Comparison of arterial blood supply to the testicles in the preoperative and early postoperative period in patients undergoing subinguinal varicocelectomy.

OBJECTIVE: Varicocele, which is the abnormal dilatation of internal spermatic veins, is known as the most surgically correctable cause of male infertility. In the evaluation of testicular arterial and venous blood supply, the scrotal colour Doppler ultrasound (CDU) is a valuable diagnostic method. The aim of this study was to investigate how the testicular blood flow is affected after varicocelectomy, and the place of scrotal CDU in the follow-up after varicocelectomy. MATERIAL AND METHODS: Thirty male patients who were diagnosed with left-sided varicocele were prospectively included in the study. Before the varicocelectomy, semen analyses were carried out, and peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were measured by CDU. In the third postoperative month, scrotal CDU and semen analysis were performed again and compared with the preoperative results. RESULTS: The arterial flow parameters PSV and EDV increased significantly, and the resistance parameters RI and PI decreased significantly, compared with the preoperative values. Sperm concentration, progressive motility and normal morphology improved in the postoperative semen analysis compared with the preoperative results. The increases in all three parameters were statistically significant. No statistically significant difference in vascular parameters was seen between the patients with improved and unimproved semen analysis. CONCLUSIONS: As confirmed by the results of semen analysis and CDU, testicular blood flow increases after varicocelectomy, resulting in the recovery of the haemodynamics of the testicle. CDU, which is generally used for diagnosis in the varicocele, can also be a valuable method of determining treatment success after surgery.

Evaluation of the efficiency of tamsulosin and Rowatinex in patients with distal ureteral stones: a prospective, randomized, controlled study.

PURPOSE: To compare the efficiency and spontaneous expulsion rates of tamsulosin and Rowatinex in patients with distal ureteral stones. METHODS: Between March and July 2009, 90 patients with distal ureteral stones <10 mm in size were included in the study. Patients were randomized in 3 groups: Group 1 (n = 31, those received 0.4 mg tamsulosin once daily), Group 2 (n = 30, those received 100 mg Rowatinex capsules 3 times a day), and Group 3 (n = 29, those received diclofenac 100 mg once daily). All patients were followed up for 10 days. RESULTS AND CONCLUSIONS: Mean age of the patients was 42.4 ± 16.1 (range, 22-75), 46.5 ± 16.5 (range, 22-76), and 43.5 ± 16.6 (range, 18-71) years in Groups 1-3, respectively. On admission, 37.8% had hematuria and 78.9% had lower urinary tract symptoms (LUTS). No statistically significant differences were detected between the three groups regarding patient age, gender, mean stone size, stone location, stone site, additional analgesic requirement, number of ureteral colics during the treatment, and upper urinary tract dilation. The mean stone expulsion time was 3.5 days in Group 1, 6 days in Group 2, and 7 days in Group 3 (P = 0.02). Stone expulsion rate was significantly high in Group 1 compared to Group 2 (P = 0.002). Similarly, stone expulsion rate was significantly high in Group 1 compared to Group 3 (P = 0.001). Medical treatment with tamsulosin seems to be effective in patients with distal ureteral stones <10 mm in size. However, use of Rowatinex does not seem to have any significant effect on clearance rate of distal ureteral calculi.