Speedy elimination of ureterolithiasis in lower part of ureters with the alpha 1-blocker--Tamsulosin.

BACKGROUND: Alpha-I blockers decrease the tension and release the spasm of smooth muscles and thus lessen the obstruction and irritation symptoms in the lower urinary tract (LUTS). They make a faster passing of calculi from the terminal part of the ureters possible. OBJECTIVES: The goal of this study was to objectively assess the improvement of difficulties caused by obstructions in ureterolithiasis localized in the lower part of the ureters of 104 randomly chosen patients (pts.) in a double-blind study. METHODS: During a period of 2 and half years (June 1999-January 2002) 104 pts. suffering from ureterolithiasis of the lower urinary tract were treated and observed. Patients were divided into two groups: A (n:53; later only 51 were evaluated) which was subjected to standard treatment and group B (n:51) where the standard treatment was supplemented by the alpha-1 blocker. As alpha-1 blocker one capsule of Tamsulosin/OMNIC 0.4/ was administered daily. RESULTS: With alpha-1 blocker, we have registered a more speedy passing of calculi from the terminal parts of ureters in 17.6% of pts. Recurrence of renal colics was less frequent and occurred in one of eight pts. as compared with group A (without the alpha-1 blocker) where a recurrence of the renal colic was observed in about every fifth pts. In group A (n:51), 62.8% of the pts. passed the calculi, whereas in group B (n:51), where standard treatment was supplemented by the administration of the alpha-1 blocker Tamsulosin, this percentage increased to 80.4%. CONCLUSION: The treatment by alpha-1 blockers considerably decreased not only LUTS but also helped to accelerate the passing of minor calculi from the terminal parts of the ureters of 80.4% of pts. It seems that alpha-1 blockers potentiate the spasmoanalgetic action of drugs used in standard methods of treatment.

[Hemodynamic changes in varicoceles and their relation to fertility]. / Hemodynamické zmeny pri varikokéle a ich vzt'ah k fertilite.

Hemodynamic changes in the vascular bed of the affected testis were studied in 45 sterile and 6 fertile patients with varicocele. The examination method used was modified abdominal angiography. The most frequently recorded change in the arterial bed was persistence of the contrast medium in the left internal testicular artery (5 patients). All these patients were from the group of sterile subjects. The most frequent finding in the venous bed was venous reflux from the left renal vein into the left internal testicular vein (45 sterile and 2 fertile patients). In some sterile patients pathologic opening or origin of the vessels was observed. The substantially higher rate of hemodynamic changes in sterile patients suggests their direct relationship to spermiogenesis.

The influence of various aetiopathogenetic factors on testicular function.

Three hundred and seventy-one patients with azoospermia were examined by means of testicular biopsy. The patients were assigned to seven histological groups according to the degree of damage found in their germinative epithelium. The degree of damage to the germinative epithelium was correlated with the aetiopathogenetic factors.

On the psychopathology of patients with disorders in the descent of the testis.

The authors deal with disorders in the descent of the testis and analyse the causes and manifestations from the point of view of fertility and indications to medical treatment or early surgery. Thirty-nine patients were examined and diagnosed as unilateral or bilateral cryptorchism and retention of the testis. The spermatogenetic functions in individual diagnosis and type of operation are described. They wish to ascertain a mutual connection between sexual function and neurotic symptoms in operated patients with regard to the 3 diagnostic groups.

Congenital anomalies of the seminal ducts.

The frequency of individual congenital anomalies of the deferens, the seminal vesicles, the ejaculatory ducts and the utricle in 158 patients treated for sterility was determined by the method of deferentovesiculography by punction. Congenital anomalies were found in 14 patients (8.8%). Anomalies of rare occurrence are demonstrated in detail. The relation of such anomalies to sterility of patients is described.

Malignant Leydig-cell tumour of testis.

A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention.