Increased Plasma Ignition Distance Practice may Prevent the Obturator Reflex Occurrences and Compare of its Effectiveness Versus Obturator Block: A Prospective, Randomized, Controlled Study.

OBJECTIVE: To compare the ability of the obturator nerve block (ONB) and increased plasma ignition distance practice (IPDP) techniques to inhibit obturator nerve reflex (ONR) occurring with bipolar transurethral resection of the bladder. METHODS: Sixty patients who had a tumor placed at the lateral sidewall or had a tumor in another part of the bladder along with the lateral wall were randomly enrolled. Cystoscopic and ultrasonographic examinations and a computerized tomography scanning of the urinary bladder were used to determine the ONB side. Group 1 consisted of patients who had the ONB procedure. Group 2 consisted of patients who had IPIDP. The severity of the ONR was classified as severe, mild, and very mild. The study's primary endpoint was ONR occurrences and successful completion of the surgery. The secondary endpoints were bleeding and bladder perforation. RESULTS: There was a significant difference in the occurrence of ONR between the two groups (P = 0.0011). However, there was no significant difference between the two groups in the ability to resect the tumor and complete the surgery (P = .764). There was no correlation between the ONR and the tumor size (P = 0.478). CONCLUSION: Our study concluded that both ONB and IPIDP have comparable results, especially in resecting tumors and completing the operation. IPIDP has some advantages over ONB, such as shorter operative time, lower total costs, and less trained personnel requirements.

The efficiency of oxerutin on apoptosis and kidney function in rats with renal ischemia reperfusion injury.

BACKGROUND: Background: Renal ischemia-reperfusion injury (RIRI) is the most frequent cause of acute renal failure in clinical conditions such as trauma and shock as well as renal surgeries. Oxerutin is a member of the flavonoid family and possesses antioxidant properties. The aim of this study was to investigate whether oxerutin has protective effects on RIRI. METHODS: Twenty-eight male Wistar albino rats were randomly divided into three groups: sham control group (n=8), RIRI group (n=10), and RIRI + oxerutin group (n=10). RIRI was achieved by clamping the left renal artery for 30 min, followed 1-h reperfusion period. Thereafter, blood samples and left kidney tissue samples were taken for histopathological and biochemical examination. Blood urea nitrogen (BUN), urea, creatinine, and cystatin C levels, which are indicators of kidney function, as well as tumor necrosis factor-alpha, which is an indicator of inflammation were analyzed in blood samples. Total antioxidant status and total oxidant status (TOS), which are indicators of oxidative stress were analyzed on renal tissues. The apoptotic index, an indicator of kidney damage, as well as histopathological changes were evaluated on renal tissues. RESULTS: The apoptotic index, TOS, tumor necrosis factor-alpha, BUN, and urea levels were lower in the RIRI + oxerutin group than in the RIRI group (p<0.05). The results demonstrated that the histopathological and biochemical properties of oxerutin protected rats from RIRI. CONCLUSION: The findings obtained in this study show that prophylactic administration of oxerutin has protective effects on apoptosis and renal failure caused by RIRI. Therefore, oxerutin can be used as an effective prophylactic agent in the treatment of RIRI.

Germline variant screening with targeted next generation sequencing in prostate cancer: phenotype-genotype correlation.

BACKGROUND: Next generation sequencing provides new information about the molecular pathogenesis of cancer. We used a targeted NGS-based multiple gene panel comprising prostate cancer (PCa) predisposing genes to assess the prevalence of germline mutations in PCa patients. METHODS: In a cohort of twenty-one PCa patients with a family history of cancer, a targeted multigene panel consisting of 39 genes associated with hereditary cancer was created and analyzed using the next generation sequencing method. The novel and pathogenic mutations detected were confirmed by Sanger sequencing method. Thereafter, the data obtained were evaluated using different genomic variant classifiers and databases. RESULTS: With an incidence of less than 5% in different populations (MAF<0.05); a total of 81 variants were identified, including 41 missense, 16 synonymous, 3 splice-site, 11 intronic, 5 in-del and 5 novels. According to the ACMG criteria, 5 (6.2%) of these variants are pathogenic/likely pathogenic; 5 (6.2%) of them were classified as novel variants. In addition, variants having very low-frequency and unknown clinical significance (VUS) in the databases were detected.

