Histopathological and biochemical comparisons of the protective effects of amifostine and l-carnitine against radiation-induced acute testicular toxicity in rats.

The aim of this study was to compare the radioprotective efficacies of amifostine (AMI) and l-carnitine (LC) against radiation-induced acute testicular damage. Thirty Wistar albino rats were randomly assigned to four groups: control (n = 6), AMI plus radiotherapy (RT) (n = 8), LC plus RT (n = 8) and RT group (n = 8). The rats were irradiated with a single dose of 20 Gy to the scrotal field. LC (300 mg/kg) and AMI (200 mg/kg) were given intraperitoneally 30 min before irradiation. The mean seminiferous tubule diameters (MSTDs) were calculated. Testicular damage was evaluated histopathologically using Johnsen's mean testicular biopsy score criteria. Malondialdehyde (MDA) and glutathione levels were measured in tissue samples. AMI plus RT and LC plus RT groups had significantly higher MSTDs than those in the RT group (p = .003 and p = .032 respectively). MDA values of both AMI plus RT and LC plus RT groups were significantly lower than those in RT group (p < .004 and p < .012 respectively). As a result, AMI and LC have a similar radioprotective effect against radiation-induced acute testicular damage, histopathologically and biochemically.

The importance of anatomical region of local anesthesia for prostate biopsy; a randomized clinical trial.

INTRODUCTION: In our study, the efficiency and reliability of lidocaine (1 cc/1%) application during transrectal ultrasound-guided (TRUS) prostate biopsy to levatores prostate was studied. Levatores prostate was visualized on a cadaver dissection previously. PATIENTS AND METHODS: Eighty outpatients with lower urinary tract complaints or were suspected clinically to have prostate cancer were submitted to TRUS-guided prostate biopsy. The ages of outpatients were ranging from 45 to 81. Patients were randomized in 2 groups: Group-I, with 40 patients submitted to local anesthesia by periprostatic injection of 1 cc 1% lidocaine before biopsy; and group-II, with 40 controls the biopsy was performed without local anesthesia. The anatomical region for anesthesia was determined via dissection. The name of this anatomical region is levatores prostatae and it has got high nerve density. The process was explained to the patients and their approvals were obtained. Levatores prostatae was detected with TRUS before biopsy. Pain; related to digital rectal examination (DRE), probe insertion or biopsy, was scored via visual analog scale (VAS). The patients were evaluated about side effects of lidocaine and early and late complications of biopsy as well. RESULTS: Both groups were similar in terms of mean age, PSA levels, prostate volume and VAS scores (p > 0.05). As for VAS score, on the group submitted to anesthesia was determined 2.34 ± 1.08, while for VAS score on the group submitted conventional biopsy was determined 5.8 ± 1.6. Between two groups, there was a statistical difference in terms of VSA score (p < 0.05); but there was no statistical difference about early and late complications of biopsy. CONCLUSIONS: The periprostatic blockage use is clearly associated with more tolerance and patient comfort during TRUS-guided biopsy. Owing to the local anesthesia introduced to the periprostatic nerve bundle localization in levatores prostate area, the patients could tolerate the pain better.

Dorsal vein rupture after practice of taqaandan, necrotising cavernositis, penile reconstruction, urethroplasty and penile prosthesis implantation.

Penile fracture is an uncommon and emergent urologic condition defined as traumatic rupture of the corpus cavernosum secondary to a blunt trauma of the erect penis. Tunica albuginea is thinned and stretched in the erect state, and a transverse tear in the corpus cavernosums may occur by a buckling force. However, penile dorsal vein tears may mimic penile fracture. Also, corporeal infection and purulent cavernositis are associated with trauma, cavernosography, priapism, intracavernosal injection therapy and penile prosthesis.

Priapism in the newborn: management and review of literature.

Priapism is a pathological condition of a penile erection that persists beyond or is unrelated to sexual stimulation. Priapism is broadly classified into two types: (i) ischaemic priapism (veno-occlusive) (low-flow), (ii) nonischaemic priapism (arterial) (high-flow). We report the case of a newborn presenting with priapism on the first day of life and also review published data on the management and follow-up of this condition.

Protective effects of quercetin on testicular torsion/detorsion-induced ischaemia-reperfusion injury in rats.

The aim of this study was to investigate the protective effect of quercetin (QE) on testicular torsion/detorsion-induced ischaemia-reperfusion (I/R) injury. A total of 24 male Wistar albino rats were divided into three groups: control, I/R and I/R treated with QE; each group contain eight animals. Testicular torsion was created by rotating the left testis 720° in a clockwise direction. The ischaemia period was 5 h and orchiectomy was performed after 5 h of detorsion. QE (15 mg kg(-1) , i.p.) was administered only once, 40 min prior to detorsion. Left orchiectomy was performed in all I/R groups. To date, no histopathological changes on testicular torsion/detorsion-induced I/R injury in rats by QE treatment have been reported. Spermatogenesis and mean seminiferous tubule diameter were significantly decreased in I/R groups were compared with the control group. Furthermore, QE treated animals showed an improved histological appearance in I/R group. Our data indicate a significant reduction in the activity of TUNEL, endothelial nitric oxide synthase and a rise in the expression of testosterone in testes tissue of I/R treated with QE therapy. We believe that further preclinical research into the utility of QE may indicate its usefulness as a potential treatment on testes injury after I/R in rats.

