A rare cause of acute urinary retention in women: meatal condyloma accuminata, a case report

Acute urinary retention in women is a rarely seen phenomenon due to pharmacological, neuromuscular, anatomical, functional and infectious causes. Human papillomaviruses causing condyloma acuminata is one of the rarely reported viral infectious cause of acute urinary retention in case reports. A 45-year-old woman with acute urinary retention was found to have a round solid lesion on external urethral meatus. Histopathological examination revealed as condyloma acuminata. Urethral condyloma can be treated by local excision as an effective method for early improvement of voiding function. Even if the genital condyloma can be locally excised, patients should be referred to the gynecologists for cervical cancer screening.Pan African Medical Journal 2016; 2

Effect of atorvastatin on spermatogenesis in rats: A stereological study

Purpose: To investigate the effects of oral atorvastatin on spermatogenesis in a rat model.Methods: Rats were equally assigned into control and study groups, the latter receiving atorvastatin (20 mg/kg/day). At the end of 12 weeks, spermatogenetic activity was evaluated using stereological and optical fractionator methods. Serum follicle-stimulating hormone (FSH), total testosterone (TT), and luteinizing hormone (LH) levels were measured using micro–ELISA kits. Total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL - C), and high-density lipoprotein cholesterol levels were also measured by enzymatic colorimetric assays.Results: Testicular stereological analysis revealed that atorvastatin reduced Sertoli cell numbers (p < 0.001), spermatogonia (p < 0.001), spermatocytes (p < 0.001), and seminiferous tubule diameters (p < 0.001). LDL – C (p = 0.01) and TG (p = 0.01) values were significantly lower in the study group compared with the control group. There was no significant difference in FSH (p = 0.44), LH (p = 0.48),and TT (p = 0.06) levels between the groups.Conclusion: The findings show that atorvastatin causes deleterious effects on rat spermatogenesis. It should therefore be used with caution in clinical practice owing to its potential adverse effects, especially on male fertility. Keywords: Statin, Atorvastatin, Spermatogenesis, Stereology, Testi

Relationship Between the Visceral Adiposity Index and Peyronie’s Disease

Objective:We aimed to investigate the relationship between Peyronie’s disease (PD) and the visceral adiposity index (VAI), which is thought to predict visceral obesity homogeneously.Materials and Methods:We included 102 healthy volunteers (Group 1) and 89 patients with PD (Group 2) in this retrospective study. We recorded demographic, anthropometric, and clinical data, including age, comorbidity, International Index of Erectile Function (IIEF) score, waist circumference (WC), body mass index (BMI), visceral adiposity index testosterone (VAI), serum fasting glucose, high-density lipoprotein (HDL), and triglyceride (TG). For Group 2 participants, plaque size, duration of symptoms, and degree of penile curvature were recorded.Results:The mean ages of Group 1 and Group 2 were 55.12±9.51 years and 54.79±9.99 years, respectively (p>0.05). The mean BMI, WC, VAI, fasting glucose, and TG values were significantly higher in Group 2 (p0.05). The mean IIEF score was lower in Group 2 than in Group 1 (p=0.008). An increase of 1 unit in the VAI value increases the probability of having PD 1.2 times (p=0.001). Each VAI integer increase decreased 1.25 points in the IIEF score, a 1 mm increase in plaque size, and a 1.98-degree increase in curvature.Conclusion:Our study has shown that VAI can be used as a reliable, independent risk factor for plaque size and penile curvature in patients with patients with PD

Should the Double-J Stent Be Removed Endoscopically after a Ureteroscopic Stone Surgery?

Objective: Ureterorenoscopic stone surgery (USS) is the primary method of ureteral stone treatment. Double-J (JJ) stenting is an integral part of a USS, and most urologists prefer to use it without an extraction string. The probable reason for such preference could be the lack of reliable and sufficient data on JJ stent use with an extraction string

Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS):A Preliminary Result

Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy due to Idiopathic Chronic Orchialgia (ICO). Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied 3 times in a week with duration 30 minutes for 4 weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS) at first and third months. Results: Median age of patients was 26.20±2.38 (22-30). Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p0.05). None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first 1 month in patients with ICO but its effect reduces by the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to better assess the efficacy of TENS for ICO

TREATMENT OF RENAL STONES WITH PERCUTANEOUS NEPHROLITHOTOMY IMPROVES RENAL FUNCTIONS IN CHRONIC KIDNEY DISEASE PATIENTS

Objective:In this study, we aimed to investigate the impact of percutaneous nephrolitotomy on kidney functions in stage III or higher chronic renal failure patients using glomerular filtration rate and serum creatinine level. Material and Method:Between 2010 and 2014, percutaneous nephrolithotomy was applied to patients who had glomerular filtration rate below 60 mL/min/1.73m2. Pre-operative demographic features, stone burden and localization, urine analysis and microbial test, serum creatinine level, direct urinary system graphy, and spiral non-enhanced computerized tomography were obtained. Intraoperative renal unit counts, anesthesia and surgery time, and X-ray exposure time were calculated. Early and late post-operative complications, hospitalization time, stone-free rate, and glomerular function rate were evaluated, retrospectively. Findings:Pre-operatively, mean creatinine value was 2,42±0.76 mg/dL, mean glomerular filtration rate was 45.3±13mL/min/1.73m2, mean stone burden was 393±40 mm², mean intervention time was 79±34 min and 12 patients were stone free (70.5%). Decrease of hemoglobin 1,6 g/dL and transfusion was done only two patients (11.8%) due to excessive bleeding. In early and long term follow-up, mean creatinine values and glomerular filtration rate were 1.98±0.72mg/dL, 2.16±0.78mL/dL and 54.1±14 mL/min/1.73m2and 51.8±15 mL/min/1.73m2, respectively. Comparison of pre-operative and post-operative creatinine and glomerular filtration rates revealed significant decrease in creatinine level and increase in glomerular filtration rate. Results:Percutaneous nephrolithotomy which eliminates urinary obstruction is safely used in the treatment of kidney stones with minimal damage on kidney functions. Stage III or higher renal failure patients who have obstructive kidney stones or recurrent urinary tract infections can effectively be treated and this may help patients to prevent progression to end-stage renal failure

THE ROLE OF OPTICAL INTERNAL URETHROTOMY FOR MALE URETHRAL STRICTURE

Introduction:Urethral stricture is characterized by decrease in urethral flow severe enough to cause acute urinary retention. Urethral strictures may develop after traumas to urethral epithelium and/or corpus spongiosum. Complication rates due to untreated urethral stricture are very high. Although various treatment methods have been described, the second most common method after urethral dilation in practice is cold-knife internal urethrotomy. The purpose of this study is to evaluate data of patients who were treated with internal urethrotomy in our clinic. Methods:This study included patients who were treated with internal urethrotomy due to internal stricture between January 2011 and May 2015. Demographic, clinical, radiological, uroflowmetric (maximum and mean urine flow rate) and operative datas of the patients were retrospectively evaluated and recorded. Results:This study included 155 patients with a mean (±standard deviation) age of 71.70 (±13.7). Etiologically the most common reason was urological surgical procedures (67%) and the most common stricture was seen at bulbomembranous urethra region (85.2%). Mean length of stricture was 5.4±2.4mm. Mean duration to remove the catheter was 1.8±1.3 days. Regional anesthesia was used in 67.7% of the patients. Our success rate was 78,1%. Comparison of maximum and mean urine flow rates pre and postoperatively revealed significant increases postoperatively. Conclusion:Internal urethrotomy is a first line treatment method for urethral strictures because it is easily applied, has a low complication rate, and can be applied with local aenesthesia in high risk patients who are unable to take general anesthesia. Although recurrence rate is high, repeatability is its greatest advantage and it causes significant relief in patients with urethral strictures, but it must be kept in mind that definitive treatment is urethroplasty

Does antegrade JJ stenting affect the total operative time during laparoscopic pyeloplasty?

Objective: We aimed to show the effect of retrograde JJ stenting and intraoperative antegrade JJ stenting techniques on operative time in patients who underwent laparoscopic pyeloplasty