Hasan Hüseyin Tavukçu

Detection of Mitochondrial DNA Mutations in Nonmuscle Invasive Bladder Cancer

BACKGROUND Mitochondrial DNA (mtDNA) mutations have been recently described in various tumors; however, data focusing on bladder cancer are scarce. To understand the significance of mtDNA mutations in bladder cancer development, we investigated the mtDNA alterations in bladder cancer cases. METHODS We studied the mtDNA in 38 bladder tumors and 21 microdissected normal bladder tissue samples. Mitochondrial genes ATPase6, CytB, ND1, and D310 region were amplified by polymerase chain reaction and then sequenced. RESULTS We detected 40 mutations in our patient population. Our findings indicate that G8697A, G14905A, C15452A, and A15607G mutations are frequent in bladder cancers (p<0.05). In addition, the incidence of A3480G, T4216C, T14798C, and G9055A mutations were higher in patients with bladder tumors. CONCLUSIONS In conclusion, the high incidence of mtDNA mutations in bladder cancer suggests that mitochondria could play an important role in carcinogenesis and mtDNA could be a valuable marker for early bladder cancer diagnosis.

Effect of Testicular Sperm Extraction Outcome on Sexual Function in Patients With Male Factor Infertility

OBJECTIVES To document the effects of the outcome of testicular sperm extraction (TESE) procedures on erectile function in patients with male factor infertility. METHODS A total of 66 nonobstructive azoospermic patients were divided into 2 groups: group I, with sperm-positive results and group II, with sperm-negative results. The patients were evaluated with the International Index of Erectile Function-5 (IIEF-5) and Hospital Anxiety-Depression Scale. Hormones were analyzed before and 6 months after the procedure. Each group was compared with the use of the paired t test, where P <.05 was accepted as statistically significant. RESULTS The mean patient age was 34.8 years (range 24-53). Of 66 cases, 26 (40%) experienced positive results for the TESE. The median IIEF-5 score before TESE for group I and group II was 22 (minimum: 11, maximum: 25) and 23 (minimum: 10, maximum: 25), respectively. The median IIEF-5 score after TESE for group I and group II was 23.5 (minimum: 10, maximum: 25) and 18 (minimum: 15, maximum: 25), respectively. In patients who reported new onset erectile dysfunction (ED) 6 months after surgery, the mean follicle-stimulating hormone and luteinizing hormone levels increased from 21 +/- 2 to 38 +/- 3 IU/L (P <.001), and from 11 +/- 2 to 14 +/- 2 IU/L (P >.05), respectively. The mean total testosterone level decreased from 7.83 +/- 2 to 2.8 +/- 2 ng/mL (P <.001). The Hospital Anxiety and Depression Scale revealed that patients who reported new onset ED also reported both depression and anxiety. CONCLUSIONS Unsuccessful TESE procedures might have a negative effect on erectile function because of hormonal and psychological reasons. The andrologist should treat the ED of the patients and refer them to the psychiatrist for anxiety and depression assessment.

Melatonin and tadalafil treatment improves erectile dysfunction after spinal cord injury in rats

Oxidative stress plays an important role both in spinal cord injury (SCI) and erectile dysfunction (ED). The present study investigated the effects of melatonin and tadalafil treatment alone or in combination on SCI‐induced ED. Male Wistar albino rats (n = 40) were divided into five groups: sham‐operated control and SCI‐injured rats given either vehicle, melatonin (10 mg/kg, i.p.), tadalafil (10 mg/kg, p.o.) or a combination of melatonin and tadalafil. Spinal cord injury was induced using a standard weight‐drop method. On Day 7 after SCI, intracavernosal pressure (ICP) was measured and all rats were decapitated. Cavernosal tissues were obtained to examine caspase 3, nitric oxide synthase (NOS), myeloperoxidase (MPO) and superoxide dismutase (SOD) activities, as well as cGMP, nerve growth factor (NGF), malondialdehyde (MDA) and glutathione (GSH) levels. Spinal cord injury caused oxidative damage, as evidenced by increases in MDA and cGMP levels. In addition, MPO and caspase 3 activites were increased after SCI, whereas GSH and NGF levels and SOD activity were reduced. Melatonin effectively reversed these oxidative changes. Furthermore, in rats treated with both melatonin and tadalafil, the recoveries were more pronounced than in rats given either melatonin or tadalafil alone. The ICP/mean arterial pressure value in vehicle‐treated SCI rats was significantly higher than in the control group, whereas in the tadalafil‐ and tadalafil + melatonin‐treated groups have returned this value had returned to control levels. As an individual treatment, and especially when combined with tadalafil, a well‐known agent in the treatment of ED, melatonin prevented SCI‐induced oxidative damage to cavernosal tissues and restored ED, most likely due to its anti‐oxidant effects.

Pre-emptive Use of Riboflavin in a Rat Model of Bilateral Cavernous Nerve Injury

effects of riboflavin (Rb) on bilateral CNI in a rat model. Materials and Methods: Twenty-four male rats were divided into four groups: control (C), patients with bilateral CNI, those with CNI receiving postoperative Rb treatment (CNI+Rb), and those with CNI receiving preand post-operative Rb treatment (Rb+CNI+Rb). Bilateral CNI was performed in all groups except for C. The CNI+Rb group was treated with 30 mg/kg Rb daily after CNI for two weeks; the Rb+CNI+Rb group was treated with 30 mg/kg Rb daily one week before CNI and then for two weeks after injury. Mean arterial pressure (MAP) and intracavernosal pressure (ICP) were measured 14 days after CNI in all groups. Tissue malondialdehyde, cyclic guanosine monophosphate, nerve growth factor, superoxide dismutase and total nitric oxide synthase (NOS) activities, neuronal NOS (nNOS) and inducible NOS (iNOS) were analyzed. Results: ICP/MAP ratio was significantly lower in the CNI (p<0.01) and CNI+Rb groups (p<0.05) compared to the control group, however, the Rb+CNI+Rb group had results comparable to the C group in terms of nNOS and iNOS expression in the Western Blot analysis. Conclusion: Rb exerted anti-oxidative and anti-inflammatory effects on CNI in a CNI rat model. Rb can be a potential beneficial agent to improve erectile function in nerve-sparing radical prostatectomy patients as a preemptive penile rehabilitation strategy, although further clinical studies are needed.

The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

Objective We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy. Material and methods We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity. Results There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high- risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%). Conclusion Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.

MP94-01 PROTECTIVE EFFECT OF PLATELET-RICH PLASMA ON URETHRAL STRICTURE MODEL OF MALE RATS

INTRODUCTION AND OBJECTIVES: Urethral stricture formation is caused by fibrosis after excessive collagen formation to the any injury or trauma to the urethra. We evaluated the affects of plateletrich plasma (PRP) on urethral stricture model of male rats. METHODS: Urethral stricture model was performed by coagulation current to the male urethra. There were 4 groups of 6 rats in each one: control (C), C+PRP applied, urethral stricture (US), US+PRP applied. PRP was applied to the urethra after coagulation current induced injury as soon as possible. On 14th day all rats were sacrified and urethral tissues investigated for collagen type I (col I), collagen type III (col III), platelet-derived growth factor-A (PDGF-A), platelet-derived growth factor-B (PDGF-B) and transforming growth factor-B (TGF-B) with quantative real-time polymerase chain reaction (RT-PCR) and Western-Blot analysis. The efffect of urethral damage and healing was investigated for col I/col III ratio. RESULTS: Collagen type I increase in fibrosis process in US is well defined. Collagen type I/ collagen type III ratio was significantly high in US group (*, p1⁄40,000) than others while US+PRP group had comparable results with the control group (p1⁄40,999). (Graphic 1) RTPCR analysis of col I, col III, PDGF-A, PDGF-B and TGF-B was shown in table 1. Graphic 1: Col I/Col III type ratio of each group. Table 1: Results of RT-PCR analysis of col I, col III, PDGF-A, PDGF-B and TGFB.(* Significant between US and US+PRP groups; & not significant between C and US+PRP groups; ** significant between C and US+PRP groups) CONCLUSIONS: Our results show that PRP has a preventive effect on stricture formation in US rat model shown by its effect on collagen synthesis, especially in recurrent cases. Further studies that eventually show the effects of PRP on human tissues is necessary and promising. Source of Funding: Istanbul Bilim University