use of semi rigid ureteroscopy and lithoclast for proximal and distal ureteral calculi

Objectives: advances in endoscopic equipment have facilitated access to the proximal urinary tract and have expanded the indications for ureteroscopy. Our aim is to assess the safety and efficacy of ureteroscopy performed for proximal and distal ureteral calculi with the use of the lithoclast

Patients and Methods: eighty one patients underwent semi-rigid ureteroscopy for ureteral calculi at the Urology Department, Minia University hospital between January 2003 and February 2006 were included in this study. Thirty nine patients had distal ureteral calculi, 22 patients with mid ureteral calculi and 20 patients with proximal ureteral calculi. The lithoclast was the only available lithotripter in all the · patients

Results: complete fragmentation was achieved in all accessible calculi, all cases [39/ 39] 100% with distal, [18/22] 82% with mid and [16/20] 80% with upper ureteral calculi. The lithotripsy time was 8.5 minutes for stones< or =1 cm and 12 minutes for stones ranging from 1.1 to 1.8 cm. Completely fragmented stones cleared spontaneously within two weeks in 97.5% of cases and all patients were free of calculi one month after the procedure. Re-treatment with the lithoclast was required in four patients for large residual fragments. The mean hospital stay was 1.2 · days. Complications were minimal and were managed conservatively

Conclusions: ureteroscopic management of proximal and distal ureteral calculi is highly successful, and the difference in success rates has narrowed. Recently no greater risk is added to the patient for endoscopy of more proximal ureteral calculi. The addition of the flexible ureteroscope could make the success rate comparable. The lithoclast is a safe effective and reliable method of intracorporeal lithotripsy

study of male reproductive toxicity in workers occupationally exposed to benzene

Introduction and objectives: There has been recently growing concern about the possible effect of environmental agents on male reproductive health. A number of studies have reported reduced semen quality among men occupationally exposed to chemicals. This study was carried out to determine the influence of occupational exposure to benzene on male reproductive function

Settings and participants: In gasoline service stations located in El-Minia governorate, a total of 88 gasoline distributor workers, aged between 24 and 52 years [33.51+/-5.72], were included in this study. Participants were exposed to benzene with duration of exposure varied from l to 28 years [8.57+/-5.39]

Methods: After complete history taking and physical examination with measuring the size of both testes, semen analyses were performed to all participants. In addition, we measured morning sample serum testosterone and follicular stimulating hormones. We analyzed the available data and studied the correlation between semen analysis parameters and hormonal profile, and the duration of exposure to benzene

Results: According to World Health Organization standardization, 31.8% of participants had abnormal semen parameters. The most evident abnormal semen characteristics include reduction in sperm concentration, motility, normal morphological forms, and the semen volume. The duration of exposure correlates with the declined quality of seminal variables after 5 years regarding sperm motility and concentration and after 7 years regarding sperm concentration, motility, morphology, and the seminal volume

Conclusion: Occupational exposure to benzene could adversely interfere with the human reproduction and fertility