Histopathological Changes that Occur on the Testicular and Penile Tissues Depending on the Treatment of Human Chorionic Gonadotropin: Rat Model

ABSTRACT Objective: To examine the histopathological effects of human chorionic gonadotropin (hCG) treatment on the penile and the testicular tissue in rat model. Methods: The rats of the hCG group (n = 8) were given daily subcutaneous injections of 50 IU of hCG for 15 days (Pregnyl, Organon). Rats of the control group (n = 8) received subcutaneous isotonic saline. All rats were sacrificed at the 1st month after hCG administration. After the received tissue samples were examined, germinal epithelial cell thickness, seminiferous tubule diameter, internal diameter of the tubules, the number of germ cell layers in the testicular tissue, and the diameters of penis, cavernous sinus lumen diameters and collagen tissue amount in the cavernous sinus surrounding were assessed in the sections prepared from the penis. Results: It was detected that there was a decrease in the testis weight, atrophy in the tubules, reduction in spermatogenesis, decrease in the mature spermatocytes, lower mean thickness and the number of cell layers of the germinal membrane in testicular tissue in the hCG group. It was found that the amount of collagen in the penile tissue was significantly higher in the hCG group and the diameters of cavernosal sinus lumens, and diameter of the penis were significantly lower in the hCG group. Conclusion: Human chorionic gonadotropin led to the deterioration in testicular histology and the histological changes in the penile tissue. The degradation in the testicular tissue and these changes formed in the penile tissue may affect the erectile tissue function.

Effect of premature ejaculation on depression and sexual functions in female partners: A report from Eastern Turkey.

BACKGROUND: Premature ejaculation (PE) is a sexual dysfunction causing female sexual dissatisfaction that eventually leads to poor quality of life in both partners. AIMS: To show the presence of depression, anxiety, sexual function disorders and their prevalence in spouses of males with PE living in Eastern Turkey. MATERIALS AND METHODS: Ninety male patients suffering from PE who referred to the andrology clinic between January 2016 and March 2017 and diagnosed with PE (Acquired Premature ejaculation) according to the DSM-IV criteria and their partners were included in the study. Male patients answered the PE Profile, Arabic Index of PE, PE Diagnostic Tool, and Arizona Sexual Experiences Scale (ASEX) Questionnaires. Spouses of male patients with PE answered the Arizona Sexual Experiences Scale, Beck Depression Inventory, and Beck Anxiety Inventory Questionnaires. SPSS software version 21.0 was used for statistical analysis. RESULTS: Our study revealed a positive correlation between the PE profile and partners' depression levels (P = 0.03). Also, the average ASEX Scale score of the both genders suggest that patients and partners believe they did not have a severe sexual function disorder. CONCLUSIONS: PE can cause psychological problems in both males and females. However, reflection of this pathology can vary from one society to another.

Laparoscopic transperitoneal nephrectomy in non-functioning inflammatory kidneys with or without renal stone.

OBJECTIVE: To compare our laparoscopic simple nephrectomy results in non-functioning inflammatory kidneys with or without renal stones. PATIENTS AND METHODS: Patients, who underwent laparoscopic transperitoneal nephrectomy for non-functioning kidney between June, 2010 and October, 2014 were included to study. Overall, data of 32 patients including 15 patients with renal stone (Group 1) and 17 patients without renal stone (Group 2) were retrospectively reviewed. RESULTS: Mean age was 44.4 ± 18.5 years (10-71) in group 1 and 35.2 ± 21 years (9-77) in group 2. Mean operation time was 95.0±25.9 minutes (70-175) in group 1 and 86.7 ± 15.1 minutes (70-125) in group 2. Mean estimated blood loss was found to be 64.13 ± 26.67 ml (30-120) in group 1 and 58.94 ± 24.24 ml (30-100) in group 2. Both groups had inflammatory findings in pathological analysis. There was no significant difference between groups regarding estimated blood loss, operation time, pre-operative and post-operative hemoglobin values, percent hemoglobin decrease, complications and hospitalization times (p > 0.05). CONCLUSIONS: Non-functioning kidney with or without renal stone could be operated safely with comparable complication rates and success via laparoscopy in experienced hands.

Should ureteroscopy be considered as the first choice for proximal ureter stones of children?

