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Objective To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. Methods Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6–12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. Results Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoid residual urine, International Prostate Symptom Score, quality of life score and prostate-specific antigen (P

We determined the efficacy and safety of flexible ureterorenoscopy for single intrarenal calculi and further stratified efficacy by stone burden. CROES collected prospective data on consecutive patients with urinary stones treated with ureterorenoscopy at 114 centers worldwide for 1 year. Only patients who underwent flexible ureterorenoscopy for a solitary renal stone were included in study. Preoperative and intraoperative characteristics, and postoperative outcomes were evaluated. Relationships between stone size and the stone-free rate, operative time, complications, hospital stay and need for re-treatment were determined. A total of 1,210 patients with a solitary kidney stone less than 10 (52.2%), 10 to 20 (43.2%) and greater than 20 mm (4.6%) were treated with flexible ureterorenoscopy. The stone-free rate negatively correlated with stone size when adjusted for body mass index. Operative time positively correlated with stone size when adjusted for body mass index. The single session stone-free rate was 90% and 80% for stones less than 10 and less than 15 mm, respectively. Patients with stones greater than 20 mm achieved a 30% stone-free rate, more often needed re-treatment and were more often rehospitalized. There was no difference in the overall complication rate by stone size. However, patients with a stone greater than 20 mm showed a higher probability of fever after flexible ureterorenoscopy than those with a smaller stone. Our data indicate that flexible ureterorenoscopy for a single intrarenal stone is a safe procedure. Best results after single session flexible ureterorenoscopy were obtained for stones less than 15 mm

To investigate whether there is any association between uroflowmetry parameters and blood levels of thyroid hormones in asymptomatic women. Materials and methods: Included in the study were 110 consecutive female patients with no urinary complaints who had thyroid function tests performed in an endocrinology clinic. Uroflowmetric measurements were performed for each patient in a sitting position. The patients were divided into 3 groups, hypo-, hyper-, and euthyroidism, and were investigated for statistical difference among them regarding maximum flow rate (Qmax), average flow rate (Qave), voided volume (VV), and voiding time (VT). Results: The mean Qmax and Qave values of hypo-, eu-, and hyperthyroid groups were 25.3 ± 9.1 and 14.9 ± 5.8, 28.6 ± 9.6 and 16.2 ± 6.4, and 21.5 ± 8.7, and 13.2 ± 5.6, respectively. In the evaluation of all groups, a statistically significant difference was found regarding Qmax (P = 0.004) and Qave (P = 0.024). When the groups were evaluated between each other, Qmax (p = 0.003) and Qave (P = 0.027) were significantly different between hyper- and euthyroid groups, with no statistically significant differences in other groups regarding the uroflowmetry parameters (P > 0.05). Conclusion: It has been found that Qmax and Qave were significantly lower in the hyperthyroid group as compared with the euthyroid group. According to these findings, it may be thought that hyperthyroidism negatively affects uroflowmetry parameters. To reach a definitive judgment, more investigations supported by urodynamic studies are necessary.

Normal bladder function depends on the complex interaction of sensory and motor pathways. Bladder dysfunction can develop as a result of several neurological conditions. It can happen in a number of ways, including diabetic cystopathy, detrusor overactivity, bladder outlet obstruction, and urge and stress urinary incontinence. Diabetic neuropathy is the most common cause of peripheral neuropathy-associated bladder dysfunction. Guillain-Barré syndrome (GBS), human immunodeficiency virus (HIV)-associated neuropathy, chronic inflammatory demyelinating polyneuropathy (CIDP), and amyloid neuropathy are other major causes. The diagnosis of bladder dysfunction should be established by the history of neurological symptoms, neurological examination, and urological evaluation. Functional evaluation of the lower urinary tract includes cystometry, sphincter electromyography, uroflowmetry, and urethral pressure profilometry. Management of urinary symptoms in patients with bladder dysfunction is usually supportive. In some cases, alpha-blocker and/or anti-muscarinic agents are needed to help improve urinary dysfunction. Intermittent self-catheterization is needed occasionally for patients with slow and/or poor recovery.

