Turkish validation of the chronic orchialgia symptom index and its association with the visual analog scale

OBJECTIVE

To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language.

MATERIAL AND METHODS

The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method.

RESULTS

The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 (p < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores (r: 0.63, p < 0.001; r = 0.32, p < 0.001; r = 0.56, p < 0.001; r = 0.59, p < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score.

CONCLUSION

The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP.

The effect of intraurethral heparin on inflammation and spongiofibrosis in a rat model of experimentally induced urethral trauma

AIM

To determine the effect of heparin administered during the early post urethral trauma period on inflammation and spongiofibrosis in rats.

MATERIALS AND METHODS

The study included 24 male rats that were randomized into 3 groups of 8 each. The urethra was traumatized using a 24-G needle sheath in all rats. Group 1 (control group) received intraurethral saline 0.9% injected b.i.d. for 27 days, group 2 received intraurethral Na-heparin (liquemine-Roche) 1500 IU kg^-1 injected b.i.d. for 27 days, and group 3 received intraurethral Na-heparin 1500 IU kg^-1 injected b.i.d and saline 0.9% s.i.d. for 27 days. On day 28 the rats' penises were degloved and penectomy was performed. Inflammation, spongiofibrosis, and congestion in the urethra were investigated in each group.

RESULTS

A statistically significant difference was found between the three groups (control, heparin, and heparin + saline) in the histopathological status of spongiofibrosis, inflammation, and congestion, respectively (P = 0.0001, P = 0.002, P = 0.0001). Severe spongiofibrosis was observed in six (75%) of the rats in group 1 (control group), whereas severe spongiofibrosis was not observed in group 2 (heparin) or group 3 (heparin + saline).

CONCLUSION

We observed that intraurethral Na-heparin 1500 IU kg^-1 injectioned during the early posturethral trauma period in rats significantly decreased inflammation, spongiofibrosis, and congestion.

Erectile dysfunction, anxiety, perceived stress, and insomnia are more common among acquired premature ejaculation patients compared to other premature ejaculation syndromes

BACKGROUND

Premature ejaculation (PE) is the most common ejaculatory function disorder. To date, four types of PE have been identified depending on the severity, onset, and course of the problem.

OBJECTIVES

The aim of this study was to investigate whether or not there is a difference between these types in respect of anxiety, perceived stress, insomnia severity, and sleep chronotype.

MATERIALS AND METHODS

The study included 112 patients diagnosed with PE in our clinic between October 2021 and May 2022. The patients were separated into groups according to PE types of lifelong (LPE, n = 39), acquired (APE, n = 45), variable (VPE, n = 10), and subjective (SPE, n = 18). In addition to the demographic and clinical data, the scores were recorded of all participants in the International Index of Erectile Function-5, Hospital Anxiety and Depression Scale, Premature Ejaculation Diagnostic Tool (PEDT), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Morningness Eveningness Questionnaire (MEQ).

RESULTS

SPE was determined more in university graduate patients (42.1% vs. LPE, 21.1%; APE, 36.8%; VPE, 0%; p = 0.01). In patients with APE, erectile dysfunction was more severe (80.0% vs. LPE, 8.0%; SPE, 12.0%; VPE, 0%; p < 0.001). The median (IQR) PEDT score was determined to be higher in APE than in LPE and SPE (16(5), 13(7), 11(5), p = 0.001, respectively). Patients with APE were determined to have higher median (IQR) ISI (21(9) vs. LPE, 8(7); SPE, 5(8); VPE 8(4), p < 0.001) and PSS scores (35(12) vs. LPE, 22 (7); SPE,22(5); VPE 21(6), p < 0.001), the sleep chronotype was more eveningness according to the MEQ (80.8% vs. LPE, 19.2%; VPE, 0%; SPE, 0%; p < 0.001), and there were seen be more anxiety symptoms (75.5% vs. LPE,12.2%; VPE, 0%; SPE, 12.2%; p < 0.001).

CONCLUSION

Psychological status and sleep health were concluded to be important factors for PE patients, and the patients with acquired PE were the group most affected by these factors.

Which type of female urinary incontinence has more impact on pelvic floor and sexual function in addition to anxiety and depression symptoms: A questionnaire-based study

PURPOSE

To evaluate pelvic floor and sexual dysfunction, and anxiety and depression symptoms in females with different urinary incontinence (UI) types.

MATERIALS AND METHODS

A cross sectional evaluation was made of 73 patients diagnosed with UI in the Urology Clinic between December 2021 and November 2022. In addition to demographic data, the points were recorded from the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory-20 (PFDI-20).

RESULTS

The mean age of the patients was 38.3 ± 3.7 years. Incontinence types of the patients were determined as 42% urgency urinary incontinence (UUI), 30.1% stress urgency incontinence (SUI), and 27.4% mixed type urinary incontinence (MUI). Anxiety symptoms were determined in 20.5% and depression symptoms in 41.1% of all the patients. The median ICIQ-FLUTS score was determined to be significantly higher in the MUI patients than in the other types [25.5 (MUI) vs. 17 (SUI), p = 0.007; 16 (UUI), p = 0.001]. The median FSFI and HADS scores were seen to be similar in all the UI types (p = 0.1). The median PFDI-20 score was found to be higher in the MUI group than in the UUI group (126.5 vs. 88.5, p = 0.02).

