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Objectives: To investigate the effects of chronic stress on bladder morphology and the impact of food preference (standard or comfort foods) on the bladder of stressed rats., Methods: In total, 32 Wistar male rats (3 months old) were divided into four groups: control (C), stressed (S), control + comfort food (C + CF), and stressed + comfort food (S + CF). Groups C and C + CF were maintained under normal conditions, while groups S and S + CF were subjected to chronic stress by the restraint method. Groups C and S received standard rat chow, while groups C + CF and S + CF received comfort food (Froot Loops®) and standard chow. The stress stimuli were induced daily for 2 h over 8 weeks. After 8 weeks, all animals were killed, and the bladders were removed and used for histomorphometric analysis., Results: Body mass was similar among the groups. Stress did not promote differences regarding food intake, but animals receiving comfort food showed higher calories intake (in kcal/Kg) than animals receiving only standard chow. The C + CF and S + CF groups preferred comfort food over the standard chow; this preference was higher in the S + CF than in the C + CF group. The surface density of smooth muscle was reduced in stressed animals, while connective tissue and elastic system fiber content were increased in stressed groups. Further, epithelial height was increased in rats submitted to chronic stress. The surface density of elastic system fibers was decreased by the consumption of comfort food., Conclusions: Chronic stress induces morphological modifications on the bladder wall and epithelium. These modifications may be related to lower urinary tract symptoms. Additionally, chronic stress caused a higher preference for comfort food intake which did not ameliorate or aggravate the stress-induced bladder alterations.

Purpose: To investigate the effects of chronic stress, associated or not with comfort food, on the morphology of the penis., Materials & Methods: Thirty-two adult Wistar rats were divided into four experimental groups: Control group (C), receiving standard rat chow, and under normal conditions; Stressed group (S), receiving standard chow, and submitted to stressful situations; Control + comfort food group (C + CF), receiving standard chow and comfort food, and under normal conditions; and Stressed + comfort food group (S + CF), receiving standard chow and comfort food, and submitted to stressful situations. At 10 weeks of age, food supply and stress were initiated. All groups had ad libitum access to standard chow and water, and groups receiving comfort food also had access to Froot Loops®. Chronic stress was induced by restriction, animals were contained daily in polypropylene tubes for 2 h, for eight weeks. After eight weeks all animals were killed; penises were removed for histomorphometric analysis., Results: Body mass was similar among the groups. Food intake in S + CF group was lower than in other groups. Concerning food preference, groups C + CF and S + CF preferred comfort food over the standard chow, with this preference being higher in S + CF than in C + CF. The area of the corpora cavernosa without tunica albuginea was lower in group S + CF than in group C. Most interestingly, the surface density of connective tissue in the corpora cavernosa was higher in groups S and S + CF compared to group C. In contrast, smooth muscle surface density was markedly lower in S + CF compared to groups C and C + CF, while group S also had reduced smooth muscle in comparison to group C., Conclusion: Chronic stress caused a morphological alteration on penile histomorphometry. Also, stress increased the preference for comfort foods which caused more deleterious effects in some parameters., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Introduction: in videolaparoscopic surgery, movements are conducted from a twenty times magnified image of an indirect operative field. The video interface used assumes the need for depth perception using two dimensions instead of three., Objective: to evaluate the effectiveness of training to perform the laparoscopic knot in a silicone model, in 8-hour courses, and to analyze the correlation of learning outcomes with factors such as: sex, age, laterality, previous knowledge in endosuture and medical specialty., Material and Methods: in this prospective and randomized study, 56 students were evaluated, who took 8-hour courses, with groups of up to ten students. We used: a white box with camera, LCD screen and silicone piece. Four exercises were performed on the silicone mold: right hand, left hand, needle at 45° and back hand., Results: 56 students (mean age = 33.28 years). The female group, n=18, mean age 29.61 years, 17 right-handed and 1 left-handed. The male group, n=38, mean age 34.57 years, 35 right-handers, 1 left-handed and 2 ambidextrous. In both groups, no correlation was observed between the analyzes of well performed knots when correlated with the age or sex of the participants., Conclusion: laparoscopic knot training, in silicone molds, in 8 h courses, proved to be effective. Factors such as gender, age, laterality, previous knowledge in endosuture and medical specialty do not interfere with the learning results.

Purpose: One of the most common malformations of the central nervous system is related to embryonic neural tube alterations. We hypothesized that anencephaly affects the development of the vagina during the human second trimester of pregnancy. Our study compared the biometric parameters of the vagina in human female fetuses with neural tube defects., Methods: In our study, 34 female fetuses were analyzed, 22 normal and 12 anencephalic, aged between 12 and 22 weeks post conception (WPC). After dissection of the pelvis and individualization of the genital tract, we evaluated the length and width of the vagina using the Image J software. We compared the means statistically using the Wilcoxon-Mann-Whitney test and performed linear regression., Results: We do not identify statistical significance between the groups for the measurements of vaginal length (Control 3.12-18.33 mm/mean = 9.08 mm/SD +  - 3.77 vs. Anencephalic 2.91-13.10 mm/mean = 7.24 mm/SD +  - 2.28, p = 0.3469) and vaginal width (Control 1.04-4.86 mm/mean = 2.71 mm/SD + - 0.94 vs. Anencephalic 1.35-3.17 mm/mean = 2.13 mm/SD + - 0.65; p = 0.2503). The linear regression analysis indicated that 78.57% significance was found in the correlations in normocephalic fetuses and 57.14% significance in anencephalic fetuses (12.3-18.6 WPC)., Conclusions: We do not find differences in the length and width of the vagina in anencephalic fetuses but the vaginal length and width shows a lesser tendency of growth in the anencephalic fetuses during the second trimester suggesting that anencephaly can impact the development of the vagina., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Early weaning can lead to changes in the morphology of organs in adulthood, and the consumption of functional foods during lactation and postnatal life is believed to prevent these changes. However, it is not known if early weaning affects testicular morphology and if the use of cocoa can prevent that. We studied the effects of maternal and postnatal supplementation of cocoa powder on the testicular morphology of early weaned adult rats. The animals were divided into four groups (n = 6 each), control group, cocoa control group, early weaning (EW) group, and cocoa early weaning (EWCa) group, and were analyzed for 90 d, after which they were euthanized. The animals from the EW group showed a reduction in the tubular diameter and height of the seminiferous epithelium, a decrease in epithelial surface density (Sv), and an increase in the lumen and proper tunic. However, the animals from the EWCa group showed an increase in the diameter and height of the epithelium, an increase in the epithelium Sv, and a decrease in the lumen and the proper tunic. The early weaning promotes morphological changes in the testicles; however, supplementation with cocoa powder can preserve the testicular histoarchitecture.

Previous studies have shown that the pig kidney is not a good model for some procedures. This study aimed to describe the relationship between the collecting system and the intrarenal arteries, the arterial segments, and to evaluate the bovine kidney as an experimental model for partial nephrectomy of the cranial pole. Polyester resin endocasts of the kidney collecting system together with the intrarenal arteries were prepared. Thirty-two kidneys were used to evaluate the relationship between the collecting system and the intrarenal arteries, while 25 kidneys were transversally sectioned at different points to simulate partial nephrectomy of the cranial pole. Polyester resin of different colors was injected into each segmental artery of the 24 kidneys to evaluate the arterial segments proportionally. The renal artery was divided into cranial and caudal primary branches in 75% of the cases. The cranioventral branch curved on the cranial pole and ran toward the ventral mid-zone in 56.3% of the cases, resembling the retropelvic artery of the human kidney. The kidney was divided into two (25%) or three (75%) arterial segments. The caudal arterial segment had the highest proportional volume (62%). The cranioventral branch was damaged in 28.6% of the kidneys sectioned 1 cm inside the hilum. The arterial branching pattern, the arterial segmentation, and the impairment of the arterial supply after the simulated partial nephrectomy of the cranial pole are quite different from those found in humans. Thus, all differences should be taken into account when using the bovine kidney as a model., (© 2020 American Association for Anatomy.)

