Gossypiboma (Retained Bladder Surgical Sponge ): A Case Report

Introduction & Objective: It is estimated that in abdominal and pelvic surgery, foreign bodies remain in one in 1500 operations. Here we report a rare kind of retained surgical sponge in the bladder of a patient that underwent open prostatectomy. Case: The patient is a 60 years old rural man from Yasuj, which came with malodor urine with obstructive and irritative urinary symptoms. He had a history of open prostatectomy 19 months ago. Evaluation revealed, cloudy urine, negative urine culture, normal PSA and normal findings in genitourinary tract sonography. The patient underwent surgery and the bladder was opened through the previous incision. The retained sponge was removed and the patient became symptom free in post operation period. Conclusion: Retained bladder sponge may be tolerated by the patient even for a long period of time. In spite of being a foreign body the patient may only complaint for obstructive and irritative voiding symptoms, which may be common in postprostatectomic patients (bladder instability)

A Study on Causes of Azoospermia in Urology Clinic of Yasuj University of Medical Sciences

ABSTRACT: Introduction & Objective: Azoospermia means no sperm in semen. It may be due to hormonal imbalance, any disorder in production of sperm, or might be due to obstruction in sperm pathway from testis till ejaculatory ducts. This study was performed to determine the causes of azoospermia in infertile male, referred to Yasuj clinic of urology. Material & Methods: This study was done during more than 2 years beginning from May 2004. Patients with at least two consecutive azoospermic semen analyses were included in this study after a complete history taking, physical examination, hormonal study (FSH, LH, prolactine, testosterone), vasography, testis biopsy and genetic evaluation. Results: Among 842 infertile men,172 patients (20.4%) were azoospermic. 28 patients (16.3%) with obstructive azoospermia and 144 patients (83.7%) with non obstructive azoospermia were detected. Common causes of non obstructive azoospermia were as follow: idiopathic 68 patients (39.53%), atrophied testes 40 patients (23.25%) , sertoli cell only 34 (19.76%) patient, undescended testes 28 (16.27%) patients and post chemotherapy in 2 (1.16%) patients. Causes of obstructive azoospermia were obstruction of epididymis or vasa deferens in 24 patients (86%) and congenital bilateral agenesis of vasa deferens in 4 patients (14%). Conclusion: Results of this study showed that about 20% of infertile men are azoospermic and the most common type of azoospermia is non obstructive type

The Role of Guide Wire in Internal Urethratomy Under Direct Vision

Background & aim: Urethral Stricture (US) is a common urolologic problem. Direct optic internal urethratomy (DOIU) is a common option for treating US. The purpose of this study was to investigate the role of the guide wire to facilitate direct vision internal in adult male patients. Methods: In this prospective study, 84 patients with anterior urethral stricture randomly divided into two groups. The first group underwent routine DOIU surgery and the second group internal urethratomy was carried out using Wolf ureteroscope 8-9.8 French and guide wire 0.035 French which inserted into bladder. Data were collected and analyzed using software (spss). Results: The mean operation time was 14 minutes in group one and for group 2 was 10 minutes. The comparison of complications after surgery showed that in the first group urethral bleeding accrued in 4 patients (9.52%) and fever infection was seen in 3 patients (7.14%) respectively but no such events were observed in group 2. The only late complication in both groups was recurrence of the stricture that was seen in 8 patients (19.04%) of group one and 3 patients (7.14%) of group 2. Conclusions: The results of this study showed that using a guide wire during DOIU may facilitates the procedure shortens the operation time and reduce the effects of short and long-term operation