Ali Ayyildiz

Effect of intraurethral Mitomycin‐C on healing and fibrosis in rats with experimentally induced urethral stricture

Abstract  Background:  In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin‐C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model.

Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: Results of 1-year follow up

Aim:  In our randomized prospective study, we aimed to evaluate the efficiency of plasmakinetic resection of prostate (PKRP) by comparing the preoperative and postoperative results of the transurethral resection of prostate (TURP) and PKRP techniques which we administered in patients with benign prostate hyperplasia (BPH) in our clinic.

Hemostatic role of a folkloric medicinal plant extract in a rat partial nephrectomy model: controlled experimental trial.

PURPOSE Ankaferd BloodStopper is a mixture of 5 plants used in traditional Turkish medicine as hemostatic agent for external traumatic, postoperative and dental bleeding. We investigated the hemostatic efficacy of Ankaferd BloodStopper for partial nephrectomy. MATERIALS AND METHODS A total of 24 Wistar rats were divided into 4 groups of 6 each. Group 1 underwent partial nephrectomy with hilar control as the conventional technique. Group 2 underwent the conventional technique with hemostatic agent application. Group 3 underwent hemostatic agent application to the renal parenchyma. In Group 4 partial nephrectomy was performed and the hemostatic agent was used without hilar control. Warm ischemia and partial nephrectomy times, and the number of hemostatic agent applications were recorded. Histopathological evaluations were completed. The Fisher, Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. RESULTS Mean kidney size was 2 x 2.5 x 0.05 cm. Mean partial nephrectomy time was 3.7, 2.7, 1.8 and 3.2 minutes in groups 1 to 4, respectively, which was significantly different between groups 1 and 3 (p = 0.007). Warm ischemia time in group 3 was less than in group 1 (p = 0.011). The number of hemostatic agent applications was higher in groups 3 and 4 compared to those in group 2 (p = 0.003). Glomerular necrosis was detected at a higher rate in group 1 compared to that in groups 3 and 4 (p = 0.015). Calcification formed significantly more in group 1 than in groups 2 to 4 (p <0.05). Erythrocyte aggregation was greater in groups 2 to 4 than in group 1 (p = 0.015). Giant cell reaction, fibrosis, inflammation and microvascular proliferation were not statistically different among the groups (p >0.05). CONCLUSIONS Ankaferd BloodStopper decreases partial nephrectomy and warm ischemia times, and provides hemostasis. Erythrocyte aggregation confirmed the hemostatic action of the agent, while the absence of glomerular necrosis and calcification may have positive relevance.

Use of porcine small intestinal submucosa in bladder augmentation in rabbit: long-term histological outcome.

Aim:  To investigate long‐term histological features of bladder augmentation using porcine small intestine submucosa (SIS) in a rabbit model.

Effect of sildenafil citrate on viability of flaps: An experimental study in rats

Various pharmacological agents have been used to try and elucidate the pathophysiology of ischaemia and necrosis of flaps. Their most important disadvantage is the need for relatively high doses given systemically, which increases the risk of potential side effects. Topical or local agents are more useful. Sildenafil citrate, the specific inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE 5) was studied as an antianginal drug during the late 1980s, but is now used for its effect on erectile function in men. Sildenafil citrate causes dilatation of peripheral arteries and veins and the inhibition of the thrombus-forming ability of platelets in vivo. Our study was designed to test the efficacy of sildenafil citrate on the viability of flaps.

A foreign body self-inserted via the urethra into the bladder: Pocket battery

A 37-year-old male patient who had intensediscomfort due to dysuria, pollacuria, wasexamined and a foreign body was determined inthe bladder. This foreign body was a type of pocket battery self inserted compulsively intothe bladder by the patient and this is thefirst published report to our knowledge.

