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S97 URINARY DIVERSION AFTER RADICAL CYSTECTOMY IN T3 AND T4 STAGE AND QUALITY OF LIFE
ice-cold glass. Blood samples were collected from the left ventricle with an injector under anesthesia.The epididymal sperm concentration was determined. The right epididymis was finely minced by anatomical scissors in 1 mL of isotonic saline in a Petri dish and allowed to incubate at room temperature. Then the supernatant fluid containing all epididymal sperm cells was counted with the help of a light microscope at 200x magnifications. The percentage of forward progressive sperm motility was evaluated using a light microscope. Results: Although CP induced oxidative stress via significant increase in the formation of TBARS, it caused a significant decline in the levels of GSH, CAT, GPx and SOD in rats. In contrast, ML prevents these effects of CP through cause an increase in GSH, CAT, GPx and SOD levels and a decrease in formation of TBARS. In addition sperm motility and serum testosterone levels significantly decrease and histopathological damage increase with CP treatment. However, the effects of CP on sperm motility, serum testosterone level, oxidative and histopathological changes are eliminated by ML treatment. Conclusions: We confirmed the toxic effects of CP at the single dose of 7 mg/ kg on testicular (increased oxidative stress and histological changes in tissue), spermatological (decreased sperm motility) and hormonal (decreased serum testosterone levels) damage in rats. Also, it is shown that ML treatment in combination with CP at the dose of 10 mg/kg/day for ten consecutive days generally reversed toxicity of CP about the reproductive system. The beneficial effects of ML against CP-induced reproductive damage may be due to its antioxidant and antiinflammatory properties. Therefore, according to our results we claim that ML, a specific LTD4 receptors antagonist, may attenuate the CP-induced reproductive toxicity.
S94
Comparison of reproductive Toxicity caused by Cisplatin and Novel Platinum-NHeterocyclic Carbane complex in adult male rats
Ciftci O.1, Beytur A.2, Cakir O.3, Gurbuz N.3, Vardi N.4 1 Inonu University Faculty of Pharmacy, Dept. of Pharmatosotic Toxicology, Malatya, Turkey, 2Inonu University Faculty of Medicine, Dept. of Urology, Malatya, Turkey, 3Inonu University Faculty of Science, Dept. of Chemistry, Malatya, Turkey, 4Inonu University Faculty of Medicine, Dept. of Embriology and Histology, Malatya, Turkey Introduction & Objectives: Cisplatin and other platinum complexes are important chemotherapeutic agents and useful in the treatment of several cancers such as prostate, ovarian and testis. However, the severe side effects including reproductive toxicity of cisplatin and other platinum complex caused limitation of their clinical usage. In this context, we aimed to compare the damage in testis caused by cisplatin and novel platinum-N-heterocyclic carbene complex (pt-NHC). Material & Methods: To this end, 35 Sprague-Dawley rats were divided randomly into five equal groups (n=7 for each group). Cisplatin and Pt-NHC were intraperitoneally administered at a single dose of 5 mg/kg or 10 mg/kg and then sacrified 10 days after this treatment. The testicular tissues and serum samples were taken from all rats for determination of reproductive toxicity. Results: The results showed that cisplatin and Pt-NHC caused toxicity on reproductive system via increased oxidative and histological damage, decreased serum testosterone levels and negatively altered sperm charesteristics in a dose dependent manner (p<0.05). On the other hand, at the same dose levels, cisplatin generally caused lower toxicity on reproductive system compared to Pt-NHC. Conclusions: In conclusion, this results suggest that Pt-NHC has more toxic effects on male reproductive system than cisplatin and in terms of clinical usage; Pt-NHC may be unsafe according to cisplatin.
S95
Preventive Rrle of amifostine in testis and bladder injuries induced by cyclophosphamide
Baseskioglu A.B.1, Yigitaslan S.2, Kaya C.1, Ozatik O.3, Ozatik Y.2, Uslu S.4 1 Osmangazi University Medical Faculty, Dept. of Urology, Eskisehir, Turkey, 2 Osmangazi University Medical Faculty, Dept. of Pharmacology, Eskisehir, Turkey, 3 SD University Medical Faculty, Dept. of Histology, Isparta, Turkey, 4Osmangazi University Medical Faculty, Dept. of Biochemistry, Eskisehir, Turkey Introduction & Objectives: Cyclophosphamide, an alkylating cytotoxic agent, causes hemorrhagic cystitis through its active metabolite acrolein, as well as myocardial and testicular injuries. On the other hand, amiphostine has long been used to minimize the detrimental effects of radiotherapy and chemotherapy on healthy tissues. In this study we aimed to prevent the vesical and testicular injuries in cyclophosphamide-treated rats by administrating amiphostine. Material & Methods: A total of 28 rats were divided into four groups. Sham group served as control. In the CYP group 200 mg/kg cyclophosphamide administered and in the AMF200 and AMF400 groups respectively 200 mg/kg and 400 mg/kg amiphostine administered 15 mins before the administration of cyclophosphamide. Samples were collected 24 h after the cyclophosphamide administration. Results: Both ratios of testis weight to body weight and epididymal sperm count were significantly decreased in the CYP group compared to control values and they increased significantly in AMF200 and AMF400 groups compared to CYP group
Eur Urol Suppl 2011;10(9):598
(P<0.05 and P=0.01, respectively). There were no significant changes in sperm morphology and no significant differences in dry/wet testis weight between groups. Bladder weight was significantly reduced in AMF400 group both than CYP group and AMF200 group (p<0.05). Moreover, dry/wet bladder weight was significantly increased in CYP group compared to control group, and significantly decreased in AMF200 and AMF400 groups compared to CYP group (P<0.5). Conclusions: Amiphostine may prevent some of the detrimental effects of cyclophosphamide on testis and bladder.
S97
Urinary diversion after radical cystectomy in T3 and T4 stage and quality of life
Marianovski V., Atanasov E., Hadjiiski H. UMHATEM “N.I.Pirogov”, Dept. of Urgent and Pediatric Urology, Sofia, Bulgaria Introduction & Objectives: Radical Cystectomy (RC), remains the elective treatment for Muscle-Invasive Bladder Cancer (MIBC), strongly recommended by major international guidelines. The aim of the study was to conduct analysis of urinary derivations after T3 and T4 stage and quality of life of these patients. Material & Methods: We observed 40 self operated and 14 patients registered for surveillance at the Oncodispensary in Sofia. All patients were after a cystectomy in T3 and T4 stage. From the self operated group there were 25 patients with primary open vesical operation and 15 patients were after preliminary partial resection of the bladder. Two patients underwent a neoajuvant chemotherapy. The age of the patients was 52-71(mean-63) for the T3 and 57-77(mean-65) for T4 stage. There were 49 males and 5 females. Quality of Life (QoL) was measured 9-12 mounts after radical cystectomy using EORTC QLQ-C30. Results: The operations were accomplished with the following urine derivations: Ureteroileocutaneostomy (Bricker derivation) – 29, transureteroureterocutaneostomy – 14, uretero-ureteroanastomosis after PNS, derivation in sigmoid colon (Mainz-II) – 2, continent pouch – 2 patients. Postoperative complications strictly related with postoperative QoL, because they reduce it . All of the patients has satisfactory QoL 9-12 mounts after RC. Conclusions: The ileal conduit can be considered an appropriate surgical solution after radical cystectomy in most patients in T3 and T4 stage, because of relative simplicity of the surgical technique, the acceptable complication rate, and the satisfactory postoperative QoL.
S98
Local relapse in ileum-neobladder – 2 cases and a literature survey
Ikic M., Atanassov G., Hauschild E., Hamidov Z., Güttner C., Krah X. Helios Klinik Blankenhain, Dept. of Urology, Blankenhain, Germany Introduction & Objectives: In the last years the orthotopic neobladder developed to the most frequently urinary diversion after radical cystectomy. She offers as far as possible a normal course of life for the patient. A relapse in the neobladder not only results in tumor specific complications, but also in functional changes. Materials & Methods: We performed 94 cystectomies in our department since 2000. An orthotopic ileum-neobladder received 63 patients. In two cases a relapse in the neobladder (3,2%) developed. One patient was a 71 year-old man with pT4 G3 N0 urothelial carcinoma of the bladder and simultaneous prostate cancer with Gleason-score 9. After primary uncomplicated cystectomy and rectosigmoid resection at the same time the patient presented after 6 months symptomes like neobladder-tamponade. Intraoperative it exposed as a tumor growth, which couldn`t completely resected transurethral. Before initiation of palliative chemotherapy the patient died of disease within 2 weeks. The second patient (71 years) supported also radical cystectomy because of pT3 G3 N0 urothelial carcinoma of the bladder. After protracted course and several inpatient residences because of deranged acid-base metabolism he applied to our hospital due to urinary retention. After hindered insertion of catheter we diagnosed also an intra-neovesical relapse. In both patients we excluded lymph node and respectively organ metastases by means of computer tomography. Results: In literature the frequency of local relapse is stated from 1,7 to 7%. It appears intermediate 3 and 151 months after cystectomy and results in an obstruction under 5%. The neobladder-function mostly isn`t affected. As therapies are descriebed palliative chemotherapy, transurethral resection to the point of complete-resection. There exists no well defined datas for the prognosis of the local relapse in ileum-neobladder. Conclusions: The local relapse in orthotopic neobladder after cystectomy demonstrate rather uncommon occurrence and is descended from remaining urethra. Rarely it affects the function of the neobladder and is treated using chemotherapy or resection. In view of its uncommon incidence it should not constitute a refutation against orthotopic urinary diversion.
