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PURPOSE: The present study aimed to investigate the effects of α-Klotho and oxidative stress markers on urinary stone disease (USD) and demonstrate their use as biochemical markers in USD. METHODS: Among the 90 individuals included, 30 individuals were healthy controls (Group 1), 30 individuals presented with USD for the first time (Group 2), and 30 individuals demonstrated recurrent USD (Group 3). Serum levels of α-Klotho, vitamin D, malondialdehyde (MDA), total oxidant status, and total antioxidant status were determined using spectrophotometry analysis. Serum calcium and parathormone levels and 24-h urine calcium levels were measured via biochemical analysis. RESULTS: No significant intergroup difference was noted in terms of age and sex. The groups had significant differences regarding α-Klotho, oxidative stress index (OSI), MDA, and 24-h urine calcium levels. α-Klotho was a determinant of 24-h urine calcium level and OSI. An increase of 1 pg/mL in α-Klotho level appeared to result in a decrease of 8.55 mg in 24-h urine calcium level and a decrease of 0.04 Arbitrary Unit in OSI. In patients experiencing USD for the first time, α-Klotho values were < 21.83 pg/mL and showed 66% sensitivity and 64% specificity. In individuals with recurrent stone formation, α-Klotho values below 19.41 pg/mL had 60% sensitivity and 77% specificity. CONCLUSIONS: The biochemical markers investigated herein, i.e., α-Klotho, OSI, and MDA, were involved in the pathogenesis of stone formation and can be used in day-to-day clinical practices of urology clinics to identify patients at risk for both first time and recurrent USD.
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Cálculos Urinários , Urolitíase , Humanos , Proteínas Klotho , Cálcio/urina , Vitamina D , Urolitíase/metabolismo , Estresse Oxidativo , Vitaminas , Biomarcadores/metabolismo , RecidivaRESUMO
The role of oxidative stress in disease pathogenesis has been extensively investigated. Researchers have gathered sufficient evidence related to oxidative stress-mediated intratesticular damage. The aim of this was study to evaluate the effects of Cornus Mas (CM) extract on intratesticular changes in rats exposed to nicotine. Thirty Wistar albino rats were divided into four groups. The groups and the administrated agents for 35 days were as follows; Control group (n=6): 0.9% saline, intraperitoneally; Nicotine group (n=7): 4 mg/kg nicotine, subcutaneous; CM group (n=7): 1000 mg/kg CM extract in 0.5 ml saline, via gavage; Nicotine + CM Group (n=8): 4 mg/kg Nicotine, subcutaneous + 1000 mg/kg CM extract via gavage. One rat each from the groups Nicotine and CM died. In spermatogenetic and histopathological examination, significant positive changes were detected in nicotine + CM group regarding seminal parameters, apoptotic cells, Factor VIII and Johnsen score as compared to nicotine group. Oxidative stress markers were higher in nicotine group as compared to the control group. OSI and MDA levels were found to be reduced in nicotine + CM group than nicotine group. Nicotine induced a significant increase in TNF-α and IL-6 levels compared to the control group; however, CM effectively counteracted this increase. We have shown that nicotine increases testicular damage, causes apoptosis of testicular cells and adversely affects spermatogenesis by increasing inflammation. We concluded that CM extract exerted beneficial effects on spermatogenesis and minimized testicular parenchymal damage, apoptosis and angiogenesis. Rapidly increasing understanding of the complexity of oxidative stress in intratesticular is the key to unlocking the potential of ROS-targeting therapies.