First Clinical Experience of Ankaferd BloodStopper as a Hemostatic Agent in Partial Nephrectomy

Open partial nephrectomy is an effective and safe alternative treatment modality to radical nephrectomy for small renal tumors. Many techniques that use hemostatic agents have been described to provide hemostasis during this procedure. Ankaferd BloodStopper® (ABS) is a unique folkloric medicinal plant extract that has been used historically in Turkish traditional medicine as a hemostatic agent. ABS has therapeutic potential to manage hemorrhage and this agent should be investigated in clinical trials. In the present case, we evaluated the effectiveness of ABS in partial nephrectomy and reviewed the literature.

Using porcine acellular collagen matrix (Pelvicol®) in bladder augmentation: experimental study

PURPOSE Evaluate the rabbit augmented bladder with Pelvicol. MATERIALS AND METHODS Twenty New Zealand rabbits were divided into 4 groups. Bladder augmentation was performed using a 10 x 10 mm sized porcine acellular collagen matrix. The material was placed on the dome of the bladder wall as a patch with 5-0 polyglycolic sutures. The bladder was resected on the 7th, 14th day, 30th and 90th days, and processed for histological analysis. RESULTS No stone formation was found in the first, second and fourth weeks. In the first week, there was inflammatory appearance and roughness in the reconstructed area when compared to other sites on the bladder wall. The material could not be seen in some bladders because of acute inflammatory reaction. The normal bladder epithelium was found on the part of the bladder wall that follows the surface of the eroded material. In the second week, edema was observed through the bladder wall. Perivesical fat tissue increased and it was not easy to distinguish it from the surrounding area. In the fourth week, the bladder wall was thickened and there was a sensation of hardness present. The inner and outer surface of the material was darker than in the other bladders. In the third month, there was no inflammatory reaction; however, there was micro calcification and irregular detrusor regeneration. CONCLUSIONS Pelvicol cannot be suitable material for bladder augmentation because of the resultant micro calcification, thickening of the bladder wall and irregular development of detrusor regeneration.

Phosphodiesterase 5 inhibitors attenuate renal tubular apoptosis after partial unilateral ureteral obstruction: an experimental study.

The aim of the present study was to evaluate the effects of phosphodiesterase 5 inhibitors on renal tubular apoptosis and also on expressions of endothelial and inducible nitric oxide synthases (eNOS and iNOS) in the ipsilateral kidney after partial unilateral ureteral obstruction (PUUO) in a rat model. Forty Wistar albino rats were divided into five groups. In Groups 1–4, left experimental PUUO was created. Sildenafil, vardenafil, and tadalafil were administrated to the rats of Groups 2–4, respectively. The pills were orally given to the rats for 30 days. Group 5 was defined as sham. After 30 days, all rats were sacrificed, and nephrectomy was performed. The renal specimens were examined histopathologically. Left hydroureteronephrosis was observed in Groups 1–4. Mean apoptotic cell count and eNOS and iNOS levels were significantly increased in Group 1 when compared with the other groups. The rats in Groups 2–4 showed significantly decreased apoptotic cell count and eNOS and iNOS values in the renal tubular tissue in accordance with Group 1 (p < 0.05). There were significant differences in apoptotic cell counts between sildenafil group and the other two study groups. The sildenafil group demonstrated lesser apoptotic cell count than the vardenafil (p = 0.021) and tadalafil (p = 0.009) groups. PUUO increases the renal tubular apoptosis and elevates NOS concentrations in renal tubular tissue after PUUO. Phosphodiesterase 5 inhibitors have a protective effect against the tubular apoptosis.

Spontaneous rupture and emergency repairment of the renal pelvis

A case of spontaneous rupture of the renal pelvis is very rare and unusual occurrence. Our case was a young woman who did not present with any disease that was a factor for pelvic rupture. The diagnosis was confirmed by abdominopelvic CT, and emergency repair of the renal pelvis was performed and a ureteral stent was inserted. Appropriate antibiotherapy was ordered, and the recovery was rapid. The differential diagnosis of this ease is discussed and the literature is reviewed: