Non-transecting urethroplasty in patients with bulbar urethral strictures shorter than three centimeters.

PURPOSE: This study aimed to compare the success and postoperative complication rates of the novel non-transecting urethroplasty (NTU) technique and conventional excision-primary anastomosis (EPA) in the surgical treatment of short bulbar urethral strictures. MATERIAL AND METHODS: Data of the patients who underwent excision-primary anastomosis or NTU procedures at our center for the surgical treatment of bulbar urethral strictures shorter than 3 cm between January 2010 and December 2018 were retrospectively reviewed. RESULTS: Forty-seven patients fulfilled the eligibility criteria for this study. Among these patients, 22 underwent NTU procedure while 25 underwent EPA. There was no difference between the two groups regarding age, stricture length, etiology, past surgical history, and duration of follow-up. The surgical success rates were 88% and 87,2% in the NTU and EPA groups, respectively (p = 0,603). The complication rates were 12% and 13,6% in NTU and EPA groups, respectively. Two groups were similar concerning complication rates (p = 0,603). CONCLUSION: The novel NTU and conventional EPA techniques are similar regarding surgical success and complication rates in the surgical treatment of bulbar urethral strictures shorter than three centimeters.

Assessments of ReDo buccal mucosal urethroplasty in terms of functional outcomes.

PURPOSE: We aimed to assess the success rates and functional outcomes of ReDo buccal mucosal graft urethroplasty (BMGU) following failed primary BMGU and evaluate the oral morbidity and changes in quality of life (QoL) after this surgery. MATERIALS AND METHODS: Data of the patients with recurrent anterior urethral stricture who underwent ReDo BMGU after failed primary BMGU were retrospectively reviewed. The collected data included the results of the urethral stricture surgery patient-reported outcome measure-lower urinary tract symptoms (USS-PROM-LUTS) and euro-quality of life visual analog scale (EQ-VAS) questionnaires performed preoperatively before and one year after surgery. The cohort was divided into two groups according to procedural success, and these groups were compared. RESULTS: Thirty-two men patients were included. Among these, twenty-seven (84.3%) cases were considered successful following ReDo BMGU. The pre-ReDo BMGU mean stricture length was significantly longer in the failure group (2.3 ± 0.6 vs. 4.4 ± 1.2 cm, p = 0.001). Except for one patient with persistent oral numbness, no severe complication was reported postoperatively in the first year. The mean USS-PROM-LUTS score decreased significantly, while the mean LUTS-related quality of life score increased significantly following ReDo BMGU (p < 0.001, p < 0.001). In addition, the mean total EQ-VAS score increased significantly from 62.75 to 78.45, indicating remarkable improvement (p < 0.001). CONCLUSIONS: Although less favorable outcomes can be anticipated in ReDo BMGU due to extensive scar tissue formation and reduced vascularity, high success and patient satisfaction rates and low oral morbidity rates were detected in ReDo BMGU cases.

Factors affecting the effectiveness and success of retrograde holmium laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction in adults.

PURPOSE: To evaluate the factors affecting the effectiveness, safety, and success of retrograde holmium:yttrium-aluminum-garnet laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction in adults. METHODS: Adult patients who underwent retrograde holmium:yttrium-aluminum-garnet laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction between January 2012 and June 2016 at our clinic were retrospectively analyzed. Success was defined as the relief of symptoms and the resolution of obstruction, as assessed via radiography. Factors affecting success were analyzed, such as the clinical characteristics, procedural outcomes, complications, and the type of ureteroscopy used in the procedure. RESULTS: Procedural success was achieved in 29 (74.4%) out of 39 patients, with a mean age of 38.3 ± 12.3 years during a median follow-up duration of 44 (33-65) months. Failure occurred at a median of 4.5 (3-22) months. It was detected that the presence of primary obstruction, ipsilateral kidney function being >30% of normal, and the length of obstruction being <1 cm positively affected procedural success (p = 0.009, p = 0.011, and p = 0.019, respectively). In the postoperative period, two Grade I and four Grade II complications were observed according to the Clavien-Dindo classification. There was a difference only in the operation time between semirigid (24) and flexible ureteroscopes (15), with the operation time being shorter with the use of a semirigid ureteroscope than with the use of a flexible uteroscope (p < 0.001). CONCLUSION: Retrograde holmium:yttrium-aluminum-garnet laser endopyelotomy is a minimally invasive method that can be used effectively and safely as the primary treatment of patients with ureteropelvic obstruction, when long-term results are also taken into consideration. The decision of performing laser endopyelotomy should be made after a detailed evaluation of the characteristics of the patient as well as of the obstruction.

