Association between selective serotonin and serotonin-noradrenaline reuptake inhibitor therapy and hematuria.

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are used as first-line treatment for many psychiatric diseases, especially major depressive disorder. However, an important side effect of these drugs is the risk of bleeding due to platelet dysfunction. The aim of this study was to determine the frequency of hematuria in patients using SSRI/SNRIs and to compare with a control group. METHODS: This study included patients who were followed up and treated with SSRI/SNRI in the psychiatric outpatient clinic of the Antalya Medical Park Hospital between 1 January 2021 and 31 March 2021 and a control group comprising patients who presented to the medical check-up outpatient clinic between the same dates. Complete urinalysis was performed for all patients and the results were compared between the groups. RESULTS: Each group included 100 patients with a female/male ratio of 1. The mean age was 41.45 ± 13.47 (16-74) years in the study group and 40.51 ± 13.75 (20-70) years in the control group (p = 0.519). Mean duration of SSRI/SNRI use in the study group was 13.35 ± 1.32 (1-64) months. The prevalence of hematuria was 17% in the SSRI/SNRI group and 6% in the control group (p = 0.015). All cases of hematuria were microscopic hematuria. CONCLUSION: Hematuria is significantly more common in patients receiving SSRI/SNRI treatment. The use of SSRI/SNRI should also be taken into account when investigating the etiology of hematuria.

Comparison of spermiograms of infertile men before and during the COVID-19 pandemic.

OBJECTIVE: Since the start of the COVID-19 pandemic, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented for infertility during the pandemic compared with the previous 2 years. METHODS: Patients who presented to a urology outpatient clinic for the first time due to infertility were included. The patients' age, semen volume, and spermiogram results were recorded. Based on the presentation date, the patients were divided into prepandemic group 1 (March 2018-February 2019), prepandemic group 2 (March 2019-February 2020), and pandemic group (March 2020-February 2021) for comparison. RESULTS: A total of 594 patients were included. There was no significant difference between the three groups in terms of the number of patients who presented for infertility (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in the prepandemic group 1, 35.5±7.1 in the prepandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There were no differences between the groups in terms of semen volume (p=0.910) or rates of normospermia and pathological spermiogram findings (p=0.222). CONCLUSIONS: In the first year of the COVID-19 pandemic, there was no significant difference in the number of patients who presented for infertility or in their spermiogram results compared with 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous 2 years.

Comparison of spermiograms of infertile men before and during the COVID-19 pandemic

SUMMARY OBJECTIVE: Since the start of the COVID-19 pandemic, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented for infertility during the pandemic compared with the previous 2 years. METHODS: Patients who presented to a urology outpatient clinic for the first time due to infertility were included. The patients' age, semen volume, and spermiogram results were recorded. Based on the presentation date, the patients were divided into prepandemic group 1 (March 2018-February 2019), prepandemic group 2 (March 2019-February 2020), and pandemic group (March 2020-February 2021) for comparison. RESULTS: A total of 594 patients were included. There was no significant difference between the three groups in terms of the number of patients who presented for infertility (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in the prepandemic group 1, 35.5±7.1 in the prepandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There were no differences between the groups in terms of semen volume (p=0.910) or rates of normospermia and pathological spermiogram findings (p=0.222). CONCLUSIONS: In the first year of the COVID-19 pandemic, there was no significant difference in the number of patients who presented for infertility or in their spermiogram results compared with 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous 2 years.

Evaluating the utility of the A.F. Genital System test for pathogen diagnosis in acute male urethritis.

