Outcomes of HUD Versus CIC in Patients With Urethral Strictures

Treatment of urethral stricture is a complex reconstructive urology treatment. Previous surgery in the treatment of urethral stricture increases the risk of urinary incontinence. Therefore, this study aimed to assess the outcome of comparing two preservative or nonsurgical methods, clean intermittent catheterization (CIC) or hydraulic urethral dilatation (HUD). Forty-eight patients diagnosed with symptomatic urethral stricture were enrolled in the study. Patients were randomly divided into two groups: Nelaton-based dilatation and HUD treatment. Patients were assessed using patient-reported outcome measure for urethral stricture surgery (USS-PROM) through direct clinical interview and were followed up for 12 months. The rate of urinary infection, the need for surgical intervention, and the patient's quality of life were considered as outcomes of the interventions. SPSS software, version 20.0, was used for statistical analysis. Overall, 23 (47.9%) patients underwent HUD of stricture and Nelaton-based dilatation of stricture was done in 25 (52.1%) patients. We found that surgical intervention was required in four patients in the HUD group, but 15 patients in the CIC group required surgical intervention. Also, the need for surgical intervention and urinary tract infection (UTI) was significantly greater in the CIC group compared with the HUD group. With respect to the patient-reported outcomes, the mean Peeling's voiding picture (Q8) and EQ-VAS score (Q16) in the HUD group (p = .02) were significantly greater than those in the CIC group (p = .02). We obtained excellent results by using an HUD catheter. This safe, simple, well-tolerated, home-based procedure reduced the need for hospital admission to operate for repeat.

Genital Ulcer as a Complication of COVID-19 Infection: A Case Report

Coronavirus disease 2019 (COVID-19), as a pandemic disease and a global concern, is a respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides its common symptoms, some other less common symptoms, including genital ulcers, have been reported. Other complications such as autoimmune disease can present with genital ulcers. Differential diagnosis includes Reiter syndrome, Behcet's disease, and psoriasis. We report a 32-year-old married man with genital ulcers due to COVID-19 infection and as a complication of his disease.

Ventral-Onlay Buccal Mucosal Graft Urethroplasty of a Perineal Fistula in a 26-Year-Old Patient With 46 XX Male Syndrome: A Case Report

Substitution urethroplasty with either a flap or graft is the gold standard for treating long segment urethral strictures. In 1992, Burger and colleagues rediscovered and popularized buccal mucosal graft (BMG). After that El-Kassaby and colleagues, in 1993, used BMG to repair anterior urethral stricture. De la Chapelle syndrome or 46 XX male syndrome is a rare genetic disorder found in 1 in 20,000-25,000 men. This condition described as a presentation of male phenotype along a 46 xx karyotype. In this case report, we report a reconstructive surgery of a 46 XX male syndrome with ambiguous genitalia who presented with the chief complaint of bulbar urethral fistula opened in the perineal space. In this case, we used a buccal mucous graft with the ventral-onlay urethroplasty technique for reconstructing the failed bulbar urethra and closure of the fistula.

A 16-year Remained UroLume Stent without any Complication; a Case Report

Lumen diameter reduction which is called urethral stricture has several causative agents including iatrogenic, inflammatory, traumatic, and idiopathic factors. The main treatment options are transurethral or open surgical interventions.The UroLume which was introduced around 33 years ago is an intraurethral stent and as a temporary treatment approach has a maximum 9-month durability, but here we present the first ever reported forgotten 16-year remained UroLume without any complication.

An unusual urethral foreign body "AA battery" associated with urethral stenosis: A case report

Urethral foreign bodies are rare with a variety of causes, including psychiatric illness, autoeroticism, intoxication, and perceived contraception, we present a 49-yr-old man who went to the emergency ward 9-month ago inserting an AA battery in his urethra. The battery was removed without surgery after 24 hours. The patient was then referred to the hospital after 5 months with complaints of obstructive urinary symptoms such as decreased urinary caliber, diagnosed with penile urethral stricture, and undergoes dilatation of the urethra. Usually, in the case of urethral stricture, the initial steps including urethral dilation and internal urethrotomy can be used.

Pan-urethral stricture with epidermolysis bullosa (EB): A case report

EB is an inherited skin disease that presents with the symptom of skin blisters following trauma, Involvement of the Urogenital system in these people is in the form of meatal stenosis, urinary tract infection and ureteral stricture. We introduce patient with EB and urethral involvement. A 32-year-old man without prenatal problems whose EB skin symptoms started at 6 months of age and urinary symptoms started at 12 years of age. Skin changes on prenatal ultrasound at 18 and 21 weeks of gestation will help in the diagnosis. Follow-up of EB patients with ultrasound will help to identify urogenital complications earlier.