Comparison between dorsal onlay and one-sided dorsolateral onlay buccal mucosal graft urethroplasty in long anterior urethral strictures.

OBJECTIVE: To compare dorsal onlay (conventional Barbagli) and one-sided dorsolateral onlay (Kulkarni technique) buccal mucosa substitution urethroplasty techniques for the treatment of long anterior urethral strictures. METHODS: Demographic data, treatment outcomes and success rates of patients who underwent either conventional Barbagli or Kulkarni urethroplasty for the treatment of an anterior urethral stricture longer than 8 cm between January 2010 and March 2019 in our center were retrospectively reviewed. RESULTS: Demographic parameters of patients who underwent the conventional Barbagli (n = 37) or Kulkarni procedure (n = 31) did not differ. The mean surgical duration and hospital stay were shorter for patients treated with the Kulkarni technique (179.5 ± 30.0 and 3.5 ± 1.2 vs 195.5 ± 28.9 min and 4.4 ± 1.8 days; P = 0.037, P = 0.002). Mean intraoperative blood loss and perioperative complication rates were signficantly lower in patients who underwent the Kulkarni technique than those who underwent the conventional Barbagli technique (164.3 ± 62.9 vs 202.4 ± 78.1 mL; P = 0.033 and 16.1% vs 37.8%; P = 0.046). The mean follow-up time period was 59.8 ± 24.7 and 63.5 ± 26.8 months for Kulkarni and conventional Barbagli techniques, respectively. Success rates based these follow-up time periods were 27 (87.1%) and 26 (70.3%) for the Kulkarni and conventional Barbagli techniques, respectively. CONCLUSION: The Kulkarni technique should be more preferred for the treatment of long anterior urethral strictures over the conventional Barbagli technique based on surgical outcomes and success rates.

Comparison of semirigid ureteroscopy, flexible ureteroscopy, and shock wave lithotripsy for initial treatment of 11-20 mm proximal ureteral stones.

OBJECTIVE: We aimed to retrospectively evaluate the effectiveness and safety of flexible ureteroscopy (f-URS), semirigid ureteroscopy (sr-URS), and shock wave lithotripsy (SWL) to treat single 11-20 mm stones in the proximal ureter. MATERIALS AND METHODS: Patients treated at our clinic for 11-20 mm single stones in the proximal ureter who underwent f-URS, sr-URS or SWL as initial lithotripsy methods were compared in terms of their clinical characteristics and treatment outcomes. RESULTS: A comparison among 201 patients who had undergone f-URS, 119 patients who had undergone sr-URS, and 162 patients who had undergone SWL showed no significant baseline differences in patients' demographic and stone characteristics. Stone-free rates on the 15th day and 3rd month were higher with f-URS (89.6% and 97%, respectively) than with sr-URS (67.2% and 94.1%, respectively) and SWL (41.4% and 79.0%, respectively; all p < 0.001). Retreatment rates were significantly higher with SWL than with the other two modalities (p < 0.001); auxiliary procedure rates were significantly lower with f-URS than with the other two modalities (p < 0.001). Treatment-related complication rate at the end of the 3rd month was lower with f-URS than with SWL (p = 0.022). Furthermore, f-URS was more effective than sr-URS for treating impacted stones. CONCLUSIONS: We found that f-URS was highly successful as an initial lithotripsy procedure for medium-sized proximal ureteral stones, and it helped achieve early stone-free outcomes with a lower need for retreatment and auxiliary procedures, lower complication rates, and higher effectiveness on the impacted stones compared with sr-URS and SWL.

Critical analysis of urethroplasty for male anterior urethral stricture: a single-center experience.

PURPOSE: Urethroplasty is the most effective treatment method for anterior urethral strictures, which constitute an important health concern for males. This study aims to investigate factors that may predict treatment failure following urethroplasty for anterior urethral strictures and evaluate outcomes of different urethroplasty techniques. METHODS: This retrospective study utilized univariate and multivariate analyses to identify factors affecting treatment success following different urethroplasty techniques performed by a single surgeon on male patients with anterior urethral strictures. Surgical outcomes of different urethroplasty techniques were evaluated individually. RESULTS: Urethroplasty procedures performed on 244 patients with a mean age of 54 years and a mean stricture length of 4.7 cm produced a success rate of 79.1%. Multivariate analyses identified stricture length and number of previous internal urethrotomy procedures as factors predicting urethroplasty success (HR 1.265, 95% CI 1.129-1.416, p < 0.001 and HR 1.188, 95% CI 1.038-1.361, p = 0.013, respectively). The eight surgical techniques used by the surgeon produced success rates that varied between 50% and 86.2%. CONCLUSION: Urethroplasty can offer satisfactory outcomes for anterior urethral strictures. Accordingly, a longer stricture length and greater number of previous internal urethrotomy procedures were associated with greater risk for urethroplasty failure. Moreover, urethroplasty techniques must be selected based on multifactorial evaluation and performed at experienced centers.

