Aim: Prostate cancer (PC) is the most common malignant tumour in men. The most widely used histological grading scheme for PC is Gleason scoring (GS). After the original, this system has been modified several times. In this study, we retrospectively investigated the new Grade-Group system (GGS). Methods: This study includes 486 cases diagnosed with PC between 2000 and 2015. All cases were re-grouped for the new GGS system and its relationship with prognosis was examined. Results: GGS subgroups had a statistically significant relationship between prognostic factors and this relationship was more significant between GGS 2 and GGS 3 [tumor status (p <0.001), age (p = 0.045), PN invasion (p <0.001), stage (p = 0.004), and LN status (p <0.001)]. In univariable survival analysis, there was a significant difference between GGS subgroups (for GGS 2-GGS 3, RFS: p = 0.035 and OS: p = 0.012; for GGS 4-GGS 5, RFS: p = 0.001 and OS: p = 0.001). In multivariable survival analysis, GGS subgroups were found to be an independent survival parameter for PC (for GGS 2-GGS 3, OS: HR = 2.56, p = 0.012 and RFS: HR = 2.69, p = 0.038; for GGS 4-GGS 5, OS: HR = 2.84, p = 0.011 and RFS: HR = 2.59, p < 0.001). Conclusions: According to our results, the new GGS performs the prognostic risk grading more accurately than the old classification. Also, the fact that this system contains fewer categories and is simpler has increased the interobserver compatibility. Keywords: Grade-group system, Gleason scoring, prostate cancer. ÖZ Amaç: Prostat kanseri (PK) erkeklerde en sık görülen malign tümördür. PK için en yaygın kullanılan histolojik derecelendirme şeması Gleason skorlamasıdır (GS). Orijinalinden sonra bu sistem birkaç kez değiştirildi. Bu çalışmada, PK için tanımlanan yeni Grade-Group sistemini (GGS) geriye dönük olarak inceledik. Yöntemler: Bu çalışma 2000-2015 yılları arasında PK tanısı konmuş 486 vakayı içermektedir. Tüm olgular yeni GGS sistemi için yeniden gruplandırıldı ve prognozla ilişkisi incelendi. Bulgular: GGS alt gruplarının prognostik faktörler arasında istatistiksel olarak anlamlı bir ilişki vardı ve bu ilişki GGS 2 ve GGS 3 arasında daha anlamlı idi [tümör durumu (p <0.001), yaş (p = 0.045), PN invazyonu (p <0.001), evre (p = 0.004), ve LN durumu (p <0.001)]. Tek değişkenli sağkalım analizinde GGS alt grupları arasında anlamlı bir fark vardı (GGS 2-GGS 3, RFS: p = 0.035 ve OS: p = 0.012; GGS 4-GGS 5, RFS için: p = 0.001 ve OS: p = 0.001). Çok değişkenli sağkalım analizinde GGS alt gruplarının PK için bağımsız bir sağkalım parametresi olduğu bulundu (GGS 2-GGS 3, OS: HR = 2.56, p = 0.012 ve RFS: HR = 2.69, p = 0.038; GGS 4- için GGS 5, OS: HR = 2.84, p = 0.011 ve RFS: HR = 2.59, p <0.001). Sonuçlar: Çalışmamıza göre, yeni GGS sistemi prognostik risk sınıflandırmasını eski sınıflandırmadan daha doğru bir şekilde gerçekleştirmektedir. Ayrıca, bu sistemin daha az kategori içermesi ve daha basit olması, gözlemciler arası uyumluluğu artırdı. Anahtar Kelimeler: Grade-grup sistemi, gleason skorlaması, prostat kanseri.

Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications. Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.

Purpose: Hypertension (HT) is known to be of the main risk factors for erectile dysfunction (ED). But non-dipping (<%10 drop in the night) of HT is not investigated truly. The aim of this study was to test the hypothesis that the non-dipper hypertensive patients are more prone to develop erectile dysfunction. Materials and Methods: This was a cross-sectional clinical study. 70 HT patients diagnosed by Ambulatory blood pressure monitoring (ABPM) were classified into 3 groups (No ED, mild to moderate and severe) according to their International Index of Erectile Function (IIEF) scores. All three groups were compared for their dipping status by ABPM, heart rate variability (HRV) by holter monitoring. Results: In our study non-dipper hypertensives had statistically more erectile dysfunction (P = 0.004). Also severe ED patients with non-dipping pattern had decreased dipping blood pressure levels then those of ED(-) patients with non-dipping HT (P = .003) Conclusion: Autonomic dysfunction especially sympathetic overactivity is associated with both non dipping pattern of HT and erectile dysfunction as a common pathologic pathway, besides there might be an association between ED and non dipping HT.

Introduction: Obstruction of the ureter may occur due to congenital, iatro-genic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. Material and methods: Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. Results: An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). Conclusions: In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.

Aim: Beside efficacy of the shock wave lithotripsy (SWL) procedure, also its negative effects on the kidneys, its relation with the oxidant/antioxidant balance and the search after biomarkers for the detection of this negative effect gained interest in the recent years. The aim of the study is to investigate the possible usage of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), Paraoxonase-1 (PON-1) and Interleukin 6 (IL-6) parameters as biomarkers for renal injury/trauma in the early period by patients undergoing SWL due to kidney stones. Material and Methods: Forty patients receiving SWL therapy due to kidney stones were included to study by collecting their blood samples before and 2 hours after the procedure. Results: It was observed that SWL therapy has deteriorated the oxidant/antioxidant balance in terms of the oxidants by analyzing the increase of IL-6 (P <0,01) and decrease in PON-1 (P = 0.049). There was no change observed in TAS (P = 0.178) and TOS (P = 0.175) and OSI (P = 0.551) parameters. Conclusion: This has shown that IL-6 and PON-1 may be more sensitive markers of renal injury after SWL in early period.

Amac: Şok dalga litotripsi (SWL) prosedurunun bobrek taslari uzerine acik etkinliginin yani sira bobrekler uzerindeki olumsuz etkileri, oksidan/antioksidan denge ile iliskisi ve bu olumsuz etkinin saptanmasi icin biyomarkir arayislari son yillarda ilgi cekmektedir. Bu calismanin amaci bobrek tasi nedeniyle SWL tedavisi uygulanan hastalarda erken donemde bobrek hasari/travma belirlenmesinde biyomarkir olarak toplam antioksidan status (TAS), toplam oksidan status (TOS), oksidatif stres indeksi (OSI), Paraoksonaz-1 (PON-1) ve Interlokin-6 (IL-6) parametrelerinin olasi kullanimini arastirmaktir. Gerec ve Yontemler: Bobrek taslari nedeniyle SWL tedavisi alan 40 hasta islemden once ve 2 saat sonra kan ornekleri toplanarak calismaya dahil edildiler. Bulgular: SWL tedavisinin oksidan/antioksidan dengesini, IL-6 artisi (P <0,01) ve PON-1 azalmasi (P = 0.049) ile oksidan parametreler yonunde bozdugu belirlenmistir. TAS (P = 0.178), TOS (P = 0.175) ve OSI (P = 0.551) parametrelerinde herhangi bir degisiklik gozlenmemistir. Sonuc: IL-6 ve PON-1'in SWL sonrasi erken donemde renal hasarin belirlenmesinde daha hassas belirtecler olabilecegi gosterilmistir.

OBJECTIVE In this study, we aimed to investigate the antioxidant effects of selenium and coenzyme Q on renal damage in a partial unilateral ureteral obstruction (PUUO) in a rat model. MATERIAL AND METHODS A total of 24 Sprague-Dawley rats were divided into four groups as Group 1 Control Group, Group 2, PUUO Group, Group 3 PUUO + coenzyme Q group, Group 4 PUUO + selenium group. Paraoxonase (PON), total antioxidant capacity (TAC), and total oxidant levels (TOS) were analyzed biochemically from tissue and blood samples. Tissue samples were examined histopathologically. RESULTS The TAC in the tissues was found to be statistically significantly increased in Groups 3 and 4, compared to Group 2. Tissue TOS was found to be significantly reduced in Groups 3 and 4, compared to Group 2. Serum PON levels were significantly increased in Group 3 and 4, compared to Group 1 and 2. Histopathological examination showed that interstitial inflammation and congestion were lesser in the coenzyme Q and selenium groups than in the PUUO group. A more significant decrease was found in the selenium group than in the coenzyme Q group. CONCLUSION Our study results showed that coenzyme Q and selenium reduced the oxidation and the damage in tissue in PUUO in rats.

