Multiplex-polymerase chain reaction for detecting microdeletions in the azoospermia factor region of Y chromosome in Iranian couples with non-obstructive infertility and recurrent pregnancy loss

Background: Approximately 15% of couples are infertile with the male factor explaining approximately 50% of the cases. One of the main genetic factors playing a role in male infertility is Y chromosomal microdeletions within the proximal long arm of the Y chromosome [Yq11], named the azoospermia factor [AZF] region. Recent studies have shown there is a potential connection between deletions of the AZF region and recurrent pregnancy loss [RPL]. The aim of this study is to examine this association by characterizing AZF microdeletions in two infertile groups: in men with non-obstructive infertility and in men with wives displaying RPL

Materials and Methods: In this is a case-control study, genomic DNA was extracted from 80 male samples including 40 non-obstructive infertile men, 20 males from couples with RPL and 20 fertile males as controls. Multiplex polymerase chain reaction was used to amplify 19 sequence tagged sites [STS] to detect AZF microdeletions. Differences between the case and control groups were evaluated by two-tailed unpaired t test. P<0.05 were considered statistically significant

Results: Only one subject was detected to have Y chromosome microdeletions in SY254, SY157 and SY255 among the 40 men with non-obstructive infertility. No microdeletion was detected in the males with wives displaying RPL and in 20 control males. Y chromosome microdeletion was neither significantly associated with non-obstructive infertility [P=0.48] nor with recurrent pregnancy loss

Conclusion: Performing Testing for Y chromosome microdeletions in men with non-obstructive infertility and couples with RPL remains inconclusive in this study

Penile fracture and its treatment: is retrograde urethrograghy necessary for management of penile fracture? / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Penile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography.</p><p><b>METHODS</b>From February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months.</p><p><b>RESULTS</b>Patients' mean age was (32.78 ± 10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88 ± 0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen.</p><p><b>CONCLUSION</b>There is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.</p>

Transarterial coil embolization in treatment of gross hematuria following self-inflicted stab wound in a horseshoe kidney / 中华创伤杂志(英文版)

Horseshoe kidney is an uncommon anomaly of the urinary system with an increased risk of injury during penetrating and blunt abdominal traumas. Self-inflicted abdominal stab wound, a rare type of abdominal injury, accounts for only a small percentage of suicidal attempts and may be infrequently encountered by physicians in trauma centers. Psychiatric disorders and alcohol or drug abuse are common risk factors in cases of self-stabbing. Here we report a rare case of self-stabbing of a horseshoe kidney. The case was a 19-year-old man with self-inflicted abdominal stab wound who was referred to our department of radiology due to re-occurred gross hematuria three days after exploratory laparotomy and surgical repair of injured abdominal organs. A horseshoe kidney was incidentally found in the patient's abdominal computed tomography. Renal angiography revealed active contrast extravasation from one of the segmental arteries. Selective transarterial embolization with a coil was successfully performed to control the hematuria.

Percutaneous treatment of bladder calculi in children: 5 years experience

We sought to evaluate the safety and efficacy of percutaneous cystolithotripsy in children. Thirty children [27 boys and 3 girls; mean age, 6.06 +/- 2.64 years; range, 1.5 to 12 years] with bladder calculi underwent percutaneous stone removal. The mean size of the largest diameters of the calculi was 24.8 +/- 8.47 mm [range, 13 mm to 50 mm]. Under general anesthesia, a 1-cm incision was made 1 to 2 cm above the pubic symphysis. A 26-F nephroscope was introduced into the bladder following tract dilation, and the calculi were removed. If the calculi were larger than 1 cm, fragmentation was performed. The procedure was done without fluoroscopy. Finally, a urethral catheter was placed for 48 hours. All patients became stone free. The mean operative time was 23.13 +/- 8.38 minutes [range, 12 to 40 minutes]. All patients were discharged 24 hours after operation, except 1, who was hospitalized 2 more days for suprapubic pain and severe irritating symptoms. No significant intraoperative or postoperative complications were seen. Percutaneous suprapubic cystolithotripsy is an efficient and safe technique for treating bladder calculi in children. We recommend this technique for treating large bladder calculi [larger than 1 cm] in children

Retrocaval ureter a study of 13 cases

The aim of this study was to report our 23-year experience in the diagnosis and treatment of retrocaval ureter. Data from 13 patients with retrocaval ureter were reviewed. Intravenous urography and retrograde pyelography had been used for confirming the diagnosis. All of the patients had been symptomatic and undergone surgery. A control intravenous urography had been performed 6 months postoperatively. The mean age of the patients was 23 years [range, 12 to 37 years]. Twelve patients [92.3%] were men. The clinical manifestations were pyelonephritis in 7 [53.8%], right flank pain in 4 [30.8%], gross hematuria in 1 [7.7%], and ureteral calculus in 1 [7.7%]. All of the patients had type 1 right-sided retrocaval ureter. Associated anomalies were seen in none of the patients. The control intravenous urography showed improvement of renal function. In our patients, the most common cause of referral was pyelonephritis. In symptomatic cases, operation is needed and can improve renal function

Kidney transplantation in older adults: does age affect graft survival?

There is a paucity of data on long-term patient and graft survival in the older kidney recipients. Our aim was to evaluate the long-term outcomes of kidney transplantation in patients aged 50 years and older and compare them with outcomes in younger recipients. Forty-seven recipients aged 50 years and older and 47 recipients aged younger than 50 years were randomly assigned to two groups [groups 1 and 2, respectively]. Patients who had received a cadaveric kidney allograft were excluded from the study. Data including demographic and clinical characteristics, early complications, early mortality, and actuarial patient and graft survival rates were collected, and the two groups were compared, accordingly. The rates of early complications and mortality were not different between the two groups. Patient survival rates at 1, 3, 5, and 7 years were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 86%, 86%, and 86% for patients in group 2, respectively [P=0.007]. Graft survival rates were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 85%, 85%, and 85% for patients in group 2, respectively [P=0.006]. Graft loss due to patient death was 33.33% in group 1 compared with 4.25% in group 2 [P<0.001]. Kidney transplantation should be considered in patients older than 50 years, since the graft survival rate is acceptable in this population, and early mortality and complications in this group are not different than those of younger recipients. Although older patients have a shorter life expectancy, they benefit from renal transplantation in ways similar to younger kidney transplant recipients

Endoscopic removal of intravesical calculus around an intrauterine contraceptive device

The intrauterine contraceptive device has been in use for many years, and migration of the device from the uterus to the pelvic cavity has been reported by many investigators. Although perforation of the uterus by an intrauterine contraceptive device is not uncommon, intravesical migration and secondary stone formation are rare complications. We report on a 35 years old woman in whom an intrauterine contraceptive device migrated from the uterus to the bladder and resulted in formation of a stone