Objective: To describe if there is bacterial growth on the tunica vaginalis cavity on patients with testicular torsion submitted to orchiectomy., Material and Methods: We prospectively analyzed 176 patients with testicular torsion submitted to orchiectomy at our facility between January 2018 and January 2020. Sixty-five were included in this study and samples of the tunica vaginalis cavity were sent to the laboratory for gram staining, culturing and antibiotic sensitivity testing. Wound healing was also evaluated at a minimum of 3 checkpoints (days 15, 45, and 90 after surgery). Student's t test was used for comparison of quantitative data between negative and positive cultures (P < .05). The Mann-Whitney test was used to verify associations between categorical variables and negative vs. positive cultures (P < .05)., Results: Of the 65 patients included in the study, with median age of 18 years (IQR 15-21), culture was negative in 58 cases (89.2%). Median time lapse from symptoms to surgery was 6.90 days (IQR 3.92-10.73). Right testicular torsion was almost twice as common as on the left side (63.07% vs 36.93%). Hydrocele was present in 47 patients (72.3%) and all wounds were healed in 84.60%, 96.90%, and 100% of the cases on the 15th, 45th, and 90th days after surgery, respectively., Conclusion: In the great majority of patients with testicular torsion treated with orchiectomy in our study, we did not observe bacterial growth in the tunica vaginalis cavity, and all patients' wounds were completely healed within 90 days after surgery., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The second gestational trimester is a very important period for male genital development. We analyzed the testicular and prostatic volume growth and compared them to the biometric parameters in human fetuses., Methods: We studied 64 testes and 32 prostates from 32 fetuses, aged 10-22 weeks postconception. Fetuses were evaluated regarding total length, crown-rump length, and bodyweight. The same observer performed all the measurements. After testicular and prostatic dissection, the prostate and testicular length, width and thickness were recorded with the aid of computer programs (Image Pro and ImageJ software, version 1.46r). Testicular volume (TV) and prostatic volume (PV) were calculated using the ellipsoid formula. Statistical analysis was performed with the GraphPad Prism program (version 6.01)., Results: The fetuses presented PV between 6.1 and 297.18 mm 2  (mean = 77.98 mm 3 ). Linear regression analysis indicated that the PV in these fetuses increased significantly and positively with fetal age (r 2  = .3120; p < .0001). We did not observe significant differences between the TV (right testis: 0.39-63.94 mm 3 ; mean = 19.84 mm 3 ; left testis: ​​​​​​0.52-55.37 mm 3 , mean = 17.25 mm 3 ). Linear regression analysis also indicated that the right and left TV (right: r 2  = .6649; p < .0001 and left: r 2  = .6792; p < .001) increased significantly and positively with fetal age., Conclusion: The prostatic growth was slower during the second gestational trimester, with significant correlations with fetal biometric parameters. The testicular growth was moderate and showed a significant correlation with fetal parameters during the studied period in human fetuses., (© 2020 Wiley Periodicals LLC.)

Analyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3-5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9-5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6-3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2-3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r 2  = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.