Introduction Clitoral blood flow measurements using clitoral color Doppler ultrasound have been performed with increasing frequency either in order to assessment of female sexual function/dysfunction. The trials to evaluate the sexual function in healthy subjects, especially in the subgroup of female elite athletes, are limited. Aim The aim of the study was to evaluate whether elite female athletes and sedentary healthy females differ in their clitoral blood flow and sexual function as an expression of their physical fitness status. Methods Twenty-five female elite athletes (Group I) and healthy female subjects (Group II) were enrolled as volunteers in the study. All women were instructed to complete the Female Sexual Function Index (FSFI) questionnaire. Each subject underwent high definition color Doppler ultrasonography to measure the clitoral blood flow parameters. Main Outcome Measures The effect of physical activity on clitoral blood flow and sexual life in women. Results Mean age, mean age of menarche, mean marriage age, and body mass index were similar for both groups. In Group I, the mean peak systolic velocity and end-diastolic velocity were higher than those of Group II, whereas the mean RI was similar for both groups. There were statistically significant differences for total FSFI score and all domain scores, except desire domain, between both groups. Conclusion In elite female athletes as compared with sedentary healthy females, better clitoral blood flow and better sexual function were demonstrated. Therefore it seems superior physical fitness correlates with better sexual function.

This study investigated the possible relationship between Helicobacter pylori infection and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The rate of seropositivity for antibodies against H. pylori was determined in a cohort of subjects with CP/CPPS and prostatitis-free control subjects.Sixty-four consecutive patients with CP/CPPS and 55 randomly selected asymptomatic men were recruited to the study. Blood samples from enrolled patients and control subjects were analysed using an enzyme-linked Immulite analyser immunoglobulin G serological test for H. pylori diagnosis. Prostate volume, prostate-specific antigen level, maximum urinary flow rate, and International Prostate Symptom Score (IPSS) and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score of the subjects were also determined. The results were analysed with chi-squared and Student's t test and statistical analysis was carried out using SPSS software.There were no significant differences in age and social status between the CP/CPPS and control groups (p0.05). Total NIH-CPSI score was significantly higher in the CP/CPPS group. Seropositivity for antibody against H. pylori was higher in the CP/CPPS than the control group (p0.05).This pilot study supports the hypothesis that H. pylori may play a role in CP/CPPS. The infection may be related to the immune response and increased cytokines in seminal plasma and/or expressed prostatic secretion. However, no study has investigated the relationship between CP/CPPS and H. pylori stool antigen positivity. This study showed that H. pylori seropositivity is high in CP/CPPS patients, but this needs to be confirmed by other studies.

Renal ischemia/reperfusion (I/R) injury is a major cause of acute renal failure. Silymarin is extracted from Silybum marianum and Cynara cardunculus seeds and fruits. The aim of this study is to investigate whether silymarin administration prevents the damage induced by I/R in rat kidneys. Thirty male Wistar rats were randomly divided into five experimental groups (n = 6, each) as follows; control group, sham-operated group, I/R group, silymarin group, and I/R + silymarin group. In the I/R and I/R + silymarin groups, both renal arteries were occluded using nontraumatic microvascular clamps for 45 min. Then, at the end of 24 h of reperfusion, the animals were killed. Kidney function tests, the serum and tissue antioxidant enzymes and oxidant products were determined. Animals that were subjected to I/R exhibited significant increase in serum urea, creatinine, and cystatin C levels compared with the rats treated with silymarin prior to the I/R process (P

Introduction: We tried to prove the effectiveness of trimetazidine (TMZ) on testicular torsion-detorsion injury. Materials and Methods: 15 male rats were equally divided into three groups: group 1 was the sham-operated control group; group 2 had 2 h of unilateral testicular ischemia followed by 3 days of reperfusion, and group 3 had 2 h of unilateral testicular ischemia followed by 3 days of oral TMZ treatment (5 mg/kg, bid) during reperfusion. In the removed testicles, tissue reduced glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), malondialdehyde (MDA) levels and pathological modified Johnson scores (MJS) were evaluated. Mann-Whitney U test was used for statistical evaluations. Results: In group 2, on the ipsilateral side, GSH were significantly lower and MDA were higher than in groups 1 and 3, though GSH and MDA were not statistically different between groups 1 and 3. On the other hand, GPx in the control testicles of group 3 was significantly lower compared to those in the counterparts of both groups 1 and 2. Among three groups, GR determined in both testicles were not statistically different. On the ipsilateral side, MJS in group 3 were lower than in the sham group, but significantly higher than in group 2. Conclusions: According to this study, TMZ has an antioxidant effect on testicular torsion-detorsion injury, though the protective effect of TMZ seems to decrease in control testicles. Consequently it has been considered that TMZ can be only used in torsion patients with a healthy contralateral testicle after further studies have been conducted.

