Publication rates of dissertations written in medical faculties of Turkey in the field of urology between the years 2008, and 2011, and citation analysis: A cross-sectional study.

OBJECTIVE: In our country, preparing dissertation is essential for the research assistants in order to complete their expertise in medicine. It is aimed to produce hypothesis for researchers via writing their dissertations, to collect data for the hypothesis established, to make the analysis and interpretation of these data, and to gain the ability for the comparison of the findings obtained with the literature. In this study, we want to investigate the publication rates and citations of urology dissertations that are written at the university hospitals in our country between 2008 and 2011. MATERIAL AND METHODS: Urology dissertations that are written at the university hospitals between 2008 and 2011 were reviewed by entering the website of Board of Higher Education Dissertation between 23-27 March 2017 and 229 dissertations were reported. The publication rates of these dissertations were analysed. RESULTS: Hundred and fourteen of 229 dissertations (49.7%) analysed were published. Of these publications, 75 (32.7%) in Science Citation Index Expanded, 24 (10.4%) in international, 15 (6.5%) are published in national indexed peer-reviewed journals. While the publication rate of 81 dissertations written in universities located in 3 metropolitan cities (Istanbul, Ankara, and Izmir) of Turkey was 50.6%, the publication rate of 148 dissertations written in remaining universities was 49.3%; and no statistically significant difference was found between the two groups (p=0.96). CONCLUSION: Preparing dissertation is a challenging process that requires considerable effort and time. At the end of this process, it is necessary to publish the dissertation in order to have it reach more people and to contribute to the literature. Even though publication rate of dissertations written in urology at university hospitals in Turkey was at acceptable level, there have still been problems required to solve.

Top cited articles in urology from Turkey.

OBJECTIVE: Citation is the name given for a scientific publication in order to be used as a reference by another publication. In this study, we reviewed the most frequently cited publications in urology from Turkey. Although the number of citations is not completely definitive on its own, it shows the importance and effect of the publication. Besides the number of citations directly determines the impact factor of the journals and this factor is generally used in the evaluation of the quality and importance of the journal. MATERIAL AND METHODS: On March 7-14, 2016, 51 studies with highest number of citations from Turkey are determined from Science Citation Index Expanded database index and the journals in which studies are published, the authors of the publications, their cities and departments, study types, publication date of the studies and the number of citations are recorded. RESULTS: The most frequently encountered subjects in the publications that are mostly cited from Turkey are urolithiasis (23.5%), infertility (15.6%), benign prostatic hyperplasia (11.7%), sexual dysfunction (11.7%) and bladder carcinoma/urothelial carcinoma (9.8%). Distribution of 51 publications is as follows: 18 case series, 11 randomized study, 7 non-randomized study, 6 study, 3 review, 3 cross-sectional studies and 3 survey studies. Of all the studies, 68.6% are from Ankara, Istanbul and Izmir and 72.5% of them have originated from the university hospitals. CONCLUSION: It is important to show the most cited Turkish publications in order to show the contribution in the world literature regarding to urology. The most cited publications in Turkey belong to urolithiasis and andrology areas. When the citation analysis publications in urology and different areas both in Turkey and in the world, it is observed that the number of our qualified publications is at acceptable levels.

Continuous positive airway pressure therapy is associated with improvement in overactive bladder symptoms in women with obstructive sleep apnea syndrome.

INTRODUCTION: To evaluate the impact of continuous positive airway pressure (CPAP) therapy on overactive bladder (OAB) symptoms in women with obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: One-hundred and fifty women underwent an overnight polysomnography study between May 2014 and September 2014. Their voiding symptoms were evaluated using the OAB symptom score (OABSS) and International Consultation on Incontinence Questionnaire Short-Form at OSAS diagnosis and approximately 3-months after CPAP therapy. OSAS severity was assessed according to the apnea-hypopnea-index. RESULTS: We evaluated 140 women and 111 of them (79.3%) reported symptoms consistent with OAB. There were no statistically significant differences between OSAS severity with a prevalence of OAB (p = 0.92). The prevalence of urinary incontinence (UI) was 35.7% (n = 50) and 39.6% (n = 44) in all patients and patients with OAB, respectively. There were no statistically significant differences between UI with OAB (p = 0.58). Baseline OABSS is comparable between OSAS severity (p = 0.143). After 3-months CPAP therapy, OABSS and ICIQ-SF sum scores were significantly decreased in patients with severe and moderate OSAS (p <0.01), however, change of OABSS sum score was insignificant in patients with mild OSAS (p = 0.44). CONCLUSIONS: CPAP therapy improves the OAB, OABSS and ICIQ-SF scores in women with severe and moderate OSAS. OSAS-induced OAB may be alleviated following CPAP therapy.

The impact of hypoxemia on serum total and free prostate-specific antigen levels in patients with chronic obstructive pulmonary disease.

