OBJECTIVE: The aim of the present study was to assess the prevalence of erectile dysfunction (ED), lower urinary tract symptoms (LUTS) and anxiety developing due to transrectal ultrasound (TRUS) guided prostate biopsy and to evaluate an alternative treatment option to reduce these complications.
MATRERIAL and METHODS: 112 patients who underwent TRUS guided biopsy were included, 34 patients with a diagnosis of prostate cancer diagnosis were excluded. For the 78 patients, International Index of Erectile Function (IIEF), International Prostate Symptom Score (IPSS) and Beck Anxiety Inventory (BAI) scores were recorded at the baseline, and 1st, and 3rd months after the procedure. Twenty-five of those 78 men used 5 mg tadalafil daily for at least 1 month before the biopsy. The data of those 25 patients was compared to the remaining 53 patients.
RESULTS: The IIEF score for the group using tadalafil was observed to be significantly lower compared to the group not using tadalafil (21.65 vs. 24.79, p=0.001), while there was no significant difference between IPSS and BAI scores (p=0,1; p=0,09) at the baseline. In both group there was an improvement for ED, LUTS and anxiety scores at the 1st and 3rd months after the procedure. However, the improvement was significantly higher in patients using 5 mg daily tadalafil.
CONCLUSION: The present study revealed that ED, LUTS and anxiety improved significantly higher in patients using 5 mg daily tadalafil than in men without any treatment. Tadalafil treatment may reduce TRUS guided biopsy complications including ED, LUTS and anxiety.

OBJECTIVE: The aim of our study is to obtain references for penile length and testicular volume according to age in prepubertal children and to contribute to the standardization of this measurement in terms of penis and testis measurement in prepubertal children. In addition, we aimed to investigate whether there is a relationship between penile length and testicular volume in children, height, weight and body mass index (BMI).
MATRERIAL and METHODS: We measured the penile length with a ruler and the testicular volume with ultrasound in 1201 children who applied to our clinic, and compared these values with the child’s height, weight and body mass index. The research is a cross-sectional study. Percentage, mean and standard deviation were used as descriptive statistics. Student t-test was used for univariate analyses. In the study, analyses were made using the SPSS 20.0 package program.
RESULTS: The mean age of the participants in the study was 4.35±2.65 years, average height measurements were 104.23±22.61 cm, average weight measurements were 18.31±8.63 kg, and average BMI (body mass index) measurements were 16.06±2.64 kg/m². As age, height, weight and BMI values increase, mean testicular volume and penile length increase (p<0.001). The mean penile length of the participants was 5.43±1.11 cm, and the mean testicular volume was 3.15±1.18 ml. Mean testicular volume increases as penis length increases (p<0.001). The mean right testicular volume of the participants was 3.15±1.19 ml and the left testicular volume was 3.15±1.19 ml, and the measurements were similar to each other (p=0.361)
CONCLUSION: As a result, there is a strong correlation between the penis length and testicular volume in the 0–10 age group, and the age-weight BMI of the children. However, we also found a strong relationship between penile length and testicular volume in boys.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has continued to affect human health and lifestyles worldwide. In this study, we aimed to investigate the effect of COVID-19 pandemic on male sexual dysfunction and potential etiological factors.
MATRERIAL and METHODS: In this cross-sectional study, the sexuality in male participants aged 18–65 years during the pandemic was evaluated through a data collection form to investigate frequency, desire, possible contributing factors and types of intercourse. The patients who admitted to the urology clinic for sexual dysfunction were included in the case group. The control group consisted of patients who applied to two different primary care clinics for any reason. Statistical analyses were performed with SPSS version 23.0 program.
RESULTS: Among the 172 participants enrolled, 57 (33.14%) and 115 (66.86%) were categorized in the patient and control groups, respectively. The mean participant age was 38.72±11.15 years in the patient group and 35.31±10.22 years in the control group. We found intergroup differences in terms of the frequency of sexual intercourse (p=0.002), desire, erection and premature ejaculation problems, and presence of sexual problems in the partner (p<0.001 for each). In the patient group, decreased or unchanged occupational physical activity and daily movement (p=0.014 and p=0.028), weight gain or loss (p=0.05), rate of starting a new medication (p=0.01), loss of job/financial loss anxiety (p=0.017) was observed at a higher rate. A decrease in vaginal sex, oral sex, kissing/touching activities and an increase in watching pornographic or erotic content were observed in the patient group (p<0.001 for each). When the concerns that contributed to the reduced frequency of sexual intercourse were examined, it was observed that the rates of ‘Anxiety of contracting a disease’ and ‘Anxiety related to occurrence of health disorders in the partner or partner’s family’ were high (p=0.001, p=0.008, respectively). It was also observed that the decrease in sexual desire had an impact on the decrease in the frequency of sexual intercourse in the patient group (p=0,013).
CONCLUSION: Factors such as anxieties, inactivity and weight gain, and starting a new medication experienced during the pandemic adversely affected male sexuality.

OBJECTIVE: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms (LUTS) in aging men. Prostate volume (PV) is important in showing the progression of BPH. Erectile dysfunction (ED) is common sexual problem in BPH patients. We aimed to investigate how increased prostate volume affects the erectile function and quality of life (QoL) of the BPH patients.
MATRERIAL and METHODS: Between May and August 2022, 154 patients diagnosed with BPH in our clinic were included in the study. Those with a PV of 30–50 cc were included in Group 1 (n=74), those with 50–80 cc in Group 2 (n=58), and those with >80 cc in Group 3 (n=22). The scores of the patients in the IPSS (International Prostate Symptom Score) and IIEF-5 (International Erectile Function Form-5) questionnaires were recorded. The QoL of the patients was evaluated with the scores given the 8th question in the IPSS questionnaire [“How would you feel if your complaints continued in the rest of your life?” 0 (Delighted) - 6 (Terrible)].
RESULTS: ED was detected in 76.6% (n=118) of all patients. It was observed that the patients in Group 1 were younger than Group 3 (61.6±6.77 vs. 66.1±6.37, p=0.04, respectively). Compared to the other groups, it was observed that the median IPSS [15 (11.5) vs. Group 2, 18 (13), p=0.006; Group 3, 21 (12), p=0.012] and QoL scores [3 (2.25) vs. Group 2, 4 (2), p=0.012; Group 3, 4 (2), p=0.03] were lower, and the median IIEF-5 score [21 (6.25) vs. Group 2, 11.5 (5.75); Group 3, 5 (1), p<0.001] was higher in Group 1. It was observed that there was a positive correlation between PV and IPSS and QoL, and a negative correlation with IIEF-5 score (p<0.05). PV was determined to be an independent risk factor for ED, regardless of age (β=-0.8, t=-17.82, p<0.001).
CONCLUSION: Increasing prostatic volume adversely affects the quality of life of BPH patients and increases the risk of developing ED.

OBJECTIVE: This research was conducted as a descriptive study to determine the effect of sexual attitude and sexual shyness on attitudes and beliefs about sexual care in midwifery students.
MATRERIAL and METHODS: This descriptive study was conducted with 274 students who were studying in the midwifery department of Bozok University Faculty of Health Sciences between February 2022 and April 2022 and accepted to participate in the study. Introductory Information Form, Sexual Embarrassment Scale (SES), Hendrick Sexual Attitude Scale (HSAS), and Sexual Attitudes and Beliefs Scale (SABS) were used to collect data. Ethics committee approval, institutional permission and informed consent of the students included in the study were obtained for the study.
RESULTS: In the study, the mean SES score of the nursing students was 17.88±6.47, the mean HSAS score was 82.87±10.19, and the mean SABS was 37.50±7.57. A positive and significant relationship was found between sexual embarrassment and sexual attitudes and beliefs regarding sexual attitude and sexual care (p<0.01). A statistically significant effect of sexual attitudes and sexual embarrassment was found on the scale of sexual beliefs and attitudes in midwifery students (p=0.005; p<0.001). 7.1% of the students’ SABS scores are explained by HSAS and SES.
CONCLUSION: According to the findings obtained from this study, it was found that the students’ SES scores were high and their SABS scores were moderate, and there was a positive relationship between sexual embarrassment and sexual attitudes and beliefs about sexual attitude and sexual care. In order to create positive attitudes and beliefs towards sexual health care, which is one of the basic elements of holistic care, it may be recommended to create a comprehensive sexual education curriculum for students.

Prostate Specific Antigen (PSA) is a glycoprotein secreted from prostate acini. Although PSA is generally considered a test used for prostate cancer (PCa), PSA is an organ-specific marker, not a disease-specific marker. It should not be forgotten that serum PSA level is important in the diagnosis of prostate cancer as well as in other benign conditions of the prostate. In this review article, the use of serum PSA in the diagnosis of BPH, in the prediction of Benign Prostatic Hyperplasia (BPH) progression, in the selection of BPH medical treatment, and in the follow-up of patients under medical treatment is described.

