Cite as: Can Urol Assoc J 2017;11(1-2):E19-25. http://dx.doi.org/10.5489/cuaj.3872 Published online January 12, 2017 AbstractIntroduction: Nitric oxide (NO) plays an important role in the ischemia and reperfusion process. In this study, we aimed to examine the effect of L-arginine, tadalafil, and their combination for prevention of the ischemia reperfusion injury after testis torsion in rats. Methods: A total of 40 adult, male Sprague-Dawley rats were allocated into five groups. Three hours of left testicular torsion was performed in each group, excluding the control group. While the ischemia reperfusion (I/R) group had no treatment, I/R + Arg group received L-arginine, I/R + Td group received tadalafil and I/R + Arg + Td group received tadalafil and L-arginine 30 minutes before the detorsion. Then the left testis was untwisted for four hours of reperfusion. After bilateral orchiectomy, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue. Spermatogenesis was evaluated with Johnsen's score. Results: LPx levels of the I/R group were found to be significantly higher than for groups that received drugs for both testes (p<0.001). GSH levels of the combination group were higher than I/R group in ipsilateral testis (p<0.01) and it was significantly higher than other groups for contralateral testis (p<0.001 for I/R group, p<0.01 for I/R + Arg, p<0.05 for I/R + Td). Mean Johnsen's score of the I/R group was found to be significantly lower than treatment groups in ipsilateral testis (p<0.001 for I/R + Arg + Td group, p<0.01 for other treatment goups) and contralateral testis (p<0.001). The mean Johnsen score of the combination group was significantly higher than that of other treatment groups in ipsilateral testis (p<0.05) and it was significantly higher than in the I/R + Td group in the contralateral testis (p<0.05). Conclusions: L-arginine, tadalafil, and combination of these two molecules showed protective effect against ischemia/reperfusion injury for both testes after unilateral testis torsion.

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Objectives: To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones. Material and Methods: We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy (URS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another. Results: Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications. Conclusions: Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.

BACKGROUND: We aimed to compare the protective effects of tadalafi l and diltiazem on renal histology after ischemia and reperfusion injury in a rat model of shock wave lithotripsy. METHODS: A total of 40 adult, male Sprague-Dawley rats were randomized into four groups as follows; control group (group C), group S (SWL + nephrectomy), group T (SWL + tadalafi l given before nephrectomy) and group D (SWL + diltiazem given before nephrectomy). Both kidneys were evaluated regarding tubular damage, peritubular fi brosis and heat shock protein-70 (HSP-70) immune-expression of glomeruli, cortical and medullar collector tubules on light microscopy. RESULTS: HSP-70 levels of cortical and medullar collector tubules, tubular damage and peritubular fi brosis scores were decreased in group T compared with group S. Similarly, HSP-70 immunostaining levels on cortical and medullar collector tubules, tubular damage and peritubular fi brosis scores were decreased in group D compared with group S. No signifi cant difference was detected between group D and group T for all parameters. CONCLUSION: As a result, shock waves induced renal cell damage due to increment of HSP-70 levels, morphological irregularity in tubules and increased peritubular fi brosis. Tadalafi l and diltiazem had benefi cial effects in decreasing renal tissue damage which was caused by SWL (Tab. 2, Fig. 6, Ref. 29). Text in PDF www.elis.sk.

Although penile keloid formation can be seen after major penile surgeries, it is rarely reported after circumcision and there is no standard method for the treatment of this complication. We present a patient who was admitted with a penile keloid mass that occurred after circumcision surgery and discuss the treatment we administered in light of the current literature review. A 7-year-old white boy was admitted to our clinic with a swollen stiff mass on the foreskin six months after circumcision. The parents indicated that no complication occurred in the early postoperative period. Physical examination revealed a white-colored stiff mass measuring approximately 2&times;1.5 cm in size along the penile ventral surface. Intralesional injection of 0.5 ml triamcinolone acetonide was administered for 12 weeks. At 9 months after circumcision, the keloid tissue was resected. Beginning from the first postoperative week, a silicone gel sheet and topical steroid application were administered for 8 weeks. At a 1-year follow-up, the penis had a satisfactory appearance.

Aim: Laparoscopy is an important part of surgical training. Laparoscopy courses are organized to increase competence of laparoscopy. This aim of this paper is to evaluate the laparoscopic surgery competence of Turkish urologists and the effectiveness of laparoscopy courses. Methods: In 2014, an online survey consisting of 11 questions was sent to 180 urologists via e-mail, among which 78 responded. The survey questions aimed at gathering information about where the urologists worked, their laparoscopic surgical experience, how long they attended laparoscopy courses, and whether they considered themselves to be competent in laparoscopic surgeries. Results: 41.2% of the respondents who considered themselves to be competent in laparoscopy and 84.1% of those who did not, stated that they wanted to attend laparoscopy courses (P<0.001). 100% of the respondents who could perform Level-1 laparoscopy surgeries stated that they did not consider themselves to be competent and wanted to receive laparoscopic training (P<0.001). 54.9% of those who did not receive laparoscopy training during their residency and 48.1% of those who received training during residency stated that they attended courses in the past. All respondents who attended long-term courses and 73.6% of those who attended short-term courses could perform laparoscopic surgeries (P<0.001). It was also determined those who attended long-term courses could perform complicated laparoscopic surgeries (P<0.001). Conclusion: This study revealed that the courses contributed a lot to laparoscopic surgical competence after residency. The study stresses that if the urologists who did not receive laparoscopy training during their residency attend long-term courses, they can increase their competence in laparoscopy.

Introduction: In this study, we aimed to compare retrospectively the efficacy of 500 mg ciprofloxacin with a combination of 400 mg cefixim and 125 mg clavulanic acid to prevent potential infections and complications after TRUS-PB. Method: We evaluated 276 patients who underwent prostate biopsy with the aim to diagnose prostate cancer between March 2014 and January 2016. First group of patients were given ciprofloxacin twice daily and the second group of patients a combination of 400 mg cefixim and 125 mg clavulanic acid once a day both for two days before the procedure and these drugs were continued 3 days after the procedure.In both groups urinalysis and urine culture were performed one day before and 10 days after procedure. Both groups were compared in terms of postoperative infections and complications. Results: Mean age of the patients was 62.5 years in Group 1,and 63.4 years in Group 2. Mean PSA level was 12.3 ng/dL, 11.4 ng/dL in group 2. Mean prostate volume was 45.3 cm 3 in Group 1, 48.5 cm 3 in Group 2. Urine culture positiitye was observed in 12 patients in Group 1 and in 10 patients of in Group 2. High fever with urine culture positivity was observed in 1 patient in Group 1 and in 2 patients in Group 2. There was no statistically difference between groups in terms of postoperative infections and complications. Conclusion: Ciprofloxacin and combination of cefixime-clavulonic acid are effective regimens for the prevention of postoperative infectious complications after TRUS-PB. Increasing antibiotic resistance in recent years will etermine the choice.

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