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    Effect of psychological stress on the L-arginine-nitric oxide pathway and semen quality
    (Assoc Bras Divulg Cientifica, 2006) Eskiocak, S.; Gozen, A. S.; Taskiran, A.; Kilic, A. S.; Eskiocak, M.; Gulen, S.
    It has been reported that mental stress causes abnormality of spermiogram parameters. We investigated the effect of psychological stress on the L-arginine-nitric oxide (NO) pathway. Semen samples were collected from 29 healthy fourth semester medical students just before (stress) and 3 months after (non-stress) the final examinations. Psychological stress was measured by the State Anxiety Inventory questionnaire. After standard semen analysis, arginase activity and NO concentration were measured spectrophotometrically in the seminal plasma. Measurements were made in duplicate. During the stress period, Sperm concentration (41.28 +/- 3.70 vs 77.62 +/- 7.13 x 10(6)/mL), rapid progressive motitity of spermatozoa (8.79 +/- 1.66 vs 20.86 +/- 1.63%) and seminal plasma arginase activity (0.12 +/- 0.01 vs 0.22 +/- 0.01 U/mL) were significantly lower than in the non-stress situation, whereas seminal plasma NO (17.28 +/- 0.56 vs 10.02 +/- 0.49 mu mol/L) was higher compared to the non-stress period (P < 0.001 for all). During stress there was a negative correlation between NO concentration and sperm, concentration, the percentage of rapid progressive motility and arginase activity (r = -0.622, P < 0.01; r = -0.425, P < 0.05 and r = -0.445, P < 0.05, respectively). These results indicate that psychological stress causes an increase of NO level and a decrease of arginase activity in the L-arginine-NO pathway. Furthermore, poor sperm quality may be due to excessive production of NO under psychological stress. In the light of these results, we suggest that the arginine-NO pathway, together with arginase and NO synthase, are involved in semen quality under stress conditions.
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    Endoscopic management of seminal-vesical cyst with right renal agenesis causing acute urinary retention
    (Mary Ann Liebert, Inc, 2006) Gozen, A. S.; Alagol, B.
    Seminal-vesicle cysts associated with renal agenesis are rare congenital or acquired lesions. We report a case of seminal-vesicle cyst causing urinary retention in a young patient with right renal agenesis who was treated successfully with transurethral unroofing. Magnetic resonance imaging aided us in making the conclusive diagnosis without the need for any invasive investigations.
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    The importance of anatomical region of local anesthesia for prostate biopsy; a randomized clinical trial
    (Verduci Publisher, 2013) Akdere, H.; Burgazli, K. M.; Aktoz, T.; Acikgoz, A.; Mericliler, M.; Gozen, A. S.
    INTRODUCTION: In our study, the efficiency and reliability of lidocaine (1 cc/1%) application during transrectal ultrasound-guided (TRUS) prostate biopsy to levatores prostate was studied. Levatores prostate was visualized on a cadaver dissection previously. PATIENTS AND METHODS: Eighty outpatients with lower urinary tract complaints or were suspected clinically to have prostate cancer were submitted to TRUS-guided prostate biopsy. The ages of outpatients were ranging from 45 to 81. Patients were randomized in 2 groups: Group-I, with 40 patients submitted to local anesthesia by periprostatic injection of 1 cc 1% lidocaine before biopsy; and group-II, with 40 controls the biopsy was performed without local anesthesia. The anatomical region for anesthesia was determined via dissection. The name of this anatomical region is levatores prostatae and it has got high nerve density. The process was explained to the patients and their approvals were obtained. Levatores prostatae was detected with TRUS before biopsy. Pain; related to digital rectal examination (DRE), probe insertion or biopsy, was scored via visual analog scale (VAS). The patients were evaluated about side effects of lidocaine and early and late complications of biopsy as well. RESULTS: Both groups were similar in terms of mean age, PSA levels, prostate volume and VAS scores (p > 0.05). As for VAS score, on the group submitted to anesthesia was determined 2.34 +/- 1.08, while for VAS score on the group submitted conventional biopsy was determined 5.8 +/- 1.6. Between two groups, there was a statistical difference in terms of VSA score (p < 0.05); but there was no statistical difference about early and late complications of biopsy. CONCLUSIONS: The periprostatic blockage use is clearly associated with more tolerance and patient comfort during TRUS-guided biopsy. Owing to the local anesthesia introduced to the periprostatic nerve bundle localization in levatores prostate area, the patients could tolerate the pain better.