Purpose The aim of the study was to investigate white blood cell counts and neutrophil to lymphocyte ratio (NLR) as markers of systemic inflammation in the diagnosis of localized testicular cancer as a malignancy with initially low volume.Materials and Methods Thirty-six patients with localized testicular cancer with a mean age of 34.22±14.89 years and 36 healthy controls with a mean age of 26.67±2.89 years were enrolled in the study. White blood cell counts and NLR were calculated from complete blood cell counts.Results White blood cell counts and NLR were statistically significantly higher in patients with testicular cancer compared with the control group (p<0.0001 for all).Conclusions Both white blood cell counts and NLR can be used as a simple test in the diagnosis of testicular cancer besides the well-known accurate serum tumor markers as AFP (alpha fetoprotein), hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase).

Objectives:To evaluate protective effects of darbepoetin and tadalafil against ischemia-reperfusion injury in ipsilateral and contralateral testicle.Materials and Methods:Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion.Results:There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000).Conclusion:The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. Material and method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI). Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20-46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group. Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.KEY WORDS: Infertility; Male sexual dysfunction; Depression; Secondary infertile man. clear definition of this time, the 12 months period is also accepted for the secondary infertility by many authors. Diagnosis of infertility can be made in nearly 15% of the couples who want to have a baby and primary or secondary infertility are detected in 90 and 10% of them (3). One of the basic and primitive instincts in human beings is reproductive instinct. Reproductive deficiency frequently creates a social stigma, which is perceived as a disgraceful condition (4). Infertility emerges from a sudden and unexpected life crisis, which can be diagnosed in the long run. It results in excessive stressful problems, which strain adjustment mechanisms (5). Studies analyzing the association between infertility and psychological functions have used one of the following models. One of them is psychological infertility model, which asserts the role of an existing psychopathology on the etiology of infertility and the other model (psychological result) claims that psychological problems arise as a result of infertility (6). Recently direct correlation of mental stress with infertility problems and its impact on the outcomes of infertility treatment has been demonstrated. For example it has been revealed that during natural disasters like earthquakes, sperm quality activities of seminal plasma superoxide dismutase and arginine decrease, and nitric oxide levels increase in men under stress (7,8). Since psychiatric disorders are more frequently analyzed during infertility investigations, scales specific to infertility process haven't been developed yet (9). In developed countries, it appears to be appropriate to take a detailed history about psychological status of the infertile couple. The rationale of this appr...

Aim We aimed to investigate the predictor role of the systemic immune‐inflammation index (SII) on Bacille Calmette‐Guerin (BCG) response in patients with high‐risk non‐muscle invasive bladder cancer (NMIBC). Methods A total of 96 patients with high‐risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence‐free survival (RFS) and progression‐free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models. Results The mean follow‐up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut‐off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds. Conclusions The SII might be a successful, non‐invasive and low‐cost parameter for prediction of BCG failure in patients with high‐risk NMIBC. The cut‐off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.

Introduction: Emphysematous pyelonephritis (EPN) is a rare acute necrotising infection of renal parenchyma. We discuss clinical details and treatment strategies of 8 patients with EPN followed at our clinic. Methods: We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 8 patients with EPN followed at our urology clinic between 2012 and 2015. Results: The mean patient age (female: 5; male: 3) was 62 (range: 51-82) years. Based on computed tomographic findings, EPN was classified as class 1 (n = 3), class 2 (n = 3) and class 3a (n = 2). All patients had fever, flank pain, nausea, and vomiting. Five patients had type 2 diabetes mellitus and 3 diabetic patients also had renal stones. Escherichia coli (n = 6), Klebsiella species (n = 1), and Proteus species (n = 1) were grown in urine cultures. All patients had unilateral involvement. Increased white blood cell counts, sedimentation rate, and C-reactive protein levels were detected in all cases. In addition to medical treatment, 2 patients underwent a nephrostomy catheter placement and another 2 patients underwent nephrectomy upon deterioration of her general health state. After achieving clinical stabilization with medical treatment, 1 patient underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotherapy. All patients were discharged with clinical cure. Conclusion: Mortality rates of EPN are gradually decreasing. Preservation of renal reserve is possible due to early diagnosis, appropriate antibiotherapy, and drainage.

Objective: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. Materials and methods: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). Results: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). Conclusions: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.

Objective: To determine the relationship between erectile dysfunction and metabolic syndrome (MetS) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Material and methods:Seventy-eight patients who were admitted to our outpatient clinic because of BPHrelated LUTS over 40 years of age were included in the study. Patients with LUTS and erectile dysfunction (ED) were evaluated by International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) forms. The National Cholesterol Education Program Adult Treatment Panel III criteria was used for the diagnosis of MetS. LUTS were classified as mild, moderate, and severe according to IPSS and ED was classified as mild-moderate, moderate, and severe according to the IIEF-5. For the evaluation of data, descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, and maximum) and also for the comparison of the variables with non-normal distribution in 3 or more than 3 groups Student's t test, Mann-Whitney U, ANOVA, chi-square, Fisher Exact tests, and Pearson correlation analysis were used. P<0.05 was accepted as the level of statistical significance.Results: Mean age of the patients included in the study was 61.83±9.15. In 34.6% of the patients with MetS, 70.5% of the patients with ED and 37.2% of the patients with severe LUTS were determined. There were no significant differences between the mean age of patients with and without metabolic syndrome (p>0.05). There was a positive correlation with age and severity of LUTS but this relationship was not found to be statistically significant (p>0.05). Mean age of the patients with ED was significantly higher than those without (p<0.001). A statistically significant relationship was not observed between the mean IPSS scores and the severity of LUTS with Mets. However, we observed a weakly positive correlation between triglyceride levels and IPSS. Mean IIEF-5 scores of the patients with MetS were significantly lower than those of the patients without MetS. Severity of ED in the patients with MetS was significantly higher than patients without MetS. The percentage of ED in patients with severe LUTS was found to be statistically higher than other patients with mild, and moderate LUTS. In addition, we found a low degree of negative correlation between IPSS and IIEF-5 scores. Conclusion:In patients with LUTS as a consequence of BPH, when severity of symptoms increases, frequency of MetS increases proportionally and severe ED is observed much more frequently.

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