Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates.

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Background: Testicular torsion is an emergency condition in which spermatogenesis may be irreversibly damaged. There have been controversial results about the effect of testicular torsion on steroidogenesis. We aimed at investigating the effect of testicular torsion on steroidogenesis. Material and Methods: A total of 40 adult male rats were divided into 4 groups. Left testicles were removed in all groups. Right testicles were torsioned and remained in the torsion position for 1, 3 and 5 h in study groups, whereas no torsion was performed in control. Serum luteinizing hormone (LH) and total testosterone (TT) levels were measured on the 3rd and 30th days of surgery and orchiectomy was performed on the 30th day of testicular torsion for histopathological evaluation. Results: TT levels of study groups were significantly lower than that of the control group on the 3rd day of torsion. LH of study groups was higher than that of the control group, but the difference was significant only in the 5 h-torsion group. The total number of Leydig cells increased in 1- and 3-h groups, whereas it decreased in the 5-hour group. Conclusion: Testosterone production and Leydig cell functions significantly decreased after 5 h torsion in the rat model. The duration of torsion less than 5 h yielded partial dysfunction on steroidogenesis.

Objective: Evaluation of Botulinum Toxin-A (BTX-A) as an alternative treatment option in patients whom previous treatments were failed. Methods: Between March 2005 and September 2006, a total 19 patients; 16 patients with overactive bladder (5 neurologic, 11 idiopathic), 2 with nocturnal enuresis, 1 with interstitial cystitis, intravesical BTX-A injection was applied. Except one patient, 18 patients with a median age 46 (20 -80) were registered to the study. Patients were examined at postoperative 3 weeks and 6 months with ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and satisfaction forms used in our clinic. Results: The median follow-up time was 16 months (6 -18). When evaluated according to diagnosis, symptoms were improved 100% in neurologic overactive bladder (5/5), 80% in idiopathic overactivity (8/10), 50% in nocturnal enuresis (1/2). In one patient with interstitial cystitis there was no improvement. Median efficiency time of BTX-A treatment was 6 months (1 -17). At 3 weeks and 6 months after the treatment, ICIQ-SF score was decreased to 3.6 and 7.5 respectively from preoperative level of 18.7. Quality of life scores at preoperative, 3 week and 6 months were 9.7, 2.7 and 4.3 respectively. Except 3 patients with overactive neurologic bladder because of spinal cord injury, symptoms of patients with pollacuria and nocturia decreased at 3. week. Even if these rates increased at 6 months they still were significantly less than preoperative status. The spinal cord injured 3 patients had clean intermittent catheterization per 1 hour and had urinary incontinence between the catheterizations preoperatively, however at 3 weeks and 6 months the intervals of catheterisations was 4 hours and 3 hours respectively and also the urinary incontinance between the catheterisations improved. At patient satisfactions, 78% of patients declared that they were pleased and underwent the procedure again and will recommend it to their relatives with similar problems. One patient had a complication as tansient weakness on her legs. Conclusion: BTX-A injections provide an alternative treatment before surgery at overactive bladder especially for those who doesn't response to medical treatment or cannot use antimuscarinics because of their side effects. Further studies with a greater number of patients are needed for determining the effectiveness of BTX-A on patients with voiding dysfunctions.