Genetic polymorphism in sex hormone metabolism and prostate cancer risk.

We compared single-nucleotide polymorphisms for point mutations in cytochrome P450 genes, including cytochrome P450c17α (CYP17), cytochrome P450 aromatase (CYP19), steroid-5-a-reductase (SRD5A2), and prostate-specific antigen (PSA) involved in androgen and estrogen production. Between January 2008 and January 2010, 90 patients were enrolled in the study. Of these patients, 28 were diagnosed with benign prostatic hyperplasia and 32 with prostate cancer, while 30 subjects were included as a control group. CYP19 1531 C>T, SRD5A2 gene V89L, CYP17 gene -34 T/C, PSA-158 (G/A) regions were evaluated for the association between polymorphisms and benign prostatic hyperplasia and prostate cancer in study population. Age, body mass index, peak urinary flow rate (Q max), voided urine volume, post-void residual urine volume, total PSA, free PSA, free/total PSA ratio, prostate weights measured by transrectal ultrasonography, erectile dysfunction score, and international prostate symptom score were compared between groups. No statistically significant difference in CYP19 1531 C>T, SRD5A2 V89L, and CYP17 -34T/C was observed in both groups when compared to the control group. The homozygote variant of PSA- 158 (G/A) was significantly lower for prostate cancer. Age, total PSA, free PSA, free/total PSA ratio, prostate weight, and Q max were evaluated using multi-variant analysis. Only Q max was significant for the homozygote variant. The probability of being homozygous was 5.8- fold higher in subjects with Q max >14 mL/s. In the Turkish population, the homozygote variant of PSA-158 (G/A) was significantly lower for prostate cancer.

Effects of testicular histopathology on sperm retrieval rates and ICSI results in non-obstructive azoospermia.

Non-obstructive azoospermia (NOA) is characterised by absence of sperm in the ejaculate. Significant relationship between the pattern of the testis histopathology of NOA and successful sperm retrieval rate is well known. In this study, we assess efficacy of testicular histopathology on sperm retrieval rates and intracytoplasmic sperm injection results after microdissection testicular sperm extraction in cases of non-obstructive azoospermia. It is a retrospective analysis of 111 NOA patients who have histopathological confirmation. According to histopathological findings, the patients were divided into three groups: Sertoli-cell-only syndrome (SCOS), maturation arrest (MA) and hypospermatogenesis. Sperm retrieval rate was significantly higher in hypospermatogenesis group compared with that in SCOS and MA groups. In terms of fertilisation and clinical pregnancy rates, there was no significant difference between the groups. As a result, compared with MA and SCOS, hypospermatogenesis has higher sperm retrieval rates. Our study revealed that once successful sperm retrieval is achieved, fertilisation and clinical pregnancy rates are similar in NOA patients.

Obturator nerve block and transurethral surgery for bladder cancer.

AIM: The obturator nerve may be accidentally stimulated during transurethral resection of lateral bladder wall tumors, causing adductor spasms. In this study, we evaluated the results of obturator nerve block (ONB) produced via a blind anatomical approach. METHODS: Between April 2004 and April 2006, 114 patients with bladder tumors located on the lateral bladder wall had undergone transurethral resection of the bladder tumor (TUR-BT) at our clinic. Sixty-three patients with adductor spasms received local anesthetic ONB; no adductor spasms were observed in the remaining 51 patients. ONB was obtained with 10 mL of 1% prilocaine infiltrated through a 22 G spinal needle using a blind anatomical approach. RESULTS: Two of the 63 patients were excluded from the study due to bladder wall perforations caused by adductor spasms. Successful ONB was performed unilaterally in 61 patients. Muscle spasms were absent in 59 of the 61 patients (97%). In 2 patients receiving spinal anesthesia, and in whom total resection of bladder tumors was performed, adductor muscle spasms were seen during deep resection of the tumor bed, which prevented surgery from proceeding further. CONCLUSION: ONB for the prevention of adductor spasms is a useful technique for the prevention of deep and uncontrolled cuts in the dorso-lateral part of the bladder wall during TUR-BT. The blind anatomical approach is a simple and easy procedure, with a high success rate.