Introduction Transrectal ultrasonography (TRUS) guided prostate needle biopsy has been performed to diagnose and stage prostate cancer for many years. There are many different bowel preparation protocols to diminish the infectious complications, but there is no standardized consensus among urologists. Therefore, we aimed to assess two different bowel preparation methods on the rate of infectious complications in patients who underwent TRUS–guided prostate biopsy. Material and methods A total of 387 cases of TRUS–guided prostate biopsy were included in this retrospective study. All patients received antibiotic prophylaxis with ciprofloxacin (500 mg) twice a day orally for 7 days starting on the day before the biopsy. The patients were divided into two groups according to the bowel preparation method used. Patients (Group 1, n = 164) only received self–administrated phosphate enema) on the morning of the prostate biopsy. Other patients (Group 2, n = 223) received sennasoid a–b laxatives the night before the prostate biopsy. Infectious complications were classified as sepsis, fever (greater than 38°C) without sepsis, and other clinical infections. Results Major complications developed in 14 cases (3.8%), including 3 cases (0.8%) of urinary retention, and 11 (3%) infectious complications, all of which were sepsis. There were 3 and 8 cases of urosepsis in Group 1 and Group 2, respectively. There were no statistically significant differences between both Groups regarding to the rates of urosepsis (p = 0.358). Conclusions Despite both methods of bowel preparation, sodium phosphate enema or sennasoid a–b calcium laxatives, before TRUS–guided prostate biopsy have similar effect on the rate of urosepsis, so both methods of bowel preparation can be safely used.

Introduction: Since comprehensive urometabolic analyses are currently more preferred for the patients with recurrent stones and with high risk of stone recurrence, we have tried to determine simple patient data increasing stone recurrence to limit sophisticated analyses to certain cases at least in particularly deprivation districts. Materials and methods: For the study 173 with first-time or recurrent urinary stone were taken. After stone treatment, various empirical metaphylaxis methods were counselled to the patients. The parameters evaluated were (a) age at onset of the disease, (b) gender, (c) urinary pH and (d) specific gravity, (e) serum calcium and (f) uric acid, (g) stone burden, (h) side, and (i) location, (j) treatment modality and (k) recurrence history. New stone formation or growing of the existing stone was considered as stone recurrence. In statistics, independent samples t, chi-square test, Kaplan–Meier, Log rank and Cox regression tests were used. Results: The mean age was 35 years. The male to female ratio was 88/85. Recurrence occurred in 49 (28%) cases at a mean of 30 months. Stone burden was significantly larger in patients with recurrent stone. In subjects treated with open surgery and with previous recurrence history, stone recurrence rate was significantly higher. In survival analyses, higher serum calcium level, larger stone burden, renal stones and previous recurrence influenced stone prognosis poorly. However in multivariate analysis, none of them was the most significant independent factor. Conclusions: According to our study, detailed urometabolic analyses may be somewhat reserved for the patients with ordinary factors increasing risk of stone recurrence including relatively high serum calcium level, large stone burden, upper urinary stone, history of recurrence and open surgery. As a result, it has been thought that the stone risk evaluation guiding detailed laboratory examination may be partially performed with first-line clinical data under limited conditions.

Circumcision has always been regarded as both an important social event and a milestone of a young man’s life in Turkish culture, especially in the Ottoman period. Herein we study an exceptional circumcision festivity which lasted 15 days in the early autumn of the year 1720, for the 4 princes of Sultan III Ahmed, some sons of two high-ranking Ottoman officials and thousands of male children of poor citizens of Istanbul as representing the beneficent of the Sultan. All the organizations of the Empire participated in this huge event, including many shows and a feast, and the preparations were initiated months before. Traditionally, this kind of important social event of Ottoman culture had been described in a literary manner, and Surname-i Vehbi was the special name for the book of this circumcision festivity with 137 colored paintings and a total of 175 pages. The original of this work, which is in the library of Topkapi Palace Museum in Istanbul, was written by Vehbi and illustrated by Levni. The importance of this antique book is that it is the last important example of the illustrated festivity books of Ottoman literature.

The aim of the study is to determine and to compare the oxidative and antioxidative status of penile corpus cavernosum and peripheral venous blood. A total of 28 adult healthy males were included in the study. Whole blood was simultaneously withdrawn from penile corpus cavernosum and the cubital vein and their plasma separated. Total antioxidant capacity (TAC), vitamin C, total protein, albumin, uric acid, bilirubin and total peroxide (TP) levels of both plasma samples were measured and compared. While TAC, total protein, albumin, bilirubin and uric acid levels were higher, vitamin C levels were lower in cavernosal blood than that of peripheral blood. On the other hand, TP level was found to be higher in penile blood samples than that of peripheral blood. We thought that the normal erectile process of the penile cavernosal body leads to increased production of oxidants as in the mechanism of ischaemia-reperfusion; however, the increase of TAC can prevent development of oxidative injury.

