ABSTRACT
In this review, we discuss the treatment options for male hypogonadism and the associated benefits and potential short- and long-term risks. The choice for treatment may depend on the cause of hypogonadism and the desire for maintaining or improving fertility. We also highlight surgical management of male hypogonadism. Comprehensive searching strategy through Well-known medical databases [MIDLINE/ PubMed, and Embase] searching articles that published in English language up to December 2017, and discussing the surgical management of male hypogonadism. Malehypogonadism is identified by the presence of symptoms or signs of male hypogonadism and consistent serum testosterone levels that are below the normally accepted adult male range. Once the medical diagnosis is confirmed, the primary goal of treatment is testosterone substitution to accomplish serum testosterone levels that remain in the mid-adult range and the symptoms and signs of hypogonadism are eliminated. Recent developments led to numerous delivery systems for testosterone. For patients with primary hypogonadism testosterone therapy is the approach of choice. The patient needs to be completely informed about expected benefits and side-effects of the treatment option. The option of the preparation should be a joint decision by a notified patient and the doctor
ABSTRACT
Unilateral ureteral obstruction [UUO] is a popular speculative version of renal injury, associated with kidney drop. Throughout the time of UUO, nephron damage is started by a boosted intratubular hydrostatic pressure and also secondary ischemia. In the course of the disease, even more, general arbitrators of kidney injury are invited
Objective: primary goal of this review was to highlight the complications following the unilateral ureteral obstruction [UUO] and obstructive uropathy in general, as well as to discuss the therapeutic strategies for this urological condition
Material and method: we review the Published literature concerning unilateral ureteral obstruction [UUO] up to August, 2017. Search was conducted using electronic databases; Medline, and Embase. Search strategy through mentioned databases was performed using medical subject headings [MeSH] as following, "obstructive uropathy", "obstructive nephropathy", "Unilateral ureteral obstruction", "UUO". Furthermore, bibliographic of the articles were manually searched for having more relevant studies. Restriction to our search was applied to only English language published studies
Conclusion: speculative UUO is an animal version of the human condition, which duplicates not only human-ureteral-tract-obstruction-induced kidney injury, it is largely held that CKD happens consequently of the procedure of damaging fibrosis. UUO is a well-described model of renal fibrosis and the mood of CKD occurrence while UUO persisting. Additionally, several crucial procedures in the pathogenesis of AKI as well as CKD, such as tubular cell injury, interstitial inflammation and fibrosis. Management approaches of UUO can be through several steps; first the diagnostic management which will indicate the need of the following two steps of treatment; whether pharmacological, as rapamycin substantially undermined kidney interstitial damages in a UUO-induced rat version of renal fibrosis, suggesting that rapamycin could have the possibility to postpone the progression of the transformation of renal mesenchymal and kidney fibrosis of surgical treatment
ABSTRACT
Background: Stone size is a key factor in the determination of the success of treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery
Aim of the Study: to assess and compare the efficacy of retrograde intrarenal surgery [RIRS] in the treatment of kidney stones greater than 2 cm versus percutaneous nephrolithotomy [PCNL]
Patients and methods: A retrospective analysis was carried out for a total of 118 patients, of which 46 patients underwent RIRS while 72 patients underwent PCNL between May 2013 and May 2017
Results: The mean duration of operation was 96.39 +/- 41.11 min in the RIRS group and 69.51 +/- 19.3 min in the PCNL group [p<0.001]. Hospital stay was significantly shorter in the RIRS group [1.32 +/- 0.6 vs. 4.19 +/- 1.9 days] in the RIRS and PCNL groups respectively [p<0.001]. Stone-free rates after one session were 67.4% and 90.3% of the RIRS and PCNL groups, respectively. Blood transfusions were required in two patients in the PCNL group. Complication rates were generally higher in the PCNL group
Conclusion: The present study concluded that RIRS can be a successful substitute to PCNL in the treatment of kidney stones with a diameter of 2-4 cm particularly in patients with comorbidities