We investigated the effect of a high-fat diet on body metabolism and ventral prostate morphology in 4-months-old offspring. The mother was fed with a control (C) or a high-fat (HF) diet during gestation and lactation. At weaning, the offspring diet remained the same (C/C, n = 8; HF/HF, n = 8) or it was switched (C/HF, n = 8; HF/C, n = 9). Biometry, blood pressure (BP), glucose, lipid metabolism and ventral prostate were evaluated. Triacylglycerol of HF/C increased, and the C/HF group had decreased HDL-c levels (P = 0.0005 and P = 0.0100, respectively). All groups on the HF diet presented hyperglycemia (P = 0.0064). Serum testosterone diminished in the C/HF group (P = 0.0218). The HF diet, regardless of the period, reduced prostatic acinar area (P < 0.0001). The epithelium height was smaller in HF/C and HF/HF groups compared with C/C and C/HF (P < 0.0001), and the volume density of epithelium was lower in HF/C group compared with the C/C and C/HF (P = 0.0024). The volume density of smooth muscle cells diminished in C/HF and HF/C (P = 0.0013), and the volume density of connective tissue was reduced in HF/C and HF/HF (P < 0.0001). High-fat diet intake during prenatal and postnatal life leads to prostatic atrophy, which may impair prostate secretory activity and contractility, and thus disturb reproductive function in adulthood., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: Many studies of neonates have shown that renal pelvis ectasia is more common in boys. The aim of this study was to determine whether there are structural differences in the renal pelvis between male and female fetuses in the second trimester of gestation., Material and Methods: We studied 34 renal pelvises obtained from 34 human fetuses (17 males and 17 females), ranging in age from 13 to 23 weeks postconception. The renal pelvis tissue was stained with Masson's trichrome to quantify connective and smooth muscle cells (SMC). The tissue also was fixed for scanning electron microscopy (SEM) in a modified Karnovsky solution. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image-Pro and ImageJ programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using simple linear correlation and the Mann-Whitney test (p<0.05)., Results: Quantitative analysis indicated differences (p=0.0275) in Vv of connective tissue in male renal pelvises (mean=55.3%) compared to female ones (mean=51.46%). Quantitative analysis indicated a significant difference (p=0.0002) in SMC in male renal pelvises (mean=12.57%) compared to female ones (mean=16.22%). When we compared the SMC at different ages, we did not find any correlation in male (r 2 =0.2657, p=0.3027) or female fetuses (r 2 =0.3798, p=0.1326). When we compared the connective tissue at different ages, we did not find any correlation in female fetuses (r 2 =0.3798, p=0.2870), but we did observe a positive correlation between the connective tissue and age in male fetuses (r 2 =0.8308, p<0.0001). SEM showed that the collagen fibers had no differences between male and female., Conclusion: The renal pelvis presents significant structural differences between male and female fetuses. The renal pelvis in males had less SMC and presented a positive correlation of connective tissue with age and the renal pelvis in female had less connective tissue without correlation with the age., Level of Evidence: III., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Anogenital distance (AGD), the distance from the anus to the genitals, is a marker of normal genital development. AGD and other biometric parameters of external female genitalia are important as ultrasonographic markers that can determine fetal gender in the first trimester. Neural tube defects are one of the commonest congenital malformations of the central nervous system, with anencephaly being the most severe defect. Female genitalia development and their association with anencephaly have not been previously described., Aim: The aim of this study was to compare the biometric parameters of external female genitalia in fetuses with anencephaly and compare it to the parameters of normocephalic fetuses at different gestational ages., Study Design: We studied 34 female fetuses, 22 normocephalic and 12 anencephalic, aged between 12 and 22 weeks post-conception. The fetuses were placed in the classic lithotomy position and before the fetal dissection, the external female genitalia were photographed with a digital camera. Biometric parameters were recorded and measurements were performed using the Image J software, version 1.46r. Clitoral length and width, clitoris to anus distance, vaginal opening length and width, vaginal opening to labia majora distance, and AGD were measured (Figure). For statistical analysis, the Wilcoxon-Mann-Whitney test was used (p < 0.05)., Results: We observed a significant difference between some measurements of the groups: the vaginal opening width was significantly greater in anencephalic fetuses and the vaginal opening length, clitoris to anus distance and vaginal opening to labia majora distance were significantly greater in normocephalic fetuses. For the clitoris length and width, we did not find statistical differences. We also did not find statistical significance in AGD between groups (normocephalic 2.32 mm [2.46-6.42/SD = 2.17] vs. anencephalic 3.93 mm [1.15-6.65/SD = 1.93]; p = 0.499). The linear regression analysis indicated that AGD increased more with age in anencephalic than in the normocephalic group, but without significant differences (r 2  = 0.01677; p < 0.318)., Discussion: This article is the first to report the female external genitalia parameters in fetuses with anencephaly. In our study we observed some alterations in biometry of the external genitalia in anencephalic fetuses, with a pattern of morphological reduction in this group. The vaginal opening length, clitoris to anus distance and vaginal opening to labia majora distance were significantly lower in anencephalic fetuses but we did not find statistical significance in clitoris measurements and AGD., Conclusions: Anencephalic fetuses had some alterations in external genitalia development, but the anogenital distances did vary significantly between the groups., (Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Background: Testicular descent is a complex process of relevant importance for the comprehension of cryptorchidism. Studies about the inguinoscrotal stage of testicular migration correlating the testicular position with fetal parameters are rare in the literature. Our hypothesis is that the transition of the testis by the inguinal canal is a very fast process and occurs at the end of the third gestational trimester., Aim: To analyze the inguinoscrotal stage of testicular descent during the human fetal period., Study Design: This is an observational study in human fetuses. We studied 217 human male fetuses ranging from 10 to 35 weeks postconception (WPC). The fetuses were well preserved and evaluated regarding crown-rump length (CRL) and body weight before dissection. Testicular position was classified as: a) abdominal, when the testis was proximal to the internal ring; b) inguinal, when it was found between the internal and external inguinal rings; and c) scrotal, when being inside the scrotum. Means were statistically compared using the unpaired t-test (P < 0.05)., Results: Of the 434 testes, 329 (75.8%) were abdominal, 48 (11.05%) were inguinal, and 57 (13.13%) were scrotal. The first case of inguinal testis was observed in a fetus with 17 WPC, 203 g, and 15 cm CRL. The 48 inguinal testes were observed in 29 fetuses (13.36%), aged between 17 and 29 WPC, weighing between 203 and 1220 g, and with CRL between 15 and 27.5 cm. Of the 29 fetuses with inguinal testes, 23 (79.32%) were aged between 20 and 26 WPC; 3 (10.34%) had 17 WPC; and 3 (10.34%) had more than 26 WPC. All the fetuses with more than 30 WPC had testes in the scrotum. We did not observe fetuses less than 17 WPC with the testes in the canal., Discussion: We found that all fetuses with more than 30 WPC had the testes located in the scrotum and that in fetuses between 17 WPC and 25 WPC, 38 testes (8.7% of the sample) were situated in the canal and only 1 testis in a fetus with 25 WPC was located in the scrotum, showing that the second stage of testicular migration through the inguinal canal rarely occurs before the 20th WPC., Conclusion: The inguinoscrotal stage of testicular descent is a fast process, observed only in 13% of the fetuses and occurring with more intensity between 20 and 26 WPC., (Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Objective: To characterize the bulbospongiosus muscle (BSM) in patients with bulbar urethral strictures., Materials and Methods: We studied 21 patients divided into 2 groups: Stricture Group (n = 14; mean age = 62.00 years) with bulbar stricture submitted to open urethroplasty; and Control Group (n = 7; mean age = 60.14 years) with penile strictures (hypospadias cripples, penile cancer and/or penile infection) who were submitted to perineal urethrostomy. Samples of the BSM were dissected and histologic sections were stained by histochemical and immunohistochemical techniques. Histomorphometric analyzes were performed on photomicrographs. Means were statistically compared using the unpaired Student t test and the Mann-Whitney test (P <.05)., Results: The etiology of bulbar urethral stricture was idiopathic in 2 cases (14.29%), post-TURP in 6 (42.86%), post open radical prostatectomy in 5 (35.71%) and post open prostatectomy in 1 case (7.14%). The average length of the stricture was 2.08 cm. The only parameter analyzed with significant difference between the groups was the vessels (significant difference between the control group: 5.11 ± 1.98% and stricture group: 3.57 ± 1.32%, P = .0460). The quantitative analysis of collagen (Control Group: 10.63 ± 5.37% and Stricture Group: 10.83 ± 4.55%, P = .9296); diameter of BSM muscle fibers (Control Group: 41.71 ± 14.63 µm and Stricture Group: 40.11 ± 8.59 µm, P = .76 and elastic system fibers (Control Group; 3.83 ± 1.54% and Stricture Group: 5.43 ± 2.90%, P = .2601) showed no significant difference., Conclusions: Histologic analysis showed a significant decrease of the BSM vessels in urethral stricture, without changes in elastic fibers, collagen, nerves, and muscle fiber diameter. These findings show that the bulbar urethral stricture causes minimal alterations in the structure of the BSM., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats., Methods: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis., Results: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05)., Conclusions: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.

Background: There are no reports comparing testicular volume between normal fetuses, fetuses with prune-belly syndrome (PBS), and fetuses with anencephaly. The study hypothesis was that PBS and especially anencephaly alter the testicular volume during the human fetal period., Aim: The objective of the study was to compare the testicular growth in fetuses with anencephaly, with PBS, and without anomalies., Study Design: This is a morphometric study of human fetuses. Seventy testes from fetuses without anomalies aged 11-22 weeks post-conception (WPC), 30 testes from fetuses with anencephaly aged 13-19 WPC, and eight testes from fetuses with PBS aged 13-16 WPC were studied. Testicular length, width, and thickness were evaluated with the aid of computer programs (Image Pro and ImageJ) (Figure). The fetal testicular volume was calculated using the ellipsoid formula: Testicular volume (TV) = [length × thickness × width] × 0.523. The Shapiro-Wilk test was used to ascertain the normality of the data and to compare quantitative data between normal fetuses vs. fetuses with anencephaly, while the Kruskal-Wallis test was used to assess gender and laterality differences. Simple linear correlations (LCs) were calculated for testicular volume according to fetal age, weight, and crown-rump length., Results: All 108 testes studied were abdominal. The right (p = 0.0310) and left (0.0470) testicular volumes were significantly smaller in fetuses with anencephaly than those in the control group. The linear regression analysis indicated that the right and the left testis volume in the control group (right: r 2  = 0.6665; left: r 2  = 0.6707) and PBS group (right: r 2  = 0.9937; left: r 2  = 0.9757) increased with fetal age (p < 0.0001). This analysis also indicated that the testicular volume in fetuses with anencephaly did not increase with fetal age (right: r 2  = 009816; left: r 2  = 0.07643)., Discussion: This article is the first to report testicular volume correlations with fetal parameters in fetuses with anencephalic and fetuses with PBS. Significant alterations were observed in testicular growth in the anencephalic group compared with the control group, and it was also observed that the bilateral cryptorchidism in PBS does not alter the testicular development and growth during the fetal period. The unequal WPC distribution between fetuses with PBS, fetuses with anencephaly, and controls and the small sample size are limitations of this study. Further studies should be performed to confirm this study's findings., Conclusions: Testicular growth is slower and does not show significant correlations with fetal parameters in fetuses with anencephalic. Significant differences in testicular development in fetuses with PBS was not observed., (Copyright © 2019 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Lower blepharoplasty is a challenging aesthetic procedure. Despite advances in clinical and neuroanatomical studies related to orbicularis oculi muscle innervation, no study has examined its histopathological aspects in different lower blepharoplasty procedures. This study aimed to assess changes in the pretarsal muscle complex in patients treated with transcutaneous lower blepharoplasty with orbicularis myotomy versus those treated with transconjunctival blepharoplasty without myotomy., Methods: A total of 268 patients underwent blepharoplasty performed by a single surgeon: transcutaneous lower blepharoplasty in 112 (41.7%) and transconjunctival lower blepharoplasty with retroseptal access in 156 (58.2%). Subsequent minor blepharoplasty procedures were performed in 32 patients with lower pretarsal orbicularis oculi muscle biopsy. Connective tissue, fibrillar elastic system, nerves, blood vessels, fiber diameter, and sarcomeres were analyzed., Results: Without myotomy: collagen, 9.46 ± 0.41%; elastin, 7.03 ± 0.62%; blood vessels, 4.25 ± 0.06%; nerves, 5.2 ± 0.55%; fiber diameter, 62 ± 8.0 μm; and sarcomere, 1.9 ± 0.11 μm. With myotomy: collagen, 19.02 ± 1.66%; elastin, 7.88 ± 1.10%; blood vessels, 5.13 ± 0.70%; nerves, 2.9 ± 0.48%; fiber diameter, 49 ± 6.5 μm; and sarcomere, 1.8 ± 0.17 μm., Discussion: Excess endomysial connective tissue, particularly between muscle fibers, should be considered pathological. The pathological changes in the pretarsal muscle complex after blepharoplasty with myotomy may have resulted from innervation interruptions as well as vascularization blockages., Conclusions: Surgeries with myotomy caused significant changes in collagen, nerves, and muscle fiber diameter. These observations strongly suggest the superiority of a technique that preserves orbicularis oculi muscle integrity., Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