Prostate-specific antigen (PSA) is the most important biochemical marker in the diagnosis and follow-up of patients with prostate cancer. In recent years, a relationship between PSA levels and hypoxic conditions has been described. However, no study has investigated the PSA levels in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the impact of hypoxemia on serum total (tPSA) and free PSA (fPSA) levels in patients with COPD. Between January 2010 and January 2014, 95 male patients who hospitalized for acute exacerbations of COPD and 80 control subjects were enrolled in the study. Serum tPSA and fPSA levels and f/tPSA ratios were determined in all patients on the first day of hospitalization (exacerbation) and 7 days after the treatment (stable state). Statistical analysis included paired t test and Mann-Whitney U test. No statistically significant differences were found between COPD and control groups with regard to the baseline characteristics, except for smoking status. The levels of serum tPSA and fPSA during exacerbation of COPD were significantly higher than the levels of the stable period (p < 0.01), whereas f/tPSA ratio did not change (p > 0.05). Hypoxemia during acute exacerbation of COPD can cause a rise in serum tPSA and fPSA levels, but f/tPSA ratio is not affected. Acute exacerbation of COPD may be added to list of the events in which PSA measurements must be interpreted with caution.

Where do patients go for treatment of urethritis?

BACKGROUND: Urethritis is characterized by urethral inflammation, and it can result from both infectious and noninfectious conditions. Physicians and other health care providers play a critical role in preventing and treating urethritis. OBJECTIVES: The aim of this study was to describe and identify predictors of health care seeking behavior among men with urethritis. PATIENTS AND METHODS: In total, 98 male patients aged between 16 to 52 years-of-age (mean 30.9 ± 8.0 years), who attended our clinic with symptoms of urethritis, were included in the study. We conducted face-to-face interviews with the patients using a 9-item survey questionnaire. Patients were divided into three groups according to their level of education as follows: group I (n = 44), elementary school; group II (n = 38), high school; and group III (n = 16), university. RESULTS: Among the 98 patients evaluated, the source of treatment was physicians in 44 patients (44.9%), drugstores in 38 cases (38.77%), and friends in 16 patients (16.32%). There was a statistically significant difference found between the groups according to the source of treatment (P < 0.001). The most common factors associated with seeking care from other sources, rather than physicians, were economic reasons in 19 patients (35.18%), confidentiality concerns in 24 (44.4%), and ease of access in 11 patients (20.37%). CONCLUSIONS: A substantial proportion of patients with urethritis sought help from other sources, rather than physicians. The results of our study show that the patients with higher levels of education were more likely to seek help from health care services. It is important to promote the public's knowledge through informative studies and educational materials in order to encourage patients to seek rapid and effective treatment from proper sources.

Massive idiopathic scrotal calcinosis.

Idiopathic scrotal calcinosis is a rare, benign condition with the presence of multiple slow-growing yellowish-white calcified asymptomatic nodules that appear within the scrotal skin. The disease affects patients in childhood or early adulthood. The etiology of idiopathic scrotal calcinosis is still controversial. It can extensively affect the scrotal skin, but primary closure is usually achievable with good esthetic outcomes.

Management of symptomatic ureteral calculi complicating pregnancy.

OBJECTIVE: To review our experiences with management of symptomatic ureteral calculi complicating pregnancy. METHODS: Between January 2001 and December 2011, 57 pregnant women were treated for symptomatic ureteral stones. The medical records of these patients were reviewed retrospectively. RESULTS: The mean patient age was 24 (range 17-37) years and gestational age at presentation was 26 weeks (range 12-38). Most of the cases (60%) occurred in the third trimester. Flank pain was the most common presenting symptom (90%). Ultrasonography was the initial test confirming diagnosis. With conservative management, spontaneous passing of stones was noted in 13 cases (22.8%). In 10 patients (17.5%), symptomatic relief occurred without spontaneous passing of stones until the end of pregnancy. Invasive management was required in 34 patients (59.6%) because of persistent pain and/or ureteral obstruction. In 29 patients, ureteral calculi were treated successfully by ureteroscopy. Stones were extracted by pneumatic lithotripsy or forceps. In 5 patients, only double-J stent was inserted during ureteroscopy as a result of unreached or migrated stone. The majority of patients (58.8%) had lower ureteric calculi. The mean size of the stones retrieved was 7 mm (range 4-13 mm). Minor complications like ureteric edema, mild ureteric laceration, or bleeding were seen in 5 patients. Three patients had a urinary tract infection and 3 complained of stent-induced bladder irritation; uterine contraction was observed after the procedure in 1 patient, but no serious obstetric or urologic complications were observed in any case. CONCLUSION: When conservative treatment fails, ureteroscopy is an effective and safe therapeutic option in symptomatic ureteral calculi complicating pregnancy.

Protective effect of trapidil on long-term histologic damage in a rat model of testicular ischemia-reperfusion injury.

