Peyronie's disease is most commonly seen in the ®fth decade of life. However, a wide range of age (20 ± 83 y) is reported. During a 6-year period, men with Peyronie's disease presenting under the age of 40 were reviewed retrospectively and followed-up. The prevalence of Peyronie's patients presenting under age 40 was 8.2%. Their mean age was 32.47 AE 5.37 (range: 23 ± 39) y and 78.9% of them presented during the acute phase of the disease. Pain on erection was a part of presenting symptom complex in 52.6% and the majority (84%) had a degree of penile curvature`60 . Erectile dysfunction (ED) was present in 21% of patients, who responded well to intracavernous injection test. After a minimal 2-year follow-up, improvement in penile deformity was observed in 36.8%, and 42.1% had stable disease while 21% experienced deterioration of the penile curvature. The onset of Peyronie's disease is clinically more noisy and acute in patients presenting under age 40 and this forces the physicians to treat them more vigorously.
Mullerian malformations result from defective fusion of the Mullerian ducts during development of the female reproductive system and have an incidence of 2-3%. The American Fertility Society classification of Mullerian anomalies is the most commonly utilized standardized classification. The least common form of these malformations is Herlyn-Werner-Wunderlich syndrome characterized by obstructed hemivagina and ipsilateral renal anomaly (OHVIRA). This syndrome has been described with case reports since 1922. Early diagnosis and surgery that include drainage of fluid and resection of the vaginal septum is necessary for OHVIRA to prevent late complications (i.e. pyocolpos, chronic cryptomenorrhea). Here in we report a case of Herlyn-Werner-Wunderlich syndrome that hymen has been preserved during the operation of non-fenestrated transverse vaginal septum resection with hysteroscopy.
Objective: Our aim was to evaluate whether capsular artery resistive index measured by transrectal power Doppler ultrasonography (US) can be used as a dynamic parameter to determine the severity of benign prostate hyperplasia and the efficiency of the treatment.
Material and methods:Fifty patients aged between 40 and 80 years who applied for lower urinary track symptoms or follow-up were included in the study. International Prostate Symptom Score (IPSS), uroflowmetry, and prostate specific antigen (PSA) were evaluated. Prostate volume and capsular artery resistive index were measured with transrectal power Doppler US. Alfuzosin XL 10 mg was given to 34 patients with lower urinary track symptoms for a month. IPSS, uroflowmetry and capsular artery resistive index values were reevaluated at the end of one month.
Results:The mean resistive index value was 0.69±0.07. There was no relationship between resistive index and age (r=0.23, p>0.05). There were significant relationships between resistive index and IPSS, PSA or prostate volume (r=0.57, p<0.05; r=0.35, p<0.05; and r=0.32, p<0.05, respectively). Significant relationships of resistive index with maximum and mean urinary flow rate (r=-0.51, p<0.05 and r=-0.49, p<0.05) were also noted. The mean resistive index value of 34 patients treated for lower urinary track symptoms was 0.72±0.06 before medication and decreased significantly to 0.66±0.04 after the treatment (p<0.05). Decrease in IPSS and increase in uroflow rates were also noted after treatment.Conclusion: Capsular artery resistive index can be used as a dynamic parameter in the estimation of the severity of benign prostate hyperplasia and efficiency of the treatment.Key words: Alfuzosin; benign prostate hyperplasia; intraprostatic pressure; power Doppler ultrasonography; resistive index.Anah tar söz cük ler: Alfuzosin; intraprostatik basınç; iyi huylu prostat büyümesi; power Doppler ultrasonografi; rezistif indeks.
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