High-fat diets affect male reproduction and sexual function. Therefore, we evaluated the effects of prolonged resveratrol administration on the metabolic, sperm, and testicular parameters of rats fed a cafeteria diet. Male Wistar rats were divided at weaning into control (C, n = 20) and cafeteria (CAF, n = 16) groups. At 3 months, half of them were given daily supplementations of resveratrol (C-R, n = 10; CAF-R, n = 8) at a dosage of 30 mg kg -1 body mass for 2 months. Animals were killed at 5 months of age, and blood, spermatozoa, and testes were collected for further analysis. Data were analyzed by one-way ANOVA, and P < 0.05 was considered statistically significant. The CAF diet promoted hyperglycemia (P < 0.0001), and treatment with resveratrol reversed this condition (P < 0.0001). The CAF diet reduced sperm viability and motility, while resveratrol improved these parameters (P < 0.05). Regarding testicular morphology, the height of the seminiferous epithelium was reduced in the CAF group compared with that of the C group (P = 0.0007). Spermatogenic cell proliferation was also reduced in the CAF group compared with that of the C group. However, the CAF-R showed an increase in cell proliferation rate compared with that of the untreated CAF group (P = 0.0024). Although it did not modify body mass, the consumption of a CAF diet promoted hyperglycemia, adverse testicular morphology remodeling, and abnormal sperm, which were attenuated by treatment with resveratrol, thus suggesting a protective effect of this antioxidant on spermatogenesis., Competing Interests: None

Obesity has adverse effects on male fertility and usually is diagnosed with a prevalence of vitamin D deficiency (VD - ). Discussion on the impact of obesity/VD - on sperm function has been limited. This study analyzed the effects of diet-induced obesity/VD - on viability and plasma membrane integrity (PMI), superoxide anion (O 2 - ) level, and DNA fragmentation (DNA frag ) in sperm Sprague-Dawley rats. The males were randomized into four groups and fed for a period of 12 weeks: G1: control diet with vitamin D (C/VD + ), G2: control diet without vitamin D (C/VD - ), G3: high-fat diet with vitamin D (HF/VD + ), and G4: high-fat diet without vitamin D (HF/VD - ). Sperm function parameters were analyzed by flow cytometry. PMI percentages and O 2 - levels were not affected by any of the diets. DNA fragmentation was increasing significantly (p<0.05) in the spermatozoa of animals with diets vitamin D deficient (G2) and diet-induced obesity (G4). Our results allow us to point out that diet-induced obesity and VD - produce greater damage in DNA sperm of rats. The use of nutraceuticals containing vitamin D could be reducing the risk of fragmentation of DNA in spermatozoa.

Objective: To analyze the structure of the cremaster in patients with retractile testis (RT), comparing the distribution of nerves, elastic system and muscles with patients having cryptorchidism and inguinal hernia (IH)., Patients and Methods: We studied 31 patients, 17 with RT (mean age=5.17years); 9 with IH (mean age=2.6) and 5 with cryptorchidism (mean age=3). A cremaster biopsy was performed and submitted to routine histological processing and studied using histochemistry and immunohistochemistry. The samples were photographed under an Olympus BX51 microscope. The images were processed with the Image J software and the cremaster muscle structures were quantified. Means were compared statistically using ANOVA and the unpaired t-test (p<0.05)., Results: There were no differences (p=0.08) in diameter of muscle fiber between the groups. The muscle fiber density differed between patients with RT and IH (p=0.02): RT (mean=17.71%, SD=16.67), IH (mean=38.06%, SD=14) and cryptorchidism (mean=21.47%, SD=16.18). There was no difference (p=0.07) in the density of elastic fibers in the three groups. We observed a lower concentration of cremaster nerves of patients with RT compared with IH (p=0.0362): RT (mean=1.72%, SD=0.58), IH (mean=3.28% SD=0.94) and cryptorchidism (mean=2.52%, SD=0.53)., Conclusions: Retractile testis is not a normal variant, and presented a similar cremaster muscle structure as in patients with cryptorchidism., Level of Evidence: II; prospective comparative study., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Aims: To study the bladder structure of fetuses with prune belly syndrome (PBS)., Methods: We studied three bladders obtained from three male fetuses with PBS and seven bladders from seven male fetuses without anomalies. Each bladder was dissected and embedded in paraffin, from which 5 μm thick sections were obtained and stained with Masson's trichrome (to quantify connective tissue and smooth muscle) and picrosirius red with polarization (to observe collagen). Immunohistochemistry with tubulin (Tubulin, beta III, Mouse Monoclonal Antibody) was applied to observe the bladder nerves. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using the Mann-Whitney test (P < 0.05)., Results: Quantitative analysis documented that smooth muscle fibers were significantly smaller (P = 0.04) in PBS fetuses (9.67% to 17.75%, mean = 13.2%) compared to control group (13.33% to 26.56%, mean = 17.43%). The analysis of collagen fibers showed predominance of green in the control group, suggesting collagen type III presence, and predominance of red in the in PBS fetal bladders, suggesting collagen type I presence in this group. The qualitative analysis of the nerves with immunohistochemistry with tubulin showed predominance of nerves in the control group., Conclusion: The bladder in PBS had lower concentrations of smooth muscle fibers, collagen type III, and nerves. These structural alterations can be one of the factors involved in urinary tract abnormality such as distended bladder in patients with PBS., (© 2017 Wiley Periodicals, Inc.)

