BackgroundIn the literature, there is not sufficient data on factors affecting the development of... more BackgroundIn the literature, there is not sufficient data on factors affecting the development of complications in patients with penile fracture after early surgical intervention.ObjectivesTo investigate the predictors of long‐term complications in patients who underwent immediate surgical repair for penile fracture.Materials/methodsThis clinical study included a total of 31 cases of penile fracture in which surgical treatment was performed within the first 24 h and penile fracture was confirmed during the operation. The patients with and without late complications were compared in terms of parameters such as age, tear size of the tunica albuginea of the penis, bilateral involvement of the corpora cavernosa involvement, urethral injuries, and duration from penile fracture to surgery.ResultsThe median age of the patients was 42 years (interquartile range: 34–51 years). The median time from penile fracture to surgery was 13 h (8–18 h). The median tear size was 16 mm (11–21 mm). Late complications were seen in 13 (41.9%) patients in the post‐operative period. Erectile dysfunction developed in five (16.1%) patients in the post‐operative period. There was no statistically significant relationship between age, tear size, time from penile fracture to surgery, and bilateral corporeal involvement in terms of erectile dysfunction development. Painful erections, penile deviations, urethral strictures, tunical scars, and re‐fracture were the other late complications. There was a significant relationship between the development of any complication and time from penile fracture to surgery (p = 0.028) and tear size (p = 0.031). In the receiver operating characteristic analysis of complication development, the cut‐off value for the time from penile fracture to surgery was 13.5 h.Discussion and conclusionWe found that the longer time interval between penile fracture and surgery worsened the patient outcomes. In addition, tear size was determined to be a predictor for long‐term complications. In our opinion, early treatment of penile fracture can prevent severe complications in these cases.
We report an unusual case of persistent postpartum clitorimegaly due to ovarian hyperreactio lute... more We report an unusual case of persistent postpartum clitorimegaly due to ovarian hyperreactio luteinalis. Duplex ultrasonography of the clitoris after intracorporeal injection of prostaglandin E l revealed marked clitoral erection and increased arterial flow, as in the penis.
Objective To investigate whether changes in the struc-disease. Furthermore, the concentration of ... more Objective To investigate whether changes in the struc-disease. Furthermore, the concentration of elastic fibres decreased with age. Electron and light ture of the tunica albuginea influence the development of erectile dysfunction. microscopy revealed the presence of distinct alterations in the tunica albuginea in impotent patients and Patients and methods Biopsy specimens taken from the tunica of 64 patients (both potent and impotent) with patients with Peyronie's disease that might interfere with function. and without Peyronie's disease were evaluated. Tissue samples were stained and examined under light and Conclusion The decrease in elastic fibre concentration and changes in microscopic features may contribute electron microscopy, and the concentration of elastic fibres present in each was measured using com-to erectile dysfunction by impairing the veno-occlusive function of the tunica albuginea. puterized image analysis. Results The concentration of elastic fibres was lower in Keywords Tunica albuginea, impotence, elastic fibre, ageing, Peyronie's disease impotent than in potent patients (P=0.0365) and was also significantly less in patients with Peyronie's and Buck's fascia and are intertwined with collagen
Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of... more Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of covid 19, 81,8% had impaired ED. None of them was vaccinated. After psychodiagnostic examination anxiety and depression were found in 27% of patients. No one from them did not complain of psychological complications before covid 19. In the remaining 73 % of patients, the exact cause of ED was unclear (p>.001). Conclusions: Despite small-scale research, it was revealed that Covid-19 had quite damaged the erectile function. also, the problem could be attached to anxiety and depression that was found out just after psychodiagnostic examination. Such a method could be recommended for the process of diagnostic for patients with ED after Covid-19. It also should be noted that the main reasons for ED after Covid-19 remain unclear but in our opinion, ED could be assessed as one of the clinical significant components for the post-covid syndrome.
High flow priapism is a quite rare condition. It is usually painless and occurs after a trauma. N... more High flow priapism is a quite rare condition. It is usually painless and occurs after a trauma. Nevertheless duplex ultrasound and selective arteriography remain to give us the final diagnosis. Here we present a young men with high flow priapism after perineal trauma.
