Objective: The purpose of our study was to compare Vacuum-assisted closure (VAC) and conventional dressings in the wound therapy of Fournier’s gangrene (FG). Materials and methods: The study evaluated 54 patients, retrospectively. Following initial removal of necrotic and devitalized tissue, in Group I patients the wounds were covered with conventional antiseptic dressings and patients continued to be treated with conventional dressings. In Group II patients VAC therapy was initiated. The collected data were compared between groups. Results: The difference between two groups were statistically significant in terms of number of daily dressing (group I: 2, group II: 0,5), VAS (group I: 8, group II: 5), number of daily analgesics (group I: 4, group II: 2), number of daily narcotic analgesics (group I: 1, group II: 0), duration of mobilization per day (group I: 40, group II: 73 minutes) (p < 0.05). Conclusions: Our study does not determine that a VAC therapy is better than conventional dressings in terms of clinical outcome. However, vacuum dressing appears an effective and successful method, which offers fewer dressing changes, less pain, and greater mobility comparing to conventional dressings in the management of FG patients.
This study investigated whether a high-fructose (HFr) diet changes the morphology of seminiferous tubules (ST) in rats and resveratrol (RES) has a possible restoring effect in this sense. Fructose (30%; w/v) was administered to rats alone or together with RES (50 mg/L) in drinking water for 8 weeks. In the HFr group, destruction of the germinal epithelium led to the detection of immature germ cells in the lumen. HFr diet gave rise to a decrease in the ST diameters (p < 0.05), Johnsen's tubular biopsy score values (p < 0.001), and an increase in the apoptotic index (p < 0.05). Ultrastructurally, HFr feeding increased lipid accumulation (p < 0.01), mitochondrial damage, and acrosomal abnormalities in spermatogenic cells. Treatment of HFr -fed rats with RES improved the reduced ST diameters and overall general histological and ultrastructural abnormalities of the STs, but did not change the increased apoptotic index.
Introduction: Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTSs) secondary to benign prostatic hyperplasia (BPH). The PUL procedure involves the placement of implants that retract the obstructing prostate lobes. This procedure achieves quantifiable improvements in functional outcomes and quality of life (QoL), while preserving erectile and ejaculatory functions. Methods: Seventeen patients diagnosed with BPH who had undergone the UroLift® procedure between March 2011 and June 2015 were retrospectively evaluated. The parameters evaluated in the pre-operative, intra-operative and 1-year post-operative period were demographic data, and pre-operative, intra-operative and 1-year post-operative results were obtained from the International Prostate Symptom Score (IPSS), Uroflowmetry QoL index, International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) for ejaculatory function (MSHQ-EjD). Results: The average improvements from baseline to 12 months after intervention were significant for the total IPSS 9.6. There was a 4.2-point increase in Qmax, a 0.9-point improvement in QoL and a 32% decrease in PVR. No statistically significant difference was found in the IIEF and MSHQ-EjD scores when the pre-operative and post-operative 3rd and 12th month scores were evaluated (p > 0.05). Conclusions: PUL offers rapid improvement in voiding and storage symptoms, QoL and flow rate that is durable to 12 months after intervention. PUL is a minimally invasive procedure that has the moderate effect in treating troublesome LUTS secondary to benign prostatic obstruction and preserving total sexual function.
Objectives: A prospective randomized study was conducted to evaluate the safety and effectiveness of bipolar plasma vaporization with a novel electrode that produces vaporization of the tissue (transurethral vaporization of the prostate, TUVP) immersed in isotonic saline compared to the standard transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). Patients and Methods: From February 2009 to February 2010, 90 patients with BPH were randomized into two groups, and underwent conventional TURP (group 1) or TUVP (group 2) utilizing bipolar plasma vaporization with an innovative electrode (Olympus Winter & Ibe GmbH, Hamburg, Germany). International Prostate Symptom Scores (IPSS), transrectal ultrasonographic findings, maximal urine flow rates (Qmax), and postvoiding residual urine (PVRU) volumes of all cases were evaluated preoperatively and 1 month, 3 months, and 1 year postoperatively. Preoperative and postoperative serum hemoglobin, hematocrit and sodium concentrations of all patients were measured. All patients included in the study were monitored for 1 year. Results: In patients in group 1 (n = 47; mean age: 64.7 ± 7.3 years) TURP was performed. The patients in group 2 (n = 43; mean age: 65.4 ± 8.9 years) underwent bipolar TUVP. Cases in the two study groups matched for demographic characteristics and clinical parameters were assessed. The evaluation of IPSS scores, PVRU, Qmax, and prostatic volumes of the patients 1 month, 3 months, and 1 year postoperatively did not reveal any significant differences between the two groups. In group 2 (TUVP), postoperative catheter indwelling times were significantly shorter, and Na serum concentrations were also markedly lower (p < 0.005). Conclusion: We detected similar effectiveness and morbidity rates in both groups. Bipolar TUVP has advantages such as shorter catheter indwelling times and hospital stays, and fewer bleeding episodes without any risk of transurethral resection syndrome. We believe that TUVP might be an alternative to TURP which is currently the ‘gold standard’ treatment in BPH.
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