Investigation of serum vitamin D and ischaemia-modified albumin levels in infertile Turkish men.

Our aim was to explore the existence of a possible relationship of sperm motility with serum 25-hydroxyvitamin D3 (25-OH VD) levels and with ischaemia-modified albumin (IMA) levels in infertile Turkish men. A total of 30 men with nonobstructive azoospermia (no spermatozoa in ejaculate), 30 men with oligospermia (total progressive motile sperm count (TPMSC) <15 × 106 /ml) and 33 fertile men with normospermia (with at least one child, as the control group) were enrolled in the study. The mean 25-OH VD levels for groups 1, 2 and 3 were 9.31 ± 6.46, 19.71 ± 12.80 and 30.52 ± 12.49 respectively (p < .05). There was a statistically significant difference in serum IMA levels among the groups (479.32 ± 307.56 vs. 296.37 ± 127.27 vs. 150.04 ± 81.05, respectively; p < .05). A positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels were determined. Infertile men had lower serum 25-OH VD and higher IMA levels than fertile men, with a positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels. Vitamin D supplementation may increase the sperm motility.

The comparison of standard and tubeless percutaneous nephrolithotomy procedures.

PURPOSE: To compare totally tubeless and standard percutaneous nephrolitotomy procedures on many parameters. MATERIALS AND METHODS: Percutaneous nephrolitotomy was performed on 195 patients between June 2009 and May 2012. The data of those patients were evaluated retrospectively. Totally tubeless cases were enrolled to Group 1, and Group 2 consisted of non-tubeless cases (re-entry or Foley catheter). RESULTS: Group 1 included 85 cases and group 2 a total of 110 patients. Paper tracing values for the kidney stones were 321.25 ± 102.4 mm(2) and 324.10 ± 169.5 mm(2) respectively. Mean fluoroscopy time was 4.9 ± 1.9 min and 5.08 ± 2.7 min, mean operation time was 78.8 ± 27.9 min and 81.9 ± 28.77 min and mean decrease in hematocrit was 2.6 ± 1.6 and 3.74 ± 1.9 respectively. All these comparisons were statistically significant. Length of hospitalization was 1.6 ± 1.1 and 3.5 ± 1.5 days for Groups 1 and 2 respectively. Mean superficial pain score was 5.8 ± 1.6 and 6.7 ± 1.2 respectively for both groups after 1 hour. At 6 hours, the scores changed to 3.87 ± 1.22 and 4.84 ± 1.3 respectively. The analgesic dose was 1.00 ± 0.7 and 1.53 ± 0.6 for the groups respectively at 6 hours. All the statistical differences were significant for these three parameters. CONCLUSIONS: We believe that, because of their post operative patient comfort and decreased length of hospital stay, totally tubeless procedures should be considered as an alternative to standard percutaneous nephrolitotomy.

Animal ethics in laparoscopic urology training.

Laparoscopic urologic operating techniques are in widespread use throughout the world and because of various advantages, over the years they have virtually become a gold standard surgical intervention method. As laparoscopy is a painstaking technique to learn, the training consists of different stages. Within these stages of training, wet laboratory training where animals are used, is the most sensitive stage. The widespread use of experimental animals in medical research necessitated standardization and the establishment of certain regulations. This standardization and organization of laws and regulations started to be discussed in Europe approximately a century ago and have been established on a certain foundation. In this rewiev article, we discuss some important points and ethic rules about laparoscopic urologic training practiced on live animals.

Anatomic variations of the celiac trunk and hepatic arterial system with digital subtraction angiography.

BACKGROUND/AIMS: Anatomical variation of the abdominal arteries is important. Historic and modern anatomists, radiologists, as well as surgeons have reported and accumulated anatomical variations with a morphological and clinical interest. During graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can be a common clinical entity. During cadaveric dissection and diagnostic radiological imaging, various types of vascular anomalies are frequently found in human abdominal viscera, especially the celiac trunk. The aim of the present study is to determine anatomical variations in the celiac trunk and hepatic arterial system. MATERIALS AND METHODS: Digital subtraction angiography data were collected from 152 consecutive donor patients (103 males and 49 females, aged between 6 and 77 years) who underwent orthotopic liver transplantation. RESULTS: We examined the anatomy of the celiac trunk in a total of 152 consecutive patients. In total, 62.5% (95/152) of patients showed the classical trifurcation of the celiac trunk. Variant right hepatic arteries arising from the superior mesenteric artery were observed in 17.8% (27/152), the hepatic arteries arising from the left gastric artery were found in 13.1% (20/152), and common hepatic arteries arising from the superior mesenteric artery were observed in 6.6% (10/152) of patients. CONCLUSION: These data are useful for planning and performing surgical and radiological procedures of the upper abdomen.

Laparoscopic pyelolithotomy in a horseshoe kidney.

The horseshoe kidney is the most frequent renal anomaly, with a prevalence of 0.25% and a male to female ratio of 2:1. In this article we aimed to report a 50-year-old man who had left kidney stones accompanied with a horseshoe kidney. In this case percutaneous nephrolithotomy was deemed to be a risky procedure due to malrotation of the pelviocalyceal system and possible interposition of bowel loops between kidney and the abdominal wall. Therefore, we preferred laparoscopic pyelolithotomy. At the end of the procedure, the patient was stone-free. We observed no complication. The patient was discharged after 72 hours. We assume that laparoscopic pyelolithotomy is a safe and effective approach for renal pelvic stone in case of horseshoe kidney.

The comparison of standard and tubeless percutaneous nephrolithotomy procedures

To compare totally tubeless and standard percutaneous nephrolitotomy procedures on many parameters.

Percutaneous nephrolitotomy was performed on 195 patients between June 2009 and May 2012. The data of those patients were evaluated retrospectively. Totally tubeless cases were enrolled to Group 1, and Group 2 consisted of non-tubeless cases (re-entry or Foley catheter).

Group 1 included 85 cases and group 2 a total of 110 patients. Paper tracing values for the kidney stones were 321.25 ± 102.4 mm2 and 324.10 ± 169.5 mm2 respectively. Mean fluoroscopy time was 4.9 ± 1.9 min and 5.08 ± 2.7 min, mean operation time was 78.8 ± 27.9 min and 81.9 ± 28.77 min and mean decrease in hematocrit was 2.6 ± 1.6 and 3.74 ± 1.9 respectively. All these comparisons were statistically significant. Length of hospitalization was 1.6 ± 1.1 and 3.5 ± 1.5 days for Groups 1 and 2 respectively. Mean superficial pain score was 5.8 ± 1.6 and 6.7 ± 1.2 respectively for both groups after 1 hour. At 6 hours, the scores changed to 3.87 ± 1.22 and 4.84 ± 1.3 respectively. The analgesic dose was 1.00 ± 0.7 and 1.53 ± 0.6 for the groups respectively at 6 hours. All the statistical differences were significant for these three parameters.

We believe that, because of their post operative patient comfort and decreased length of hospital stay, totally tubeless procedures should be considered as an alternative to standard percutaneous nephrolitotomy. .