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OBJECTIVE: To assess the results of endoscopic ureterocele treatments as well as the effects of ureterocele location (intravesical vs. ectopic) and anatomy (single vs. duplicated system) on treatment outcomes. MATERIAL AND METHODS: Following the Systematic Reviews and Meta-Analyses (PRISMA) standards, several medical databases as well as Google Scholar were searched comprehensively. Studies describing secondary operation outcomes for endoscopic transurethral incision and puncture were included. Studies were required to compare patients according to ureterocele location (intravesical or ectopic) and anatomy (single or duplex system) or preoperative reflux. Meta-analysis was conducted using Comprehensive Meta-analysis (CMA) software. RESULTS: A total of 83 studies entered this systematic review consisting of 3022 patients. According to the meta-analysis of 16 studies, the risk ratio (RR) of reoperation after ureterocele incision was significantly higher in patients with ectopic vs. intravesical ureteroceles (RR: 2.42; 95% CI: 1.89-3.11; P < 0.001; I2: 14.89%). Also, a higher reoperation rate was reported in patients with duplex system ureteroceles (DSU) vs. single system ureteroceles (SSU) with little heterogeneity based on 9 studies. (RR: 2.50; 95% CI: 1.60-3.91; P < 0.001; I2: 13.83%). CONCLUSION: Our results showed that ectopic ureteroceles and duplex systems are associated with higher reoperation rates after endoscopic procedures.
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INTRODUCTION: Various techniques have been developed for the rapid control of bleeding as a potential surgical complication. Research shows that the Surgicel has a significant effect on reducing bleeding in most surgeries; however, in our experimental observations on patients undergoing open prostatectomy, not only no significant reduction was seen in the amount of bleeding, but in some cases, Surgicel led to infection. Therefore, in this study, the effect of the Surgicel on infection and bleeding in open prostatectomy was investigated. MATERIALS AND METHODS: Thirty patients undergoing open prostatectomy were randomly divided into two groups. To control bleeding after suturing the bladder neck, the Surgicel was installed in the first group, while it was not in the second group. Hemoglobin, hematocrit, PT, PTT, INR, bleeding rate, and postoperative complications were evaluated in all patients. RESULTS: In the studied groups, hemoglobin level and hematocrit percentage before surgery and on the first and second days after surgery, along with coagulation status, were compared in terms of PT, PTT, and INR. There were no significant differences between the studied variables and baseline variables. CONCLUSION: The present study revealed that the Surgicel in open prostatectomy was ineffective in controlling bleeding and can lead to infection.
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INTRODUCTION: Considering that the use of aromatase inhibitors in the treatment of infertile men is a new approach and obesity in men is one of the factors affecting infertility, we decided to compare the effect of combined therapy of Human chorionic gonadotropin (HCG) and Letrozole and either of the two methods alone on the spermogram parameters in obese men with idiopathic infertility. MATERIALS AND METHODS: This clinical trial study was performed with the participation of 15 infertile and obese men from 2018 to 2019 in Tabriz (infertility clinics); Patients were randomly divided into three groups; The first group received treatment with Letrozole 2.5 mg daily alone, the second group received treatment with HCG ampoules at a dose of 5000 units twice a week, and the third group received combination therapy with HCG ampoules at a dose of 5000 units twice a week and letrozole tablets at a dose of 2.5 mg daily; The results of testosterone and sperm tests before and after the intervention were evaluated by t-test and linear regression tests in SPSS21 software. A p-value less than 0.05 was considered significant. RESULTS: There was no statistically significant difference between semen indices and hormones studied before the intervention (P < 0.05), while after the intervention there were statistically significant differences between all variables compared to those before the intervention (P < 0.05); Also, the rate of change in the third group was much more favorable than the other two groups. CONCLUSION: The combination of HCG ampules with letrozole tablets compared to the use of these drugs alone improved sperm count, sperm motility, and sperm morphology.