Determining the Effect of Ashwagandha Plant Powder on Men with Semen Disorders

Introduction: Infertility, which is defined as the inability to conceive after one year of intercourse without the use of contraceptive methods, affects 15% of couples. 30-40% of the causes of male infertility are related to sperm disorders. The most common cause of infertility in men is their inability to produce enough healthy, active and active sperm, so the aim of this study was to determine the effect of ashwagandha powder on men with semen disorders. Materials and Methods: This study is a double-blind, clinical, randomized trial. Subjects were entered the study after obtaining informed consent and having inclusion and exclusion criteria. All subjects were clinically examined by a urologist. Blood and urine tests were also performed to ensure the health status of the individuals. Subjects did not take any PDE-V inhibitors or glucocorticoids, chemical, herbal and hormonal drugs for infertility treatment in the 4 weeks before the start of the study and until the end of the study. Finally, demographic information was obtained from all individuals and statistical calculations were performed using the statistical software SPSS. Results: In general, our results showed that the consumption of ashwagandha powder in the first experimental group was 41.3 ± 16.66% in the pre-test stage, 46.53±13.42% in the post-test stage and 45.5%±11.99% in the follow-up stage. These values were 41.23 ±19.85% in the placebo group of the pre-test stage, 41.0%±19.15 in the post-test stage and  40.37±19.41 % in the follow-up stage. This indicates that ashwagandha increased semen performance scores and sperm motility in different stages of the test compared to the second experimental group. Conclusion: The use of medicinal plants with male fertility enhancement properties can be used as a substitute or supplement for chemical drugs that affect male fertility. On the other hand, it is recommended that chemical drugs with fertility-reducing properties be less used or not used in men with infertility disorders.

The effect of vitamin C on the gene expression profile of sperm protamines in the male partners of couples with recurrent pregnancy loss: A randomized clinical trial

Objective

Since sperm abnormalities are known to be a major reason for recurrent pregnancy loss (RPL), any defects in DNA structure and chromatin condensation can place embryos at risk in the early stage of development and implantation. As antioxidants such as vitamin C may play a protective role against the destruction of protamine genes in sperm chromatin, this study was conducted to evaluate the effects of vitamin C on chromatin and the expression of protamine genes in the male partners of couples with RPL.

Methods

Twenty male partners of couples with RPL were selected as the intervention group and received vitamin C supplementation (250 mg daily for 3 months). Healthy fertile men (n=20) were included as controls. Sperm chromatin, DNA integrity, and the expression levels of protamine genes were evaluated before and after treatment.

Results

Significant differences were found in sperm morphology, protamine deficiency, and apoptosis between the two groups and before and after vitamin C administration. A significant change was found in mRNA levels of PRM1, PRM2, and the PRM1/PRM2 ratio after treatment.

Conclusion

Daily oral administration of vitamin C may improve human sperm parameters and DNA integrity by increasing protamine gene expression levels in the male partners of couples with RPL. The beneficial effects of vitamin C supplementation as an antioxidant for the male partners of couples with RPL could lead to improved pregnancy outcomes in these cases.

Sperm chromatin and DNA integrity, methyltransferase mRNA levels, and global DNA methylation in oligoasthenoteratozoospermia

Objective

To investigate sperm chromatin/DNA integrity, global DNA methylation, and DNMT mRNA transcription in men with oligoasthenoteratozoospermia (OAT) compared with normozoospermic men.

Methods

Semen samples from 32 OAT patients who comprised the case group and 32 normozoospermic men who comprised the control group were isolated and purified using a standard gradient isolation procedure according to World Health Organization criteria. DNMT1, DNMT3A, and DNMT3B transcripts were then compared between groups using real-time quantitative reverse-transcription polymerase chain reaction. Global DNA methylation in sperm was determined by an enzyme-linked immunosorbent assay. Protamine deficiency and the proportion of apoptotic spermatozoa were evaluated using chromomycin A3 (CMA3), aniline blue (AB), and toluidine blue (TB) staining, as well as the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. The p-values <0.05 were considered to indicate statistical significance.

Results

Significantly higher proportions of AB+, TB+, CMA3+, and TUNEL+ spermatozoa, as well as DNMT3A and DNMT3B transcription, were found in the OAT group. Positive correlations were detected between sperm parameters, DNA/chromatin damage, and DNMT3A and DNMT3B transcripts. Global DNA methylation was significantly higher in the OAT patients and had a significant correlation with abnormal results of all sperm chromatin integrity tests, but was not associated with DNMT1, DNMT3A, or DNMT3B expression.

Conclusion

Oligoasthenoteratozoospermic men showed abnormal sperm parameters, abnormal chromatin/DNA integrity, and a higher global DNA methylation rate, as well as overexpression of DNMT mRNA.