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AbbreviationsAKI = acute kidney injury BMI = body mass index CKD = chronic kidney disease DM = diabetes mellitus PN = partial nephrectomy PPV = positive predictive value RN = radical nephrectomy RPN = robotic partial nephrectomy WIT = warm ischemia time

Introduction We evaluated the efficacy and safety of laparoscopic ureterolithotomy (LPU) for the treatment of large proximal ureteric stone. Methods A retrospective multicenter analysis for patients with solitary impacted proximal ureteric stone ≥15 mm who underwent LPU from 2016 to 2019 was performed. Primary outcome was to estimate the stone‐free rate (SFR). SFR was defined as absence of residual stones on postoperative computed tomography scan. Secondary outcome was to assess the perioperative outcomes, as well as to review literature data of randomized controlled trials and meta‐analyses comparing LPU to other treatment options. Results Forty‐four patients were included in our study. Mean stone size was 22.9 ± 5.8 mm and median follow‐up was 14 months. Three patients had previous abdominal surgery, one patient had severe degree of scoliosis and six patients failed primary therapy. All stones were extracted successfully (SFR = 100%) without need of auxiliary treatments. Mean operative time and estimated blood loss were 86.6 ± 14.1 minutes. and 11.9 ± 14.7 mL, respectively. No intraoperative complications or conversion to open surgery were reported. No major postoperative complications (≥grade 3) were reported. Mean length of hospital stay was 2 ± 0.8 days. Conclusions For treatment of large ureteric stones, our study showed that LPU achieves 100% stone‐free status. When performed by well‐trained laparoscopic surgeons, it is safe and has no major perioperative complications. According to our results and literature data, when counseling patients with large impacted proximal ureteral stones, LPU should be advised as the procedure that has the higher SFR, lower auxiliary treatments, and comparable complication rates to other treatments.

Background & Objective: Erectile dysfunction (ED) is one of the extrahepatic manifestations of hepatitis C virus infection that greatly affects patients’ quality of life. Unfortunately, some of the drugs used for HCV treatment may have a negative impact on the patient’s erectile function such as the pegylated interferon. Currently, with the introduction of directacting antiviral drugs, there are scarce data in the literature about its potential impact on erectile function. In these settings, we aimed to assess the impact of sofosbuvir-based therapy on male erectile function. Methods: This prospective interventional study was carried out in Benha University hospitals between January 2019 and May 2020. The study included all consecutive HCV patients with simultaneous ED coming to the hepatology outpatient clinic. Patients were divided into a study group who received sofosbuvir-based therapy (group A) or a control group who received silymarin therapy (group B). The International Index of Erectile Function-5 (IIEF-5) was used for assessment of erectile function at different time points (pretreatment, 6 months, and 12 months after treatment). Different variables in both groups have been statistically analyzed. Results: Overall, 75 patients who received sofosbuvir-based therapy and a control group (n = 35) matched for age and pretreatment variables (Child–Turcotte–Pugh score and Fibrosis‐ 4 score). There was no significant difference between both groups in the pretreatment data. On the other hand, the posttreatment IIEF-5 was significantly higher in the sofosbuvir arm compared to the silymarin arm both at six months (p<0.001) and at 12 months (p<0.001). Furthermore, the age and the stage of liver fibrosis were negatively correlated with IIEF-5 at all-time points. Conclusion: The age and the stage of liver fibrosis are significantly correlated with the degree of ED. Furthermore, sofosbuvir-based therapy may be associated with significant improvement in the patients’ erectile function.

Objectives: The aim of this study was to assess changes in quality of life and pain alleviation in women with refractory Interstitial Cystitis/Painful Bladder syndrome following a combined intravesical injection of Botulinum Toxin-A and Hyaluronic Acid instillation versus Hyaluronic acid instillation alone. Methods: Two groups of women with painful bladder syndrome/interstitial cystitis were randomly divided (one to one randomization). Intravesical injections of botulinum toxin-A and intravesical Hyaluronic acid were given to Group (I). Only Hyaluronic acid was instilled intravesically in Group II. Patients were given voiding diaries, a visual analogue scale for pelvic pain, the International Cystitis Symptom Index and Problem Index, the Pelvic Pain Urgency/Frequency Patient Symptom Scale, and the Patient Health Questionnaire-9 to assess the candidates' quality of life. The Student t-test and mean and standard deviation were used in statistical analysis, with p 0.05 considered as significant (IBM SPSS statistics) Results: Thirty-four women were included in this study. The pain severity (VAS) of group (I) cases dropped dramatically from 8.5 ± 1.5 at the start to 3.9 ± 2.4 after three months and 2.9 ± 2.1 after six months. Among group (II) cases, the pain score reduced dramatically from 8.6 ± 1.3 to 5.8 ± 1.4 to 4.3 ± 2.6. Conclusions: In patients with refractory Interstitial Cystitis/Bladder Discomfort Syndrome, Botulinum Toxin-A injection combined with Hyaluronic Acid instillation improves pelvic pain and improves quality of life.

BaCKgroUNd: The impact of warm ischemia time (WiT) on renal functional recovery remains controversial. We examined the length of WiT>30 min on the long-term renal function following on-clamp partial nephrectomy (pN). MeThodS: data from 23 centers for patients undergoing on-clamp pN between 2000 and 2018 were analyzed. We included patients with two kidneys, single tumor, cT1, minimum 1-year follow-up, and preoperative eGFR≥60 mL/

Objectives: To report on the live birth rates (LBRs) following percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia (OA) and factors affecting treatment outcome which is under reported in the literature.Methods: This is a multicenter study that was conducted in Egypt including all couples undergoing intra cytoplasmic sperm injection (ICSI) for OA using PESA-derived sperms. Men were subdivided according to aetiology into congenital, iatrogenic and idiopathic groups. Fertilization, pregnancy and LBRs were determined and compared in each group. The longitudinal LBR, crude and expected cumulative delivery rates (CCDR, ECDR) were calculated. Multiple logistic regression analysis was used to determine significant associations between maternal, paternal and ICSI factors with successful live births.Results: Ninety couples were included in the study. Viable sperm for ICSI was retrieved in 89 men (98.9%). A total of 155 ICSI cycles with 17 frozen embryo transfers resulted in 81 pregnan-cies and 55 live births. After 5 cycles, the longitudinal LBR, CCDR and ECDR were 30%, 57.3% and 88.6% respectively. Maternal age and number of fertilized eggs were the only fac-tors significantly affecting LBRs.Conclusions: PESA is a minimally invasive procedure for secur-ing viable sperm for ICSI in OA men, with high cumulative delivery rates. Maternal age and number of fertilized eggs are the only factors that significantly affecting LBR. The contempo-rary longitudinal and cumulative LBRs provide objective out-come data to counsel OA patients undergoing fertility treat-ments.