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    P-wave dispersion in patients with premature ejaculation
    (Pagepress Publ, 2025) Akkoc, Ali; Oncel, Can Ramazan; Cemal, Koseoglu
    Background: Premature ejaculation (PE) is one of the common male sexual disorders and is associated with autonomic nervous system imbalance. P-wave dispersion (PWD), a marker of atrial electrical heterogeneity and a predictor of atrial arrhythmias, has not been previously investigated in the PE population. This study aimed to investigate PWD in patients with PE and to evaluate whether the subtypes of PE, namely acquired (APE) and lifelong (LLPE), differ in terms of atrial conduction parameters. Methods: Seventy-eight male patients were included in the study. The distribution of patients was 40 healthy controls, 21 patients with APE, and 17 patients with LLPE. All patients underwent 12-lead electrocardiography to evaluate PWD. Echocardiographic, hormonal, and biochemical parameters were recorded to exclude confounding factors. PWD was defined as the difference between the maximum (Pmax) and minimum P wave durations (Pmin). Results: PWD was significantly increased in both PE groups compared to the control group (APE: 44.4 +/- 4.1 ms; LLPE: 48.1 +/- 2.1 ms; control: 38.2 +/- 3.4 ms; p < 0.001). Pmin was significantly lower in the PE groups, while Pmax remained comparable among all groups. There was no significant difference in PWD between the PE groups (p = 0.38). All patients had normal echocardiographic and hormonal parameters, and there were no significant differences in age, body mass index, blood pressure, or heart rate between the groups. Conclusions: PWD was significantly higher in patients with PE. This indicates that the patients of PE are at a higher risk of developing cardiovascular diseases like atrial fibrillation.
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    The effect untreated right subclinical varicocele on the outcomes of contralateral left clinical varicocelectomy in infertile patients
    (Pagepress Publ, 2023) Yilmaz, Sevgin; Topcuoglu, Murat; Cakan, Murat; Akkoc, Ali; Ucar, Murat
    Purpose: The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA). Materials and methods: Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up. Results: The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations. Conclusions: Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.