Azoospermide testisin histopatolojik,elektron mikroskobik ve radyolojik incelenmesi

TEZ4199Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1982.Kaynakça (s. 52-55) var.55 s. res. ; 30 cm.

Superficial dorsal penile vein thrombosis: Mondor's disease of penis

Bu çalışmada penisin yüzeyel dorsal veninin tromboflebitinin (Mondor hastalığı) etiyolojisinin, tanısının ve tedavisinin bir hastanın ışığında hatırlatılması amaçlandı. Kliniğimize başvuran 31 yaşında bir hastada tespit edilen Mondor hastalığı antibiyotik ve antienflamatuar ilaçlar ile başarılı bir şekilde tedavi edildi. Yüzeyel penil dorsal venin tromboflebiti çok fazla karşılaşmadığımız ancak tedavisi ve tanısı aslında oldukça kolay olan bir patolojidir. Akut rahatsızlık esnasında antienflamatuar ilaçlar yararlı ise de hastalığın sürecine etki göstermez.Introduction: it has been aimed to remind the etiological, diagnostic and therapeutic aspects of thrombophlebitis of the superficial dorsal vein of the penis (penile Mondor's disease) in the light of a case. Materials and Methods: A 31 years old patient who has Mondor's disease was treated with antibiotics and anti-inflammatory drugs successfully.Conclusion: Superfıcial dorsal penile vein thrombosis is a rare but easily diagnosed and treated benign disease. Anti-inflammatory drugs are useful in the presence of acute discotnfort but they do not affect the course of the disease

Our laparoscopy experience in the nonpalpable testes

Laparoskopik teknikler bir çok açık ürolojik girişimlere alternatif olarak ortaya çıkmıştır. Çocuk ürolojisinde laparoskopinin önemli uygulama alanlarından biri ele gelmeyen testisin tanı ve tedavisidir. Bu yazıda, ele gelmeyen testisli olgulardaki ilk laparoskopi deneyimlerimizin sonuçları sunulmaktadır. Aralık 2000-Temmuz 2001 tarihleri arasında 10 olguya genel anestezi ile laparoskopi uygulandı, internal spermatik damarlar ve vaz deferensin internal inguinal ringden girdiği görülen olgularda, inguinal kanal eksplore edildi. İntraabdominal testisi olan olgularda, laparoskopik orşiopeksi veya orşiektomi uygulandı, internal spermatik damarların kör sonlanması kaybolan (vanishing) testis olarak kabul edildi. 18 ay-25 yaş arası (ortalama 9.8 yıl) 10 erkek olguda 17 ele gelmeyen testisle karşılaşıldı. Bunlardan vaz deferensin ve damarsal yapıların internal inguinal ringe girdiği görülen 11'inde inguinal bölgeye eksplorasyon yapıldı. On testise orşiopeksi, bir testise de orşiektomi yapıldı. On yedi testisin 4'ü intraabdominaldi. Bunlardan 2'sine laparoskopik orşiopeksi, 2'sine de laparoskopik orşiektomi uygulandı. Bilateral ele gelmeyen testisi olan bir olguda vaz, damarlar ve testis görülemediği için, testisin olmadığı kabul edildi. Ele gelmeyen testislerin tanısında ullrasonografi ve/veya bilgisayarlı tomografinin yeterli bilgi vermediği durumlarda minimal invazif bir yöntem olan diyagnostik laparoskopi kesin tanının konulmasında yardımcı olduğu gibi, inlraabdominal teslisli olgularda orşiektomi veya orşiopeksi gibi tedaviler laparoskopik olarak yapılabilmekledir. Bu nedenle laparoskopi, ele gelmeyen testislerin tanı ve tedavisinde önemli yeri olan bir yöntemdir.Introduction: Laparoscopic techniques were introduced as alternatives to many open urologie procedures. In pediatrie urology, one of the main applications of laparoscopy is the evaluation and treatment of nonpalpable testis. We are presenting our initial experience with laparoscopy in patients with nonpalpable testis. Materials and Methods: Laparoscopy was performed under general anesthesia on 10 patients from December 2000 to July 2001. If the internal spermatic vessels and vas deferens made their way into the internal inguinal ring, the inguinal canal was dissected. Laparoscopic orchiopexy or orchiectomy was performed in cases with intra-abdominal testis. If the internal spermatic vessels terminated within blind end intraperitoneally, making it impossible to identify the testis, the case was judged to be vanishing testis. Results: Ten boys, aged from 18 months to 25 years (median 9.8 years) were identified with 17 nonpalpable testes. Of 17 nonpalpable testes, in 11 the vas and vessels entered an open internal ring. The inguinal region was explored in all the 11 testes. Orchiopexy was performed on 10 testes and orchiectomy was performed on one testis. Four of 17 testes were intra-abdominal. Laparoscopic orchiopexy was performed in two testes and laparoscopic orchiectomy was performed in two testes. In one boy with bilateral nonpalpable testes neither vas and vessels nor testes were visualized and this case was diagnosed as vanishing testis. Conclusion: Diagnostic laparoscopy is a very helpful minimally invasive technique in the diagnosis of nonpalpable testes especially when ultrasonography and/or computed tomography are not informative. In addition, orchiectomy and orchiopexy can be done as laparoscopically in the patients with intraabdominal testes. Therefore, the laparoscopy has an important role in the diagnosis and treatment of nonpalpable testes

