Renal stone density on native CT-scan as a predictor of treatment outcomes in shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5-20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients' renal function and obtained stone characteristics using a native CT scan. Patients were then scheduled for ESWL by the same machine and operator under fluoroscopy, with two-week intervals between treatment sessions when more than one treatment session was required. Before each new session, a new KUB-US was performed to reevaluate the stone. One hundred and twenty patient records were analyzed, 64 (53.3%) males and 56 (46.7%) females, with a mean age of 38.6 years and a mean stone size of 13.15 mm. Treatment with ESWL cleared stones in 76 (63.3%) patients, while 44 (36.7%) failed the treatment. The mean stone density in patients whose stones were cleared was significantly lower (661 vs. 1001) (P<0.001). Estimating renal calculus (or kidney stone) density on a native CT scan might help prognosticate ESWL treatment outcomes regarding stone clearance rates and the number of sessions required to clear a stone.

Comparison of the Safety and Efficacy of Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment of Bladder Stones in Children.

This study aimed to compare the safety and efficacy of laser lithotripsy and pneumatic lithotripsy, the two most commonly used transurethral lithotripsy methods for treating bladder stones in children in Iraq. Between January 2013 and December 2016, 64 children with bladder stones were included in this prospective randomized study, after ethical committee approval and written consent from the children's parents or caregivers were obtained. Patients were assigned randomly by computer software to two groups treated with either pneumatic cystolithotripsy or laser lithotripsy. A 9 Fr. semirigid ureteroscope was used to pass the lithotripter through and fragment the stone. A catheter of 8-12 Fr. was then introduced and kept in place for 24 h. All children were hospitalized for 24 h, and the catheter was removed the next morning. Outpatient follow-up was maintained for 6-12 months. In terms of operation outcomes and complications, the laser lithotripsy group had a significantly longer duration of operation (74.5 ± 26.6 min vs. 51.5 ± 17.2 min, p = 0.001), whereas the number of patients requiring an extended hospital stay was significantly higher in the pneumatic lithotripsy group (48.5% vs. 16.1%, p = 0.006). Moreover, pneumatic lithotripsy was associated with a significantly greater risk of having at least one adverse effect (64% greater than that in the laser group). Stone clearance rates did not significantly differ between treatment groups. In conclusion, both pneumatic and laser lithotripters can be used to treat children with bladder stones with high efficacy and safety.

Effects of Covid-19 vaccination on different semen parameters.

BACKGROUND: The possible effects of COVID-19 vaccines on reproductive health and male fertility in particular have been discussed intensely by the scientific community and the public since their introduction during the pandemic. On news outlets and social media platforms, many claims have been raised regarding the deleterious effects of COVID-19 vaccines on sperm quality without scientific evidence. In response to this emerging conflict, we designed this study to evaluate and assess the effect of the Pfizer-BioNTech mRNA COVID-19 vaccine on male fertility represented by the semen analysis parameters. RESULTS: Comparing the semen parameters of the participants before and after vaccination, no statistically significant effects on semen volume, pH or normal sperm concentration and morphology were shown. However, there were statistically significant differences on total sperm motility (P = 0.05) and progressive motility (P = 0.02). These differences are clinically insignificant given the fact that both readings before and after vaccination were within the normal ranges, according to the WHO manual guidelines for the examination and processing of human semen. CONCLUSION: Our data suggest that the Pfizer-BioNTech mRNA COVID-19 vaccine has no deleterious effects on semen parameters.

RéSUMé: CONTEXTE: Les effets possibles des vaccins contre la COVID-19 sur la santé reproductive et la fertilité masculine, en particulier, ont fait l'objet d'intenses discussions de la part de la communauté scientifique et du public depuis leur introduction pendant la pandémie. Sur les médias et les plateformes de médias sociaux, de nombreuses allégations ont été soulevées concernant les effets délétères des vaccins contre la COVID-19 sur la qualité du sperme, sans preuves scientifiques. En réponse à ce conflit émergent, nous avons conçu cette étude pour évaluer et déterminer l'effet du vaccin COVID-19 à ARNm de Pfizer-BioNTech sur la fertilité masculine représentée par les paramètres d'analyse du sperme. RéSULTATS: En comparant les paramètres du sperme des participants avant et après la vaccination, aucun effet statistiquement significatif sur le volume de sperme, le pH ou la concentration normale et la morphologie de spermatozoïdes, n'a été montré. Cependant, il y avait des différences statistiquement significatives sur la mobilité totale des spermatozoïdes (P = 0,05) et sur leur mobilité progressive (P = 0,02). Ces différences sont cliniquement insignifiantes étant donné que les deux lectures avant et après la vaccination se situaient dans des fourchettes normales, selon les directives manuelles de l'OMS pour l'examen et le traitement du sperme humain. CONCLUSION: Nos données indiquent que le vaccin à ARNm COVID-19 de Pfizer-BioNTech n'a aucun effet délétère sur les paramètres du sperme. MOTS-CLéS: COVID-19, Analyse du Sperme, Vaccin COVID-19 à ARNm de Pfizer-BioNTech, Infertilité masculine.

Renoprotective effect of mannitol infusion during extracorporeal shock lithotripsy.

OBJECTIVE: To evaluate the role of mannitol infusion in preventing or ameliorating renal injury that accompanies shock wave lithotripsy as measured by changes in resistive index (RI). METHODS: Between February and September 2006, 38 patients (28 men and 10 women) underwent extracorporeal shock wave lithotripsy (ESWL) for radiologically documented renal stones in The Surgical Specialties Hospital ESWL unit, Baghdad, Iraq. The 38 patients aged 20-50 years with renal stones of 10-20 mm size, scheduled for ESWL therapy, were divided into a control group (20 patients) and mannitol group (treatment group of 18 patients). All patients had their renal RI measured before ESWL, immediately after ESWL, then 3 and 7 days later. While patients in the mannitol group were given 0.5 gm/kg mannitol infusion during lithotripsy, the control group patients were given nothing. Changes in renal RI in both groups were evaluated statistically within the group and between the 2 groups. RESULTS: A significant rise in renal RI was found in the control group immediately after ESWL, then 3 and 7 days after. It increased from an initial value of 0.5875 to 0.6500, 0.6300, and 0.6245. The mannitol group showed fewer changes, yet still significant from 0.5850 to 0.6061, 0.6022, and 0.5967. This elevation of renal RI in the control group when compared to the mannitol group was statistically significant. CONCLUSION: Mannitol has a renoprotective function when given during ESWL, as evidenced by the statistically significant reduction in renal RI.