Viburnum opulus: could it be a new alternative, such as lemon juice, to pharmacological therapy in hypocitraturic stone patients?

OBJECTIVE: Citrate, potassium, and calcium levels in Viburnum opulus (V. opulus) and lemon juice were compared to evaluate the usability of V. opulus in mild to moderate level hypocitraturic stone disease. MATERIALS AND METHODS: V. opulus and lemon fruits were squeezed in a blender and 10 samples of each of 100 ml were prepared. Citrate, calcium, sodium, potassium, magnesium, and pH levels in these samples were examined. RESULTS: Potassium was found to be statistically significantly higher in V. opulus than that in lemon juice (p = 0.006) whereas sodium (p = 0.004) and calcium (p = 0.008) were found to be lower. There was no difference between them in terms of the amount of magnesium and citrate. CONCUSIONS: Because V. opulus contains citrate as high as lemon juice does and it is a potassium-rich and calciumand sodium-poor fluid, it can be an alternative to pharmaceutical treatment in mild-to-moderate degree hypocitraturic stone patients. These findings should be supported with clinical studies.

Effect of SWL on renal hemodynamics: could a change in renal artery contraction-relaxation responses be the cause?

The aim of this study was to reveal the effect of shock wave lithotripsy (SWL) on renal artery contraction-relaxation responses and the relation of this effect with renal hemodynamics. Twenty-four rabbits are divided into six different groups. The first two groups evaluated as the control groups. After isolating the kidneys, we applied phenylephrine (Ph) and acetylcholine (Ach) in the first group and sodium nitroprusside (SNP) and histamine (H) in the second group. In the third, fourth, fifth and sixth groups, 14.5 kV shock wave (SW) was focused on the left kidneys. We adjusted the number of shocks to a total of 500, 1,500, and 3,000 SW, in the third, fourth and fifth groups, respectively. After isolating the kidneys, Ph, Ach was given in groups 3, 4 and 5. In the sixth group, to get the SNP and the H responses, 3,000 shocks modality was utilized. Marked contractile responses were obtained by phenylephrine in the control group. In kidneys that were exposed to 500 shocks SWL procedures, a decrease in contractile responses and hence, in perfusion pressures in different concentrations of phenylephrine was noted. However, a notable change in relaxation responses occurred after 3,000-shock applications. No difference in relaxation responses to nitroprusside, a direct vasodilating agent, was observed in any group, compared to the control group. Another cause of deterioration of renal hemodynamics after SWL can be attributed to the reduction in renal artery contraction-relaxation responses that result in the vascular smooth muscle and endothelial damage.

Quantitative analysis of colonization with real-time PCR to identify the role of Oxalobacter formigenes in calcium oxalate urolithiasis.

The objective of the study was to quantitatively measure the number of Oxalobacter formigenes (O. formigenes) colonizations in the gastrointestinal tract in calcium oxalate-forming patients with real-time polymerase chain reaction (PCR). Calcium oxalate-forming patients (n: 27) were included in the study. Serum calcium, sodium, potassium, urea and creatinine levels, as well as 24 h urine levels of calcium and oxalate were measured. The numbers of O. formigenes colonies in stool samples were detected by real-time PCR. One or two metabolic abnormalities were detected in 15 of 27 patients. The O. formigenes levels in patients with metabolic disturbance were significantly decreased when compared to the patients with no metabolic abnormalities (p: 0.038). The undetectable levels of O. formigenes were encountered in one of five patients with hypercalciuria, in three of four patients with hyperoxaluria and in four of six patients with both hypercalciuria and hyperoxaluria. In nine patients with a history of stone recurrence, O. formigenes colonization was significantly lower than the patients with the first stone attack (p: 0.001). O. formigenes formation ceased or significantly diminished in patients with calcium oxalate stones with a coexistence of both hyperoxaluria and hypercalciuria. The measurement of O. formigenes colonies by real-time PCR seemed to be an inconvenient and expensive method. For this reason, the real-time PCR measurements can be spared for the patients with stone recurrences and with metabolic abnormalities like hypercalciuria and hyperoxaluria. The exact measurement of O. formigenes may also help more accurate programming of O. formigenes-based treatments.

Evaluation of pheniramine maleate and zofenopril in reducing renal damage induced by unilateral ureter obstruction. An experimental study.