Background and Design.-In our clinic, 162 couples underwent 421 cycles of intrauterine inseminati... more Background and Design.-In our clinic, 162 couples underwent 421 cycles of intrauterine insemination (IUI) with male factor infertility but normal female findings. The purpose of this study was to evaluate the relationship between the total motile sperm count and the success of intrauterine insemination. Results.-Twenty-two of 24 pregnancies had occurred in the group which underwent 289 cycles of IUI with total motile sperm count more than 5 million/cc. On the other hand only two pregnancies were obtained in the group which underwent 132 cycles of IUI with total motile sperm count less than 5 million/cc. Statistical significance was present in success of IUI between groups with total motile sperm count less than and more than 5 million/cc (χ 2 = 6.27, p< 0.01). Conclusion.-Post washed total motile sperm count may be considered as a predictive criteria of the success for pregnancy in couples with male factor infertility.
Prolaktinin (PRL) spermatogenez ve sperm parametreleri uzerine olan etkisi henuz kesinlesmemistir... more Prolaktinin (PRL) spermatogenez ve sperm parametreleri uzerine olan etkisi henuz kesinlesmemistir. Infertilite olgularinda hiperprolaktinemi ve spermatogenez arasindaki iliskiyi degerlendirmek amaci ile 85 infertil ve hiperprolaktinemili hastayi arastirdik. Olgularimizin hepsinde serum PRL, folikul stimulan hormon, luteinizan hormon, total testosteron duzeyi tayinleri ve en az iki semen analizi yapilmistir. Hiperprolaktinemi saptanan olgularda bromokriptin mesilat tedavisine baslanmis ve 24 aylik bir sure sonunda PRL duzeyleri normale donmus, ancak bu durum semen analizi parametrelerine yansimamistir. Sonuc olarak hiperprolaktineminin sperm sayi, morfolojisi ve motilitesine etkisinin az oldugunu ve tedavisinin erkek infertilitesi tedavisinde katkisinin anlamli olmadigini saptadik.
Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or... more Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or transvesical) for benign prostatic enlargement was assessed before and after operation in a prospective study. Results. Six months after the operation only 80 of them were available for evaluation. Preoperatively, 22 could not maintain their erections to achieve coitus. Six months after operation a decrease in erection had been experienced by 18 of remaining 58 patients, while 1 with erectile dysfunction before surgery declared an improvement. Conclusion. Prostatectomy operations had negative effect on erectile function of men, and there is no significant difference between both procedures.
Administration of vasoactive drugs intracavernously is a well-known easily used and inexpensive a... more Administration of vasoactive drugs intracavernously is a well-known easily used and inexpensive alternative in treatment of a certain group of patients with erectile dysfunction. There are a few drugs used for this purpose, but we prefer papaverine as the first choice because it is easily available and inexpensive in our country. We used alprostadil only in nonresponders to papaverine or if there was any complication with papaverine. We present a series of 69 patients, 24 with psychogenic (34.8%), 27 with organic (39.1%), and 18 (26.1) with mixed etiology of erectile dysfunction, treated with intracavernous self-injection therapy. Mean follow-up of the patients was 13.6 months (7-30 months). In this study, 3,430 papaverine and 780 alprostadil injections were performed in 56 and 13 patients, respectively. In 75% of the papaverine injections and in 83% of the alprostadil injections, erections were achieved sufficient for sexual intercourse. During the follow-up, there were not any abnormal alterations in liver function tests. The main complaint of the patients who used papaverine was a burning sensation (98%) during administration of the drug, which did not last more than 1 minute. Of 13 patients in the alprostadil group, 56.9% of the patients complained mainly of discomfort during erection. We concluded that intracavernous therapy is a good and inexpensive option in the management of erectile dysfunction in carefully selected patients.
Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of... more Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of covid 19, 81,8% had impaired ED. None of them was vaccinated. After psychodiagnostic examination anxiety and depression were found in 27% of patients. No one from them did not complain of psychological complications before covid 19. In the remaining 73 % of patients, the exact cause of ED was unclear (p>.001). Conclusions: Despite small-scale research, it was revealed that Covid-19 had quite damaged the erectile function. also, the problem could be attached to anxiety and depression that was found out just after psychodiagnostic examination. Such a method could be recommended for the process of diagnostic for patients with ED after Covid-19. It also should be noted that the main reasons for ED after Covid-19 remain unclear but in our opinion, ED could be assessed as one of the clinical significant components for the post-covid syndrome.