This study evaluated the effectiveness of the A.F. Genital System (Liofilchem® , Italy) in detecting pathogens compared with multiplex real-time polymerase chain reaction (PCR) in men with acute urethritis. Men diagnosed as having acute urethritis between 1 April 2021 and 31 December 2021 were included. Urethral swab samples were obtained for A.F. Genital System and PCR testing in a randomly determined order. The efficacy of the A.F. Genital System was analysed by comparing the results of the two tests. The study included 83 patients (mean age 34.1 ± 11.3 years). A urethritis pathogen was detected in 69 patients (83.1%) by PCR and only 15 patients (18.1%) with the A.F. Genital System. The sensitivity of the A.F. Genital System in detecting acute urethritis pathogens was 21.7% (95% confidence interval [CI]: 13.6-32.8), and the specificity was 100% (95% CI: 78.5-100). Its sensitivity was 20% (95% CI: 7.1-45.2) in the diagnosis of gonococcal urethritis and 19.1% (95% CI: 11.2-30.4) in the diagnosis of non-gonococcal urethritis. PCR detected two or more urethritis pathogens in 9 patients (13.0%), while no polymicrobial infection was detected with the A.F. Genital System. Based on the results of multiplex real-time PCR, the A.F. Genital System had very low sensitivity in the detection of pathogens in acute male urethritis. It should be kept in mind that using this test in patients with acute urethritis may result in a high missed diagnosis rate for urethritis pathogens.

Prognostic value of HPV DNA in Urothelial Carcinoma of the Bladder: A Preliminary Report of 2-Year Follow-up Results.

PURPOSE: The association between the human papillomavirus (HPV) and anogenital carcinomas is well established. However, despite its anatomic adjacency, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is less clear. Recent meta-analysis and case-control studies demonstrated a significant relationship between the presence of HPV DNA and UCB. The aim of this clinical study was to compare the 2-year follow-up results of HPV-positive and HPV-negative UCB patients to evaluate the prognostic value of HPV DNA positivity in UCB. METHODS: The study included patients with stage pTa and pT1 UCB who underwent polymerase chain reaction (PCR) analysis of HPV DNA between January 1 and November 30, 2018. Based on their PCR results, 19 HPV-positive and 38 HPV-negative UCB patients who had regular follow-up in our clinic were evaluated in terms of tumor recurrence and disease progression over a 2-year follow-up period. RESULTS: There was no significant difference between the groups in terms of age, follow-up time, smoking, or tumor grade (P= .576, P= .368, P= .080, and P= .454). Tumor recurrence was observed at least once in 47.3% (n=9) of the 19 HPV-positive patients and 36.8% (n=14) of the 38 HPV-negative patients (P= .445). There was no difference in disease progression between the groups during follow-up. CONCLUSION: In our sample of UCB patients, the presence of HPV DNA was associated with a trend toward higher recurrence rate during the 2-year follow-up, though the difference was not statistically significant. No difference in disease progression was observed based on HPV DNA positivity.

Effect of Edentulism and Oral Quality of Life on Sexual Functions in Men: A Cohort Prospective Study.

INTRODUCTION: Edentulism has a serious impact on quality of life (QoL), and changes in QoL can affect sexual functioning. AIM: To assess the correlation between oral health-related quality of life (OHQoL) and sexual function in edentulous men. METHODS: A total of 148 men (18-70 years) with incomplete natural dentition completed the International Index of Erectile Function (IIEF) and Oral Health Impact Profile (OHIP-14) at 4 time points: before (T0), during (T1), 4 weeks after (T2), and 1 year (T3) after dental treatment. Kruskal-Wallis, Friedman, and Spearman's rank correlation tests were used for statistical analyses (significance at P < .05). RESULTS: IIEF total scores differed significantly between the time points (P < .001), with medians and interquartile ranges (IQR) of 46 (7), 42 (8), 49 (6), and 52 (5) at T0, T1, T2, and T3, respectively. The highest rate of sexual dysfunction was detected at T1 (42.2%) and the lowest at T3 (26.6%). IIEF domain scores also decreased at T1 and increased at T2 and T3 compared with T0 (P < .05). Median (IQR) OHIP-14 scores were 26.0 (8), 28.0 (8), 20.0 (6), and 18.0 (5), respectively (P < .001). OHIP score was significantly correlated with IIEF domain scores (P < .05) and there were strong negative correlations between OHIP and total IIEF scores at T0 (r = -0.737), T1 (r = -0.802), T2 (r = -0.831), and T3 (r = -0.722) (P = <.001 for all). MAIN OUTCOME MEASURE: Changes and correlations in IEFF and OHIP-14 scores; SD and ED prevalances at T0; T1; T2 and T3 periods. CLINICAL IMPLICATIONS: Sexual functions was significantly correlate with OHQoL; thus patients with ED should also be examined in terms of toothlessness. CONCLUSION: OHQoL was significantly associated with sexual function in men. However, correcting the problem of edentulism improved OHQoL and sexual function, with the best results observed after 1-year follow-up. H Turgut, S Turgut. Effect of Edentulism and Oral Quality of Life on Sexual Functions in Men: A Cohort Prospective Study. Sex Med 2021;9:100305.

