improve sexual function of sexual active women with OAB. Patients may be informed about this potential benefit of anticholinergic treatment, to improve their sexual function.

The relationship between female sexual function index domains and premature ejaculation.

PURPOSE: The aim of this prospective, observational study was to investigate the relationship between premature ejaculation (PE) and female sexual response cycle, using the female sexual function index (FSFI). The FSFI evaluates female sexual function in six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. METHODS: All men were considered to have PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine (ISSM) Committee. All men were also assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT) using stopwatch which was held by the partner. All women completed the FSFI. RESULTS: A total of 181 couples who had regular sexual intercourse with one partner for the past 6 months were enrolled the study. By the definition of ISSM Committee, there were 117 men with PE and 64 men without PE. Partners of men with PE had significantly lower total FSFI scores than did partners of men without PE (21.8 ± 3.5 for PE and 26.4 ± 3.1 for non-PE, p < 0.001). Moreover, all the domains of the FSFI scoring system were separately associated with PE. According to the mean FSFI scores, the 48.43% of women had sexual dysfunction in the non-PE group, and all women had sexual dysfunction in PE group. CONCLUSION: PE is associated with female sexual dysfunction and all of the female sexual dysfunction domains, as determined by FSFI scores.