Oxidative stress and phenotype frequencies of paraoxonase-1 in teratozoospermia.

Oxidative stress causes infertility in men by affecting especially sperm morphology. The aim of the study was to examine the frequencies of paraoxonase-1 (PON1) phenotypes and the serum PON1, arylesterase, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, catalase and thiol levels in teratozoospermic infertile men and normospermic fertile men. The study included 184 teratozoospermic infertile men and 72 normospermic fertile men. The double substrate method was employed to determine the phenotype distribution of PON1. The evaluation of sperm morphology was made in accordance with the Kruger's criteria. TAS, catalase and thiol levels were determined to be significantly lower in teratozoospermic infertile men compared to normospermic fertile men. A significant change was not observed in the levels of TOS, PON1 and arylesterase. There was a positive correlation between catalase and thiol levels and sperm morphology. While there were significantly more teratozoospermic men with AA phenotypes compared to normospermic men, there were significantly more persons with AB and BB phenotypes in normospermic men than in teratozoospermic men. As far as we know, such a study was conducted for the first time and suggests that PON1 phenotypic distribution may play a significant role in sterile males because of impaired sperm morphology.

Trifecta Outcomes of Laparoscopic Partial Nephrectomy for T1a and T1b Renal Tumors: A Single-Center Experience in a Tertiary Care Institution.

Objective: To assess the effectiveness and safety of laparoscopic partial nephrectomy (LPN) in T1a and T1b renal tumors using "Trifecta" in partial nephrectomy and determine the predictive factors in respect to the criteria that constitute Trifecta. Materials and Methods: We retrospectively analyzed the data harvested from the patients who underwent LPN for T1a or T1b tumors. Preoperative, perioperative, and postoperative outcomes were evaluated and analyzed. Patients who had grade <2 Clavien complications, negative surgical margins, and minimal renal function deterioration (warm ischemia time [WIT] ≤25 minutes and ≤15% postoperative estimated glomerular filtration rate [eGFR] decrease) were acccepted to fit the strict Trifecta outcomes. Multivariate analysis was done using logistic regression test to determine the predictive factors affecting Trifecta. Results: A total of 128 patients underwent LPN. Of these, 65 (50.8%) patients had cT1a and 63 (49.2%) patients had cT1b renal tumors. The mean age was 55.8 (24-85) years. Mean operative time was 143.6 (100-200) minutes. A total of five (3.9%) patients had positive surgical margins. Mean WIT was 22.1 minutes. Ten patients (7.8%) had a >15% decrease in eGFR after surgery. Complications were observed in 11 (8.6%) patients. A total of 78 (60.9%) patients had strict trifecta outcomes. Tumor size was found to be a predictive factor affecting Trifecta at multivariate analysis. Conclusions: LPN procedure has been shown to demonstrate improved strict Trifecta outcomes in patients with T1a and T1b renal tumors. Only the tumor size was found to be a predictive factor regarding the Trifecta criteria.

Comparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy

Background: Scoring systems are useful to inform the patients about the success and complication rates of the operation prior the surgery. Aims: To determine the applicability of the popular scoring systems (Guy's, stone size, tract length, obstruction, number of involved calices, and essence/stone density and Clinical Research Office of the Endourological Society) by means of examining preoperative data of patients treated with percutaneous nephrolithotomy. Study Design: Cross sectional study. Methods: We retrospectively reviewed files of the patients who had undergone percutaneous nephrolithotomy in our center between 2011 and 2015. Excluded from the study were patients aged <18 years, and those who were not assessed preoperatively with computed tomography. Preoperative computed tomography images of all patients were assessed by a single observer, and patients were graded based on three scoring system. Demographic data were analyzed along with perioperative data (operation, fluoroscopy, length of hospital stay, changes in hematocrit values, location, and number of access sites, stone-free and complication rates). Results: A total of 298 patients who had been treated with 300 procedures were enrolled into the study. Mean age, stone burden, number of stones, and density were 48.1±12.9 years, 663.5±442.8 mm2, 1.8±1.1 and 888.3±273 HU respectively. Scores of the cases based on Guy's, stone size, tract length, obstruction, number of involved calices, and essence/stone density, and Clinical Research Office of the Endourological Society scoring system were calculated as 2, 7.6, and 222.1 points respectively. 81.6% of the patients were stone-free. Complications were detected in 30 (9.9%) patients. Based on receiver operating characteristic curve analysis a positive correlation was detected between success rate and scoring systems, i.e., Guy's (p=<0.001, r=-0.309), stone size, tract length, obstruction, number of involved calices, and essence/stone density (p=<0.001, r=-0.295), and Clinical Research Office of the Endourological Society (p=<0.001, r=0.426). The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. The sensitivity rates rates for Guy's, Clinical Research Office of the Endourological Society and Stone scoring system were as 78.78%, 80% and 82.34% respectively. Conclusion: All of scoring systems predicted correctly the success of the percutaneous nephrolithotomy procedures. The Clinical Research Office of the Endourological Society scoring system had the highest predictive value.