INTRODUCTION: Obstruction of the ureter may occur due to congenital, iatrogenic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. MATERIAL AND METHODS: Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. RESULTS: An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). CONCLUSIONS: In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.

Citrate, oxalate, sodium, and magnesium levels in fresh juices of three different types of tomatoes: evaluation in the light of the results of studies on orange and lemon juices.

Fruit and vegetable juices containing citrate may be recommended as an alternative in mild to moderate level hypocitraturic calcium stone formers who cannot tolerate pharmacological treatment. Tomato has been proved a citrate-rich vegetable. Tomato juice usage as citrate sources in hypocitraturic recurrent stone formers were evaluated in the light of the results of studies on orange and lemon juices. Ten 100 ml samples were prepared from three different tomato types processed through a blender. These samples were examined in terms of citrate, oxalate, calcium, magnesium, and sodium contents. No difference was detected between the parameters tested in three different tomato juices. Fresh tomato juice may be useful in hypocitraturic recurrent stone formers due to its high content of citrate and magnesium, and low content of sodium and oxalate. As the three different types of tomatoes did not differ in terms of citrate, magnesium, sodium, and oxalate content, they may be useful for clinical use if also supported by clinical studies.

The effect of coenzyme Q and selenium on kidney in rats with partial unilateral ureteral obstruction.

OBJECTIVE: In this study, we aimed to investigate the antioxidant effects of selenium and coenzyme Q on renal damage in a partial unilateral ureteral obstruction (PUUO) in a rat model. MATERIAL AND METHODS: A total of 24 Sprague-Dawley rats were divided into four groups as Group 1 Control Group, Group 2, PUUO Group, Group 3 PUUO + coenzyme Q group, Group 4 PUUO + selenium group. Paraoxonase (PON), total antioxidant capacity (TAC), and total oxidant levels (TOS) were analyzed biochemically from tissue and blood samples. Tissue samples were examined histopathologically. RESULTS: The TAC in the tissues was found to be statistically significantly increased in Groups 3 and 4, compared to Group 2. Tissue TOS was found to be significantly reduced in Groups 3 and 4, compared to Group 2. Serum PON levels were significantly increased in Group 3 and 4, compared to Group 1 and 2. Histopathological examination showed that interstitial inflammation and congestion were lesser in the coenzyme Q and selenium groups than in the PUUO group. A more significant decrease was found in the selenium group than in the coenzyme Q group. CONCLUSION: Our study results showed that coenzyme Q and selenium reduced the oxidation and the damage in tissue in PUUO in rats.

Local anesthesia with 20-mL prilocaine infiltration: the ultimate point for analgesia during shockwave lithotripsy?

PURPOSE: The effectiveness of 10 mL and 20 mL local prilocaine infiltration for analgesic purposes during shockwave lithotripsy (SWL) was compared, and the differences in pain intensity and need for additional analgesics were defined. PATIENTS AND METHODS: One hundred and twenty-one patients between the ages of 16 and 69 with kidney stones were randomly separated into two groups. The 60 patients in group 1 received 10 mL prilocaine subcutaneously and deep lumbar infiltration into the area 1 cm below the twelfth rib 2 minutes before SWL. The 61 patients in group 2 received 20 mL subcutaneously and deep lumbar infiltration of prilocaine to the same locale, again 2 minutes before the process. All the patients received one session of SWL. For measurement of pain intensity, the 0 to 100 mm visual analog scale (VAS) was used at 1 minute and every 10 minutes during the process. Intravenous fentanyl was administered to patients who had steady or increasing intensity of pain during the process. RESULTS: VAS values were statistically significantly higher in patients in group 1 compared with patients in group 2 during the process. While 40 patients received additional analgesia in group 1, only three patients in group 2 needed additional analgesia. CONCLUSION: Use of 20 mL subcutaneous and deep lumbar prilocaine infiltration during SWL for analgesic purposes is recommended as an efficient, cost-effective, anesthetist-independent, and reliable method.

Significance of p57(Kip2) down-regulation in oncogenesis of bladder carcinoma: an immunohistochemical study.

