Correlation of Postoperative Outcomes According to the Amount of Prostatic Tissue Removed in Patients Undergoing Transurethral Resection of the Prostate.

OBJECTIVE: The present study assesses the effect of the proportion of tissue resected during transurethral resections of the prostate (TUR-P) on lower urinary tract symptoms (LUTS) and other parameters in patients with a benign prostatic obstruction (BPO). MATERIALS AND METHODS: Forty-three patients who underwent TUR-P between 2018 and 2021 were assessed prospectively. The patients were divided into two groups according to the percentage of tissue removed (group 1 <30%, group 2 >30% resection). Age, prostate volume, amount of resected tissue, operative time, length of hospital stay, duration of catheterization, International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax), and serum prostate-specific antigen (PSA) (ng/dl) at preoperative and postoperative three months were recorded. RESULTS: The percentage of tissue removed was 22.2% vs. 48.4% (p = 0.001), IPSS reduction was 77.7% vs. 83.3% (p = 0.048), QoL improvement was 77.2% vs. 84.8% (p = 0.133), Qmax increase was 171.3% vs. 193.5% (p = 0.032), and serum PSA decrease was 56.4% vs. 69.2% (p = 0.049) in groups 1 and 2, respectively. In addition, the operative time was 38.5 vs. 53.6 min (p = 0.001), the length of hospital stay was 2.0 vs. 2.4 days (p = 0.001), and the duration of catheterization average was 4.1 vs. 4.9 days (p = 0.002). CONCLUSION: Resections of at least 30% of prostatic tissue can provide a significant improvement in the symptoms and parameters related to benign prostatic obstruction, while resections of less than 30% of prostatic tissue can effectively reduce urinary symptoms and improve the quality of life in older adult patients with comorbidities who require shorter operating times.

Peroxinitrite and Malondialdehyde as Biomarkers for Overactive Bladder.

OBJECTIVE: To measure urine malondialdehyde (MDA) and urine peroxynitrite (ONOO) levels in patients with overactive bladder (OAB), and compare them with healthy individuals; to determine the change of those markers in OAB patients prescribed antimuscarinic drugs. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: The Department of Urology, School of Medicine, University of Gaziantep, Gaziantep, Turkey, between August 2021 and February 2022. METHODOLOGY: Patients diagnosed with OAB (Group 1), and healthy controls (Group 2) were compared. Urinary MDA (µmol/L) and ONOO (µmol/L) levels were measured in all participants. The patients diagnosed with OAB were underwent antimuscarinic therapy with propiverine 30 mg. The levels of MDA (µmol/L) and ONOO (µmol/L) were reanalysed during the third month of antimuscarinic therapy. Patients with stress urinary incontinence, neurogenic bladder, pelvic organ prolapse stage ≥3 (POP-Q ≥3), interstitial cystitis (bladder pain syndrome), history of pelvic radiotherapy, symptoms of bladder outlet obstruction, Qmax <10 ml/sec for men and <15 ml/sec for women measured by uroflowmetry, and history of pelvic and incontinence surgery were excluded from the study. RESULTS: There was no difference in the mean age and or gender distribution of the two groups (p=0.166 and p=0.774, respectively). While the mean MDA levels were significantly higher in patients with OAB, (3.34 ± 1.06µmol/L vs. 2.62 ± 1.45µmol/L, p=0.036), no significant change was detected in ONOO levels between the groups (1.03 ± 0.75 µmol/L vs. 0.71 ± 022 µmol/L, p >0.05). Although no significant change was detected in MDA levels after antimuscarinic therapy (3.50 ± 1.19 µmol/L, p=0.529), there was a statistically significant increase in ONOO levels (1.49 ± 1.45 µmol/L, p=0.013). CONCLUSION: MDA might be used in the diagnosis of OAB, as a biomarker, similar to recent studies. ONOO was evaluated for the first time in the literature for the diagnosis of OAB, unfortunately, no significant outcomes were obtained. In addition, both MDA and ONOO had no role in monitoring antimuscarinic therapy. KEY WORDS: Overactive bladder, Peroxynitrite, Malondialdehyde.

Evaluation of the results of laser endopyelotomy with two different technique in ureteropelvic junction obstruction.

INTRODUCTION: Failed pyeloplasty procedures are caused by large amounts of scarring, and peripelvic fibrosis. This finding has been associated with urinary extravasations to the operation, urosepsis or an excessive tissue reaction. The treatment options for secondary UPJO (Ureteropelvic Junction Obstruction) are the same with the options for primary procedures: in cases of very poor renal function, various pyeloplasty forms (open and laparoscopic), and ureterocalicostomy or sometimes nephrectomy may be considered in severe renal function loss. Whereas, endoscopic treatment can be considered in elective cases. STUDY DESIGN: A total of 46 young patients who underwent endopyelotomy due to secondary ureteropelvic obstruction between January 2013 and September 2018 were included in the study. Patients underwent semirigid URS (Ureterorenoscopy) guided laser endopyelotomy until July 2015, and the patients had flexible URS guided laser endopyelotomy since July 2015. RESULTS: The mean age of the patients was found as 17.7 ± 4.2 and 16.9 ± 5.7 years in the SURSLE (Semirigid Ureterorenoscopy Laser Endopyelotomy), and FURSLE (Flexible Ureterorenoscopy Laser Endopyelotomy) groups, respectively. Success of the procedure was confirmed in 20 (83%) patients in the SURSLE group, and 19 (86%) patients in the FURSLE group who had no obstructive symptoms based on USG, GFR and excretion curves on the renogram ordered in the 24th month. Four (16%) patients in the SURSLE group, and 3 (14%) patients in the FURSLE group were accepted as failed, their treatments were arranged for additional surgical procedures, and these patients were taken under the follow-up protocol. DISCUSSION: This is one of the first studies comparing endopyelotomy with semirigid URS and flexible URS in patients with ureteropelvic stenosis. Long-term results with a large series of patients are not known, and our approach can be considered only as an individual method. There are different treatment options in UPJO. The use of fluoroscopy has advantages in endourologic operations. Therefore, lower radiation exposure can be a rational approach for protecting a person. Similarly, providing necessary protection also for physicians and operating room personnel is essential. In our study, shorter fluoroscopy time with SURSLE provided an advantage over FURSLE in terms of radiation exposure. CONCLUSION: Of semirigid and flexible URS techniques that have no superiority over each other in terms of success, preferring semi-rigid URS guided laser endopyelotomy with lower ionizing radiation used, is more rational.

Synthesis, structures and anticancer potentials of platinum(II) saccharinate complexes of tertiary phosphines with phenyl and cyclohexyl groups targeting mitochondria and DNA.

A series of new Pt(II) saccharinate complexes containing PR3 ligands (PPh3, PPh2Cy, PPhCy2 and PCy3) with progressive phenyl (Ph) replacement by cyclohexyl (Cy) were synthesized and structurally characterized by IR, NMR, ESI-MS and X-ray diffraction. The anticancer activity of the complexes was tested against human breast (MCF-7), lung (A549), colon (HCT116), and prostate (DU145) cancer cell lines as well as against normal bronchial epithelial (BEAS-2B) cells. Trans-configured complexes 1, 3 and 5 emerged as potential anticancer drug candidates. The mechanism of action of the potent complexes was then investigated in detail. The three complexes interacted with DNA by groove binding and with HSA via hydrophobic IIA subdomain. Furthermore, the complexes cleaved plasmid DNA efficiently. Cellular uptake studies in MCF-7 cells showed that the biologically active complexes were mainly localized in cytoplasm. The cytotoxic activity was a function of the lipophilicity and cellular accumulation of the complexes. As determined by M30, Annexin V and Caspase 3/7 activity assays, the complexes induced apoptosis in MCF-7 and HCT116 cells. Mechanistic studies showed that the potent complexes cause excessive generation of reactive oxygen species (ROS) and display a dual action, concurrently targeting both mitochondria and genomic DNA.