'Multimodal' approach to management of prostate biopsy pain and effects on sexual function: efficacy of levobupivacaine adjuvant to diclofenac sodium - a prospective randomized trial.

We assessed the analgesic efficacy of levobupivacaine when administered as an adjuvant to diclofenac sodium in prostate biopsy pain management and effects of prostate biopsy on sexual function. Ninety patients underwent transrectal ultrasound (TRUS)-guided biopsy of the prostate and were randomly assigned to three groups: group D received diclofenac sodium suppository; Group L received periprostatic injection of levobupivacaine; group DL received diclofenac suppository and levobupivacaine in addition. Patients were asked to use a visual analogue scale score (VAS) questionnaire about pain after 10 core prostate biopsy. Sixty-two patients reported to be prostate cancer-free underwent further evaluation with the International Index of Erectile Function-5 (IIEF-5) questionnaire at 1 and 3 months after biopsy. Mean pain scores during prostate biopsy were significantly lower in group DL and were superior to the group L and group D (P < 0.001). Mean IIEF-5 score prior to biopsies was significantly higher when compared with the mean IIEF-5 score 1 month after biopsy (P < 0.0001). Mean IIEF-5 scores 1 month after biopsy were significantly lower when compared with the mean IIEF-5 scores 3 months after biopsy (P = 0.002). TRUS-guided prostate biopsies have a statistically significant impact on short-term erectile function, but this difference is not clinically significant; however, medium-term erectile function is not affected both statistically and clinically.

A case of calcified ureteritis cystica: an indiscernible condition from ureterolithiasis.

Ureteritis cystica is characterized by formation of multiple cysts in the wall of the renal pelvis or ureter. The clinical course is usually slow, but manifests if the cysts cause infection or obstruction. Stones are further complication to the disease. In this case study, we present a 39-year-old male originally referred with renal colic and misdiagnosed as ureterolithiasis due to the calcifiying cysts.

Penile and scrotal involvement in Buerger's disease.

Buerger's disease (thromboangiitis obliterans) is a recurrent inflammatory, nonatherosclerotic vasoocclusive disease, which typically affects small and medium-sized arteries, veins and nerves of the upper and lower extremities. Although the exact underlying causes of Buerger's disease are still unknown, the disease is strongly associated with tobacco smoking. Affected patients are mostly young male smokers who develop ulcers and gangrene of the toes and fingers as a result of vascular ischaemia. We report a 47-year-old man with scrotal and penile necrosis. Partial penectomy, scrotal debridement and urethra-cutaneous anastomosis were performed.

Radioiodine-induced kidney damage and protective effect of amifostine: An experimental study.

BACKGROUND: Ablative radioiodine-131 ((131)I) therapy is used in the standart treatment procedure of thyroid carcinoma and procedures using (131)I represent the majority of Nuclear Medicine therapeutic procedures. The principal route of (131)I excretion after the administration of (131)I is the urine. Amifostine is an organic thiophosphate ester prodrug and the kidney concentrations of the active metabolite WR-1065 are about 100 times higher than tumour concentrations. To our knowledge, there is no published data in literature presenting acute effect of radioiodine on renal tissue during high dose I-131 radioiodine treatment (RIT). Additionally, it is not known whether amifostine takes role in this process. MATERIALS AND METHODS: In this study, 50 healthy female Wistar albino rats, weighing 200-250 g and averaging 16 weeks old were utilised. The rats were randomly divided into ten groups. 1- Sham group (n=5), 2- Amifostine group (n=5): rats pretreated with 1 cc amifostine (200 mg/kg) by intraperitoneal injection, 3- Radioactive iodine first day group (RI-1) (n=5): rats treated with 1 cc oral 185 MBq radioactive iodine-131 and sacrification performed after 1(st) day, 4- Amifostine + Radioactive iodine first day group (A+RI-1) (n=5): rats pretreated with amifostine (200 mg/kg) by intraperitoneal injection and rats treated with 5mCi radioactive iodine-131 and sacrification performed after 1(st) day. 5- Radioactive iodine third day group (RI-3) (n=5), 6- Amifostine + Radioactive iodine third day group (A+RI-3) (n=5), 7- Radioactive iodine fifth day group (RI-5) (n=5), 8- Amifostine + Radioactive iodine fifth day group (A+RI-5) (n=5), 9- Radioactive iodine seventh day group (RI-7) (n=5) and 10- Amifostine + Radioactive iodine seventh day group (A+RI-7) (n=5). The renal cast formation and tubular damage are evaluated by a pathologist in a blinded manner. RESULTS: Ablative radioiodine-131 therapy induced renal tubular damage was significantly higher in the radioactive iodine fifth day group (RI-5) when compared with the Sham group (p=0.01) and Amifostine group (p=0.01). CONCLUSIONS: A marked ablative radioiodine-131 induced renal toxicity was seen at fifth day of the therapy after a single RIT application and the main histopathological change was tubular damage. Amifostine have protective effects against ablative radioiodine-131 therapy and this effect is significant at fifth day of the therapy.