Hormonal levels, semen parameters and presence of antisperm antibodies in patients treated for testicular torsion

In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel of testicular torsion. The objective of this study was to evaluate late endocrine profile, seminal parameters and antisperm antibody levels after testicular torsion and to analyze the impact of orchiectomy or detorsion on the organ's fate. This is a cross-sectional study that involves 17 patients evaluated after testicular torsion 12 patients were treated with orchiectomy [group 1] and 5 were treated with orchiopexy [group 2]. All patients were assessed by semen analysis, endocrine profile [follicle-stimulating hormone [FSH], luteinizing hormone [LH] and testosterone] and seminal antisperm antibody levels. A group of 15 proven fertile men was used as the control group. Results: Median ischemia time in group 1 [48hs] was significantly higher than in group 2 [7hs]. Both groups demonstrated a decrease in sperm count and morphology compared with controls.; Group 1 showed a significantly higher motility than group 2 [p=0.02]. Group 1 also showed a significantly better morphology than group 2, [p=0.002]. All patients presented an endocrine profile within normal ranges and no significant difference in antisperm antibody levels was detected between the groups. However, a trend for higher levels was found in patients treated for testicular torsion, regardless of the fate of the testis. Moreover, no significant correlation was found between antisperm antibody levels and age at torsion, ischemia time, seminal parameters or treatment applied. We found that after torsion, patients maintain hormonal levels within normal ranges. Testicular fate did not have any correlation with the formation of antisperm antibodies. Although sperm quality is preserved in most of the patients with the exception of sperm morphology, patients treated with orchiectomy presented better motility and morphology compared with the detorsion group

Evaluation of bulbocavernosus reflex in the investigation of diabetic impotence

The pathology of erectile dysfunction may be an autonomic neuropathy, vasculogenic, endocrine deficiency, psychological or a combination of these factors This study was undertaken to determine the predictive value of Electrophysiological elicited Bulbocavernosus Reflex in discrimination between neurogenic and non- neurogenic impotence in diabetic patient. Twenty five male diabetic patients were recruited from out-patients attending the urology department at AL-KADIMYA Teaching Hospital. Bulbocavernosus Reflex [BCR] was evaluated on all patients at AL- NAHRAIN College of Medicine department of physiology, using the methods described by Rushworth. Test sensitivity was 72%, while test specificity was 83.3%. An abnormal Bulbocavernosus reflex carries a high probability of neuropathology. A degree of objectivity in the evaluation of possible neurogenic impotence can be offered by testing the Bulbocavernosus Reflex

Treatment of pediatric urolithiasis in Iraq: five-year study

To report our experience with the management of childhood urolithiasis during a 5 year period. Between April 1999 and April 2004, 204 children with urolithiasis were prospectively evaluated, treated, and followed up in a university hospital in Baghdad. There were 150 males [73.5%] and 54 females [26.5%]. There was a history of previous stones in 73 [35.8%]. Stones were located in multiple sites in 80 children. Metabolic disorders were present in 58 [72.5%] of those with multiple sites. Etiology for stone formation was established in 89.7% of cases; 10.3% were idiopathic. Metabolic disorders were detected in 147 patients [72.1%]. Recurrent urinary tract infection was present in 87 patients [42.6%]. Anatomical defects of the renal system were present in 25 patients [12.3%]. The follow up of 156 patients [76.5%] ranged from one month to 5 years [mean= 36 months]. of those 156 patients, surgery was performed on 51. Extracorporeal shock wave lithotripsy [ESWL] was performed in 26, medical therapy was used in 111, and 19 patients were kept on observation. The ultimate stone free rates were 78.7%, 38.5% and 24.3% following surgery, ESWL and medical therapy respectively. Recurrence of stone disease was 19.7% following surgery. Respectively, 46.9% and 11.5% of patients receiving medical therapy, ESWL had no change in stone size. A combined approach with one or more techniques was applied to our patients. Our results indicate that a comprehensive approach to the care of pediatric urolithiasis requires attention to metabolic disorders

Treatment of infertility due to retrograde ejaculation

Retrograde ejaculation is an uncommon cause of infertility. This condition is easily diagnosed and potentially treatable. Patients and This study included 8 infertile couples with the husband having retrograde ejaculation. Motile spermS were obtained using a method of urinary alkalization by systemic medication in addition to bladder irrigation with an alkaline solution. Fertilization was performed by intrauterine insemination. One pregnancy was obtained. Although the success rate in this study was lower than that reported in the literature, for the individual patient affected by retrograde ejaculation, the technique is simple, inexpensive, and noninvasive and may provide a viable and more easily accessible alternative to the more sophisticated methods in current use in specialized centers