Spinal cord injury is a major cause of lifelong morbidity. Functional micturition problems are common while the management choices are comparatively narrow. Some patients are refractory to the combination of the available therapeutics, namely the anticholinergics and a beta-adrenergic named mirabegron. In this paper we report our results of using gabapentin as an add-on treatment in the refractory overactive detrusor cases secondary to spinal cord injury. Material and Methods A total of 27 patients who had spinal cord injury between the levels of second thoracic and fourth lumbar vertebrae and had an overactive detrusor in urodynamic studies were included in this retrospective study. The patients were selected as they also had not responded to a combination of an anticholinergic and mirabegron and had neuropathic pain. Gabapentin treatment was added to the previous therapy. Demographics, previous treatments, chronic conditions, urodynamic findings, clinical and urodynamic responses are reported in this paper. Results We observed the response in the urodynamic studies of 11 patients (40.17%), in terms of decreased detrusor contractions, maximal detrusor pressure, and the number of the incontinence episodes. Sixteen patients did not respond to the gabapentin add-on therapy and were referred for Botulinum Toxin injections to the bladder. Conclusion Gabapentin add-on therapy can be considered as an option in neurogenic overactive detrusor patients who did not respond to the combination of anticholinergics and mirabegron. The approved usage of gabapentin for neurogenic pain justifies its usage in this area. In our selected patient group, who had not responded to the combination therapy, we observed a clinical benefit in one-third of the patients.

Objectives: Myroides spp. is an environmental pathogen and causes disease in immunocompromised patients. In this study, we report an outbreak of urinary tract infections caused by M. odoratimimus in a university hospital in Turkey. Methods: A total of 25 M. odoratimimus strains isolated from the clinical samples of 20 patients in our intensive care units and clinics were included in the study. Phenotypic and genotypic identification of isolates was performed using conventional methods, VITEK®-2 automated identification system, Matrix Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry and 16S-RNA Microbial Diagnosis methods. In addition, Repetitive Extragenic Palindromic Elements (REP) PCR Assay method was applied for molecular epidemiological analysis. Results: All cases were diagnosed with nosocomial urinary tract infection, except for one case diagnosed with nosocomial bacteraemia. One of the M. odoratimimus isolates was sensitive to piperacillin/tazobactam (MIC: ≤4 µg/ml) and one isolate was moderately sensitive to cefepime (MIC: 16 µg/ml). Other M. odoratimimus isolates were resistant to the tested antibiotics of beta lactams, monobactams, carbapenems, aminoglycosides, fluoroquinolones and sulphonamides. When 10 isolates were evaluated with the REP PCR method, DNA finger print similarities were visually determined and there was a similar DNA pattern among them. Myroides source was not detected in environmental samples. Conclusion: Clinicians should consider that Myroides spp. isolates with multiple and broad-spectrum drug resistance may be a serious nosocomial pathogen like Pseudomonas aeruginosa or Acinetobacter baumannii. In order to choose the best treatment regimen, this atypical pathogen needs to be quickly identified and antibiotic susceptibility tests performed.

ABSTRACT Aim: To investigate the effect of COVID-19 on sexual dysfunction in women. Materials and Methods: The women diagnosed with COVID-19 and hospitalized at a tertiary hospital were included. They completed the Introductory Data Form, the Female Sexual Function Index-(FSFI), and the Short Form-36 Quality of Life Scale (SF-36). Results: 15 women between the ages of 19-49 who completed the treatment protocol, discharged at least 14 days before, and who had not been diagnosed as sexual dysfunction sexually active earlier were included to the study. It was detected that weekly sexual intercourse before and after COVID-19 significantly differed (p=0.047). The frequency of relationships decreased statistically after COVID-19. The mean value of the FSFI satisfaction score differs from COVID-19 before and after diagnosis (p=0.012). The mean satisfaction score before COVID-19 was 3.47, and after COVID-19 was 2.93. The score of the subgroups of FSFI did not differ from COVID-19 before and after diagnosis (p>0.050). The median value of SF-36 pain differs from COVID-19 before and after diagnosis (p=0.008). Conclusion: it was concluded that the frequency of sexual intercourse, sexual satisfaction in women decreased after COVID-19 disease, and the quality of life scores did not change in a statistically significant way.

