Is the Effectiveness of Self-Visualization During Flexible Cystoscopy Gender-Dependent in Patients with no Previous Cystoscopy History? A Prospective Randomized Study

ABSTRACT Purpose: To evaluate the effect of real-time self-visualisation (SV) of the procedure during flexible cystoscopy (FC) on pain and anxiety in male and female patients with no prior cystoscopy history. Patients and Methods: Between Dec 2022-May 2024, 400 patients who underwent office-based FC were enrolled into prospective randomized study in accordance with CONSORT. Patients were randomised into two groups (SV and no-SV) using sequential (1:1 ratio) randomisation. To ensure equal numbers of male and female patients in each group, one consecutive male patient was assigned to the SV group, while the next male patient was assigned to the non-SV group; the same randomization was done for females. The primary endpoint was to evaluate the pain during FC (during urethral insertion of the cystoscope and bladder examination stages) of both groups. The secondary endpoint was to evaluate anxiety, patient satisfaction, and willingness to undergo the procedure of both groups. Results: In males, significant lower pain scores were detected in SV group during urethral insertion of the cystoscope (1.4 vs. 4.8, p<0.001) and during bladder examination (0.9 vs. 3.1, p<0.001). However, pain scores during urethral insertion of the cystoscope (1.9 vs. 2, p=0.38) and during bladder examination (1.2 vs. 1.3, p=0.63) were statistically similar between two groups in female patients. In both genders, significant lower anxiety levels, higher patient satisfaction and higher willingness to undergo repeat cystoscopy were detected in SV group. Conclusion: SV during FC may be beneficial in reducing pain in male patients but not in female patients. SV during FC has a positive effect on anxiety, patients’ satisfaction, and willingness to undergo repeat procedures, regardless of gender

The Effect of General and Regıonal Anesthesıa on the Neutrophıl / Lymphocyte and Platelet / Lymphocyte Ratıos Durıng Bladder Tumor Surgery; Retrospectıve Study.

Abstract BACKGROUND: Among the indicators of SIR are changes in the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This study aimed to determine the effect of general and regional anesthesia on SIR during short-term transurethral bladder resection (TUR-B) surgery. METHODS: The 66 included patients were divided into 2 groups: Group 1 (general anesthesia) and Group 2 (regional anesthesia). The lymphocyte, platelet, and neutrophil counts before surgery and 1 h after surgery were obtained from the patients’ records. The indicators of SIR the NLR and PLR were calculated preoperatively and postoperatively. Differences between the groups in the NLR and PLR were investigated.RESULTS: At 1 h postsurgery there weren’t any significant differences in the neutrophil, lymphocyte, platelet counts, or the NLR and PLR in groups, as compared to presurgery; however, the lymphocyte count was higher (but not significantly) in both groups, as compared to presurgery. The neutrophil count and NLR were lower (but not significantly) in Group 1 at postsurgery. CONCLUSIONS: General and regional anesthesia have no effect on postoperative SIR in patients with bladder tumors that may require multiple surgeries and administration of anesthesia; however, we think larger scale prospective studies are needed to more clearly understand neutrophil count and NLR changes in bladder cancer surgery patients administered general anesthesia.</jats:p

The impact of diabetes mellitus on urinary continence after holmium laser enucleation of the prostate due to lower urinary tract symptoms: a retrospective study

INTRODUCTION: Diabetes mellitus (DM) is known as a risk factor of stress urinary incontinence after Holmium laser enucleation of the prostate (HoLEP). We aimed to compare the postoperative continence status of patients with and without DM, after HoLEP surgery. MATERIAL AND METHODS: A total of 214 patients who underwent HoLEP between January 2017 and January 2020 were retrospectively assessed. Functional outcomes, perioperative total operation time (TOT)(min), enucleation time (ET)(min), enucleation efficiency (EE)(g/min), enucleated tissue weight (ETW)(g), morcellation efficiency (ME)(g/min), morcellation time (MT)(min), continence status, intraoperative and postoperative complications according to Clavien–Dindo classification were recorded. RESULTS: A total of 96 patients had DM additional to benign prostate hyperplasia (BPH) (Group 1), while 118 patients had only benign prostate hyperplasia without DM (Group 2). When comparing preoperative and postoperative functional outcomes, a statistically significant improvement was observed in both groups from baseline to the 1(st) and 6(th) month follow-up (p ≤0.001). There were no statistically significant differences between groups in postoperative stress urinary incontinence at postoperative months 1 and 6 (1.7% vs 2.1%, p = 1 and 0.8% vs 1%, p = 1; respectively). There was no significant difference between groups in intraoperative and postoperative complications (p >0.05). CONCLUSIONS: HoLEP is safe to perform in patients with DM at low complication and urinary incontinence rates

Prognostic Importance of Single-Nucleotide Polymorphisms in IL-6, IL-10, TGF-β1, IFN-γ, and TNF-α Genes in Chronic Phase Chronic Myeloid Leukemia

The aim of this study was to explore the association between polymorphisms of five cytokine genes and clinical parameters in patients with Philadelphia-positive (Ph+) chronic myeloid leukemia (CML) treated with imatinib. We analyzed five cytokine genes (interleukin [IL]-6, IL-10, gamma interferon [IFN-γ], transforming growth factor beta-1 [TGF-β1], and tumor necrosis factor-alpha [TNF-α]) in 60 cases with Ph+ CML and 74 healthy controls. Cytokine genotyping was performed by the polymerase chain reaction-sequence-specific primer. All data were analyzed using the de Finetti program and SPSS version 14.0 for Windows. No significant differences were detected between the CML group and healthy controls with respect to the distributions and numbers of genotypes and alleles in TNF-α, TGF-β1, IL-10, and IFN-γ. However, the GG genotype associated with high expression in IL-6 was found to be significantly more frequent in CML as compared to controls (p=0.010). The median follow-up time was 49.3 months (range 6.1–168.4) and the median duration of imatinib treatment was 39.5 months (range 5.2–103.4) for these patients. On multivariateanalysis, only IL-10 GCC/GCC highly produced haplotypes were significantly associated with a shorter event-free survival. The relationship between cytokine genotypes/haplotypes and clinical parameters in CML has not been investigated before. Our results suggest that IL-10 may be a useful marker for CML prognosis and theGG genotype of the IL-6 gene may be associated with susceptibility