The aim of this study was to evaluate, in vitro, the bactericidal effect of antimicrobial photodynamic therapy (AmPDT) using phenothiazinium dyes (Toluidine Blue O and methylene blue, 1:1) using different concentrations (100, 50, 25, 12.5, and 6.25 μg/mL) associated to red laser with different energy densities (2.4, 4.8, 7.2, 9.6, and 12 J/cm 2 ) on a strain of Staphylococcus aureus (ATCC 23529). On this study, tests were performed in triplicate and the samples were distributed into 36 test groups: Control and bacterial suspensions were irradiated with the different energy densities, respectively, in the absence of photosensitizer, bacterial suspensions were irradiated with the laser in the different concentrations of the photosensitizer, and finally bacterial suspensions only in the presence of phenothiazinium dye. The pre-irradiation time was 5 min. Therefore, we analyzed the potential of the AmPDT by counting colony-forming units. The logarithm of CFU/mL (log10 CFU/mL) was calculated and the data was analyzed statistically (ANOVA, Tukey's test, p < 0.05). The results showed that the association 50 and 100 μg/mL with 12 J/cm 2 showed the highest percentage of inhibition (100 %). Based upon the present results, it may be concluded that the AmPDT was able to enhance the antimicrobial effect of phenothiazines and both concentration of the compound and energy density are important factors for greater effectiveness of therapy.

Objectives: To assess the incidence of testicular appendices (Tas), epididymal anomalies (EAs), and processus vaginalis (PV) patency in patients with undescended testis (UT) according to testicular position and to compare them with human fetuses., Methods: We studied 85 patients (108 testes) with cryptorchidism and compared the features with those of 15 fetuses (30 testes) with scrotal testes. We analyzed the relationships among the testis and epididymis, patency of PV, and the presence of TAs. We used the Chi-square test for statistical analysis ( p < 0.05)., Results: In 108 UT, 72 (66.66%) had PV patent, 67 (62.03%) had TAs, and 39 (36.12%) had EAs. Of the 108 UT, 14 were abdominal (12.96%; 14 had PV patency, 9 TAs, and 7 EAs); 81 were inguinal (75%; 52 had PV patency, 45 TAs, and 31 EAs), and 13 were suprascrotal (12.03%; 6 had PV patency, 13 TAs, and 1 EAs). The patency of PV was more frequently associated with EAs ( p = 0.00364). The EAs had a higher prevalence in UT compared with fetuses ( p = 0.0005)., Conclusions: Undescended testis has a higher risk of anatomical anomalies and the testes situated in abdomen and inguinal canal have a higher risk of presenting patency of PV and EAs.

Objective . To analyze the penile and urethral meatus biometry and its correlation with meatoplasty during endoscopic resections. We also propose a new classification for urethral meatus morphology. Materials and Methods . We prospectively studied 105 patients who underwent prostate and bladder transurethral resections. We performed standardized measurement of penile and urethral meatus biometry followed by penile photo in the front position. The need to perform meatoplasty or dilatation during resectoscope introduction was registered. Data were analyzed comparing the correlation between two groups: without intervention (Group A) and with intervention (Group B). Results . We observed in Group A and Group B, respectively, the average length of urethral meatus of 1.07 cm versus 0.75 cm ( p < 0.001) and average width of urethral meatus of 0.59 cm versus 0.38 cm ( p < 0.001). Considering the morphology of the urethral meatus, we propose a new classification, in the following groups: (a) typical; (b) slit; (c) point-like; (d) horseshoe; and (e) megameatus. The point-like meatus was the one that most needed intervention, followed by the slit and the typical meatus ( p < 0.001). Conclusions . Point-like and slit-shaped urethral meatus, as well as reduced length and width of the urethral meatus, are the determining factors., Competing Interests: The authors have no competing interests to declare.

Purpose:: To evaluate the glomerular loss after arteriovenous or arterial warm ischemia in a swine model., Methods:: Twenty four pigs were divided into Group Sham (submitted to all surgical steps except the renal ischemia), Group AV (submitted to 30 minutes of warm ischemia by arteriovenous clamping of left kidney vessels), and Group A (submitted to 30 minutes of ischemia by arterial clamping). Right kidneys were used as controls. Weigh, volume, cortical volume, glomerular volumetric density (Vv[Glom]), volume-weighted glomerular volume (VWGV), and the total number of glomeruli were measured for each organ., Results:: Group AV showed a 24.5% reduction in its left kidney Vv[Glom] and a 25.4% reduction in the VWGV, when compared to the right kidney. Reductions were also observed when compared to kidneys of sham group. There was a reduction of 19.2% in the total number of glomeruli in AV kidneys. No difference was observed in any parameters analyzed on the left kidneys from group A., Conclusions:: Renal warm ischemia of 30 minutes by arterial clamping did not caused significant glomerular damage, but arteriovenous clamping caused significant glomerular loss in a swine model. Clamping only the renal artery should be considered to minimize renal injury after partial nephrectomies.

Purpose:: To investigate the protective effect of L-arginine on the prostate (nonneoplasic) of rats with radiation-induced injury., Methods:: Twenty-nine Wistar rats, male adult, allocated into three groups: Control group (C) was not exposed to irradiation (n=10); Radiated group (R) had undergone pelvic irradiation (n=10); Supplemented and radiated group (R+S) had undergone pelvic irradiation plus L-arginine supplementation (n=9). The animals were observed for signs of toxicity. After euthanization, the prostate was dissected under magnification and stained by hematoxylin and eosin to study acinar structures and stained with Picrosirius red for collagen analysis., Results:: After radiation exposure, all animals presented diarrhea, but supplementation with L-arginine reduced this effect. The weight gain in the R+S group was significantly higher than in the C and R groups. In the R+S group the collagen density and the prostate acinar area was similar to the R and C groups. Epithelial height was significantly reduced in group R compared with group C (p<0.0001). When comparing the group R+S with R, a statistical difference was observed to be present (p<0.0001)., Conclusions:: Pelvic radiation promotes systemic effects and some structural modifications in the ventral prostate of rats. These modifications can be prevented by oral supplementation with L-arginine.

Competing Interests: Conflicts of Interest: None declared.

Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis., Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p<0.05)., Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116)., Conclusions: Retractile testis is not a normal variant with a significant risk of patent processos vaginalis and epididymal anomalies., Competing Interests: Conflicts of Interest: None declared., (Copyright© by the International Brazilian Journal of Urology.)

