Objective: To investigate the association between serum testosterone levels and the severity of penile curvature and plaque size in men with Peyronie’s disease (PD). Materials and Methods: This retrospective cross-sectional study included 108 men diagnosed with Peyronie’s disease who presented to our urology outpatient clinic between January 2022 and July 2025. Patients with prior testosterone replacement therapy, pelvic surgery, intralesional treatment, or systemic conditions affecting testosterone metabolism were excluded. Demographic and clinical data—including disease duration, penile pain, erectile dysfunction (assessed by IIEF-5), and disease phase—were recorded. Penile curvature was assessed via self-photographs during natural or pharmacologically induced erections, and plaque size was measured ultrasonographically. Fasting morning serum samples were analyzed for total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and metabolic parameters. Results: Mean age was 59.6 ± 7.5 years, and mean disease duration was 22.7 ± 29.4 months. Mean horizontal and vertical curvatures were 12.1 ± 19° and 28.5 ± 19.8°, respectively. Mean plaque size was 8.9 ± 7 mm. No significant differences were observed between hypogonadal and eugonadal groups in curvature severity (p>0.05), plaque size (p=0.54), or disease phase. Hypogonadal men had significantly lower SHBG and estradiol levels and higher HbA1c and triglyceride values (all p<0.05). No correlations were found between testosterone levels and curvature degree or plaque dimensions. Conclusion: Serum testosterone levels are not associated with PD severity. Hypogonadism appears to be a comorbidity rather than a determinant of disease severity, suggesting routine testosterone evaluation may not be necessary in PD management. Keywords: Peyronie’s disease, penile curvature, penile plaque, testosterone levels

Background: To investigate whether intramuscular vitamin B12 treatment has an effect on ejaculaory functions in male patients with vitamin B12 deficiency. Methods: Male patients diagnosed with vitamin B12 deficiency in the internal medicine outpatient clinic of our hospital between October 2024 and March 2025 and started to receive intramuscular vitamin B12 treatment were included in study. The scores obtained from the self-estimated intravaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), and premature ejaculation profile (PEP) questionnaires, reflecting the ejaculatory status of these patients before treatment, were recorded. After 3 months of treatment, these scores were re-recorded via phone calls, and scores recorded before and after treatment were compared. Results: The study included 54 patients. The mean age of the patients was 43.46 +/- 13.3 years, the mean pretreatment IELT was 2.4 +/- 1.4 min, and the mean pre-treatment PEDT score was 11.5 +/- 4.6. In both the whole patient group and the premature ejaculation (PE) group, a statistically significant difference was observed in the items of perceived control over ejaculation, satisfaction with sexual intercourse, and interpersonal difficulty related to ejaculation from the PEP questionnaire forms completed after treatment, with no significant change found in the item of personal distress related to ejaculation. In terms of IELT and PEDT, no differences were observed in the whole patient group after treatment, whereas a statistically significant improvement was observed in the PE group. Conclusions: Intramuscular vitamin B12 may delay ejaculation times and improve sexual satisfaction levels in male patients based on the responses given by the patients to the questions in the survey forms. Clinical Trial Registration: The study was retrospectively registered with ClinicalTrials.gov as: NCT07036497.

Objectives: In this study, we aimed to evaluate the parameters that could predict clinically insignificant prostate cancer (ciPCa) in men who underwent transrectal ultrasound (TRUS)-guided prostate biopsy. Methods: Data of patients who underwent transrectal prostate biopsy between January 2015 and November 2019 were examined retrospectively. Free/total PSA ratio (fPSA%), serum total and free prostate-specific antigen (PSA) levels, prostate volumes (PV) measured by ultrasonography, and PSA density (PSAD) values of the patients before biopsy were recorded. ciPCa patients were defined as patients with Gleason scores ≤6 and clinical stage ≤T2a (Group 1). The remaining patients (Gleason score >6 and clinical stage >T2a) were included in Group 2 (clinical significant prostate cancer (csPCa). The parameters examined before biopsy were compared between groups. Results: After performing the exclusion criteria, the study counts in 168 patients with the current data of total/free PSA levels, age, PV calculated by TRUS, rectal examination findings, and pathology reports. Group 1 consisted of 115 patients and Group 2 consisted of 53 patients. In the univariate analysis, PV, total PSA and PSAD were found significantly different between groups, while age, free PSA, and fPSA% showed no significant difference between the two groups. According to the results of the multivariate analysis, the independent predictor of ciPCa was determined to be PSAD while total PSA and PV were not independent predictors. Conclusion: PSAD was found to be superior to other PSA kinetics in predicting ciPCa.