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Background. Little is known about the natural history of erectile dysfunction. Erectile dysfuncti... more Background. Little is known about the natural history of erectile dysfunction. Erectile dysfunction is clearly a symptom of many conditions and certain risk factors have been identified, some of which may be emanable to prevention strategies. Among these, hypogonadism in association with a number of endocrinologic conditions have been demonstrated as a risk factor. Design. Over a period of 7 years, from 1991 to 1998, 2750 men who had referred to our sexual dysfunctions center for erectile dysfunction have been evaluated. Sexual hystory, physical examination, hormonal evaluation (prolactin, free testosterone), Doppler ultrasound, intracavernous pharmacotest and if indicated DICC and neurologic evaluation have been performed. Data were analyzed from the files of the patients. Patients with endocrinological causes without other etiology were included in the study group. The mean age of the patients were 39.2 (range 2375). The therapy given and results of the therapy were analyzed.
ssor. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u... more ssor. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u l U n iv e rs ity , Is ta n b u l. T urke y. ' * In s tru c to r. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u l U n iv e rs ity , Is ta n b u l. T u rke y. * • ' R e se a rch A s s is ta n t. D e p a rtm e n t o f U rology. C e rra h p a şa F a c u lty o f M e d ic in e , Is ta n b u l U n ive rsity, Is ta n b u l, T urke y. S U M M A R Y An unusual case of penile fracture (rupture of corpus cavernosum) that accidentally occurred during sexual intercourse is presented. The injury also involved the rupture of the urethra. The need for immediate surgery is emphasized when compared to the complications of conservative treatment.
Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or... more Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or transvesical) for benign prostatic enlargement was assessed before and after operation in a prospective study. Results. Six months after the operation only 80 of them were available for evaluation. Preoperatively, 22 could not maintain their erections to achieve coitus. Six months after operation a decrease in erection had been experienced by 18 of remaining 58 patients, while 1 with erectile dysfunction before surgery declared an improvement. Conclusion. Prostatectomy operations had negative effect on erectile function of men, and there is no significant difference between both procedures.
BackgroundIn the literature, there is not sufficient data on factors affecting the development of... more BackgroundIn the literature, there is not sufficient data on factors affecting the development of complications in patients with penile fracture after early surgical intervention.ObjectivesTo investigate the predictors of long‐term complications in patients who underwent immediate surgical repair for penile fracture.Materials/methodsThis clinical study included a total of 31 cases of penile fracture in which surgical treatment was performed within the first 24 h and penile fracture was confirmed during the operation. The patients with and without late complications were compared in terms of parameters such as age, tear size of the tunica albuginea of the penis, bilateral involvement of the corpora cavernosa involvement, urethral injuries, and duration from penile fracture to surgery.ResultsThe median age of the patients was 42 years (interquartile range: 34–51 years). The median time from penile fracture to surgery was 13 h (8–18 h). The median tear size was 16 mm (11–21 mm). Late complications were seen in 13 (41.9%) patients in the post‐operative period. Erectile dysfunction developed in five (16.1%) patients in the post‐operative period. There was no statistically significant relationship between age, tear size, time from penile fracture to surgery, and bilateral corporeal involvement in terms of erectile dysfunction development. Painful erections, penile deviations, urethral strictures, tunical scars, and re‐fracture were the other late complications. There was a significant relationship between the development of any complication and time from penile fracture to surgery (p = 0.028) and tear size (p = 0.031). In the receiver operating characteristic analysis of complication development, the cut‐off value for the time from penile fracture to surgery was 13.5 h.Discussion and conclusionWe found that the longer time interval between penile fracture and surgery worsened the patient outcomes. In addition, tear size was determined to be a predictor for long‐term complications. In our opinion, early treatment of penile fracture can prevent severe complications in these cases.
We report an unusual case of persistent postpartum clitorimegaly due to ovarian hyperreactio lute... more We report an unusual case of persistent postpartum clitorimegaly due to ovarian hyperreactio luteinalis. Duplex ultrasonography of the clitoris after intracorporeal injection of prostaglandin E l revealed marked clitoral erection and increased arterial flow, as in the penis.