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Cornus , Masculino , Ratos , Animais , Ratos Wistar , Nicotina/farmacologia , Estresse Oxidativo , Solução Salina , Extratos Vegetais/farmacologiaRESUMO
Decreased quality of life is observed in individuals who fear surgery or experience severe symptoms due to urinary system stone disease (USSD). As a result, some patients seek complementary and alternative medicine (CAM) methods. This research evaluates preoperative CAM usage and its effects on quality of life for patients who experience renal colic (RC) due to USSD. The research was conducted between April 2020 and 2021 in the application and research center of a university. One hundred ten patients who were scheduled to have surgery due to USSD were included in the study. The data were collected using the "personal information form," "Use of CAM Methods of Individuals," and 36-item Short-Form Health Survey (SF-36) forms. Of research participants, 47.3% reported using at least one CAM method. The most common methods were exercise combined with phytotherapy (16.4%) and dietary supplements (15.5%). The proportion of participants who reported using 1 or multiple CAM methods for pain was 48.1%. The Social Functioning scores obtained from the SF-36 of the CAM users were statistically significant. For the participants who used a CAM method, the average Role-Emotional score obtained from the SF-36 was statistically significant. Health professionals should know which CAM methods patients may prefer and to what extent various CAM methods affect quality of life. More studies are needed to identify factors affecting the use of CAM methods in patients with RC attacks and to understand the relationship between CAM method(s) and quality of life.
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Terapias Complementares , Cólica Renal , Humanos , Qualidade de Vida/psicologia , Cólica Renal/terapia , Inquéritos e Questionários , Terapias Complementares/métodos , FitoterapiaRESUMO
INTRODUCTION: It is thought that both individuals are affected psychologically and sexually in couples experiencing abortion. In addition to the stress caused by infertility, sexual life may also be negatively affected in couples who experience psychogenic wear, such as abortion and curettage. The aim of this study is to evaluate male sexual functions in infertile couples with a history of abortion and male infertility component. METHODS: Five hundred forty-seven male patients' data were evaluated retrospectively. Group 1 was the included the males of the couples without abortion history and the rest with abortion history was group 2. In addition to demographic data, abortion history, libido level, presence of morning erection and intercourse frequency were evaluated. Hormone levels of all patients were evaluated. After that we created sub-group 1 and sub-group 2 from these groups, respectively, due to whether the patients fulfilled the international index of erectile function (IIEF), Beck anxiety inventory (BAI) and Beck depression inventory (BDI). RESULTS: There were not any significant differences between the groups regarding psychiatric scale scores, hormone levels, libido, intercourse frequency and IIEF scores. Only orgasmic dysfunction was significant in the males of the couples with abortion history. CONCLUSION: Man is not affected from abortion process in which woman get involved. Men only have orgasmic dysfunction when there is one or more abortion history in couples.
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Aborto Induzido , Disfunção Erétil , Infertilidade Masculina , Aborto Induzido/efeitos adversos , Disfunção Erétil/etiologia , Feminino , Hormônios , Humanos , Infertilidade Masculina/etiologia , Masculino , Gravidez , Estudos RetrospectivosRESUMO
Introduction Mammals' sexual functions exhibit seasonal variations that have been attributed to changes in the daylight. In this study, taking into consideration endocrine and psychogenic status, we aimed to investigate whether human males experience changes in erectile functions and sexual desire depending on daylight periods and seasons, and whether periodicity exists in human sexual behavior. Materials and methods International Index of Erectile Function (IIEF) and psychiatric scale scores of 221 male patients were evaluated. In addition, hormonal parameters of the patients were examined. These data were first evaluated in two groups (summer and winter) according to local daylight amounts the participants received. Then IIEF scores were also analyzed according to four conventional seasons (winter, spring, summer, and autumn). Results There was no significant difference in laboratory data, psychiatric scale scores and IIEF evaluations between summer and winter groups. Moreover, no significant difference was found in terms of sexual desire and erectile functions in terms of four seasons (p > 0.05). Conclusion According to the results of this study, there is no periodicity in human sexual functions both in relation to daylight and four seasons.
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PURPOSE: Incontinence is a condition that can cause significant problems that can affect patients' quality of social, emotional, psychological and sexual life. The aim of this study was to evaluate the level of anxiety, health anxiety, depression and somatosensory amplification in patients with urge incontinence. MATERIALS AND METHODS: The study group consisted of 58 patients that met the inclusion criteria. The control group consisted of 67 volunteer participants that did not have physical or psychiatric illness and incontinence complaints. All participants filled out sociodemographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Somatosensory Amplification Scale (SSAS) and Health Anxiety Inventory (HAI). RESULTS: The mean duration of incontinence in patients with urge incontinence was 16.55 ± 10.03 months. The mean age in urge incontinence group and the control group were 40.98 ± 9.58 and 39.1 ± 7.89 years, respectively. The mean values of SSAS, HAI and BAI scores in the incontinence group were significantly higher than the control group (P < .001), but there was no significant difference between the groups in terms of BDI scores. The linear regression analysis indicated that HAI and BAI significantly affected SSAS (P = .025 and 0.019, respectively). CONCLUSIONS: Anxiety, health anxiety and somatosensory amplification are more common in patients who report urge incontinence. For these reasons, we believe that psychiatric evaluation should be included in the diagnosis and treatment process of patients presenting with urgency and incontinence symptoms.
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Depressão , Incontinência Urinária , Adulto , Ansiedade , Transtornos de Ansiedade , Depressão/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Escalas de Graduação PsiquiátricaRESUMO
Introduction Renal colic is often confused with low back pain (LBP) and other pathologies. Computed tomography (CT) is frequently used to reach a definitive diagnosis, but its use increases the exposure to radiation. Researchers have tried to predict urinary stones in patients presenting with flank pain. Several scoring systems have been introduced; however, none of them provide a prediction based on the physical examination of the patient upon initial presentation to the outpatient clinic. In this study, we aimed to investigate whether we can predict the presence of stone with visual analogue scale (VAS) questionnaire during the first admission. Materials and methods Patients with complaints of flank pain were started to be followed for three months in our urology clinic. After the definitive diagnosis was made the patients were classified into two groups: renal colic group (group 1; n=36) and the LBP group (group 2; n=30). Results In logistic regression analysis, the possibility of renal colic increased 5.4 times more per one-unit increase in the VAS score. In receiver operating characteristic (ROC) analyses, when the VAS was 4.5, the diagnosis of renal colic could be made with 88% sensitivity and 71% specificity. Conclusion If the VAS score is ≤ 4 in patients that have flank pain without limitation of movement, it is more likely to manage these patients with a simple medical treatment plan. In these patients, unnecessary ultrasonography (US) scans be reduced by 86.3% and unnecessary CT scans by 88.8%. A VAS score of ≥5 should warn the clinician about the necessity of routine urinary stone examinations.
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PURPOSE: In this study, we aimed to find a more accurate predicting constant value of energy per mm3xHounsfield Unit (HU) to ablate urinary stones by endoscopic stone treatment. MATERIAL AND METHODS: The files of 142 patients who underwent rigid or flexible ureteroscopic laser lithotripsy in our clinic between December 2018 and March 2020 were evaluated retrospectively. Total energy administered for the ablation of the stone was obtained from the registry of the Ho:YAG laser and recorded to the follow-up forms. The constant value was calculated for each stone, and the final mean value was figured out by calculation of the mean of all constant values. RESULTS: The study was conducted with 142 patients; 102 males and 40 females. The mean age of the population was 46.61 ± 14.58 years. The number of stones was 1.27 ± 0.67. The mean constant value of energy needed per mm3xHU for urinary stones was 22.87 milliwatt. CONCLUSION: This study was conducted to report a predictive constant value and is the very first study evaluating the energy prediction per mm3xHU. The data of the study showed that the constant value is 22.87 mW/mm3xHU. Urologists may estimate the required energy and plan the surgery according to the outcomes of the study. As a future aspect of our study, the constant value may represent predictive information about the time and accuracy of the operation.
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Lasers de Estado Sólido/uso terapêutico , Litotripsia a Laser/métodos , Cálculos Urinários/terapia , Adulto , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Fenômenos Físicos , Estudos RetrospectivosRESUMO
INTRODUCTION: Ureteral stones may have an influence on kidney functions due to postrenal obstruction or urinary infections. Urgent decompression or stone removal is necessary and recommended to prevent further complications in case of severe conditions such as anuria and urosepsis. Although it is believed that ureteral stone removal would result in renal function improvement, there are still unclear points on whether ureteroscopy (URS) can provide benefit as expected and has some adverse effects. In this study, we aimed to evaluate the alteration of kidney functions of patients who undergo rigid or flexible URS for ureteral stones and find if there are any influencing factors on kidney function alteration. MATERIALS AND METHOD: We analyzed 126 patients who underwent retrograde intrarenal surgery (RIRS) for renal stones between May 2018 and February 2020 prospectively. The estimated glomerular filtration rate (eGFR) was calculated on the day before the surgery, by modification of diet in renal disease (MDRD) formula. The calculation was repeated and saved three times during follow-up for the same patient; on the day after the operation, on the postoperative 30th day, and the postoperative 90th day. Then, we evaluated the renal function by comparing eGFR and assessed the predicting factors affecting the kidney function. RESULTS: Preoperative mean eGFR was 82.28 ± 25.20 mL/min/1.73 m2 for the study group. Mean eGFR was calculated 90.92 ± 22.97 mL/min/1.73 m2 on the first postoperative day, and 94.54 ± 21.95 mL/min/1.73 m2 on the third-month follow-up. The mean change in eGFR was 8.63 ± 16.68 mL/min/1.73 m2 in the early period and 12.26 ± 21.09 mL/min/1.73 m2 in the long-term follow-up period. Fifty-one patients improved on chronic kidney disease (CKD) stage, and 13 deteriorated in three months follow-up. CONCLUSION: Removing the stone and relieving the obstruction by ureteroscopic treatment have an alteration on eGFR. Although eGFR improves in the short-term follow-up, amelioration is evident in long-term follow-up, especially in female patients. The other predictive factors for eGFR improvement after URS are the presence of ureteral obstruction and high preoperative serum creatinine levels.
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OBJECTIVE: To evaluate the macula and optic disc in varicocele patients with optical coherence tomography angiography (OCTA). METHODS: The right eyes of 30 patients with varicocele and 30 healthy volunteers were evaluated. Superficial and deep capillary plexus vascular densities, foveal avascular zone (FAZ) width, and optic disc parameters were measured with OCTA. RESULTS: There was a significant decrease in vascular density in the superficial and deep capillary plexus in the varicocele group compared to the control group, but no difference was found in FAZ and optic disc parameters. CONCLUSION: Patients with varicocele have reduced microvascular density in the retina; therefore, it may be beneficial to perform a detailed eye examination with OCTA in these patients.
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Introduction: Preoperative assessment of renal stones is essential to selecting treatment options and achieving high success rates; thus, some nephrolithometric scoring systems have been developed by using preoperative clinical data and stone characteristics. Initially, nomograms predicting stone-free rates (SFRs) were designed for percutaneous nephrolithotomy. After this, some were modified, and new scoring systems were developed for retrograde intrarenal surgery (RIRS). In this study, we aimed at validating and comparing the accuracy of four scoring systems predicting the SFR of RIRS. Materials and Methods: We conducted a prospective study. The data of 110 consecutive patients who required RIRS for renal stones between May 2018 and February 2020 were evaluated. The patients were divided into four groups regarding total score: 0, 1, 2, ≥3 according to the Resorlu-Unsal Stone Score (RUSS). The scores were calculated between 5 and 15 for the size of the stone, topography or location, degree of obstruction of the urinary system, number of stones, and evaluation of Hounsfield units (S.T.O.N.E.) scoring system. Modified Seoul National University Renal Stone Complexity (S-ReSC) scores of the patients were between 1 and 12. Finally, the patients were classified between 4 and 10 points with the R.I.R.S. scoring system. Results: The mean RUSS, S.T.O.N.E., R.I.R.S., and modified S-ReSC scores were 1.14 (±0.818), 10.78 (±1.499), 6.50 (±1.305), and 2.29 (±1.710), respectively. The area under curve values of RUSS, S.T.O.N.E., R.I.R.S., and S-ReSC were 0.735 (95% confidence interval [CI] 0.623-0.826), 0.725 (95% CI 0.626-0.823), 0.752 (95% CI 0.646-0.857), and 0.755 (95% CI 0.660-0.849), respectively. Logistic regression analysis revealed that the RUSS was an independent predictive factor for SFR (p = 0.028). Conclusion: The results showed that all four scoring systems predict the SFRs for RIRS accurately. However, surgeons should prefer RUSS when all four nomograms are available, except when assessing single renal stones. In that case, S-ReSC should be used for assessment. Three other nomograms except the S.T.O.N.E. scoring system can be suitable for the assessment of lower caliceal stones.
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Cálculos Renais , Nefrolitotomia Percutânea , Humanos , Cálculos Renais/cirurgia , Estudos Prospectivos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: The aim of this study was to evaluate the relationship between body mass index (BMI) and sperm parameters and reproductive hormone levels in patients with no known risk factors for infertility. MATERIAL AND METHODS: Four hundred patients who met the study's inclusion criteria were divided into three groups according to their BMI values as normal weight (BMI: 18.5-24.9 kg/m2), overweight (BMI 25-29.9 kg/m2), and obese (BMI ≥30 kg/m2). Semen parameters, reproductive hormone levels and testosterone/estradiol ratio were compared retrospectively between the groups. RESULTS: There was no significant difference between the groups in terms of age and infertility period. The mean BMI of all the patients was 26.6 ±4.08, and the BMI in the normal, overweight and obese groups were 22.6 ±1.7, 27.4 ±1.3, and 33.4 ±2.9, respectively (p <0.001). There was no significant difference between the groups in terms of serum follicle stimulating hormone, luteinizing hormone, estradiol, prolactin, semen volume, sperm concentration, total sperm count, and progressive and total motility. Serum testosterone (T) level and testosterone/estradiol (T/E2) ratio were significantly higher in the normal BMI group (p <0.001). CONCLUSIONS: Adipose tissue increase was not significantly correlated with change in the semen parameters and it was negatively correlated with T levels and T/E2 ratio.
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OBJECTIVE: Varicocele is the most commonly surgically curable cause of male infertility. However, the mechanisms related to the effect of reducing fertility potential have not been clearly identified. The aim of this study was to investigate the effects of varicocelectomy on semen parameters, reproductive hormones and testosterone / estradiol ratio. Matherial and methods: Fifty seven patients outcomes were evaluated before and 6 months after subinguinal microsurgical varicocelectomy. Semen parameters, reproductice hormones and testosteron/estradiol ratio results of patients were compared retrospectively. RESULTS: The mean age was 26.8 years. Fifty four (94.7%) patients had grade 3 and 3 (5.3%) patients had grade 2 varicocele. There was a significant increase in semen parameters except semen volume. There was a statistically significant increase in serum testosterone levels, but not on testosterone/ estradiol ratio. CONCLUSIONS: According to our results, microsurgical subinguinal varicocelectomy can be recommended for both improving semen parameters and hormonal recovery.
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Estradiol/sangue , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Prolactina/sangue , Análise do Sêmen , Testosterona/sangue , Varicocele/cirurgia , Adolescente , Adulto , Humanos , Canal Inguinal , Masculino , Estudos Retrospectivos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto JovemRESUMO
FSH in infertile patients may be measured in the normal range and abnormal semen analysis findings may be observed in patients with normal FSH values. A recent study predicts that the sperm morphology and concentration may be impaired if the FSH value is above 4.5 IU/L. Therefore, this study aimed to define a clinically more useful upper limit for FSH as an indicator for male infertility. In this study 1,893 infertile male patients were evaluated retrospectively. Physical examination, hormone analysis (total testosterone (TT), FSH, luteinizing hormone (LH), estradiol (E2), sex hormone binding globulin (SHBG) and prolactin (PRL)), semen analyzes were recorded and analyzed retrospectively. Logistic regression analysis, 95% confidence intervals and probability ratios were calculated to show the relationship between categorical hormone levels (quarters) and semen parameters. Hormone levels were categorized using the distribution quarters in the study population. FSH values of 62% of the cases with sperm concentration <15 million/ml were greater than 4.8 IU/L. 59.7% of patients with sperm count <39 million had FSH values greater than 4.8 IU/L. In conclusion, FSH values above 4.8 IU/L were found to be abnormal when the male factor was investigated for infertility. ABBREVIATIONS: FSH: Follicular Stimulating Hormone; GnRH: Gonadotropin-releasing Hormone; HPGA: Hypothalamic-Pituitary-Gonadal Axis; TT: Total Testosterone; LH: Luteinizing Hormone; E2: Estradiol; SHBG: Sex Hormone Binding Globulin; PRL: Prolactin; WHO: World Health Organization; AUC: Area Under the Curve.