Costovertebral angle as a novel tool for predicting the thoracic complication risk following percutaneous nephrolithotomy requiring supracostal access.

INTRODUCTION: The objective of this study was to determine whether the costovertebral angle (CVA) and other factors can predict the risk of thoracic complications following percutaneous nephrolithotomy (PCNL). METHODS: The data of patients who underwent prone PCNL with supracostal access at Suleyman Demirel University Hospital between January 2015 and December 2019 were retrospectively reviewed. Patients' demographics information (age, sex, body mass index [BMI], stone size, and stone location), operative data (supracostal access site, renal puncture site, and laterality), and postoperative thoracic complications (pleural injury) were evaluated. The CVA was measured on preoperative posteroanterior chest X-ray images. The mean CVA of patients with and without thoracic complications was evaluated. RESULTS: A total of 89 patients (mean age 46.12±15.66 years; 59 men and 30 women) with supracostal access were included in the study. Thoracic complications occurred in 17 (19.1%) patients. Nine (52.9%) hemothorax cases, five (29.4%) pneumothorax cases, and three (17.7%) urinothorax cases were detected. There was a statistically significant difference in the complication rate compared to the percutaneous access site (10th-11th supracostal vs. 11th-12th supracostal, p=0.004). The mean CVA was significantly lower in patients with complications (45.47±3.59) than in those without complications (53.26±5.98) (p=0.000). No association was found (p>0.05) with age, sex, BMI, laterality, stone surface area, and access site among patients with and without thoracic complications. CONCLUSIONS: Preoperative CVA can be an effective tool in predicting the risk of postoperative thoracic complications.

Prostate cancer incidence and diagnosis in men with PSA levels >20 ng/ml: is it possible to decrease the number of biopsy cores?

OBJECTIVES: To define if less number of cores would be sufficient to diagnose prostate cancer (PCa) in men with PSA levels >20 ng/ml and to reveal the cancer detection rates in this population. METHODS: The data of the men who had 12-core prostate biopsy with a PSA value >20 ng/mg were reviewed. We recorded age, prostate volume, PSA level, and pathology report findings. Patients grouped according to PSA levels and compared for PCa detection rates, and several parameters. We created 16 prostate biopsy scenarios (S1-S16) and applied these to our database to find out the best biopsy protocol to detect PCa. RESULTS: A total of 336 patients with a mean age of 70.5 (47-91) years were included. Mean PSA level was 190.6 (20-5474) ng/ml. PCa detection rates were 55.3%, 81.0%, and 97.7% in patients with PSA levels 20-49.99, 50-99.99, and ≥100 ng/ml, respectively. PSA level was correlated to clinically more important digital rectal examination findings. We selected 2 cores in S1-S6, 4 cores in S7-S12, and 6 cores in S13-S16. We calculated the sensitivity of each scenario and found that all scenarios in PSA Group 3 had a sensitivity >95%. In Group 2, S8, S10, S13, and S14 and in Group 1, only S14 had sensitivity >95%. CONCLUSIONS: It is not necessary to take 10-12 core biopsy samples in men with PSA levels >20 ng/ml. We recommend taking 2, 4, and 6 samples for patients with PSA levels ≥100 ng/ml, 50-99.99 ng/ml, and 20-49.99 ng/ml, respectively.

Can we Predict Preoperative Tumor Aggressivity with Hemogram Parameters in Renal Cell Carcinoma? a Novel Calculation Method.

We aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with renal cell carcinoma. We retrospectively analyzed 127 patients' data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR. P values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR. P values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively.

Protective impact of resveratrol in experimental rat model of hyperoxaluria.

PURPOSE: Resveratrol (RES) is a polyphenol with antioxidant, anti-inflammatory, and many other physiological effects on tissues. In the present study, the effect of resveratrol in hyperoxaluria driven nephrolithiasis/nephrocalcinosis is investigated. METHODS: Wistar-Albino rats of 250-300 g (male, n = 24) were included in the present study. The rats were randomized into three groups: Group 1 consisted of the controls (n = 8), Group 2 of hyperoxaluria (1% ethylene glycol (EG), n = 8), and Group 3 of the treatment (1% EG + 10 mg/kg of RES, n = 8) group. At the beginning and fifth week of the study, two rats from each group were placed in metabolic cages for 24 h and their urine was collected. At the end of the study, the rats were killed and their blood was collected from the vena cava inferior. The right kidneys of the rats were used for biochemical and the left ones for immunohistochemical analyzes. Malondialdehyde (MDA), catalase, urea, calcium, oxalate, and creatinine clearance were studied in the blood, urine, and kidney tissues. Moreover, routine histological evaluation, and p38-MAPK and NFkB immunohistochemical analyses were conducted. RESULTS: In the hyperoxaluria group, urinary oxalate levels were higher than the control group; yet, lower in the treatment group compared to hyperoxaluria group (p < 0.05). Serum MDA levels in the hyperoxaluria group were higher than the control group; but in the treatment group it is lower than the hyperoxaluria group (p < 0.05). P38 MAPK activity was higher in the hyperoxaluria group compared to the control (p < 0.05). However, in terms of p38 MAPK activity, there were no statistically significant difference between hyperoxaluria and the treatment group (p < 0.069). Whereas NFkB activity in the hyperoxaluria group is higher than the control (p < 0.001), no statistically significant difference was observed with the treatment group. CONCLUSIONS: In the present study, resveratrol was seen to prevent hyperoxaluria. With preventing oxidative stress factors and Randall plaque formation caused by free oxygen radicals, resveratrol can be an alternative treatment option that can increase the success rate in preventing stone recurrence in the future.

Protective effect of theophylline on renal functions in experimental pneumoperitoneum model.

Our objective in this experimental study is to research the effect of the intra-abdominal pressure which rises following pneumoperitoneum and whether Theophylline has a possible protective activity on this situation. In our study, 24 Wistar Albino rats were used. Rats were divided into two groups. The first group was set for only pneumoperitoneum model. The second group was given 15 mg/kg of Theophylline intraperitoneally before setting pneumoperitoneum model. Then urea, creatinine, cystatin-C, tissue and serum total antioxidant capacity, total oxidant capacity and oxidative stress index in two groups were measured and compared with each other. Apoptosis and histopathological conditions in the renal tissues were examined. The differences between the groups were analyzed with the Mann-Whitney U test. Results were considered significant at p < 0.05. No statistically significant difference was determined between tissue and serum averages in two groups in terms of TAS, TOS and OSI values (p > 0.05). The mean value of urea were similar in pneumoperitoneum and pneumoperitoneum + theophylline groups (p = 0.12). The mean cystatin-C value was 2.2 ± 0.3 µg/mL in pneumoperitoneum, 1.74 ± 0.33 µg/mL in pneumoperitoneum + theophylline (p = 0.002). According to our study, lower cystatin-C levels in the group, where Theophylline was given, are suggestive of lower renal injury in this group. However, this opinion is interrogated as there is no difference in terms of tissue and serum TAS, TOS, OSI and urea values between the groups.

Where do patients go for treatment of urethritis?

BACKGROUND: Urethritis is characterized by urethral inflammation, and it can result from both infectious and noninfectious conditions. Physicians and other health care providers play a critical role in preventing and treating urethritis. OBJECTIVES: The aim of this study was to describe and identify predictors of health care seeking behavior among men with urethritis. PATIENTS AND METHODS: In total, 98 male patients aged between 16 to 52 years-of-age (mean 30.9 ± 8.0 years), who attended our clinic with symptoms of urethritis, were included in the study. We conducted face-to-face interviews with the patients using a 9-item survey questionnaire. Patients were divided into three groups according to their level of education as follows: group I (n = 44), elementary school; group II (n = 38), high school; and group III (n = 16), university. RESULTS: Among the 98 patients evaluated, the source of treatment was physicians in 44 patients (44.9%), drugstores in 38 cases (38.77%), and friends in 16 patients (16.32%). There was a statistically significant difference found between the groups according to the source of treatment (P < 0.001). The most common factors associated with seeking care from other sources, rather than physicians, were economic reasons in 19 patients (35.18%), confidentiality concerns in 24 (44.4%), and ease of access in 11 patients (20.37%). CONCLUSIONS: A substantial proportion of patients with urethritis sought help from other sources, rather than physicians. The results of our study show that the patients with higher levels of education were more likely to seek help from health care services. It is important to promote the public's knowledge through informative studies and educational materials in order to encourage patients to seek rapid and effective treatment from proper sources.

Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

Comparison of different autogenous graft materials for reconstruction of large segment vas deferens defect: experimental study in rat.

PURPOSE: Vasectomy is one of the most common urological operations performed, and provides permanent contraception. Many vasectomized men ultimately seek vasectomy reversal because of unforeseen changes in lifestyle. Vasovasostomy has varying rates of success. In this study, we utilize vas deferens (VD), artery, and vein grafts to reconstruct 30% and 50%defects of the total vas deferens length. MATERIALS AND METHODS: Forty two male Wistar rats were divided into three groups as VD graft, carotid artery and external jugular vein transplantations. Each group was equally divided into 2 different subgroups according to the length of transplant material as 1.0 cm (n = 7) and 1.5 cm (n = 7). To evaluate whether these materials may be used for long segment vas deferens reconstruction, the patency rate, partial or total graft occlusion, and histologic examination of all specimens were examined. RESULTS: No patency was found in any of the grafts and many of them suffered destructive changes in anatomic structure. Sperm granulomas were determined around the testicular side anastomosis due to accumulated semen fluid which was in our belief, a result of aperistaltic zone caused by the grafts. CONCLUSION: When the poor results obtained in our study are put into perspective, vasoepididymostomy is the only treatment method to date for reconstruction of large segment vas deferens defects.

Utility of serum creatinine/cystatin C ratio in diagnosis of postrenal acute kidney injury.

BACKGROUND: In obstructive uropathy, despite a severe increase in the serum creatinine (Cr) levels, only a mild cystatin C (CysC) increase was previously reported. Therefore, we aimed to determine the availability of serum Cr/CysC ratio in predicting postrenal acute kidney injury (AKI). MATERIALS AND METHODS: This was a cross-sectional study involving 61-adult patients with heterogeneous AKI cases. Patients with bilateral pelvicalyceal dilatation in renal sonography were considered as postrenal AKI group (n = 15) and others were intrinsic AKI group (n = 46). Venous blood sampling for blood urea nitrogen, Cr and CysC measurements were performed on admission. RESULTS: The mean age of study population was 66.3 ± 15.5 years; 38 (62%) of which were male. Two groups were similar regarding age, gender, and comorbidities. Cr/CysC ratio was significantly higher in postrenal AKI group (6.9 ± 3.1 vs. 4.4 ± 2.1, P = 0.007). CONCLUSION: We suggest that serum Cr/CysC ratio seems to be a useful diagnostic tool for detection of postrenal AKI cases, especially for the cases without definite hydronephrosis.

Management and outcomes of penile fracture: 10 years' experience from a tertiary care center.

OBJECTIVES: To evaluate our experience on diagnosis and management of penile fractures. MATERIALS AND METHODS: This retrospective study included 31 patients who were treated for penile fracture between 2002 and 2012. We analyzed the etiology of penile fracture, concomitant pathologies such as urethral injury, deep or superficial dorsal vein ruptures, treatment modalities (surgery or conservative treatment) and complications of treatment modalities. RESULTS: The mean age of the patients was 32 years (range, 23-47 years). In 27 patients (87%), the cause of penile fracture was sexual intercourse. Patients presented with swelling, pain and popping or cracking sound in penis. The diagnosis of penile fracture was established clinically in all of the patients. There were no urethral injuries or dorsal vein ruptures. Ten patients who refused surgical treatment were treated conservatively and remaining 21 patients with early surgical intervention. Among conservatively treated patients, two suffered from erectile dysfunction, two from painful erection and another two from penile curvature. No serious complications such as erectile dysfunction, penile curvature or painful erection were observed in surgically treated patients. CONCLUSION: Penile fracture can be diagnosed easily with history and physical examination, and favorable functional results can be achieved with early surgical repair.

