Introduction: We aimed at comparing the success rates of primary enuretic alarm therapy with those of secondary alarm therapy after failed pharmacotherapy in the treatment of monosymptomatic nocturnal enuresis (MNE). Patients and Methods: We randomly applied enuretic alarm therapy in 35 MNE patients (group 1) and desmopressin therapy in 49 MNE patients (group 2). The success and rebound rates after 3 and 6 months were determined. We also applied enuretic alarm therapy as a secondary treatment in 19 group 2 patients with complete rebound after 6 months (group 3). The success rates of patients who have received primary and secondary enuretic alarm therapy were compared. Results: The success rates for groups 1 and 2 were 82.65 and 81.63%, respectively (p = 0.885), at 3 months and 54.28 and 26.53%, respectively (p = 0.007), at 6 months. The success rates in group 3 were 84.21 and 52.63%, respectively, at 3 and 6 months. When these success rates were compared between groups 1 and 3, no statistically significant difference was found (p = 1.000). Conclusion: Prior pharmacotherapy did not increase success rates of alarm therapy in our MNE patients.
Objective:Folate, vitamin B12 and iron are important vitamin and minerals which play role in the development of nervous system. The aim of this study was looking at the presence of folate, vitamin B12 and iron deficiency among patients with Primary nocturnal enuresis (PNE) and possible relation between the delay of central nervous system (CNS) development, PNE and folate, vitamin B12 and iron states.Methods: Consecutively applied forty patients with PNE (23 girls and 17 boys) and otherwise normal thirty control subjects (17 girls and 13 boys) were included in the study. Average ages (in range) of PNE and the control group were 9.2(6-12) years and 9.3 (6-12) years accordingly. Age, height, weight, complete blood count, blood vitamin B12, folate, ferritin and iron values of both groups were recorded and compared to each other.Results:Average vitamin B12 and folate levels of patients with PNE were significantly and statistically lower compared to those of the control group. Average blood iron of patients with PNE was significantly higher than that of the control group and also average ferritin level of the PNE group was detected to be higher than the control group but this relation was statistically insignificant.Conclusion: Primary nocturnal enuresis is related to the delay in CNS maturation so it was thought that low vitamin B12 and folate which were found in patients with PNE may have role in the delay of CNS maturation. Additionally, further studies are needed to investigate the role of vitamin B12 and folate either alone or as combination in treatment of patients with PNE who have low vitamin B12and folate level.
ÖzetSerum testosteron seviyelerinde azalma güçsüzlük, halsizlik, depresif ruh hali gibi sistemik belirtilerin yanı sıra libidoda azalma, erektil disfonksiyon (ED) gibi seksüel belirti ve bulgulara da yol açabilmektedir. Düşük testosteron seviyesi korporal veno-okluziv mekanizmada da bozukluğa yol açabilmektedir. Çalışmamızda venöz yetmezlik, ED ve hipogonadizm birlikteliği olan olgularda testosteron replasman tedavisi ile venöz yetmezliğin tedavi edilebileceğini göstermeyi amaçladık. Çalışma Ocak 2009-Mart 2012 tarihleri arasında ED yakınması ile kliniğimize başvuran 500 hastanın dosya kayıtları incelenerek retrospektif olarak gerçekleştirildi. ED sebebi olabilecek diğer nedenler ekarte edilerek hipogonadizm ve venöz yetmezlik tespit edilmiş ve en az 6 ay androjen replasman tedavisi uygulanmış 37 hasta çalışmaya alındı. Tüm olgular IIEF-5 (International Index of Erectile Disfuncion) skoru, serum testosteron ölçümleri ve penil renkli Doppler Ultrasonografi (PRDUS) ile değerlendirildi. Altı aylık tedavi sonrası hastaların IIEF-5 skorları ve testosteron ölçümleri tekrarlanarak ve tedavi öncesi değerlerle istatistiksel olarak karşılaştırılarak androjen replasman tedavisinin faydalı olup olmadığı araştırıldı. Hastaların tamamının testosteron yerine koyma tedavisi ile fizyolojik seviyelerde testosteron değerlerine ulaştığı tespit edildi. Tedavi sonunda total ve serbest testosteron seviyelerinde istatistiksel olarak anlamlı artış saptanırken hemoglobin ve PSA değerlerinde değişim izlenmedi. Hastaların ortalama IIEF skorlarında da artma 37 hastanın 29'unda (%78) saptandı. Hiçbir hastada androjen replasman tedavisine bağlı herhangi bir yan etki olmadığı görüldü. ED hastalarında hipogonadizm ve hipogonadizm bağımlı venöz yetmezliğin de mutlaka akla getirilmesi ve testosteron replasmanı ile büyük ölçüde tedavi edilebileceği inancındayız. Anahtar kelimeler: Erektil disfonksiyon; hipogonadizm; testosteron. AbstractDecreases in plasma testosterone levels cause not only fatigue, depression, but also sexual symptoms such as decrease in libido or erectile dysfunction (ED). Low testosterone levels can cause venoocclusive dysfunction. In this study, we aimed to show that ED could be treated by testosterone replacement in patients with venoocclusive dysfunction and hipogonadism. Data of 500 patients applied to our clinic with ED between January 2009-March 2012 were examined retrospectively for coexistence of erectile dysfunction, hipogonadism and venoocclusive dysfunction. International Index of Erectile Disfuncion (IIEF-5) scores and plasma testosterone levels of the patients were evaluated. Venoocclusive dysfunction was determined by penile color Doppler ultrasound. After excluding other causes that can cause ED, 37 patients administered testosterone replacement therapy for hipogonadism and venoocclusive erectile dysfunction, were enrolled in the study. After 6 months, IIEF-5 scores and plasma testosterone levels of the patients were reevaluated. After treatment, 29 of 37 patients (78%) were found to improve for ED. Patients with...
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