Background: To provide the urologist with the proper histopathological diagnosis of nephrectomy specimens, to correlate the compatibilty of clinical diagnosis and indications of nephrectomy with histopathological results and to see the relative frequency of each type and its specific pathologic characters. The study was conducted at Azadi teaching hospital and in the department of pathology, college of medicine, university of Duhok during a period from (Nov 2012-Nov 2014). A total 161 nephrectomy specimens were examined grossly. Representative blocks were taken for histopathological examination. 76 patients (47.2%) of the patients were males, (85) 52.8% were females, with male: female ratio of 1:1.08. The mean age was 35.6 years. The histological examinations revealed in descending order 62.65% were inflammatory conditions (including chronic pyelonephritis, xanthogranulomatous pyelonephritis and tuberculous pyelonephritis). Adult type malignant conditions were found in 26% of the total cases (including renal cell carcinoma and transitional cell carcinoma). Only one case was lymphoma and other metastatic carcinoma. 9.8 % were cystic lesions of the kidney, 4.96 % were pediatric tumors (including nephroblastoma only), 2.48% was angiomyolipoma. The study concludes a wide range of renal pathology in this locality, histopathological examination for every nephrectomy specimen is the corner stone for a clinico-morphological correlation and proper management. The chronic pyelonephritis is the most and frequent pathologic indication for nephrectomy irrespective of age or sex. Xanthogranulomatous pyelonephritis is seen in age below 25 years and was usually associated with nephrolithiasis. Renal cell carcinoma is the most common kidney cancer in adults affects mainly males followed by transitional cell carcinoma and Nephroblastoma which is the main type of malignant tumors of the kidney in children. Secondary in the kidney, SCC and lymphoma are rare tumors.

Background and Objectives: Urinary bladder like any organ in the body that involved by many non-neoplastic and neoplastic lesions. These lesions are more disabling than being fatal. Bladder tumor is the seventh most common tumor worldwide. Although progress has been made in the field of non-invasive imaging, histopathological study of bladder biopsy still the gold standard for tumor diagnosis, grading, staging and management conducted to clarify the pathological changes of various lesions in the urinary bladder biopsies that obtained by cystoscopy, and to categorize the bladder tumor according to WHO classification. Subject and Method: All the subjects involved in this study were obtained from central laboratory and private laboratories in period extended from January 2009 to December 2015 Results: Histologically 376 cystoscopic biopsies w and females were 90 (23.9%); the male to female ratio was 3.1:1 Non neoplastic lesions accounted for 97 cases (25.8%), Neoplastic lesions accounted for 279 total cases 9.4% of patients were pres there were 87 (89.7%) inflammatory lesions, and the urothelial transitional cell carcinomas were the most common histopathological ones among the neoplastic lesions 278 (99.6%). Adenocarcinoma were found in three cases, squamous cell carcinoma in two, one with sarcomatoid carcinoma and metastatic lesion in one. Conclusions: This study conclud neoplastic ones. The non-invasive low grade tansitional cell carcinoma is the commonest type among bladder tumors and more frequently seen in males above age of 60, where's inflammatory lesions are more frequent non neoplastic dise presenting symptom of the patients with bladder lesions.

Background: percutaneous nephrolithotomy (PCNL) is regarded as the treatment of choice for most renal stones larger than 2cm. Colon injury is one of the rare and preventable complications during PCNL. The rare and unusual location of the colon behind the kidney (retrorenal colon) is an anatomical predisposing factor and other factors that can result in colon perforation during PCNL. Aim: To evaluate the prevalence of retrorenal and posterolateral colon and among CT scanned patients.Patients and methods: one thousand CT scanned patients of all ages and both sexes were included and their CT images were evaluated prospectively at the CT scan center at Azadi Teaching Hospital for the presence of retrorenal colon and the relation of the colon to different parts of the kidney. Results: In this study, 1000 CT scanned patients of different ages and both sexes were included. There were 522 males and 478 females; their ages ranged from 6 to 85 years. The overall prevalence of retrorenal colon was 7.5% (6.3% in males and 8.7% in females). The prevalence of retro renal colon according to different ages was: at below 10 y was 16%, 11-20 years 8.3%, 21-30 y 5.9 %, 31-40 y 7.2 %, 41-50y 7.2%, 51-60y 11.2%, 61-70y 5.8% 71-80y 7.2% and at 81-90 y was 9%, and the differences regarding the ages and sexes were statistically not significant. The lower pole of the left kidney is the most common part involved by the retrorenal colon in 70.6%, while the right lowers pole by 12%, the left middle part by 10.6%, and bilateral lower poles by 6.6%. Conclusion: Locally, the prevalence of retrorenal colon is within the usual range with no sex or age predominance, and a pre-operative abdominal CT scan (native one) is a diagnostic one and is essential if left lower renal calyx is planned to be targeted to avoid colonic injury.