The aim of this study was to evaluate the effects of tension-free vaginal tape (TVT) on sexual function in women with stress urinary incontinence (SUI) by questionnaire. Thirty-two sexually active and married women who were planned for TVT to treat SUI constituted the patient group, and 25 women who were healthy, sexually active and married, were selected as the control group; the ages of both groups matched. Sexual functions (desire, arousal, orgasm, pain and satisfaction) were evaluated with the Index of Female Sexual Function (IFSF), and continence status during sexual intercourse was asked about both preoperatively and postoperatively in the 6th month. The mean domain scores of sexual functions such as desire, arousal, orgasm, pain and overall satisfaction preoperatively and postoperatively were 3.37+/-0.69, 3.82+/-0.62, 3.40+/-0.95, 3.41+/-0.98, 3.16+/-1.09 and 3.32+/-0.79, 3.71+/-0.53, 3.06+/-1.04, 2.75+/-1.29, 2.88+/-0.63, respectively, and postoperative scores insignificantly decreased. Also, these scores in the control group were 3.64+/-0.66, 3.96+/-0.73, 4.12+/-0.78, 3.96+/-1.14 and 3.68+/-0.92. In comparison with the control group, whereas all of the preoperative domain scores were found to be decreased but were statistically insignificant except orgasmic function, postoperative scores significantly worsened, except for desire and arousal. However, preoperatively nine patients explained that they had incontinence during sexual intercourse, and this problem persisted in two postoperatively ( p = 0.043). This study shows that both SUI and the TVT procedure negatively affect sexual function in women.

The objectives of this study were to compare the protective influence of exogenous nitric oxide on renal ischemia reperfusion (I/R) injury with that of the antioxidant vitamins C and E. Sprague-Dawley rats were divided into three groups ( n=12 per group). Normal saline solution was given in group 1, a vitamin C (200 mg/kg/d) plus vitamin E (100 mg/kg/d) combination in group 2 for 3 days before operating and Na-nitroprusside (5 mg/kg/d) in group 3 before reperfusion. The left kidneys were exposed to warm ischemia for 40 min followed by reperfusion for 90 min. The right kidneys were used as internal controls. After both kidneys were removed, histopathological examinations were performed, and oxidative and antioxidative parameters were measured. In the postischemic reperfused rat kidneys, the renal lipid peroxidation level was significantly lower, and the renal GSH level higher in the group given Na-nitroprusside compared with groups 1 and 2. Renal specific xanthine oxidase activity was also significantly lower in the group treated with Na-nitroprusside than in the groups given vitamins or saline. There was a significant, negative correlation between lipid peroxidation and reduced glutathione levels. Our results suggest that the exogenous nitric oxide (Na-nitroprusside) inhibits xanthine oxidase, and has more apparent preventive features for renal I/R injury than the antioxidant vitamins C+E.

To evaluate the predictive power of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, testicular biopsy histology and male age were evaluated with respect to the success of sperm retrieval in a microdissection testicular sperm extraction (microTESE) procedure, pregnancy and live birth rates.We examined the data of 131 infertile men with non-obstructive azoospermia, who have undergone microTESE operation. The men were classified into two groups based on serum follicle-stimulating hormone (FSH) levels ≤ 15 mIU/mL (group 1) and15 mIU/mL (group 2).Group 1 consisted of 59 patients (mean age 36.2 ± 6.2 years) and group 2 consisted of 72 (mean age 38.8 ± 7.4 years) patients. Sperm retrieval and pregnancy rates were 66.1% and 16.9% in normal FSH group, respectively. These parameters were higher than those of men with FSH15 (43% and 8.3%, respectively). Only 128 patients had histopathological diagnosis. Sperm was retrieved from 12/30 (40%) patients with maturation arrest, 9/29 (31.03%) patients with seminiferous tubules atrophy, 14/40 (35%) patients with sertoli cell only syndrome and 13/13 (100%) of patients with hypospermatogenesis. There was no statistically significant difference in pathological diagnosis between pregnancy and live birth rates.These results demonstrate that there is a significant difference with sperm retrieval, pregnancy rates and live birth rates comparing the FSH levels. Histopathological findings did not associate with successful microTESE, pregnancy rates and live birth rates.

