The Efficacy and Safety of Retrograde Intrarenal Surgery in Elderly Patients: A Propensity Score Matching Study by the RIRSearch Group.

INTRODUCTION: To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in elderly patients by comparing them with propensity score-matched age groups. METHODS: Patients who underwent RIRS to treat upper urinary tract stone disease at seven centers were included in the study and were divided into four groups. The age intervals of the patients in Group 1, Group 2, Group 3, and Group 4 were 18-29 years old, 30-49 years old, 50-64 years old, and over 65 years old, respectively. Propensity score matching analysis was used to homogenize the groups in terms of demographic and clinical properties. Operative results, preoperative complications, peroperative complications, postoperative complications, duration of hospitalization time, and stone-free status were compared between groups. RESULTS: A total of 1,017 patients were included in the study. There were 69 (9.9%) patients in Group 1, 324 (46.5%) in Group 2, 217 (31.1%) in Group 3, and 87 (12.5%) in Group 4 after propensity score matching. The operation time and postoperative complication rates were significantly different among groups, whereas the hospitalization time, peroperative complication rates, and stone-free status were similar. The operation time was significantly higher in patients over 65 years old (p=0.001). The postoperative complication rates were significantly higher in Group 1 with Clavien I-II complication predominance (p=0.003). CONCLUSION: The efficacy and safety of RIRS did not change with aging, and RIRS was an effective option for the treatment of upper urinary system stones in elderly patients.

Evaluation of information accuracy and clarity: ChatGPT responses to the most frequently asked questions about premature ejaculation.

Background: Premature ejaculation (PE) is the most prevalent sexual dysfunction in men, and like many diseases and conditions, patients use Internet sources like ChatGPT, which is a popular artificial intelligence-based language model, for queries about this andrological disorder. Aim: The objective of this research was to evaluate the quality, readability, and understanding of texts produced by ChatGPT in response to frequently requested inquiries on PE. Methods: In this study we used Google Trends to identify the most frequently searched phrases related to PE. Subsequently, the discovered keywords were methodically entered into ChatGPT, and the resulting replies were assessed for quality using the Ensuring Quality Information for Patients (EQIP) program. The produced texts were assessed for readability using the Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), and DISCERN metrics. Outcomes: This investigation has identified substantial concerns about the quality of texts produced by ChatGPT, highlighting severe problems with reading and understanding. Results: The mean EQIP score for the texts was determined to be 45.93 ± 4.34, while the FRES was 15.8 ± 8.73. Additionally, the FKGL score was computed to be 15.68 ± 1.67 and the DISCERN score was 38.1 ± 3.78. The comparatively low average EQIP and DISCERN scores suggest that improvements are required to increase the quality and dependability of the presented information. In addition, the FKGL scores indicate a significant degree of linguistic intricacy, requiring a level of knowledge comparable to about 14 to 15 years of formal schooling in order to understand. The texts about treatment, which are the most frequently searched items, are more difficult to understand compared to other texts about other categories. Clinical Implications: The results of this research suggest that compared to texts on other topics the PE texts produced by ChatGPT exhibit a higher degree of complexity, which exceeds the recommended reading threshold for effective health communication. Currently, ChatGPT is cannot be considered a substitute for comprehensive medical consultations. Strengths and Limitations: This study is to our knowledge the first reported research investigating the quality and comprehensibility of information generated by ChatGPT in relation to frequently requested queries about PE. The main limitation is that the investigation included only the first 25 popular keywords in English. Conclusion: ChatGPT is incapable of replacing the need for thorough medical consultations.

Responses of Five Different Artificial Intelligence Chatbots to the Top Searched Queries About Erectile Dysfunction: A Comparative Analysis.

The aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots-ChatGPT, Bard, Bing, Ernie, and Copilot-to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were "erectile dysfunction cause", "how to erectile dysfunction," and "erectile dysfunction treatment." Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients.

The effect of the pandemic period on Bladder Pain Syndrome patients under amitriptyline treatment.

INTRODUCTION: COVID-19 is a disease that may cause anxiety, depression, and stress. Bladder pain syndrome (BPS) is a disease in which stress and psychological factors might negatively affect its course. In this study, we aimed to examine the possible clinical aggregation of the pandemic period on BPS patients. MATERIALS AND METHODS: A total of 35 BPS patients diagnosed between 2010 and 2018 were included. All patients were using medical treatment, and the follow-up period was at least 6 months. According to our clinical follow-up protocol, the BPS patients were given the King's Health Questionnaire (KHQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Overactive Bladder Form V8 (OAB-V8), and Visual Analog Score (VAS) in every visit. In the sixth month of the pandemic, the clinical course of the patients was questioned by telephone or video interview, and their treatment continuities were questioned. Information was received about the delays in their follow-up and the difficulties in accessing healthcare opportunities. The same questionnaires were filled out and compared with pre-pandemic scores. RESULTS: The mean age of the patients included in the study was 50.2 ± 13.32 (min:20, max:74), 11 were males and 24 were females. The mean follow-up periods were 71.8 ± 35.6 months. All questionnaire scores showed an increase compared to the pre-pandemic period. A statistically significant increase was detected during the pandemic in all sub-units of the KHQ. The VAS and OAB-V8 scores of 16 patients who requested hospital admission were significantly higher than before the pandemic. However, there was no statistically significant difference in the increase in VAS and OAB-V8 scores of the 19 patients who refused to come to the hospital. CONCLUSION: BPS patients have been negatively affected by the emotional effects of the COVID-19 pandemic. Due to the fear, stress, anxiety, and depression, the symptoms of BPS patients exacerbated, and the patients could not receive the necessary support due to a lack of regular follow-ups.

Erectile dysfunction iceberg in an urology outpatient clinic: How can we encourage our patients to be more forthcoming?

The study's aim was to document the rates of declared and hidden erectile dysfunction (ED) at urology outpatient clinic while attempting to develop a method to encourage patients to talk about ED. A total of 506 patients, all of whom underwent the same procedure by the same clinician with a standard algorithm, were prospectively evaluated. The patients who declared ED as their primary or secondary symptom were grouped as 'very early treatment seekers' (VETS) and 'early treatment seekers' (ETS) respectively. The patients who hid their ED until directly questioned and the patients whose ED was diagnosed with an IIEF-5 questionnaire were grouped as 'late treatment seekers' (LTS) and 'very late treatment seekers' (VLTS) respectively. The total number of ED was 291 (57.5%), comprised of 54 (18.6%) patients in the VETS, 48 (16.5%) in the ETS, 143 (49.1%) in the LTS and 46 (15.8%) in the VLTS groups. The rate of severe ED was significantly higher in the VETS group, whereas the rate of mild ED was significantly higher in the VLTS group (p < .001). Most of the patients would not seek help for their ED until the clinician directly or indirectly questioned them. Simple manipulations uncovered the hidden ED patients.