Influence of hypothermia on ischemic changes during testicular torsion

Testis torsiybnlannda surenin iskemik degisiklere olan etkisini ve bu etkinin hipotermi ile ne derecede geciktirebilecegini a(astirmak. Gereg ve Y6ntem:Or\ kopege bilateral orsiektomi uygulanarak, 20 adet torsiyone testis omegi elde edildi. Elde edilen ornekler 35°C, 20°C ve 5°C sicakliktaki ortamlarda 1 saat, 2 saat, 3 saat ve 6 saat bekletilerek histopatolojikjncelemeler icin ornekler alindi. Histopatolojik degerlendirmeler Johnsen testis biyopsi skoruna gore yapildi. Buigular: Isik mikroskobunda incelenen omeklerde 35°C'da 3 saat iginde seminifer tubulerde yer yer nekroza rastlandi. Ortalart|a Johnsen skoru 1.30±0.47 idi. Ortalama Johnsen skoru 20°C'da 3.0±0.65, 5"C'da 5.95+0.76 idi. 5°C'da 6 saat^bekletilen omeklerde seminifer tubul bazal membranlannin intakt oldugu ve spermatogonyumlarda vakuolizasyon gelistigi goruldu. Ortalama Johnsen skoru 4.95+0.76 idi. 20°C ve 35°C'da nekroz vardi. Ortalama Johnsen skoru, sirasiyla, 1.25±0.44 ve 1.20+0.41 idi. Bu saatte elde edilen omeklerde 5°C ile 20°C ve 5°C ile 35°C arasinda istatistiksel olarak anlamli fark varken, 20°C ile 35°C arasinda anlamli fark yoktu. Sonug: Akut testis torsiyonlu hastalann testislerine uygulanan hipotermi, cerrahi tedaviye alternatif degildir. Ancak testikuler canlilgi uzatarak cerrahi girisim igin zaman kazandirip or§iektomi sikligini azaltabilir.Influence of Hypothermia on Ischemic Changes During Testicular Torsion-Objective: To evaluate the effects of elapsed time and hypothermia on ischemic changes after testicular torsion. Material and Methods: Bilateral orchiectomies were done in 10 mature dogs and 20 torsioned testes were obtained. The samples were examined histopathologically after one hour, two hours, three hours and six hours of incubation in saline bath at 35°C, 20°C and 5°C. Histopathologic examinations were done with light microscopy according to Johnsen testicular score system. At a normal testicular temperature of35°C after 3 hours, necrosis was seen in some areas of seminiferous tubules. The mean Johnsen score was 1.30±0.47. At 20°C the mean Johnsen score was 3.0+0.65. At 5°C mean Johnsen score was 5.95±0.76. At a temperature of5°C and after 6 hours, basal membranes of seminiferous tubules were intact and spermatogonia showed vacuolization. The mean Johnsen score was 4.95±0.76. At 20°C and 35°C necrosis was present. The mean Johnsen scores in these groups were 1.25±0.44 and 1.20±0.41, respectively. Johnsen scores after six hours at 5°C and 20°C, and at 5°C and 35°C differed significantly while scores at 20°C and 35°C were comparable. Conclusions: Hypothermia is not an alternative to srgical exploration in-acute scrota! swelling. However, it may delay manifestations of irreversible damage, ^ prolong safe period until surgery and thus decrease orchiectomy rates

Ultrastructure of the seminiferous tubules in human testes before and after varicocelectomy

PubMedID: 14618398Ultrastructure of the membrana propria and the seminiferous epithelium was studied in infertile human testis both before and 3-6 months after varicocelectomy. The frequent alterations, observed before and after the operation, were extremely thickened membrana propria, deep invaginations, multilamination and knob-like formation of basal laminae and formation of multinucleated spermatids, which were all considered as the common response of the testis to different noxious agents. Although the cells of the seminiferous epithelium were clearly affected by varicocele before varicocelectomy, many areas exhibited normal features after the operation. Furthermore, multinucleated cells, sharing common features of Sertoli cell and spermatogonium, were observed, as well as presence of well-developed annulate lamellae in the Sertoli cells, exhibiting centrioles in the vicinity of their nuclei after varicocelectomy. These multiple ultrastructural observations indicate that Sertoli cell division takes place. This study suggests that if the observation period of the tissue samples after varicocelectomy is long enough, the reversible changes of the tubular cells would be seen much more frequently

Ameliorating effects of curcumin on nicotine-induced mice testes

Background/aim: The aim of this study was to determine the antioxidative effect of curcumin on nicotine-induced mice testis. Materials and methods: Sixty Swiss albino male mice were divided into five groups, each containing 12 mice. The first group was used as a control. To induce toxicity in the second and third group, nicotine (0.4 mg/kg/day) was injected intraperitoneally into mice for 14 and 28 days, respectively. The mice in the fourth and fifth group were injected with nicotine (0.4 mg/kg/day) and orally treated with curcumin (200 mg/kg) for 14 and 28 days, respectively. Testosterone levels were measured from blood samples and testis tissues were examined under light and electron microscopes. Results: Light and electron microscopic examinations of the nicotine-induced groups showed evident degenerations in spermatogenic cells, Sertoli cells, and Leydig cells. The groups treated with curcumin had less testicular alterations. The mice that were sacrificed after 28 days in the groups treated with curcumin showed minor degenerations. Furthermore, the median levels of testosterone significantly decreased in the nicotine-induced groups in comparison with those in the control group. Conclusion: The results indicated that curcumin might be a potential therapeutic agent for testicular injury caused by nicotine addiction.Background/aim: The aim of this study was to determine the antioxidative effect of curcumin on nicotine-induced mice testis. Materials and methods: Sixty Swiss albino male mice were divided into five groups, each containing 12 mice. The first group was used as a control. To induce toxicity in the second and third group, nicotine (0.4 mg/kg/day) was injected intraperitoneally into mice for 14 and 28 days, respectively. The mice in the fourth and fifth group were injected with nicotine (0.4 mg/kg/day) and orally treated with curcumin (200 mg/kg) for 14 and 28 days, respectively. Testosterone levels were measured from blood samples and testis tissues were examined under light and electron microscopes. Results: Light and electron microscopic examinations of the nicotine-induced groups showed evident degenerations in spermatogenic cells, Sertoli cells, and Leydig cells. The groups treated with curcumin had less testicular alterations. The mice that were sacrificed after 28 days in the groups treated with curcumin showed minor degenerations. Furthermore, the median levels of testosterone significantly decreased in the nicotine-induced groups in comparison with those in the control group. Conclusion: The results indicated that curcumin might be a potential therapeutic agent for testicular injury caused by nicotine addiction

Bladder biopsies under topical lidocaine anesthesia

Rastlantısal mesane biopsileri çoğunlukla genel veya spinal anestezi altında yapılmaktadır. Bu çalışmada, topikal İidokain anestezisi altında alınan cold cup mesane biopsilerinin tolerabilıte, komplikasyon ve kalitesini belirlemeyi amaçladık. Ocak 1994- Aralık 1994 tarihleri arasında, daha önce yüzeye! mesane kanseri tanısı ile TUR-B uygulanan ve her üç ayda bir sistoskopi ile kontrol edilen 20 hastaya lokal anestezi altında cold cup mesane biopsisi yapıldı. Lokal anestezi amacı ile erkek hastalara external meatustan steril jel seklinde hazırlanmış 10 mi. İidokain HCI solüsyonu instile edildikten sonra, tüm hastalarda mesaneye, ince bir nelaton kateter (10-12 F) yardımıyla aynı solüsyondan 50 mi. verildi. Hasta toleransının iyi olduğu görüldü. Asın ağrı duyan 2 hasta, diazepam ile sedatize edildikten sonra işlemin sürdürülmesine karar verdi. Daha fazla ağrısı olan 1 hastada işlem kesilmek zorunda kalındı. Topikal anesteziye bağlı komplikasyon gözlenmedi. Tüm hastalardan alınan örnekler, histopatolojik inceleme için yeterli bulundu. Sonuç olarak, seçilmiş olgularda topikal İidokain anestezisinin hastayı genel veya spinal anestezinin risklerinden koruyan, basit ve ucuz bir teknik olduğu görüldü