Epispadias surgery has mainly two components: bladder and genitourethral reconstruction. Herein, a novel vulvoplasty method, an alternative for the latter component, carried out in a rare case of female epispadias was presented. In a 6-year-old girl admitted with complaint of total incontinence, epispadias without evident extrophy associated with adequate bladder capacity was determined. Firstly the vulvoplasty in which a circumferencial skin flap around the urethral meatus was rolled backwards, and secondly bladder neck reconstruction was performed. The vulvoplasty resulted in sufficient cosmetic outcome and continence up to half an hour, and after cervicoplasty total day and night continence at rest or on exertion were obtained. It was concluded that this vulvoplasty with sufficient cosmetic outcome could be considered as a first stage operation in female epispadias, because it could facilitate bladder neck reconstruction by increasing urethral resistance, and contribute to continence.

We describe a rare case of an extragonadal retroperitoneal pure yolk sac (endodermal sinus) tumor in the paraaortic region. Radiologic investigation, which included abdominal ultrasound ,computed tomography (CT), and magnetic resonance imaging (MRI) showed a large soft tissue mass occupying the inter paraaortic, renal, pancreatic and splenic region. Radionuclide bone scans demonstrated no bone metastases. The serum alpha fetoprotein (α-FP) level was high; however β-HCG was normal. Pathologic examination of the surgical specimen showed extragonadal yolk sac tumor. After postoperative chemotherapy, follow-up CT revealed decreased residual tumoral tissues and α-FP level returned to normal.

Urinary stone disease is a complex multifactorial disorder influenced by both intrinsic and environmental factors. It is generally known that age and sex are risk factors for urinary stone disease. Also men have higher mean urinary oxalate concentrations than women. In addition, in animal and human studies, testosterone has been shown to increase the formation of urinary stones. This suggests that sex hormones are considered to be involved in the pathogenesis of stone disease. Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine disorders of women in the reproductive age, affecting 5–10 % of women in this life span. It is characterized with chronic anovulation\oligo-ovulation, clinical or biochemical evidence of hyperandrogenism and polycystic ovaries on ultrasound examination. Hyperandrogenism, the main feature of PCOS, may trigger the urinary stone formation besides hirsutism, alopecia and acne. Therefore, we hypothesize that PCOS accompanied by hyperandrogenism may be a risk factor in the formation of urinary stone disease.

Objectives: Although no part of the human anatomy is invulnerable to hydatid disease, it has been reported to occur mostly in vital organs such as liver, lungs and brain. Hydatid disease of the urinary tract is uncommon accounting for only 2% of all such cases. Testes are extremely rare sites for echinococcosis. To our knowledge there are only 3 cases of testicular hydatid cyst described. In this animal model, we studied echinococcosis in rabbit testis. Methods: We directly infected the unilateral testis of 4 male rabbits with infective protoscolices via intratesticular injection and housed them under pathogen-free conditions for 10 weeks. All rabbits survived during the follow-up period and then, at the 10th week, all testes were removed for histopathologic investigation. Results: Despite of the direct infection of the rabbit testes with Echinococcus granulosus, there was no demonstrable hydatid cyst after a 10-week period except from some fibrosis in the injection tract of the testicular tissue in 1 case. Conclusion: The testes are extremely rare anatomic locations for echinococcosis infection. The mechanism of this resistance should be another reason apart from blood-testicular barrier. We think that low temperature in the scrotum or different properties of the testicular tissue may be the reasons of this defense mechanism. If this hypothesis clarifies with the further studies, new treatment options may be defined in the medical literature for the hydatid cyst.

WOS:000257413600019 PubMed: 18211980 Background: Renal ischaemia followed by reperfusion leads to acute renal failure in both native kidneys and renal allografts, which is a complex pathophysiologic process involving hypoxia and free radical (FR) damage. The oil of Nigella sativa (NSO) has been subjected to considerable pharmacological investigations that have revealed its antioxidant activity in different conditions. But there is no previously reported study about its effect on ischaemia/reperfusion (I/R) injury of kidneys. The aim of this study was to investigate the possible effects of NSO in I/R-induced renal injury in rats. Methods: Thirty healthy male Wistar albino rats were randomly assigned to one of the following groups: control, sham, I/R, NSO+I/R, I/R+NSO and NSO. I/R, NSO+I/R and I/R+NSO rats were subjected to bilateral renal ischaemia followed by reperfusion and then all the rats were killed and kidney function tests, serum and tissue oxidants and antioxidants were determined and histopathological examinations were performed. Results: Pre- and post-treatment with NSO produced reduction in serum levels of blood urea nitrogen (BUN) and creatinine caused by I/R and significantly improved serum enzymatic activities of superoxide dismutase (SOD) and glutathion peroxidase (GSH-Px) and also tissue enzymatic activities of catalase (CAT), SOD and GSH-Px. NSO treatment resulted in lower total oxidant status (TOS) and higher total antioxidant capacity (TAC) levels and also significant reduction in serum and tissue malondialdehyde (MDA), nitric oxide (NO) and protein carbonyl content (PCC) that were increased by renal I/R injury. The kidneys of untreated ischaemic rats had a higher histopathological score, while treatment with NSO nearly preserved the normal morphology of the kidney. Conclusions: In view of previous observations and our data, with the potent FR scavenger and antioxidant properties, NSO seems to be a highly promising agent for protecting tissues from oxidative damage and preventing organ damage due to renal I/R.

