SUMMARYThe most common cause of male infertility is idiopathic oligoasthenozoospermia. Empirical medical treatment for idiopathic male infertility is still a controversial issue. The aim of this study was to evaluate any possible effects of combining vitamin E as antioxidant and clomiphene citrate as antiestrogen on spermatozoa concentration and motility in comparison to give either of medications alone in patients with idiopathic oligoasthenozoospermia. This is a comparative prospective randomized study. Ninety patients with idiopathic oligoasthenozoospermia were randomized into equally three groups: Group A: received vitamin E (400 mg/day) for 6 months. Group B: received clomiphene citrate (25 mg daily) for 6 months. Group C: received combination of both drugs in the same doses for 6 months. All patients were subjected to the following: history taking, general and genital examination, semen analysis, serum FSH, total testosterone, and scrotal duplex. Semen examination was performed according to the guidelines of (WHO, 2010), at the start of treatment and was repeated after 3 months and after 6 months of treatment. Regarding vitamin E group, there was insignificant increase in mean sperm concentration after 6 months of treatment in comparison to baseline. On the other hand, there was a significant improvement of mean sperm concentration in the other two groups after 6 months of treatment, with more significance in combination therapy group (p = 0.001). The mean total sperm motility has improved in all patients groups, in comparison to baseline, with more significance in combination therapy group. In vitamin E group, it was 28.07 AE 9.65% (p = 0.000). For those in clomiphene citrate group, was 33.33 AE 14.10% (p = 0.003) and 40.50 AE 17.54% (p = 0.000) in combination therapy group. Combining antioxidant and antiestrogen therapy is a valid option for the treatment of a selected group of men with unexplained isolated oligoasthenozoospermia.

No abstract

No abstract

Please cite this article in press as: Elghamrawi H, et al. Predictive factors of bladder outlet obstruction following the tensionfree vaginal tape obturator (TVTO) procedure in females treated surgically for stress urinary incontinence. Afr J Urol (2015), http://dx. AbstractObjectives: To identify patients at risk for postoperative outlet obstruction after the tension-free vaginal tape obturator (TVTO) procedure in order to allow for better counseling and possible treatment alternatives. Subjects and methods: This prospective study was carried out on 85 women who underwent the TVTO procedure for treatment of stress urinary incontinence (SUI). Preoperatively, a detailed medical history was taken from all patients, and all were subjected to physical examination, routine labs, abdominal and pelvic ultrasound and urodynamic studies (cystometry and assessment of the detrusor leak point pressure (DLPP), abdominal leak point pressure (ALPP), pressure flow and post-void residual (PVR) urine). The TVTO procedure was carried out by the same surgeon in all cases. Postoperative voiding dysfunction in this study was defined as the subjective feeling of difficult voiding, a weak stream and/or incomplete evacuation, and a PVR urine volume >100 ml, a urine flow rate <15 ml/s or urinary retention on examination. The following risk factors for postoperative bladder outlet obstruction were evaluated: age, history of previous incontinence surgery, parity, menopausal status, type of SUI, grade of SUI, residual urine, Q max and P det Q max . Statistical analysis was done using the SPSS package version 1.5. Results: 75% of our patients were cured. Denovo urgency or urge incontinence developed in 5.8% of the patients. Voiding dysfunction according to our definition developed in 24.7% of the patients. On multivariate analysis, Q max was the only risk factor that could predict postoperative bladder outlet obstruction (p = 0.002, odds ratio = 0.658, 95% C.I.).Please cite this article in press as: Elghamrawi H, et al. Predictive factors of bladder outlet obstruction following the tensionfree vaginal tape obturator (TVTO) procedure in females treated surgically for stress urinary incontinence. Afr J Urol (2015), http://dx. No. of Pages 4 2 H. Elghamrawi et al. Conclusion:Preoperative Q max is the only independent risk factor for postoperative bladder outlet obstruction in women undergoing TVTO surgery. Brief summary: TVTO is an effective surgical option for genuine stress incontinence in females. Preoperative Q max is the only independent risk factor for postoperative bladder outlet obstruction.