The first reported values of microplastics in prostate.

BACKGROUND: Microplastics are ubiquitous, widespread environmental pollutants with unavoidable human exposure. Herein, it was aimed to investigate the presence of microplastics in prostate tissue. METHODS: Prostate tissues from 12 patients who underwent Trans Urethral Resection of the Prostate (TUR-P) were analyzed to investigate the presence of microplastics. Initially, the prostate tissues were analyzed for microplastic particles using a light microscope after extraction. Subsequently, the chemical composition of the particles found in the prostate tissues was characterized using Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) spectrophotometry. RESULTS: Microplastic particles of various types were detected in 6 out of 12 patients. All detected plastic particles in this study were microplastics, with sizes below 26 µm in size. These microplastics exhibited different shapes as pellets, spheres or fibers. Overall, among the 12 analyzed prostate tissue samples, four different types of plastic were identified in six samples. The most common type of microplastic detected was Polyamide (Nylon 6), found in samples from three patients. Other detected types, Polypropylene, Polyacrylic Acid and Poly (dimethylsiloxane) were each determined in samples from one patient. CONCLUSIONS: This is the first study to demonstrate the presence of microplastics in prostate tissue, serving as an exploratory investigation, which can trigger further research to validate the results in a larger patient cohort.

The role of multiparametric magnetic resonance imaging in the diagnosis of granulomatous prostatitis mimicking prostate cancer.

PURPOSE: Aimed to investigate the role of multiparametric magnetic resonance imaging (mp-MRI) in the diagnosis of granulomatous prostatitis caused by intravesical Bacillus Calmette-Guérin (BCG). METHODS: In this prospective, single-center study, 10 male patients who were given intravesical BCG due to intermediate- and high-risk bladder cancer were included. Before transurethral resection of bladder tumors (TURB), all patients were evaluated by mp-MRI, serum prostate-specific antigen (PSA), and digital rectal examination (DRE). Serum PSA levels and DRE findings were evaluated before and after intravesical BCG treatment. Prostate mp-MRI was performed for patients with elevated levels of serum PSA and/or with abnormal DRE findings. Then, MRI fusion + systematic prostate biopsy was performed. Demographic data of the patients before and after intravesical BCG were compared. RESULTS: The average age of the patients was 66.9 years (55-87 years). While PSA was 1.7 ng/ml before intravesical BCG treatment, it was 4.3 ng/ml after intravesical BCG treatment (p = 0.005). PSA density (PSAD) was 0.04 and 0.10 before and after the treatment, respectively (p = 0.012). DRE findings of all patients were normal before the treatment. However, abnormal findings were detected in 80% of them after the treatment (p = 0.008). PI-RADS ≥ 3 lesions were found to be significantly higher in all patients after intravesical BCG (p = 0.004). CONCLUSION: Granulomatous prostatitis is a rare complication of intravesical BCG. High PSA, abnormal DRE, and PI-RADS ≥ 3 lesions detected after intravesical BCG should suggest granulomatous prostatitis and unnecessary biopsies may be avoided.

Complementary Ureterorenoscopy after extracorporeal Shock Wave Lithotripsy in proximal ureteral stones: success and complications.

OBJECTIVE: The aim of this study was to demonstrate the effect of extracorporeal shock wave lithotripsy application on the success and complications of ureteroscopic lithotripsy in proximal ureter stones. METHODS: The data of 87 patients who did not respond to shock wave lithotripsy and underwent ureteroscopic lithotripsy were retrospectively analyzed and classified as group I, and 99 patients who received ureteroscopic lithotripsy as primary treatment were classified as group II. Demographic features, response to treatment, and preoperative and postoperative complications were compared between the two groups. RESULTS: There was no difference between the two groups in terms of gender, operation times, stone sizes, and ureteroscope diameters. (p>0.05). Infective complications such as postoperative fever, pyelonephritis, and urosepsis were similar in both groups (p=0.142, p=0.291, and p=0.948). Stone migration was observed in 10 (11.5%) and 6 (6.1%) patients in groups I and II, respectively (p=0.291). Impacted stone was seen in 47 (54%) patients in group I and in 15 (15.2%) patients in group II (p<0.0001). Mucosal laceration occurred in 11 (12.6%) and 3 (3%) patients in groups I and II, respectively (p=0.028). Ureteral perforation was detected in 3 (3.4%) patients in group I and 1 (1%) patient in group II, whereas ureteral avulsion was not observed in either group (p=0.524). CONCLUSIONS: It was concluded that the application of shock wave lithotripsy before ureteroscopic lithotripsy in proximal ureter stones did not affect the success. Although the results are similar in terms of postoperative infection, shock wave lithotripsy application has been found to increase the risk of stone impaction into the mucosa and ureteral laceration.

Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results.

PURPOSE We aimed to investigate the accuracy of Vesical Imaging - Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system. METHODS A prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist. RESULTS Using the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]). CONCLUSION The mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system.

Early ureteroscopic lithotripsy in acute renal colic caused by ureteral calculi.

PURPOSE: We aimed at comparing the success and complications of early semirigid ureteroscopy (URS) and elective URS in ureteral calculi with renal colic that do not respond to analgesics. METHODS: We retrospectively analyzed the data of 690 patients with obstructive ureteral stones who underwent URS with stone retrieval. 247 patients who underwent early URS within the first 12 h were classified as group I and 443 patients who underwent elective URS as group II. Both groups were compared in terms of age, sex, creatinine, eGFR, stone size, laterality, location and number of stones, type of lithotriptor, presence of hydronephrosis and success and complication rates. RESULTS: The mean age of the patients was 50.4 (18-89 years) (p > 0.05). There was no statistically significant difference between the groups in terms of age, eGFR, side, presence of hydronephrosis, fever, mucosal damage, stone migration, perforated ureter, ureteral avulsion, ureteral stent insertion at the end of the surgery and sepsis (p > 0.05). Both groups had male dominance (p > 0.05). Creatinine was significantly lower in Group I (p < 0.05). The mean stone size was also significantly lower in Group I (p < 0.05). Middle and proximal ureteral calculi were more common in Group II (p < 0.05). Multiple stones were higher in Group II (p < 0.05). The dominant type of lithotriptor used was pneumatic in Group I and laser in Group II (p < 0.05). Stone-free rates (SFRs) were higher in Group I (98% vs 90% in the first month) (p < 0.05). Postoperative hematuria and infection were more common in Group II (p < 0.05). CONCLUSIONS: In selected cases, early ureteroscopy is an effective and safe method for distal ureteral calculi smaller than 10 mm that are painful and resistant to analgesic treatment.

Comparison of the protective effect of dipyridamole and acetylsalicylic acid on long-term histologic damage in a rat model of testicular ischemia-reperfusion injury.

PURPOSE: Ischemia reperfusion injury arising from testicular torsion results in a loss of spermatogenesis and a significant increase in germ cell apoptosis. We investigated the effects of dipyridamole and acetylsalicylic acid (ASA), 2 well-known platelet inhibitors, on testicular ischemia reperfusion injury. METHODS: Thirty adult male Sprague-Dawley rats were randomly divided into 5 groups (n = 6 for each group): control, sham-operated, torsion/detorsion (T/D), T/D + dipyridamole, and T/D + ASA. Testicular ischemia was achieved by rotating the left testis 720° clockwise for 2 hours. Thirty minutes before torsion, 10 mg/kg dipyridamole was injected transperitoneally in the T/D + dipyridamole group, and 100 mg/kg ASA was injected transperitoneally in the T/D + ASA group. Sixty days after the initial surgical procedure, ipsilateral orchiectomies were performed for histopathologic examination to determine Johnsen's mean testicular biopsy score (MTBS), mean seminiferous tubular diameter (MSTD), and apoptotic index (AI) in all groups. RESULTS: Unilateral testicular torsion-detorsion led to a significant decrease in Johnsen's MTBS and MSTD values in the ipsilateral testis and a significant increase in AI values of the T/D group. There were no significant differences between the T/D + dipyridamole and control groups in terms of MSTD and MTBS values. Although an amount of improvement exits in T/D + ASA group, there were significant differences between the T/D + ASA and control group MSTD and MTBS values. There was no significant difference between the T/D + dipyridamole and control groups in terms of AI values (P > .05), but the differences between the T/D + ASA and control groups were significant despite a slight decline in AI values of the T/D + ASA group. CONCLUSIONS: Our findings show that the use of dipyridamole before testicular reperfusion has a potentially protective effect against long-term injury in testicular ischemia reperfusion injury.