Aim: To show if lower urinary tract symptoms (LUTS) could be symptoms of COVID-19 with validated questionnaires. Methods: The 96 COVID-19 patients who were hospitalized at a tertiary center were collected retrospectively. After the exclusion criteria, 46 patients were consisted as the study population. The male and female patients then fill formed the International Prostate Symptom Score and Urinary Symptom Profile respectively. All patients responded to these questions for the three period. Results: 27 female (58.6 %) and 19 male (41.4 %) COVID-19 patients answered the questions In the male patients, while there were no statistically significant differences in the total IPSS, the voiding IPSS score, and quality of life between the three periods (p=0.148; p=0.933, p=0.079, respectively), the storage IPSS scores had a significant difference between the three periods (p=0.05). In the female patients, low stream scores, were similar between the three periods (p=0.368). The scores of stress incontinence and an overactive bladder had a significant difference between the three periods (p=0.05 and p=0.05). Conclusion: LUTS, especially storage symptoms, might be one of the initial symptoms of COVID-19 and the clinicians should evaluate LUTS with other known symptoms of the virus when a patient is suspected of having COVID-19.

Aims: To evaluate the diagnostic significance of the novel index combining preoperative hemoglobin, albumin levels, lymphocyte and platelet counts (HALP) in prostate cancer (PCa) patients. Methods: Between January 1, 2015 to December 31, 2018 at the Hitit University Erol Olçok Education and Research Hospital 225 patients who had undergone transrectal ultrasound guided prostate biopsy or prostate surgery were analyzed retrospectively. A total of patients; 155 had benign prostate hyperplasia (group 1) and 70 had PCa (group 2). The preoperative serum levels of hemoglobin, albumin, lymphocyte counts, and platelet counts were recorded. The HALP scores and the sub parameters of this index for each of the two groups were compared. Results: The total Prostate Specific Antigen (PSA), albumin and lymphocyte differences between the groups were statistically significant (p=0.0002, p=0.0001, p= 0.005). The median value of HALP scores in Group 1 and 2 were 49.43 and 51.2 respectively, and this was not statistically significant between groups (p=0.737). The HALP score had the least Area Under Curve (AUC) value compared to the others (0.514). the AUC of Albumin was larger than PSA for diagnostic efficacy in PCa patients (0.696-0.656). However, albumin levels were statistically significant compared to platelet count and the HALP score (p=0.0033, p=0.0068), except PSA and lymphocyte (p=0.4580, p=0.1717). Conclusion:Further prospective clinical studies that include more patients from multiple centers are needed to show the diagnostic role of the HALP score and its compounds on the patients with PCa.

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.

Backgrounds: To investigate the association between assisted reproductive technology (ART) treatments and the Coronavirus Disease 2019 (COVID-19). Methods: The data of the 17 infertility patients who were treated with ART between 01 and 11 March 2020 at a Reproductive Endocrinology and Infertility Unit of a tertiary center were collected retrospectively. The patients were then asked if they were positive for the COVID-19 or had symptoms of the illness. Results: Ovarian stimulation, oocyte pick-up, and intracytoplasmic sperm injection were used for all of the patients. Nine (52.9%) patients’ embryos were transferred and pregnancy was detected in 4 of the 9 patients after the assisted reproductive treatments. At the time of the interview, none of the infertile women had any symptoms of the COVID-19 or a confirmed diagnosis from a positive test result for the COVID-19 nucleic acids by real-time fluorescence reverse transcription-polymerase chain reaction. Conclusion: When turning to normal practice life, all patients should be evaluated for COVID-19 during pre, per and post-treatment time in order to stop the ART and protect against the cases from the possible side effects of assisted reproductive treatments, especially the possible, but undefined, predisposition factor to COVID-19.