Is There Any Effect of Retrograde Intrarenal Stone Surgery on Renal Functions in Childhood?

Purpose In this study, we aimed to demonstrate whether retrograde intrarenal stone surgery (RIRS) performed due to renal stones during the childhood period has any detrimental impact on renal functions. Materials and methods We retrospectively analyzed 121 patients aged 2 to 16 years who underwent RIRS for renal stones between March 2018 and February 2023. Data were available for 41 patients. The estimated glomerular filtration rate (eGFR) was computed using the modification of diet in renal disease (MDRD) formula on the day preceding the surgery and the third month after the surgery. We employed the National Kidney Foundation's chronic kidney disease (CKD) classification to categorize the glomerular filtration rate (GFR) into five groups. Preoperative and postoperative eGFR values of pediatric patients were compared by analyzing changes in CKD groups. Results Of the patients included in the study, 21 (51.2%) were male, while 20 (48.8%) were female children. No significant difference was found between the preoperative median eGFR and the postoperative median eGFR values (p=0.958). In the 3rd month after surgery, it was observed that 5 (12.1%) patients showed an improvement in their CKD stage, while deterioration was noted in 1 (2.4%) patient. Although a negative correlation was observed between the median eGFR change and both the operation time and the stone volume in Pearson correlation analysis, it was determined that this change did not create a significant difference (p=0.213 and p=0.295, respectively). Conclusion Stone surgery conducted with RIRS appears to yield positive outcomes on kidney function in the pediatric population. Nevertheless, being particularly attentive to patients with prolonged operation times and larger stone volumes is essential.

An Experimental Rat Model Study: Is There Any Effect of Syringic Acid on Ischemia-Reperfusion Injury in Priapism?

Purpose The purpose of this research is to examine the impact of syringic acid on ischemia-reperfusion injury in cavernosal tissue, utilizing a rat model of induced priapism. Materials and methods A total of 24 rats were allocated into three groups. Group 1 was designated as the control group, while Group 2 underwent ischemia-reperfusion injury assessment using the priapism model. Group 3 underwent the same procedures as Group 2, with the addition of intraperitoneal administration of syringic acid (100 mg/kg) 60 min after priapism initiation. All rats underwent penectomy, and sufficient blood samples were collected. Histopathological assessment of penile cavernosal tissue involved grading tissue damage, inflammation, vasocongestion, desquamation, and edema on a scale of 0-3 (0: normal, 1: mild, 2: moderate, 3: severe). Result Significant differences were observed among the three groups in terms of IL-1 beta and TNF-alpha levels (p=0.001 and p<0.001, respectively). IL-1 beta and TNF-alpha levels in Group 2 were found to be significantly higher than Group 3 (p=0.003 and p=0.004). There was also a significant difference among the three groups in terms of median MDA levels (p<0.001). Furthermore, the median MDA level in Group 2 was found to be significantly higher than that in Group 3 (p<0.001). While significant differences were observed among the three groups in terms of median SOD and GSH-px levels, no significant difference was found among the groups in terms of median PC levels (p=0.004, p= 0.048, and p=0.159, respectively). In direct microscopic examination, a significant improvement in pathological scores was noted in Group 3 compared to Group 2 (p<0.001). Conclusion Syringic acid demonstrated protective properties against ischemia-reperfusion injury caused by priapism in cavernosal tissue.

Protective Effects of Syringic Acid on Ischemia-Reperfusion Injury in Testicular Torsion: An Experimental Study in a Rat Model.

AIM: The purpose of this study was to assess the effectiveness of syringic acid in preventing ischemia-reperfusion injury following detorsion in a rat model of induced testicular torsion. MATERIAL AND METHODS: In our study, a total of 24 rats, eight in each group, were used. Group 1 served as the control group. Group 2 underwent testicular torsion and detorsion. Group 3 underwent the same procedures as Group 2, but also received 100 mg/kg syringic acid immediately following ischemia. Spectrophotometric analysis was performed on blood samples, and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), as well as the values of malondialdehyde (MDA), were evaluated under direct microscopic examination of the testis to determine tissue injury. The architecture of the seminiferous tubules and spermatogenesis processes were graded using the Johnsen and Cosentino scoring systems. RESULTS: The mean value of MDA was higher in Group 2 compared to the other groups (p < 0.001). Group 3 demonstrated a decline in the concentrations of proinflammatory cytokines, such as tumor necrosis factor-alpha, interleukin-6, and interleukin-1 beta, as indicated by biochemical analysis of blood samples, when compared to Group 2 (p-values: 0.045, 0.001, and <0.001, respectively). In addition, the improvement in Johnsen and Cosentino scores was significantly higher in Group 3 compared to Group 2 (p = 0.028 and p = 0.001, respectively). CONCLUSION: These findings suggest that syringic acid has a protective effect against testicular oxidative damage.