Background and Aim: Anterior colporrhaphy means plication of the anterior vaginal wall fibromuscular layer to correct the prolapse and to support the bladder, and is considered a traditional procedure. Urinary symptoms may associate cystocele like irritative urinary symptoms and stress incontinence and these symptoms may be relieved upon cystocele correction. However, cystocele repair may lead to urinary symptoms due to extensive local dissection of the anterior vaginal wall that results in bladder denervation injury. The aim of this study is to study the urinary symptoms before and after cystocele repair. Patients and Methods: A prospective cross-sectional study was performed including 100 patients referred for anterior colporrhaphy surgery from March 2018 through December 2019 at the departments of Urology and gynecology at Azadi Teaching Hospital and Duhok Maternity Hospital in Duhok City, Kurdistan Region/Iraq. Pre and postoperative urological symptoms were evaluated. Results: One hundred female patients subjected to anterior colporrhaphy, the mean patient's age was 39.42 years, the mean parity was 5.57 and BMI was 28.60. Seventy-five 75% of patients had history of vaginal delivery, while 25% of them had history of both vaginal delivery and cesarean section. The results show significant improvement of vaginal bulge by 92%, Stressincontinence(SI) 71.4%, urge incontinence 67%, frequency 59%, urgency 57.3%, nocturia 57% and dyspareunia 60%. Meanwhile, urinary tract infection and obstructive urinary symptoms were not significantly improved. Conclusion:The study showed that women with coexistent irritative urinary symptoms and stress urinary incontinence with POP will show significant improvement after surgery.

Background: surgical sperm retrieval and in vitro fertilization using intracytoplasmic sperm injection is the only hope for the infertile men with permanent azoospermia to father a biologic child since its introduction by the Palmero group in 1992. Aim of the study:To study the testicular sperm retrieval rate of azoospermic infertile men and the pregnancy outcome by intracytoplasmic sperm injection at Azadi infertility center. Patients and methods: A retrospective study of 220 azoospermic infertile patients were evaluated and dealt with at Azadi infertility center at Duhok, Kurdistan, Iraq, during the period from 2011-2020. They were diagnosed with either obstructive or nonobstructive azoospermia. One hundred forty-three of them were subjected to conventional testicular sperm extraction for sperm retrieval, and the sperms, when detected, were cryopreserved if the surgery was performed in advance. Sixty-one couples accepted the option of intracytoplasmic sperm injection at the Azadi infertility center. Ovarian stimulation performed by the gonadotrophin-releasing hormone agonist and antagonist protocol, and intracytoplasmic sperm injection was performed by the embryologist. The pregnancy result was regarded successful if serum βhCG level is more than 25 mIU/ml two weeks after embryo transfer or miscarriage if serum βhCG level is below 25 mIU/ml or lack of fetal heart beating in trans vaginal ultrasound examination. The pregnancy is then followed regularly through the antenatal care unit. All the completed pregnancies were delivered by the Caesarian section. Results: Out of 1301 infertile couples, 220 (16.9%) were azoospermic. Testicular sperm extraction was performed for 143 men. One hundred and one men (70.6%) were positive and 42 men (29.3%) were negative for sperm retrieval and 61 of them accepted to proceed for intracytoplasmic sperm injection, 47 (77%) with obstructive azoospermia and 14 (23%) with nonobstructive azoospermia. Freshly extracted sperms were used in 40 (65.6%) ICSI cycles while cryopreserved sperms in 21(34.4%) cycles. The number of ova retrieved ranged from 2-17 with a mean of 8.6. Successful fertilization confirmed in 57 cycles and positive biochemical pregnancy confirmed in 27 (47.3%), miscarriage in 4 out of 27 pregnancies (14.8%) and 16/57 (28%) gave live birth of 11 singletons, 4 twins and one triplet and seven still with ongoing pregnancy. Two birth defects were reported among the delivered babies. Conclusions: The sperm retrieval rates in obstructive azoospermia were lower than the usual rates using the conventional testicular sperm extraction. Microsurgical testicular sperm extraction is advised for nonobstructive azoospermia. The fertilization rates, biochemical pregnancy, miscarriage and baby take home were within the usual rates no increase in the birth defects rates in ICSI.

