[ effects of tamsulosin versus indomethacin in the expulsion of the lower urethral stones]

Urinary stones are among the most prevalent urological diseases [1-15%]. While passing from kidneys to bladder, these stones stay in the lower urethra, causing painful spasms. Watchful waiting method [between 1-6 weeks] is one of the most common remedies in the treatment of lower urethral stones on the other hand, alpha-receptors, which help with controlling the spasm, exist in the distal urethras, especially in the trigone of the bladder. So, we decided to study the effects of Tamsulosin [alpha-blockers], as compared to Incomethacin, on patients suffering from distal urethral stones. The objective of this study is to evaluate the effect of alpha-blocker [Tamsulosin] on the expulsion of lower urethral stones in the patients who referred to Bahman 22nd and Aria hospitals in one year. 85 patients who were diagnosed as suffering from urethral stones were randomly divided into 2 groups. 46 patients who were placed in the first group received Tamsulosin [0.4 mg/daily] with suppository of Indomethacin for 10 days. The other 39 patients in the second group received only Indomethacin. After taking the prescribed medicines, the patients were again examined and controlled by KUB and Ultrasound. Then, the results were compared using statistical analysis. 32 of the patients in the first group [the case] who had received Tamsulosin had stone expulsion while the other 14 patients did not. Among the patients in the control group [a total of 39], 22 patients had stone expulsion while 17 patients did not. The result of chi-square test revealed that the 2 groups were not significantly different from each other in terms of stone expulsion and prognosis [P=0.209]. There were no statistical differences between the groups of study according to age, gender and the stone size, either. According to these findings, we do not suggest the prescription of Tamsulosin as an adjuvant therapy for stone expulsion in patients who have lower ureteral stone without considering their stone size and gender. Instead, just prescribing pain relief [if necessary] and physical activity with large amount of oral liquid intake during the watchful waiting period are enough

[ risk factors of cryptorchidism in new born children]

Cryptorchidism is the most common urologic congenital malformation in males which contributed to increasing male infertility and testicular tumors. So, it seems to be necessary to identify its risk factors. Being a case-control study, the investigation consists of 37 cases of cryptorchid boys and 40 normal boys as the control group. Both cases and controls attended a face to-face interview, using the same questionnaire. The collected information was then analyzed by running a chi-square test using SPSS. We found significant positive associations between cryptorchidism and each of the following variables: hypertension during pregnancy [P=0.0327]; premature birth [P=0.0028]; low birth weight [P=0.0478]; UTI during pregnancy [P=0.0162] and brich presentation [P=0.0302]. However, although some risk factors like maternal age, fever during the first trimester of pregnancy, maternal blood group, cesarean section, being the first-born child of the mother and twins have been reported to cause cryptorchidism, we found no evidence to suggest so. In addition, it was the first time that maternal education and UTI during pregnancy were investigated, too. We concluded a significant positive association between UTI during pregnancy, but did not find any relation between cryptorchidism and maternal education. These findings suggest that not only might cryptorchidism be associated with genetic factors, but also can be increased by environmental factors. In order to arrive at more definite conclusions, further studies are needed to be carried out, in this respect

case report of left median ureteral transitional cell carcinoma

Ureteral transitional cell carcinoma [TCC] is the most common cellular type of upper urinary tract cancers which remains undiagnosed for a long time due to its nonspecific symptoms and the unlikelihood of being detected at early stages of investigation. As a result, it is often so well-developed and progressed at the time of admission that it usually leads to a poor survival and high rate of recurrence, even by applying appropriate medical and surgical approaches. Conversely, early diagnosis and therapy is usually associated with a good prognosis. A report of a 65 year old woman with a history of 3 years of recurrent, painless hematuria is presented. The IVP showed a masked left ureteral turtusity associated with mild dilatation of the left ureteral and renal pelvic. The CT scan revealed hypodence foci at the left upper ureter accompanied with dilatation of the left pyelocalyciel system as well as that of the upper and middle parts of the left ureter. Finally, as a result of removing the bladder cuff through a left nephroureterectomy, both ureteroscopy and tissue sampling confirmed a low grade TCC

Surveying ESWL impact on pancreatic enzymes

Urinary stones are the third most common disease of urinary tract. More than 90% of renal stones are successfully treated by ESWL with a success rate of 68-86%. The present study was conducted to survey ESWL impact on pancreatic enzymes. This descriptive-analytic study was performed on 87 patients suffered from renal stone. For all patients, a questionnaire including the demographic features, stone characteristics, and ESWL data, was filled, then, the serum lipase and amylase titers were obtained both before and 24 hours after ESWL. Data were analyzed by SPSS software. The study population included 58 men and 31 women with the mean age of 40 years. 48 had right-sided renal stones versus 39 with left-sided stone. The serum titers of amylase and lipase showed an increment in 57.5% and 61%, respectively, however, this increment was above normal range in only two patients. There was statistically significant association between the increment of serum amylase and lipase [P=0.0001]. The increased serum amylase and lipase was more common in left ESWL. Only in one case of right renal stone, the serum lipase and amylase showed significant elevation following ESWL. In spite of the harmlessness of ESWL for pancreas, it is recommended to measure serum lipase or amylase in ESWL of right kidney to detect the rare cases of acute pancreatitis

Study of the serum and urine calcium in patients with urinary stone in formation Khorasan, Iran

Background and Purpose: Urinary stones are the third most common cause of urinary tract disorders and hypercalciuria is reported in 30% to 55% of patients. Therefore, this study is intended to study the serum and urine calcium in patients with urinary stone formation in khorasan, Iran

Methods and Materials: This descriptive-analytical study was conducted from 2003 summer through 2005 spring on 100 patients [case] and 51 non-patients [control]. Relevant data were collected through questionnaire, serum calcium measurement [morning blood sampling] and urinary calcium measurement [24-hour urine collection]

Results: Hypercalciuria was observed in 9% of the case group and 2% of the control group. No significant difference was observed in the urinary calcium of the two groups. [2.23???1.07 vs. 2.13???1.10 mg per kg body weight/24 hours]. Hypocalcaemia was detected in one of the cases but in the control group, nobody was so. Also, no significant differences were observed in the serum calcium of the two groups [9.07???0.68 vs. 9.13???0.64 mg/dl]

Conclusion: Compared with references and recent publication, regional hypercaliuria is obviously lower and it is inferred that empirical therapy to prevent stone formation by reducing calcium has no therapeutic role. There seems no need for routine examination of serum calcium