Scrotal Tissue Necrosis in a Patient with Urethral Stricture Treated with Internal Urethrotomy and Mitomycin-C Injection

An 89-year-old male patient was admitted with open scrotal tissue wound. Approximately 4x4 cm scrotal necrotic tissue extending to the anal region was observed. It was learned that the patient underwent radical prostatectomy 9 years ago and then, internal urethrotomy was performed due to urethral stricture. Urethroscopy showed an anterior urethral stricture 2 cm in length. After internal urethrotomy, 20 mg of mitomycin-C (MMC) was diluted with 50 cc saline and injected as an intralesional injection (10 cc) and instillation (40 cc). In previous applications, our patients have tolerated this treatment during the process. In this case report, we present the case of scrotal tissue necrosis and treatment in a patient in whom internal urethrotomy and intralesional MMC application were performed

Assessment of Serotonin Metabolite 5-hydroxyindoleacetic Acid Levels in Urine Sample for Diagnosis and Treatment Efficacy in Children with Dysfunctional Voiding and Their Interaction with Biofeedback Therapy

Objective:Dysfunctional voiding (DV), which is explained as an incoordination between the external urethral sphincter and the bladder, is a situation developing in neurologically normal children. Serotonin has some effects on the lower urinary tract which cannot be fully explained. The selective 5-hydroxyindoleacetic acid (5-HIAA) agonist improves voiding efficacy in the rat model with voiding dysfunction as serotonin. Serotonin decomposes to 5-HIAA which excreted from urine. We considered that a problem in neuromodulator levels can lead to DV and evaluated the levels of 5-HIAA in urine.Materials and Methods:Our study included 130 children aged 5-15 years who were diagnosed with DV and 48 children with no urological complaints as controls. Urine samples were taken only once in control group, and 3 times [before and after the biofeedback treatment (sixth month and twelfth month)] in the study group to determine the difference and the interaction between 5-HIAA and biofeedback therapy.Results:Biofeedback therapy was found to be an effective method in the treatment of DV. However, there was no significant difference in the level of mean urine 5-HIAA/creatinine (u5-HIAA/Cr) between study (6.139±3.652) and control groups (6.374±4.329) (p=0.751). The mean u5-HIAA/Cr levels in the DV group at baseline and at the end of biofeedback therapy (6th month) were 6.249±4.132 and 6.19±4.715, respectively (p=0.951). The mean u5-HIAA/Cr levels in the DV group at baseline and at 12 months were 5.901±3.291 and 6.644±4.206, respectively (p=0.557). There was no significant difference in u5-HIAA/Cr levels between pre-treatment and post-treatment in the DV group.Conclusion:We still do not know if a problem at the level of neurotransmitter metabolite in the central nervous system plays a role in the etiology of DV. We evaluated this relationship, but we could not find a significant result. New studies are needed to get more information about the role of neuromodulators in the etiology and treatment of DV

Genetik Analizde t4;22 (q21;p13) Resiprokal Translokasyon Saptanan Azospermi Olgusu

Azospermi santrifüje edilen semen örneğinde hiç spermatozoa saptanmaması olarak tanımlanır. Azospermi tüm erkeklerin yaklaşık % 1’inde bulunurken infertil erkeklerin ise yaklaşık %15’inde saptanmaktadır. Azospermili erkeklerin değerlendirilmesinde altta yatan etyolojinin belirlenmesi tedavi planı açısından önemlidir. Etyoloji nonobstrüktif ve obstrüktif azospermi olarak gruplanabilir. Nonobstrüktif azospermi hipotalamik-hipofizer-gonadal aksta sorun nedeniyle oluşurken, obstrüktif azospermide rete testis ile ejakulator kanal arasındaki herhangi bir seviyede obstrüksiyona bağlı sprem transportunda bozulma vardır. Testis kaynaklı azospermi genellikle düzeltilemez. Primer testiküler yetmezlik nedeniyle oluşan azospermide muhtemel kromozomal anomali açısından genetik testler yapılmalıdır. Genetik analiz sonucu t4;22 (q21;p13) resiprokal translokasyon saplanan bir azospermi olgusu sunulmuştur