Update on the Management of Urological Problems Following Kidney Transplantation.

Urological problems in kidney transplant recipients are not limited only to posttransplantation urological complications. These problems are a cause of significant patient mortality and morbidity that have wide-ranging effects on graft survival throughout the entire life of the graft. Ultimately, the transplant comprises a major portion of the urinary system; therefore, the transplant team should be prepared for foreseeable and unforeseeable urological problems in the short and long terms. These mainly include postoperative urological complications (urine leakage, ureteral stenosis, and vesicoureteral reflux), bladder outlet obstruction, and graft urolithiasis. In recent years, significant advances have been made in the management of urological complications, especially due to advances in endourologic interventions. The aim of this review is to summarize the management of urological problems after kidney transplantation in the context of the current literature.

Does the sexual function of the spouses change after the TOT procedure?

AIM: This prospective study aimed to evaluate sexual function in women who underwent transobturator tape (TOT) sling surgery and their male sexual partners compared to before the procedure. MATERIALS AND METHODS: The study included a total of 202 women with stress urinary incontinence who underwent the TOT procedure between April 2018 and February 2020, and their partners. All of the women completed the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and Female Sexual Function Index (FSFI) questionnaire while their partners completed the International Index of Erectile Function (IIEF-5) questionnaire before and 6 months after the procedure. RESULTS: Mean IIQ-7 and UDI-6 scores were significantly lower at postoperative month 6 compared to preoperative values (p < 0.001). Mean FSFI scores were 22.5 ± 1.7 preoperatively and 27.8 ± 1.6 at postoperative month 6 (p < 0.001). Pain score did not change significantly (p = 0.4), but there were significant increases in the other FSFI domains of desire, arousal, lubrication, and satisfaction (p < 0.001, p < 0.001, p < 0.001, p < 0.001). The partners' mean IIEF score was 50.05 ± 5.4 preoperatively and increased to 59.7 ± 6.8 postoperatively (p < 0.001). No significant differences were detected in erectile or orgasmic function (p = 0.16, p = 0.67), whereas desire, intercourse satisfaction, and overall satisfaction scores increased significantly (p < 0.001, p < 0.001, p < 0.001). CONCLUSION: TOT surgery improves sexual function not only in women but also their partners.

Evaluation of the efficacy of sexual intercourse on distal ureteral stones in women: a prospective, randomized, controlled study.

AIM: To evaluate the efficacy of sexual intercourse in the expulsion of distal ureteric stones in women. MATERIALS AND METHODS: A total of seventy woman patients with distal ureteral or intramural stone were randomly divided into two groups. Group 1 included 35 patients who were advised to do sexual intercourse 3-4 times/week with the administration of symptomatic treatment, and group 2 (control group) included 35 patients receiving symptomatic treatment only and were instructed not to do sexual intercourse or masturbation during the study. After 4 weeks follow up; the expulsion rate, need for analgesic and ureterorenoscopic lithotripsy were compared for each group. RESULTS: The mean ages of the patients in groups 1 and 2 were 36.4 ± 10.8, 37.1 ± 12.4, respectively. The mean stone size was 7.01 ± 1.6 in group 1, 6.67 ± 1.4 mm in group 2 (p: 0.3). Stone expulsion rate, in the first 2 weeks for group 1 was 80% (28/35), while 51.4% (18/35) in group 2 (p < 0.001). In the 4th week, the expulsion rate for group 1 was 85.7%, but 60% in group 2 (p < 0.001). The mean expulsion time was shorter in group 1 (12 ± 4.2 days) than group 2 (16.1 ± 6.4 days) (p < 0.01). The analgesic needs in groups 1 and 2 were found to be 1.9 ± 0.7, 2.6 ± 0.8 times/a day respectively, and were significantly lower in group 1 (p < 0.001). CONCLUSION: At least three or four sexual intercourses per week seem to increase the spontaneous passage for distal or intramural ureteral stones in women. Furthermore, sexual intercourse reduces the need for analgesics.

Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey.

OBJECTIVE: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. METHODOLOGY: The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. RESULTS: A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. CONCLUSIONS: Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.

Evaluation of the efficacy of masturbation on distal ureteral stones: a prospective, randomized, controlled study.

PURPOSE: To evaluate the effect of masturbation on the spontaneous expulsion of distal ureteral stones 5-10 mm in size. MATERIAL AND METHODS: A total of 128 men with distal ureteral stones were randomly divided into 3 groups. All patients received standard medical therapy. Patients in group 1 (n = 43) were instructed to masturbate at least 3-4 times a week, patients in group 2 (n = 41) received tamsulosin 0.4 mg/day, and patients in group 3 (controls, n = 44) received standard medical therapy alone. Rates of expulsion, need for analgesic, and ureterorenoscopic lithotripsy were compared between the groups. RESULTS: The mean ages of the patients in groups 1, 2, and 3 were 37 ± 5.0, 37.6 ± 4.6, and 38.4 ± 6.8 years, respectively (p = 0.7). The mean stone size in each group was 6.93 ± 1.1 mm, 7.1 ± 0.9 mm, and 6.87 ± 1.1 mm, respectively (p = 0.4). Spontaneous passage rates in groups 1, 2, and 3 were 81.4%, 80.5%, and 43.2%, respectively, and were significantly higher in group 1 (p = 0.001) and group 2 (p = 0.001) when compared with group 3. Analgesic requirement in groups 1, 2, and 3 was 1.7 ± 0.6, 1.5 ± 0.6, and 1.8 ± 0.6 times per day, respectively, and was significantly lower in the tamsulosin group than in the control group (p = 0.004) CONCLUSION: Masturbation and tamsulosin increased the spontaneous passage of distal ureteral stones 5-10 mm in size. Masturbating at least 3-4 times a week was as effective as tamsulosin. Masturbation and tamsulosin also reduced the need for ureterorenoscopic lithotripsy.

New Approach to Microscopy of Gram-Stained Urethral Smear: The Kissing Slide Method.

BACKGROUND: The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis. METHODS: The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings. RESULTS: The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ≥5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%-75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%-40.93%) for the conventional method. At a threshold of ≥2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%-90.5%) and 50% (95% CI, 33.15%-66.85%) in all patients, and 66.67% (95% CI, 41.71%-84.82%) and 20% (95% CI, 7.047%-45.19%) in cases without visible urethral discharge, respectively. CONCLUSION: The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings.

Ivabradine inhibits carbachol-induced contractions of isolated rat urinary bladder.

BACKGROUND: Overactive bladder (OAB), a symptom syndrome defined as urgency, is a common clinical condition, which sometimes cannot be satisfactorily treated with current medications in every subject; therefore, alternatives are needed. OBJECTIVES: The aim of this in vitro study was to investigate the effects of ivabradine, a selective pacemaker If current inhibitor, on agonist-induced isometric contractions of the bladder smooth muscles. MATERIAL AND METHODS: Urinary bladder strips were isolated from adult male Wistar rats and suspended in a tissue bath containing physiological solution. The strips were contracted by bath applications of carbachol (CCh, 1 µM). Ivabradine (30 µM, 60 µM or 90 µM) was added to the tissue bath either prior to or after the application of the agonist, and the resulting contractile activity was compared to the preceding contractile activity. The amplitude and area under force-time curves (AUFC) of the isometric contractions were evaluated. RESULTS: The addition of CCh caused a marked stimulation of contractile force in isolated urinary bladder strips, which was significantly inhibited by ivabradine, both in terms of peak amplitude (29% ±3%, 20% ±6% and 18% ±6% by 30 µM, 60 µM and 90 µM ivabradine, respectively) and AUFC (47% ±5.5%, 35% ±8% and 35% ±6% by 30 µM, 60 µM and 90 µM ivabradine, respectively; n = 7 for each). Pre-treatment with ivabradine (10 µM) significantly attenuated the contractile response to CCh (1 µM; mean peak amplitude from 1493 ±216 mg to 680 ±95 mg; p < 0.003; n = 7). CONCLUSIONS: The results of this in vitro study demonstrated that ivabradine inhibits cholinergic agonistinduced bladder contractions, which means that in the future ivabradine may be used in OAB treatment.

The Current Perspectives of Stem Cell Therapy in Orthopedic Surgery.

CONTEXT: Musculoskeletal injuries may be painful, troublesome, life limiting and also one of the global health problems. There has been considerable amount of interest during the past two decades to stem cells and tissue engineering techniques in orthopedic surgery, especially to manage special and compulsive injuries within the musculoskeletal system. EVIDENCE ACQUISITION: The aim of this study was to present a literature review regarding the most recent progress in stem cell procedures and current indications in orthopedics clinical care practice. The Medline and PubMed library databases were searched for the articles related with stem cell procedures in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. RESULTS: Various sources of stem cells have been studied for orthopedics clinical care practice. Stem cell therapy has successfully used for major orthopedic procedures in terms of bone-joint injuries (fractures-bone defects, nonunion, and spinal injuries), osteoarthritis-cartilage defects, ligament-tendon injuries, femoral head osteonecrosis and osteogenesis imperfecta. Stem cells have also used in bone tissue engineering in combining with the scaffolds and provided faster and better healing of tissues. CONCLUSIONS: Large amounts of preclinical studies have been made of stem cells and there is an increasing interest to perform these studies within the human population but preclinical studies are insufficient; therefore, much more and efficient studies should be conducted to evaluate the efficacy and safety of stem cells.

Seasonal preponderance in testicular torsion: is it a myth?

OBJECTIVE: In this study, we aimed to investigate the relation of testicular torsion and weather conditions, and to report results from Turkey, a country located between temperate and sub-tropical climate zones. METHODS: A total of 56 patients that had surgery with the diagnosis of testicular torsion in Ankara Education and Research Hospital Urology Clinic between 2005 and 2014 were included in the study. Age of the patient, side of torsion, date and time at onset of pain, scrotal exploration time, ischemia duration, degree of cord torsion, the surgical procedure performed, and scrotal Doppler ultrasound (USG) findings at the time of diagnosis and 1 month after surgery were retrospectively analyzed. The web archives of Turkish Republic Meteorology General Directorate was used to determine the seasonal and mean temperatures at the time of diagnosis. The data were analyzed with SPSS v. 16 statistical package program using Chi-square, Mann- Whitney U and Wilcoxon tests. RESULTS: The mean age of 56 males included in the study was 18.88 ± 0.73 years. Right testicular torsion was seen in 23, and left testicular torsion was seen in 33 patients. Testicular arterial flow was absent in 37, arterial flow was moderately decreased in 12, and significantly decreased in 7 patients on Doppler USG. Detorsion procedure was performed in 46 patients while 10 patients had orchiectomy. Nine patients were admitted in summer, 14 in fall, 15 in winter, and 18 in spring. The mean air temperature at the time of admittance was 9.31 ± 1.05 °C. The prevalence of testicular torsion was not found different among the seasons (p=0.39). The analysis of air temperature at the time of admittance of the patients revealed that it was below 15 °C in 40 patients while it was above 15 °C in 16 patients, with a significant difference in between (p=0.002). CONCLUSIONS: The prevalence of testicular torsion did not change in relation with the seasons. However, it was determined that its prevalence was directly proportional to the air temperature, and increased particularly below 15 °C.

Seasonal preponderance in testicular torsión: is it a myth / Preponderancia estacional de la torsión testicular: ¿Es un mito?