Trabajo presentado en la 11th International Conference on Durability of Building Materials and Components - Globality and Locality in Durability, celebrada en Estambul (Turquía) del 11 al 14 de mayo de 2008, The main objective of repair mortars, usually applied in patching is to restore the geometry and integrity of the material and the repassivate the reinforcing steel. Repair materials can be of two different natures: cement based or polymer based. In the case of cementitious repair materials, a polymer may be added that will dissolve or disperse during mixing. With any of these alternatives the steel should exhibit after repair a very low corrosion rate which is described as “be repassivated”. An additional property appreciated in repair mortars is their resistance to the penetration of the aggressive substances: carbonation and chloride ions. In present paper, four different repair materials are tested in an accelerated manner in order to rank them for application in a particular structure. The tests performed have been water absorption, mercury porosimetry, corrosion potential and corrosion rate after carbonation and after chloride penetration. The accelerated carbonation was made in a chamber at 100% CO2 and the accelerated chloride ingress by applying an electrical field. The results indicate very different performance regarding corrosion of the steel: While one of the mortars exhibited immediate corrosion depassivation when tested, there is another not depassivated after one year in the same conditions. These different behaviours claim for the need to test these materials. In the paper attempts are made to justify the very different performance from the results obtained on the microstructure., The financial support of The Scientific and Research Council of Turkey to the second author is gratefully appreciated. The authors would like also to thank SIKA for the fruitful collaboration in these kinds of studies.

Background: Ischemia-reperfusion (I/R) injury is one of the leading causes of acute renal failure. β-(1→3)-Glucans are glucose polymers with a variety of stimulatory effects on the immune system. We designed this study to determine the possible protective effect of the orally administered soluble β-glucan against I/R injury. Methods: 30 rats were randomly divided into 5 experimental groups (control, sham operated, β-glucan, I/R and I/R+β-glucan groups, n = 6 each). β-Glucan was administered orally to 6 rats of the β-glucan and I/R+β-glucan groups. The rats were subjected to bilateral renal ischemia followed by reperfusion in the I/R and I/R+β-glucan groups. All of the rats were then sacrificed and kidney function tests, serum and tissue oxidants and antioxidants were evaluated. Results: The serum urea and cystatin C levels were significantly higher in the I/R group compared to the I/R+β-glucan group (p < 0.01). The serum and tissue antioxidant markers (SOD, GSH-Px) were significantly lower in the I/R group than the I/R+β-glucan group (p < 0.01). The serum oxidant markers (NO and PC) were significantly higher in the I/R group than the I/R+β-glucan group (p < 0.01). Conclusion: Based on the present data, we conclude that increased antioxidants and decreased oxidants modulated by β-glucan attenuated the renal I/R injury.

Rupture of the urinary collecting system associated with peripelvic extravasation of the urine is an unusual condition and commonly associated with obstructing calculus. We report a patient, recently given chemotherapy due to lymphoma, with acute abdomen symptoms. He had a renal pelvis rupture with perirenal extravasation of urine, an uncommon condition due to a stone in the ureter. Diagnosis was suspected on serial ultrasonography, and confirmed by computed tomograhy. Diagnosis, follow-up, and therapeutic approach are discussed.

Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

Retroperitoneal fibrosis was first described in 1905 by Albarran, a French urologist, who performed ureterolysis for ureteral compression produced by the disease. However, this disease became an established clinical entity by Ormond's account in the English literature in 1948. Pericystitis plastica has been used the define an extremely rare type of Idiopathic retroperitoneal fibrosis (IRF) constricting the bladder. In this study, we discussed the recovery of 29-year-old woman with pericystitis plastica who was misdiagnosed as pelvic malignancy or a chronic/subacut pelvic inflammation at the first evaluation.

