Testicular sperm retrieval method: histological effects of location of incision.

This research was conducted to evaluate the effects of a transverse vs. longitudinal incision for testicular sperm retrieval. Rats were divided into 4 groups: I: control, II: sham operation, III: longitudinal incision TSRM, IV: transverse incision TSRM. Group II (sham operation) had a dissection of left testis/spermatic cord, then closure of wound. Group III underwent dissection of left testis, then a "longitudinal" incision (15 mm long) of testis, which was fully opened then closed again and sutured with 5-0 Vicryl sutures. Group IV underwent dissection of the left testis, opening of the testis with a "transverse" incision, then closure with 5-0 Vicryl. The seminiferous tubule diameter was 0.118-0.224 mm in all groups. Inflammation and abscess formation occurred in one testis each in the sham and longitudinal incision groups, and in two testes in the transverse incision group. There were no differences in histopathology or scoring between the longitudinal and the transverse incision.

Is it necessary to use sexual health inventory for men (SHIM) routinely?

This study was conducted to evaluate the prevalence of erectile dysfunction (ED) according to the Sexual Health Inventory for Men (SHIM) and its relationship with age and education. Six hundred and thirty-nine male patients aged > or = 20 years attending a urology clinic were studied. After a detailed history and physical examination, all patients were evaluated with SHIM. Scores were categorized into 5 groups: severe (1-7), moderate (8-11), mild-moderate (12-16), mild (17-21) and normal (22-25). The patients were classified into three groups according to their application to the urology clinic: A--patients attending specifically for ED; B--patients not ED based on SHIM and attending not for ED; C--patients ED based on SHIM, but attending not for ED. In addition, patients were partitioned into 3 age groups according to their age: 20-35, 35-55 and >55 years. Educational levels were of 2 groups: lower education and higher education. Erectile dysfunction was determined in 3.7% in the 20-35 years group, 55% in 35-55 years and 41% in >55 years (P < 0.01). In men having ED through SHIM and attending not for ED, the ratio of ED was higher in the lower education than in the higher education groups (p = 0.01). SHIM is a diagnostic tool used for ED, and routine application of SHIM for patients attending the urology clinic is advisable.

Relationship between metabolic syndrome and erectile dysfunction.

AIM: To determine the relationship between metabolic syndrome (MS) and erectile dysfunction (ED) and to see which risk factors correlated the best with ED. METHODS: Seventy-nine cardiology clinic outpatients with coronary artery disease (CAD) and lipid metabolism disorder were recruited. They were categorized as having MS, hypertension (blood pressure greater than 130/85 mmHg) and dyslipidemia. ED was classified based on International Index of Erectile Function scores. Patients were grouped into quartiles based on body mass index (BMI). Chi-square, Pearson's correlation and regression tests were used for statistical analysis. RESULTS: The mean age of the patients was 56.6 years. ED was diagnosed in 59 (74.7 %) of the 79 patients. In the 38 patients with MS, all had ED. ED was not significantly correlated with cholesterol levels (P>0.05), but was found often in patients who had both hypercholesterolemia and HT (P<0.01). Nineteen (76 %) of the 25 patients who had dyslipidemia had ED. However, ED was not significantly correlated with dyslipidemia (P >0.05). Twenty-two of the 23 patients who had BMI greater than 30 had ED, which was significantly more prevalent than that in those who had normal BMI (P<0.01). ED was seen in 38 of 53 smoker patients. Although ED was more prevalent in cigarette smokers, it was not significantly different from non-smokers (P>0.5). CONCLUSION: ED is present in a high percentage of patients with MS. Among multiple risk factors for ED, MS correlates the most highly. The next most important risk group is the patients with hypertension +hypercholestrolemia and obesity (BMI 30).

Does asymptomatic inflammation increase PSA? A histopathological study comparing benign and malignant tissue biopsy specimens.

AIM: To determine the effect of inflammation on postage-specific antigen (PSA) levels in patients who were performed transrectal ultrasonography (TRUSG) guided prostate biopsy because of high PSA levels. MATERIALS AND METHOD: 376 tissue specimens of 47 patients with BPH and 176 tissue specimens of 22 patients with prostate adenocancer were analysed histopathologically. Digital rectal examination, TRUSG, and PSA measurements were performed to all the patients before biopsy. Sextant biopsy was performed. Two pathologists examined all the biopsy specimens in blinded fashion. Inflammation pattern was categorized as glandular, periglandular, stromal and perivascular and intensity of inflammation graded from 1 to 3. RESULTS: The mean age of the patients was 66.2 years. The mean serum PSA level of the initial biopsy was 8.7 ng/ml in the BPH and 13.4 ng/ml in the prostate Ca. No relation was found between the serum total PSA levels and prostate volume or patient's age in BPH patients (P = 0.258). In BPH patients stromal, periglandular, glandular inflammations did not increase PSA levels. Perivascular inflammation increased PSA levels significantly. CONCLUSION: The inflammation in perivascular field increases serum PSA levels (P = 0.007). Although high serum PSA levels shows correlation with cancer in biopsy, there is no such significant relation with rebiopsy results and PSA levels at last studies. Because of this, these patients' biopsy samples must be reinspected for infection findings and atipic biopsy or high grade PIN. The result of our study showed that histological perivascular infection within the prostatic gland is a significant factor to serum PSA levels in BPH. If you have negative biopsy sample, pathology must indicate the place of the infection. Follow up of this patient and rebiopsy time are decided according to the result of this negative biopsy sample.

Ultrastructural effect of sildenafil citrate on corpus cavernosum and other genital organs in female rats.

AIM: To determine the ultrastructural effects of sildenafil on the female genital organs. METHODS: Twenty female cycling Wistar albino rats weighing 250+/-20 g were randomly divided into two groups of 10 each. Rats of one group were gavaged with 0.5 mg.kg(-1).d(-1) of sildenafil 3 days in a week for 4 weeks and the other served as the controls. After cessation of treatment animals were sacrificed by cervical dislocation under methoxyflurane anaesthesia. The clitoris, vagina, uterus and bartholin glands were taken at the estrous and were fixed with 10% formalin solution for light microscopy and 2.5% glutaraldehyde and osmic acid for electron microscopy. RESULTS: Under the light microscope, the fibrocollageous tissue was found increased, the capillaries enlarged and the connecting tissue elements increased in the corpus cavernosum in the treated group. On electron microscopy, increased connective tissue, fibroblasts with notched nucleus, shorten immature collagen fibers without striation were seen. Abundant foldings and penetration with collagen bundles were observed in the basal membrane. Large connection complexes, especially gap junctions among the wide capillary endothelial cells were observed. CONCLUSION: There are evident histological changes due to sildenafil citrate in female rat corpus cavernosum. The clitoris and bartholin glands were the most effected organs. While the histopathological changes of clitoral tissue could be expected, an increase in the mass of bartholin gland was surprising.

Renal functions of enuretic and nonenuretic children: hypernatriuria and kaliuresis as causes of nocturnal enuresis.

OBJECTIVE: The aim of this study was to investigate the pathophysiologic cause(s) of primary nocturnal enuresis. Therefore, electrolyte concentrations of urine specimens were evaluated in the morning, and alterations compared between enuretics and nonenuretics. METHODS AND PATIENTS: First morning urine specimens of 27 enuretics and 21 nonenuretic subjects fed the same diet were collected, and urinary electrolytes were measured. The urinary Ca/Cr ratio, tubular reabsorption of phosphorus (TRP) and fractional sodium (FE Na%) and potassium excretions (FE K%) were determined for patients and controls. RESULTS: There was no significant difference in the Ca/Cr ratio and TRP between patients and controls, but enuretic patients had significantly higher FE Na% and FE K% values than controls (p < 0.001). There were significant positive correlations between FE Na% and (r = 0.81, p < 0.001) FE K% and the frequency of bedwetting, respectively, among enuretic patients (r = 0.54, p < 0.001). CONCLUSION: Since Na and K excretion of enuretic patients was higher than in nonenuretics, it can be concluded that there may be a benign hereditary and/or postural renal tubular handling disorder of Na and K in enuretic children.