AIMS AND BACKGROUND: Cyclin-dependent kinase inhibitors have important roles in the oncogenesis of various tumors including urothelial cancer. The aim of this study was to establish the importance of p57(Kip2), a unique cyclin-dependent kinase inhibitor, in the oncogenesis of bladder carcinoma. This article also focused on another cyclin-dependent kinase inhibitor, p27(Kip1), and telomerase enzyme and examined the relationship between these proteins. MATERIAL AND METHODS: Thirty-one patients with urothelial carcinomas of the bladder and 7 cases with normal urinary bladder mucosa were included in the study. Immunohistochemical study was performed by monoclonal antibodies of p27(Kip1), p57(Kip2), and the telomerase subunit (hTERT). All immunohistochemical preparations were evaluated by an immunohistochemical histological score. RESULTS: p57(Kip2) and p27Kip1) expression were seen in all of the cases of normal mucosa. In carcinoma cases, 8 of 31 (25.8%) showed p57(Kip2) nuclear positivity and 20 of 31 (64.5%) expressed nuclear p27(Kip1). HSCOREs of carcinoma cases showed lower scores of nuclear p57(Kip2) and p27(Kip1) than normal mucosa, but only HSCOREs of nuclear p57(Kip2) (P = 0.001) showed statistical significance. Despite unknown significance, cytoplasmic p57(Kip2) and p27(Kip1) were also evaluated. Immunohistochemical analysis showed that carcinomas expressed higher HSCOREs of hTERT than normal mucosa, and there was a significant difference (P = 0.026) between muscle invasive carcinomas and normal mucosa. CONCLUSIONS: The data showed that p57(Kip2) down-regulation along with p27(Kip1) is a well-established feature of urothelial carcinoma. Probably, this down-regulation of cyclin-dependent kinase inhibitors supports the proliferation phase of oncogenesis. In the study, we also showed that hTERT expression was up-regulated in higher stages of urothelial carcinoma.

Investigation of the antioxidant effects of pheniramine maleate and nebivolol on testicular damage in rats with experimentally induced testis torsion.

PURPOSE: To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol. METHODS: Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples. RESULTS: The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant. CONCLUSIONS: Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.

Use of the NMDA antagonist magnesium sulfate during monitored anesthesia care for shockwave lithotripsy.

PURPOSE: To assess whether intravenous magnesium sulfate infusion affects analgesic requirements during monitored anesthesia care (MAC) for shockwave lithotripsy (SWL). PATIENTS AND METHODS: Fifty patients in ASA class I or II undergoing SWL with MAC were randomized into two groups. Induction of MAC was produced by bolus doses of midazolam 0.03 mg/kg(-1) and fentanyl 0.5 microg/kg(-1) followed by intravenous infusion of midazolam 0.015 to 0.06 mg/kg(-1)/hr(-1) with fentanyl supplementation 0.2 microg/kg(-1). In addition, group I patients received magnesium sulfate 30 mg/kg(-1) intravenously as a bolus dose followed by a continuous infusion of 10 mg/kg(-1) /hr(-1) beginning 15 minutes before induction of sedation. The midazolam infusion rate and additional fentanyl doses were adjusted by verbal analog scale (VAS) measurements, observer assessment sedation score (OAA/S), and achieving a target bispectral index (BIS) in a range of 70 to 90. At the end of SWL, the total midazolam and total fentanyl consumptions were recorded, and the serum magnesium concentration was measured. RESULTS: Magnesium caused significant decreases in the total consumption of midazolam (P = 0.001) and fentanyl (P = 0.001). The VAS values at the 15th, 20th, and 25th minute in group I were significantly lower than in group II. In group I, hemodynamic and arterial oxygen parameters were better than in group II. CONCLUSION: A magnesium bolus and infusion can be utilized to reduce analgesic requirements under MAC during SWL.

Effects of vardenafil on intraocular pressure and orbital hemodynamics.

