The Effect of Varicocelectomy on Semen Analysis and Serum Levels of InhibinB

Background: Varicocele means dilation and torsion of spermatic veins. About 15%-40% of infertile men suffer from Varicocele. It seems that 70% of secondary infertility in men occurs due to Varicocele. Varicocele is the most common surgical cause for male infertility. Varicocelectomy is considered as the best treatment method for patients with Varicocele that increases 30%-50% of the postoperative fertility rate. The purpose of this study was to investigate the effect of Varicocelectomy on inhibin B and use this marker to predict infertility in men.Methods: In this study, all infertile patients in any age that were candidate for Varicocelectomy and hospitalized in Imam Hospital in Urmia were included. Exclusion criteria were defined as orchitis, trauma, diabetes, radiotherapy, chemotherapy and coitus complications. Sperm analysis (SA) was conducted three times for patients and then serum levels of FSH, LH, T, inhibin B, SA were measured before surgery and also six months after surgery. Furthermore, during the hospitalization and infertility period, testes were examined before surgery in terms of consistency and size.Results: The mean ± SEM (standard error median) age of 40 patients was 28.4±5.14 (range: 18-40) years old. Mean size of the testes and mean sperm density and serum levels of LH.FSH remained the same. However, mean sperm motility, serum levels of T and inhibin B were statistically significant after the Varicocelectomy (p-value=0.005). A significant relationship was found between serum levels of inhibin B and infertility; however, there was no significant relationship between sperm count and serum levels of LH, FSH and T. Varicocelectomy can improve sperm motility and increase Inhibin B in patients and so improves spermatogenesis parameters and it may be one of the causes of fertility in patients.Conclusion: The results of this study indicate that sperm motility and increase in inhibin B after Varicocelectomy can improve spermatogenesis parameters. Serum levels of FSH, T, LH and sperm morphology and also grade of Varicocele, patient age, and testis size have no effect on spermatogenesis and fertility after Varicocelectomy.

Evaluation of the Relationship of Low Back Pain with Spinal Anesthesia and its Related Factors in Patients Undergoing Urological Surgery

Background: Spinal anesthesia is the common method in outpatient surgeries, which has complications such as back pain. We aimed to evaluate the relationship between low back pain (LBP) with spinal anesthesia and its related factors in patients undergoing urological surgery. Materials and methods: In this cross-sectional study, 1000 patients undergoing urological surgery were enrolled. The severity of LBP was measured using the VAS (visual analog scale) pain on the 1st day, the 1st week, and the 1st month postoperatively. Patients’ age, sex, and the duration of surgery were collected. data analysis was performed using SPSS software, version 17. Results: Of the 1000 patients undergoing urological surgery, 636 (63.6%) patients and 364 (36.5%) patients underwent spinal and general anesthesia, respectively. In patients under general anesthesia, the LBP prevalence was higher than in patients under spinal anesthesia on the 1st week and the 1st month after surgery (P<0.05). So, the LBP prevalence was as follows: on the 1st day (general anesthesia: 14.5% vs spinal anesthesia: 24.1%, p=0.09), at the 1st week (general anesthesia: 24.9% vs spinal anesthesia:13.5%, P=0.001) and the1th month (general anesthesia: 13.8% vs spinal anesthesia: 4%, P=0.001). On 1st day and 1st week after surgery, the rate of LBP was significantly higher in the >45-year age group than in the age group less than 45 years (P<0.05). The pain rate was higher in patients who had surgery duration of more than 2.5 hours in all three time periods (P=0.001). Conclusion: Although the LBP prevalence on 1st day after surgery in patients undergoing urological surgeries under spinal anesthesia was higher than in patients who underwent general anesthesia, there was a significant decrease in pain levels during the first week and month following the surgery in patients under spinal anesthesia. Older age and longer duration of surgery were related factors to pain

Evaluating the prevalence of nephrolithiasis in kidney transplant recipients admitted to Imam Khomeini Hospital in Urmia in 2018-2019.

Introduction: Nephrolithiasis is almost common urological disease in the world that involves near 10 percent of adult population. Several researches are demonstrative of increasing prevalence and incidence of nephrolithiasis in industrial societies, because of changing the life style, food regimen and obesity that is very common. Though prevalence of nephrolithiasis in grafted kidney is rare, but because of importance of effects after grafting or graft rejection is needed to attention and study. Methods: In this research incidence of nephrolithiasis and the difference of it before and after the kidney transplantation in graft receiver of kidney in Urmia Imam Khomeini hospital for two years in 2018-2019 has studied, and followed after one year. Relation between age, education level, and sex have been evaluated too. Results: In this study 32 receiver of kidney transplant have been studied. Among this 32 patient 3 cases had nephrolithiasis after transplantation that they didn’t have any history of nephrolithiasis, And 3 cases had history of nephrolithiasis that after transplantation no kidney stone was seen (P<0.05).Higher prevalence of nephrolithiasis was significantly related to higher level of education (p<0.05), but age and sex was not significantly different in two groups (P>0.05). Conclusion: It’s concluded that the main reason of nephrolithiasis is the kidney organ that can make stone in the new body, and level of education was higher in the nephrolithiasis group (affected or have the history) than the healthy group

Evaluation of men’s knowledge, attitudes, and performance toward Prostate Cancer in the Urology Clinic of Imam Khomeini Hospital, Urmia, Iran

Introduction: Prostate cancer is the second most common cancer after lung cancer worldwide. In 2018, there were 1276106 new cases and 3.8% (358989 cases) of the population who died of this cancer were men. (What do you mean? All were men because we are talking about prostate cancer, but do you mean the mortality rate?) We aimed to evaluate men's knowledge, attitudes, and performance toward prostate cancer. Materials and Methods: A descriptive analysis was done on 385 men in the urology clinic of Imam Khomeini Hospital. Men aged at least 40 with no history of prostate cancer were included in this survey. The researchers made a questionnaire including two parts: the first part comprised information about knowledge, attitudes, performance, and the second part consisted of demographics. The men’s function was divided into two groups according to performing the PSA test: the good function group (PSA tests were done) and the weak function group (PSA tests were not done).  Data analyzed were analyzed using SPSS software, version 20. Results: The mean±SD age of the men was 63.9±8.9 years and 56.6% of them were city dwellers. 22.7% had a university degree. Most (38.5%) were Self-employed and most (76.3%) had no family history of prostate cancer. Most participants answered the general questions about prostate cancer, but they did not have suitable and reliable information about related risk factors, diet, and sexual activity. ‌ Conclusion: Considering the positive effect of people's knowledge on their attitude and their attitude on their performance, by holding training classes and education for people at risk their attitude and ultimately their performance towards prostate cancer prevention would be improved

Improvement of Erectile Dysfunction by Revascularization Surgery Following Urethroplasty in Patients with Pelvic Fracture

Introduction: Erectile dysfunction is one of the most common sexual disorders in men and affects one out of every five men over the age of 40 years. Penile revascularization is one of the methods for treating erectile dysfunction in these patients.Methods: The participants were patients who had erectile dysfunction after a pelvic fracture. These patients had Urethroplasty for at least one year ago due to urethral trauma and also undergone penile micro vascularization surgery. Sexual activity was allowed from the second month accompanied with the administration of tadalafil and yohimbine prior to intercourse.Results: In this study, 52 patients with the mean age of 30.65 ± 7 years (range: 24-45) were included. 24 patients (46%) were married. The mean time interval between pelvic fracture and surgery was 49.80 ± 16.30 months (range: 22 to 85). Complete response was seen in 9 cases (17.3%), relative responses in 18 (34.6%), and treatment failure in 25 cases (48.1%). The treatment results did not show any significant difference between the two dissimilar surgical procedures (Micheal versus-Virag) (P = 0.58).Conclusion: Based on this case-series, it is concluded that penile revascularization surgery seems to have a relatively good effect on the improvement of vascular erectile dysfunction in patients with pelvic fracture urethral distraction effect following Urethroplasty

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

Introduction: Transurethral lithotripsy (TUL) is an appropriate treatment for ureteral stones and is usually used for stones in the middle and lower part of the ureter. Different devices such as Holmium laser, stone basket and stone cone exist to prevent any fragments from retropulsion during TUL. The present study aims to compare the advantages and disadvantages of the Holmium laser, stone basket and stone cone. Methods: A retrospective study was conducted from September 2016 to January 2018 comparing various TUL methods in 88 subjects with proximal ureteral calculi. The study participants were devided into four matched groups. The first one included 20 patients undergoing TUL with no device (Group 1), the second group included 22 patients undergoing TUL while using the stone retrieval basket, the third group included 18 patients undergoing TUL while utilizing the stone cone and the fourth group included 28 patients undergoing TUL while using Hol-YAG laser. Results: A residual stone ≥ 3 mm was recorded in 15.9% of the patients. stone free rate were seen in 100%, 90.9, 83.3%and 55% in Holmium laser group, retrieval basket group, stone cone group and no device group respectively(p:0.001). Lowest rate of surgery complications including ureteral perforation, Post-operative fever and mucosal damage between 4 groups (p: 0.003) and highest time of surgery (p: 0.001) belong to laser group. If we want to ignore the laser group, success rate for lithotripsy was better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone. Conclusion:We can safely conclude that laser significantly help to prevent stone migration during TUL. If we want to ignore the laser group, success rate for lithotripsy was significantly better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone