Objective Lower urinary tract dysfunction (LUTD) are quite commonly seen in Multiple Sclerosis (MS). In this study we aimed to show the relationship between the LUTD symptoms and disease related parameters including the severity, duration, subtypes and the lesion localization of MS. Material and MethodIn a prospective study, we recorded demographic information, MS subtypes, disease duration, disease severity, neurological examinations, scores of Expanded Disability Status Scale (EDSS), lower urinary tract symptoms (LUTS), duration of the symptoms, urinary tract examination, urinary function tests (Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS)), urodynamic evaluation results of 42 MS patients whom admitted to our neurology department during the last 3 months. Statistical analysis was performed by using ANOVA, Mann Whitney-U test and non-parametric Pearson test. p<0.05 was considered statistically significant.Results 42 patients (13 male, 29 female) who were diagnosed with MS according to the 2010 revised McDonald criteria included in our study while patients with history of diabetes mellitus, urinary tract infections, and urological surgery were excluded. There was no significant relationship between the presence of LUTS, and age, gender, EDSS, MS subtypes, duration of illness (p>0,05). A statistically significant difference was found between the genders, EDSS and irritative symptoms (p<0,05) while no significance was found between obstructive symptoms (p>0,05). There was no statistically significant difference between the localization of the lesion and presence of the irritative and obstructive symptoms (p>0,05).Conclusion Our study indicates that, disease severity is an important determinant factor of irritative urinary symptoms in MS patients. ( Sakarya Med J 2016, 6(4):190-195 )Keywords Multiple Sclerosis, urinary system, questionnaire Öz Amaç Multipl Sklerozda (MS), alt üriner sistem fonksiyon bozuklukları oldukça sık görülmektedir. Çalışmamızda, MS hastalarında alt üriner sistem disfonksiyon semptomları ile hastalığın şiddeti, süresi, alt tipi ve lezyon lokalizasyonu arasındaki ilişkiyi göstermeyi amaçladık. Materyal ve Metod
Introduction: The success of the robot assisted radical prostatectomy (RARP) procedures depend on a successful team, however the literature focuses on the performance of a console surgeon. The aim of this study was to evaluate surgical outcomes of the surgeons during the learning curve in relation to the bedside assistant's experience level during RARP. Materials and Methods: We retrospectively reviewed two non - laparoscopic, beginner robotic surgeon's cases, and we divided the patients into two groups. The first surgeon completed the operations on 20 patients with a beginner bedside assistant in February - May 2009 (Group-1). The second surgeon completed operations on 16 patients with an experienced (at least 150 cases) bedside assistant in February 2015 - December 2015 (Group-2). The collected data included age, prostate volume, prostate specific antigen (PSA), estimated blood loss, complications and percent of positive surgical margins. In addition, the elapsed time for trocar insertion, robot docking, console surgery, specimen extraction and total anesthesia time were measured separately. Results: There were no significant differences between the groups in terms of age, comorbidity, prostate volume, PSA value, preoperative Gleason score, number of positive cores, postoperative Gleason score, pathological grade, protection rate of neurovascular bundles, surgical margin positivity, postoperative complications, length of hospital stay, or estimated blood loss. The robot docking, trocar placement, console surgery, anesthesia and specimen extraction times were significantly shorter in group 2 than they were in group 1 (17.75 ± 3.53 min vs. 30.20 ± 7.54 min, p ≤ 0.001; 9.63 ± 2.71 min vs. 14.40 ± 4.52 min, p = 0.001; 189.06 ± 27.70 min vs. 244.95 ± 80.58 min, p = 0.01; 230.94 ± 30.83 min vs. 306.75 ± 87.96 min, p = 0.002; 10.19 ± 2.54 min vs. 17.55 ± 8.79 min, p = 0.002; respectively). Conclusion: Although the bedside assistant's experience in RARP does not appear to influence the robotic surgeon's oncological outcomes during the learning curve, it may reduce the potential complications by shortening the total operation time.
Introduction: To evaluate the influence of previous experience as bedside assistants on patient selection, perioperative and pathological results in robot assisted laparoscopic radical prostatectomy. Materials and Methods: The first 50 cases of two robotic surgeons were reviewed retrospectively. Group 1 consisted of the first 50 cases of the surgeon with previous experience as a robotic bedside assistant between September 2016-July 2018, while Group 2 included the first 50 cases of the surgeon with no bedside assistant experience between February 2009-December 2009. Groups were examined in terms of demographics, prostate volume, presence of median lobe, prostate specific antigen (PSA), preoperative Gleason score, positive core number, clinical stage, console surgery time, estimated blood loss, postoperative Gleason score, pathological stage, positive surgical margin rate, postoperative complications, length of hospital stay and biochemical recurrence rate. Results: Previous abdominal surgery and the presence of median lobe hypertrophy rates were higher in Group 1 than in Group 2 (20% vs. 4%, p=0.014; 24% vs. 6%, p=0.012; respectively). In addition, patients in Group 1 were in a higher clinical stage than those in Group 2 (cT2: 70% vs. 28%, p=0.001). Median console surgery time and median length of hospital stay was significantly shorter in Group 1 than in Group 2 (170 min vs. 240 min, p=0.001; 3 vs. 4, p=0.022; respectively). Clavien grade 3 complication rate was higher in Group 2 but was statistically insignificant. Conclusion: Our findings might reflect that previous bedside assistant experience led to an increase in self-confidence and the ability to manage troubleshooting and made it more likely for surgeons to start with more difficult cases with more challenging patients. It is recommended that novice surgeons serve as bedside assistants before moving on to consoles.
IntroductionElements can be divided into two groups: the essential elements of the first group are necessary for metabolic and life processes, such as calcium (Ca), chromium (Cr), copper (Cu), manganese (Mn), magnesium (Mg), and zinc (Zn), and the nonessential second group includes elements that are toxic to humans, such as aluminum (Al), arsenic (As), cadmium (Cd), lead (Pb), and thallium (Tl). Trace elements are essential for testicular growth and development. Among the essential elements, Cu and Zn play a particular role in the reproductive system. Zn and Cu were first studied and evaluated in semen (1). Exposure to inorganic lead is detrimental to human semen quality (2). Leads do not only affect the spermatozoa count but also damage the spermatozoa structure and function (3).Humans are exposed to elements at low concentrations either voluntarily via supplementation or involuntarily via intake or contact with contaminated materials. Some elements, such as Cd, Pb, As, and mercury (Hg), are nonessential and can be measured in most of the general population (1,4). Pb may adversely affect sperm morphology and motility (5,6). Hg is associated with sperm abnormalities in subfertile males (7). Other Background/aim: Studies suggest that trace elements may have an adverse impact on male reproduction, even at low levels. We tried to investigate the relationships between these metals and semen quality in various body fluids among men with infertility. Materials and methods:A total of 255 samples of blood, semen, and urine were collected from 85 men suffering from infertility. Inductively coupled plasma-optical emission spectrometry was used for the determination of 22 trace elements. We compared the results of the semen parameters with the results of the element determinations.Results: Because of the high proportion of samples with values lower than the limit of detection for a number of the elements, only 8 of a total 22 trace elements were determined in the samples. When the concentrations of sperm were classified according to the World Health Organization's guidelines for normospermia, oligospermia, and azoospermia, statistically significant differences were found among Zn, Ca, Al, Cu, Mg, Se, and Sr concentrations in various serum, sperm, and urine samples (P < 0.05). Conclusion:In the present study, we found significant correlations between concentrations of Zn, Ca, Al, Cu, Mg, Se, and Sr and semen parameters in various body fluids.
This study aimed to present the association between the serum level of brain-derived neurotrophic factor (BDNF) and the lifelong premature ejaculation (PE). The data of 40 patients with lifelong PE and 40 healthy controls were evaluated prospectively. PE diagnostic tool and patient-reported outcome measures were performed to the participants. The serum BDNF level measurement was made after the collecting of blood samples in both groups. The mean ± SD age of the PE and control group was 34.43 ± 5.71 and 33.03 ± 3.97 years respectively (p = .228). Only the participant who has been married included in the study, and there was no difference in the mean marriage duration. In both groups, smoking status, alcohol use and body mass index were similar. The median PE diagnostic tool scores were 15 (11-20), and serum BDNF levels were 225.3 (26.1-689.6) ng/ml in the PE group, 5 (0-9) and 540.9 (102.9-769.2) ng/ ml in the control group respectively (p < .001 for both). The patients with PE had significantly lower serum BDNF levels. Our study suggests that lower serum BDNF levels may be directly related to lifelong PE.
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