Objective To investigate whether changes in the struc-disease. Furthermore, the concentration of ... more Objective To investigate whether changes in the struc-disease. Furthermore, the concentration of elastic fibres decreased with age. Electron and light ture of the tunica albuginea influence the development of erectile dysfunction. microscopy revealed the presence of distinct alterations in the tunica albuginea in impotent patients and Patients and methods Biopsy specimens taken from the tunica of 64 patients (both potent and impotent) with patients with Peyronie's disease that might interfere with function. and without Peyronie's disease were evaluated. Tissue samples were stained and examined under light and Conclusion The decrease in elastic fibre concentration and changes in microscopic features may contribute electron microscopy, and the concentration of elastic fibres present in each was measured using com-to erectile dysfunction by impairing the veno-occlusive function of the tunica albuginea. puterized image analysis. Results The concentration of elastic fibres was lower in Keywords Tunica albuginea, impotence, elastic fibre, ageing, Peyronie's disease impotent than in potent patients (P=0.0365) and was also significantly less in patients with Peyronie's and Buck's fascia and are intertwined with collagen
Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of... more Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of covid 19, 81,8% had impaired ED. None of them was vaccinated. After psychodiagnostic examination anxiety and depression were found in 27% of patients. No one from them did not complain of psychological complications before covid 19. In the remaining 73 % of patients, the exact cause of ED was unclear (p>.001). Conclusions: Despite small-scale research, it was revealed that Covid-19 had quite damaged the erectile function. also, the problem could be attached to anxiety and depression that was found out just after psychodiagnostic examination. Such a method could be recommended for the process of diagnostic for patients with ED after Covid-19. It also should be noted that the main reasons for ED after Covid-19 remain unclear but in our opinion, ED could be assessed as one of the clinical significant components for the post-covid syndrome.
High flow priapism is a quite rare condition. It is usually painless and occurs after a trauma. N... more High flow priapism is a quite rare condition. It is usually painless and occurs after a trauma. Nevertheless duplex ultrasound and selective arteriography remain to give us the final diagnosis. Here we present a young men with high flow priapism after perineal trauma.
Background and Design.-In our clinic, 162 couples underwent 421 cycles of intrauterine inseminati... more Background and Design.-In our clinic, 162 couples underwent 421 cycles of intrauterine insemination (IUI) with male factor infertility but normal female findings. The purpose of this study was to evaluate the relationship between the total motile sperm count and the success of intrauterine insemination. Results.-Twenty-two of 24 pregnancies had occurred in the group which underwent 289 cycles of IUI with total motile sperm count more than 5 million/cc. On the other hand only two pregnancies were obtained in the group which underwent 132 cycles of IUI with total motile sperm count less than 5 million/cc. Statistical significance was present in success of IUI between groups with total motile sperm count less than and more than 5 million/cc (χ 2 = 6.27, p< 0.01). Conclusion.-Post washed total motile sperm count may be considered as a predictive criteria of the success for pregnancy in couples with male factor infertility.
Prolaktinin (PRL) spermatogenez ve sperm parametreleri uzerine olan etkisi henuz kesinlesmemistir... more Prolaktinin (PRL) spermatogenez ve sperm parametreleri uzerine olan etkisi henuz kesinlesmemistir. Infertilite olgularinda hiperprolaktinemi ve spermatogenez arasindaki iliskiyi degerlendirmek amaci ile 85 infertil ve hiperprolaktinemili hastayi arastirdik. Olgularimizin hepsinde serum PRL, folikul stimulan hormon, luteinizan hormon, total testosteron duzeyi tayinleri ve en az iki semen analizi yapilmistir. Hiperprolaktinemi saptanan olgularda bromokriptin mesilat tedavisine baslanmis ve 24 aylik bir sure sonunda PRL duzeyleri normale donmus, ancak bu durum semen analizi parametrelerine yansimamistir. Sonuc olarak hiperprolaktineminin sperm sayi, morfolojisi ve motilitesine etkisinin az oldugunu ve tedavisinin erkek infertilitesi tedavisinde katkisinin anlamli olmadigini saptadik.
Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or... more Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or transvesical) for benign prostatic enlargement was assessed before and after operation in a prospective study. Results. Six months after the operation only 80 of them were available for evaluation. Preoperatively, 22 could not maintain their erections to achieve coitus. Six months after operation a decrease in erection had been experienced by 18 of remaining 58 patients, while 1 with erectile dysfunction before surgery declared an improvement. Conclusion. Prostatectomy operations had negative effect on erectile function of men, and there is no significant difference between both procedures.