Objectives: Millions of male children are circumcised throughout the world. We investigated the opinions and thoughts about the past and future aspects of circumcision by interviewing 100 male family members of the health care staff. Methods: 100 male volunteers answered a questionnaire comprising questions about their personal observations, feelings, festivities and opinions about their own circumcisions as well as their views about the circumcision phenomenon as a parent, and the legality of circumcision. Results: 81% of the volunteers in our study had been circumcised by traditional circumcisers. The rest had been circumcised by doctors (10%), barbers (7%) and sheikhs (2%). In 90% the circumcision took place at home, 7% in hospitals and in 3% in village squares. While 66% of the subjects do not remember anything, the remaining 33% reported some bad sensations like fear, pain and shame about their circumcisions, and 1 (1%) subject reported happiness. As a parent, they answered the questions on their preferences on the place and performer of the circumcision. 44% preferred to have circumcision performed in the hospital by a physician, 26% at home by a physician, and 30% at home by a circumciser. Conclusion: There are significant changes in the attitudes of people in Turkey on circumcision as a traditional culture, though its perception has remained unchanged.

Although no part of the human anatomy is invulnerable to hydatid disease, it has been reported to occur mostly in vital organs such as liver, lungs and brain. Hydatid disease of the urinary tract is uncommon accounting for only 2% of all such cases. Testes are extremely rare sites for echinococcosis. To our knowledge there are only 3 cases of testicular hydatid cyst described. In this animal model, we studied echinococcosis in rabbit testis.We directly infected the unilateral testis of 4 male rabbits with infective protoscolices via intratesticular injection and housed them under pathogen-free conditions for 10 weeks. All rabbits survived during the follow-up period and then, at the 10th week, all testes were removed for histopathologic investigation.Despite of the direct infection of the rabbit testes with Echinococcus granulosus, there was no demonstrable hydatid cyst after a 10-week period except from some fibrosis in the injection tract of the testicular tissue in 1 case.The testes are extremely rare anatomic locations for echinococcosis infection. The mechanism of this resistance should be another reason apart from blood-testicular barrier. We think that low temperature in the scrotum or different properties of the testicular tissue may be the reasons of this defense mechanism. If this hypothesis clarifies with the further studies, new treatment options may be defined in the medical literature for the hydatid cyst.

To evaluate central nervous system functioning involvement in nocturnal enuresis, P300 and N200 event-related brain potentials and brainstem auditory-evoked potentials (BAER) were assessed in a group of 35 enuretic boys aged 7-9 years. The measurements of enuretic group were compared to those of age and sex matched non-enuretics. P300 latency in the enuretic group was significantly longer than in non-enurefic group (420 ms at parietal scalp (Pz), 414 ms at central scalp (Cz) versus 386 ins at Pz, 376 ms at Cz; P < 0.01 and P < 0.01, respectively). Both enuretic and non-enuretic subjects were divided into three subgroups his age. There was no significant difference in terms of both P300 amplitude and N200 latency and N200 amplitude between non-enuretic age subgroups. But, P300 latency over central scalp in 8 years old non-enuretic subgroup was significantly longer than in 9 years old non-enuretic subgroup (P < 0.01). No significant difference was found in latency and amplitude of P300 and N200 latency between enuretic subgroups. However, N200 amplitude at Cz in 8 years old enuretic subgroup was significantly lower than both in 7 years old enuretic subgroup and in 9 years old enuretic subgroup (P < 0.01 and P < 0.01, respectively). There were significant topographical differences in latency and amplitude of P300 and in N200 latency in enuretic age subgroups, only. There was no significant difference in interpeak latencies I-III, I-V and III-V and wave latencies I, III and V of BAERs between enuretic group and non-enuretic subgroup. Longer interpeak and wave latencies of BAERs were found both in 8 years old enuretic subgroup and 8 years old non-enuretic subgroup. Conclusion: Longer P300 latency in primer enuretics compare to non-enuretics is an evidence of a maturational delay of central nervous system functioning. (C) 2002 Elsevier Science B.V. All rights reserved.

Objective: To investigate the effectiveness of a new tension-adjustment technique for postoperative voiding difficulties encountered after sling operations. Method: To test our new method, urethral obstruction was developed in 5 female dogs by modifying the sling operation by exerting more tension on a specially prepared polypropylene strip in which a gap had been developed. After filling the bladder with isotonic solution, detrusor contractions were induced by pelvic nerve stimulations, and urodynamic studies were performed to document the urethral obstruction. In each case Foley catheters were inserted into the bladder and left in place until the time of tension adjustment. Tension adjustment was performed in the 1st, 2nd, 3rd, 4th and 5th weeks postoperatively for dogs 1, 2, 3, 4, and 5, respectively. Results: On the day of tension adjustment, after filling the bladder with isotonic solution and removing the Foley catheter, none of the dogs, except dog 3, was able to produce a free flow of urine either spontaneously or provoked by detrusor contractions. The release of the prolene sutures was readily achieved in all cases except dog 5. In this case, sling takedown was achieved after surgical exploration in which the sling location was confirmed by following the prolene sutures and Hegar’s dilator. After identifying the sling, the gap was opened by cutting the prolene sutures, instead of a sling incision. Release of the prolene sutures resulted in a distinct drop in the urethra with decreased resistance of Hegar’s dilator. The improvement in voiding was confirmed by postoperative urodynamic studies and was immediate in all cases. Conclusion: Our new technique for postoperative voiding difficulties encountered after sling operation is simple, effective and avoids re-operation in the early postoperative period.

