The Effect of Human Chorionic Gonadotropin Treatment Before Testicular Sperm Extraction in Non-Obstructive Azoospermia

Aim: To investigate our experience on empirical hCG treatment of patients with idiopathic non-obstructive azoospermia (NOAT Material and Method: hCC group consisted of 34 patients who were empirically treated with hCG despite normal serum FSH and LH levels and normal testicular volumes. KG was administered as 2500 IU twice weekly subcutaneous injections for 10 to 14 weeks prior to testicular sperm extraction (TESE). Control group consisted of 49 age and spouse age matched patients who underwent TESE in the same time period. Sperm retrieval rate (SRR), and follicle stimulating hormone (FSH), lutenizing hormone (LH) and testosterone levels, volume of testicles, fertilization rate (FR), implantation rate (IR), pregnancy rate (PR), live birth rate (LBR) and cancel rate (CR) and surgical technique were compared between the two groups. Results: Conventional technique was used in 14 of the 17 patients (82.30/:) with successful sperm retrieval in the KG group, and 18 of the 28 patients (64,390) in the control group (p=0,170). There were no differences between groups in terms of SRR (p=0.338). There were no significant differences in patient age, mean infertility period, mean values of FSH. LH, testosterone, estradiol levels, and testis volume between the two groups (pa0.05). There were no statistically significant differences for FR, IR, PR. LBR between the tuvo groups (p>0.05). Discussion: Empirical hCG treatment in patients with idiopathic NOA did not result in improved SRR. hCG treatment did not have any effect on the success of ICSI

Is Learning Curve Short for MicroTESE Operation in Nonobstructive Azoospermic Patients?

Aim: To evaluate learning curve in microdissection testicular sperm extraction (microTESE) surgery performed in non-obstructive azoospermia patients. Material and Method: The study included 300 non-obstructive azoospermic (NOA) patients, who underwent microTESE surgery performed by a single urologist. The patients were divided into three groups (the first 100 patients, the second 100 patients, and the third 100 patients) and these groups were compared in terms of sperm retrieval rate (SRR) and other clinical parameters. It was planned to compare the patients in first 99 patients between themselves in case there is no difference between the groups in terms of SRR. Results: The overall SRR was 47% in 300 NOA patients. No significant difference was determined between the three groups in terms of SRR (49%, 46%, and 46%, respectively). Accordingly, the first 99 patients were re-compared in terms of SRR (the first 33 patients, the second 33 patients, and the third 33 patients). It was observed that there is also no significant difference between these groups in terms of SRR (54.5%, 42.4%, and 51.5%, respectively). Moreover, no significant difference was determined between all of the groups in terms of patient age, testis volume, and serum follicle-stimulating hormone and testosterone levels. It was observed that duration of surgery has been significantly shortened in all groups as the number of surgical procedures increased. Discussion: Learning curve in microTESE surgery is shorter according to learning curves in other urological surgeries

Percutaneous Nephrolithotomy for Kidney Stones in Patients with Hematological Malignancy

To define the alterations in the outcomes of percutaneous nephrolithotomy (PNL) operations for kidney stones in patients with history of hematological malignancy (HM). Material and Method: Between 2000 and 2013, 1700 adult patients underwent PNL for the treatment of kidney stones in our institution. Four of these patients had a history of HM and considered to be HM group (n=4). Ten elderly (>65 years) patients who had no history of operation, HM or any other co-morbide diseases were chosen as the control group (n=10). Surgical parameters, success rates, additional treatments and complications were evaluated. Results: Statistical analyses showed no significant differences between HM and control group according to stone area, operation time, fluoroscopy time, hospitalization time,Delta Hb, blood transfusion rates and INR values (p>0.05). Statistical analyses revealed no significant differences between HM and control groups according to the success rates (p=0.470). Statistical analyses revealed no significant difference between groups for additional treatment requirements (p=0.882). No major perioperative complication was seen in both of the groups. Discussion: The treatment of kidney stone disease by PNL in patients with hematological malignancy is feasible, safe and effective. However, close cooperation with the Hematology Department before the operation is mandatory

Ureteral fibroepithelial polyps with calculi: a case series

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Expression of maspin in testis tumors with germ cells and its relation with angiogenesis factors

Background/aim: We aimed to evaluate the importance of maspin expression in testicular tumors with germ cells, its effect on prognosis, and the relation with angiogenesis factors. Materials and methods: The paraffin blocks of the orchiectomy materials of 32 patients who had undergone orchiectomy due to testicular tumors were taken within the scope of the study. The specimens of the cases included in the study group were reexamined under light microscope. Results: While just one maspin-positive sample was found in the seminoma cases, maspin stained positively in 6 of the nonseminoma germ cell tumors (NSGCTs). No statistical difference was found between maspin and tumor stage, size, alpha fetoprotein values, vascular endothelial growth factor, Ki-67, and CD31. A statistically positive correlation was only determined between maspin and p53 (P < 0.001). Conclusion: Maspin protein, whose expression in some tumors is accepted as a poor prognostic factor, is also expressed in testicular tumors with germ cells. However, according to our study, it is difficult to say whether this protein is a favorable or poor prognostic factor in testicular tumors and to understand how the effect mechanism works. The positive correlation between maspin and p53 in the NSGCTs makes us think that maspin might have displayed an effect on the p53 pathway

Effects of androgen deprivation therapy on cognitive functions in patients with metastatic prostate cancer: A multicentric, prospective study of the Society of Urological Surgery Andrology group

Aims of the study The aim of this study was to investigate the impact of testosterone deficiency on cognitive functions in metastatic prostate cancer patients receiving androgen deprivation therapy (ADT)

Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study

Introduction: Coronavirus disease 2019 (COVID-19) pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life

Comparison of Cajal-like cells in pelvis and proximal ureter of kidney with and without hydronephrosis

Objectives: To evaluate effects of Cajal-like cells on human renal pelvis and proximal ureter on peristalsis. Materials and Methods: 63 patients submitted to nephrectomy due to atrophic non- functional kidney associated with hydroureteronephrosis were included as study group and 30 cases with nephrectomy due to other reasons were included as control group. Samples from renal pelvis and proximal ureters were obtained and sections of 5 mu form paraffin blocks of these samples were prepared; layers of lamina propria and muscularis mucosa were examined by immune-histochemistry using CD117 in order to determine count and distribution of Cajal-like cells. Results: During immune-histochemical examinations of sections, obtained from renal pelvis and proximal ureter of hydronephrotic kidneys by CD117, Cajal-like cells number determined in lamina propria and muscularis propria was statistically significantly lower compared to control group (p<0.001). Distribution of Cajal-like cells in renal pelvis and proximal tubulus was similar under examination by light microscope, and also both groups were not different from each other regarding staining intensity of Cajal-like cells by c-kit. Conclusion: Significantly reduced number of Cajal-like cells in study group compared to control group, shows that these cells may have a key role in regulation of peristalsis at level of renal pelvis and proximal ureter in urinary system