Purpose: To investigate the effect of mirabegron 50 mg/daily for JJ stent-related symptoms after ureteroscopic stone surgery. Methods: Medical records of 145 patients who were given a single daily oral dose of 50 mg of mirabegron for relieving stent-related symptoms were retrospectively analyzed. Demographic and clinical data and stone parameters were recorded. All participants completed the Turkish version of the Ureter Symptom Score Questionnaire (USSQ-T) on the postoperative seventh day, and again after at least three weeks, before JJ stent removal. The severity of stent-related symptoms was statistically compared before and after the mirabegron treatment. Results: The mean urinary symptoms score decreased significantly from 30.87 ± 9.43 to 22.61 ± 6.78 (p < 0.0001), mean body pain score decreased significantly from 21.82 ± 11.22 to 14.03 ± 7.52 (p < 0.0001), mean work performance score decreased from 10.50 ± 8.61 to 7.02 ± 6.51 (p < 0.0001), and mean general health score decreased significantly from 15.43 ± 6.50 to 11.12 ± 3.70 (p < 0.0001). The mean sexual matters score significantly decreased from 3.88 ± 3.40 to 2.48 ± 2.03 (p < 0.0001), the additional problem score decreased from 9.31 ± 4.61 to 6.51 ± 2.83 (p < 0.0001), and the overall quality of life (QoL) score decreased from 5.18 ± 1.94 to 4.23 ± 1.71 after mirabegron use (p < 0.0001). Conclusion: Daily use of 50g of mirabegron significantly improved stent-related symptoms, sexual matters, and quality of life.
Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology: The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results: A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared to normal life. Conclusions: Covid-19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.
Objective: To identify pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology: After approval by the local ethics committee, all patients with nocturia (≥1 nocturnal void/night) were included and filled the overactive bladder questionnaire (OABq), nocturia quality of life (N-QoL), ICIQ-MLUTS (male), ICIQ-FLUTS (female) and 3-day frequency-volume chart. Patients were divided into three groups according the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis were performed between groups, p<0.05 was deemed as statistically significant. Results: 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria, reduced bladder capacity and global polyuria; respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the afore-mentioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia; 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher nocturnal polyuria, global polyuria and reduced bladder capacity rates. Conclusions: Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardization of the diagnostic and treatment approaches as well as for the design of future clinical trials.
Objectives: There is no standardized and up-to-date education model for urology residents in our country. We aimed to describe our National E learning education model for urology residents. Methodology: The ERTP working group; consisting of urologists was established by Society of Urological Surgery to create E-learning model and curriculum at April 2018. Learning objectives were set up in order to determine and standardize the contents of the presentations. In accordance with the Bloom Taxonomy, 834 learning objectives were created for a total of 90 lectures (18 lectures for each PGY year). Totally 90 videos were shoot by specialized instructors and webcasts were prepared. Webcasts were posted at uropedia.com.tr, which is the web library of Society of Urological Surgery. Satisfaction of residents and instructors was evaluated with feedbacks. An assessment of knowledge was measured with multiple-choice exam. Results: A total of 43 centers and 250 urology residents were included in ERTP during the academic year 2018/2019. There were 93/38/43/34/25 urology residents at 1st/2nd/3rd/4th and 5th year of residency, respectively. Majority of the residents (99.1%) completed the ERTP. The overall satisfaction rate of residents and instructors were 4,29 and 4,67(min:1 so bad, max:5 so good). An assessment exam was performed to urology residents at the end of the ERTP and the mean score was calculated as 57.99 points (min:20, max:82). Conclusion: Due to the Covid-19 pandemic, most of the educational programs had to move online platforms. We used this reliable and easily accessible e-learning platform for standardization of training in urology on national basis. We aim to share this model with international residency training programs.