PURPOSE: The aim of this study was to investigate the effects of vardenafil on systemic blood pressure, intraocular pressure (IOP), and orbital hemodynamics. METHODS: Twenty-one (21) volunteers suffering erectile dysfunction, with an average age of 51.5 +/- 6.2 years, were enrolled into the study. Brachial blood pressures and IOP were measured, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were evaluated by color Doppler ultrasonography (CDU) before vardenafil intake. All measurements were repeated after 20 min of vardenafil intake. A paired Student t test was used to evaluate the changes. RESULTS: Systolic blood pressure did not change significantly where diastolic blood pressure decreased significantly (P = 0.043) after drug ingestion. There was no significant change in IOP. Increase in EDV of CRA was significant (P = 0.04), but the increase of orbital blood flow velocities of OA and PCA were insignificant. CONCLUSIONS: The recommended dose of vardenafil has no negative effects on orbital hemodynamics and IOP in patients with erectile dysfunction.

Endogenous sex steroids and bone mineral density in healthy men.

OBJECTIVE: To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. METHODS: Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. RESULTS: The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. CONCLUSION: Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD.

Window technique on circumcision.

OBJECTIVE: To remove the preputium by using a simple, quick and safe method without damaging glans, frenulum and urethra as well as with a good cosmetic result. PATIENTS AND METHODS: The procedure, remind the guillotine technique at first, but completely different from it. Basically, a long haemostat is applied onto preputium and skin and subdermal tissue were incised; a small window is opened at dorsal of preputial mucosa and it is excised, while observing glans and frenulum. RESULTS: The circumcisions were performed in a quick, safe and pretty bloodless way. There was no case with glans amputation, frenulum short cut or urethral damage, even if a clamp includes the foreskin with a part of glans or excess frenulum unnoticedly. CONCLUSION: This technique is simple, quick, relatively bloodless operation with cosmetically good result. Morever it is quite safe against to amputation of glans, frenular short cut or urethral fistula formation.

Magnetic resonance imaging (MRI) in penile metastases of extragenitourinary cancers.

BACKGROUND: The aim of present study is to evaluate the efficacy of magnetic resonance imaging (MRI) in different types of penile metastases. MATERIALS AND METHODS: In this report, we present three cases of penile metastases that have been developed secondary to extragenitourinary malignancies. Two of them did not have any primary malignancy history. RESULTS: Penile biopsies were performed in all patients and metastatic penile tumours were found due to extragenitourinary malignancies. Penile MRI was performed before biopsies. The findings of MRI were correlated with histopathologic diagnosis. Moreover, penile MRI was found to be more sensitive in the evaluation of the lesions than ultrasonography. CONCLUSION: MRI can be accepted as a reliable non-invasive method for the evaluation of the extent of penile metastases and involvement of tunica albuginea or urethral.

Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy.

BACKGROUND AND PURPOSE: To investigate the effect and usefulness of Eutectic Mixture of Local Anesthetic (EMLA) applied with an occlusive dressing and used simultaneously with a low dose of fentanyl during shockwave lithotripsy (SWL). PATIENTS AND METHODS: One hundred sixty patients with kidney stones, aged between 19 and 68 years, were randomly divided into seven groups that were treated as follows: group 1: fentanyl 1 microg/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 microg/kg; group 3: occlusive dressing and IV fentanyl 0.25 microg/kg; group 4: placebo cream and IV fentanyl 0.25 microg/kg; group 5: EMLA cream and IV fentanyl 0.25 microg/kg; group 6: placebo cream and IV fentanyl 0.25 microg/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 microg/kg with an occlusive dressing. The mean arterial pressure (MAP), heart rate, ventilatory rate, and oxygen saturation (SpO(2)) were recorded on all patients. A visual analog scale 0-100 mm (VAS) was used for the evaluation of pain. The skin integrity was inspected to detect any lesions after SWL. RESULTS: The SpO(2) in group 1 was lower statistically than in the other groups. The VAS score in group 7 was clearly lower than in the others in the first, tenth, and twentieth minutes and at the end of SWL. In groups 6 and 7, additional fentanyl doses were lower than in the other groups, but only in group 7 was the total fentanyl dosage low. Skin lesions were not seen only in groups 3, 6, and 7. CONCLUSION: Use of EMLA and an occlusive dressing with low doses of fentanyl during SWL provides appropriate analgesia with minimal morbidity.

BAG-1 expression in hyperplastic and neoplastic prostate tissue: is there any relationship with BCL-related proteins and androgen receptor status?

