Does inhibin-B help us to confidently refuse diagnostic testicular biopsy in azoospermia?

In the recent years, the use of laboratory blood factors such as FSH and inhibin-B for the assessment of spermatogenesis in different studies has increased; of course, the conflicting results have also been achieved. To investigate if the measurement of inhibin-B can help surgeon to reduce unnecessary diagnostic testicular biopsies in males with azoospermia. This cross-sectional study was done during July 2006 to September 2007 on 41 patients with azoospermia. FSH and inhibin-B were measured and bilateral open testicular biopsy was performed for all patients. Sperm was seen in 29% of biopsies that in 100% of these samples inhibin-B was more than 100 pg/mL and FSH was less than twice the normal [p=0.001]. Inhibin-B had significant correlation inversely with testicular fibrosis and Sertoli cell only syndrome [p=0.043 and p=0.011, respectively] and directly with incomplete spermatocytic maturation arrest and obstructive azoospermia [p=0.027 and p=0.013, respectively]. FSH was only correlated with obstructive azoospermia [p=0.001]. We suggest that if FSH is less than twice the normal, inhibin-B should be measured and if its level is less than 100 pg/mL, we can cancel about the half of unnecessary diagnostic testicular biopsies

Comparison of snodgrass and mathieu surgical techniques in anterior distal shaft hypospadias repair

To compare the outcomes of Mathieu and Snodgrass techniques in the repair of anterior distal shaft hypospadias. From 2001 to 2003, 33 patients with the mean age of 7.06 +/- 3.44 [range 2 to 12] years suffering from anterior distal shaft hypospadias, were assessed. Inclusion criteria were anterior distal shaft hypospadias, and exclusion criteria were association with chordee, circumcision, and surgical repair history. Fifteen patients underwent surgical repair using Snodgrass technique and 18 patients, using Mathieu technique. Surgeries were performed by one single surgeon, acquainted with both techniques. Patients were examined 1 week, 1 month, and 6 months after discharge. Data including duration of the surgery, stenting time, duration of hospitalization, and any kind of complications such as break down, meatal stenosis, and fistula formation were collected. Also, success rate was calculated for every single patient and accordingly, the two groups were compared. Mean operative time, stenting duration, and hospital stay were 94 +/- 26.06 minutes, 5.06 +/- 1.31 days, and 3.93 +/- 1.86 days in Mathieu group and 106.11 +/- 23.04 minutes, 5.11 +/- 1.56 days, and 4.55 +/- 1.29 days in Snodgrass group, respectively [P >0.05]. The rate of break down, meatal stenosis, and fistula formation were 0%, 0%, and 5.55% in Mathieu group and 0%, 6.66%, and 13.32% in Snodgrass group, respectively [P >0.05]. Success rate was 80.02% in Snodgrass group and 94.45% in Mathieu group [P >0.05]. In spite of some reports about preference for Snodgrass technique, we concluded that these techniques are as acceptable and as effective as each other for hypospodias repairing, regardless of cosmetic outcomes; however, we need further studies and larger sample sizes to determine which is the superior technique

Effect of antibiotic therapy on asymptomatic bacteriuria in kidney transplant recipients

Asymptomatic bacteriuria is a very common complication after kidney transplantation and the need for antibiotic therapy is controversial. The aim of this study was to evaluate the effect of antibiotic therapy on the clinical course of asymptomatic bacteriuria in renal transplant recipients. In the present study, 88 kidney transplant recipients with asymptomatic bacteriuria were divided into two groups of cases and controls. The patients had been selected from among those with at least 1 year follow-up. In the case group, asymptomatic bacteriuric episodes were treated with antibiotics, and in control group, they were followed without antibiotic therapy. The follow-up period was 9 to 12 months. Bacteriuric episodes, symptomatic urinary tract infection [UTI] episodes, and changes in plasma creatinine level were recorded and compared between the two groups. The rate of bacteriuric episodes and symptomatic UTIs were not significantly different between the two groups [P >0.05]. In addition, level of plasma creatinine did not increase significantly in neither of the groups during the study [P >0.05]. It seems that treatment of asymptomatic bacteriuria in kidney recipients does not decrease the rate of UTI episodes afterwards. Asymptomatic bacteriuria does not affect renal function in short term. Thus, we can abandon antibiotic therapy, subject to careful follow-up