Is there any advantage in the use of absorbable sutures in congenital penile curvature surgery performed in childhood? / ¿Existe alguna ventaja de utilizar suturas absorbibles en la cirugía de curvatura de pene congénita realizada en niños?

Objective: To compare the long-term outcomes of corporeal plication using absorbable versus nonabsorbable sutures for the treatment of congenital penile curvature in childhood.Materials and methods: Forty seven children who underwent congenital penile curvature repair between 11 and 140 months of age were included in the study. All children were operated on using the incisional plication technique and were divided into two groups: Absorbable-polyglactine (PLG, n=23, 48.93%) and nonabsorbable-polypropilen (PP, n=24, 51.06%) according to the suture material used for plication. Surgical outcomes were compared between groups.Results: Mean follow-up period was 19.02±4.66 months. There was no significant difference between the mean age of the children in two groups included in the study (PLG=41.39±34.63 months vs PP=53.66±37.42 months, p=0.250). There was no significant difference in penile straightening degree between the two groups in the postoperative follow-up (PLG=27.39±6.88 vs PP=31.08±6.38, p=0.06). Similarly, there was no significant difference between two groups in terms of postoperative curvature recurrence (p=0.681). However, palpable suture knots in the plication area was significantly higher in the PP group in the postoperative period (25.0% vs 4.3%, p=0.047).Conclusion: The use of absorbable sutures in congenital penile curvature surgery in childhood has similar success rates with the use of nonabsorbable sutures and provides lower complications that are secondary to nonabsorbable sutures. (AU)

Objetivo: Comparar los resultados a largo plazo de la plicatura corpórea utilizando suturas absorbibles vs. no absorbibles para el tratamiento de la curvatura de pene congénita en niños.Materiales y métodos: Se incluyó en el estudio a 47 niños sometidos a reparación de curvatura congénita del pene de entre 11 y 140 meses de edad. Todos los niños fueron operados utilizando la técnica de plicatura incisional, dividiéndose en dos grupos: poliglactina absorbible (PLG, n = 23, 48,93%) y polipropileno no absorbible (PP, n = 24, 51,06%), en virtud del material de sutura utilizado para la plicatura. Se compararon los resultados quirúrgicos entre los grupos.Resultados: El periodo de seguimiento medio fue de 19,02 ± 4,66 meses. No se produjo diferencia significativa en cuanto a la edad media de los niños de los dos grupos incluidos en el estudio (PLG = 41,39 ± 34,63 meses vs. PP = 53,66 ± 37,42 meses, p = 0,250). No se produjo diferencia significativa en cuanto a enderezamiento del pene entre los dos grupos durante el seguimiento posoperatorio (PLG = 27,39 ± 6,88 vs. PP = 31,08 ± 6,38, p = 0,06). De igual modo, no existió diferencia significativa entre los dos grupos en términos de recidiva posoperatoria de la curvatura (p = 0,681). Sin embargo, los nudos palpables de sutura en la zona de plicatura fueron significativamente mayores en el grupo PP en el periodo posoperatorio (25 vs. 4,3%, p = 0,047).Conclusión: El uso de suturas absorbibles en la cirugía de curvatura congénita de pene en niños tuvo tasas de éxito similares con el uso de suturas no absorbibles, aportando menores complicaciones que las secundarias a las suturas no absorbibles. (AU)

Is there any advantage in the use of absorbable sutures in congenital penile curvature surgery performed in childhood?

OBJECTIVE: To compare the long-term outcomes of corporeal plication using absorbable versus nonabsorbable sutures for the treatment of congenital penile curvature in childhood. MATERIALS AND METHODS: Forty seven children who underwent congenital penile curvature repair between 11 and 140 months of age were included in the study. All children were operated on using the incisional plication technique and were divided into two groups: Absorbable-polyglactine (PLG, n=23, 48.93%) and nonabsorbable-polypropilen (PP, n=24, 51.06%) according to the suture material used for plication. Surgical outcomes were compared between groups. RESULTS: Mean follow-up period was 19.02±4.66 months. There was no significant difference between the mean age of the children in two groups included in the study (PLG=41.39±34.63 months vs PP=53.66±37.42 months, p=0.250). There was no significant difference in penile straightening degree between the two groups in the postoperative follow-up (PLG=27.39±6.88 vs PP=31.08±6.38, p=0.06). Similarly, there was no significant difference between two groups in terms of postoperative curvature recurrence (p=0.681). However, palpable suture knots in the plication area was significantly higher in the PP group in the postoperative period (25.0% vs 4.3%, p=0.047). CONCLUSION: The use of absorbable sutures in congenital penile curvature surgery in childhood has similar success rates with the use of nonabsorbable sutures and provides lower complications that are secondary to nonabsorbable sutures.

Early surgical repair or conservative treatment? Comparing patients with penile fracture concerning long-term sexual functions.

BACKGROUND: To compare the patients who underwent early surgical repair of penile fracture, which is one of the urological emergencies, and patients who recovered with conservative treatment concerning long-term sexual functions. METHODS: The data of 42 patients who applied to our clinic with penile fracture between January 2010 and January 2020 were retrospectively analyzed. The patients were categorized into two groups as early operated and followed-up conservatively. The preoperative and postoperative findings of the patients were compared with the International Erectile Function Scale (IIEF-6) scores in the long-term follow-up. RESULTS: The median age of the patients was 35 (20-65) years and the median follow-up period was 52 (8-120) months. The postoperative mean IIEF-6 score of the patients was 22.98±6.52. There was no significant difference between the surgical and the conservative groups concerning postoperative complications (p=0.460). In the follow-up period, the presence of palpable plaque on the rupture area was significantly higher in the conservative group (p=0.041). However, there was no significant difference between the groups concerning IIEF-6 scores (p=0.085). CONCLUSION: Although there is no significant difference in long-term IIEF-6 scores between the two groups, the rate of palpable plaque formation is higher in patients followed-up conservatively. Therefore, early surgical repair should be considered in the foreground, especially in patients with a large rupture area.

Is combined topical-local anesthesia technique adequate for visual internal urethrotomy in the treatment of traumatic posterior urethral strictures and prostatic urethral stenoses?

BACKGROUND: To compare the effectiveness of spinal anesthesia (SA) and the combination of intraurethral topical instillation of 2% lidocaine + intraurethral local visual injection anesthesia (T + LIA) for visual internal urethrotomy (VIU) in the treatment of traumatic posterior urethral strictures and prostatic urethral stenoses. METHODS: In this study, the results of 178 patients who underwent visual internal urethrotomy for posterior urethral strictures and prostatic urethral stenoses secondary to trauma in our clinic between October 2018 and January 2020 were analyzed retrospectively. Patients were divided into two groups as combined T + LIA (n=146, 82.08%) group and SA (n=32, 17.97%) group according to the type of anesthesia used. The preoperative clinical data and postoperative results of the patients were analyzed and compared between the groups. RESULTS: The mean age of the patients was 67.99±10.87 years and the mean follow-up was 5.32±3.27 months. The median age of the patients in the T + LIA group was significantly higher than that of the patients in the SA group (p=0.033). There was no statistically significant difference between the groups regarding preoperative Q-max value (p=0.931). Similarly, the rate of postoperative improvement in the Q-max values of the patients was similar between the groups (p=0.572). The presence of postoperative complications and recurrence rates were similar between the groups (p=0.879 and p=0.904, respectively). CONCLUSION: Compared to spinal anesthesia, T + LIA anesthesia is a safe and effective technique for visual internal urethrotomy in treating traumatic posterior urethral strictures and prostatic urethral stenoses, with a high rate of success and acceptable rate of complications.