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    Bacteriuria and socioeconomic associations among pregnant women in Malatya, Turkey
    (W B Saunders Co Ltd, 2005) Gunes, G; Gunes, A; Tekiner, S; Karaoglu, L; Kaya, M; Pehlivan, E
    [Abstract Not Available]
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    Evoked cavernous activity
    (Lippincott Williams & Wilkins, 2002) Yilmaz, U; Soylu, A; Ozcan, C; Kutlu, R; Gunes, A
    Purpose: Corpus cavernosum electromyography has been widely done to evaluate autonomic dysfunction in patients with erectile dysfunction. We assessed the value of corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin responses for their accuracy in determining autonomic involvement in cases of erectile dysfunction. Materials and Method: We evaluated 75 men with erectile dysfunction by corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests at our neurourology laboratory. The etiology of dysfunction was vascular, neurogenic, psychogenic or mixed based on a detailed medical and sexual history, physical examination, electrophysiological and laboratory studies, penile color Doppler ultrasonography, and cavernosography and/or cavernosometry. Autonomic involvement was clinically assessed by systemic findings, such as orthostatic hypotension, impaired gastrointestinal motility, sinus dysrhythmia and secretomotor changes. A concentric electromyography needle placed in the right cavernous body was used to record corpus cavernosum electromyography and evoked cavernous activity. The right median nerve was stimulated electrically with 13 to 16 mA. to determine evoked cavernous activity and the penile sympathetic skin response. The latter response was recorded with silver disc electrodes placed on the left cavernous body. All tests were performed using an electromyography/ evoked potential machine. We determined the relationships among corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests in respect to etiological factors. Results: The 56 patients with normal corpus cavernosum electromyography activity had also evoked cavernous activity and a penile sympathetic skin response except for 1 with no penile sympathetic skin response but evoked cavernous activity. None of these patients had autonomic neuropathy. Of the 19 patients without corpus cavernosum electromyography activity 11 had evoked cavernous activity, including 10 with no autonomic neuropathy. The remaining 8 patients had no evoked cavernous activity, of whom 7 had autonomic neuropathy. A penile sympathetic skin response was recorded in 18 men with absent corpus cavernosum electromyography. Conclusions: Due to false-negative results on corpus cavernosum electromyography and penile sympathetic skin response testing evoked cavernous activity seems more reliable for determining autonomic involvement in the pathophysiology of erectile dysfunction.
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    Percutaneous nephrolithotomy for pediatric stone disease - Our experience with adult-sized equipment
    (Informa Healthcare, 2003) Gunes, A; Ugras, MY; Yilmaz, U; Baydinc, C; Soylu, A
    Objective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydro-pneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.