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Öğe Bladder Neck Collagen Injection in the Treatment of Congenital Retrograde Ejaculation: A Case Report(Springernature, 2017) Cakiroglu, Basri; Sinanoglu, Orhun; Arda, ErsanThe present study describes the first successful treatment of a congenital retrograde ejaculation case with a submucosal collagen injection to the bladder neck. A 28-year-old male (height 170 cm, weight 80 kg) attended to the urology outpatient clinic with complaints of scattered urine stream and absence of ejaculation. The laboratory tests, including hormone profile (follicle stimulating hormone, luteinizing hormone, and testosterone) and the routine blood count were within normal ranges, whereas semen analysis demonstrated a total absence of ejaculation. The analysis of post-ejaculate urine specimens revealed an elevated sperm concentration indicative of retrograde ejaculation. The cystoscopy was performed; the prostatic urethra was normal, the verumontanum was in the orthotopic position, and the bladder neck was wide opened. Dextranomer/hyaluronic acid copolymer (Deflux, 8 ml) was injected into the bladder neck at clock positions of one, five, seven, and 11 o'clock. During the same procedure, the large opening in the vesical collum was obliterated. During the first followup (four weeks after surgery), the patient was able to produce a normal (2.8 ml) ejaculation volume. The sperm analysis revealed normozoospermia, with 25 million spermatozoa/ml, 26% (a) and 57% (a + b) motility, and 14% normal morphology. The submucosal bladder neck collagen injection is a minimally invasive technique that quickly restores anterograde ejaculation and should be considered in the patients with congenital or acquired retrograde ejaculation and for those who did not respond to the medical treatment.Öğe Does Mild Hydronephrosis Induced by Full-Bladder Improve Outcomes in Patients Undergoing Shock Wave Lithotripsy for Lower Calyceal Stones?: A Prospective Randomized Study(Urol & Nephrol Res Ctr-Unrc, 2018) Hazar, Ismet Aydin; Cakiroglu, Basri; Sinanoglu, Orhun; Akgun, Feride Sinem; Arda, Ersan; Yuksel, Ilkan; Akdere, HakanPurpose: To compare the outcomes, sessions and shock wave numbers in patients undergoing standard procedure shock wave lithotripsy (SWL) and patients undergoing SWL with mild hydronephrosis induced by full-bladder following oral hydration before SWL procedure for lower calyceal stones. Materials and Methods: Between January 2014-January 2016 a total of 371 patients who underwent SWL, for lower pole calyceal stones 2 cm, were included into the study. 127 patients were treated in the supine position (Group A), 123 in the prone position (Group B) and 121 in the prone position with full bladder and mild hydronephrosis checked by ultrasound before procedure (Group C). There were 286 men and 85 women with a mean SD age of 36 11 years Results: The mean (SD) stone sizes within the group A, group B and group C were 11 mm (+/- 3 mm), 12 mm (+/- 4.1 mm) and 11 mm ( +/- 3.8 mm) respectively. No significant difference was found in age (P =.18) and stone size between 3 groups (P =.07). The median interquartile range (IQR) number of shocks within the group A, group B and group C were 7600 (3855), 6500 (4300) and 6700 (4915) respectively. Significant difference was found in number of shock waves among 3 groups (P <.01). The difference between groups according to stone expulsion rate was found significant in all sessions (P =.01). Conclusion: The present study suggests that mild hydronephrotic status induced by full-bladder before SWL can lower cost and patient discomfort by decrease in number of sessions and increase in stone clearance.