Peroxinitrite and Malondialdehyde as Biomarkers for Overactive Bladder.

OBJECTIVE: To measure urine malondialdehyde (MDA) and urine peroxynitrite (ONOO) levels in patients with overactive bladder (OAB), and compare them with healthy individuals; to determine the change of those markers in OAB patients prescribed antimuscarinic drugs. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: The Department of Urology, School of Medicine, University of Gaziantep, Gaziantep, Turkey, between August 2021 and February 2022. METHODOLOGY: Patients diagnosed with OAB (Group 1), and healthy controls (Group 2) were compared. Urinary MDA (µmol/L) and ONOO (µmol/L) levels were measured in all participants. The patients diagnosed with OAB were underwent antimuscarinic therapy with propiverine 30 mg. The levels of MDA (µmol/L) and ONOO (µmol/L) were reanalysed during the third month of antimuscarinic therapy. Patients with stress urinary incontinence, neurogenic bladder, pelvic organ prolapse stage ≥3 (POP-Q ≥3), interstitial cystitis (bladder pain syndrome), history of pelvic radiotherapy, symptoms of bladder outlet obstruction, Qmax <10 ml/sec for men and <15 ml/sec for women measured by uroflowmetry, and history of pelvic and incontinence surgery were excluded from the study. RESULTS: There was no difference in the mean age and or gender distribution of the two groups (p=0.166 and p=0.774, respectively). While the mean MDA levels were significantly higher in patients with OAB, (3.34 ± 1.06µmol/L vs. 2.62 ± 1.45µmol/L, p=0.036), no significant change was detected in ONOO levels between the groups (1.03 ± 0.75 µmol/L vs. 0.71 ± 022 µmol/L, p >0.05). Although no significant change was detected in MDA levels after antimuscarinic therapy (3.50 ± 1.19 µmol/L, p=0.529), there was a statistically significant increase in ONOO levels (1.49 ± 1.45 µmol/L, p=0.013). CONCLUSION: MDA might be used in the diagnosis of OAB, as a biomarker, similar to recent studies. ONOO was evaluated for the first time in the literature for the diagnosis of OAB, unfortunately, no significant outcomes were obtained. In addition, both MDA and ONOO had no role in monitoring antimuscarinic therapy. KEY WORDS: Overactive bladder, Peroxynitrite, Malondialdehyde.

Effects of Nigella sativa oil and thymoquinone on radiation-induced oxidative stress in kidney tissue of rats.

Ionizing radiation leads to release of free radicals into the systemic circulation from irradiated tissues. These free radicals cause oxidative stress in distant organs. Oxidative status may be reversed by naturally occurring antioxidant agents. The aim of this study was to investigate protective and antioxidant effects of Nigella sativa oil (NSO) and thymoquinone (TQ) in kidney tissue of rats exposed to cranial irradiation. Forty-eight Sprague-Dawley rats were divided into six groups: IR group received irradiation (IR) to total cranium plus saline; IR plus NSO group received IR and NSO; IR plus TQ group received IR and TQ; sham group did not receive NSO, TQ or IR; control group of TQ received dimethyl sulfoxide; control group of NSO received saline. Total oxidant status (TOS), oxidative stress index (OSI) and lipid hydroperoxide (LOOH) levels were studied as oxidative parameters, and total antioxidant status (TAS), total sulfhydryl levels, paraoxonase (PON), ceruloplasmin (Cp) and arylesterase activities were determined as antioxidative parameters in the kidney tissue of rats. Kidney TOS, OSI and LOOH levels were significantly lower in IR plus TQ, IR plus NSO and sham groups compared to IR group (p < 0.001). TAS, PON and Cp activities in IR group were significantly lower compared to the control group (p < 0.001). PON and Cp activities were significantly higher in IR plus NSO and IR plus TQ groups compared to IR group (p < 0.001). In conclusion, free radicals generated by cranial ionizing radiation exposure cause oxidative stress in kidney. NSO and TQ exhibit protective and antioxidant effects against oxidative damage in rats.

Correlation between the NGF levels and questionnaire forms in patients receiving antimuscarinic treatment and those receiving onabotulinum toxin-A injection.

OBJECTIVE: To compare nerve growth factor (NGF) levels in patients who received antimuscarinic, versus onabotulinum toxin-A (onaBoNT-A) injection, as well as to investigate whether there is a correlation between NGF levels, and 8-item overactive bladder questionnaire(OAB-V8), urogenital distress inventory (UDI)-6, and incontinence impact questionnaire (IIQ)-7 forms. MATERIAL AND METHODS: Fourty adult patients with OAB were enrolled in this prospective study. An antimuscarinic was prescribed to 20 naive patients, and onaBoNT-A injection was administered to 20 patients, who were refractory to antimuscarinics. Urine samples were obtained before, and after 3rd and 6th months of treatment, and NGF levels were measured. Symptom scores of OAB-V8, UDI-6,and IIQ-7 were recorded. RESULTS: There was no significant difference between groups in terms of the initial OAB-V8, IIQ-7, and UDI-6 scores, whereas NGF values showed no significant difference over time in onaBoNT-A group (p=0.069, p=0.069). NGF levels were significantly lower in 3rd and 6th months, in patients receiving antimuscarinic (p=0.003, p=0.007); a strong correlation was found in 3rd month between the NGF levels, OAB-V8 scores (r=0.704, p=0.001), and IIQ-7 scores (r=0.676, p=0.001), and a moderate correlation between NGF levels, and UDI-6 scores (r=0.583, p=0.007). In the 6th months, a very strong correlation was found between NGF levels, and OAB-V8 scores (r=0.811, p=0.004), and a strong correlation was found between NGF levels, and IIQ-7 scores (r=0.671, p=0.001). In onaBoNT-A group, there was no significant correlation between NGF levels, and other variables. CONCLUSION: NGF level might be a good marker to evaluate effectiveness of treatment in patients receiving antimuscarinics, owing to correlation of urinary NGF levels with symptom scores. Lack of correlation in patients receiving onaBoNT-A injection could be a result of differences in the mechanism of action.

Outcomes of miniaturized percutaneous nephrolitotomy in infants: single centre experience.

OBJECTIVES: The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients. MATERIAL AND METHODS: From May 2012 to April 2016, the medical records of 74 infant patients who underwent mini-PNL for renal stones were reviewed retrospectively. All infants were evaluated with the plain abdominal radiograph, urinary ultrasound, noncontrast computerized tomography and/or intravenous urogram. Pre-operative, intraoperative and post-operative data were analyzed. RESULTS: A total of 74 infant (42 male, 32 female) with a mean age 21.5±8.2 (10-36) months were included in this study. The mean size of the stones was 22.0±5.9 (14-45) mm. A 17 Fr rigid pediatric nephroscope with a pneumatic intracorporeal lithotripsy were used through 20-22 Fr access sheath. The stone-free rate was 84.7% at 1 month after the operation. Mean operative time was 74.0 (40-140) min. Mean fluoroscopy screening time was as 4.3(3.1-8.6) min. Average hospitalization time was 3.8 (2-9) day. Auxiliary procedures were performed to 11(15.3%) patients (7 extracorporeal shock wave lithotripsy, 3 re- percutaneous nephrolitotomy, 1 retrograde intrarenal surgery). No major complication classified as Clavien IV-V observed in study group. CONCLUSIONS: Mini-PNL with pneumatic intracorporeal lithotripsy can be performed safely and effectively to manage kidney stones in infants with high stone free rate and low complications.