Objective and Hypothesis We aimed to investigate the reasons of storage symptoms ( SS) after transurethral resection of the prostate (TURP). The hypothesis was that a positive correlation would be identified between preoperative and postoperative SS in patients with undergoing TURP and starting early solifenacin treatment in patients with high preoperative SS would be reasonable. In addition, we aimed to analyze multiple other risk factors for post-TURP SS. Materials and Methods A total of 160 patients undergoing TURP were prospectively evaluated and divided into two groups according to their OABS. Those with a score of ≥10 points were Group 1 (G1), and those with <10 points Group 2 (G2). In addition, patients in each group were randomly further divided into two subgroups: those who were started on 5 mg solifenacin succinate in the early postoperative period (G1/G2 A) and those who were not (G1/G2 B). In additions to SS Preop, perop and at the 3rd-month of postoperatively 14 variable were evaluated. The effects of these factors, surgery and the efficacy of an early medical treatment on the postoperative SS were investigated. LUTS were assessed by International Prostate Symptom Score (IPSS) and SS were assessed by sum of IPSS 2, 4 and 7 questionnaires (Storage, S- IPSS). Results Preoperative IPSS and S-IPSS were significantly higher in G1 (p<0.001); there was a significant improvement at IPSS, S-IPSS, QoL score, Qmax, and PVR for all groups after surgery. Only preoperative S-IPSS was found to have significant effect on postoperative SS (p<0.001). There was a significant difference between G1A and G1B but no significant difference between G2A and G2B in terms of SS at postoperatively. In addition to this, prostatic volume was found smaller than non-symptomatic patients in de novo SS patients. Conclusion TURP provides significant improvement in both storage and voiding symptoms. The predictive value of the preoperative S-IPSS on postop SS is significant. These results suggest that 5 mg solifenacin succinate treatment in the early postoperative period may be beneficial for patients with high preoperative SS and may not be beneficial in others. Small prostatic volume may bode ill for postoperative SS in the patients with de novo SS.

ObjectiveThe aim of the present study was to investigate serum ghrelin and orexin levels in patients with varicocele and compare these levels with idiopathic infertile male and healthy control cases.MethodsThis study enrolled 24 men with varicocele, 24 males having idiopathic infertility, and 21 fertile men as the control group. Hormonal analyses, ghrelin and orexin levels were measured samples. Semen was analyzed after 3 and 5 days of sexual abstinence.ResultsSerum ghrelin levels were statistically different among the three groups (p=0.015), and it was due to a statistically lower level in group-1 than the level in the control cases (p=0.012). On the other hand, serum orexin levels were lower than healthy subjects in infertile groups with/without varicocele, but there was no difference (p=0.685) among three groups. Serum ghrelin level showed a negative and significant correlation only with sperm motility (r=−0.646, p=0.022), there was no correlation with other parameters. On the other hand, serum orexin levels did not show a significant correlation with seminal parameters.ConclusionBoth new investigated peptides ghrelin and orexin have regulatory effects on testicular function. However, ghrelin has a more obvious and complex effect on spermatogenesis. Impaired seminal parameters, especially motility was associated with increased serum ghrelin levels in infertile patients, especially with varicocele.

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 gua-nosine 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: We are reporting the 39 patients’ outcomes who underwent percutaneous nephrolithotomy and purulent urine is encountered at the initial steps of surgery. Method: Of 873 patients who underwent PCNL, 48 had purulent fluid during the initial puncture. After excluding those at risk for infection, we studied 39 patients' preoperative and postoperative variables - including postoperative day (POD) 1,3,5 fevers. In group 1, 21 patients had a nephrostomy tube placed, and PCNL was postponed. In group 2, 18 patients had successful stone removal in the first session. Results: All surgeries were successful, with no septic events during follow-up. No significant differences in preoperative variables were found. 14% and 22% of patients in groups 1 and 2 had infected fluid (p= 0.470). Four patients in group 1 (19 %) and seven patients in group 2 (38.9 %) had a high fever (≥ 38 C) on POD1 (p =0.171), and 1 (5%) in group 1 and 3 (17%) in group 2 had high fever on POD 3 (p= 0.22). No patients remained with high fever on POD5. Mild sepsis was diagnosed in 9.5 % of group 1 and 16 % of group 2 (p= 0,820), and hospitalization time differed significantly (p< 0.001). Stone size and operation time were correlated with postoperative fever, and prolonged hospital stays were correlated with positive blood cultures and postponed procedures. Conclusion: PCNL with proper technique and antibiotics can lead to quicker recovery and reduced hospitalization in selected patients with pus in their urine during surgery

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