S94
Comparison of reproductive Toxicity caused by Cisplatin and Novel Platinum-NHeterocyclic Carbane complex in adult male rats
Ciftci O.1, Beytur A.2, Cakir O.3, Gurbuz N.3, Vardi N.4 1 Inonu University Faculty of Pharmacy, Dept. of Pharmatosotic Toxicology, Malatya, Turkey, 2Inonu University Faculty of Medicine, Dept. of Urology, Malatya, Turkey, 3Inonu University Faculty of Science, Dept. of Chemistry, Malatya, Turkey, 4Inonu University Faculty of Medicine, Dept. of Embriology and Histology, Malatya, Turkey Introduction & Objectives: Cisplatin and other platinum complexes are important chemotherapeutic agents and useful in the treatment of several cancers such as prostate, ovarian and testis. However, the severe side effects including reproductive toxicity of cisplatin and other platinum complex caused limitation of their clinical usage. In this context, we aimed to compare the damage in testis caused by cisplatin and novel platinum-N-heterocyclic carbene complex (pt-NHC). Material & Methods: To this end, 35 Sprague-Dawley rats were divided randomly into five equal groups (n=7 for each group). Cisplatin and Pt-NHC were intraperitoneally administered at a single dose of 5 mg/kg or 10 mg/kg and then sacrified 10 days after this treatment. The testicular tissues and serum samples were taken from all rats for determination of reproductive toxicity. Results: The results showed that cisplatin and Pt-NHC caused toxicity on reproductive system via increased oxidative and histological damage, decreased serum testosterone levels and negatively altered sperm charesteristics in a dose dependent manner (p<0.05). On the other hand, at the same dose levels, cisplatin generally caused lower toxicity on reproductive system compared to Pt-NHC. Conclusions: In conclusion, this results suggest that Pt-NHC has more toxic effects on male reproductive system than cisplatin and in terms of clinical usage; Pt-NHC may be unsafe according to cisplatin.
S95
Preventive Rrle of amifostine in testis and bladder injuries induced by cyclophosphamide
Baseskioglu A.B.1, Yigitaslan S.2, Kaya C.1, Ozatik O.3, Ozatik Y.2, Uslu S.4 1 Osmangazi University Medical Faculty, Dept. of Urology, Eskisehir, Turkey, 2 Osmangazi University Medical Faculty, Dept. of Pharmacology, Eskisehir, Turkey, 3 SD University Medical Faculty, Dept. of Histology, Isparta, Turkey, 4Osmangazi University Medical Faculty, Dept. of Biochemistry, Eskisehir, Turkey Introduction & Objectives: Cyclophosphamide, an alkylating cytotoxic agent, causes hemorrhagic cystitis through its active metabolite acrolein, as well as myocardial and testicular injuries. On the other hand, amiphostine has long been used to minimize the detrimental effects of radiotherapy and chemotherapy on healthy tissues. In this study we aimed to prevent the vesical and testicular injuries in cyclophosphamide-treated rats by administrating amiphostine. Material & Methods: A total of 28 rats were divided into four groups. Sham group served as control. In the CYP group 200 mg/kg cyclophosphamide administered and in the AMF200 and AMF400 groups respectively 200 mg/kg and 400 mg/kg amiphostine administered 15 mins before the administration of cyclophosphamide. Samples were collected 24 h after the cyclophosphamide administration. Results: Both ratios of testis weight to body weight and epididymal sperm count were significantly decreased in the CYP group compared to control values and they increased significantly in AMF200 and AMF400 groups compared to CYP group
Eur Urol Suppl 2011;10(9):598
(P<0.05 and P=0.01, respectively). There were no significant changes in sperm morphology and no significant differences in dry/wet testis weight between groups. Bladder weight was significantly reduced in AMF400 group both than CYP group and AMF200 group (p<0.05). Moreover, dry/wet bladder weight was significantly increased in CYP group compared to control group, and significantly decreased in AMF200 and AMF400 groups compared to CYP group (P<0.5). Conclusions: Amiphostine may prevent some of the detrimental effects of cyclophosphamide on testis and bladder.