Wi-Fi (2.45 GHz)- and mobile phone (900 and 1800 MHz)-induced risks on oxidative stress and elements in kidney and testis of rats during pregnancy and the development of offspring.

The present study was designed to determine the effects of both Wi-Fi (2.45 GHz)- and mobile phone (900 and 1800 MHz)-induced electromagnetic radiation (EMR) on oxidative stress and trace element levels in the kidney and testis of growing rats from pregnancy to 6 weeks of age. Thirty-two rats and their 96 newborn offspring were equally divided into four different groups, namely, control, 2.45 GHz, 900 MHz, and 1800 MHz groups. The 2.45 GHz, 900 MHz, and 1,800 MHz groups were exposed to EMR for 60 min/day during pregnancy and growth. During the fourth, fifth, and sixth weeks of the experiment, kidney and testis samples were taken from decapitated rats. Results from the fourth week showed that the level of lipid peroxidation in the kidney and testis and the copper, zinc, reduced glutathione (GSH), glutathione peroxidase (GSH-Px), and total antioxidant status (TAS) values in the kidney decreased in the EMR groups, while iron concentrations in the kidney as well as vitamin A and vitamin E concentrations in the testis increased in the EMR groups. Results for fifth-week samples showed that iron, vitamin A, and ß-carotene concentrations in the kidney increased in the EMR groups, while the GSH and TAS levels decreased. The sixth week results showed that iron concentrations in the kidney and the extent of lipid peroxidation in the kidney and testis increased in the EMR groups, while copper, TAS, and GSH concentrations decreased. There were no statistically significant differences in kidney chromium, magnesium, and manganese concentrations among the four groups. In conclusion, Wi-Fi- and mobile phone-induced EMR caused oxidative damage by increasing the extent of lipid peroxidation and the iron level, while decreasing total antioxidant status, copper, and GSH values. Wi-Fi- and mobile phone-induced EMR may cause precocious puberty and oxidative kidney and testis injury in growing rats.

Management of symptomatic ureteral calculi complicating pregnancy.

OBJECTIVE: To review our experiences with management of symptomatic ureteral calculi complicating pregnancy. METHODS: Between January 2001 and December 2011, 57 pregnant women were treated for symptomatic ureteral stones. The medical records of these patients were reviewed retrospectively. RESULTS: The mean patient age was 24 (range 17-37) years and gestational age at presentation was 26 weeks (range 12-38). Most of the cases (60%) occurred in the third trimester. Flank pain was the most common presenting symptom (90%). Ultrasonography was the initial test confirming diagnosis. With conservative management, spontaneous passing of stones was noted in 13 cases (22.8%). In 10 patients (17.5%), symptomatic relief occurred without spontaneous passing of stones until the end of pregnancy. Invasive management was required in 34 patients (59.6%) because of persistent pain and/or ureteral obstruction. In 29 patients, ureteral calculi were treated successfully by ureteroscopy. Stones were extracted by pneumatic lithotripsy or forceps. In 5 patients, only double-J stent was inserted during ureteroscopy as a result of unreached or migrated stone. The majority of patients (58.8%) had lower ureteric calculi. The mean size of the stones retrieved was 7 mm (range 4-13 mm). Minor complications like ureteric edema, mild ureteric laceration, or bleeding were seen in 5 patients. Three patients had a urinary tract infection and 3 complained of stent-induced bladder irritation; uterine contraction was observed after the procedure in 1 patient, but no serious obstetric or urologic complications were observed in any case. CONCLUSION: When conservative treatment fails, ureteroscopy is an effective and safe therapeutic option in symptomatic ureteral calculi complicating pregnancy.

Correlation between BMD and bone scintigraphy in patients with prostate cancer.

