Prevention of postcircumcision meatal stenosis

Meatal stenosis is a condition that almost always is acquired after neonatal circumcision. Circumcision is one of the most common surgical operations throughout the world, and meatal stenosis is one its late complications. We evaluated the topical use of a lubricant jelly after circumcision in boys in order to reduce the risk of meatal stenosis. To evaluate the use of lubricant in prevention of postcircumcision meatal stenosis and other complications. From April 2010 to September 2012, 300 boys younger than 2 year old referred to AL-RAMADI TEACHING HOSPITAL IN ANBAR, IRAQ and my clinic, were involved in a randomized controlled trial. They were referred for circumcision. The parents in the study group were instructed to use petroleum jelly on the circumcision site after each diaper change for 6 months. In the control group, no topical medication was used. The children were followed up regularly and evaluated for meatal stenosis, bleeding, infection, and recovery time. Three hundred boys younger than 2 years old participated in the study. None of the children in the lubricant group developed meatal stenosis, while 91 [60.6%] in the control group developed postcircumcision meatal stenosis [P=0 .0000] which is statistically highly significant. Infection of the circumcision site was observed in 2 [1.3%] and 14 [9.3%] children of the lubricant and control groups, respectively [P=0 .0004] which is statistically highly significant. Two boys [1.3%] in the lubricant group and 29 [19.3%] in the control group had postcircumcision bleeding [P=0 .0007] which is statistically highly significant. Finally, the mean time of recovery in the lubricant group was 3.8 +/- 1.2 days, while it was 6.9 +/- 4.2 days in the control group [P = 0.03]. Based on the findings of this study we can conclude that using petroleum jelly after circumcision is considerably effective for reducing postcircumcision meatal stenosis and other complications

effect of acute urinary retention on the accuracy of serum prostate-specific antigen level measurements

The level of PSA in serum is increased by inflammation of the prostate, urinary retention,prostatic infection, benign prostatic hyperplasia,prostate cancer, and prostatic manipulation. [3] To study the effect of acute urinary retention on the serum prostate-specific antigen [PSA] concentration. Blood samples for serum PSA measurement were obtained [PSA1], and an indwelling urethral catheter was inserted for 2 weeks. Before catheter removal, a second blood sample for measurement of serum PSA level [PSA2] was obtained. In patients who were able to void, a third sample was obtained 3 weeks later [PSA3]. In the first and second visits, digital rectal examinations [DRE1, DRE2] were performed to assess prostate volume. Mean PSA levels [PSA1, PSA2, and PSA3] and prostate volumes [DRE1, DRE2] were compared. Fourty-two patients with a mean age of 70.18 years [range 56 to 85 years] participated in this study.mean PSA level at the time of AUR [PSA1] was 7.02 ng/mL [median, 5.8 ng/mL; range, 0.9 to 30.4 ng/mL]. The mean PSA2 level was 5.5 ng/mL [median, 3.9 ng/mL; range, 0.7 to 39 ng/mL], lower than the PSA1 level.This association was statistically non significant P>0.05. The mean prostate volume at the time of DRE1 [43.4 mL; median, 45 mL; range, 30 to 60 mL] was significantly higher than at DRE2 [37.8 mL; median, 40 mL; range, 25 to 50 mL] [P<0.001]. PSA3 was measured in 42 patients 4 weeks after retention [2 weeks after catheter removal]. In this group of patients, mean PSA2 and PSA3 levels were 5.5 ng/mL and 5.1 ng/mL, respectively [median, 3.9 and 3.5, respectively, P>0.05]. Acute urinary retention can increase serum PSA levels. In this series, we found that this effect may continue up to 2 weeks

Association between testicular microlithiasis and infertility

Testicular microlithiasis [TM] is an uncommon condition, usually brought to attention when some other condition is being investigated. There have been reports suggesting a link between testicular microlithiasis and testicular dysfunction and tumors. To study the association between testicular microlithiasis and male infertility. From January 2010 to January 2011, 140 patients with different scrotal lesions presented to urologic consultation department at Al-Ramadi teaching hospital were included in this prospective study, all patients were examined by gray scale and doppler ultrasonograghy, their age ranges from 15 to 55 years. All cases of microlithiasis were recorded and complete information obtained from each patient. Seminal fluid analysis [SFA] was done for each patient with microlithiasis. The age of patients ranges from 15 to 55 years [mean 34.6]. Of 140 patients, 6 patients had microlithiasis [4.28%]. Of 6 patients with microlithiasis, 5 patients were married and infertile and one of them had varicocele and one patient had testicular atrophy. One patient was unmarried but has varicocele and abnormal seminal fluid analysis. There is strong association between testicular microlithiasis and infertility. Hypospermatogenesis in patients with TM may relate to both the degree of testicular dysgenesis and the presence or absence of concomitant scrotal pathology [eg, scrotal varicocele and testicular atrophy]