Knowledge of the formation of the normal male urethra may elucidate the etiology of hypospadias. We describe urethral formation in the mouse, show the similarities and relevance to human urethral development, and introduce the concept of the epithelial seam formation and remodeling during urethral formation. Three mechanisms may account for epithelial seam formation: (1) epithelial-mesenchymal transformation similar to that described in the fusion of the palatal shelves, (2) apoptosis, and/or (3) tissue remodeling via cellular migration. Urethral development in the embryonic mouse (14-21 days of gestation) was compared with urethral formation in embryonic human specimens (8-16 weeks of gestation) by using histology, immunohistochemistry, and three-dimensional reconstruction. The urethra forms by fusion of the epithelial edges of the urethral folds, giving a midline epithelial seam. The epithelial seam is remodeled via cellular migration into a centrally located urethra and ventrally displaced remnant of epithelial cells. The epithelial seam is remodeled by narrowing approximately at its midpoint, with subsequent epithelial migration into the urethra or penile skin. The epithelial cells are replaced by mesenchymal cells. This remodeling seam displays a narrow band (approximately 30 microns wide) of apoptotic activity corresponding to the mesenchymal cells and not to epithelial cells. No evidence was seen of the co-expression of cytokeratin and mesenchymal markers (actin or vimentin). Urethral seam formation occurs in both the mouse and the human. Our data in the mouse support the hypothesis that seam transformation occurs via cellular migration and not by epithelial mesenchymal transformation or epithelial apoptosis. We postulate that disruption of epithelial fusion remodeling, and cellular migration leads to hypospadias.

The purpose of the present study was to compare chosen physical fitness characteristics of Turkish professional basketball players in different divisions (first and second division) and playing positions. Forty-five professional male basketball players (14 guards, 15 forwards, 16 centers) participated in this study voluntarily. For each player, anthropometric measurements were performed, as well as a multi-stage 20 m shuttle run, isokinetic leg strength, squat jump (SJ), countermovement jump (CMJ), 10–30 meter single-sprint and T-drill agility tests. The differences in terms of division were evaluated by independent t-test and the differences by playing position were evaluated by one-way ANOVA with Post Hoc Tukey test. First division players’ CMJ measurements were significantly higher than those of second division players’ (p≤0.05), whereas second division players’ 10 m sprint times were significantly better than those of first division players’ (p≤0.05). In addition, forwards and centers were significantly taller than guards. Centers were significantly heavier and their T-drill test performances were inferior to those of forwards and guards (p≤0.05). Moreover, guards had a significantly higher maximal oxygen uptake (VO2 max) than centers. Guards and forwards showed significantly better performance in the 10 and 30 m sprint tests than centers (p≤0.05). Forwards and centers had significantly better left leg flexor strength at 180°.s−1(p≤0.05). In conclusion, the findings of the present study indicated that physical performance of professional basketball players differed among guards, forwards and centers, whereas there were not significant differences between first and second division players. According to the present study, court positions have different demands and physical attributes which are specific to each playing position in professional basketball players. Therefore, these results suggest that coaches should tailor fitness programs according to specific positions on the court.

A clear understanding of the anatomy of the human clitoris is important for surgical reconstruction. As in the human penis, nerves in the clitoris form an extensive network around the tunica of the corporeal body with a nerve-free zone at the midline 12 o'clock position. Care should be taken to preserve all nerves. Reduction of the glans clitoris should not violate the extensive innervation that predominates on the dorsal aspect of the glans. The normal clitoris has corporeal bodies that are smaller but analogous to those of the penis. One may consider their function when extensive resection is considered.

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Objective To describe the detailed anatomy of the urethral plate in relation to its controversial role in hypospadias surgery. Materials and methods A newborn penis with proximal penile hypospadias and two fetal penises with distal shaft hypospadias were included in the study; 30 normal fetal penises served as the control. Specimens were embedded in paraf®n and serially sectioned (6 mm) after formalin ®xation. Every 10th section was stained with haematoxylin and eosin.Immunohistochemical staining for nerves (S100), smooth muscles (a-actin), blood vessels (factor VIII) and epithelium (cytokeratins 7, 14 and 18) were used on selected sections, with particular attention to the urethral plate. Masson's trichrome and Sirius Red stains were used to localize collagen. Results There were extensive blood vessels, glands and smooth muscle under the urethral plate in the hypospadias specimens. These relatively well organized tissues corresponded to an abnormally formed corpus spongiosum. The glands underneath the urethral plate and adjacent to the normal urethra showed positive staining for cytokeratins 7 and 18, respectively (markers of endodermal origin) but were negative for cytokeratin 14 (a marker of ectodermal origin). Penile skin and urethral plate epithelium stained positively for cytokeratin 14 but not for cytokeratin 7 and 18. The urethral plate has a rich nerve supply, as determined by S100 staining.Collagen intensity under the urethral plate was no different from that in normal areas. Tunica albuginea stained intensely for type I and III collagen. Conclusion These results show that the urethral plate is well vascularized, has a rich nerve supply and an extensive muscular and connective tissue backing. These features may explain the lower complication rate with onlay¯aps than with tube¯aps. Therefore, from these anatomical ®ndings, we continue to advocate preservation of the urethral plate and the onlay island¯ap for hypospadias reconstruction.

Increased knowledge of normal and hypospadiac penile anatomy with respect to the nerves, corporeal bodies, glans and vascularity is useful for the strategic design of penile reconstructive procedures.

Objectives: To prospectively evaluate the efficacy of single dose antibiotic prophylaxis in 12-core transrectal ultrasonography (TRUS) guided prostate biopsy. Methods: A total of 400 patients who underwent prostate biopsy with TRUS guidance were included. The patients were prospectively randomized in three groups regarding antibiotic prophylaxis. The first group (139 patients) received a single gram of intramuscular ceftriaxone, while the second group (131 patients) had a 3-day course of oral ciprofloxacin. The third group (130 patients) had single oral 500 mg of ciprofloxacin. All patients had urine cultures prior to biopsy and on the second day after biopsy. Results: The study groups were compared in terms of the results of urine cultures and clinical parameters. Overall, only seven patients (1.8% of the cases) had positive urine cultures with no difference between these three groups. Additionally, no significant difference was observed regarding morbidity rates in all groups. Only eight patients (2%) developed major complications requiring hospitalization. There was no increase in the rate of infectious complications when the biopsy core numbers were increased up to 12. Conclusions: The current study suggests that a single oral dose of antimicrobial prophylaxis is reasonable in TRUS prostate biopsy even in the case of 12-core sampling.

The high power diode laser provided significant improvements in International Prostate Symptom Score and the maximal flow rate with low morbidity. Thus, these results of prostate vaporization with the high power diode laser, representing what is to our knowledge the first clinical study in the literature, are encouraging.