The ovine kidney has been recently determined to be a better model than the swine kidney for the study of collecting system healing after partial nephrectomy. However, there is no histological study comparing the collecting systems of these species. To compare human, swine, and ovine collecting systems using histomorphometry. The collecting systems of 10 kidneys from each species (human, swine, and ovine) were processed for histomorphometry. The thickness of the three layers (mucosal connective tissue, submucosal muscular, and adventitial connective tissue) were measured. The densities of smooth muscle fibers, elastic system fibers, and cells were also measured. Additionally, blood vessel density in the adventitial connective tissue was measured. Analysis of the collecting systems from the three species presented several differences. The adventitial connective tissue from the swine samples was thicker, with more blood vessels and smooth muscle fibers, compared with that from the human and ovine samples. Swine also had higher density of elastic fibers on the submucosal muscular layer. Ovine and human collecting systems shared several similar features, such as blood vessel and elastic fiber density in all layers and the density of cellular and muscular fibers in the submucosal muscular and adventitial connective tissue layers. The collecting system of the ovine kidney is more similar to that of the human kidney compared with that of the swine kidney. This may explain the differences between the healing mechanisms in swine and those in humans and sheep after partial nephrectomy. Anat Rec, 299:967-972, 2016. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Introduction: Penile curvature correction with plaque incision and graft (PIG) increases the risk of erectile dysfunction (ED) and is associated with mechanical and geometric abnormalities., Aims: The aim of this study was to create and validate a new PIG technique using minimum graft area to correct simple or complex penile curvature with or without hourglass deformity, while avoiding mechanical and geometric abnormalities., Methods: Using our cotton fabric model, we created a mathematic solution for PIG with no residual defects. This was applied in nine men who had sufficient penile rigidity while penetrating their respective partners. They underwent fascia lata patch corporoplasty using the new developed technique (iPad [Apple Corp, Palo Alto, CA, USA] app: iGrafter). Subjects answered the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire preoperatively and at the end of follow-up., Main Outcome Measures: The main outcome measures used were patient demographics, erectile function, residual curvature, patient satisfaction, graft area, and complications., Results: After a mean follow-up of 17.8 months, no significant complication was noted. Complete penile straightening was achieved in all patients. The short side of the penis increased a mean of 3 cm in length, and the mean graft area was 12.4 cm(2). At the end of the follow-up, three patients developed recurrent deformity. One patient presented severe fibrosis in the corpora cavernosa and severe ED. There was no significant difference between the mean preoperative and postoperative IIEF-5 scores (20.6 vs 19.4, respectively). At the end of follow-up, all patients were able to have sexual intercourse (two with and seven without pharmacological aid). Eight of the nine patients were satisfied with the surgical result., Conclusion: Penile curvature surgical correction using the iGrafter seems to be an efficient and safe procedure, which uses minimum graft area and preserves erectile function after penile rectification, without resulting in residual deformities. Further research is needed to confirm the efficacy of this procedure., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring., Material and Methods: Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test., Results: The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied., Conclusions: The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester.

Objectives: To investigate the protective effect of L-Glutamine in animals undergone to ventral radiation when the target organ is not the prostate., Materials and Methods: Wistar rats were divided into groups of 10 animals each: Controls (C), maintained under standard conditions and not exposed to radiation, Radiated group (R) undergone to abdominal radiation only and Radiated plus supplemented by L-glutamine group (R+G). The animals of group R+G were supplemented with L-glutamine at the beginning of the experiment until death in the 22nd day. The ventral prostate was dissected and processed for morphometrical analysis. The epithelial height, collagen density and acinar area were objectively assessed in histological sections., Results: Epithelial height was significantly reduced in R group in comparison to C group (p= 0.005). However, there was no statistical difference between the C and R+G groups. Collagen surface density in the C and R groups were not statistically different, but a significant difference was observed when comparing groups R+G and R (p=0.040). The R+G group values did not differ significantly from C group. The acinar prostate area of group R was similar to that of C (p= 0.971), but in R+G it was significantly reduced when compared with the C (p= 0.038) and R (p= 0.001) groups., Conclusions: Pelvic radiation promotes structural modifications in ventral prostate of rats, which can be reduced by L-Glutamine.

Previous studies have demonstrated that the pig collecting system heals after partial nephrectomy without closure. Recently, a study in sheep showed that partial nephrectomy without closure of the collecting system resulted in urinary leakage and urinoma. The aim of this study was to present detailed anatomical findings on the intrarenal anatomy of the sheep. Forty two kidneys were used to produce tridimensional endocasts of the collecting system together with the intrarenal arteries. A renal pelvis which displayed 11-19 (mean of 16) renal recesses was present. There were no calices present. The renal artery was singular in each kidney and gave two primary branches one to the dorsal surface and one to ventral surface. Dorsal and ventral branches of the renal artery were classified based on the relationship between their branching pattern and the collecting system as: type I (cranial and caudal segmental arteries), type II (cranial, middle and caudal segmental arteries) or type III (cranial, cranial middle, caudal middle, and caudal segmental arteries). Type I was the most common branching pattern for the dorsal and ventral branches of the renal artery. The arterial supply of the caudal pole of the sheep kidney supports its use as an experimental model due to the similarity to the human kidney. However, the lack of a retropelvic artery discourages the use of the cranial pole in experiments in which the arteries are an important aspect to be considered., (© 2016 Wiley Periodicals, Inc.)

Purpose: The aim of this paper is to analyze if the anatomy type of the collector system (CS) limits the accessibility of flexible ureteroscopy (FUR) in the lower pole., Methods: We analyzed the pyelographies of 51 patients submitted to FUR and divided the CS into four groups: A1-kidney midzone (KM) drained by minor calices (Mc) that are dependent on the superior or on the inferior caliceal groups; A2-KM drained by crossed calices; B1-KM drained by a major caliceal group independent both of the superior and inferior groups, and B2-KM drained by Mc entering directly into the renal pelvis. We studied the number of calices, the angle between the lower infundibulum and renal pelvis, and the angle between the lower infundibulum and the inferior Mc. With the use of a flexible ureteroscope, the access attempt was made to all of lower pole calices. Averages were statistically compared using the ANOVA and Unpaired T test (p < 0.05)., Results: We found 14 kidneys of A1 (27.45 %); 4 of A2 (7.84 %); 17 of B1 (33.33 %); and 16 of B2 (31.37 %). The LIP was >90° in 31 kidneys (60.78 %) and between 61° and 90° in 20 kidneys (39.22 %). We did not find angles smaller than 60°. The group A1 presented 48 Mc and the UF was able to access 42 (87.5 %); the group A2 had 11 Mc and the UF was able to access 7 (63.64 %); the group B1 had 48 Mc and the UF was able to access 41 (85.42 %) and in group B2 we observed 41 Mc and the UF could access 35 (85.36 %). There was no statistical difference in the accessibility between the groups (p = 0.2610)., Conclusions: Collecting system with kidney midzone drained by crossed calices presented the lower accessibility rate during FUR.

