History of establishment and evaluation of Ottoman-Turkish urology inside the surgical science.

The first urological international organization occurred in Paris in 1908, and three Ottoman urologists were present among a total of 29. In that year, the Ottoman Urological society had only nine urologists, and almost all were from the Ottoman minorities with the exception of two under the main branch of General Surgery. Among them, Cemil Pasha who was the first dean and department chief of Surgery and Urology of the Medical School in a modern manner (1909) was the most dominant pioneer of the Turkish Surgery-Urology. Four beds out of 20 were separated for the urology clinic.

A retrospective review of 307 men with Peyronie's disease.

PURPOSE: We discuss the clinical appearance and natural outcome of Peyronie's disease. MATERIALS AND METHODS: During an 8-year period 307 men with Peyronie's disease were evaluated, and clinical characteristics, risk (factors), penile deformities, erectile status and outcome were analyzed. RESULTS: Mean patient age plus or minus standard deviation was 52.8 +/- 9.3 years (range 23 to 76). Penile deformity, pain on erection and palpable nodule were the most common (85%) presenting symptoms, usually in different combinations. The remaining 15% of men (mean age 59.4 +/- 6.5 years) were not aware of the penile deformity and were diagnosed during standard evaluation for erectile dysfunction. Dorsal (45.6%) and lateral (29.3%) were the most common curvatures. The degree of deformity was less than 30 degrees in 42.7% of patients, 31 to 60 degrees in 38.8% and greater than 60 degrees in 18.6%. At least 1 risk factor for systemic vascular disease was identified in 67.5% of patients, and hypercholesterolemia and diabetes were the most common. Patients with at least 1 risk factor had a significantly higher risk for severe penile deformity. Of the men 54.4% complained of erectile dysfunction and the probability of diminished erectile capacity was 86.7% in patients older than 60 years, with Peyronie's disease for more than 12 months and at least 1 risk factor. Of 63 patients presenting with the acute phase of disease penile deformity deteriorated in 30.2%, did not change in 66.7% and resolved spontaneously in 3.2% without any treatment after a mean followup of 8.4 months. CONCLUSIONS: Our data show that penile deformities are disabling (greater than 30 degrees) in 62.5% of cases. Risk factors, such as serum lipid abnormalities, diabetes and hypertension, seem to have significant impact on the severity of symptoms and outcome. Patients must be informed that Peyronie's disease is progressive in 30.2% without treatment and spontaneous resolution is rare.

Sexual dysfunction in type II diabetic females: a comparative study.

Diabetes Mellitus (DM) is considered to play a principle role in the etiopathogenesis of sexual dysfunction both in men and women. The aim of this study is to evaluate sexual function in Type II diabetic women. A total of 72 young diabetic women (mean age: 38.8 years) with no other systemic diseases and 60 age-matched healthy women were enrolled in our study. We sought from them a detailed medical and sexual history and used the Index of Female Sexual function (IFSF) questionnaire (Kaplan et al., 1999). The mean IFSF score of diabetic women was 29.3 +/- 6.4 and was 37.7 +/- 3.5 in normal cases (p < 0.05). Lack of libido was the most common symptom in diabetics and was observed in 77% of the women. Diminished clitoral sensation was observed in 62.5% of the women, 37.5% complained of vaginal dryness and 41.6% had vaginal discomfort. Orgasmic dysfunction was found in 49% of the women. The incidence of all these related symptoms were significantly higher when compared to controls. We concluded that significant percentage of diabetic women that we observed experience sexual dysfunction of varying degrees that diminishes their quality of life.

Can varicocelectomy significantly change the way couples use assisted reproductive technologies?

PURPOSE: We assessed how varicocelectomy alters semen quality in a large cohort of infertile men and determined whether it can change patient candidacy for assisted reproductive technology procedures. MATERIALS AND METHODS: A cohort of 540 infertile men with clinical palpable varicocele underwent microsurgical varicocelectomy and were followed more than 1 and 2 years postoperatively for alterations in semen quality and conception, respectively. Preoperatively and postoperatively the total motile sperm count was calculated in all semen analyses. Based on total motile sperm count values patients were divided into 4 groups according to the type of assisted reproductive technology for which they qualified, including 0 to 1.5 million or less (intracytoplasmic sperm injection candidates), 1.5 to 5 million or less (in vitro fertilization candidates), 5 to less than 20 million (intrauterine insemination candidates) and 20 million or greater sperm (spontaneous pregnancy candidates). Preoperative and postoperative semen quality was compared among individuals in these cohorts to determine the shifts in assisted reproductive technology care that are possible after varicolectomy. RESULTS: Mean patient age was 29.5 years (range 18 to 58). Microsurgical varicocelectomy was bilateral in 393 patients (73%), on the left side in 146 (27%) and on the right side in 1 (0.2%). A positive response to varicocelectomy, defined as a greater than 50% increase in total motile sperm count, was observed in 271 patients (50%). An overall spontaneous pregnancy rate of 36.6% was achieved after varicocelectomy with a mean time to conception of 7 months (range 1 to 19). Of preoperative in vitro fertilization and intracytoplasmic sperm injection candidates 31% became intrauterine insemination or spontaneous pregnancy candidates after varicolectomy. Of intrauterine insemination candidates 42% gained the potential for spontaneous pregnancy. CONCLUSIONS: Varicocelectomy has significant potential not only to obviate the need for assisted reproductive technology, but also to down stage or shift the level of assisted reproductive technology needed to bypass male factor infertility.