IntroductionVaricocele is a common problem with a high prevalence in population with primary and secondary infertilities. The adverse effects of varicocele on spermatogenesis and fertility are known, but the association between clinical varicocele and testosterone is not clear. Hence, we decided to evaluate the serum levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in patients with varicocele after varicocelectomy.MethodsIn this study, 100 patients with varicocele were divided into two groups: hypogonadal patients with testosterone level <280 ng/dL and eugonadal patients with testosterone level >280 ng/dL. The serum levels of testosterone, FSH, and LH were measured before surgery and 3 months after surgery, and the results were analyzed using the SPSS software. P-value <0.05 was considered statistically significant.ResultsPatients with varicocele after puberty till 50 years were divided into two groups: hypogonadal (testosterone <280 ng/dL) and eugonadal (testosterone >280 ng/dL) patients who required varicocelectomy. The mean testosterone level before surgery in hypogonadal patients was 215.22±83.31 ng/dL, which reached 326.95±35.125 ng/dL after surgery (P<0.0001), which was significant. There was no significant decrease in the mean FSH level, but there was a significant decrease in the mean LH level after varicocelectomy. In eugonadal group, testosterone level before surgery was 471.90±145.71 ng/dL, which reached 469.57±145.61 ng/dL after surgery, which was not significant.ConclusionIn our study, patients who underwent varicocelectomy had improved testosterone levels, so that this increase was more significant in hypogonadal patients than in eugonadal patients. Decrease in LH and FSH levels in all patients was seen after varicocelectomy, which can be due to increase in testosterone levels.

The patient was a 51-year-old lady with left flank colicky pain accompanied with nausea and vomiting for a month. Transurethral lithotripsy and ureteral stent placement was considered for the patient. The patient had a narrow ureteral lumen and while bringing the ureteroscope out, ureteral avulsion occurred at a distance approximately 4 cm from ureteropelvic junction. After bringing the uretroscope out, the avulsed ureter was observed hanging at the tip of the ureteroscope. Anastomosis of the ureter to the bladder was accomplished with Lich–Gregoir technique. A drainage tube was inserted at the site of incision and the surgical wound closed. The patient was discharged with acceptable general condition after 3 days and the drainage tube removed. The ureteral stent was removed 4 weeks later by cystoscopy. An ultrasound imaging study of the genitourinary system 8 months into the patients follow up showed normal size, echo and cortical thickness in the operated kidney after renal autotransplantation.

Introduction:Diagnosis of renal cortical lesions by radioisotopes in nuclear medicine is one of the most common techniques and procedures can be performed by different radiotracer. However, all these materials are accurate in determining kidney function, but there are differences between them in the field. The purpose of this study was to evaluate the effectiveness of EC scans compared with DMSA scan in the detection of cortical lesions and DRF.Methods:65 cases, which have been referred for various reasons, for DMSA scans were enrolled. Patients 1 week after DMSA scan with the previous consent of the EC being scanned. The results were compared in terms of convergence as well as sensitivity, specificity, positive and negative predictive value of EC with respect to the results of DMSA scan.Results:PPV of EC was 100%, negative predictive value of EC was 68.75%, sensitivity of EC was 90.74% and specificity of EC was 100% in the detection of cortical lesions. DMSA scan and EC convergence rates result in cortical lesions in our study was high.Discussion:We suggest EC scan as an alternative to reduce the cost of therapy and radiation, but considering the benefits of DMSA scan, it could remain the gold standard method of diagnosis.

Objective:The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy (ESWL).Materials and Methods:A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi (diameter ≤2 cm) were enrolled from February 2010 to September 2010. ESWL protocol was performed by 2,500 shocks per session. The patients were randomized into two groups: (1) 26 patients who were given 25 mg hydrochlorothiazide twice daily; and (2) 26 patients who received placebo. The stone-free rate was defined as residual calculus size ≤4 mm in controlled ultrasound on 2nd week, 1 month and 3 months after ESWL.Results:19 (78%) of the first group and 9 (42.9%) of the second group were stone-free after one session of ESWL (P = 0.02). 88% of the group 1 and 47.8% of the group 2 were stone-free on 1 month after ESWL (P = 0.003); however, this effect of hydrochlorothiazide was not related to the patients' body mass index, age and gender. The accessory treatment procedures were applied in 24% of the group 1 compared with 19% of the group 2 during 3 months (P = 0.68). All patients in both groups were stone-free on 3 months following lithotripsy.Conclusions:Hydrochlorothiazide did not impact on the stone-free rate and using accessory procedure within 3 months; however, it decreased duration of stone-free status and number of ESWL sessions.

Given the predictive role of serum cystatin C in kidney function, the poor financial status of patients with chronic kidney diseases and the high cost of this test, it should be considered only in high risk patients with high probability of transplantation rejection. Taghizadeh Introduction: Serum cystatin C is not routinely used in the evaluation of renal function and this may be due to its high cost, lack of adequate studies to approve the use of cystatin C and lack of accessibility and reliability. Many kidney transplanted patients encounter with decreased performance before creatinine rising and go toward rejection without certain actions. Certainly, the early detection of renal function reduction can prevent spiritual and physical damage among patients. Objectives: This study was aimed to determine the predictive value of serum cystatin C and creatinine in the assessment of allograft function in the early period after kidney transplantation in Urmia city, Iran. Patients and Methods: In this prospective study, serum creatinine, cystatin C and glomerular filtration rate (GFR) of 49 kidney transplanted patients in the 3rd, 8th and 14th day were measured and compared together. The correlation of creatinine and cystatin C was examined using Spearman's correlation. ROC curves were used to investigate sensitivity and specificity. Results: In this study, there was a statistically significant relationship between serum levels of creatinine and serum levels of cystatin C in 3rd, 8th and 14th day. The sensitivity and specificity of cystatin C in 14th day were 76% and 91.2%, respectively and for creatinine were 72% and 75% respectively, indicating cystatin C is a more sensitive indicator compared to creatinine on the 14th day in the presence of loss of GFR below 60 mL/cc. Conclusion: Serum cystatin C as a valuable marker can be an effective predictor marker of renal function reduction beside creatinine. Due to high cost of measuring kits of serum cystatin C, it is not possible to use this marker in all transplanted patients in the world. Therefore, we can use this marker in high-risk patients with probability of transplantation rejection. Please cite this paper as: