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Objectives To evaluate the efficacy of a eutectic mixture of local anesthetics (EMLA) cream compared with dimethyl sulfoxide (DMSO) with lidocaine during extracorporeal shock wave lithotripsy (ESWL) in a prospective randomized study. Methods Of 167 patients, 85 received 10 g of EMLA cream (EMLA group) and 82 received 10 g of 40% DMSO (DMSO group) with an amount of lidocaine equal to that in the lidocaine gel, applied to the skin of the flank at the area of entry of the shock wave marked by the urologist. A second-generation lithotriptor Siemens Lithostar was used. The degree of pain was rated by the patients using a 10-point visual analog scale. Results In 80 patients in the EMLA group (94%), the entire procedure was performed with no, minor, or tolerable pain after the application of EMLA cream (pain score 5.2 ± 1.3). In 5 EMLA patients (6%), EWSL was interrupted because of intolerable pain. Of the 82 DMSO patients, 80 (98%) underwent the entire procedure with no, minor, or tolerable pain after the application of DMSO with lidocaine (pain score 3.7 ± 1.1). In 2 DMSO patients (2%), EWSL was interrupted because of intolerable pain. The pain scores were significantly lower for the DMSO group than for the EMLA group ( P = 0.011). Conclusions Our findings have indicated that the pain scores were significantly lower for the DMSO group than for the EMLA group. In addition to the local anesthetic effect of DMSO, diuretic, anti-inflammatory, muscle relaxant, and hydroxyl radical scavenger effects can be important for patients undergoing ESWL. These effects should be evaluated with new studies of patients undergoing ESWL.

Ureteral stents have been widely used for more than two decades with different indications. Due to the widespread usage of ureteral stents, the number of possible complications of ureteral stents has increased, including stent migration, encrustation, stone formation, and fragmentation. Among these complications, ureteral stent fragmentation is rare. Herein, we present a case of spontaneous ureteral stent fragmentation and review the relevant literature.

Objectives: We undertook the present study to investigate the possible alteration of oxidant/antioxidant status in the circulation of patients with prostate cancer and benign prostatic hyperplasia. Design and methods: Thiobarbituric acid reactive substances (TBARS), the enzyme activities of superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT) and copper (Cu) and zinc (Zn) levels were estimated in the erythrocytes of 25 non-metastatic prostate cancer patients, 36 benign prostatic hyperplasia (BPH) patients and 24 age- and sex-matched healthy subjects (controls). Results: TBARS concentrations were significantly increased, while erythrocyte GPX and SOD activities were significantly decreased in the prostate cancer group versus controls (P < 0.001) and BPH group (P < 0.05). Zn levels were lowered in prostate cancer patients versus controls (P < 0.01) with no significant changes between BPH and cancer groups. Similarly, lipid peroxidation was increased (P < 0.05) with decreased SOD activity and Zn level (P < 0.05) in BPH versus controls. Conclusion: These results reveal an alteration in the lipid peroxidation index, with concomitant changes in the antioxidant defense system in prostate cancer patients compared to BPH patients. We hypothesize that an altered prooxidant–antioxidant balance may lead to an increase in oxidative damage and consequently may play an important role in prostate carcinogenesis. Keywords: Prostate cancer; Oxidative stress; Lipid peroxidation; Antioxidant enzymes