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    Association Between Prostate Volume and Red Cell Distribution Width
    (Wiley, 2014) Zorba, Orhan U.; Uzun, Hakki; Onem, Kadir; Cetinkaya, Mehmet; Rifaioglu, Murat; Akca, Nezih
    ObjectivesTo evaluate relation between red cell distribution width (RDW) and benign prostatic hyperplasia (BPH). MethodsThe overall study population consisted of 942 men with lower urinary tract symptoms (LUTS), ranging in age from 60 to 85years old. Patients with disorder or medication that can influence lower urinary tract or erythrocytes were excluded from the study. The relationship between RDW, white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and prostate volume, International Prostate Symptom Score (IPSS) were assessed with multivariate linear regression model. Patients were analyzed in four groups stratified according to the quartiles of prostate volume. The one-way analysis of variance (anova) was used to compare RDW, WBC CRP, and ESR between different quartiles of prostate volume. ResultsA graded and independent association of RDW with the prostate volume was identified (P=0.001). RDW was significantly associated with prostate volume in multivariate linear regression model that was adjusted for age and hemoglobin. IPSS was significantly correlated with RDW, CRP and ESR. However significance was lost after adjustment for age and prostate volume. The RDW was significantly associated with the surgical treatment in the multivariate linear regression model that was adjusted for age and prostate volume. ConclusionsA correlation between an increased RDW and prostate volume was suggested by the new data from this study. This relation may be a consequence of inflammatory stress arising from BPH. The significant association between the easy, inexpensive RDW may provide a rational basis to include the RDW in algorithms for surgery risk prediction.
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    Autonomic Nervous System Dysfunction in Lifelong Premature Ejaculation: Analysis of Heart Rate Variability
    (Elsevier Science Inc, 2012) Zorba, Orhan Unal; Cicek, Yuksel; Uzun, Hakki; Cetinkaya, Mehmet; Onem, Kadir; Rifaioglu, Mehmet Murat
    OBJECTIVE To identify autonomic nervous dysfunction in patients with lifelong premature ejaculation. METHODS The study participants were 25 men with lifelong premature ejaculation and 25 healthy controls. The parameters of 24-hour heart rate variability that are influenced by the autonomic nervous system were compared between the men with lifelong premature ejaculation and the healthy controls. RESULTS The laboratory results of all patients were within normal limits, and no significant differences were found between the patients and the controls in age, body weight, and body mass index. A low-frequency signal that is influenced by the sympathetic system was increased in the patients (P = .026). Furthermore, a high-frequency signal that is influenced by the parasympathetic system was decreased in the patients (P = .011). Finally, the low frequency-to-high frequency ratio, an indicator of the balance between the two components of the autonomic nervous system, was increased in the patients (P = .002). CONCLUSION To our knowledge, no study has investigated the influence of the autonomic nervous system on 24-hour heart rate variability in premature ejaculation. In the present study, sympathetic activity was increased in men with lifelong premature ejaculation; this overactivity might lead to lifelong premature ejaculation. Additional studies are required to reveal the possible alteration of the autonomic nervous system in premature ejaculation. UROLOGY 80: 1283-1286, 2012. (c) 2012 Elsevier Inc.
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    Is There a Relation between Reticular Formation and Storage Symptoms in Men
    (Wiley, 2014) Zorba, Orhan U.; Kirbas, Serkan; Uzun, Hakki; Onem, Kadir; Cetinkaya, Mehmet; Rifaioglu, Mehmet M.
    ObjectiveTo reveal brainstem originated pathology in men with different types of lower urinary tract symptoms blink reflex latency times were assessed. MethodsA total of 32 men, 16 with storage and 16 with voiding symptoms, were enrolled in the study. Blink reflex latency times were analyzed through electrical stimulation of the supraorbital nerve. Two responses in the orbicularis oculi muscle were recorded: the latency times for the early ipsilateral response, R1, and the late bilateral responses, R2. ResultsThe mean ages of the patients with storage and voiding symptoms were 57.316.87 and 58.06 +/- 6.29years, respectively. The R2 latency times were significantly longer in men with storage symptoms. However, the R1 latency times were similar for the two groups. ConclusionLate blink latency times were long only in patients who had storage symptoms. An oligosynaptic path through the trigeminal nuclei, which includes one or two interneurons, is responsible for early response; however, late response is relayed through a polysynaptic path, including neurons in the reticular formation. It has also been shown that stimulation of the pontine reticular formation inhibits the micturition contraction. In some patients, storage symptoms may result from pathology that originates with the reticular formation and this pathology may lead to increases in late blink latency times. Additional studies are needed on other reflexes that are mediated through reticular formation, in order to show the possible dysfunction of the reticular formation in men with storage symptoms.
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    Overactive Bladder and Pontine Reticular Formation
    (Karger, 2013) Zorba, Orhan Unal; Kirbas, Serkan; Uzun, Hakki; Cetinkaya, Mehmet; Onem, Kadir; Rifaioglu, Mehmet Murat
    Background: The etiology of overactive bladder (OAB) remains unclear. Observed neurogenic factors in the literature are limited to suprapontine or spinal pathologies. The blink reflex is a useful tool in the evaluation of brainstem functions. Blink reflex latency times were evaluated in order to reveal pathology in the brainstem. Methods: A total of 60 women, 30 patients with idiopathic OAB and 30 healthy controls, were enrolled in the study. Blink reflex latency times were analyzed by electrical stimulation of the supraorbital nerve. Two responses in the orbicularis oculi muscle, early ipsilateral response (R1) and late bilateral response (R2) latency times, were recorded. Results: Mean ages of the patients and controls were 51.9 +/- 5.3 and 49.2 +/- 6.2 years, respectively. R2 latency times were significantly higher in patients than in controls. However, R1 latency times were similar between the two groups. Conclusions:The results of the study suggest a significant relation between late blink latencytimes and OAB. An oligosynaptic path via the trigeminal nuclei is responsible for R1; however, R2 response is relayed through the reticular formation. Stimulation of pontine reticular formation inhibits micturition contraction. In some patients, idiopathic OAB may result from reticular formation-originated pathology. Additional studies on other reticular formation-mediated reflexes are needed to reveal possible dysfunction of reticular formation. Copyright (C) 2013 S. Karger AG, Basel