Osman Ergün

N-acetyl cysteine attenuates diazinon exposure-induced oxidative stress in rat testis

The aim of this study was to investigate the gonadotoxic effects of diazinon and its mechanism of action with special reference to its possible reactive oxygen species generating potential in rat testis and the protective effect of N‐Acetyl Cysteine (NAC) on the exposure of diazinon. The vehicle was given orally to the control group and NAC, diazinon, combination of NAC and diazinon were given to three treatment groups for 4 weeks. Testis lipid peroxidation levels were higher in diazinon group than in control although lipid peroxidation levels were lower in diazinon + NAC group than in diazinon group. The reduced glutathione (GSH) levels were lower in diazinon group than in control and NAC group although its levels were higher in diazinon + NAC group than in diazinon group. Vitamin C, Vitamin E and β‐carotene concentrations were also lower in diazinon group than in control and NAC groups. Vitamin E and β‐carotene concentrations were higher in diazinon + NAC group than diazinon group. Glutathione peroxidase activity and vitamin A concentrations in the testis did not show any difference between the four groups. In conclusion, we observed that NAC treatment modulated diazinon‐induced oxidative injury in the rat testis. These findings suggest that NAC supplementation can be useful in testis oxidative injury caused by the organophosphate insecticides.

Long-term effects of microsurgical varicocelectomy on pain and sperm parameters in clinical varicocele patients with scrotal pain complaints

We aimed to investigate the long‐term effects of microsurgical varicocelectomy on pain improvement and sperm parameters in patients with varicocele‐related pain. A total of 72 patients who had undergone microsurgical subinguinal varicocelectomy because of varicocele with scrotal pain between 2004 and 2009 were included in the study. The patients were grouped according to the presence or absence of pain following surgical treatment. The patients expressing a decrease in frequency and severity of pain or minimal fullness sense were included in the pain‐positive group. The mean follow‐up period was 54.4 ± 18.06 months. There was left‐sided varicocele in 80.3% of patients, while 19.7% had bilateral varicocele. In our study, complete success rate (Visual Analog Scale: 0–1) was found to be 79.2% (57/72), while failure (complete and partial failure) rate was 20.8% (15/72), and a significant difference was found (P < 0.05). Microsurgical subinguinal varicocelectomy is a reliable approach for clinically varicocele patients with scrotal pain complaints. Regardless of the type of pain, varicocelectomy significantly decreases pain. The success of the treatment is not related to the degree of varicocele.

Bilateral Hydronephrosis Secondary to Cystocele

Abstract A 75-year-old patient applied to the urology clinic with a cystocele and ultrasonography of urinary tract evidencing bilateral grade III hydronephrosis. She didn’t complain about any urination problem. Gynecologic examination showed a marked cystocele throughout its entire extension on the anterior wall of vagina. The excretory urography confirmed the presence of bilateral hydronephrosis and ‘narrowing distal ureters.’ An anterior colporrhaphy and tension-free vaginal tape procedure were performed without any complication. At the third month of the follow-up, regression in hydronephrosis was observed and there was no urinary complaint. In women presenting dilatation of upper urinary tract, pelvic organ prolapses must be kept in mind and a convenient examination is the key point to rule it out. Unnoticed cases can lead to a wrong diagnosis and redundant surgery.

A Giant Scrotal Cavernous Hemangioma Extending to the Penis and Perineum: A Case Report

Cavernous hemangioma is a congenital, benign vascular tumor that occurs in the deep dermis and subcutaneous tissue. Scrotal hemangiomas are rare entities and are usually diagnosed in childhood. Adult scrotal hemangiomas are also extremely rare. They are infrequently encountered in adults because they are usually removed in childhood. Urologists often face difficulties in deciding surgery to treat a genital cavernous hemangioma. Here, we report a case of scrotal cavernous hemangioma that involved the entire penis and scrotum, and extended to the perineum in a 44‐year‐old man, and we review the literature.

The Effect of Micronized Purified Flavonoid Fraction on the Prevention of Testicular Pathologies in Adolescent Rats with Experimentally Induced Varicocele

PURPOSE We investigated the effect of micronized purified flavonoid fraction on the prevention of testicular pathologies following varicocele induction. MATERIALS AND METHODS A total of 66 adolescent (6-week-old) male Wistar rats were included in study. Rats were divided into 7 groups, including group 1--control, group 2--sham operation, group 3--left varicocele induced, group 4--varicocele induced, varicocelectomy done 4 weeks later and micronized purified flavonoid fraction administered for 4 weeks, group 5--varicocele induced and micronized purified flavonoid fraction administered for 8 weeks, group 6--varicocele induced and beginning 4 weeks later micronized purified flavonoid fraction administered for 4 weeks, and group 7--varicocele induced and varicocelectomy done 4 weeks later. Before sacrifice bilateral real-time testicular microvascular perfusion of all rats was measured using the PeriFlux System 5000 PF 5010 LDPM Unit (Perimed, Järfälla, Sweden). All testes were graded according to the Johnsen scoring system. To assess apoptosis caspase-3 levels were measured. RESULTS Testicular weight in group 3 was markedly decreased and the extent of seminiferous tubular damage was significantly increased compared with the other groups. Bilateral testicular blood flow and the number of apoptotic germ cells were greater in group 3. Significantly higher Johnsen scores and a meaningful decrease in the apoptotic index were detected in groups 4 to 7 compared with group 3. CONCLUSIONS We observed favorable effects of micronized purified flavonoid fraction on the regression of testicular damage secondary to varicocele.

The Effect of Prostate Weight on the Radical Prostatectomy Outcomes

DOI: 10.4328/JCAM.552 Received: 20.12.2010 Accepted: 02.01.2011 Printed: 01.01.2012 J Clin Anal Med 2012;3(1):56-8 Corresponding Author: Taylan Oksay, Süleyman Demirel Üniversitesi Tıp Fak.Üroloji AD, 32400 Isparta, Türkiye. T.: +90246 2119259 F.: +90 246 2371762 E-Mail: drtaylanoksay@yahoo.com Özet Amaç: Prostat kanserli hastalarda büyük prostat hacminin radikal prostatektomi sonuçları (kanser kontrolü, üriner kontinans, erektil fonksiyon) üzerine olan etkileri değerlendirildi. Gereç ve Yöntem: Radikal retropubik prostatektomi operasyonu yapılan 92 hastanın dosyaları retrospektif olarak değerlendirildi. Hastaların demografik verileri, tümör karakteristikleri, onkolojik, üriner ve erektil fonksiyon sonuçları toplandı. Sonuçlar prostat ağırlıklarına (Grup 1: ≤60 g, Grup 2: >60 g) göre karşılaştırıldı. Bulgular: Hastaların %35,9’unun prostat ağırlığı >60 g idi. Büyük prostat hacmine sahip hastaların preoperatif Prostat Spesifik Antijen (PSA) seviyeleri (9.9 – 14.1 ng/ml, p<0.05) daha yüksek idi ve bu grupta biyopsi Gleason skoru ≤6 olan hasta sayısı (%76.3 %87.9, p<0.05) daha fazla idi. Grup 2’de patolojik olarak T2a-b evresinde olan hasta sayısı (%20.4 %45.4, p<0.05) daha fazla idi. Gruplar arasında cerrahi sınır pozitifliği, biyokimyasal rekürrens, kontinans durumu ve erektil fonksiyon açısından fark yoktu. Sonuç: Büyük prostat hacmine sahip prostat kanserli hastalarda radikal prostatektomi operasyonu yüksek PSA seviyelerine rağmen iyi ve yeterli onkolojik sonuçlar sağlamaktadır ve küçük prostat ile karşılaştırıldığında üriner ve erektil fonksiyonlar açısından bir fark oluşturmamaktadır.

Comparison of Q-tip test and POP-Q staging system for the assessment of urethral hypermobility

Özet Amaç: Bu çal man n amac pelvik organ prolapsusu derecelendirme (The pelvic organ prolapse quantification, POP-Q) sistemi ile tespit edilen vajen ön duvar orta hatt nda eksternal üretral meatustan itibaren 3 cm proksimalde yer alan Aa noktas ndaki desensus ile Q tip test aç s aras ndaki ili kiye bakarak üretral hipermobiliteyi de erlendirmektir. Gereç ve yöntem: Pelvik organ prolapsusu ve/veya üriner inkontinans ikayeti olan 50 kad n hasta prospektif olarak de erlendirildi. Prolapsusu olan tüm hastalar n inkontinans ikayeti de mevcuttu. Daha önce inkontinans nedeni ile cerrahi tedavi geçiren hastalar çal ma d b rak ld . Bütün hastalara ürojinekolojik de erlendirme kapsam nda fizik muayene, idrar tahlili, postmiksiyonel rezidü ölçümü, pet testi, ürodinamik inceleme yap ld . Fizik muayene, Q tip test, POP-Q sistem ölçümlerini ve nöromusküler de erlendirmeyi içermekteydi. Bulgular: Ortalama Q tip test aç s 42.9o bulundu. Elli hastan n %80’inde üretral hipermobilite mevcuttu. POP-Q sistemine göre hastalar n %12.5’sinde evre 0, %15.5’inde evre 1, %64’ünde evre 2, %8’inde evre 3-4 prolapsusu vard . Aa noktas -3 den +3’e do ru yer de i tirdikçe (median -1) Q tip test aç s nda art gözlendi. Evre 2 ve üzerindeki hastalarda %97.2 oran nda üretral hipermobilite mevcuttu. Aa noktas ile Q tip test aç s aras nda istatistiksel olarak anlaml pozitif bir korelasyon saptand (r=0.799, p=0.0001). Sonuç: Q tip testinin uygulay c ve hasta kaynakl nedenlerden dolay standardizasyon zorlu u vard r. Bu nedenle evre 2 ve üzeri pelvik organ prolapsusu olan hastalarda Q tip testinin de erlendirme d tutularak yerine daha standardize bir de erlendirme yöntemi olan POP-Q evreleme sisteminin kullan m umut vericidir ve üzerinde daha geni ara t rmalar yapmaya de erdir.