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ABSTRACT: To compare the factors affecting sexual function in premenopausal women with type 2 diabetes using the female sexual function index (FSFI).
Cross-sectional study.
Premenopausal women with type 2 diabetes and healthy volunteers in an academic research environment.
Sixty-two type 2 diabetic women were compared with 50 controls. The FSFI scores of the patients were compared according to age, duration of diabetes, marriage, socioeconomic status, parity, menstruation regularity, body mass index (BMI), and smoking.
None.
Female sexual function index scores.
The mean FSFI score in diabetics was lower than in controls. Menstrual irregularity and duration of diabetes affected female sexual function unlike age, BMI, socioeconomic status, duration of marriage, or parity. Regularly menstruating women had higher FSFI scores (27.1 ± 6.7) than irregularly menstruating women (20.7 ± 7.4). Type 2 diabetics were divided into three groups according to duration of diabetes. The women having diabetes longer than 10 years had the worse sexual function. Also, smoking affected inversely female sexual well being.
Menstrual disturbance, smoking, and longer duration of diabetes (more than 10 years) impair FSFI scores in premenopausal women with type 2 diabetes.
Fertility and sterility 10/2010; 94(5):1840-3. · 3.97 Impact Factor
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ABSTRACT: To identify the prognostic factors and the new parameters that might predict a worse outcome in nonsurvivors compared with survivors of Fournier's gangrene (FG) and evaluated the validity of the Fournier's Gangrene Severity Index (FGSI) in patients with FG.
The medical records of 18 patients with FG who were treated and followed up in our clinic were reviewed. Data were collected in terms of medical history, symptoms, and physical examination findings. The biochemical, hematologic, and bacteriologic study (aerobic and anaeorobic wound cultures) results at admission and at the final evaluation, the physical examination findings, the timing and extent of surgical debridement, and the antibiotic therapy were also recorded. The Charlson Comorbidity Index (CCI) and FGSI were evaluated stratified by survival.
The results were evaluated for 2 groups: those who survived (n = 14) and those who did not (n = 4). The admission FGSI score was 5.00 +/- 2.91 (range 0-10) for survivors compared with 13.5 +/- 2.62 (range 9-15) for nonsurvivors (P = .001). The CCI score was 3 +/- 1.5 in survivors and 7 +/- 2.2 in nonsurvivors (P = .008). Individual laboratory parameters such as hypomagnesemia, hemoglobin, hematocrit, alkaline phosphatase, creatinine, and the heart and respiratory rates were associated with a worse prognosis. In addition, a FGSI >9, rectal involvement, colostomy diversion, and a high CCI were associated with high mortality.
Low magnesium levels might be a new parameter for a worse prognosis. High CCI and FGSI scores might be associated with a worse prognosis in patients with FG. A FGSI threshold of 9 was a predictor of mortality during the initial assessment.
Urology 05/2010; 75(5):1193-8. · 2.43 Impact Factor
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Current Oncology 04/2010; 17(2):4-5; author reply 5. · 2.47 Impact Factor
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Urology 03/2010; 75(3):675. · 2.43 Impact Factor
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ABSTRACT: This prospective, randomized, and double-blind clinical study aimed to assess the analgesic efficacy of single-dose intramuscular (IM) injection of dexketoprofen (group DE) compared with single-dose IM injection of diclofenac (group DI) in patients who were undergoing shockwave lithotripsy (SWL). Patients and
A total of 70 men with single renal or ureteral stones were randomly separated into two groups. The 40 men in group DI received 75 mg IM diclofenac sodium and 30 men in Group DE received 50 mg IM dexketoprofen trometamol 30 minutes before SWL. A 10-point visual analog scale was used to evaluate pain.
The age, body mass index, and mean stone burden were comparable between the two groups (P > 0.05). The mean visual analog scale score for group DE was statistically lower compared with the score for group DI (P = 0.02). In 34 (85%) of the 40 men in group DI, the SWL procedure was performed with no, minor, or tolerable pain. In group DE, however, 28 (93.3%) of 30 patients evaluated the pain severity as no, minor, or tolerable (p = 0.01). No major/minor adverse effects were observed in group DI, whereas in one patient in group DE, dyspepsia after injection was noticed (P = 0.423).
The severity of SWL-related pain was significantly better tolerated with dexketoprofen trometamol. During an SWL procedure, the analgesic efficacy of dexketoprofen was greater than that of diclofenac sodium. Although statistically insignificant, a little increased risk for gastric irritation was noticed with dexketoprofen.
Journal of endourology / Endourological Society 03/2010; 24(6):1031-5. · 1.75 Impact Factor
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ABSTRACT: The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi < or =10 mm. 92 patients having single radio-opaque proximal ureteral stone < or =10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified according to stone diameters <5 and 5-10 mm. The data of these subgroups were also compared. Stone expulsion rates showed statistically significant difference between tamsulosin receivers and non-receivers (35.7 vs 30%, p = 0.04). Time to stone expulsion period was also shortened in those receiving tamsulosin (8.4 +/- 3.3 vs 11.6 +/- 4.1 days, p = 0.015). Likewise, the mean VAS score and renal colic episodes during follow-up period were significantly diminished in Group 2 patients (4.5 +/- 2.3 vs 8.8 +/- 2.9, p < 0.01 and 66.6 vs 36%, p = 0.001, respectively). Among the stones <5 mm, tamsulosin receiving patients had higher spontaneous passage rate (71.4 vs 50%, p < 0.001). The prominent effect of tamsulosin on the 5-10 mm stones was the relocation of the stones to a more distal part of ureter (39.3 vs 18.7%, p = 0.001). Administration of tamsulosin in the medical management of proximal ureteral calculi can facilitate the spontaneous passage rate in the stone <5 mm and the relocation of the stones between 5 and 10 mm to more distal part of the ureter.
Urological Research 02/2010; 38(3):195-9. · 1.23 Impact Factor
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ABSTRACT: In this experimental study, we assessed the preventive effects of coenzyme Q(10) (CoQ(10)) in a rat model of ischemia/reperfusion injury. The results of this study show that CoQ(10) administration before the reperfusion period of testicular torsion provides a significant decrease in testicular lipid peroxidation products and expressions of inducible nitric oxide synthase, endothelial nitric oxide synthase, and germ cell-specific apoptosis.
Fertility and sterility 09/2009; 93(1):280-2. · 3.97 Impact Factor
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ABSTRACT: We investigated the effect of intraperitoneal vardenafil (1 mg/kg) administration during an ischemic period in a rat model of testicular torsion/detorsion (T/D). Twenty-one adult Wistar rats were equally randomized into a control group, a T/D group and a vardenafil group. The control group was designed to collect basal values for biochemical and histopathological parameters. The T/D group underwent testicular torsion for 1 hour. The vardenafil group received vardenafil (1 mg/kg) intraperitoneally at 30 minutes after torsion. All rats were sacrificed 4 hours after reperfusion to evaluate the tissue levels of malondialdehyde and total antioxidant status. Germ cell apoptosis was evaluated using the apoptosis protease activating factor 1 antibody in all groups. The expressions of endothelial nitric oxide synthase (NOS) and inducible NOS were also assessed in both testes of all rats. The malondialdehyde levels in the T/D group were significantly higher than in the control and vardenafil groups. There were also significant decreases in total antioxidant status in the T/D group compared with the control and vardenafil groups. Vardenafil treatment significantly reduced apoptosis protease activating factor 1, endothelial NOS and inducible NOS levels in the vardenafil group compared with the T/D group. Administration of 1 mg/kg vardenafil during testicular torsion decreased ischemia/reperfusion cellular damage. Our results indicate that the reduction in oxidative stress by vardenafil may play a major role in its cytoprotective effects.
The Kaohsiung journal of medical sciences 08/2009; 25(7):374-80. · 0.61 Impact Factor
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ABSTRACT: The associations between the gene polymorphisms and erectile dysfunction (ED) are limited.
To examine a potential association between variable number of tandem repeats (intron 4 VNTR), G894T polymorphisms, and ED in Turkish men.