Assisted Reproductive Technologies (ART) are widely used all over the world for couples who want to have children. Ethical debates about IVF in most countries no longer examine ART procedurally. Although IVF is used so frequently and widely, it includes some ethical concerns. In addition, with ART, parents can choose the gender and physical characteristics of their children; Homosexual individuals or single women can have children. Many different treatments such as mitochondrial replacement therapies, gamete and embryo donation, and surrogacy are possible with ART. Can we do everything that is medically and technically possible? Before making a judgment about an application that focuses on people, especially about new technologies, two basic questions must be asked: “What would happen if everyone made this application?” and “what does this practice lead to?”. In this way, we can easily see the consequences of a ethical practice in a particular field when spread to the public. Defending reproductive autonomy and the desire to have children under all conditions makes the child an object of the parents. For this reason, while developing ART, not only the reproductive freedom of individuals or the right for one to make their own decisions but also the rights of the child should be considered. In addition, biotechnologies that aim to improve and change humans attack human dignity and creation. This article aimed to discuss ART from an ethical perspective, both from a technical and social aspect.

All of the microorganisms (bacteria, viruses, fungi) found in humans are called “microbiota”, and the genomes of all these microorganisms are called “microbiomes”. To date, more than 10,000 types of bacteria and fungi, and more than 3000 types of viruses have been identified in humans. Nine percent of human microbiota is present in the urogenital system and it is known that semen in both fertile and infertile men is not sterile due to microbiota. Prevotella, Finegoldia, Pseudomonas, Peptinophilus, Streptococcus, Anaerococcus, Lactobacillus and Corynebacterium bacterial genera are considered to be the most frequently detected major microbiota components of the sperm microbiome. Although the relationship between semen microbiota and semen parameters is still not clear, it is known that bacteriospermia has a negative effect on sperm count, motility and sperm DNA fragmentation. However, especially in studies using NGS (nextgeneration DNA sequencing) technique, semen microbiota of both fertile and infertile patients were found to be similar. Although intratesticular tissues are sterile according to standard culture methods, Firmicutes and Clostridia species are found to be low, Peptoniphilus species completely absent and Actinobacteria species are found to be high in intratesticular tissue of patients who cannot find sperm by mTESE procedure. In addition, embryos obtained by assisted reproduction techniques show better growth in the presence of Enterobacteriaceae in the semen microbiota, but lower quality in the presence of Alphaproteobacteria and Gammaproteobacteria. Although it has been shown that the use of probiotics provides a 3.5-fold decrease in the amount of ROS in semen and a six-fold increase in sperm motility, the relationship between probiotic use and semen parameters is still unclear. In conclusion, the relationship between semen microbiota and male infertility is still not sufficient considering the limited evidence available. With the developing technology and knowledge, the role of non-pathogenic microbiatal organisms that may have a protective role in the treatment of idiopathic male infertility should be evaluated by future research.

Nowadays penile prothesis and artificial urinary sphincter surgeries are widely performed in men with refractory erectile dysfunction and urinary incontinence. Both surgeries are becoming more popular and the effectiveness of these surgical modalities are increasing with time. In addition, technological developments associated to prostheses gives surgeons several opportunities, thus performing more easier surgeries with low complication rates. Nowadays, even uncommonly seen; vascular injury, palpable reservoir or infection can be encountered after prostheses surgeries. Furthermore, especially in cases with previous pelvic surgery history, the use of new developed prostheses is recommended to prevent rarely seen complications; including vascular/ bowel injury, postoperative palpable reservoir and infection. In this review, we described the placement of reservoirs in difficult prosthesis cases and evaluated the results of such surgeries.

Human papilloma virus (HPV) is the most common sexually transmitted infection (STI) agent in the world. HPV can cause genital warts called condyloma acuminatum as well as precancerous and cancerous lesions. The 100% association of HPV, an oncogenic virus, with cervical cancer, and the fact that previous prevalence studies were generally conducted on women, left HPV infection in men in the background. Because of the increase in prevalence studies including men and the association of patients with penile intraepithelial neoplasia (PIN) at a rate of 70–100% and those with penile cancer at a rate of 50%; in addition since it is seen in the penile urethral meatus and rarely in the urethra and associated with prostate cancer in several studies; leading to male infertility, it is a virus that should be known and given importance in terms of male sexual health. This review aimed to evaluate the current diagnosis, treatment and prevention methods of HPV infections in men.