Semirigid ureteroscopy is effective, with a 90% stone-free rate and efficacy quotient. Most complications are low grade and self-limiting. Our results confirm that prolonged operative time is an independent predictor of complications, and should be considered when choosing and performing the treatment modality.

Testicular torsion (TT) is a serious urologic emergency that is observed in adolescent males and that can lead to infertility if left untreated. The ischemia-reperfusion (I/R) injury due to TT has been implicated in the pathogenesis of testicular damage. We investigated the effects of melatonin on oxidative damage in the ipsilateral and contralateral testes of rats induced by unilateral TT. A total of 21 prepubertal male Wistar albino rats were divided into three groups, each consisting of seven rats. In Group 1 (SHAM group): a sham operation to the left testis and bilateral orchiectomy were performed. In Group 2 (I/R group): I/R injury was created by rotating the left testis 720° in a clockwise direction for 2 h and detorsing the testis after 2 h. Group 3 (I/R + MEL group): rats were subjected to I/R injury and one-shot melatonin injection (50 mg kg−1, intraperitoneal (i.p.)). The testes of the rats were excised bilaterally in all groups. The testicular tissue activities of antioxidant catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase enzymes (GSH-Px), and the tissue levels of malondialdehyde (MDA), protein carbonyl (PC) and nitric oxide (NO) were determined. Administration of melatonin caused a significant decrease in lipid peroxidation and enzyme activities in the ipsilateral testis when compared with the control group (P < 0.05). All of the changes in the enzyme activities of the contralateral testis were insignificant (P > 0.05). MDA levels were significantly altered in the contralateral testis (P = 0.009). Melatonin administration decreased the deleterious effects of I/R injury in the ipsilateral torted testes of the rats. The contralateral testes were slightly affected by unilateral TT.

Introduction The effects of squamous and/or glandular differentiation in urothelial carcinoma of bladder on recurrence, progression and survival rate were evaluated in this study. Patients and methods Between 1998 and 2003, a total of 223 patients who had been treated with transurethral resection for bladder cancers were evaluated. The patients were divided into two groups as; Group I: tumor patients with squamous and/or glandular differentiation, Group II: patients without these findings. Results Histologically 189 (84.7%) were conventional urothelial carcinoma and 34 (15.2%) were tumors with squamous and/or glandular differentiation. The mean age of the patients was 64.4 ± 12.7 (range 36-81) years. Survival rates within a period of 46.23 ± 14.8 (12-67) months were 76.47% for Group I and 89.94% for Group II (P = 0.027). The stage distribution as pTa, pT1, and ‡pT2 was 2 (5.9%), 18 (52.9%), and 14 (41.2%) in Group I and 101 (53.4%), 51 (27%) and 37 (19.6%) in group II, respectively (P = 0.001). There was a statistically significant tendency towards higher stage at presentation in Group I and the grade distribution was significantly higher in Group I than Group II (P < 0.001). Conclusion High recurrence rates and poor prognosis of these patients should be kept in mind in the follow-up period. In this respect, these patients should be followed up closely.

This experimental study was designed to produce ischemia-reperfusion (I/R) injury in rat corpus cavernosum by inducing 1 h of priapism and investigating the effects of melatonin on the levels of oxidative injury parameters. Twenty-one adult male rats were randomly divided into three groups as follows; sham operated, control group (Group C): only penectomy was performed and blood (3 ml) drawn from vena cava inferior (VCI), ischemia and reperfusion group (Group I/R); priapism (1 h) + ½ h reperfusion + penectomy + blood from VCI, melatonin treatment group (Group I/R + M); priapism (1 h) + melatonin (½ h before reperfusion, 50 mg/kg, ip) + ½ h reperfusion + penectomy + blood from VCI. Priapism was induced with a vacuum erection device (cut tip of 2-cc syringe) and a rubber band was placed at the base of the erect penis. In two groups, excluding Group C, penectomies were performed after 1 h of ischemic priapism and ½ h reperfusion for biochemical analysis of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA) and protein carbonyl (PC) in the tissues. In all groups, about 3 ml blood was drawn from VCI to study the same parameters in systemic circulation. The results were compared statistically using one-way analysis of variance (ANOVA). As a result, in biochemical examination of penile tissues, there were significant increase in SOD, CAT activities and MDA levels in I/R group in comparison with group C (P < 0.05). With melatonin treatment, these levels were decreased closer to control levels (P < 0.05). The changes in PC levels were insignificant in penile tissues of all groups (P > 0.05). Analysis of serum in all rats revealed that the activity of SOD and the levels of MDA, NO and PC were increased in I/R group when compared with control group but with multiple comparisons only the increases in SOD activity and NO level were significant (P < 0.05). Decrease in the activity of SOD and the levels of NO and PC were significant after melatonin administration in serum of all groups (P < 0.05). The results of this study showed that experimentally induced priapism caused oxidative injury in cavernosal tissues of rats, and treatment with melatonin alleviated these effects. From the result of this experimental study, it can be extrapolated that melatonin may be used as an antioxidant agent in the treatment of ischemic priapism in the future urology practice.

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