Background: Diagnosis of acute appendicitis continues to be a real challenge in clinical setting. The recurrence or persistence of pain in the right lower abdomen following appendicectomy is known as post appendicectomy syndrome. This is mainly duetopreoperative misdiagnosis (or over diagnosis) and/or postoperative complications. Negative appendicectomy (appendicectomy in the absence of appendiceal disease) rate has been on the rise. In this study, we looked at patients with recurrent orpersistent right iliac fossa pain post-appendicectomy and investigated the potential causes for this. Patients and methods: A prospective study, 47 post-appendicectomy patients presented to Duhok Emergency Hospital, Kurdistan region, Iraq with recurrent or persistent right iliac fossa pain (January 2017-January 2019). Detailed history taking and clinical examination, as well as appropriate investigations were undertaken as well as review of the previous admission records, investigations, surgical notes and histopathology reports. Results: Clinical assessment and investigations confirmed the presence of primary cause, other than acute appendicitis or appendectomy-related, for the pain (negative appendicectomy). These included: gastroenterological and inflammatory (lymphadenitis, adhesions, stump appendicitis, familial Mediterranean fever, and perforated duodenal ulcer), gynaecological (ovarian cyst, dysmenorrhea, polycystic ovary syndrome), urological (renal stones, ureteric stone, acute right pyelonephritis) and locomotors (disc prolapsed). In 22 patients, no surgical cause was found and a diagnosis of functional pain was given. Conclusion: In our study, we have managed to identify the causes of negative appendicectomy. We could not quantify the incidence of such cases but do recognise that these cases raise a question about how to improve diagnostic accuracy. Until now, no diagnostic tool could give a 100% accurate diagnosis but rather a combination of clinical judgement following history and appropriate examination and investigations.

Background:To evaluate the efficacy and safety of pediatric ureteroscopy and Holmium: YAG laser lithotripsy in the management of ureteric calculi in children. Patients and Methods:A Prospective study of 49 children (age ranged 2 ureteric calculi underwent ureteroscopy with a semi Holmium:YAG laser lithotripsy. The stone size ranged from 4 KUB, IVU and CT scan in some cases. All the procedures were done under general anaesthesia and on lithotomy position, and JJ stents inserted at the end of the procedure. Results:Of 49 patients, 43 patients were stone free after first ureteroscopic lithotripsy and after a second ureteroscopy in five patients, one patient developed ureteric injury and treated with open ureterolithotomy.Postcases with fever, 3 with gross hematuria and one with urinary extravasation due perforation. Conclusions:Ureteroscopy and Ho:YAG laser lithotripsy is an effective and relatively safe in the treatment of pediatric ureteric calculi.

Peripheral blood lymphocytes from goats (local breed) were cultivated in RPMI-1640 medium containing 15µg/ml of BudR 20 µg/ml of PHA for different times (12, 24, 36, 48, 60, 72 and 96( hrs. to determination the cell cycle duration. Blastogenesis was appeared post first 12hr of cultivation followed by first mitoses post 24 hrs. of culture initiation. The second and third cell cycling lasted 22 and 21 hrs, respectively. Effects of 6-thioguanine, methotrexate , colchicine and tamoxifen on cell cycle progression were investigated. Goat cells were found to be resistant to tamoxifen and MTX and sensitive to 6 TG and colchicine, which could be use as genetic markers to chick cellular genome integrity. Priming of goat blood lymphocytes was achieved by treating the blood with PHA for 24hr. Such treatment increased the in vitro growing period of derived lymphoblasts with short cycling time. However, PHA was found to be a promoting factor for initiation of blastogenesis and cell divisions in goat blood lymphoblasts. These techniques: Genetic markers, cytogenetic analysis cell cycling and lymphoblast explantation are crucial processes for nuclear transplantation processes.