Laparoscopic cystolithotomy and transvaginal extraction for removal of a large bladder stone

Mesane taşları tüm üriner sistem taşlarının %5’ini oluşturmaktadır. Küçük taşlar transüretral sistolitotripsi ile tedavi edilirler fakat büyük mesane taşlarının bu yöntemle tedavisi uzun operasyon süresi gerektirir ve üretral travma olasılığı daha fazladır. Operasyon süresini kısaltmak ve üretrayı korumak için perkütan sistolitotripsi, açık veya laparoskopik sistolitotomi uygulanabilmektedir. Laparoskopik sistolitotomide daha iyi bir kozmetik sonuç için, büyük taşlar cilt kesisine alternatif yollardan çıkartılabilir. Bu olgu sunumunda, genç bir kadın hastadaki büyük mesane taşının laparoskopik sistolitotomi ve transvajinal ekstraksiyon ile tedavisi, literatür eşliğinde irdelenmektedir.Bladder stones constitute 5% of all urinary tract stones. Although small stones can be treated with transurethral cystolithotripsy, treatment of a large stone with this method may be more traumatic for the urethra and requires longer operative time. Alternatively, percutaneous cystolithotripsy, open or laparoscopic cystolithotomy can be performed in order to shorten the operative time. In the laparoscopic cystolithotomy, the method of stone extraction predominantly determines the cosmetic results. Alternative extraction routes to skin incision may be used for bigger stones to obtain better cosmetic results. Herein, we report a case of laparoscopic cystolithotomy with transvaginal extraction of a big bladder stone in a young woman and we discuss the related literature

Comparison of laser treatment with transurethral prostatectomy in surgical treatment of benign prostatic hyperplasia

Benign prostat hiperplazisinin cerrahi tedavisinde vizüel laser ablasyonu (VLAP) yönteminin etkinliği ve güvenilirliği transüretral prostatektomi (TURP) ile toplam 40 hasta içeren randomize, prospektif bir çalışmada karşılaştırıldı. Etkinlik ölçütleri olarak preoperatif ve postoperatif altıncı ay uluslararası semptom skoru (IPSS), maksimum idrar akım hızı ve rezidüel idrar miktarları; güvenilirlik ölçütleri olarak preoperatif ve postoperatif erken dönem (uyandırma odası) kan sodyum ve hematokrit değerleri kullanıldı. Buna göre iki grupta da mortaliteye rastlanmadı. Güvenilirlik parametreleri karşılaştırıldığında her iki yöntem arasında anlamlı fark gözlenmedi. Etkinlik parametrelerinde ise her iki grupta ciddi iyileşme gözlenirken bu iyileşmenin TURP grubunda daha belirgin olduğu saptandı. Prostatın laser ablasyonunun ancak uygun olgularda TURP'ye alternatif olabileceği düşünüldü.Comparison of Laser Treatment ıvith Transurethral Prostatectomy in Surgical Treatment of Benign Prostatic Hyperplasia- The efficacy and safety ofvisual laser ablation (VLAP) in surgical treatment of benign prostatic hyperplasia were compared ıvith those of transurethral prostatectomy in a randomised, prospective sudy zvhich included a total of '40 patients. The parameters of efficacy were preoperative and postoperative sixth month International symptom scores (IPSS), maximum urinary floıv rates and postvoiding residual urine volumes; ıvhile the parameters of safety luere preoperative and early postoperative (recovery room) serum sodium and hematocrit levels. No mortality was recorded overall. The safety parameters zvere comparable in the tıvo treatment groups. Although both groups shoıved significant amelioration, the efficacy ıvas more prominent in the TURP patients. Laser ablation ofthe prostate can be considered as an altenative method of treatment against TURP in only selected patients