Sixty-four men with ED and 82 healthy men as a control group were included in the study. The patients were evaluated by medical history, International Index of Erectile Function (IIEF), serum glucose, and lipid profiles. VNTR and G894T polymorphism were assessed by isolated DNA blood samples obtained from the patient group with ED and controls.
Assesment of IIEF and VNTR and G894T polymorphism in the isolated DNA blood samples.
Genotype distributions of endothelial nitric oxide syntase (eNOS) gene intron 4 VNTR polymorphisms in the patient group were similar to those in the healthy group (P > 0.05). The frequency of the eNOS gene intron 4 genotype was found as bb: 55 (67.1%), ab: 26 (31.7%), and aa: 1 (1.2%) in the controls and bb: 43 (67.2%), ab: 19 (29.7%), and aa: 2 (3.1%) in the patient group. The frequency of the G894T was found as gg: 61 (74.4%), gt: 21 (25.6%), and tt: 0 (0.0%) in the controls and gg: 32 (50.0%), gt: 27 (42.1%), and tt: 5 (7.8%) in the patient group (P = 0.002). The frequencies of the "t" allele were 21 (12.8%) in the control group and 37 (28.9%) in the patient group (P = 0.001). Logistic regression analysis showed that G894T polymorphism was an independent risk factor for ED.
We found significant differences in allelic and genotypic frequencies between patients and controls for the G894T eNOS polymorphisms. The presence of 894T allele in carriers increased the risk of ED. No association was found between VNTR polymorphism and in patients with ED.
Journal of Sexual Medicine 06/2009; 6(5):1423-9. · 3.55 Impact Factor
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ABSTRACT: In current study, visual appearance of pure calcium phosphate (CaP) urinary stones by its morphology from plain radiograph (KUB), were investigated. We reviewed patients with urinary stone disease who underwent stone sur-gery. Among cases with crystallographically analyzed stones; 60 patients with pure CaP renal or ureteral stones (greater than 1 cm) were selected. Two endourologists and a uroradiologist familiar with the radiographic patterns of different types of pure stones were invited separately, to evaluate pretreatment KUB. Four different radiographic patterns were identified mainly with the assistance of previous studies. Smooth edged, homogenous stones with denser opacity were in-cluded in Group 1. Stones with irregular edges and stippled border were included in Group 2. Relatively uniform stones with radial striations and moderate density were decided to form Group 3. Calculi with the least radiodensity and loosely aggregated with a lacy structure were included in Group 4. Overall, 68.9% of CaP calculi were included in Groups 1 and 2 by all participants. Best concordance between endourologists and the uroradiologist was demonstrated in the evaluation of smaller calculi (< 150 mm2). On KUB, CaP urinary calculi were mostly seen as dense relatively homogenous stones and sometimes with stippled borders. With an increase in pretreatment stone size, interobserver and interdisciplinary variabil-ities increased.
Current Medical Imaging Reviews 01/2009; 5:238-241. · 0.71 Impact Factor
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ABSTRACT: Testicular apoptosis has been shown in human specimens, but its correlation with serum gonadotropins and testosterone levels has not been studied. The aim of this study was to evaluate the relationship of apoptosis with serum hormone levels and testicular histopathological findings in infertile men.
Testis biopsy specimens were obtained for routine clinical purposes from 41 azoospermic men. The biopsy material was divided into two parts: one part was fixed in Bouin's solution and processed using paraffin embedding and HE staining, and the other was fixed in 10% neutral buffered formalin and embedded in paraffin for the detection of apoptosis using TUNEL. To determine the apoptotic index, the number of apoptotic cells was divided by the total number of the counted cells and multiplied by 100 to calculate the percentage.
The apoptotic index was significantly higher in specimens with maturation arrest than in those with normal spermatogenesis (p = 0.016), hypospermatogenesis (p = 0.05), and Sertoli-cell-only specimens (p < 0.001). A significant negative correlation was found between serum follicle-stimulating hormone levels and the apoptotic index (r = -0.356, p = 0.01).
Our results demonstrate there is a relationship between increased apoptosis and testicular dysfunction, and indicate a prominent role for apoptosis in human male infertility.
Urologia Internationalis 01/2009; 83(3):349-53. · 0.99 Impact Factor
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ABSTRACT: Obstructive sleep apnea-hypopnea syndrome (OSAHS) may have a significant negative effect on sexual function.
To evaluate female sexual function in women with OSAHS.
Twenty-six patients with OSAHS were evaluated in two groups according to apnea-hypopnea index as mild (5-15, Group I, N = 16) or moderate-severe (>or=15, Group II, N = 10). A third group (N = 10) of patients suspected of sleeping disorders other than OSAHS who also underwent polysomnographic studies served as the control group. All women were evaluated with a detailed sexual history including Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). Meanwhile, serum levels of estradiol, prolactin, total and free testosterone and dihydroepiandrostenedione-S were determined.
FSFI, BDI, and serum hormonal levels.
The mean ages and total FSFI scores of Group I, Group II and the control group were 46 +/- 7.1, 45 +/- 3.8, and 41 +/- 5.4 (P > 0.05); 24.7 +/- 5.3, 24.5 +/- 6.3, and 30.0 +/- 2.5 (P < 0.05), respectively. The mean FSFI domain scores were not statistically different between Groups I and II (P > 0.05) (desire, 3.18 +/- 1.2 vs. 2.92 +/- 1.6; arousal, 3.96 +/- 1.1 vs. 3.67 +/- 1.2; lubrication, 4.83 +/- 1.0 vs. 4.12 +/- 1.1; orgasm 4.0 +/- 1.1 vs. 5.15 +/- 2.9; satisfaction 3.96 +/- 1.1 vs. 4.05 +/- 1.4 pain; 4.84 +/- 1.2 vs. 4.65 +/- 1.3). However, the mean scores of desire (3.18 +/- 1.2 vs. 3.96 +/- 0.7), orgasm (4.0 +/- 1.1 vs. 5.0 +/- 1.1), and satisfaction (3.96 +/- 1.1 vs. 4.76 +/- 1.0) domains of Group I were significantly lower than the control group. Meanwhile, the mean scores of desire (2.92 +/- 1.6 vs. 3.96 +/- 0.7) and lubrication (4.12 +/- 1.1 vs. 5.22 +/- 0.9) domains were statistically different between Group II and the control group. The mean BDI scores of patients in Group I, Group II and the control group were 19.3 +/- 6.3, 20.2 +/- 6.6, and 11.0 +/- 7.1, respectively (P < 0.01). In addition, the mean levels of hormonal parameters were not significantly different from the control group (P > 0.05).
OSAHS is associated with a significant decrease in female sexual function. However, severity of OSAHS is not related with the degree of female sexual dysfunction (FSD). This situation reveals that both organic and psychogenic issues are being involved in FSD related with OSAHS.
Journal of Sexual Medicine 11/2008; 5(11):2600-9. · 3.55 Impact Factor
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ABSTRACT: Most patients with pathological fractures due to cancer metastasis have a limited life expectancy. Orthopaedic procedures, therefore, should be minimally invasive in order to avoid additional surgical morbidity. The purpose of this study was to analyse the results of minimally invasive approaches, including locked intramedullary nailing, followed by early postoperative radiation for pathological humeral shaft fractures. Twenty-four pathological fractures of the humerus diaphysis in 23 patients were treated with the prospective protocol, including antegrade unreamed intramedullary nailing and postoperative radiotherapy (20 Gy and five fractions). The patients and results of the surgery were evaluated by the Musculoskeletal Tumor Society upper extremity scoring system. All patients had a stable extremity, and the average function of 20 patients was 64% of the normal upper extremity function. Only one patient required revision surgery. The minimally invasive treatment of patients with pathological fractures of the humeral shaft with closed unreamed intramedullary nailing combined with adjuvant radiotherapy is an effective and safe procedure, even in seriously ill patients.
International Orthopaedics 05/2008; 33(3):707-12. · 2.03 Impact Factor
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ABSTRACT: To assess the outcomes of the surgical techniques used in Peyronie's disease (PD) surgery.
One hundred fifty patients received surgical treatment for PD. Fifteen and 75 patients underwent simple corporoplasties and incision of the plaque, and venous (IV) grafting, respectively, whereas 60 patients with erectile dysfunction underwent penile prosthesis implantation. At follow-up, the erectile function and penile deformity were assessed at 3 and 12 mo postoperatively, and every 6 mo thereafter.
Postoperative results were satisfactory in 14 of 15 patients with simple corporoplasties, with a mean angle of deformity and follow-up of 51.0 degrees +/-14.9 degrees and 21.0+/-9.7 mo, respectively. Among patients undergoing IV grafting with sapheneous vein (mean curvature angle: 61.6 degrees +/-19.5 degrees ), 70 were regularly seen with a mean follow-up of 41.7+/-35.1 mo. Penile curvature was completely straightened in 53 (75.7%) patients, whereas 12.8% and 11.4% had residual curvature less than 20 degrees and more than 20 degrees , respectively. The mean degree of penile curvature of patients with penile prosthesis was 46.9 degrees +/-20.1 degrees . Straightening of the penis was accomplished with implantation of the prosthesis only, manual modeling, plaque incision and grafting (autologous rectus fascia in the majority), incision of the plaque, and penile plication in 35%, 30%, 33.3%, 1.6%, and 1.6%, respectively. In the prosthesis group, two patients had recurrent curvatures.
IV grafting is a good option with satisfactory mid- and long-term outcome. Insertion of the prosthesis only and manual modeling correct the curvature in the majority of the patients. For the remaining patients, autologous rectus fascia is an appropriate graft material.
European Urology 03/2008; 53(2):432-9. · 8.49 Impact Factor
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ABSTRACT: The present study was performed to evaluate the use of patellar tendon-bearing ankle foot orthesis for the treatment of Charcot arthropathy in a series of patients with spina bifida. A cohort of 350 spina bifida patients, ages ranging between 12 months and 22 years were evaluated in our clinic between June 1993 and March 2004. Charcot arthropathy was seen in five of these children. Treatment was initiated with nonsteroidal anti-inflammatory drugs, oral bisphosphonates and immobilization. No change was observed in the patients' symptoms after a month of treatment. At this time, a patellar tendon-bearing ankle foot orthesis was prescribed and used for a period of 6 to 24 months. All patients improved within 2 months. At the end of 2 years of follow-up, three patients are still using the brace without any complaints. One patient still has symptoms, although she is wearing her brace, but she has had significant improvement compared with the initiation of therapy. Non-weight-bearing, immobilization and surgery are the known treatment choices in Charcot arthropathy. Little experience exists about this entity and its treatment. Our experience reveals that the patellar tendon-bearing ankle foot orthesis leads to significant improvement in children with Charcot arthropathy without surgery and immobilization.
Journal of Pediatric Orthopaedics B 10/2007; 16(5):373-9. · 0.47 Impact Factor
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ABSTRACT: Although women may undergo changes in sexual function during pregnancy, there are limited studies correlating possible sexual function changes to androgen blood levels during the pregnancy.
To search for a possible correlation, we performed a cross-sectional observational study to assess sexual function scores and androgen blood levels of women during pregnancy.
A total of 589 healthy pregnant women were recruited to the present cross-sectional study. Of these patients, 116 (19.6%), 220 (37.3%), and 253 (42.9%) were in their first, second, and third trimesters, respectively. They were evaluated with a detailed medical and sexual history, including IFSF questionnaire. In addition, maternal serum androgen levels (testosterone, dehydroepiandrosterone sulphate, free testosterone) were determined in each trimester during regular follow-ups.
Assessment of Index of Female Sexual Function (IFSF) domains and serum androgen levels in each trimester.
The mean age of the three groups were similar (P > 0.05). Overall, total IFSF scores of women in the first and second trimesters were 21.4 +/- 10.1 and 22.3 +/- 10, respectively, while it was 15.9 +/- 12.3 during the third trimester (P < 0.05). The most common sexual dysfunction symptom was diminished clitoral sensation, observed in 94.2% of the patients, followed by lack of libido in 92.6% and orgasmic disorder in 81%. No correlation was detected between total IFSF score and serum androgen levels.
In this cross-sectional study, we noted lower sexual function scores in women in the third trimester of their pregnancies compared with those in their first two trimesters of pregnancy. These lower sexual function scores in the third trimester were not associated with lower androgen levels. We plan to perform a future prospective study to better assess both the change in sexual function and also its possible relation to androgen levels in pregnant women.
Journal of Sexual Medicine 10/2007; 4(5):1381-7. · 3.55 Impact Factor
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ABSTRACT: The aim of this study was to evaluate age-related changes in free/total prostate-specific antigen (f/t PSA) ratio, focusing on the avoidance of unnecessary prostate biopsies.
A total of 898 men aged 30-88 years without a history of prostate surgery and disease were enrolled into the study. Serum tPSA, fPSA and f/t PSA ratios were determined for the study population and for different age categories. All males who had suspicious digital rectal examination and tPSA >4 ng/mL underwent transrectal ultrasonography-guided prostate biopsy. Receiver operating characteristic (ROC) curves for each group were generated by plotting the sensitivity vs. 1-specificity for the f/t PSA ratio. The sensitivity and specificity were obtained using different f/t PSA ratio cutoffs for different age groups.
Prostate cancer was detected in 63 patients (7%). Age-specific cutoffs were determined according to likelihood ratios at the levels of 10%, 15% and 15% f/t PSA ratio for ages 50-59, 60-69 and >/=70 years, respectively. However, a single cutoff of 10% is recommended across all age ranges (positive likelihood ratio 2.36). ROC curves demonstrated that the area under the curve (AUC) was significant for all patients with initial PSA of 4-10 ng/mL (AUC 0.703-0.796), except for the >/=70-year age group (AUC 0.549).
The current study showed that the use of f/t PSA ratio in patients with PSA levels of 4-10 ng/mL should enhance the specificity of PSA screening and decrease the number of unnecessary biopsies. f/t PSA levels may show dissimilarities according to age and ethnicity, so further studies are warranted to identify this relationship.
Clinical Chemistry and Laboratory Medicine 02/2007; 45(7):912-6. · 2.15 Impact Factor
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ABSTRACT: We report a 13-year-old girl with Ewing's sarcoma of the tibia who was treated with multiagent chemotherapy, followed by local control tumor surgery consisting of wide resection of the tumor and bone transport with distraction osteogenesis for reconstruction. The bone defect created by resection was 13 cm long and was replaced by bone transport using a monolateral external fixator. Evaluation of the resected specimen revealed wide tumor-free margins with 100% chemonecrosis. A planned Harmon-type autogenous bone grafting between the middle and proximal segments of the tibia (docking site) was done primarily after docking occurred, and a solid union was obtained by 23 months after resection. The bone healing index (treatment index) was 54 days/1 cm distraction, which is indicative of slow healing. Clinical evaluation of the affected extremity using the Musculoskeletal Tumor Society rating system revealed 80% normal functional capability. Indications for bone transport in reconstruction of bone defects created by wide resection of bone sarcomas are discussed. In retrospect, we have concerns regarding the suitability of this technique in the setting of diaphyseal sarcoma reconstruction in patients with Ewing's sarcoma who require aggressive and intense multiagent chemotherapy.
Clinical Orthopaedics and Related Research 06/2005; · 2.53 Impact Factor
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ABSTRACT: Pseudoaneurysm of the internal pudendal artery or its branches is a rare complication of pelvic trauma. It generally causes arteriocavernosal fistula leading to priapism. Connection between the urethra and the pseudoaneurysm has been documented in a few cases; however, pseudoaneurysm causing a urethral pseudodiverticulum has not been reported. We report a 7-year-old boy with a pseudoaneurysm of the bulbourethral branch of the left internal pudendal artery leading to a urethral pseudodiverticulum.
Pediatric Radiology 06/2004; 34(5):435-7. · 1.67 Impact Factor
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Clinical Orthopaedics and Related Research 05/2004; · 2.53 Impact Factor