Background: Bleeding due to dorsal venous complex (DVC) injury is generally regarded as the main cause of stress for the surgeon during radical retropubic prostatectomy (RRP) and radical cystoprostatectomy (RSP). Despite its significance, previous studies have not adequately explored preventive strategies for DVC bleeding. This study aimed to determine whether applying an artificial erection (AE) before transecting the DVC in a rat model could effectively reduce bleeding. Methods: This study was conducted using 10 male Wistar albino rats, aged 16 weeks and weighed between 300 and 350 grams. These rats were randomly divided into two groups: one group underwent artificial erection (AE) before transecting the dorsal venous complex (DVC) (AE+, n = 5), while the other group did not (AE-, n = 5). At the end of the study, we compared the volume of aspirated blood around the transected DVC between the two groups. Results: In the AE- group, an average of 4.28 mL of blood was aspirated (range: 3.8 mL to 4.7 mL), while in the AE+ group, an average of 1.54 mL of sero-hemorrhagic fluid was aspirated (range: 1.4 mL to 1.7 mL). The difference between the two groups was statistically significant (p = 0.009). Conclusions: The results of this study suggest that DVC bleeding caused by DVC transection can be significantly reduced by inducing penile erection using the AE technique in rats. This study lays the groundwork for a novel approach to minimizing DVC bleeding and offers an original contribution to the field, enhancing the understanding and management of DVC bleeding.

Aim: To investigate whether inflammation plays a role in the pathogenesis of patients diagnosed with overactive bladder (OAB). Material-Method: Patients who applied to the urology outpatient clinic with a preliminary diagnosis of OAB between March 2022 and September 2023 and were diagnosed were prospectively included in the study. Demographic data of the patients, such as age, gender and body mass index (BMI), were recorded. The number of urgency attacks, pollakiuria and nocturia, OAB-V8 scores (0-40) and the anticholinergics used were recorded. Blood group, whole blood and biochemical values measured from peripheral blood at outpatient clinic admissions, among the inflammation markers neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), C reactive protein/albumin (CRP/Albumin) ratio and Deritis (AST/ALT) ratios were recorded. Patients with urinary tract infection, renal function test abnormalities, and patients with a history of previous urological surgery were excluded from the study. Patients who presented to the outpatient clinic with non-OAB were included as the control group. Hemogram and biochemical values of these patients were also recorded. Data recorded at baseline were compared between groups. Results: A total of 198 patients were included in the study (OAB group n: 99, control group n: 99). The mean age of all patients was 52.3±15 years, and the mean OAB-V8 score was 11.9±9.9. No statistically significant difference was observed between the groups in terms of gender and blood group. No statistically significant difference was observed between the groups in terms of hemoglobin, hematocrit, lymphocyte, platelet, AST, ALT, albumin, NLR, LMR, PLR, Deritis, MLR and CRP/albumin ratio. The mean age of the OAB group was found to be significantly higher than the control group (p

IntroductionWe aimed to investigate whether a low intrarenal pressure provided by ureteral access sheath (UAS) use had a positive effect on the prevention of acute kidney injury through the evaluation of the myo-inositol oxygenase (MIOX).Material and methodsThe patients were divided into two groups according to whether a 9.5/11.5-Fr UAS was used during retrograde intrarenal surgery (RIRS): UAS group and non-UAS group. RIRS was performed under gravity irrigation and manual pumping was not used. For the measurement of MIOX, 5 cc blood samples were taken from the patients preoperatively and four hours postoperatively.ResultsOperation time and hospital stay were significantly longer in the UAS group. The mean preoperative and postoperative MIOX values were 0.77 +/- 0.36 ng/ml and 0.74 +/- 0.38 ng/ml, respectively, in the UAS group, and 0.74 +/- 0.31 ng/ml and 0.83 +/- 0.40 ng/ml, respectively, in the non-UAS group. The mean MIOX change was -0.29 +/- 0.36 in the UAS group and 0.08 +/- 0.44 in the non-UAS group, indicating no significant difference between the groups.ConclusionEven if UAS is not used, significant acute kidney injury is not observed under gravity irrigation and therefore, if we avoid manual pumping, the intrarenal pressure remains low, thus potentially rendering the use of 9,5/11,5-Fr UAS unnecessary.

Purpose: The objective was evaluate the effect of a connective tissue massage on pain, applied analgesic amounts and length of hospitalization of the patients. Method: The study was a prospective, randomized, controlled clinical trial and conducted at a thoracic surgery department of university hospital. The patients were randomly allocated to 1 of 2 groups: a control group (n=27) and the experimental group (n=27). Standard medical treatment, care and pulmonary rehabilitation program were applied to both groups. In addition, a total of 5 sessions of connective tissue massage were applied to the experimental group. Pain level of the patients was evaluated at every 24 hours as of the zeroth postoperative day. VAS was used as a one-dimensional scale for pain assessment. Totally applied analgesic amounts and length of hospitalization of the patients were recorded. Results: There was no statistically significant difference between the experimental and control groups on the postoperative 0th and 1st days. A statistically significant difference was found between VAS averages on postoperative 2nd, 3rd, 4th, 5th, 6th and 7th days (p

Erectile dysfunction (ED) is associated with endothelial damage, especially atherosclerosis. The search for biomarkers that can predict ED still continues. Adropin is known to affect nitric oxide (NO) bioavailability and energy homeostasis. In our study, we have aimed to investigate the relationship between serum adropin levels and ED. Male patients with and without ED between 40-60 years of age, who presented to the outpatient clinics of urology between November 2019-February 2020, were prospectively included in the study. Biochemical values measured at the time of admission to the outpatient clinic. According to the International Index of Erectile Function -5 (IIEF-5) scores which range between 5 and 25 points, patients with a score <= 21 were considered to have ED. The patients were divided into two groups: as ED and non -ED control groups. Laboratory values obtained at admission to outpatient clinics of urology were compared between groups. Patients with (n: 40), and without (n: 40) ED were included in the study. The mean age (50.2 +/- 5.7 years), average body mass index (BMI) (29.7 +/- 2.5 kg/m(2)), IIEF score (15.8 +/- 6 pts), serum adropin (584.8 +/- 172 pg/mL), and total testosterone (396.4 +/- 91.7 ng/dL) levels were recorded. Serum adropin and testosterone levels were statistically significantly higher in the non -ED group than in the ED group (712.3 +/- 222 pg/mL vs. 511.1 +/- 145 pg/mL, p < 0.001 and 420.5 +/- 56 ng/dL vs. 374.3 +/- 98 ng/dL, respectively p = 0.032). Whereas fasting blood glucose (FBG) values were found to be statistically significantly higher in the ED group (100.2 +/- 14 mg/dL vs. 143.8 +/- 78 mg/dL, p = 0.001). According to the results of our study, serum levels of adropin which improves endothelial functions were comparatively lower in ED patients, as expected.

Background:Atherosclerosis and insulin resistance play an important role in the development of erectile dysfunction (ED), and few studies have comprehensively evaluated more specific indicators like atherogenic indices and the triglyceride-glucose (TyG) index in the assessment of ED. Aim:This study aimed to reveal the role of atherogenic indices (atherogenic index of plasma [AIP], Castelli risk index-1/2 [CRI-1/2], and atherogenic coefficient [AC]) based on plasma lipid ratios, which have been used as more sensitive indicators of atherosclerosis in recent years, and the TyG index, a practical indicator of insulin resistance, in predicting vasculogenic ED. Methods:The study included a total of 199 patients who met the inclusion criteria and a total of 51 control subjects without ED complaints according to the International Index of Erectile Function (IIEF-5) scores (>21) between May 2021 and October 2022. For all participants, the demographic and biochemical parameters were evaluated, and atherogenic indices, namely CRI-1 (total cholesterol/high-density lipoprotein [HDL]), CRI-2 (LDL/HDL) AIP [log10(triglycerides/HDL)], and AC (non-HDL/HDL), as well as the TyG index [Ln {fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2}] were calculated. Outcomes:The TyG index, which is an indicator of insulin resistance, and atherogenic indices such as CRI-1, AIP, and AC were significantly associated with ED, and especially AIP and the TyG index seem to be more important in the evaluation of ED. Results:According to the univariate analysis, the patient group had significantly higher CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; P = .005), AIP (0.31 ± 0.26 vs 0.13 ± 0.2; P < .001), AC (4.1 ± 1.4 vs 3.70 ± 1.2; P = .026), and TyG (9.16 ± 0.71 vs 8.77 ± 0.52; P < .001) values compared with the control group. In the correlation analysis, a significant negative correlation was found between the AIP and TyG index and the IIEF-5 scores (r2 = 0.120, P < .001 between AIP and IIEF-5; r2 = 0.091, P < .001 between TyG index and IIEF-5). The multivariate analysis revealed AIP and the TyG index as independent predictive factors for ED. Clinical Implications:The use of atherogenic indices and TyG index in daily urology practice can help physicians in the diagnosis and follow-up of ED. Strengths and Limitations:The lack of sex hormone-binding globulin and free testosterone levels represents a limitation of our study. Another limitation is that the severity of ED was determined using the IIEF-5 scores, rather than a more objective method, such as penile artery ultrasound. Conclusion:Atherogenic indices and the TyG index can be used as inexpensive and practical markers to predict the severity of arteriogenic ED.