Dorsal onlay buccal mucosal graft urethroplasty in the treatment of urethral strictures - does the stricture length affect success?

BACKGROUND: Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results. OBJECTIVES: To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique. MATERIAL AND METHODS: Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤7 cm, and >7 cm), and localization of the stricture were assessed as the factors affecting success rate. RESULTS: The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.26 and p=0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p=0.002 and p=0.025). CONCLUSIONS: Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques.

Management of renal cysts.

BACKGROUND AND OBJECTIVES: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. METHODS: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. RESULTS: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. CONCLUSION: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy.

Does the modified STING method increase the success rate in the management of moderate or high-grade reflux?

PURPOSE: To evaluate the efficacy of subureteral injection types in patients with middle- to high-grade vesicoureteral reflux (VUR). MATERIALS AND METHODS: Between June 1999 and September 2010, subureteral dextranomer was applied at our clinic to 149 patients (214 refluxing ureters) with grades II, III, and IV VUR. Group 1 consisted of 54 patients (80 ureters), and group 2 consisted of 95 patients (134 ureters). The standard subureteric transurethral injection (STING) procedure was applied to group 1, and the modified STING procedure was applied to group 2. A second and if needed a third injection was applied to unsuccessfully treated patients. The mean follow-up period was 2 years. Patients were evaluated by cystography and ultrasonography in the third month of follow-up. RESULTS: VUR was resolved completely after a single injection in 54/80 ureters (67.5%) in group 1 and in 94/134 ureters (70.1%) in group 2. Overall successes after a second or a third injection were 61/80 (76.2%) and 111/134 (82.8%), respectively. There was a statistically significant difference between the groups only for grade IV reflux following multiple injections (p<0.05). CONCLUSIONS: Endoscopic treatment of VUR is a recommended treatment because it is minimally invasive, efficient, and repeatable. Our study confirmed that a modified STING procedure can be an alternative treatment to the standard technique.

Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review.

Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.

A good alternative to indwelling catheter owing to benign prostate hyperplasia in elderly: Memotherm prostatic stent.

OBJECTIVE: To evaluate the long-term results of using Memotherm (Angiomed Gmbh & Co.) prostatic stents in the treatment of bladder outlet obstruction from benign prostatic hyperplasia (BPH) in patients with high anesthetic risk for surgery. METHODS: A total of 29 patients with BPH, who were ruled unfit for surgery, underwent a prostatic stenting procedure between 1998 and 2005 at our hospital, with a mean age of 75 years (range, 65-87) and a mean symptomatic period of 62.5 months (range, 7-180). All patients had previous failed medical treatment for severe lower urinary tract symptoms and evaluated as high risk for anesthesia. Mean follow-up period was 6.8 years (range, 60-125 months). Preprocedural, first year, and fifth year postprocedural values for peak flow rates, residual urine volumes, Turkish symptom scores, and quality of life index scores were compared and evaluated. RESULTS: Memotherm prostatic stent placement was successful in treating 25 patients with BPH (86%) at high risk for surgery who had prostate-related urinary obstruction. For the remaining 4 patients (13.8%), stent migration into the bladder prompted removal of the stents. Marked improvement in residual urine volume, Turkish symptom score, quality of life index scores, and peak flow rates were observed 1 and 5 years after the procedure. CONCLUSION: The results of our study suggest that placement of Memotherm prostatic stents is an effective treatment option in elderly patients with BPH at high anesthetic risk. And by this way, the possible unwanted results of continuous catherization and patient discomfort might be prevented.

Stone compositions in Turkey: an analysis according to gender and region.