Hemanjiomlar en sık görülen benign vasküler lezyonlardır. Kadınlarda erkeklere göre 3 kat daha fazla görülmektedir. Bu vasküler lezyonlar genellikle asemptomatik seyrederler ve rastlantısal olarak tespit edilirler. Hemanjiomlar farklı biyolojik davranışlar gösterirler. Hemanjiomların farklı tedavi yöntemleri mevcuttur. Yüzeyel hemanjiomlar, spontan regresyon olasılığından dolayı genellikle takip edilirler. Diğer hemanjiom türlerinde ise cerrahi ve cerrahi dışı tedavi yöntemleri (IFN-a, steroidler, sklerozan ajanlar, lazer) uygulanabilir. Skrotal hemanjiom ise skrotumun nadir görülen vasküler benign tümörüdür. Preoperatif değerlendirmede doppler ultrasonografi, bilgisayarlı tomografi ve manyetik rezonans gibi görüntüleme yöntemleri kullanılabilir. Bu yazıda, skrotal kitle nedeniyle operasyon yapılan 25 yaşında erkek hastada skrotal hemanjiom olgusu sunuldu.

PURPOSE:To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol.METHODS:Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples.RESULTS:The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant.CONCLUSIONS:Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.

Amaç: Testiste iskemi/reperfüsyon (I/R) etkili ile oluşan oksidatif hasar üzereine Pirasetam’ın koruyucu etkilerini araştırmak. Gereç ve yöntemler: Ratlar rastgele 4 gruba ayrıldı. Grup 1 (sham, kontrol), Grup 2 = I/R (iskemi/reperfüsyon), ilaç verilmedi. Grup 3 = I/R + Pirasetam 250 mg/kg (i.p) ve Grup 4 = I/R + Pirasetam 500 mg/kg (i.p). Pirasetam intraperitoneal yolla testis torsiyonunu takiben 60. dakikada verilmiştir. Her 4 grupta işlemin başlangıcından 6 saat sonra ipsilateral sol testis ve kontralateral sağ testisler çıkarılmıştır. Bulgular: Çalışmamızda, Pirasetam’ın artan dozlarda (250 - 500 mg/kg) verilmesinin total antioksidan kapasiteyi (TAS) istatistiksel olarak anlamlı arttırdığını, oksidan kapasite markırı olan total oksidan düzeyi (TOS) istatistiksel açıdan anlamlı olmayan düzeyde arttırdığını ve oksidatif stres indeks oranını (OSI) ise istatistiksel olarak anlamlı düzeyde azalttığını belirledik. İpsilateral ve kontralateral testis grupları arasında Johnsen skorlama sistemine göre istatistiksel farklılık saptamadık. Sonuç: Bizim düşüncemize göre, Pirasetam tedavisi testis örneklerinde antioksidan aktiviteyi arttırmış, oksidan aktiviteyi de baskılamıştır. Ancak, histopatolojik incelemede ve spermatogenes skorlarında bir değişime neden olmamıştır.

Amaç: Dimetil Sülfoksit (DMSO) ve Pirasetam’ın deneysel unilateral üreter obstrüksiyonu (UÜO) oluşturulan ratlarda böbrek hasarını azaltıcı etkilerinin incelenmesi. Gereç ve Yöntem: Çalışma her biri 6 Sprague-Dawley rattan oluşan 4 deney grubunda yürütüldü. Grup 1: sham, Grup 2: UÜO (kontrol grubu), Grup 3: UÜO + DMSO 3.8 g/kg grubu, Grup 4: UUO + Piracetam 500 mg/kg grubu olarak tanımlandı. Total antioksidan kapasite (TAK) ve total oksidan seviye (TOS) ölçümleri ve histopatolojik inceleme için doku ve kan örnekleri alındı. Doku örnekleri histopatolojik olarak da incelendi. Bulgular: Biyokimyasal ve histopatolojik böbrek hasarı incelendi. Doku Total Antioksidan Kapasite (TAK) düzeyleri değerlendirildiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve 4’de istatiksel olarak anlamlı bir artış olduğu görüldü. Grup 3 ve Grup 4 arasında ise istatiksel olarak anlamlı bir artış olduğu saptandı (p<0.001). Doku Total Oksidan Seviye (TOS) değerleri incelendiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve Grup 4’de oksidan düzeyinde istatiksel olarak anlamlı bir azalma olduğu; aynı zamanda Grup 3 ve Grup 4 arasında da istatiksel olarak anlamlı bir azalma olduğu saptandı (p<0.001). Doku Oksidatif Stres Indeksi (OSI) parametresi incelendiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve 4’de OSI değerlerinde istatiksel olarak anlamlı bir azalma olduğu tespit edildi. Histopatolojik inceleme de böbrek dokusunda Grup 2’ye göre Grup 3 ve 4’te histopatolojik olarak istatistiksel olarak bir fark saptanmadı. Sonuç: Dokuda biyokimyasal düzeyde DMSO ve Pirasetam’ın antioksidan etkili olduğu aynı etkinin histolojik olarak koruyucu etkinlik oluşturmadığı saptanmıştır. Bununla birlikte bu ilaçların farklı doz ve sürelerle yapılacak çalışmalar ile doku antioksidan özelliklerinin saptanabileceği düşünülmektedir.