Administration of vasoactive drugs intracavernously is a well-known easily used and inexpensive a... more Administration of vasoactive drugs intracavernously is a well-known easily used and inexpensive alternative in treatment of a certain group of patients with erectile dysfunction. There are a few drugs used for this purpose, but we prefer papaverine as the first choice because it is easily available and inexpensive in our country. We used alprostadil only in nonresponders to papaverine or if there was any complication with papaverine. We present a series of 69 patients, 24 with psychogenic (34.8%), 27 with organic (39.1%), and 18 (26.1) with mixed etiology of erectile dysfunction, treated with intracavernous self-injection therapy. Mean follow-up of the patients was 13.6 months (7-30 months). In this study, 3,430 papaverine and 780 alprostadil injections were performed in 56 and 13 patients, respectively. In 75% of the papaverine injections and in 83% of the alprostadil injections, erections were achieved sufficient for sexual intercourse. During the follow-up, there were not any abnormal alterations in liver function tests. The main complaint of the patients who used papaverine was a burning sensation (98%) during administration of the drug, which did not last more than 1 minute. Of 13 patients in the alprostadil group, 56.9% of the patients complained mainly of discomfort during erection. We concluded that intracavernous therapy is a good and inexpensive option in the management of erectile dysfunction in carefully selected patients.
Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of... more Results: The study found that among patients who underwent moderate (48%) or hard form (12.1%) of covid 19, 81,8% had impaired ED. None of them was vaccinated. After psychodiagnostic examination anxiety and depression were found in 27% of patients. No one from them did not complain of psychological complications before covid 19. In the remaining 73 % of patients, the exact cause of ED was unclear (p>.001). Conclusions: Despite small-scale research, it was revealed that Covid-19 had quite damaged the erectile function. also, the problem could be attached to anxiety and depression that was found out just after psychodiagnostic examination. Such a method could be recommended for the process of diagnostic for patients with ED after Covid-19. It also should be noted that the main reasons for ED after Covid-19 remain unclear but in our opinion, ED could be assessed as one of the clinical significant components for the post-covid syndrome.
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Background. Little is known about the natural history of erectile dysfunction. Erectile dysfuncti... more Background. Little is known about the natural history of erectile dysfunction. Erectile dysfunction is clearly a symptom of many conditions and certain risk factors have been identified, some of which may be emanable to prevention strategies. Among these, hypogonadism in association with a number of endocrinologic conditions have been demonstrated as a risk factor. Design. Over a period of 7 years, from 1991 to 1998, 2750 men who had referred to our sexual dysfunctions center for erectile dysfunction have been evaluated. Sexual hystory, physical examination, hormonal evaluation (prolactin, free testosterone), Doppler ultrasound, intracavernous pharmacotest and if indicated DICC and neurologic evaluation have been performed. Data were analyzed from the files of the patients. Patients with endocrinological causes without other etiology were included in the study group. The mean age of the patients were 39.2 (range 2375). The therapy given and results of the therapy were analyzed.
ssor. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u... more ssor. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u l U n iv e rs ity , Is ta n b u l. T urke y. ' * In s tru c to r. D e p a rtm e n t o f U rology, C e rra h p a şa F a c u lty o f M e d ic in e. Is ta n b u l U n iv e rs ity , Is ta n b u l. T u rke y. * • ' R e se a rch A s s is ta n t. D e p a rtm e n t o f U rology. C e rra h p a şa F a c u lty o f M e d ic in e , Is ta n b u l U n ive rsity, Is ta n b u l, T urke y. S U M M A R Y An unusual case of penile fracture (rupture of corpus cavernosum) that accidentally occurred during sexual intercourse is presented. The injury also involved the rupture of the urethra. The need for immediate surgery is emphasized when compared to the complications of conservative treatment.
Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or... more Background and Design. Erectile function of 105 men who underwent prostatectomy (transurethral or transvesical) for benign prostatic enlargement was assessed before and after operation in a prospective study. Results. Six months after the operation only 80 of them were available for evaluation. Preoperatively, 22 could not maintain their erections to achieve coitus. Six months after operation a decrease in erection had been experienced by 18 of remaining 58 patients, while 1 with erectile dysfunction before surgery declared an improvement. Conclusion. Prostatectomy operations had negative effect on erectile function of men, and there is no significant difference between both procedures.
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