OBJECTIVES: In this study, we aimed to analyze the ureter stones that had been treated using rigid ureteroscopy and pneumatic lithotripsy without mechanically dilating the ureteral orifice. PATIENTS AND METHODS: Records of 110 patients who had undergone rigid ureteroscopy and pneumatic lithotripsy due to ureteral stone between February 2005 and May 2011 were retrospectively analyzed. The location and size of the stone and additional anomalies in the urinary tract on the preoperative direct urinary system (DUS) X-Ray, urinary system ultrasonography (USG), intravenous pyelography (IVP) if performed, and computed tomography (CT), were found from the records of the patients. RESULTS: The mean age of the patients was 5.2 (range 1-17 years). 74 (67.2%) of the patients were males and 36 (32.8%) were females. A total of 115 rigid ureteroscopies were performed on 110 patients. 72 (65%) of the stones were located in the lower ureter, 21 (19%) were located in the middle part of the ureter, and 17 (15.4%) were located in the upper ureter. The mean stone size was determined as 7.5 mm (range 5-15). The mean stone size was determined as 7.4 mm in the lower ureter, as 8.3 mm in the middle ureter, and 8.4 mm in the upper ureter. No difference was found between the sizes of the stones in different locations (p = 0.121). The stone free rate was found as 92.2% for all ureteral stones. The total stone free rate according to the location of the stones was determined as 79.2% in the upper ureter, as 94.4% in the middle ureter and 93,8% in the lower ureter (p = 0.022). The total complication rate was 7.6%. Complication rates were 7.2%, 4.1% and 10.7% for the lower, middle and upper ureter, respectively (p = 0.411) (Table I). No difference was found in terms of complication rates according to location of the stone in the ureter. No major perioperative or postoperative complications developed. A double J stent was inserted in 36 (32%) patients for 2-3 weeks. CONCLUSIONS: We suggest that rigid ureteroscopy may be considered as the first choice for treatment of not only distal-middle ureter stones, but also for proximal ureter stones.

Modified Raz operation backed with periurethral roll mesh in female stress urinary incontinence.

OBJECTIVES: With the modifications that we made, the aim is to increase the effectiveness and the success rate of the Raz operation in the treatment of stress urinary incontinence (SUI) and to present a new approach in the treatment by reducing the complication rates. PATIENTS AND METHODS: Between November 2002 and December 2010, the Raz operation that we modified with the changes such as the placement of cystostomy catheter with the Lowsley clamp, vaginal incision of the bilateral oblique, the placement of periurethral roll mesh, the use of a single 0-degree stamey needle instead of a double needle applicator, binding the sutures mutually and on the support of the polypropylene mesh in suprapubic region was performed to 81 female patients with SUI in lithotomy position under the regional anesthesia. RESULTS: We performed the modified Raz operation to 81 female patients with SUI, who had the complaint of urinary incontinence with the effort lasting for about 4.5 years (between 1-16 years) and whose ages were 28-83 years (mean 55.2 years), childbirth numbers were 0-11 (mean 4.8), weights were 60-85 kg (mean 69.3 kg), and 32 of whom (39.5%) were of grade 1, 49 of whom (60.5%) were of grade 2 with the amnesia of SUI, and whose stress test was (+) in the physical examination. While the duration of the operation was 39.8 minutes (20-85 minutes) and the duration of the hospitalization was 2.9 days (2-4 days), the duration of the stay of the patients with the cystostomy catheter was determined to be 4.8 days (3-11 days). We found the rate of our success as 93.8% according to the objective criteria. CONCLUSIONS: With the modifications that we made, we increased the success rate of the Raz operation and reduced the rates of the complication. We believe that the place of our modification method in incontinence surgery becomes more clearly with the comparison of the other anti-incontinence surgery techniques in patient groups with the same characteristics.

The effectiveness of extracorporeal shock wave lithotripsy in the treatment of ureteral stones in children.

PURPOSE: In our study, we evaluated retrospectively the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral stones in children. MATERIALS AND METHODS: Between the dates of 2005-2010, 62 children who were applied ESWL due to the ureteral stone in our Clinic and consisted of 42 males and 20 girls whose mean age was 6.6+/=3.1 were evaluated. 31 (50%) of the patients were upper ureteral stone, 10 (16.1%) of them were middle ureteral stone and 21 (33.9%) of them were lower ureteral stone. The sizes of the stones were 4 to 17 mm, the average was 7.1 mm. ESWL was performed in the supine position for upper ureteral stones, in the supine/prone position for middle and lower ureteral stones. RESULTS: Stone-free rate was determined as 93.5% in three-month follow-up of the patients. Re-treatment was done at 14.5% of the patients. The implementation of ESWL was ended unsuccessfully at 4 children (6.5%). A significant difference was not detected between three-month stone-free rates in terms of the size of the stones and location. There was not any serious complication at any of the patients. CONCLUSIONS: According to these findings ESWL with its high stone-free rates and negligible complications is the first method to be refered in the treatment of ureteral stones in children.