S97
Urinary diversion after radical cystectomy in T3 and T4 stage and quality of life
Marianovski V., Atanasov E., Hadjiiski H. UMHATEM “N.I.Pirogov”, Dept. of Urgent and Pediatric Urology, Sofia, Bulgaria Introduction & Objectives: Radical Cystectomy (RC), remains the elective treatment for Muscle-Invasive Bladder Cancer (MIBC), strongly recommended by major international guidelines. The aim of the study was to conduct analysis of urinary derivations after T3 and T4 stage and quality of life of these patients. Material & Methods: We observed 40 self operated and 14 patients registered for surveillance at the Oncodispensary in Sofia. All patients were after a cystectomy in T3 and T4 stage. From the self operated group there were 25 patients with primary open vesical operation and 15 patients were after preliminary partial resection of the bladder. Two patients underwent a neoajuvant chemotherapy. The age of the patients was 52-71(mean-63) for the T3 and 57-77(mean-65) for T4 stage. There were 49 males and 5 females. Quality of Life (QoL) was measured 9-12 mounts after radical cystectomy using EORTC QLQ-C30. Results: The operations were accomplished with the following urine derivations: Ureteroileocutaneostomy (Bricker derivation) – 29, transureteroureterocutaneostomy – 14, uretero-ureteroanastomosis after PNS, derivation in sigmoid colon (Mainz-II) – 2, continent pouch – 2 patients. Postoperative complications strictly related with postoperative QoL, because they reduce it . All of the patients has satisfactory QoL 9-12 mounts after RC. Conclusions: The ileal conduit can be considered an appropriate surgical solution after radical cystectomy in most patients in T3 and T4 stage, because of relative simplicity of the surgical technique, the acceptable complication rate, and the satisfactory postoperative QoL.
S98
Local relapse in ileum-neobladder – 2 cases and a literature survey
Ikic M., Atanassov G., Hauschild E., Hamidov Z., Güttner C., Krah X. Helios Klinik Blankenhain, Dept. of Urology, Blankenhain, Germany Introduction & Objectives: In the last years the orthotopic neobladder developed to the most frequently urinary diversion after radical cystectomy. She offers as far as possible a normal course of life for the patient. A relapse in the neobladder not only results in tumor specific complications, but also in functional changes. Materials & Methods: We performed 94 cystectomies in our department since 2000. An orthotopic ileum-neobladder received 63 patients. In two cases a relapse in the neobladder (3,2%) developed. One patient was a 71 year-old man with pT4 G3 N0 urothelial carcinoma of the bladder and simultaneous prostate cancer with Gleason-score 9. After primary uncomplicated cystectomy and rectosigmoid resection at the same time the patient presented after 6 months symptomes like neobladder-tamponade. Intraoperative it exposed as a tumor growth, which couldn`t completely resected transurethral. Before initiation of palliative chemotherapy the patient died of disease within 2 weeks. The second patient (71 years) supported also radical cystectomy because of pT3 G3 N0 urothelial carcinoma of the bladder. After protracted course and several inpatient residences because of deranged acid-base metabolism he applied to our hospital due to urinary retention. After hindered insertion of catheter we diagnosed also an intra-neovesical relapse. In both patients we excluded lymph node and respectively organ metastases by means of computer tomography. Results: In literature the frequency of local relapse is stated from 1,7 to 7%. It appears intermediate 3 and 151 months after cystectomy and results in an obstruction under 5%. The neobladder-function mostly isn`t affected. As therapies are descriebed palliative chemotherapy, transurethral resection to the point of complete-resection. There exists no well defined datas for the prognosis of the local relapse in ileum-neobladder. Conclusions: The local relapse in orthotopic neobladder after cystectomy demonstrate rather uncommon occurrence and is descended from remaining urethra. Rarely it affects the function of the neobladder and is treated using chemotherapy or resection. In view of its uncommon incidence it should not constitute a refutation against orthotopic urinary diversion.