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

Human leukocyte antigen in iraqi azoospermic patients a pilot study

Approximately 15 to 20% of infertile men have azoospermia. In the Y chromosome, a deletion termed the azoospermic factor has been found in cases of idiopathic azoospermia. It remains unresolved if MHC-mediated effects on fertility are based on direct immunological or non-immunological effect of human leukocyte antigen [HLA] genes or rather on defects in MHC-associated non-HLA genes that affect gamete quality and embryonic development. The object of this study was to study HLA genes in azoospermic Iraqi men for the first time in order to detect any association between HAL class I antigens and idiopathic azoospermia. A prospective pilot study was conducted from July 2001 to February 2002. Twelve azoospermic patients were tested from the Department of Urology at the Medical City Hospital, and 26 married, fertile males were studied as a control group. HLA typing was performed at the histocompatibility laboratory of the kidney transplant unit HLA-A, - B and -C antigens were determined using the two-stage lymphocytotoxicity test. HLA-A3, A26 and B21 were significantly higher in azoospermic patients in comparison with the control group [P<0.05]. The findings suggest that idiopathic azoospermia may have a genetic basis related to HLA factors

association between vesicoureteral reflux and HLA class I antigen

vesicoureteral reflux is a retrograde propulsion of urine into the upper urinary tract during bladder contraction. Five grades were standardized based on degree of dilatation affecting the ureter and renal collecting system. The main etiological factor is the genetic predisposition. To find if there is a correlation between HLA class I antigen and VUR. A study was conducted on 25 VUR patients admitted to the Medical City Hospital and 50 normal individuals selected from healthy kidney donors attending kidney transplantation unit in the period between August 2002 and February 2003. HLA typing to HLA class I antigen using standard microlymphocytotoxicity technique was done for each individual. HLA class I antigens were detected in each group, which showed higher frequencies for HLA-A23, A25 and B16 among VUR patients, yet no statistical significance was observed

Non-urological conditions found in patients who referred themselves to a urology clinic

In the absence of an organized referral system, some patients may refer themselves to a specialty clinic. The aim of this study was to demonstrate the non-urological outcomes found in a group of patients who referred themselves to a urological clinic. Thirty-six [13 males and 23 females] out of 1234 self-referred patients, were included. They presented to the urology clinic thinking that their diseases were urinary in origin. They were clerked and investigated. Diagnoses of 28 different non-urological conditions were made. Specialists should have a high index of suspicion when evaluating patients of the possibility of diagnosis unrelated to their specialty. The importance of a complete history and physical examination is reemphasized

Cytomegalovirus [CMV] infection in kidney transplantation patients: a local experience

Renal transplant recipients are at an increased risk for CMV infection. The goal here was to study the experience with CMV in an Iraqi kidney transplantation program. The records of 100 patients who underwent transplantation from January 1997 to August 2000 were reviewed with regard to CMV infection. Enzyme-linked immunosorbent assay [ELISA] technique was used. Sero-negative recipients were transplanted only from sero-negative donors. Fifty-three recipients had donations from related donors and 47 received kidneys from non-related donors. Five sero-positive patients developed CMV infection. This occurred 1-5 months after the transplant. Jaundice, pneumonia, myelodepression, and septicemia were the main clinical presentations. Three patients were lost to follow up. One patient died. One patient, who received acyclovir, has survived. The survival of the patient treated with acyclovir was unexpected and raises questions about its possible effectiveness in prophylaxis

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