OBJECTIVES: Trapidil is an antianginal compound with a broad spectrum of pharmacological activities. In recent years, it has been used successfully to decrease ischemia-reperfusion injury in several organ systems. We evaluated the effect of trapidil on the long-term histologic damage in testicular ischemia-reperfusion injury. METHODS: Adult male Wistar rats were divided into three groups of six rats each. One group underwent 2 h of testicular torsion; one received pretreatment with trapidil before detorsion; and one group underwent sham operation. All rats underwent bilateral orchiectomy 60 days after the experiment. The mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score were determined by histological examination of each testis. RESULTS: Testicular torsion-detorsion caused a significant decrease in the mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score in the ipsilateral testes, but not in the contralateral testes. The animals treated with trapidil had a significant increase in these histological parameters as compared to the torsion-detorsion group. CONCLUSION: Trapidil administration before reperfusion may have the potential to decrease the long-term histologic damage that occurs after experimental testicular torsion. Trapidil is used as an antianginal drug and additional clinical studies are required to elucidate the protective role of trapidil in patients with testicular torsion.

Is catheter cause of subjectivity in sensations perceived during filling cystometry?

OBJECTIVES: To investigate the impact of the catheter on perceptions of filling. In our previous study, we demonstrated that some patients perceived sensations despite a lack of filling during cystometry. METHODS: The study included 45 patients with lower urinary tract symptoms attributed to benign prostatic hyperplasia. The average patient age was 57.9 years (range 48 to 79). Patients were draped to keep them from seeing their penis and the filling bag, pump, and screen process. In the first phase, the catheter was fixed to the penile skin without introducing it through the urethra, and the patient was told the test had begun. At the end of the first phase, the bladder was emptied. Before the second phase, an 8F urodynamic catheter was introduced, but during the test, nothing was infused. During the third phase, filling cystometry was performed with a 50-mL/min pump speed. The bladder was emptied after all three phases. The times that elapsed until each sensation was perceived, in seconds, were used to compare the sensations. RESULTS: In the first phase, 21 patients reported a first sensation, 10 reported first desire, and 4 reported normal desire, despite a lack of catheterization. No statistically significant difference was found between the mean first sensation/first desire, first sensation/normal desire, first desire/normal desire ratios of the patients who perceived sensations in the three phases and the strong desire/normal desire ratios of the patients in the second and third phases (P >0.05 for all). CONCLUSIONS: Although the perceptions were reported in the first and second phases, the catheter could not be the sole cause of the subjectivity.

Protective effect of vascular endothelial growth factor on histologic changes in testicular ischemia-reperfusion injury.

OBJECTIVE: To evaluate the efficacy of vascular endothelial growth factor (VEGF) on long-term histologic damage in testicular ischemia-reperfusion injury. DESIGN: Controlled experimental study using rats. SETTING: University of Mersin School of Medicine, Mersin, Turkey. ANIMAL(S): Sixteen adult male Wistar rats. INTERVENTION(S): Five rats underwent 2 hours of testicular torsion. Six rats received VEGF injection into the testis before detorsion. Five rats underwent sham operation. MAIN OUTCOME MEASURE(S): Mean seminiferous tubular diameter (MSTD), germinal epithelial cell thickness (GECT), mean testicular biopsy score (MTBS), and apoptosis (caspase-3-positive cells). RESULT(S): Testicular torsion-detorsion caused a significant decrease in MSTD, GECT, and MTBS and a significant increase in the mean value of caspase-3-positive cells in ipsilateral testes but not in the contralateral testes. The MSTD, GECT, and MTBS of the ipsilateral testes were significantly higher in the group treated with VEGF than in the torsion-detorsion group. The animals treated with VEGF had a significant decrease in the mean value of ipsilateral testicular caspase-3-positive cells compared with the torsion-detorsion group. CONCLUSION(S): Vascular endothelial growth factor might have a role in testicular damage caused by ischemia-reperfusion. Administering VEGF before reperfusion might have the potential to decrease the long-term histologic damage after testicular torsion.

General anesthesia does not affect the serum complexed and free prostate specific antigen levels.

PRINCIPLES: Serum prostate-specific antigen (PSA) level is a widely used serum marker for diagnosis and management of prostate cancer. Although not well-defined, liver appears to be the most likely site of PSA metabolism. However, general anaesthesia usually changes hepatic blood flow, therefore it may affect the metabolism of PSA. In this study we investigated the affect of general anaesthesia on the serum total PSA, free PSA and free to total PSA levels. METHODS: 30 male patients who were hospitalised in the internal medicine clinic (non-surgery group) and 30 male patients who would undergo operation under general anaesthesia (15 for cholecystectomy and 15 for inguinal hernia repair) enrolled into the study. PSA measurement was done on the day of the hospitalisation (which was also the day of operation for surgery group), on the 24th hour following the first measurement and on the 21st day. Anaesthesia was standardized for all patients. RESULTS: There was no statistically significant difference in serum total PSA (p >0.05), free PSA levels (p >0.05) and free to total PSA ratio (p >0.05) between the surgery and non-surgery groups. There were statistically significant decreases in the 24th hour total PSA levels (13.8% in surgery group, p <0.05, and 13.1% in non-surgery group, p <0.05) and in the free PSA levels (4.0% in surgery group, p <0.05, and 8.2% in non-surgery group, p <0.05). There was no statistically significant difference in the free to total PSA ratios (p >0.05 and p >0.05, respectively). CONCLUSIONS: Anaesthesia does not affect PSA levels alone. However, hospitalisation decreases total and free PSA levels, although it does not have an affect on free to total PSA ratio.