Testicular torsion: a perspective from the Middle East

Objective: To report our experience in the management of testicular torsion with emphasis on seasonal variation, salvage rate and the status of the torted testis 3-6 months after orchidopexy

Subjects and Methods: Seventy-five patients with a presumptive diagnosis of testicular torsion, who presented to our hospital between January 1999 and December 2002, were included in the study. Following scrotal exploration, 63 patients were found to have testicular torsion. Of these, 11 with nonviable testes had orchiectomy while 52 with viable testes had orchidopexy. Both groups of patients had simultaneous contralateral orchidopexy. Patients who had orchidopexy were followed up 3-monthly by testicular ultrasound to assess the volume of the affected testis

Results: Sixty-three patients were confirmed to have testicular torsion. The average number of new cases in the winter was 6.7 compared to 4 in the summer. Fifty-two patients underwent orchidopexy to give an operative salvage rate of 82.5%. Of 51 patients in whom the duration of torsion was less than 24 h, 1 [2.0%] had a nonviable testis, whereas of 12 patients in whom the duration of torsion was more than 24 h, 10 [83.3%] had a nonviable testis. After a minimum follow-up of 3 months for patients who had orchidopexy, 7 [13.5%] developed testicular atrophy. The incidence rate was estimated to be 7.9 cases per 100,000 population

Conclusion: The highest incidence was during the cold season. The outcome of surgical management of testicular torsion was dependent on the duration of torsion

Extracorporeal shock wave lithotripsy for uorolithiasis-experience with 1500 patients

The advent of endourology and extracorporeal shock wave lithotripsy [ESWL] has radically changed the current therapeutic spectrum for urolithiasis. ESWL is presently the treatment of choice for the vast majority of patients with urinary calculus disease. We report our experiences in treating 1500 patients with urolithiasis by administering shock wave therapy on the Siemen's Lithostar. There were 612 patients with ureteric calculi and 46 with vesical stones. The size of the calculus varied from 4 to 115 mm in the largest dimension. Fifty two patients had co-existing congenital anomalies of the upper urinary tract, 46 had a solitary kidney and 29 had varying levels of renal insufficiency. We treated 96.6% of the patients under intravenous sedation. Pre-ESWL auxilliary procedures were essential in 95.2%, with JJ ureteral stenting in 1406 patients The rate for major complication was 0.4%; we have recorded an average 6 month stone-free rate of 84.6%

Diagnostic imaging in benign prostatic hyperplasia

Transabdominal ultrasound remains the most cost effective method to screen for BPH in patients with normal urinanalysis and renal function and those who did not have history of urolithiasis, urinary tract tumors or previous surgery. CT and MRI should be reserved for tumor staging and follow-up after treatment. Benign prostatic hyperplasia [BPH] is the most common neoplasm that affects men,it is estimated that 80% of men aged 40 years or older will have some changes of benign prostatic hyperplasia and 70% of these patients will develop bladder out flow obstruction

Renal oncocytoma: a case report and review of the literature

Renal oncocytomas are rare tumours which account for only 3% of renal neoplasms. Here we report a case of renal oncocytoma. The symptomatology, radiological findings, histopathology and treatment are discussed