Sexual function after Stoppa hernia repair in patients with bilateral inguinal hernia.

BACKGROUND: This study was performed to evaluate the effect of Stoppa hernia repair on sexual function of the patients with bilateral inguinal hernia. METHODS: In a prospective follow-up study, 50 patients with bilateral inguinal hernia were investigated to assess sexual function before and 1 and 6 months after standardized Stoppa hernioplasty using the International Index of Erectile Function (IIEF) questionnaire. The mean scores obtained on pre- and postoperative visits for all domains of sexual function were analyzed and compared with the Friedman and paired Wilcoxon tests. RESULTS: The mean score of IIEF at the first month after surgery was significantly declined compared to that before surgery and 6 months after surgery (P< 0.001), while the difference between preoperative score and the score at 6 months after surgery was not significant CONCLUSION: Bilateral inguinal mesh repair with Stoppa technique can decreased sexual activity of the patients at one month after surgery, nevertheless it returns to its initial condition at 6 months after surgery. This suggests that the Stoppa technique does not affect the sexual function of patients with bilateral inguinal hernia.

A Nonspecific Penile Ulcer Leading to the Diagnosis of Wegener's Granulomatosis.

The presented case describes a 53-year-old male who had been treated for non-specific cutaneous lesions for two months without any improvement. He was referred to our department after developing an erosive penile ulcer. Investigation for sexually transmitted diseases and Mycobacterium tuberculosis ended with negative results. Penile ulcer biopsy suggested the diagnosis of Wegener's granulomatosis (WG). The patient presented with upper respiratory tract symptoms during this period. Measuring antineutrophil cytoplasmic antibodies (c-ANCA), confirmed the diagnosis. Immunosuppressive therapy was initiated and resulted in a favorable response.

The evaluation of ureteroscopy and pneumatic lithotripsy results in pregnant women with urethral calculi.

BACKGROUND: Urinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases. OBJECTIVES: The aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones. PATIENTS AND METHODS: From 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography. RESULTS: The mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation. CONCLUSIONS: In conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients' symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.

Percutaneous nephrolithotomy of kidney calculi in horseshoe kidney.

INTRODUCTION: The aim of this study was to evaluate percutaneous nephrolithotomy (PCNL) in horseshoe kidneys with calculi. MATERIALS AND METHODS: Between 1995 and 2005, we performed PCNL in 9 patients with horseshoe kidney. In 3 of them, there was a single calculus and the rest had multiple calculi in the pelvis and at least 1 in the calyxes. Ultrasonography, plain abdominal radiography, and intravenous urography (IVU) were performed in all patients. We used fluoroscopy for entering the system and then, pneumatic or ultrasonic lithotripsy was used. RESULTS: In all except 1 patient (88.9%) we could access the system. Single calculi in 3 patients were removed. In 5 patients with multiple calculi, the calculus causing obstruction was removed, and in 3, the calculi located in the calyxes were removed too. Consequently, 66.7% were stone-free at the end of the procedure. In 2 patients, there were residual calculi in the calyxes and they underwent candidates for extracorporeal shockwave lithotripsy. CONCLUSION: Percutaneous nephrolithotomy can be used in patients with horseshoe kidney if the patient selection is appropriate and the surgeon is experienced enough. The success rate and complications are the same as the patients with normal anatomy. However, access to the lower calyx is more difficult due to its anatomic status.

Ratios of free to total prostate-specific antigen and total prostate specific antigen to protein concentrations in saliva and serum of healthy men.

INTRODUCTION: We evaluated the ratio of free to total prostate-specific antigen (PSA) and PSA to protein concentrations in saliva and serum of healthy men. MATERIALS AND METHODS: Concentrations of protein, free PSA, and total PSA in serum and saliva were measured in 30 healthy men aged 42 to 73 years, and their ratios were compared between the two fluids. RESULTS: There was a significant direct correlation between serum free-total PSA ratios of serum and saliva (P = .04) and between total PSA-protein ratios of serum and saliva (P = .02). Also, there were significant correlations between total and free PSA levels in saliva (P = .05) and between those in serum (P < .001). Significant inverse and direct correlations were detected between the body mass index and serum values of total PSA-protein (P = .04) and free-total PSA (P = .01), respectively. CONCLUSION: We can use saliva sample instead of serum sample for estimation of free-total PSA and total PSA-protein levels in men without prostate diseases. There is, however, a pressing need for much additional research in this area before the true clinical value of saliva as a diagnostic fluid can be determined.