AIMS AND BACKGROUND: To evaluate the function and distribution of BAG-1 protein in hyperplastic and neoplastic prostate tissue and establish the relationship between this protein and BCL-related proteins (BCL-2 and BAX), androgen receptor (AR) expression and chromogranin A. METHODS: Twenty-eight prostatic adenocarcinomas and 16 prostate hyperplasias were included in this retrospective study. BAG-1, BCL-2, BAX, androgen receptor and chromogranin A immunostaining was performed by means of standard avidin-biotin peroxidase methods. The M30 antibody was used to identify preapoptotic and apoptotic cells. The immunohistochemical histological score (HSCORE) semiquantative system was used to evaluate immunohistochemical staining. RESULTS: Statistical analysis showed a significant difference in HSCOREs of BAX, M30 and AR between the carcinoma and hyperplasia groups. Carcinomas expressed higher HSCOREs of these markers than hyperplasias. There were significant differences in nuclear and cytoplasmic BAG-1 positivity between high and low-grade carcinomas. BAG-1 expression was higher in low-grade carcinomas. In the carcinoma group there was a positive correlation (Pearson) between BCL-2 and cytoplasmic/nuclear BAG-1. In the hyperplasia group there was a negative correlation between BAX and BCL-2, and between AR and M30. We also detected a positive correlation between AR and nuclear/cytoplasmic BAG-1 and between nuclear and cytoplasmic BAG-1 in hyperplasias. BAG-1 showed the same specific basal cell localization as BCL-2 in hyperplastic and normal glands. CONCLUSIONS: The BAG-1 protein showed a distinct distribution pattern in hyperplastic and neoplastic prostate. BAG-1 in association with BCL-2 inhibits apoptosis and may prolong the life of neoplastic cells and give them a chance to gain new oncogenic features in early carcinogenesis.

Terazosin in the treatment of premature ejaculation: a short-term follow-up.

AIM: The aim of the present study was to evaluate the efficacy of terazosine in patients with premature ejaculation and lower urinary tract symptoms (LUTS), after excluding other sexual disorders and chronic prostatitis. METHODS: A total of 90 patients with premature ejaculation and LUTS were enrolled to the study after excluding sexual disorders, prostatitis and benign prostatic hyperplasia. The patients were divided into two groups. Sixty patients in group 1 were treated with terazosine 5 mg daily for a month. Patients were followed monthly and questioned for their ejaculation problem. The results were classified as cure, improvement and ineffective. If patients showed improvement and ineffectiveness, the treatment was continued with 10 mg daily for the following month. Group 2 was included 30 patients, and placebo was applied for a month. At the end of this period, in patients who did not show any improvement, terazosine 10 mg was started. RESULTS: In the treatment group, at the 1st month follow-up, 21 patients (35%) were cured, 20 (33.3%) showed improvement. In 19 (31.7%) patients, the treatment was ineffective. In group 2, 9 (30%) patients showed improvement and the rest had no-changes after one-month follow up. There was statistically significant difference between two groups (Pearson chi2 test = 0.000). Later, terazosine 10 mg was given to the patients in group 2 and to the patients who showed improvement or unsuccessful result with terazosine 5 mg. With terazosine 10 mg, 10 (14.5%) patients were cured, 29 (42.2%) patients were improved. Finally, terazosine treatment in patients with premature ejaculation was found to be effective in 60 patients (66.7%). CONCLUSION: Alpha blockers seem to be physiological medical agents in the treatment of premature ejaculation since ejaculation is under sympathetic control. Moreover, these agents are effective in lower urinary tract and they should be used in patients with premature ejaculation and lower urinary tract symptoms.

Medical and alternative therapies in urinary tract stone disease.

Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their efficiency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guidelines are useful in promoting public health and developing nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient's nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing lithogenic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.

Multiple urethral anomalies: Parameatal urethral cyst, penile curvature, incomplete hypospadiac anterior duplication of the urethra and distal hipospadias.

The male genitourinary system is quite complex. There are numerous known anomalies of the male urethra either as isolated cases or in combination with other disorders. An improved understanding of the embryology and anatomy of the normal male urethral development might help explain the causes of the various urethral abnormalities. We contribute to the etiology of congenital anomalies with this multiple urethral anomalies case.

The antioxidant effect of dexmedetomidine on testicular ischemia-reperfusion injury.

PURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 µg/kg Dex (group 3) and 100 µg/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 µg/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 µg/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides.