Factors affecting the need for ureteral catheterization in symptomatic pregnancy hydronephrosis.

PURPOSE: In our study, considering the clinical parameters we aimed to determine the most appropriate treatment approach for symptomatic gestational hydronephrosis and conditions requiring DJS insertion. METHODS: Our study was a retrospective cross-sectional study and 137 patients were included. The patients were divided into two groups: those with conservative follow-up and those with DJS. Demographic and clinical data, the degree of HUN detected in urinary ultrasonography and the anteroposterior diameter of the renal pelvis were evaluated. Factors affecting the need for DJS between groups were investigated. Also, it was aimed to determine the cut-off value for the HUN degree and renal pelvis AP diameter in patients with DJS. RESULTS: The presence of urinary system stones was statistically significantly higher in the group with DJS than in the group without DJS (p = 0.014). HUN degrees and AP diameter were statistically significantly higher in the DJS group (p < 0.001, p < 0.001, respectively). HUN degree and renal pelvis AP diameter were the two most important predictors for DJS insertion (p = 0.005, p = 0.015, respectively). The AP diameter cut-off value for DJS installation was determined as 20.5 mm. CONCLUSION: Although there are conservative and surgical treatment options for symptomatic hydronephrosis of pregnancy, the factors at the decision point between these options are still a matter of debate. In our study, we concluded that the most important determinants at this decision point are the HUN degree and renal pelvis AP diameter. We think that the cut-off values we have determined for these markers will guide clinicians in deciding on treatment.

The Effect of Lymphovascular Invasion on Short-Term Tumor Recurrence and Progression in Stage T1 Bladder Cancer.

Introduction Lymphovascular invasion (LVI) is the most important stage for tumor spread and metastasis. The role of LVI in transurethral resection is not yet clear. In this study, the progression and recurrences of patients who underwent transurethral resection bladder tumor (TUR-BT) and T1 high-grade tumor and concomitant LVI were detected in pathology results and were evaluated. Methods Our study included 58 patients, who underwent TUR-BT with the suspicion of bladder cancer and were pathologically diagnosed with T1 stage bladder cancer and who did not undergo radical surgery, in the Urology Clinic of Afyonkarahisar Health Sciences University, Turkey. The patient's age, gender, tumor size, tumor grade, presence of LVI, second resection, recurrence, and progression rates at three months and one year were compared. Results LVI was detected in the pathology specimens of nine (15.5%) of the 58 patients who were included in the study. When the one-year progression was evaluated, progression to T2 tumor was detected in six (66.7%) patients in the group with LVI and five (10.2%) patients in the group without LVI, and the progression was significantly higher in the group with LVI (p=0.001). In logistic regression analysis, the only significant predictor for one-year progression was the presence of LVI (p=0.001). Conclusion According to the results of our study, the presence of LVI in the pathology specimens of patients with T1 high grade significantly increases the progression. Suggesting radical cystectomy and neoadjuvant chemotherapy to patients with LVI in the early period seems to be a more accurate approach, considering the course of the disease.

Impact of Preoperative Video-Based Education on Anxiety Levels in Patients with Renal Stones Scheduled for Flexible Ureteroscopic Lithotripsy: A Comparative Study Using APAIS and STAI.

BACKGROUND Anxiety prior to surgery can impact patient outcomes and satisfaction. In light of this, our study aimed to examine the effects of preoperative video-based information versus verbal information on anxiety levels among 60 patients with renal stones slated for flexible ureteroscopic lithotripsy. Anxiety was measured using the Amsterdam Pre-Operative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI). MATERIAL AND METHODS We enrolled 60 patients with renal stones who were scheduled for flexible ureteroscopic lithotripsy. These patients were divided randomly into two groups: Group 1 (30 patients) received preoperative video-based information and Group 2 (30 patients) received only verbal information. Anxiety levels were assessed preoperatively using both the APAIS and STAI. On the first postoperative day, each patient indicated their pain using a visual analogue scale and filled out a questionnaire about their willingness to undergo the procedure again. RESULTS Group 1 exhibited lower anxiety levels as reflected by the APAIS scores for anesthesia (P=0.02), surgery (P<0.001), overall (P<0.001), and information needs (P<0.001). While there was no significant difference in the STAI-trait anxiety scores between the groups (P=0.15), Group 2 demonstrated notably higher anxiety levels concerning the surgical procedure, as measured by the STAI-state scores (P<0.001). The average pain score was 4.23 ± 2.17 for Group 1 and 5.37 ± 2.83 for Group 2 (P=0.08). Patients in Group 1 showed a greater willingness to undergo the surgery again (P=0.02). CONCLUSIONS Delivering preoperative information through videos significantly diminishes anxiety levels in patients about to undergo retrograde intrarenal surgery compared to traditional verbal communication.

The Effect of Health Literacy on Men Seeking Medical Attention for Erectile Dysfunction.

Objective In this study, we aimed to determine if there was any relationship between patients with erectile dysfunction (ED) who do not seek medical help at the hospitals and their health literacy (HL) levels. Materials and methods The study included 68 patients. Patients with a main complaint of ED were included in Group 1, and those with benign prostatic hyperplasia (BPH) or who requested an age-related check-up were included in Group 2. Questions 1-5 and 15 of the International Index of Erectile Function (IIEF)-15 scale evaluating erectile functions were collected as IIEF-6 for the purpose of this study. Severe ED was defined as having a score of 0-10, while moderate ED was defined as a score of 11-16. Both patients with severe and moderate ED were considered and included in the study. The European Health Literacy Scale (HLS-EU) and the Turkey Health Literacy Scale-32 (THLS-32) were used for the evaluation of HL. Results The HLS-EU person-specific mean index was found to be 37.22 ±5.29 in Group 1 and 30.46 ±6.32 in Group 2. The THLS-32 person-specific mean index was determined to be 37.68 ±5.41 in Group 1 and 30.94 ±6.13 in Group 2. In Group 1, 58.3% of patients were classified as having sufficient HL and 22.2% were classified as having excellent HL. In Group 2, 21.9% of patients were classified as having sufficient HL and 3.1% were classified as having excellent HL. Conclusions As societal income, education levels, and HL levels increase, ED will become more important to individuals, motivating them to seek timely medical attention, and thereby leading to earlier diagnoses of potential primary pathologies.