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ARTICLE INFO ______________________________________________________________ ______________________Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. Materials and Methods:In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups.Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

Totally ultrasonography-guided PCNL has satisfactory outcomes compared with the standard technique of PCNL, without any major complications and with the advantage of preventing radiation hazards and damage to the adjacent organs. Furthermore, using this technique, anesthesia is more tolerable in the flank position.

Even in our first report with limited experience, it seems that the efficacy of PCNL with ultrasonography in supine position is comparable to PCNL in prone position with fluoroscopy with no more complications.

To compare the amount of the kidney displacement in the complete supine percutaneous nephrolithotripsy (PCNL) to the prone PCNL during getting renal access. Thirty-three patients were randomly divided into two groups. The patients in group A were placed in the complete supine position and the patients in group B in the prone position. Amounts of the kidney displacement in three states and other data were analyzed. The mean amount of the kidney displacement in the complete supine PCNL was 10.1 ± 7.9 mm in stage 1, 10.7 ± 8.28 mm in stage 2 and 12.2 ± 10.4 mm in stage 3. The mean amount of the kidney displacement in prone PCNL was 16.6 ± 5.8 mm in stage 1, 16.2 ± 6.3 mm in stage 2 and 17.6 ± 6.7 mm in stage 3. In stages 1 and 2, a significant difference between the two groups derived from the mean amount of the kidney displacement, but the difference was not statistically significant in stage 3. Adjusted for age, gender, BMI, stone burden and position of PCNL, prone position was a predictor caused significantly more displacement in all three stages. Among other predictors, only BMI had a significant effect on the amount of the kidney displacement (in stages 2 and 3). Performing PCNL in the complete supine position is safe and effective and leads to less kidney displacement during getting renal access and therefore, it may be considered in most patients requiring PCNL.

Objective: This study aimed at comparing the urinary protein levels in calcium stone formers with those of healthy individuals. Patients and Methods: From January 2002 until June 2004, 100 calcium stone formers (mean age 38.6 ± 10.3 years), who had at least two episodes of calcium stone formation, were compared with 100 healthy individuals (mean age 33.8 ± 9.7 years). Their 24-hour urinary protein levels, using SDS-PAGE, were measured. Results: The mean 24-hour urinary Tamm-Horsfall protein (THP) levels were 3.3 ± 0.8 mg in the case group and 4.6 ± 1.9 mg in the controls, and the difference was not statistically significant (p = 0.53). However, the THP levels in individuals with and without bacteriuria were significantly different (15.8 ± 3.3 mg vs. 2.6 ± 1.0 mg, p = 0.0001). The mean 24-hour urinary albumin concentrations were 163.31 ± 15.1 mg in the case group and 74.26 ± 4.6 mg in the controls. The mean 24-hour urinary transferrin levels were 8.09 ± 2.7 mg in the case group and 0.40 ± 0.3 mg in the controls. The differences were statistically significant for both albumin and transferrin (p < 0.0001 and p = 0.0063, respectively). There were no significant differences in any other mean urinary protein concentrations between cases and controls. Conclusions: The THP level in the urine of stone formers is not quantitatively different from that of healthy individuals, but it increases in association with bacteriuria. Albumin and transferrin may play a presumptive role in stone formation.

Laparoscopic transperitoneal ureterolithotomy is a safe and effective treatment modality for skilled surgeons and a convenient option for patients. Challenges, such as lower ureteral stones, redo cases, and antegrade double J stent insertion, can be overcome by experience.

Scrotal ultrasound is a non-invasive method to evaluate spermatic veins in varicoceles. Ultrasound can evaluate venous dimension change at rest after upright position (ΔD(R) ). ΔD( R) > 2.5 mm distinguishes patients with abnormal semen analysis. ΔD( R) has the most accuracy in predicting abnormal spermatogenesis. Ultrasound findings improve differentiation between patients with abnormal and normal spermatogeneses.