Introduction: In this prospective randomized controlled study, we investigated the efficacy of obturator nerve block (ONB) on adductor muscle spasm and related short-term outcomes and complications in patients who underwent transurethral resection of lateral wall-located bladder tumours (TURBT).Methods: Between July 2014 and February 2015, 70 patients scheduled to undergo TUR of lateral bladder wall tumours were enrolled in the study. All patients were preoperatively evaluated by cystoscopy and imaging tools and selected according to localized tumours on the lateral bladder wall. Patients were randomly allocated to Group SA (35 patients who underwent only spinal anesthesia) and Group ONB (35 patients who underwent spinal anesthesia combined with ONB by the nerve stimulator). An independent observer, blinded to the approach, evaluated the obturator signs, including adductor muscle contraction, bladder perforation, and completeness of the resection during the TURBT procedure.Results: The differences between groups regarding mean operation time, tumour size, and number were not statistically significant (p > 0.05). Adductor muscle contraction was detected in 40% of patients in Group SA and 11.4% in Group ONB. This difference was statistically significant (p = 0.021). Complete bladder perforation was detected in 2 patients in Group SA, whereas no perforation was observed in Group ONB. There was no case of severe bleeding in both groups. Conclusions: We found that ONB performed after spinal anesthesia was effective in preventing intraoperative complications due to adductor muscle spasm while performing TURBT. Our study limitations include its small sample size, since we only enrolled patients with primary lateral wall-localized bladder tumo

To investigate the potential protective effects of losartan on varicocele-induced germ cell apoptosis, 24 adult male Sprague Dawley rats were divided into three groups: a sham operation was performed in SHAM group, and experimental left varicocele was created in VAR and VAR + LOS groups. Additionally, in VAR + LOS group, losartan was administered for 30 days starting on the day of surgery. At the end of 30 days, all animals were sacrificed and left orchiectomy was performed. Testicular injury and spermatogenesis were evaluated according to Johnsen scoring system. To assess the nitrosative stress, immunohistochemical staining for endothelial nitric oxide synthase was used and evaluated by H-score and apoptotic index (AI) of germ cells was analysed by TUNEL method. A significant decrease in the mean Johnsen score (JS) was observed in VAR group compared with SHAM (p < .001). The mean H-score and AI were significantly higher in VAR group compared with SHAM (p < .001). After losartan administration, mean JS was significantly increased (p < .001) and mean H-score and AI were significantly decreased compared with VAR group (p < .001 and .01, respectively). Findings of this suggest that losartan acts as a potent protective agent against varicocele-induced germ cell apoptosis.

Urinary incontinence is one of the major urinary symptoms in children and adolescents and can lead to major distress for the affected children and their parents. In accordance with the definitions of the Standardization Committee of the International Children's Continence Society, daytime urinary incontinence (DUI) is uncontrollable leakage of urine during the day. The aim of this cross-sectional study was to investigate the prevalence and associated risk factors of DUI in Turkish primary school children. The questionnaire, which covered sociodemographic variables and the voiding habits of the children, was completed by the parents of 2,353 children who were attending primary school in Denizli, a developing city of Turkey. The children's voiding habits were evaluated by use of the Dysfunctional Voiding and Incontinence Symptoms Score, which is a validated questionnaire. Children with a history of neurological or urological diseases were excluded. The participation rate was 91.9% (2,164 people). The overall prevalence of DUI was 8.0%. The incidence of DUI tended to decrease with increasing age and was not significantly different between genders (boys, 8.8%; girls, 7.3%; p=0.062). Age, maternal education level, family history of daytime wetting, settlement (urban/rural), history of constipation, urinary tract infection, and urgency were independent risk factors of DUI. Our findings showed that DUI is a common health problem in primary school children. In an effort to increase awareness of children's voiding problems and the risk factors for urinary dysfunction in the population, educational programs and larger school-based screening should be carried out, especially in regions with low socioeconomic status.

Objective: We investigated the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) on germ cell testicular tumors (GCT). Material and methods: The data of 53 patients who underwent inguinal orchiectomy were analyzed retrospectively. NLR was calculated from the preoperative complete blood cell counts. Receiver operating characteristic (ROC) analysis was performed to find the threshold values for NLR. Correlations between cancer-specific survival (CSS) and progression-free survival (PFS) and NLR were evaluated. Results: The mean follow-up time was 23.55±18.06 months. The mean level of NLR was 3.08±1.81. Optimal threshold values of NLR was calculated as 3.55 for PFS (area under curve, AUC: 0.55) and 3.0 for CSS (AUC: 0.66). For patients with a NLR of <3.55 and NLR of ≥3.55, mean times-to-progression were 55.71 months (95% CI, 51.27-60.14) and 51.95 months (95% CI, 38.02-65.87, p=0.152), respectively. As well as, for patients with a NLR of <3.0 and NLR of ≥3.0, mean times -to-cancer specific death were 54.72 months (95% CI, 49.05-60.38) and 49.43 months (95% CI, 37.64-61.22, p=0.119), respectively. Conclusion: Preoperative NLR is not a useful tool to predict the prognosis of patients with GCT.

Spermatic vein thrombosis is a very uncommon clinical entity. Most cases involve the left side. Herein, we present an unusual case of a young man who presented with spermatic vein thrombosis on the right side with an underlying Factor V Leiden mutation. To our knowledge, it is the first case in the literature.