ObjectivesTo evaluate the incidence and risk factors for the development of flank incisional hernias or bulges following surgical flank approaches to the kidney.Patients and methodsIn all, 100 consecutive adult patients who underwent variable renal surgeries via flank approaches were included in this prospective study. The incidence and risk factors for flank hernias and bulges were studied at 1- and 6-months postoperatively.ResultsAt 6 months postoperatively, the incidence of flank bulge was 14% and for lumbar hernia was 10%. The univariate analysis showed 13 significant factors to be associated with the occurrence of a flank bulge or hernia following flank incisions. When the significant risk factors in the univariate analysis were studied by multivariate analysis, using a logistic regression analysis, four independent risk factors were identified. These were: body mass index (BMI) ≥26.3 kg/m2 (P = 0.04), the use of a self-retaining retractor during surgery (P = 0.02), not preserving or identifying the neurovascular bundle (NVB) during surgery (P = 0.028), and postoperative abdominal distention (P = 0.001). Moreover, all cases included in our study who underwent en masse wound closure, developed surgical wound infection or who had constipation developed postoperative flank bulge or hernia.ConclusionHigh BMI, the use of self-retaining retractor, not identifying or preserving the NVB, postoperative abdominal distention, en masse wound closure, surgical wound infection, and constipation are significant risk factors associated with postoperative flank hernia and bulge.

ObjectivesTo determine the preoperative, intraoperative and postoperative risk factors that influence the development of persistent post-transurethral resection of the prostate (TURP) urinary tract infection (UTI) defined as pyuria and/or bacteriuria remaining for 3 weeks after surgery.Patients and methodsThis is a prospective study including 100 patients scheduled for TURP. Urine analysis and culture was performed immediately after catheter removal, then at 1 and 3 weeks postoperatively, and the results were correlated to various preoperative, intraoperative and postoperative potential risk factors to detect any significant relation to persistent UTI.ResultsThere was a statistically significant relationship between bacteriuria and the following risk factors: old age, past history of diabetes mellitus, large prostatic size, positive preoperative urine analysis and culture, preoperative catheter use, previous urological interventions, large size of sheath, long duration of operation, postoperative catheter events and postoperative manual wash.ConclusionsMany risk factors have been found to contribute to the development of post-TURP UTI and avoiding these factors can enhance recovery of patients undergoing TURP.

MT-RNR2 plays its anti-apoptotic role partly by avoiding deploying energy from complete oxidation of organic compounds to inorganic wastes. Thus MT-RNR2 can potentially serve as a new biomarker in the diagnosis of bladder carcinoma especially that it is present in blood circulation.

Klinefelter syndrome patients are mostly clinically azoospermic, and before the era of TESE, were unable to father genetically their own offspring. Nonmosaic Klinefelter [NMK] patients have chances of fatherhood once sperm is harvested from the epididymal seminiferous tubules and further injected in the ovarian cytoplasm. We report a case of 36y old NMK patient, treated for 3 months with supportive and hormonal medication achieving a pregnancy after TESE/ICSI. This is the first published case of successful conception in a couple with a nonmosaic Klinefelter father in Egypt using TESE/ICSI. Review of the literature for any advantages of mTESE over TESE and conception demonstrated higher pregnancy rates by TESE although the sperm retrieval rate was similar in both techniques. Conclusion:Nonmosaic Klinefelter patients should no longer be considered sterile.

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