CONCLUSION

The sexual dysfunction and psychological symptoms were found to be similar in the patients according to UI type. The MUI patients were seen to have more incontinence symptoms compared to the other types and experienced more pelvic floor dysfunction than patients with UUI.

COVID-19 effect on perioperative findings of flexible/semi-rigid ureterorenoscopic lithotripsy: A match-pair analysis

PURPOSE

If not treated on time with proper management options, urolithiasis cause serious morphologic and functional alterations in the involved renal units. Like many other pathologies, the diagnosis, treatment, and follow-up principles of patients with urinary stones have been negatively affected by the unestimated changes in the healthcare systems dealing intensively with COVID-19 patients. In this present study, we aimed to evaluate and present the possible effects of COVID-19 infection on the ureterorenoscopic stone treatment.

MATERIALS AND METHODS

Clinical and procedural characteristics of 96 patients undergoing flexible and/or rigid ureterorenoscopy because of urolithiasis between March 2020 and January 2021 were evaluated in a retrospective manner. Obtained data were evaluated after match-pair analysis in a comparative manner between cases with a positive medical history of COVID-19 infection (Group 1, n: 48) and those without any COVID-19 infection (Group 2, n: 48).

RESULTS

There was no statistically significant difference between the two groups of cases with respect to age, gender, associated comorbidities, and stone characteristics (p > 0.05). The mean serum creatinine level was determined to be higher in Group 1 than in Group 2 (1.15 ± 0.59 mg/dl, 0.83 ± 0.21 mg/dl, p = 0.007, respectively). Evaluation of the operative parameters revealed longer mean time from diagnosis to surgery (33.5 ± 14.27 vs 12.12 ± 6.33 days, p = 0.001), operating time, median length of stay in hospital along with higher additional intervention rates, and Clavien-Dindo complication scores again in Group 1 (p < 0.05).

CONCLUSION

Our results indicate that the presence of COVID-19 infection anamnesis may affect the clinical and operative parameters of ureteroscopic stone management in cases with urolithiasis due to the possible effects of renal units damage and longer waiting time. Urologists may be aware of these unestimated problems during and after the intervention to take necessary measures for a safe and successful ureteroscopic stone removal.

Retraction Note: Obturator nerve block transurethral surgery for bladder cancer: comparison of inguinal and intravesical approaches: prospective randomized trial

The Editor-in-Chief has retracted this article [1] because it shows significant overlap with a previously published article by Pladzyk et al. [2].

The relationship between histopathology and age factor in patients who were operated for renal masses

OBJECTIVE

Renal neoplasms have a predilection to occur in older patients and they are often malignant. They may have different structural characteristics according to age groups. In our study, we have investigated age-related demographic characteristics of the patients who were operated because of suspected malignant renal masses.

MATERIALS AND METHODS

Between 2010 and 2014, 129 patients were treated surgically for suspected malignant renal masses at our institution. These cases had undergone open radical, open partial, and laparoscopic radical nephrectomies. Patients were divided into two groups based on their ages and evaluated accordingly as Group 1 (≤50 years) and Group 2 (>50 years). Groups were compared based on their clinical and pathological features.

RESULTS

Group 1 and Group 2 consisted of 29 (22.4%) and 91 (77.6%) patients, respectively. The mean age of younger patients was 43.1 years (23-49 years), with a male to female ratio of 19/10, while the average tumor size was 57.6 mm (20-120 mm). Twenty-four patients (83%) had a malignant pathology and five patients (17%) had a benign pathology. Clear cell carcinoma was diagnosed in 67% of the patients in both groups. There was no significant difference with respect to age and tumor size of male and female patients in the younger age group, while younger female adults tended to have a more benign pathology than their male counterparts (40% and 5%, respectively, p<0.05).

CONCLUSION

There was no significant difference with respect to gender, tumor size, laterality, and surgical and pathologic features between younger and older patients. An organ- sparing approach should be strongly considered when treatment for renal tumors in young females is performed because of a potentially higher incidence of a benign pathology of renal masses.

Effect of Hypericum perforatum on intraperitoneal adhesion formation in rats

INTRODUCTION

The aim of this study was to evaluate the efficacy of Hypericum perforatum for prevention of adhesion formation in rats.

MATERIAL AND METHODS

Twenty-four female wistar rats underwent left uterine horn adhesion model. Rats were randomised into 4 groups. Group 1 (Control): Closure of abdominal incision without any agent administration. Group 2: Closure of incision after administration of intraperitoneal (i.p.) Ringer's lactate solution. Group 3: Closure of incision after administration of i.p. olive oil (diluent of H. perforatum). Group 4: Hypericum perforatum extract (Ecodab(®)) was administered i.p. before the closure of incision. Fourteen days later, relaparatomy was performed and surgical adhesion scores, inflammation and fibrosis scores were noted. Groups were compared according to these scores.

RESULTS

There was statistical significant difference between ringer's lactate group and olive oil group according to surgical adhesion score (p = 0.009). However, groups were not different according to inflammation and fibrosis scores (p > 0.05).

CONCLUSIONS

Despite antiinflammatory, antioxidants and antimicrobial properties of H. perforatum, our results revealed no positive effect of H. perforatum on the prevention of intraperitoneal adhesion formation.