Xanthogranulomatous pyelonephritis (XGP) is a rare benign condition with unknown aetiology and chronic infection of kidney. Commonly, most cases are related with urinary tract obstruction, nephrolithiasis, infection, diabetes, and/or immune compromise. XGP is associated with destruction of the renal parenchyma and granulomatous inflammation with foamy lipid-laden macrophages resulting from obstructive uropathy. It closely mimics a malignancy, exhibiting local tissue invasion and destruction. Adjacent organs especially duodenum as well as very rarely pancreas or spleen may be involved. Additionally, XGP is known as notorious for fistulisations, such as pyelocutaneous and ureterocutaneous fistulae, which have been reported as well described. XGP may be indistinguishable from renal cell carcinoma by radiographic and clinic consultation so it must be diagnosed based on the histopathologic examinations. Furthermore, macroscopic appearance of XGP is a mass of yellow tissue with focal haemorrhage besides necrosis and in this regard, it grossly resembles renal cell carcinoma. Here, we report the case of a 32-year-old female, preoperatively diagnosed as malignancy by clinical examination. Our further pathological evaluations revealed very rarely adhesion of XGP to pancreas tissue.

Amaç: Testis torsiyonunda cerrahi olarak detorsiyone edilen testiste gelişen iskemi/reperfüzyon (I/R) hasarı üzerine İloprost ve düşük doz Metotreksat'ın koruyucu etkilerini araştırmak.Gereç ve Yöntem: Ratlar rastgele 4 gruba ayrıldı.Grup 1 (sham), Grup 2 = İskemi/Reperfüzyon, ilaç verilmedi.Grup 3 = İskemi/Reperfüzyon + İloprost (10 µg/kg) ve Grup 4 = İskemi/Reperfüzyon + Düşük doz Metotreksat (6 mg/kg).Torsiyon/iskemi ve detorsiyon/reperfüzyon süreleri 4'er saat olarak belirlenmiştir.Medikasyonlar intraperitoneal yolla testis torsiyonunu takiben 3. saatte verilmiştir.Her 4 grupta işlemin başlangıcından 8 saat sonra detorsiyone sağ testis çıkarılmıştır.Bulgular: Çalışmamızda, iloprost ve düşük doz metotreksat verilmesinin total antioksidan kapasiteyi (TAK) istatistiksel olarak anlamlı arttırdığını, oksidan kapasite markırı olan total oksidan kapasite (TOK) ve oksidatif stres indeks oranını (OSI) ise istatistiksel olarak anlamlı düzeyde azalttığını belirledik.İskemireperfüzyon grubu testislerde testis grupları arasında Johnsen skorlama sistemine göre istatistiksel farklılık

We conducted a prospective study of transient evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in men who were taking an oral phosphodiesterase type 5 (PDE5) inhibitor for erectile dysfunction. Our study group was made up of 30 men (60 ears), aged 34 to 60 years (mean: 50.9). They were randomly divided into three groups; 10 men were given sildenafil (Viagra) at 50 mg twice a week, 10 were given tadalafil (Cialis) at 20 mg twice a week, and 10 were given vardenafil (Levitra) at 20 mg twice a week. All patients took their drug for 3 weeks, for a total of 6 tablets for each patient. Audiometric tests and TEOAE and DPOAE measurements were performed before and after treatment. Post-treatment audiometry demonstrated improvement in hearing in all three groups. However, post-treatment TEOAE amplitudes and DPOAE amplitudes differed among the three groups; they were significantly higher in the sildenafil group at 1.0 kHz and the same in the tadalafil group; in the vardenafil group, the DPOAE amplitude was significantly lower at 3.0 kHz while there was no change in the TEOAE amplitude. We speculate that the possible mechanism for these findings is that PDE5 inhibitors block degradation of cyclic guanosine monophosphate (cGMP) and induce dilation of the cochlear microcirculation, resulting in an increase in cochlear blood flow. We also believe that the decrease in DPOAE amplitudes at 3.0 kHz seen in the vardenafil group may be related to an accumulation of nitric oxide/cGMP complex, which is toxic to the cochlea; however, since there was no change in TEOAE amplitude in the vardenafil group, this influence may be minimal. Further studies are needed to obtain a more comprehensive assessment of the effects of PDE5 inhibitors on hearing with the use of higher doses and longer durations of therapy.

OBJECTIVE To evaluate the early effect of sildenafil on the retinal nerve fiber layer (RNFL) thickness. PATIENTS AND METHODS Sixty eyes of 60 patients were enrolled in the study. The patients underwent RNFL analysis by scanning laser polarimetry (Nerve Fiber Analyzer, GDx VCC:5.3.3; Laser Diagnostic Technologies, San Diego, CA, USA) before and after a single 100 mg dose of sildenafil. Sixty eyes of 60 volunteers of similar age and sex distribution were taken as the control group. The RNFL thickness parameters evaluated included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average (SA), inferior average (IA), TSNIT standard deviation (SD), and nerve fiber index (NFI). RESULTS The mean age of the patients was 53,52 ± 9,26 years. The mean pre- and post-treatment TSNIT, SA, IA, TSNIT SD, and NFI of the patients were 57.46 ± 4.94 µ versus 56.90 ± 4.59 microns (µ), 68.93 ± 6,12 µ versus 67,79 ± 5,49 µ, 66,71 ± 7.10 µ versus 66.31 ± 6.82 µ, 24 ± 3.86 µ versus 23.40 ± 4.05 µ, and 16.50 ± 6.08 µ versus 14.92 ± 6.76 µ, respectively. There were no statistically significant differences between pre- and post-treatment RNFL thicknesses (p = 0.527, p = 0.281, p = 0.754, p = 0.416, p = 0.185, respectively). CONCLUSIONS A single 100 mg dose of sildenafil seems to have no unfavorable effect on RNFL thickness in the acute phase of treatment.

Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their efficiency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guidelines are useful in promoting public health and developing nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient's nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing lithogenic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.

The aim of this study was to investigate the antioxidant properties of udenafil citrate (1.4 mg kg(-1) -2.8 mg kg(-1) ), dexmedetomidine 25 μg kg(-1) and piracetam 200 mg kg(-1) administered on ipsilateral/contralateral testes after ischaemia in a rat model of testicular torsion/detorsion (T/D) and define its protective effect histologically. Fifty-six Wistar albino rats were included and randomly assigned into 6 groups. No intervention was performed in control group (Group 1, n = 8) and in torsion/detorsion group, (Group 2, n = 8). Udenafil 1.4 mg kg(-1) was given to torsion/detorsion group (Group 3, n = 10), udenafil 2.8 mg kg(-1) was given to torsion/detorsion group (Group 4, n = 10), piracetam 200 mg kg(-1) was given to torsion/detorsion group (Group 5, n = 10) and dexmedetomidine 25 μg kg(-1) was given to torsion/detorsion group (Group 6, n = 10) intraperitoneally after 60 mins of testicular torsion. Biochemical and histopathological testicular injury were evaluated. When the tissue was examined by TOS values, Group 3, Group 4 and Group 5 were significantly lower than Group 2. In contrary Group 6 values were significantly higher than Group 2. The increasing doses of udenafil demonstrated antioxidant properties on the testis tissue and histopathological that protects the testicles.

PURPOSE To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 µg/kg Dex (group 3) and 100 µg/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 µg/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 µg/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides.

The male genitourinary system is quite complex. There are numerous known anomalies of the male urethra either as isolated cases or in combination with other disorders. An improved understanding of the embryology and anatomy of the normal male urethral development might help explain the causes of the various urethral abnormalities. We contribute to the etiology of congenital anomalies with this multiple urethral anomalies case.