Objective: We aimed to demonstrate the relationship between urine analysis and culture of patients with DJ stents with significant urinary infection and thus prevent unnecessary antibiotic use and over-treatment. Material and Methods: The data of patients who had DJS insertion between 2016 and 2019 were investigated retrospectively. Results: A total of 152 patients were included in the study. The mean age of the patients was 48.9±14.9 years. Indications for DJS insertion were as follow: endoscopic ureter and kidney stone treatment was percutaneous nephrolithotomy in 108 (71.2%) patients, percutaneous nephrolithotomy in 20 (13.2%) patients and renal transplantation in 6 patients. The urine analysis of the patients revealed nitrite (+) in 8 patients and leukocyte esterase (+) in 117 patients (77%). In 20 patients (13.2%), various microorganism growths were observed in urine culture. 75% of patients with nitrite were positive in urine culture. No significant difference was found between urine cultures of patients with and without comorbidity (p = 0.132). In multivariate regression analysis, age, gender, catheter stay duration, and indications for DJS were not found top predict urinary tract infection (p> 0.05 for all variables). Conclusion: In patients with ureteral stent, nitrite positivity predicts urinary tract infection at a high rate and necessitate urine culture followed by appropriate antibiotic treatment.
ABSTRACT Objective Our objective in this study was to evaluate the factors predicting female sexual dysfunction (FSD) in patients with diabetes mellitus (DM). Subjects and methods The study included 149 women with DM. Sexual function was evaluated with the Female Sexual Function Index (FSFI) questionnaire, in which total scores under 26.55 characterized the occurrence of FSD (Group 1 > 26.55, Group 2 < 26.55). We recorded the patients’ demographic, metabolic, and hormonal data. Ophthalmologic, neurologic, and renal complications were also evaluated. The antioxidant status of the patients in both groups was determined by measuring the activity of the enzymes paraoxonase-1 (PON-1) and arylesterase (ARE). Results Based on the FSFI scores, 60 patients were allocated to Group 1 (26.6 ± 12.3) and 89 to Group 2 (22.6 ± 9.5). Group 2 compared with Group 1 had significantly (p < 0.05) higher mean concentrations of glycated hemoglobin (HbA1c), glucose, triglycerides, and insulin, along with higher rates of metformin use, smoking, retinopathy, and nephropathy. The mean serum ARE concentrations were significantly lower in Group 2 compared with Group 1 (p = 0.000), but the mean serum PON-1 concentrations were similar between both groups (p = 0.218). On multivariable regression analysis, age, ARE activity, Beck Depression Inventory (BDI) score, and menopause were significant independent predictors of FSD (p < 0.05). Conclusions In this study, we evaluated the predictive factors determining FSD caused by DM. Despite the significant results found in our study, future randomized controlled studies with a long follow-up and a larger number of patients are required to determine how DM affects FSD.
OBJETIVO: La prostatectomia radical con preservacion de nervios ofrece un excelente control del cancer pero la recuperacion de la continencia y la funcion sexual son inciertas. Presentamos los detalles operatorios y las tecnicas quirurgicas en nuestra experiencia con la prostatectomia radical asistida por robot para el cancer de prostata organo confinado.
METODOS: Entre los anos 2009 y 2012, 68 pacientes con cancer de prostata clinicamente localizado fuero sometidos a prostatectomia radical asistida por robot con preservacion de fascia, preservacion de nervios, intrafascial, y anastomosis vesicouretral anatomica. Ninguno de los pacientes tenia incontinencia. 48 de los pacientes tenian una puntuacion del cuestionario IIEF-5 de potencia igual o superior a 22 sin tomar inhibidores de la fosfodiesterasa 5. Nuestras tecnicas incluian conservacion del cuello vesical, conservacion de la fascia endopelvica y los ligamentos puboprostaticos, abordaje conservador de nervios intrafascial, sutura selectiva del complejo de la vena dorsal del pene, y reconstruccion anterior y posterior.
Evaluamos a los pacientes en el primer, 3er, 6o y 12o mes postoperatorios para determinar si estas tecnicas se correlacionan con recuperacion temprana de la continencia urinaria y la potencia.
RESULTADOS: El tiempo de operacion medio fue de 258,2±78,5 minutos y el sangrado estimado medio durante la operacion de 111,2 ± 22,9 cc. Se realizo conservacion bilateral de nervios en 62 casos (91,2%) y unilateral en 6 casos (8,8%). El tiempo medio hasta la retirada del drenaje fue de 2,3 ± 0,9 dias, y la estancia hospitalaria media de 3,4 ± 1,1 dias. La sonda vesical fue retirada en el dia 9,9 ± 0,9 del postoperatorio. Hubo margenes positivos en 10 pacientes (14,7%). Las tasas de continencia a 1, 3, 6 y 12 meses fueron 74,2%, 76,9%, 80,6%, y 95,6%, respectivamente. Durante el mismo periodo, entre los pacientes sin disfuncion erectil las tasas de potencia fueron 29,4%, 38,2%, 54,1%, y 75%, respectivamente. Todas las operaciones se completaron satisfactoriamente, y no hubo complicaciones graves.
CONCLUSIONES: Es necesario un abordaje mas global para la comunicacion de resultados de la cirugia del cancer de prostata. Los hallazgos de nuestro estudio sugieren que las tecnicas con conservacion de fascia tienen una influencia positiva en la recuperacion temprana de la continencia urinaria. Sin embargo, son necesarios estudios aleatorizados controlados con grandes muestras.
We evaluated the genotypes of the serotonin transporter gene (5-HTT) in patients with premature ejaculation (PE) to determine the role of genetic factors in the etiopathogenesis of PE and possibly to identify the patient subgroups.A total of 70 PE patients and 70 controls were included in this study.All men were heterosexual, had no other disorders and were either married or in a stable relationship.PE was defined as ejaculation that occurred within 1 min of vaginal intromission.Genomic DNA from patients and controls was analyzed using polymerase chain reaction, and allelic variations of the promoter region of the serotonin transporter gene (5-HTTLPR) were determined.The 5-HTTLPR (serotonin transporter promoter gene) genotypes in PE patients vs. controls were distributed as follows: L/L 16% vs. 17%, L/S 30% vs. 53% and S/S 54% vs. 28%.We examined the haplotype analysis for three polymorphisms of the 5-HTTLPR gene: LL, LS and SS.The appropriateness of the allele frequencies in the 5-HTTLPR gene was analyzed by the Hardy-Weinberg equilibrium using the χ 2 -test.The short (S) allele of the 5-HTTLPR gene was significantly more frequent in PE patients than in controls (P < 0.05).We suggest that the 5-HTTLPR gene plays a role in the pathophysiology of all primary PE cases.Further studies are needed to evaluate the relationship between 5-HTTLPR gene polymorphism and patient subgroup (such as primary and secondary PE) responses to selective serotonin reuptake inhibitors as well as ethnic differences.