Background: The hemoglobin, albumin, lymphocyte and platelet (HALP) score integrates readily available blood markers that reflect systemic inflammation, nutritional status, and immune response, all of which can influence cancer progression. This study investigated the association between the HALP score and clinicopathological characteristics in patients with testicular tumor.Methods: Data of patients who underwent radical orchiectomy for testicular tumors between January 2020 and January 2024 were reviewed. Preoperative serum tumor markers, hemogram parameters and albumin levels were recorded. Tumor stages were recorded from postoperative radiological imaging and serum tumor markers. The association between postoperative results and HALP score was analyzed.Results: A total of 74 male patients were included in the study. The mean age of the patients was 30.27 +/- 6.42 years. The mean HALP score in the patient group with metastasis and retroperitoneal lypmh node invasion (RPLNI) was statistically significantly lower than the patients without metastasis and RPLNI. HALP score decreased statistically significantly with increasing tumor T stage, N stage and M stage. In addition, the mean HALP score values of patients who received chemotherapy, developed progression and mortality were statistically significantly lower than those of patients who did not.Conclusions: Lower HALP scores are significantly associated with advanced disease and poorer prognosis in patients with testicular tumor. The HALP score, composed of routinely measured blood markers, may serve as a convenient and cost-effective prognostic tool to identify patients at higher risk and guide personalized management strategies.

Background:This study aims to investigate the effectiveness of kinesio taping on pain, respiratory function, and respiratory muscle strength in patients after posterolateral thoracotomy.Methods:Between June 2019 and May 2020, a total of 88 patients (48 males, 40 females; mean age: 56.1±9.0 years; range, 28 to 69 years) following posterolateral thoracotomy were randomly allocated to the therapeutic kinesio taping group (n=44) or the control group (n=33). Kinesio taping was applied to the kinesio taping group for seven days. Pain, respiratory functions, respiratory muscle strength, amount of analgesic drug use, and quality of life were evaluated preoperatively, on postoperative Day 0, before tape application, postoperative Days 1, 2, and 7, and at postoperative first month.Results:There was no significant difference between the groups in terms of demographic and clinical characteristics. The results of respiratory functions and respiratory muscle strength were all improved in both groups, while there were more significant improvements in the kinesio taping group. There was a statistically significant difference in the mean Visual Analog Scale scores on postoperative Days 2 and 7 between the two groups. The amount of tramadol use of the patients in the kinesio taping group was significantly lower on postoperative Days 2 and 7 than in the control group.Conclusion:Kinesio taping is an effective method to reduce pain and improve respiratory function after posterolateral thoracotomy. Therefore, it is thought that kinesio taping should be applied as a part of the pulmonary rehabilitation program after thoracotomy.