OBJECTIVE: In this study, we aimed to investigate the relation of testicular torsion and weather conditions, and to report results from Turkey, a country located between temperate and sub-tropical climate zones. METHODS: A total of 56 patients that had surgery with the diagnosis of testicular torsion in Ankara Education and Research Hospital Urology Clinic between 2005 and 2014 were included in the study. Age of the patient, side of torsion, date and time at onset of pain, scrotal exploration time, ischemia duration, degree Arch. Esp. Urol. 2015; 68 (10): 750-754 of cord torsion, the surgical procedure performed, and scrotal Doppler ultrasound (USG) findings at the time of diagnosis and 1 month after surgery were retrospectively analyzed. The web archives of Turkish Republic Meteorology General Directorate was used to determine the seasonal and mean temperatures at the time of diagnosis. The data were analyzed with SPSS V. 16 statistical package program using Chi-square, Mann-Whitney U and Wilcoxon tests. RESULTS: The mean age of 56 males included in the study was 18.88 ± 0.73 years. Right testicular torsion was seen in 23, and left testicular torsion was seen in 33 patients. Testicular arterial flow was absent in 37, arterial flow was moderately decreased in 12, and significantly decreased in 7 patients on Doppler USG. Detorsion procedure was performed in 46 patients while 10 patients had orchiectomy. Nine patients were admitted in summer, 14 in fall, 15 in winter, and 18 in spring. The mean air temperature at the time of admittance was 9.31 ± 1.05ºC. The prevalence of testicular torsion was not found different among the seasons (p = 0.39). The analysis of air temperature at the time of admittance of the patients revealed that it was below 15ºC in 40 patients while it was above 15ºC in 16 patients, with a significant difference in between (p = 0.002). CONCLUSIONS: The prevalence of testicular torsion did not change in relation with the seasons. However, it was determined that its prevalence was directly proportional to the air temperature, and increased particularly below 15ºC

OBJETIVO: En este estudio buscamos investigar la relación entre la torsión testicular y las condiciones meteorológicas, y comunicar los resultados de Turquía, un país localizado entre las zonas climáticas templada y subtropical. Metodos: Se incluyeron en el estudio 56 pacientes que fueron intervenidos con el diagnostico de torsión testicular en la consulta de Urología del Hospital Ankara Education and Research Hospital entre 2005 y 2014. La edad del paciente, el lado de la torsión, la fecha y hora del inicio del dolor, la hora de la exploración escrotal, el tiempo de isquemia, el grado de torsión del cordón, la intervención quirúrgica realizada y los hallazgos de la ecografía Doppler en el momento del diagnostico y al mes de la cirugía fueron analizados retrospectivamente. Se utilizaron los archivos web de la Dirección General de Meteorología de la República Turca para determinar las temperaturas estacionales y medias en el momento del diagnóstico. Los datos se analizaron con el programa SPSS V. 16 statistical package utilizando las pruebas de Chi-cuadrado, U de Mann-Whitney y Wilcoxon. RESULTADOS: La edad media de los 56 varones incluidos en el estudio fue de 18,88 ± 0.73 años. La torsión fue derecha en 23 pacientes e izquierda en 33. No había flujo arterial testicular en la ecografía Doppler en 37 pacientes, estaba moderadamente disminuido en 12 y significativamente disminuido en 7. Se realizó detorsión en 46 pacientes y orquiectomía en 10. Nueve pacientes ingresaron en verano, 14 en otoño, 15 en invierno y 18 en primavera. La temperatura media del aire en el momento del ingreso era de 9,31 ± 1,05ºC. No se encontró una prevalencia diferente de torsión testicular entre las estaciones (p = 0,39). El análisis de la temperatura del aire en el momento del ingreso reveló que era menor de 15ºC en 40 pacientes y mayor de 15ºC en 16 pacientes, con una diferencia significativa (p = 0,002). CONCLUSION: La prevalencia de torsión testicular no cambia en relación con las estaciones. Sin embargo, se determinó que su prevalencia era directamente proporcional a la temperatura del aire, y aumentaba particularmente por debajo de 15ºC

Choosing the right imaging method in muscle hernias: musculoskeletal ultrasonography.

Muscle hernia (MH) is a focal protrusion of muscle into the overlying subcutaneous tissue through an acquired or congenital facial defect. Herniation in the thigh muscles is not common and there are limited reports evaluating this pathology using ultrasonography (US). A 28-year-old amateur football player presented with a palpable mass on the anterior aspect of his right thigh. Sonographic examination demonstrated a MH through a fascial defect, which is called mushroom appearance. Based on the clinical and sonographic findings, the diagnosis of a MH in the rectus femoris muscle was established. Today, there is no doubt anymore on the role of musculoskeletal US in the field of sports injuries. Therefore, with its various advantages (non-invasive, practical and convenient, inexpensive, etc.), US is the key imaging method in the diagnosis of MHs.