Oner Odabas

The Efficacy of Fluoxetine in the Treatment of Premature Ejaculation: A Double-Blind Placebo Controlled Study

PURPOSE The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined. MATERIALS AND METHODS The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation. RESULTS The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects. CONCLUSIONS Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.

Undescended Testes in Adults: Clinical Significance of Resistive Index Values of the Testicular Artery Measured by Doppler Ultrasound as a Predictor of Testicular Histology

PURPOSE We evaluated the clinical significance of arterial impedance as a predictor of testicular histology in adults with undescended (inguinal) testes. MATERIALS AND METHODS We performed arterial impedance and testicular diameter measurements with the use of color Doppler ultrasonography on 22 adults with undescended testes. Arterial impedance of the contralateral descended testes served as controls. All patients later underwent inguinal orchiectomy and the testes were examined histologically. RESULTS Of the 22 undescended testes, 7 had arterial impedance values below 0.50, and the other 15 had values equal to or above 0.50. All testes with arterial impedance values below 0.50 had histologic scores between 2 and 3, whereas the others had scores of 3 and 8. Arterial impedance values and testicular volumes in the contralateral testes were significantly higher than the undescended testes. Although some of the testes with arterial impedance values above 0.50 had histologic score 3, testes with arterial impedance values below 0.50 never exceeded score 3. Volume differences of the undescended testes were not statistically significant. CONCLUSIONS Arterial impedance of an undescended testis may have a predictive value and provide more accurate information about its histology than the volume measurement itself.

Fibroepithelial polyp of the ureter associated with an adjacent ureteral calculus

Ureteral fibroepithelial polyps are rare benign tumours. Sometimes an ureteric calculus may be seen, proximal to the polyp. We describe a case of fibroepithelial polyp (FEP) associated with a calculus in the distal part of the right ureter.To our knowledge this is the first ureteral FEP reported in the literature associated with a ureteral calculus distal to it. Aetiology, clinical features, diagnosis and therapy of fibroepithelial polyps are discussed in the light of the literature.

Experimental testicular torsion and its effects on the contralateral testicle.

ObjectiveFollowing experimental unilateral torsion of the testis the histologic effects of unilateral testicular torsion on the contralateral testis were investigated.Materials and methodsUtilizing detorsion or orchiectomy at 4 hours and 8 hours after torsion, the effects of early and late treatment modalities on the contralateral testicle were observed.ResultsMorphometry of the contralateral testis revealed some alterations including focal sclerosis, decrease in mean seminiferous tubular diameter and a marked increase of the Leydig cells in some subgroups.ConclusionIn spite of some changes, definite evidence for contralateral damage due to ipsilateral torsion contributing to male infertility was hardly observed.

Evaluation of 42 patients with chronic abacterial prostatitis: Are there any underlying correctable pathologies?

Forty-two young men with abacterial prostatitis underwent physical examination, semen analyses, rectal US (TRUS) and magnetic resonance imaging (MRI) of the pelvis.Findings on TRUS showed no distinct differences like capsular irregularity, dilatation of the seminal vesicles and calcified foci in the prostate. In MRI pathologic conditions were noted as transitional zone cysts, prostatic utricle cysts and abscesses of the seminal vesicles.MRI had been found superior to TRUS in imaging the prostate and to predict associated pathologic conditions. It is also concluded that some additional factors as a cause of prostatitis must be determined in patients with chronic abacterial prostatitis.

Primary non-mucinous, non-papillary adenocarcinoma of the ureter

We report a case of primary, non-mucinous, non-papillary ureteral poorly differentiated adenocarcinoma. The primary focus could only be detected during surgical exploration, because computed tomography (CT), ultrasonography (US), intravenous urography (IVU) and other radiologic and endoscopic procedures revealed no primary neoplastic focus, only lymph node and various bone metastases.Total nephroureterectomy with a bladder cuff was performed to decrease pain of the patient and to remove the primary tumoral focus.

Can LDH activity in spermatic vein indicate testicular damage? A preliminary report

We aimed to investigate the relationship between varicocele and lactic dehydrogenase (LDH), an intracellular enzyme that indicates cellular damage.LDH levels were measured in the blood samples of 17 oligoasthenospermic infertile patients with varicocele which were obtained synchronously from spermatic and peripheral veins during operation. Sperm counts ranged from 1 to 74 million/ml, while motility ranged from 10% to 60%.LDH level in spermatic vein was found statistically higher than the level in peripheral vein (p=0.042). There was no correlation between sperm counts and LDH level in spermatic vein.We found a significant increase in spermatic vein LDH level in varicocele. We think that further studies are needed to reveal the relationship between spermatic vein LDH level and varicocele.

Extraperitoneoscopic ureterocutaneostomy with hernia repair

Ureterocutaneostomy, which is functionally similar to an incontinent ileal conduit, is reasonable especially as a palliative procedure in patients with unresectable pelvic mass and dilated ureter. During the past years, laparoscopy has grown in popularity and became an alternative technique for the treatment of certain pathologies in urological practice. Although the transperitoneal method offers more space and better vision for identification of anatomical landmarks, the introduction of the balloon dissector has permitted quick dilatation and easier access to the retroperitoneum.

Testicular needle biopsy: Is it a safe and adequate method?

We aimed to investigate if testicular needle biopsy is adequate and safe for the examination of testis. Needle biopsies were performed on 21 testes of 5 patients with advanced prostate cancer and 11 patients with cryptorchidism before orchiectomy. Biopsies were done with the prostatic tru-cut needle. After needle biopsy, the tract and puncture sites were explored and an incisional biopsy was performed on each testis. Both needle specimens and open biopsy specimens were fixed in Bouins solution and sent for histologic examination.There were small haematomas in two testes and moderate haemorrhage between tunica vaginalis layers in another. The tissues obtained by needle biopsy were sufficient except for two specimens and diagnostic accuracy was perfect. Nevertheless, measurement of the seminiferous tubules of the lamina propria could not be achieved in many cases.

Eighteen-month Follow-up of Cystovaginoplasty: A New Augmentation Operation for Repair of Vesicovaginal Fistulae

We present an 18-month follow-up of a cystovaginoplasty case. Surgery was performed because of a large vesicovaginal fistula. A new technique using the vagina as a pouch was utilized.