OBJECTIVE: To evaluate the compositions of the kidney stones obtained from different regions of Turkey and to present the gender and regional differences. METHODS: The study included 6453 kidney stones obtained from patients from different parts of Turkey. All of the stones were obtained using ureterorenoscopy, percutaneous stone surgery, laparoscopic or open stone surgery, or extracorporeal shock wave lithotripsy. X-ray diffraction crystallography method was used for analysis. RESULTS: At the end of the analysis, 11 different stone types including calcium oxalate (Ca-ox) monohydrate (whewellite, COM), Ca-ox dihydrate (weddellite, COD), uric acid, cystine, struvite, biurea, xanthine brushite, quartz, whitlockite, and dahlite were determined either in pure or mixed conditions. Of the stones, 80.4% were Ca-ox (55.7% COM, 5.9% COD, 18.8% COM + COD), 4.8% uric acid, 3.1% cystine, and 3.3% were phosphate stones (dahlite, brushite, struvite, whitlockite). The remaining 8.4% of the stones were in mixed form with different combinations. Of the patients, 4411 were men (68.3%) and 2042 were women (31.7%). CONCLUSION: Ca-ox was the most frequently encountered stone type in our country as it is worldwide. The distribution of the other stone types is different than the other countries. The information about the structure of the stone has significant contribution to the understanding of the stone formation etiology, programming of the treatment process, and prevention of the recurrences. The study is significant in presenting the stone profile of Turkey.

Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia.

OBJECTIVE: There are limited data on whether there is an association between nocturia, benign prostatic hyperplasia (BPH) and endothelial dysfunction. The aim of the present study was to evaluate whether there is an association between nocturia and endothelial dysfunction in patients with BPH. MATERIAL AND METHODS: Forty-two men with a diagnosis of BPH and 42 age-matched controls were enrolled. All patients were assessed for frequency and duration of nocturia, and prostate volume, completed the International Prostate Symptom Score (IPSS) questionnaire, and underwent brachial flow-mediated dilatation (FMD) evaluation. RESULTS: There was a negative correlation between FMD and frequency of nocturia (r = -0.879, p < 0.0001). Moreover, there was a negative correlation between duration of nocturia and FMD (r = -0.890, p < 0.0001). In addition, FMD was significantly decreased in the BPH group compared with the control group (6.0 ± 0.09 to 7.8 ± 0.10%) (p = 0.0001). CONCLUSION: In patients with BPH, nocturia is associated with endothelial dysfunction and may be an insidious risk factor for cardiovascular disease.

Comparison of uni-and bilateral buccal mucosa harvesting in terms of oral morbidity.

OBJECTIVE: To evaluate the intraoral morbidity associated with uni- or bilateral buccal mucosa graft harvesting in the treatment of urethral stricture. MATERIAL AND METHODS: Forty-two men with anterior urethral stricture who were treated with dorsal onlay buccal mucosal graft urethroplasty were enrolled in this study. The graft was harvested from both cheeks in patients with a stricture length of ≥7 cm and from one cheek, if the stricture length was <7 cm. The postoperative pain scores, the time required both to return to a regular diet, and also to achieve full mouth opening, intrtaoral numbness and the salivary changes were compared between two groups. RESULTS: The bilateral buccal mucosal graft harvest group was disadvantaged in terms of the 7(th) day pain score, the time required both to return to a regular diet also to achieve full mouth opening (p<0.05). No significant intergroup differences were found in the terms of salivary changes and intraoral numbness. CONCLUSION: Although, intraoral morbidity of bilateral buccal mucosa graft harvesting is more marked than that of the unilateral harvesting, in the short term, it is well tolerated by the patients in the long term.

Metastatic prostate adenocarcinoma presenting as supraclavicular lymphadenopathy: a report of two cases.

Clinical examination is very important in the practice of medicine. In patients presenting with a supraclavicular mass, a number of diseases including cancer should be ruled out. Two patients who presented with a bulky left supraclavicular mass were evaluated. Their medical history revealed complaints attributed to lower urinary tract infection. We performed histopathological examination of the lymph nodes with radiological evaluation of the thorax and abdomen. The final diagnoses were prostate cancer in both patients. It should always be kept in mind that prostate cancer is the most frequent cancer in elderly men, and although very unusual, the presenting finding can be cervical or supraclavicular lymphadenopathy; thus clinicians should be aware of urological examinations in such cases.

Villous adenoma of the urinary bladder: rare location.

Villous adenomas are common lesions of the gastrointestinal tract but they are rarely located in the urinary tract including the urinary bladder. There are a few case reports and series in the literature. Here we report a 43-year-old male patient who had a polypoid lesion located on the left lateral wall of the urinary bladder. Transurethral resection was performed. The diagnosis was 'villous adenoma of urinary bladder' with clinical and histopathological findings. Villous adenomas are mostly seen in elderly males. The coexistence of villous adenoma with adenocarcinoma, squamous cell carcinoma, and urothelial carcinoma was observed but there is not clear evidence about progression to carcinoma, in spite of its colonic counterpart. Generally complete surgical resection is accepted as curative but there are no exact data about follow-up and recurrence. By presenting this case, we aim to emphasize that it is a rare but important lesion because of coexistence with malignancies and uncertain malignant potential.

Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis.

UNLABELLED: What's known on the subject? and What does the study add? Milroy reported 84% success at a mean of 4.5 years follow-up by usage of a permanently implantable "urolume" spent in 1993. Memotherm was developed later, especially for urologic use. Our study is one of the largest in this urea, with a high number of patients and a long follow-up period. OBJECTIVE: • To evaluate the effectiveness and long-term results of permanent urethral stent (Memotherm) implantation in the treatment of recurrent bulbar urethral stricture. PATIENTS AND METHODS: • In all, 47 patients with a history of previous unsuccessful treatment for bulbar urethral stricture were treated using Memotherm bulbar urethral stents between 1998 and 2002. • Long-term follow-up data was analysed and discussed. RESULTS: • At the end of the 7-year period 37 of 47 patients (78.7%) had been treated successfully. • Post-micturition dribbling incontinence lasting up to 3 months after stent placement occurred in 32 (68.1%) patients, but this was reduced to only seven patients (14.9%) by the 7-year follow-up. • There was stress incontinence of various severities in nine (19.2%) patients at the 1-year follow-up. These patients were those who had stenosed urethral segments adjacent to the external sphincter. At the long-term follow-up <10% of the patients had stress incontinence complaints. CONCLUSION: • Memotherm is a good treatment option in patients with recurrent bulbar urethral stricture of any cause.

The beneficial effects of tadalafil on renal ischemia-reperfusion injury in rats.

Acute renal failure due to ischemia-reperfusion (I/R) injury is a common complication in cardiovascular surgery. We determined the influence of tadalafil on renal injury in a renal I/R model in rats. For this purpose, 21 male Wistar albino rats were separated into 3 groups: sham, placebo and tadalafil. A right nephrectomy was performed, and the left renal pedicles were occluded for 60 min and reperfused for 60 min in the placebo and tadalafil groups. A single dose of tadalafil (10 mg/kg) through an orogastric tube was administered to the tadalafil group. Tubular atrophy with acute inflammation in renal histology, total oxidant status (TOS) and total antioxidant status (TAS) were determined in tissue homogenates. Compared to the tadalafil group, tubular atrophy and acute inflammation was significant in the placebo group. TAS levels were significantly higher in the tadalafil group compared to the placebo (p = 0.01) and sham groups (p = 0.04). While TOS levels were significantly higher in the placebo group (p = 0.03), tadalafil did not significantly alter the TOS levels. The beneficial effects of tadalafil can be attributed to its protective effects on renal tubular cells and inhibition of leukocyte infiltration in renal tissue. We think that tadalafil treatment has an important role in reducing renal injury resulting from renal I/R.

Protective effect of thymoquinone in experimental testicular torsion.

OBJECTIVES: To investigate the protective role of thymoquinone (TQ) on unilateral testicular ischemia-reperfusion (I/R) injury in mice. MATERIALS AND METHODS: Experiments were performed on male C57BL/6 mice (8 weeks old, 20-25 g). The animals were divided into 3 groups including 6 mice in each group: control (sham), torsion/detorsion (TD) and TD+TQ. Mice, except the sham-operated group, were subjected to left unilateral torsion (720° rotation in the clockwise direction). The experiments were finished after sham operation time for controls, 120 min torsion and 240 min detorsion for the other groups. In the TD+TQ group 10 mg TQ was injected intraperitoneally 30 min before detorsion. RESULTS: In the TD group total oxidative stress (TOS), oxidative stress index (OSI) and malondialdehyde (MDA) levels were higher than in the controls. TQ treatment decreased MDA, TOS and OSI values, but did not affect the total antioxidant capacity and myeloperoxidase activity in the TD+TQ group. Upon histological examination, mice in the TD group displayed moderate-to-severe disruption of the seminiferous epithelium. Treatment with TQ resulted in significantly reduced histological damage associated with I/R injury. CONCLUSION: Our results suggested that TQ treatment may have a protective effect on testicular I/R injury.