Background: Gluteal augmentation surgery has grown by 42 % per year; however, the epidemiological profile of patients who seek this treatment has never been studied., Objective: To establish the epidemiological profile of patients who have undergone gluteoplasty surgery, evaluating their level of satisfaction and the social impact caused by the surgery., Methods: Fifty patients, with ages ranging from 23 to 57 years replied to a specific questionnaire and the esthetic result of the surgery was evaluated. Thirty-seven patients were analyzed prospectively, using CT scans and gluteal reconstruction. The esthetic result was evaluated by eight plastic surgeon specialists from SBCP., Results: About satisfaction and quality of life, 98 % of the patients demonstrated improvement in some aspect of life. Analysis of the marital status of patients showed that 24 % of them have changed it. Therefore, all cases showed positive correlations between implant size and monthly income, age and satisfaction of patients. There has also been a positive correlation between implant size and recovery time. There was no statistically significant correlation between the esthetic result and the implant volume or the anthropometric measurements., Conclusions: The epidemiological profile of patients undergoing gluteoplasty augmentation with implants is predominantly white skin, 36 years old, unrelated to the occupation or socioeconomic status. Augmentation gluteoplasty with implants is a surgery with a high level of satisfaction to patients, improving life in many aspects but, mainly, affectively. Its outcome produces a natural look and is hardly noticed by others., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background: The pig has been considered the best model for renal surgery. However, recent research has demonstrated that the kidney of pigs heals differently from that of humans. The objective of this study was to evaluate sheep as an alternative animal model for studying collecting system healing after laparoscopic partial nephrectomy., Materials and Methods: The caudal pole of the left kidney was removed from eight female adult domestic sheep using laparoscopic partial nephrectomy. Monopolar energy was used for hemostasis only in the parenchyma, avoiding coagulation near the collecting system, which was left opened. After 14 d, all animals were euthanized, and their left kidney was removed. Serum levels of urea and creatinine were assessed preoperatively and postoperatively (on days 2, 6, 10, and 14), and peritoneal fluid samples were collected during necropsy for urea and creatinine evaluation. An ex vivo retrograde pyelogram was performed, and a retrograde injection of methylene blue ink was administered to evaluate urinary leakage. Samples from the operated pole were analyzed using histologic methods., Results: During necropsy, an urinoma surrounding the operated kidney was observed in one animal. Peritoneal fluid levels of urea and creatinine were elevated. Retrograde pyelograms exhibited contrast-medium extravasation through the operated pole in all kidneys. The opened collecting system was also confirmed by methylene blue ink injection. The operated pole was covered by collagenous tissue and adhered to adjacent organs., Conclusions: Sheep should be considered as an adequate experimental model for research on collecting system healing after partial nephrectomy., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpuse: The aim of this study was to analyze the anatomy of the inferior pole collecting system and the mid-renal-zone classification in human endocasts applied to flexible ureteroscopy., Methods: 170 three-dimensional polyester resin endocasts of the kidney collecting system were obtained from 85 adult cadavers. We divided the endocasts into four groups: A1--kidney midzone (KM), drained by minor calices (mc) that are dependent on the superior or the inferior caliceal groups; A2--KM drained by crossed calices; B1--KM drained by a major caliceal group independent of both the superior and inferior groups; and B2--KM drained by mc entering directly into the renal pelvis. We studied the number of calices, the angle between the lower infundibulum and renal pelvis and the angle between the lower infundibulum and the inferior mc (LIICA). Means were statistically compared using ANOVA and the unpaired T test (p < 0.05)., Results: We found 57 (33.53 %) endocasts of group A1; 23 (13.53 %) of group A2; 59 (34.71 %) of group B1; and 31 (18.23 %) of group B2. The inferior pole was drained by four or more calices in 84 cases (49.41 %), distributed into groups as follows: A1 = 35 cases (41.67 %); A2 = 18 (21.43 %); B1 = 22 (26.19 %); and B2 = 9 (10.71 %). Perpendicular mc were observed in 15 cases (8.82 %). We did not observe statistical differences between the LIICA in the groups studied., Conclusions: Collector systems with kidney midzone drained by minor calices that are dependent on the superior or on the inferior caliceal groups presented at least two restrictive anatomical features. The mid-renal-zone classification was predictive of anatomical risk factors for lower pole ureteroscopy difficulties.

Purpose: We evaluated testicular morphology and spermatozoid parameters in spontaneously hypertensive rats treated with enalapril., Materials and Methods: Spontaneously hypertensive rats were assigned to a hypertensive nontreated group and a hypertensive enalapril treated group. Wistar-Kyoto normotensive rats served as controls. Systolic blood pressure was measured weekly. Spermatozoid concentration, motility and viability were determined in samples collected from the epididymal tail. Testicular morphology was analyzed by morphometric methods. All data were compared using ANOVA and the Tukey post test with p <0.05 considered significant., Results: Systolic blood pressure in the enalapril treated group was similar to that in controls but lower than in the nontreated group. Sperm concentration in the enalapril treated group was similar to that in controls and greater than in the nontreated group. Testicular vascular volumetric density decreased in the nontreated group while in enalapril treated rats this parameter was similar to that in controls. Volumetric density of the seminiferous epithelium in the enalapril treated group was higher than in the nontreated group and controls, indicating a possibly positive effect of enalapril on spermatogenesis., Conclusions: In this animal model hypertension caused morphological changes in the testis and upon spermatozoid production. Enalapril treatment partially protected the testicles from these alterations, restoring normal spermatozoid production., (Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Orchiopexy is performed as part of cryptorchidism and testicular torsion treatment. The inflammation caused by the needle and suture penetration has been suggested to be one of the possible causes of subfertility after parenchymal transfixation of the testicles. The purpose of the present study was to investigate testicular alterations after parenchymal transfixation sutures at different ages in rats. Prepubertal, pubertal, and adult rats were submitted to parenchymal suturing (without tying the knots, thus avoiding local ischemic injury) of the right testicle, which was maintained for 4 hours. All animals were subjected to euthanasia on completion of 14 weeks of life. The right testicles were studied as the sutured testicles, whereas the left organs were studied as contralateral. One age-matched control group of rats that was not submitted to any procedure was used for comparison. During euthanasia, sperm were collected from the tail of the epididymal and evaluated for concentration, motility, and viability. Samples from testicular tissue were collected for morphologic analysis. Sperm analysis indicated that only the adult operated animals presented reductions in motility (38.2% of adult vs. 54.1% of control; P = 0.02) and viability (16.6% of adult vs. 24.6% of control; P = 0.003). Several morphologic alterations were noted both in sutured and in contralateral testes at all ages. For instance, the seminiferous epithelium volumetric density of right testicles was reduced from 50.4% in controls to 32.3% in prepubertal operated animals, 45.3% in pubertal operated animals, and 39.4% in adult operated animals (P < 0.05). The seminiferous epithelium volumetric density was also reduced to 39.9% and 39.0% in contralateral testicles of animals operated before and after puberty, respectively (P < 0.05). The animals operated on before puberty and in adulthood showed more testicular morphologic alterations, as seminiferous tubule volumetric density, seminiferous tubule length, and tubular diameter were reduced only in prepubertal and/or adult operated animals. Testicular transfixation in rats led to important morphologic modifications in the ipsilateral and contralateral organs. These alterations were observed regardless of the age when surgery was performed, but they were milder in animals operated on during puberty. Orchiopexy techniques that do not involve the application of testicular transfixation sutures should be recommended., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: To evaluate the penile morphological modifications of pubertal and adult rats chronically treated with supra-physiological doses of anabolic androgenic steroids., Methods: Forty-eight male Wistar rats were distributed into four groups: two control groups, 105- and 65-day-old (C105 and C65, respectively) injected with peanut oil (vehicle); and two treated groups, 105- and 65-day-old (T105 and T65, respectively) injected with nandrolone decanoate at a dose of 10 mg Kg-1 of body weight. The rats were injected once a week for eight weeks. The rats were then killed and their penises were processed for histomorphometric analyses. The mean of each parameter was statistically compared., Results: A corpus cavernosum reduction of 12.5% and 10.9% was observed in the T105 and T65 groups, respectively, when compared with their respective control groups. The cavernosum smooth muscle surface density diminished by 5.6% and 12.9% in the T65 and T105 groups, respectively, when compared with their controls. In contrast, the sinusoidal space increased by 17% in the T105 group and decreased by 9.6% in the T65 group., Conclusion: The use of supra-physiological doses of AAS promotes structural changes in the rat penis, by altering the proportions of corpus cavernosum tissues, in both pubertal and adult treated animals.

Purpose: To investigate the structural and functional changes induced by corticosterone (CORT) in the ventral prostrate (VP) of rats in order to study chronic stress effects in the prepubertal phase., Methods: Wistar rats received daily saline or CORT injections during the pubertal period from the 5th to 25th day of postnatal life. The animals were distributed into four groups: 1 - Control (n=5); 2 - Control 99mTc-P (n=5); 3 - Treated with CORT (n=14); 4 - Treated with CORT and 99mTc-P (n=10). All rats were sacrificed at two months of age. Technical tissue uptakes of 99mTc-P were used to evaluate the functional and stereological methods for morphological analysis., Results: Acini distribution in the group treated with CORT differed significantly (p<0.0001) from the control. The control group's epithelial average height (10.01±0.24 microns) was statistically significant (p<0.0001) from rats treated with CORT (19.27±0.73microns). The collagen distribution was lower in the treated group (2.79%) when compared to control (3.97%). The radioactivity percentage in the groups marked with 99mTc-P (%Ati/g) did not demonstrate a statistically significant difference (p=0.285897)., Conclusion: Chronic administration of corticosterone in prepubertal rats causes changes in their acinar structure and their ventral prostate stroma, indicating possible deleterious effects of this hormone.

