A preliminary evaluation of serum level of testosterone, LH, and FSH in patients with varicocele after varicocelectomy as a kidney-related disease.

INTRODUCTION: Varicocele is a common problem with a high prevalence in population with primary and secondary infertilities. The adverse effects of varicocele on spermatogenesis and fertility are known, but the association between clinical varicocele and testosterone is not clear. Hence, we decided to evaluate the serum levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in patients with varicocele after varicocelectomy. METHODS: In this study, 100 patients with varicocele were divided into two groups: hypogonadal patients with testosterone level <280 ng/dL and eugonadal patients with testosterone level >280 ng/dL. The serum levels of testosterone, FSH, and LH were measured before surgery and 3 months after surgery, and the results were analyzed using the SPSS software. P-value <0.05 was considered statistically significant. RESULTS: Patients with varicocele after puberty till 50 years were divided into two groups: hypogonadal (testosterone <280 ng/dL) and eugonadal (testosterone >280 ng/dL) patients who required varicocelectomy. The mean testosterone level before surgery in hypogonadal patients was 215.22±83.31 ng/dL, which reached 326.95±35.125 ng/dL after surgery (P<0.0001), which was significant. There was no significant decrease in the mean FSH level, but there was a significant decrease in the mean LH level after varicocelectomy. In eugonadal group, testosterone level before surgery was 471.90±145.71 ng/dL, which reached 469.57±145.61 ng/dL after surgery, which was not significant. CONCLUSION: In our study, patients who underwent varicocelectomy had improved testosterone levels, so that this increase was more significant in hypogonadal patients than in eugonadal patients. Decrease in LH and FSH levels in all patients was seen after varicocelectomy, which can be due to increase in testosterone levels.

Analysis of Interleukin-17 mRNA Level in the Urinary Cells of Kidney Transplant Recipients with Stable Function.

OBJECTIVES: Kidney transplantation supports patients with end-stage kidney diseases. Many factors control the allograft function in kidney transplant recipients. Interleukin-17 (IL-17) can be used as a non-invasive diagnostic biomarker of rejection. The aim of this study was to evaluate the expression of IL-17 mRNA in urinary cells of kidney transplant recipients with stable function. MATERIAL AND METHODS: A total of 40 renal transplant recipients who were admitted for surgery and 30 healthy controls were enrolled in the study. From each patient, 30 mL urine samples were collected in 50 mL tubes on days 3 and 5 after renal transplantation; also, 30 mL urine samples were obtained from controls. Quantitative Real-Time PCR (qRT-PCR) technique was used for analysis of IL-17 mRNA level in the tested groups; 2-ÄÄCT method was performed for determining the relative gene expression between tested groups. RESULTS: The mRNA expression mean ± SE of fold in patients and controls were 3.58±1.61 fold and 2.85±1.37 fold, respectively. The mRNA expression mean of IL-17 (fold) was not statistically different in tested groups (P-value = 0.63). CONCLUSIONS: In kidney transplant recipients, urinary IL-17 expression provides informative data in relation to the allograft function regardless of allograft pathology.

Effects of hydrochlorothiazide on kidney stone therapy with extracorporeal shock wave lithotripsy.

OBJECTIVE: The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi (diameter ≤2 cm) were enrolled from February 2010 to September 2010. ESWL protocol was performed by 2,500 shocks per session. The patients were randomized into two groups: (1) 26 patients who were given 25 mg hydrochlorothiazide twice daily; and (2) 26 patients who received placebo. The stone-free rate was defined as residual calculus size ≤4 mm in controlled ultrasound on 2(nd) week, 1 month and 3 months after ESWL. RESULTS: 19 (78%) of the first group and 9 (42.9%) of the second group were stone-free after one session of ESWL (P = 0.02). 88% of the group 1 and 47.8% of the group 2 were stone-free on 1 month after ESWL (P = 0.003); however, this effect of hydrochlorothiazide was not related to the patients' body mass index, age and gender. The accessory treatment procedures were applied in 24% of the group 1 compared with 19% of the group 2 during 3 months (P = 0.68). All patients in both groups were stone-free on 3 months following lithotripsy. CONCLUSIONS: Hydrochlorothiazide did not impact on the stone-free rate and using accessory procedure within 3 months; however, it decreased duration of stone-free status and number of ESWL sessions.

Preventive effect of tamsulosin on postoperative urinary retention.

PURPOSE: To investigate the prophylactic effect of Tamsulosin, a super-selective alpha-1a adrenergic blocking agent, on the development of urinary retention in men undergoing elective inguinal herniorrhaphy. MATERIALS AND METHODS: From May 2010 through November 2011, a total of 80 males who underwent elective inguinal herniorrhaphy in a university hospital were included in this study. Patients were randomly assigned to one of two groups. In group one (control), the patients were given two doses of placebo orally, 6 hours before surgery and 6 to 12 hours after surgery. Patients in group two were given 0.4 mg of Tamsulosin orally in the same manner as the placebo. All patients were closely followed for 24 hours post-operatively, and any voiding difficulties or urinary retention was recorded. RESULTS: There were 40 patients in group one (control group) and 40 patients in group two (Tamsulosin group). The patients' mean age was 64 years. In group one, 6 patients and in group two, 1 patient required catheterization. Thus, 15% of patients in group I and 2.5% of patients in group II had urinary retention. The difference in the requirement for catheterization was statistically significant (p=0.04). The technique of herniorrhaphy, the side of the body in which the hernia was located, the type of anesthesia, the duration of the surgery, and the severity of pre-operative urinary symptoms had no significant effect on the incidence of urinary retention. CONCLUSIONS: The use of perioperative Tamsulosin represents an effective strategy to reduce the risk of post-operative urinary retention following inguinal herniorrhaphy.

Frequency of occurrence of vesico-ureteral reflux in kidney transplanted patients with the new technique of uretero-neo- cystostomy (Barry-Taguchi).

There are several ways of performing vesico-ureteral anastomosis in kidney trans-plantation (Tx); they are broadly classified into two categories: extra-vesical and intra-vesical. Extra-vesical methods are preferred in kidney transplantation. In this study, we attempt to integrate two extra-vesical techniques of Barry and Taguchi and to evaluate the frequency of occurrence of vesico-ureteral reflux (VUR) with this technique. Also, an attempt is made to compare the results with other techniques reported in the literature. Fifty consecutive transplant recipients, who underwent uretero-neo-cystostomy (uretero-vesical anastomosis) by the new technique of Barry-Taguchi were evaluated for VUR by sonography and cystoureterography, six months after Tx. The mean age of the study subjects was 34.8 years; there were 33 males and 17 females. The mean time between Tx and evaluating for VUR was 6.6 months. Two cases of asymptomatic VUR (4%) were detected at the end of the study period. The occurrence of 4% asymptomatic VUR suggests that this technique is more acceptable compared to others. Because of the simple nature of the procedure as well as the short time required, this technique could be a suitable choice in kidney transplantation.