The study aimed to investigate the effects of dexmedetomidine against ischaemia‐reperfusion injury occurring after priapism in a model of induced‐priapism in rats. A total of 18 male rats were randomised into three groups. Group 1 was the control group. A priapism model was performed rats in Group 2 and then ischaemia‐reperfusion injury was evaluated. Group 3 had similar procedures to the rats in Group 2. Rats in Group 3 additionally had 100 μg/kg dexmedetomidine administered intraperitoneally immediately after reperfusion. Blood and tissue samples were analysed. Biochemical analysis of blood samples revealed a decrease in the levels of the pro‐inflammatory cytokines including interleukin‐1 beta (IL‐1 Beta), interleukin‐6 (IL‐6), and tumour necrosis factor‐alpha (TNF‐alpha) in Group 3 compared to Group 2 (p:.04, p:.009 and p:.009, respectively). Similarly, the highest malondialdehyde (MDA) level was in Group 2 (p:.002). The levels of antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) activities were significantly higher in Group 3 than that of Group 2 (p:.037 and p:.045, respectively). Direct microscopic examinations revealed positive changes in desquamation, oedema, inflammation and vasocongestion scores in Group 3 compared to Group 2 (p:.007, p:.008, p:.007 and p:.006, respectively). Dexmedetomidine has a protective effect against ischaemia‐reperfusion injury in penile tissue.

Cerebral events which cause deterioration in reflex arch, neckrelated diseases, esophageal, stomach and other gastrointestinal diseases, thoracic diseases such as pneumonia and tumor, cardiovascular diseases, metabolic causes such as alcohol and hypocapnia, pharmacological agents such as carboplatin and cyclophosphamide are among the causes of resistant and persistent hiccups (Table 1) (1,4).

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The elderly population has been increasing significantly in our century. In our study, it was aimed to analyze the treatment results of elderly male patients who underwent holmium laser lithotripsy (HLL) for urethral stones under local anesthesia. We evaluated a total of 31 male patients, aged ≥65 years, diagnosed with urethral stones and treated with HLL under local anesthesia. We noted the demographic data and visual pain scores (VAS) of the patients and the duration of the operation and hospital stay. Our analysis involved both the success rates of the surgical procedure and the complication rates according to the modified Clavien classification. In addition. we determined the patients’ preoperative clinical status using the Charlson comorbidity index (CCI). The mean age of the patients was 71.65 ± 8.19 years. Acute urinary retention was the most common complaint (45.2%). Their mean scores were 7.68 ± 2.53 according to CCI. The average operation time was 15.48 ± 5.22 min and the VAS was 2.03 ± 1.08. All patients were stone-free and there was a marked improvement in their symptoms None of them stayed in the hospital for more than one day. We did not observe any Grade 3 or higher complications. In light of the data obtained in our study, we concluded that HLL is an effective and reliable method to treat urethral stones under local anesthesia in elderly male patients.

Introduction: Our century has witnessed a significant increase in obesity, which in its turn, bears several major risks in management of systemic anesthesia. In this context, use of this treatment without general or regional anesthesia is of critical importance for patients under this group. Aim: In present study, it was aimed to analyze the efficacy and safety of holmium laser lithotripsy (HLL) under local anesthesia in obese male patients with bladder stones. Material and Method: In our study, we evaluated a total of 64 obese male patients with body mass index (BMI) ≥30 kg/m2, diagnosed with bladder stones and treated HLL under local anesthesia. Demographic data, stone size, operative time, urethral catheterization time and length of hospital stay of the patients were analyzed. Visual Analogue Scale (VAS) scores was calculated for each patient during the procedure. Complications were graded according to modified Clavien classification system. Results: The mean age of patients was 50.58±13.04 years and BMI was 33.46±2.59 kg/m2. Mean stone size was 2.51±1.04 cm and operative time was 43.91±15.92 minutes. None of the patients had severe pain and the mean VAS score was calculated as 2.31±1.02. Mean length of hospital stay was 1.25±1.04 days. Grade 3 or higher complications were not observed according to modified Clavien classification system. Mean urethral catheterization time was 1.56±1.45 days, although varying due to underlying etiological factor. All patients were stone-free and there was a marked improvement in clinical findings. Conclusion: Use of HLL under local anesthesia is a safe and efficacious approach in obese male patients with bladder stone.