Objective: To evaluate biocompatibility of a cellulosic exopolysaccharide (CEC) as bulking agent in rabbit urinary bladder., Materials and Methods: The experimental study was developed at the Nucleus for Experimental Surgery or UFPE. The new agent was injected into the bladder of the adult rabbits using a small abdominal incision. Animals were injected with 0.2 mL of dextranomer microspheres (Dx) plus hyaluronic acid and CEC. The animals were studied after 3 days (G1), 90 days (G2), and 11 months (G3). The biocompatibility was evaluated according to the histologic parameters (presence of blood vessels, inflammatory reaction, and collagen deposition) by a quantitative analysis. The Student paired t test was used for continuous variables, and the scores were compared through the chi-square test., Results: Both materials were structurally homogeneous and free from inflammatory cells or blood vessels (G1). In 3-month samples (G2), CEC areas were densely invaded by fibroblasts and blood vessels. Dx areas were fragmented but still homogeneous and free from cells or blood vessels. Samples from 3 and 11 months showed a significant difference in favor of CEC especially concerning preservation of material in the implant site, as well as the presence of neovascularization. This experimental study represents a positive outcome in terms of reflux resolution in the long term. Further studies may be necessary to confirm its efficacy when in clinical use., Conclusion: The CEC exhibited low inflammatory response and integrated with the host tissue better than Dx in the long-term follow-up., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: We compared and contrasted the structure of the gubernaculum testis in fetuses with prune belly syndrome and normal controls., Materials and Methods: We studied a total of 6 gubernacula from 3 male fetuses with prune belly syndrome and a total of 14 from 7 male fetuses without an anomaly. Gubernacular specimens were cut into 5 μm sections and stained with Masson trichrome to quantify connective tissue and smooth muscle cells, with Weigert stain to observe elastic fibers and with picrosirius red with polarization to observe collagen. Immunohistochemical analysis was done with tubulin to observe the nerves. Images were captured with a BX51 microscope and DP70 camera (Olympus®). Stereological analysis was done with Image-Pro and ImageJ (MediaCybernetics®) using a grid to determine volumetric density. Means were statistically compared with the Mann-Whitney test. All tests were 2-sided with p <0.05 considered statistically significant., Results: Prune belly syndrome fetuses were at 17 to 31 weeks of gestation and control fetuses were at 12 to 35 weeks of gestation. Quantitative analysis showed no difference in the volumetric density of smooth muscle cells in prune belly syndrome vs control gubernacula (mean 15.70% vs 19%, p = 0.2321). Collagen fiber analysis revealed a predominance of green areas in prune belly syndrome gubernacula, suggesting collagen type III, and a predominance of red areas in control gubernacula, suggesting collagen type I. Elastic fibers were significantly smaller in prune belly syndrome gubernacula than in control gubernacula (mean 14.06% vs 24.6%, p = 0.0190). Quantitative analysis demonstrated no difference in the volumetric density of nerves in prune belly syndrome or control gubernacula (mean 5.200% vs 3.158%, p = 0.2302)., Conclusions: The gubernaculum in fetuses with prune belly syndrome had altered concentrations of collagen and elastic fibers. These structural alterations could be one of the factors involved in cryptorchidism in prune belly syndrome., (Copyright © 2015. Published by Elsevier Inc.)

Purpose: To evaluate the effects of different high-fat diets on body mass, carbohydrate metabolism and testicular morphology in rats seven months old., Materials and Methods: Male Wistar rats were divided into four groups: SC (standard chow), HF-S (high fat diet rich in saturated fatty acids), HF-P (high fat diet rich in polyunsaturated fatty acids), HF-SP (high fat diet rich in saturated and polyunsaturated fatty acids). The rats were fed for 16 weeks. Blood samples, testes and genital fat deposits were collected for analysis. Data were analyzed by one-way ANOVA and Bonferroni post hoc test, considering p<0.05 as statistically significant., Results: Different high-fat diets promoted an increase in the body mass (p<0.0001). The genital fat deposits were higher in the high-fat groups (HF-S, HF-P, HF-SP) (p=0.0004). Regarding serum parameters, the animals in the HF-S and HF-SP groups presented hyperglycemia (p=0.0060), hyperinsulinemia (p=0.0030) and hypercholesterolemia (p=0.0021). All of the hyperlipidemic groups showed hyperleptinemia (p=0.0019). Concerning the testis, the HF-S group showed a reduction on the seminiferous epithelium height (p=0.0003) and cell proliferation (p=0.0450). Seminiferous tubule diameter was lower in the HF-SP than in the SC group (p=0.0010)., Conclusions: The high fat diet administration, independent of the lipid quality, promotes overweight. Diet rich in saturated fatty acids (lard) alters the carbohydrate metabolism and the testicular morphology with reductions of seminiferous epithelium height, seminiferous tubule diameter and cell proliferation which could be related to a disturbance of spermatogenesis.

Purpose: To evaluate the structure of the endopelvic fascia in prostates of different weights., Methods: We studied 10 patients with BPH (prostates> 90 g); 10 patients with prostate adenocarcinoma (PAC) (prostates< 60 g) and five young male cadavers (control group). During the surgery a small sample of endopelvic fascia was obtained. We analyzed elastic fibers, collagen and smooth muscle. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using the one-way ANOVA with the Bonferroni test and a p<0.05 was considered statistically significant., Results: The mean of the prostate weight was 122 g in BPH patients, 53.1g in PAC patients and 18.6g in control group. Quantitative analysis documented that there are no differences (p=0.19) in Vv of elastic fibers and in Vv of type III collagen (p=0.88) between the three groups. There was a significant difference (p=0<0.0001) in the quantification of SMC in patients with prostates > 90 g (mean=9.61%) when compared to patients with prostates < 60 g (mean=17.92%) and with the control group (mean=33.35%)., Conclusion: There are differences in endopelvic fascia structure in prostates> 90 g, which can be an additional factor for pre-operatory evaluation of radical prostatectomy.

The use of morphometrical tools in biomedical research permits the accurate comparison of specimens subjected to different conditions, and the surface density of structures is commonly used for this purpose. The traditional point-counting method is reliable but time-consuming, with computer-aided methods being proposed as an alternative. The aim of this study was to compare the surface density data of penile corpus cavernosum trabecular smooth muscle in different groups of rats, measured by two observers using the point-counting or color-based segmentation method. Ten normotensive and 10 hypertensive male rats were used in this study. Rat penises were processed to obtain smooth muscle immunostained histological slices and photomicrographs captured for analysis. The smooth muscle surface density was measured in both groups by two different observers by the point-counting method and by the color-based segmentation method. Hypertensive rats showed an increase in smooth muscle surface density by the two methods, and no difference was found between the results of the two observers. However, surface density values were higher by the point-counting method. The use of either method did not influence the final interpretation of the results, and both proved to have adequate reproducibility. However, as differences were found between the two methods, results obtained by either method should not be compared.