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OBJECTIVE: To report our outcomes with the use of buccal mucosal graft anastomotic urethroplasty to reconstruct complex anterior urethral strictures.METHODS: Between October 2007 and January 2011 we conducted a retrospective review of a series of 65 patients from 2 different centers. We analyzed demographic data, surgical outcomes and complications. RESULTS: Patient mean age was 50.09 years (range: 25 to 75), mean stricture length was 3.95 cm (range: 3 to 7 cm) and mean follow-up 33.13 months (range: 12.7 to 52.77). Eighty percent of patients had prior treatments, mainly direct visual internal urethrotomy (DVIU) and urethral dilatation. Most frequent etiologies were iatrogenic in 46.15% of patients and idiopathic in 35.38% of patients. Success rate was achieved in 96.92% of patients; only 2 patients presented recurrence and were treated successfully with one DVIU. Clavien Dindo I-II complications were found in 59% of patients. No patient had chronic sequels.CONCLUSION: Augmented anastomotic urethroplasty using dorsal onlay buccal mucosa graft enables correction, in one time, of long segment urethral strictures with severe spongiofibrosis and/or obliterated lumen. Our outcomes are comparable with those of previously reported in international series
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OBJECTIVE: To determine the effect of a botanical formulation of Herniaria glabra, Agropyron repens, Equisetum arvense, and Sambucus nigra as a preventive agent in an experimentally induced nefrolithiasis model in rats.METHODS: Six groups of six Wistar male rats each were induced for nefrolithiasis by treatment with 0.75% ethylene glycol (EG) and 1% ammonium chloride for three days and then EG only for 15 days. One group was treated with placebo (control group) and the other groups (treated groups) were treated with 30 mg/Kg, 60 mg/Kg, 125 mg/Kg, 250 mg/Kgand 500 mg/Kg of the plant extract formulation (PEF). 24-h urine and water samples were collected one day before EG administration and at 7, 13 and 18 days to determine diuresis, crystalluria and urine biochemistry. The kidneys were removed for histological analysis. The phytochemical characterization of PEF and each of its component plant extracts was performed using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry.RESULTS: Animals treated with 125 mg/Kg of the PEFhad statistically significantly lower calcium oxalate crystals deposits content compared to the control group. All PEF doses statistically significantly decreased the number of microcalcifications compared to the control group. Furthermore, the number of kidneys affected by subcapsular fibrosis was statistically significantly higher in control group than in treated groups with the PEF. The diuresis of the 125 mg/Kg and 500 mg/Kg PEF-treated groups was statistically significantly higher than that of the control group. A phytochemical analysis demonstrated the presence of flavonoids, dicarboxylic acids and saponins.CONCLUSION: Treatment with PEF prevents deposits of calcium oxalate crystals formation and of microcalcifications in the kidney, and reduces the risk of fibrosis subcapsular. 125 mg/Kg of PEF is the dose that has a greater effect on the studied parameters.
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OBJECTIVE: In this study, we aimed toinvestigate the relation of testicular torsion and weatherconditions, and to report results from Turkey, a countrylocated between temperate and sub-tropical climatezones.METHODS: A total of 56 patients that had surgery withthe diagnosis of testicular torsion in Ankara Educationand Research Hospital Urology Clinic between 2005and 2014 were included in the study. Age of thepatient, side of torsion, date and time at onset of pain,scrotal exploration time, ischemia duration, degreeArch. Esp. Urol. 2015; 68 (10): 750-754of cord torsion, the surgical procedure performed,and scrotal Doppler ultrasound (USG) findings at thetime of diagnosis and 1 month after surgery wereretrospectively analyzed. The web archives of TurkishRepublic Meteorology General Directorate was used todetermine the seasonal and mean temperatures at thetime of diagnosis. The data were analyzed with SPSSv. 16 statistical package program using Chi-square,Mann-Whitney U and Wilcoxon tests.RESULTS: The mean age of 56 males included in thestudy was 18.88 ± 0.73 years. Right testicular torsionwas seen in 23, and left testicular torsion was seen in 33patients. Testicular arterial flow was absent in 37, arterialflow was moderately decreased in 12, and significantlydecreased in 7 patients on Doppler USG. Detorsionprocedure was performed in 46 patients while 10patients had orchiectomy. Nine patients were admittedin summer, 14 in fall, 15 in winter, and 18 in spring.The mean air temperature at the time of admittance was9.31 ± 1.05ºC. The prevalence of testicular torsionwas not found different among the seasons (p=0.39).The analysis of air temperature at the time of admittanceof the patients revealed that it was below 15ºC in 40patients while it was above 15ºC in 16 patients, with asignificant difference in between (p=0.002).CONCLUSIONS: The prevalence of testicular torsion didnot change in relation with the seasons. However, it wasdetermined that its prevalence was directly proportionalto the air temperature, and increased particularly below15ºC
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OBJECTIVE: To report two new cases of IgG4-related retroperitoneal fibrosis, a recently described pathology.METHODS: We analyze two cases diagnosed in our center and performed a literature review. RESULT: IgG4 related disease is a recently described entity that includes previously not related pathologies. The clinical manifestations are highly variable and its presentation is usually subacute. The treatment of choice is glucocorticoids. In our first case the outcome was favorable with corticosteroids and azathioprine. However, the second case required surgery on 2 occasions with radical nephrectomy. The diagnosis of the latter was made nine years after the onset of symptoms when the biopsy was reviewed; at that moment immunosuppressive therapy was not started.CONCLUSIONS: It is very important to know and diagnose this disease because of the good response to treatment that prevents complications.
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