Introduction: To investigate whether ordinary tests used in urolithiasis can increase the diagnostic value of unenhanced helical computed tomography (HCT). Materials and Methods: Of all patients admitted with acute flank pain, 137 without radiocontrast allergy, pregnancy and renal insufficiency were included in the study. After urinalysis (Ur) and ultrasonography (USG), HCT without a contrast agent was taken by 5-mm collimation, thereafter excretory urography (EU) was obtained. Confirmation of a stone was done by various tests and/or treatment methods. Statistically, the predictive values of HCT, USG, EU and Ur and their combinations were evaluated using the area under the receiver operating characteristic curve (AROC). Results: The patients’ mean age was 38 (range 4–72) years. Sensitivity values of HCT, USG, EU and Ur were 97, 69, 71 and 81%, respectively. Their specificity values were 96, 87, 91 and 65%, respectively. The widest AROC was found for HCT (97%). The best test combination was [HCT or USG] according to the AROC value (93%), but none of the AROC values of the test combinations was higher than that of HCT. However, 95% confidence intervals of the AROC values of these tests and their combinations overlapped. Conclusions: Because the HCT combinations with other tests improved the diagnostic value of HCT, they should be preferred in some individuals suspected of having urolithiasis. However, the most feasible single test meeting the all usage purposes was HCT in terms of the AROC value, and the combination was [HCT or USG] in which either HCT or USG was positive.

A 39-year-old woman with three children presented with primary severe urinary incontinence. Epispadias without exstrophy was determined in physical examination. The single-stage procedure including vulvoplasty and modified Young-Dees-Leadbetter bladder neck repair was performed to obtain sufficient cosmetic outcome and continence. Excellent functional and cosmetic results were obtained.

Patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTSs) have a considerably higher prevalence of cardiovascular disease (CVD) than the general population in old age. Many hypotheses have been created to explain traditional clinical risk factors of CVD, including age, male gender, cigarette smoking, inheritance, high blood pressure (BP), obesity, elevated fasting plasma glucose, diabetes mellitus, dyslipidemia, decreased physical activity and metabolic syndrome; or nontraditional risk factors such as oxidative stress, inflammation, vascular calcification, malnutrition, homocysteine and genetic variation. Although these risk factors are important in CVD pathophysiology and clinical presentation, there is still no single theory sufficient to provide an adequate explanation for all the properties of CVD. We speculate that by causing nocturia-induced sleep disturbances, BP variability, increased sympathetic activity, non-dipping BP variations; BPH may be an insidious risk factor for CVD. Benign prostate hyperplasia may be related to increased BP, coronary ischemic hearth disease or other cardiovascular pathologic conditions. This attention on BPH may produce a new approach to the diagnosis and treatment of CVD. Although the underlying mechanisms are still exactly unclear, further prospective randomized controlled studies are needed to identify if patients with BPH/LUTS is higher risk for CVD.

The objective of this study is to identify any apoptotic effect of shock wave lithotripsy (SWL) for distal ureteral stones on ovarian tissue. Twenty-one female New Zealand White rabbits were divided into three groups of seven rabbits each: I (control), and II, III (treated and killed 14 and 28 days after SWL, respectively). The left distal ureteral segment of the anesthetized (ketamine HCl, 20 mg/kg) animals in groups II and III was exposed to 1,500 shock waves at 17 kV. Localization of the distal ureteral segments was achieved following contrast medium (Iohexol 300 mg of I/ml) injection. The animals were killed on day 14 or 28 after SWL, and the ovaries were removed. The follicle number with apoptotic changes in ovarian tissue was compared with control group. Apoptotic changes were determined by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL) method. No increased apoptosis was detected in all groups. The mean number of TUNEL-positive follicle in groups I, II and III was 9.3 +/- A 2.9, 8.1 +/- A 2.6 and 8.7 +/- A 2.9, respectively. There were no statistically significant differences among all groups regarding the number of TUNEL-positive follicle (P = 0.647). Also, no histomorphological change other than apoptosis was detected in the study groups. In conclusion, SWL treatment for distal ureteral stones does not induce apoptotic changes on ovarian tissue.