Combined usage of estrogen and melatonin restores bladder contractility and reduces kidney and bladder damage in ovariectomized and pinealectomized rat.

OBJECTIVE: The incidence of urinary bladder disturbances and renal structural changes and functional decline are found to increase with age. METHODS: We investigated the effect of melatonin treatment in addition to estrogen replacement therapy in pinealectomized (Px) and ovariectomized (Ovx) rats. 56 female Wistar rats were divided into seven groups, each containing eight animals: Sham, (Ovx), (Px), Px+Ovx, Px+Ovx receiving estrogen (Px+Ovx+E), Px+Ovx receiving melatonin (Px+Ovx+M) and Px+Ovx estrogen and melatonin supplemented (Px+Ovx+EM) group (EM group). We evaluated reduced glutathione (GSH) levels and malondialdehyde (MDA) levels. The mean collagen fiber (CF)/smooth muscle (SM) ratio in the bladder wall and structure of the kidney were examined histolologically. We also recorded response of the bladder contractility to acetylcholine (Ach). RESULTS: Px and Ovx groups showed statistically significant reductions of antioxidant defenses, impaired Ach-evoked contraction, histological changes compared with the control group. Also, these changes were prominent in Px+Ovx group compared with all other groups. Both estrogen and melatonin reversed these changes however best restoration was observed in the EM group. CONCLUSIONS: Px performed in addition to Ovx led to a distinct increase in oxidative damage in bladder and renal tissue and deteriorate of the detrussor function. Either estradiol or melatonin replacement alone or in combination prevents significant alterations of tissue histology and bladder contractility following Ovx and Px. Thus, combination treatment appears to be the best method to restore both contractility and histomorphology of bladder and kidney tissues after Ovx and Px (Tab. 3, Fig. 4, Ref. 44).

Effects of pinealectomy and exogenous melatonin on the brains, testes, duodena and stomachs of rats.

BACKGROUND: It is generally agreed that physiological levels of melatonin, a hormone secreted by the pineal gland, are important in protecting against oxidative stress-induced tissue damage. AIM: We investigated the effects that pinealectomy and the administration of exogenous melatonin have on the brains, testes, duodena and stomachs of rats. MATERIALS AND METHODS: Pinealectomized (Px) and sham-operated (non-Px) rats were used. We evaluated structural changes, and catalase (CAT), reduced glutathione (GSH), super oxide dismutase (SOD) and malondialdehyde (MDA) levels. The rats were divided into the following five groups (eight rats in each group): sham (non-Px), Px+ vehicle, Px+ melatonin (10 mg/kg given daily intraperitoneally for a week), melatonin and ethyl alcohol. RESULTS: The antioxidant levels in the tissue of Px rats were significantly lower than in those of the sham group. Administering melatonin significantly increased antioxidant levels (p < 0.05). The Px rats also showed a significant increase in MDA levels when compared to the sham group, and administering melatonin to the Px rats significantly reduced their MDA levels (p < 0.05). The severity of caspase-3 staining was lower in the Px+ melatonin group than in the Px+vehicle group. CONCLUSIONS: These findings suggest that significantly more oxidative and structural changes occur in rats' brains, spinal cords and testes after pinealectomy, but that this can be diminished by melatonin treatment. However, Px does not have important effects on the duodenum and stomach.

Single intrathecal fentanyl for combined spinal epidural anesthesia confers no advantage over hemodynamic effects in elderly patients.

BACKGROUND: Neuroaxial blockade for ambulatory transurethral resection of the prostate is a well established technique. Patients in this group are often at high risk for perioperative complications from concurrent diseases. The purpose of this study was to compare the elderly patients who received intrathecal fentanyl alone or intrathecal fentanyl plus bupivacaine or epidural anesthesia for transurethral resection of prostate surgery. MATERIAL AND METHODS: Ninety-nine patients were prospectively randomized to receive fentanyl 25 microg (Group F), fentanyl 25 microg plus hyperbaric bupivacaine 2.5 mg (Group BF), or epidural anesthesia adding fentanyl 50 microg (Group E) by combined spinal epidural anesthesia technique. RESULTS: The amount of local anesthetics used until when the sensorial block reached the level of T10 was significantly lower in the Group BF than in the Group E and the Group F (p < 0.001). Maximum level of sensory block was significantly lower in the Group BF than in the Group E and the Group F (p = 0.01). The time elapsed until the sensory block reached T10, the regression of sensory block to L5 level were significantly lower in the Group BF than in the Group E and the Group F (p = 0.005, p < 0.001, respectively). Compared to the basal values, mean arterial pressures were significantly lower in the Group BF than in the Group E and the Group F (p < 0.05). The occurrence of hypotension was significantly lower in the Group BF (9.4%) than in the Group E (18.2%) and the Group F (24.2%). CONCLUSIONS: Intrathecal hyperbaric bupivacaine 2.5 mg plus fentanyl 25 microg administration provides shorter motor block onset time, less local anesthetic usage and adequate hemodynamic stability in elderly patients.

Erectile dysfunction in testicular cancer patients treated with chemotherapy.

Information on male potency in testicular cancer (TC) patients treated with chemotherapy is insufficient. We aimed to assess the levels of depression and anxiety symptoms, sexual function and gonodotrophins. Participants (n = 27) were identified and recruited from the genitourinary services of two medical centres, one in Inonu University and the other in the Firat University. All patients are TC patients treated with chemotherapy after unilateral orchiectomy. Participants completed follow-up assessments after the completion of the chemotherapy regimen. Serum luteinising hormone, follicle-stimulating hormone and testosterone levels were determined after blood samples had been taken in the morning after an overnight fast. International Index of Erectile Function (IIEF-15) was also used to evaluate erectile dysfunction (ED) score. Beck Depression and Beck Anxiety Scale were used to assess psychological symptoms. The findings indicated that men treated with chemotherapy had significantly different IIEF-15 and Beck Anxiety scores compared with men who did not receive chemotherapy. But no statistically significant difference was determined in the serum gonodotrophin levels and depression score between the two groups. It is concluded that patients with TC undergoing chemotherapy have greater risk than normal men for ED, independently of the gonodotrophin's level.

Perineal ectopic testis: a case report.

Perineal ectopia testis (PET) is a rare congenital anomaly with prevalence of 1% of all cases of undescended testes. PET may be associated with a congenital hernia. The ectopic testis is relatively rare but is easily recognized and treated by orchiopexy. We report a 8 years old male with empty scrotum. He was diagnosed to PET and was treated with orchiopexy.

Iatrogenic foreign body in bladder induced recurrent urinary tract infection: a case report.

Urinary tract infections (UTI) are the most common infections in women. Although these infections can be seen in healthy women without any anatomical and functional pathology in etiology, foreign bodies should also be considered. We present a foreign body case due to iatrogenic causes which had recurrent urinary tract infections for 5-6 months and that did not respond to medical treatment.

Primer malignant melanoma of kidney: a case report.

We report a case of malignant melanoma of the kidney presenting as a primary tumor. This tumor was found incidentally in a 67-year-old man. This is a rare primer malign melanoma case of the kidney in 67-year old man, with no history of melanoma, presenting with an asymptomatic solitary renal mass. The patient underwent a right radical nephrectomy, We discuss the probability that this tumor is renal in origin and directly linked to the origin of malignant melanoma.

The effect of varicocoelectomy on the relationship of oxidative stress in peripheral and internal spermatic vein with semen parameters.

The aim of this prospective controlled study was to investigate the levels of reactive oxygen species (ROS), including asymmetric dimethylarginine (ADMA), oxidative stress index (OSI) and total oxidant capacity (TOC), and antioxidants with total antioxidant capacity (TAC) in peripheral and internal spermatic veins blood, the relationship of these factors with sperm parameters in the infertile varicocoele patients, and the amelioration effect of varicocoelectomy on these outcomes. Thirty-one primary infertile varicocoele patients and 31 fertile control patients evaluated for determining the levels of ADMA, TOC, OSI, superoxide dismutase (SOD), glutathione (GSH), TAC, and semen analysis. The patients' preoperative SOD, GSH and TAC levels, which were significantly lower than the controls, significantly increased postoperatively. Although SOD and GSH were significantly higher in spermatic vein compared to median cubital vein, TAC was significantly higher in median cubital vein. ADMA, TOC and OSI were significantly higher in the patient group. TOC and OSI were significantly higher in spermatic vein compared to median cubital vein. Postoperative TOC, OSI and ADMA reduced to the control levels. Total antioxidant capacity in the peripheral circulation and oxidative stress index in the internal spermatic vein could give an idea about the possible improvement in sperm count acquired by varicocoelectomy.

The role of National Institutes of Health category IV prostatitis in accurately staging the newly diagnosed prostate cancer.

BACKGROUND: It has been known that the National Institutes of Health category IV (NIH-IV) prostatitis increases the serum total prostate-specific antigen (tPSA) in patients with benign prostatic hyperplasia. However, the effect of NIH-IV prostatitis on tPSA levels, which are used for staging prostate cancer (PCa) in patients with PCa, has not been previously investigated. AIM: To evaluate the effect of NIH-IV prostatitis on the tPSA which is used for staging PCa in patients with newly diagnosed PCa. METHOD: A total of 198 patients in whom PCa was detected were included in the study. Group 1 included patients with only PCa, while Group 2 included patients with prostatitis and PCa. The tPSA levels of patients in Groups 1 and 2 were compared. RESULTS: A total of 120 (61%) PCa (Group 1) and 78 (39%) PCa+NIH-IV prostatitis (Group 2) patients were identified. The tPSA levels of 70 (58%) patients in Group 1 and 22 (28%) patients in Group 2 were at the interval of <20 ng/ml (the mean levels of tPSA: 11.8±4.5 and 14.1±3.3, respectively). The tPSA levels of 50 (42%) patients in Group 1 and 56 (72%) patients in Group 2 were within the range of ≥20 ng/ml (the mean levels of tPSA: 39.9±31.0 and 47.0±29.2, respectively). Within both the <20 ng/ml range and ≥20 ng/ml range, the mean tPSA value in Group 2 was found to be significantly higher than that of Group 1 (p=0.03 and 0.01, respectively). CONCLUSION: The existence of NIH-IV prostatitis together with cancer in patients with PCa significantly increases the tPSA level which is used in staging the PCa.

Evaluation of the effects of ozone therapy on Escherichia coli-induced cytitis in rat.

OBJECTIVES: The aim of the study was to investigate the effect of ozone on oxidative/nitrosative stress and bladder injury caused by Escherichia coli in rat bladder. METHODS: Twenty-one Wistar-Albino-type female rats included in the study were divided into three groups of equal number: (1) sham operation (control), (2) E. coli-only (EC), (3) EC + ozone. After ozone therapy for 3 days, urine and tissue samples were obtained for biochemical, microbiological, and histopathological analysis. RESULTS: Tissue malondialdehyde (MDA), myeloperoxidase (MPO), and nitric oxide (NO) level were increased, whereas superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity was decreased in the EC group. MDA, MPO, and NO levels were decreased, whereas SOD, GPx activity was increased in the ozone-treated group. Also, there was no bacterial translocation in this group. CONCLUSION: The results of the present study suggest that ozone may be used as an agent to protect the bladder from oxidative/nitrosative stress occurring in cystitis.