Aim: Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are common surgical methods in the treatment of kidney stones. Possible effects on kidneys are an important factor in determining the surgical procedure and the surgical method. In our study, kidney injury molecule-1 (KIM-1) and myo-inositol oxygenase (MIOX) were used to compare acute kidney injury in patients that underwent PNL and RIRS. Material and Method:Eighty patients aged 20 to 75, who underwent PNL or RIRS in our urology clinic between November 2018 and February 2020 were included in the study. In this prospective study, the demographic characteristics, stone size, operation time, preoperative and postoperative hemoglobin and biochemistry values of the patients were recorded. 5 cc blood samples taken from the patients before the operation and at the fourth hour after the operation were centrifuged and kept at -80 °C, and the KIM-1 and MIOX levels were measured in the biochemistry department. Results: There was no difference between the groups in terms of demographic data; however,the operation time and length of hospital stay were significantly longer in the PNL group. The mean increase in MIOX was 10.583±9.73 ng/ml and 7.501±16.46 ng/ml in the PNL and RIRS groups, respectively. Although there was a statistically significant increase in both groups, this increase was greater in the PNL group. A significant increase was observed only in the PNL group in the postoperative period (p=0.003). Discussion and Conclusion:The findings of the study suggest that the PNL procedure causes more damage to the kidneys than RIRS.

Gerçek anlamda ortak bir eser üretme projesi olarak ortaya çıkan bu eserde, özel hukuk ve kamu hukuku alanındaki güncel ve onemli konulara yer verilmiştir. Doç. Dr. Tayfun Ercan editörlüğünde farklı hukuk fakültelerinde görevli akademisyenler tarafindan kaleme alınmıştır. Eser hazırlanırken güncel hukuki meselelere çözüm bulma arayışı benimsenmiş bu amaç doğrultusunda yerli ve yabancı literatür taranarak zengin bir kaynakça ortaya çıkmıştır. Yargıtay kararları ile teorik bilginin yanı sıra uygulamaya yer verilmiştir. Okuyucuya güncel hukuki meselelerde yol göstermeye yönelik bu eserin önemli bir ihtiyacı karşıladığı değerlendirilmektedir.

Objective: Investigating the effects of the preoperative short term intensive pulmonary rehabilitation program applied for patients who have undergone lung resection by thoracotomy, on lung functions, complication rates and length of hospital stay during the postoperative period.Methods: A prospective randomized trial of sixty patients were enrolled who would undergo pulmonary resection by thoracot-omy and were randomly divided in two groups. Intensive pulmonary rehabilitation was performed on these patients in the study group 3 hours a day throughout 7 days during the preoperative period. Groups were compared with respect to their spirometric pulmonary functions, respiratory parameters, blood gas parameters, complication rates and length of hospital stay.Results: Total incidence rate of complications in the patients from the control group significantly increased(p=0,028). When patients who underwent lobectomy and wedge resection were observed, length of hospital stay of those in the control group was seen to be statistically higher in comparison with the study group(p<0,05).Conclusion: We consider that it will be very beneficial to perform a short term and intensive pulmonary rehabilitation program on every patient possible who is planned to undergo thoracotomy and lobectomy or wedge resection treatment.

Amaç: Bu çalışmada, fleksibl üreterorenoskopi (f-URS) sırasında yaygın olarak kullanılan üreteral erişim kılıfının (ÜEK) postoperatif enfektif komplikasyonlar ve böbrek fonksiyonları üzerine etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Retrospektif yöntem ile Ocak 2021-Temmuz 2023 tarihleri arasında böbrek ya da proksimal üreter taşı nedeniyle f-URS yapılmış olan hastaların verileri tarandı. Hastaların ameliyat süreleri ve erişim kılıfı kullanım durumları, preoperatif görüntüleri ve postoperatif ateş, sepsis, üriner sistem enfeksiyonu (ÜSE) durumları ve periferik kandan ve idrar tetkikinden bakılan inflamasyon belirteçleri kaydedildi. Hastaların kreatinin ve glomerüler filtrasyon hız (GFH) değişimleri ile taburcu olduktan sonra ilk 2 haftadaki acil servis başvuruları kaydedildi. Hastalar ÜEK kullanılmayanlar ve kullanılanlar olarak 2 gruba ayrıldı. Gruplar arasında kaydedilen veriler karşılaştırıldı. Bulgular: Çalışmaya toplamda 124 hasta dâhil edildi. Hastaların ortalama yaşı 48,15±17,06 yıl idi. Hastalar ÜEK kullanılmayan (Grup 1, n=70) ve kullanılan (Grup 2, n=54) olarak 2 gruba ayrıldı. Her iki grup arasında cinsiyet, taş tarafı, double J stent (DJS) takılması, postoperatif sepsis, postoperatif ÜSE, postoperatif lökosit esteraz pozitifliği, postoperatif hematüri ve postoperatif acil servise başvuru açısından istatistiksel olarak anlamlı farklılık izlenmedi. Postoperatif ateş, idrar tetkikinde nitrit pozitifliği, beyaz kan hücresi ve Creaktif protein erişim kılıfı kullanılmayan hasta grubunda istatistiksel olarak anlamlı yüksek bulundu. Her iki grup arasında ortalama yaş, ameliyat süresi, postoperatif DJS çekim günü, kreatinin ve GFH değişimleri açısından istatistiksel olarak anlamlı farklılık izlenmedi. Sonuç: Böbrek taşı hastalarında erişim kılıfı kullanmanın böbrek fonksiyonları üzerinde koruyucu etkisi gözlenmemekle birlikte, postoperatif enfektif komplikasyonları bir miktar azaltabilir.

Smooth muscle tumors of uncertain malignant potential, the borderline tumors arising from the smooth muscle cells, usually grow slowly and do not fulfill the diagnostic criteria of leiomyosarcoma and its variants, but may behave in a malignant manner. A 15-year-old female patient with an endobronchial mass in the left main bronchus on thoracic computed tomography underwent thoracotomy and tracheobronchoplasty with a wide and safe margin. Histopathological evaluation revealed a smooth muscle tumor of uncertain malignant potential. There were no complications related to the operation during the hospital stay. At six months of surgery, there were no symptoms or signs suggesting any recurrence in her follow-up. In conclusion, In conclusion, pulmonary leiomyomas may rarely present as an endobronchial mass and may mimic asthma by causing respiratory symptoms developing as attacks due to displacement of the mass within the lumen.

Objective: To compare the anaesthesia methods in percutaneous nephrolithotomy in terms of safety and effectiveness in elderly men. Methods: Elderly male patients who had undergone percutaneous nephrolithotomy were screened retrospectively and divided into 2 groups: percutaneous nephrolithotomy under combined spino-epidural anaesthesia (Group CSEA, n = 70) and percutaneous nephrolithotomy under general anaesthesia (Group GA, n = 114). Preoperative, perioperative and postoperative outcome measures were examined. Results: Between the two groups, there was no statistically significant difference in terms of stone burden, stone location, presence of the previous operation in the same kidney, presence of staghorn stones, mean American Society of Anesthesiologists scores and presence of abnormal kidney (p > 0.05). The mean duration time in the operation room and post-anaesthesia care unit (PACU) was statistically shorter in the Group CSEA (p < 0.01). There was no significant difference between the two groups in terms of Clavien Grade 1 and above complications (p > 0.05). Stone-free rates and success rates were similar in both groups (p = 0.133 and p = 0.273, respectively). Conclusion: The type of anaesthesia does not affect the success rate and complication rate of percutaneous nephrolithotomy in elderly male patients. Patients who underwent percutaneous nephrolithotomy under CSEA needed less analgesic injection during the postoperative period. CSEA can shorten the time a patient spends in the operating room and PACU, which provides more effective use of operation room working hours. KEY MESSAGE Combined spino-epidural anaesthesia (CSEA) can be safely administered in elderly men during PNL operation without affecting surgical success. CSEA patients less occupy the operating rooms. CSEA patients' postoperative period is more comfortable because of the less painful period.

