Does isotretinoin affect spermatogenesis in the long term? A rat model.

OBJECTIVES: Spermatogenesis, in which cell regeneration continues, can be affected by environmental, chemical, psychological factors or various diseases. There is conflicting information in the literature about the effect of isotretinoin, which is widely used in acne treatment, on testes and spermatogenesis. Therefore, we planned a rat study to evaluate the long-term efficacy of oral isotretinoin on testicular tissues and spermatogenesis. MATERIALS AND METHODS: The Group 1 (n = 6) 7.5 mg/kg/day and the Group 2 (n = 6) received isotretinoin at a dose of 30 mg/kg/day dissolved in sunflower oil, the Sham Group (n = 6) received only sunflower oil by gavage, and the control group (n = 6) received standard feed and water for four weeks. After the 4th week, all animals were fed with standard feed and water and followed for the next four weeks. At the end of the 8th week, all animals were sacrificed under deep anesthesia. Seminiferous tubule diameters, epithelial thickness, apoptotic index, sperm number and motility recorded Results: Sperm count, motility, vitality, diameter of seminiferous tubule and germinal epithelium thickness were decreased and apoptotic index increased in the groups received isotretinoin. There was no significant difference between the groups in terms of testosterone levels. CONCLUSIONS: We consider that further comprehensive studies, including human clinical trials, should be conducted to examine the negative effects of isotretinoin on spermatogenesis in the long term especially when there is a need using isotretinoin in men for various reasons and to eliminate the contradictions in the literature in this regard.

Effect of Transurethral Thermotherapy on Storage Symptoms Associated with Lower Urinary System Complaints in Elderly.

BACKGROUND: Storage symptoms are pathology with increasing frequency and importance among elderly men. The efficacy and advantages of the new bipolar radiofrequency prostate thermotherapy method were investigated for storage symptoms in elderly. METHODS: The outcomes for 150 elderly patients with significant storage symptoms accompanying voiding symptoms were investigated. The patients' Qmax (maximum urinary flow rate), prostate volumes, OAB-V8 (overactivebladder-Validated 8) and quality of life scores were questioned before the procedure and 1st month and 6th month. RESULTS: OAB-V8 total score had mean value of 26.3, with values identified as 16.2 (p < 0.001) at the end of the 1st month and 13.9 (p = 0.001) at the end of the 6th month. There were significant reductions in daytime frequent urination, uncomfortable urgency and sudden feeling of urgency complaints (p < 0.001). Thirty-five patients had significant fall in urgency with incontinence (p = 0.016). CONCLUSIONS: The bipolar radiofrequency thermotherapy method provides significant improvement of storage symptoms in elderly men. It is thought that this method has advantages in terms of its effects on storage and voiding symptoms in the elderly.

Bipolar radiofrequency thermotherapy vs. transurethral resection of the prostate: Effect on nocturia as a result of benign prostatic obstruction.

INTRODUCTION: The purpose of this study was to investigate and compare the effects of radiofrequency thermotherapy (RF) thermotherapy and transurethral resection of the prostate (TURP) on nocturia and associated quality of life in patients diagnosed with benign prostatic obstruction (BPO) under medical treatment who have complaints of persistent nocturia. METHODS: The results of patients who underwent RF thermotherapy and TURP procedures between February 2019 and February 2022 were examined, and their three-month results were compared based on their uroflowmetry values, International Prostate Symptom Score (IPSS) values, nocturia frequency, and Nocturia Quality of Life Questionnaire scores. RESULTS: While the frequency of nocturia in the RF thermotherapy group that was 4.5±1.6 before the procedure decreased to 2.3±1.4 after the procedure (p=0.002), this value in the TURP group decreased from 5.1±2.42 to 3.9±2.1 (p=0.044). RF thermotherapy was found to be more effective than TURP (p<0.005). Significantly, more noticeable improvements were observed in most nocturia-related next-day complaints and nocturia-related concerns in the RF thermotherapy group than the TURP group. CONCLUSIONS: It was observed that RF thermotherapy had a more acceptable effect on obstructive complaints in comparison to TURP, and it could be more effective on nocturia and associated quality of life. RF ablation treatment may be offered as an appropriate option to treat nocturia complaints in suitable patients.

Can transurethral thermotherapy save elderly patients with benign prostatic obstruction and high ASA score?

INTRODUCTION: The Aim of this study was to investigate the efficacy of the new bipolar radiofrequency prostate thermotherapy method for those with high potential surgical risk and also for patients with a chronic catheter. MATERIAL AND METHODS: 103 patients attending our clinic due to BPO and related complaints with high ASA score had outcomes after the procedure recorded prospectively and investigated retrospectively. Qmax, prostate volume, IPSS score, quality of life score, and presence of catheters were recorded before the procedure and analyzed with the outcomes after the procedure. RESULTS: The ASA scores were calculated as 3.0 ± 1.0 (IQR). Before the procedure, Qmax values (mean (SD)) were 5.11 ± 5.37 ml/s, while in the 6th month after the procedure Qmax values were identified as 10.45 ± 3.8 ml/s (p < 0.001). Of 53 patients (55.2%) with chronic catheters who could not be operated, 30 (61.2%) no longer required urinary catheter. CONCLUSION: Bipolar RF thermotherapy appears to be an effective method for patients with BPO who cannot be operated. Due to the surgical risks of patients dependent on the catheter in spite of receiving medical treatment, it is a good alternative to remove catheter dependence. It may be one of the methods that should be remembered, especially in this patient group.