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Fertilidade , Hormônio Foliculoestimulante Humano/sangue , Infertilidade Masculina/sangue , Adolescente , Adulto , Biomarcadores/sangue , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Valores de Referência , Estudos Retrospectivos , Contagem de Espermatozoides , Adulto JovemRESUMO
Background: Urinary system stone disease is an important health problem. It has been reported to have a prevalence of 14.8% in Turkey. The aim of the renal stone removal surgery is to clear the stones with minimal complications. Retrograde intrarenal surgery (RIRS) is a safe method due to the fewer and minor complications. As a clinic in central Anatolia, we aimed at researching the factors affecting RIRS success in our area. Methods: After local ethics committee's approval, the data of the patients who had undergone RIRS between 2014 and 2019 were reviewed. Patients who were <18 years old, had kidney anomalies, and had both ureter and kidney stones were excluded from the study. The patients who were defined as successful were named as Group 1 and the others were named as Group 2. The demographic, intraoperative, and postoperative data of the two groups were compared. Results: There were a total of 416 patients in our study. Group 1 consisted of 332 patients, whereas Group 2 had 84 patients. Opacity was significantly different between the groups (P = .004). Stone size, stone volume, and operation time were significantly higher in Group 2. After logistic regression analysis, we found that stone size, opacity, and operation time affected the success of RIRS significantly (P < .05). There was a reverse relationship with stone size, operation time, and opacity. Conclusions: We believe that in patients who have large lower calix stones and who want effective treatment, percutaneous nephrolithotomy should still be an option for treatment.
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Cálculos Renais/cirurgia , Rim/cirurgia , Nefrolitotomia Percutânea/métodos , Ureter/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Cálculos Renais/epidemiologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Período Pós-Operatório , Fatores de Tempo , Resultado do Tratamento , Turquia/epidemiologiaRESUMO
In this study, we aimed to evaluate the effect of carob extract against intratesticular histological, apoptotic, biochemical and spermatogenic changes in rats exposed to nicotine. Twenty-eight rats were divided into four groups and were administered saline, nicotine, carob, or nicotine + carob once a day for 35 days. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX), GSH, total anti-oxidative status (TAS), total oxidative status (TOS), oxidative stress index (OSI), IL-6, TNF-α and seminal parameters were evaluated. Johnsen's testicular histopathological examination, factor VIII protein (angiogenesis marker) and the number of apoptotic cells were determined in the testicular tissues. The spermatogenic and histopathological examination revealed that nicotine + carob group had significant positive changes in seminal parameters, Johnsen score, apoptotic cell count and factor VIII protein compared to nicotine group. Biochemical test results indicated that the nicotine + carob group had significantly lower TAS levels compared to the control group; however, those levels were higher than those of the nicotine group. Nicotine caused a significant increase in IL-6 and TNF-α levels compared to the control group, but carob seems to significantly counteract that increase. In conclusion, carob extract had positive effects on spermatogenesis and reduced testicular parenchymal damage, apoptosis and angiogenesis.
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Antioxidantes , Nicotina , Animais , Catalase/metabolismo , Galactanos , Masculino , Mananas , Nicotina/toxicidade , Estresse Oxidativo , Gomas Vegetais , Ratos , Superóxido Dismutase/metabolismoRESUMO
PURPOSE: The aim of this study is to evaluate the effects of anesthesia methods on the success of urethral access and stone access achievement in endoscopic treatment of urolithiasis. MATERIALS AND METHODS: In this prospective randomized study, 105 patients who underwent primary ureterorenoscopy (URS) procedure for ureteral stones were evaluated. The patients were randomized into three groups by permuted block randomization according to the applied anesthesia method: General anesthesia (GA): 33 patients, Spinal anesthesia (SA): 31 patients, and Epidural anesthesia (EA): 31 patients. Ten patients, whose ureteral access was not successful, were dropped out. The success of the three anesthesia methods on the success of the ureter access and its effects on surgical outcomes were compared. RESULTS: There was no statistically significant difference among the three groups in terms of the demographic values and preoperative features except the American Society of Anesthesiologists (ASA) status. Dilatation and the access time to stone were statistically significantly longer in SA and EA group compared to the GA group. There was no statistically significant difference among the groups in terms of operation, lithotripsy time, stone-free rate (SFR), and complication rates. The Visual Analog Scale (VAS) scores in the 8th and 24th hours were statistically significantly higher in the GA group. CONCLUSION: In patients who decided to undergo primary ureterorenoscopy procedure, it can be suggested to treat with GA to provide a better relaxation of the ureter if there are no contraindications.
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Anestesia Epidural , Anestesia Geral , Raquianestesia , Cálculos Ureterais/cirurgia , Ureteroscopia , Adulto , Anestesia Epidural/efeitos adversos , Anestesia Geral/efeitos adversos , Raquianestesia/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do TratamentoRESUMO
Background: Retrograde intrarenal surgery (RIRS) is a safe and minimally invasive method for the endoscopic treatment of upper urinary system stones especially sized <2 cm. Ureteral entrance is an important stage of RIRS. General anesthesia (GA) is usually used for RIRS. There is not enough data about the effect of anesthesia methods on the success of ureteral entrance and RIRS. We aimed to evaluate the effects of anesthesia methods (spinal anesthesia [SA], epidural anesthesia [EA], and GA) on the ureteral access and RIRS outcomes in primary surgery. Methods: After local ethical approval, 105 patients were prospectively randomized into three groups according to the anesthesia methods. GA, SA, and EA were defined as Group 1, 2, and 3, respectively. Results: Stone density was statistically significantly different between three groups (P = .008). Lithotripsy and operation time were significantly lower in Group 3 (P = .001). Dilatation and stone access time were significantly lower in Group 1. There was no statistically significant difference for scopy time, success, Visual Analog Scale score at 8th and 24th hours, and intraoperative and postoperative complications. Conclusions: GA may be recommended to decrease manipulations for the success of first ureteral access and time to reach the stone if there is not any contraindication.
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Anestesia Epidural , Anestesia Geral , Raquianestesia , Cálculos Renais/cirurgia , Ureteroscopia , Adulto , Dilatação , Feminino , Humanos , Litotripsia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos , Resultado do Tratamento , UreterRESUMO
Objective The aim of this study is to determine the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and red blood cell distribution width (RDW)/platelet ratio (RPR) values, which are pro-inflammatory markers, with abnormal sperm parameters, and to evaluate their availability as predictive markers. Materials and methods A total of 160 patients, 80 of whom were the control group, formed with match-pair analysis (Group 1), and 80 patients with abnormal sperm analysis, who met the study criteria (Group 2), were included in the study. Complete blood count results were recorded. NLR, PLR, and RPR values were calculated using hematological parameters, and a comparison was made between the two groups. Results The mean age was 31.23 ± 5.1 years in Group 1 and 31.33 ± 6.4 years in Group 2. NLR values were 1.84 ± 0.57-1.87 ± 0.65 (P =0.77), PLR values were 105.42 ± 23.89-111.42 ± 34.54 (P = 0.62) and RPR values were 0.05 ± 0.009-0.05 ± 0.01 (P =0.45), respectively. There was no statistically significant difference between the groups. Conclusions We investigated whether NLR, PLR, and RPR results can be used as a predictive marker on abnormal sperm parameters. We do not recommend the use of these parameters as a predictive marker.
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OBJECTIVE: the aim of this study is to determine the prevalence of male factor infertility with the clinical patterns of patients in our region. MATERIALS AND METHODS: this is a descriptive retrospective study of 406 infertility cases presented at our urology clinic from February 2018 to February 2019. We assessed hormone and physical examination data, semen analysis results, the contribution of male and female factors to infertility, and types of infertility (i.e., primary or secondary). RESULTS: the age of the male patients ranged from 18 to 50 years, with a mean of 30 ± 5 years. Asthenozoospermia was the leading cause of male factor infertility in 77 patients (19%). Male factors as the sole cause of infertility were found in 185 (45.6%) couples. Female factors as the sole cause were found in 32 couples (7.9%). Primary infertility was determined in 314 (77.3%) patients, and 92 (22.7%) had secondary infertility. CONCLUSION: according to our results, the male infertility rate was high among couples reporting infertility. Couples should be informed about the causes of infertility, which may be due factors attributed to either sex.