Background Increased carotid artery intima-media thickness (CIMT) has been shown to be associated with erectile dysfunction (ED), but studies evaluating the efficacy of CIMT in predicting drug response are lacking in the literature.Aim We aimed to evaluate the efficacy of CIMT in predicting the response to phosphodiesterase-5 inhibitors (PDE5-I).Methods A total of 274 subjects were divided into two groups: ED patients (n = 150) and controls (n = 124). The patients in the ED group were further divided into the subgroups of severe, moderate, mild-moderate, and mild ED. Blood tests, carotid ultrasonography, and the International Index of Erectile Function-5 (IIEF-5) diagnostic tool were applied to all subjects. Tadalafil was administered to each patient. The patients were re-evaluated using the IIEF-5 questionnaire after 2 months of treatment. According to their response to medication, the patients were evaluated as responders or nonresponders.Outcomes Increased CIMT was significantly associated with the failure of PDE5-I therapy, especially in patients with moderate/mild-moderate ED.Results Fasting blood glucose, body mass index, and CIMT were significantly higher in the ED group compared to the control group (P = .021, P = .006, and P < .001, respectively). The IIEF-5 score was significantly lower in the ED group (P < .001). CIMT was significantly correlated with the IIEF-5 score. When the total patient group was evaluated, the CIMT value of the responders was significantly lower than that of the nonresponders (P = .001). CIMT was significantly higher among the nonresponders with moderate/mild-moderate ED compared to the responders (P = .004 and .008, respectively), while there was no significant difference in CIMT between the responders and nonresponders with severe or mild ED. A receiver operating characteristic (ROC) analysis of CIMT was performed for discrimination between nonresponders and responders with moderate/mild-moderate ED. The area under the ROC curve was 0.801 (0.682-0.921) (P = .001), and the cutoff value was determined to be 0.825 mm, at which CIMT predicted the response to treatment with 65% sensitivity and 89% specificity.Clinical Implications Using a validated CIMT cutoff value can help the physician inform the patient about the possibility of drug failure and avoid attempting second-line therapy too soon.Strengths and Limitations There are three main limitations to our study. First, the number of participants was low. Second, ultrasound is a relatively subjective method, and third, all measurements were made by the same radiologist.Conclusion CIMT can be used as a predictor of response to PDE5-I therapies in patients with moderate/mild-moderate ED.

Objective: To compare single-port and two-port video-assisted thoracoscopic sympathectomies for treatment of hyperhidrosis in terms of postoperative complications and patient satisfaction. Design: Cross-sectional survey design with telephone interviews Setting: Multispecialty tertiary care teaching hospital. Subjects: Ninety-four patients with complaints of hyperhidrosis who underwent 166 thoracic sympathectomies with video-assisted thoracoscopic surgery between January 2009 and July 2017 were interviewed with a predetermined questionnaire. Other relevant data were extracted from patient files. Interventions: Not applicable Main Outcome Measures: Length of hospital stay, duration of operation, occurrence of pneumothorax, compensatory sweating, postoperative pain, postoperative tube thoracostomy and dissatisfaction related to surgical scars Results: Fifty-three patients who underwent a total of 97 single port endoscopic thoracic sympathectomies (ETS) had a mean age of 23.1 years, whereas 41 patients who underwent a total of 69 two ETS had a mean age of 23.6 years. Mean duration of operation and mean hospital stay were 15.64 minutes and 1.84 days for single-port ETS, and 19.44 minutes and 1.76 days for two-port ETS. For single-port ETS, there was postoperative pneumothorax in 23 of 97 cases, 18 of which were treated with tube thoracostomy, and for two-port ETS, in 10 of 69 cases, nine of which were treated with tube thoracostomy. The majority of the pneumothoraces were in patients who were operated on towards the beginning of the study duration. Conclusions: Provided that surgeons have adequate experience, single-port ETS is associated with similar rates of complications and better patient satisfaction, and thus, is preferable to two-port ETS.

Object Native T 1 mapping provides tissue‐specific T 1 relaxation times, which can be used to identify structural changes in the various organs. The object of this article was to evaluate the bladder wall of patients with overactive bladder using native T 1 mapping and compare the relaxation times of patients and healthy controls. Material and methods Seventeen patients with a diagnosis of overactive bladder and 15 healthy controls were enrolled in this prospective study. All participants underwent pelvic MRI and T 1 maps were acquired. Native T 1 relaxation times were calculated via regions of interest acquired from the anterosuperior wall of the bladder in all participants. Mean T 1 relaxation times of the overactive bladder patients were compared with those of controls. Results Overactive bladder patients had statistically significantly higher T 1 relaxation times compared with controls ( p = 0.004). In the subgroup analysis, there was no statistically significant difference between males (1113.42 ± 62.4) and females (1176.70 ± 100.9) regarding the T 1 relaxation times ( p = 0.165). There were no correlations between age and T 1 relaxation times in patient or control groups ( r = 0.057, p = 0.825, and r = 0.052, p = 0.932, respectively). Conclusion Native T 1 mapping can identify structural changes in the bladder wall of patients with overactive bladder. This technique has a promising role in the diagnosis of patients with suspected overactive bladder.