OBJECTIVE: Bone metastasis is a major cause of morbidity in prostatic cancer. Therefore, detecting and monitoring bone lesions are crucial for treatment of prostatic carcinoma. We aimed to evaluate total body bone mineral density and regional bone mineral density in patients with prostate cancer with and without metastases, and to compare them with bone scintigraphy. METHODS: Fifty-four patients with prostatic carcinoma and 20 healthy subjects were investigated with bone scintigraphy and dual-energy X-ray absorptiometry. The bone scintigraphic findings were classified as normal (score 0: n = 22), abnormal but not typical for metastases (score 1: n = 18), and typical pattern of metastases (score 2: n = 14). RESULTS: The patients with bone metastases prostate cancer had significantly higher total bone mineral density and regional bone mineral density of trunk and pelvis than healthy controls and prostate cancer patients without bone metastases. There was a significant positive correlation between bone scan score and total bone mineral density and regional bone mineral density of trunk and pelvis (r = 0.328, P < 0.05, r = 0.60, P < 0.001, r = 0.480, P < 0.001, respectively). CONCLUSION: Our results show that patients of prostate cancer with bone metastases have increased bone mineral density (BMD) in the pelvis and trunk, possibly because of a predominance of osteoblastic over osteolytic metastases demonstrated by Tc-99m MDP bone scan.

Androgen deprivation therapy for prostate cancer: effects on hand function.

OBJECTIVES: Prostate cancer is the most frequently diagnosed malignancy. Luteinizing hormone-releasing hormone (LH-RH) agonists are used in most patients with locally advanced and metastatic prostate cancer, and decrease testosterone production. We aimed to find out the effects of androgen deprivation therapy with LH-RH agonist on the hand function, quality of life, and mood of the patients with prostate cancer. SUBJECTS: A total of 20 patients with locally advanced prostate cancer and 20 age-matched healthy men were included in the study as LH-RH and control groups, respectively. MAIN MEASURES: Age, body mass index, occupation and dominant hand, physical activity level, Beck depression inventory scores, 15D quality of life questionnaire scores, and Duruoz hand index scores were recorded. Handgrip strength was tested in the dominant hand using the Jamar hand dynamometer (Sammons Preston, Inc., Bollingbrook, IL). The Grooved Pegboard Test was used to test manual dexterity. Serum concentrations of total and free testosterone, estradiol levels were measured. RESULTS: There were no differences between the groups in body mass index, physical activity level, and age (P > 0.05). Serum total and free testosterone, estradiol level, and the mean grip strength score were statistically lower in the LH-RH group. Manual dexterity was diminished in the LH-RH group (P < 0.001). The Duruoz hand index, and Beck depression inventory and 15D quality of life questionnaire scores were statistically lower in the LH-RH group (P < 0.005). We found a correlation between handgrip strength, dexterity, Beck depression inventory scores, 15D quality of life questionnaire scores, and total and free testosterone. CONCLUSION: Men with low testosterone levels caused by androgen deprivation therapy have worse grip strength, dexterity, 15D quality of life questionnaire scores, and depressive symptoms than age-matched men who have not received androgen deprivation therapy.

Does experimental pain assessment before biopsy predict for pain during transrectal ultrasound-guided prostate biopsy?

OBJECTIVES: To evaluate whether assessment of experimental pain perception using the modified tourniquet test before a biopsy procedure could predict the pain scores during transrectal ultrasound-guided prostate biopsy. However, the relationship between the experimental pain assessment before prostate biopsy and the pain scores during the biopsy procedure has not been established. METHODS: A total of 67 men who underwent transrectal ultrasound-guided 12-core prostate biopsy were prospectively enrolled in the study. The day before biopsy, a modified submaximal effort tourniquet test was performed on all patients. During the test, pain scores were recorded at 30, 60, 90, and 120 seconds after inflation of the blood pressure cuff. Pain scores were also recorded during probe introduction into the rectum and prostate biopsy. Pain was assessed using a visual analogue scale (VAS). RESULTS: A significant correlation was found between the VAS scores in the tourniquet test and the VAS scores during probe introduction and the VAS scores during prostate biopsy (P <0.0001). The most significant correlation was found between the VAS scores during prostate biopsy and the VAS 60-second scores during the tourniquet test (P <0.0001, r=0.756). No significant relation was found between the VAS scores and age, prostate volume, or prostate-specific antigen level (P >0.05). CONCLUSIONS: Our results have shown that a simple and quick tourniquet test could be useful in identifying those men who will experience greater pain during transrectal ultrasound-guided prostate biopsy. In the light of these data, additional studies will be planned to evaluate whether experimental pain assessment before the procedure could predict the analgesic potency of pain-relieving treatment during prostate biopsy.