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    Early effects of extracorporeal shock-wave lithotripsy exposure on testicular sperm morphology
    (Informa Healthcare, 2004) Basar, MM; Samli, MM; Erbil, M; Ozergin, O; Basar, R; Atan, A
    Objective: To investigate the effects of extracorporeal shock-wave lithotripsy (ESWL) applied to the pelvic region on testicular histology and spermatogenesis. Material and Methods: ESWL (2000 shock waves over a 20-min period at 18 kV) was applied to 12 adult New Zealand male rabbits. The rabbits were divided into three equal groups: those in Group I were sacrificed I h after the intervention, those in Group 2 were sacrificed on the 3rd day and those in Group 3 were sacrificed on the 7th day. Both testicles were removed for histopathological examination to investigate the effects of ESWL. Transmission electron microscopy (TEM) was used to detect ultrastructural changes. Epididymal and testicular touch-print preparations were stained with SperMac(R) stain in order to evaluate the morphology of the spermatozoa. Results: There were no significant differences between the groups in terms of sperm morphology (p = 0.386). TEM revealed only huge vacuolation of Sertoli cells and diffuse edema in the mitochondria of Sertoli cells. Conclusion: No detrimental effect of ESWL on sperm morphology was detected in this study. We conclude that shock waves do not cause severe permanent effects but only transient disorders in testes.
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    Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with non-gonococcal urethritis
    (Natl Inst Infectious Diseases, 2004) Kilic, D; Basar, MM; Kaygusuz, S; Yilmaz, E; Basar, H; Batislam, E
    The aim of present study was to evaluate the occurrence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in non-gonococcal urethritis (NGU) and to determine the bacterial resistance to six antibiotics in order to determine the most suitable treatment strategy. A total of 50 patients were enrolled into the study. Urethral samples were taken with a dacron swab placed into urethra 2-3 cm in males, and vaginal samples were taken from the endocervical region in women. The patient samples that did not grow Neisseria gonorrhoeae were accepted as NGU. Direct immunofluorescence technique was used for the investigation of C. trachomatis. Mycoplasma IST was used for the isolation of M. hominis and U. urealyticum. U. urealyticum was isolated from 24 patients. Thirteen of them had only U. urealyticum, and the rest had mixed pathogen organisms (7 U. urealyticum + M. hominis; 3 U. urealyticum + C. trachomatis, and 1 U. urealyticum + M. hominis + C. trachomatis). C trachomatis was detected in 12 patients. While 8 patients had C. trachomatis only, the rest had a mixture of the pathogen organisms listed above. Partner examinations could be performed for only 22 patients' partners. In the evaluation of antibiotic susceptibility, higher resistance was obtained against ofloxacin in U. urealyticum, and against erythromycin with M. hominis. Our results indicated that doxycycline or ofloxacin should be the first choice when empirical treatment is necessary.
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    Primary bilateral spermatocele
    (Blackwell Publishing Asia, 2003) Basar, H; Baydar, S; Boyunaga, H; Batislam, E; Basar, MM; Yilmaz, E
    We report the case of a bilateral, relatively huge, multilocular spermatocele diagnosed at sonography with surgical and pathological correlation. A 45-year-old man presented with bilateral, large inguinoscrotal masses. He had had the masses since his adolescence and their size gradually increased in the past 5 years. Scrotal ultrasonographic examination showed cystic fluid masses that were 65 x 45 x 50 mm in size on the right and 55 x 45 x 40 mm in size on the left side in multilocular spaces. The cystic masses were excised via bilateral inguinoscrotal incision staying near the body of the epididymis. The patient had fathered three children with no fertility problem.
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    Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids
    (Blackwell Publishing Asia, 2003) Yilmaz, E; Batislam, E; Basar, MM; Basar, H
    Objective: The objective of our study was to assess the efficacy of topical steroids in the treatment of phimosis and evaluate patients using the Diagnostic and Statistical Manual-III-Revised (DSM-III-R) test with the aim of eliminating castration anxiety of circumcision in the phallic period. Methods: One hundred and forty-nine children with phimosis who required circumcision were included the study. The average age of the children was 4.47 years. All children underwent the DSM-III-R test and their parents were questioned. Patients were separated randomly into three groups. Group I comprised 51 children who would undergo circumcision; group II comprised 50 children who would be treated with a topical corticosteroid (0.05% bethamethasone cream) twice daily for 1 month; and group III comprised 48 children who would be treated with a topical placebo cream. On the 5th day of treatment, parents were told to retract the prepuce and were given hygiene routine instructions. Patients were seen immediately after treatment and again 2 months later. Results: In group II, 16 of the 50 children had non-retractable prepuce. Forty-two cases of phimosis were corrected after treatment. Eight patients received further monthly treatment and five benefited from the second course of treatment. In group III, 17 of the 48 patients had non-retractable prepuce and four had satisfactory results. Forty-four patients received placebo treatment for another month and eventually, 40 children underwent circumcision in this group. DSM-III-R test results showed a significant shift to anxiety in the circumcision group. The were no significant differences in the other groups. Conclusion: Topical steroids for the treatment of phimosis is a highly effective treatment alternative to surgery. It avoids or delays circumcision and can be practised during the phallic period to decrease castration anxiety. The treatment is suitable for patients from any religious or cultural background.
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    Testicular tissue nitric oxide and thiobarbituric acid reactive substance levels: evaluation with respect to the pathogenesis of varicocele
    (Springer, 2004) Kisa, U; Basar, MM; Ferhat, M; Yilmaz, E; Basar, H; Caglayan, O; Batislam, E
    The aim of the present study is to evaluate tissue nitric oxide (NO) and thiobarbituric acid reactive substance (TBARS) levels in testicular tissue, and to determine their relationship with seminal parameters in order to explain possible effects on varicocele pathophysiology.Ten adult male Wistar rats at 8 weeks old underwent partial left renal vein ligation. A sham operation was performed on control rats in a second group of another ten rats. All animals were killed 4 weeks after surgery. The testes were removed and histological changes were observed by light microscopy with haematoxylin and eosin stain on half of each testis. The rest of testis was used for the evaluation of testicular tissue NO and TBARS levels. Epididymal aspirated seminal plasma was used for semen analysis and morphological analysis was carried out according to Kruger's criteria. Statistical analysis was performed by using Mann-Whitney U-tests and Spearman rank correlations between the two groups for NO and TBARS levels and for seminal parameters. Testicular tissue NO and TBARS levels (mean+/-SEM) were 62.8+/-10.1 mumol/g protein and 4.7+/-0.3 nmol/g protein in group 1. These parameters were 16.9+/-2.2 mumol/g protein and 3.1+/-0.2 nmol/g protein in the group 2 controls. There were significant differences between these parameters (P-NO=0.000, P-TBARS=0.001). Although a positive and significant correlation between testicular tissue NO and TBARS levels was found (r(s)=0.739, P=0.014), there was only a strong negative correlation between NO levels and sperm motility in group 1 (r(s)=-0.815, P=0.004). We found that this effect of NO on sperm motility was independent from TBARS levels after regression analysis (r(2)=-0.687, beta=0.825, P=0.034). Although there were statistically significant differences in seminal parameters between the two groups, there was no difference between them in the histopathological examination. We found that sperm motility was significantly related to testicular tissue NO levels only. Thus, we suggest that NO is an important mediator in the pathogenesis of varicocele. TBARS and other substances have been effective via NO pathways.
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    Torsion of an epididymal cyst
    (Wiley, 2004) Yilmaz, E; Batislam, E; Bozdogan, O; Basar, H; Basar, MM
    Torsion of an epididymal cyst is a very rare condition. We present a case of torsion of an epididymal cyst in a 13-year-old boy. The patient presented with acute scrotal pain. Scrotal ultrasonography showed a 38 x 35 x 30 mm fluid-filled mass within the caput of the left epididymis. Histologically, the cells of the epididymal duct were necrotic. To our knowledge, this is the second case report in the literature.