Urology Journal

Purpose: This study investigated the impact of synbiotics on blood and urinary concentrations of factors related to kidney stone formation in overweight or obese patients with hyperoxaluria.

Materials and methods: A randomized double-blind clinical trial was conducted involving forty-four patients assigned to either synbiotic or placebo groups. Participants received their respective capsules twice daily for 12 weeks. Blood and 24-hour urine samples were collected at baseline and week 12 for biochemical analyses.

Results: Urinary oxalate significantly decreased in the synbiotic group compared with both baseline (P=.001) and placebo (P=.001). Other biochemical markers showed no significant differences, while urine volume increased in both groups without between-group variance.

Conclusion: Synbiotic supplementation significantly reduced urinary oxalate but did not affect other blood or urinary parameters associated with kidney stone formation.

Purpose: To evaluate the effectiveness of contralateral testicular volume measurements in differentiating monorchidism from intra-abdominal viable testes in children with non-palpable testes (NPt).

Materials and Methods: The data of 179 patients who underwent surgery for undescended testes between January 2017 and January 2024 were retrospectively reviewed. The study included 33 patients with unilateral non-palpable testes. Testicular volumes were measured by ultrasonography 6-12 months prior to diagnostic laparoscopy, and the surgical findings were recorded.

Results: Diagnostic laparoscopy was performed on 33 children with non-palpable testes. For five patients, staged orchiopexy was planned due to the testes being 2 cm or more away from the internal inguinal ring. In 22 patients, inguinal orchiopexy was performed as the testes were around the internal inguinal ring (AIR). In the remaining six patients, no testes were found; the spermatic cord and vessels terminated at the internal inguinal ring (vanishing) or were atrophic (nubbin). There was a significant difference in the contralateral testicular volumes between patients with vanishing testes and those with intra-abdominal viable testes (p < 0.001). Additionally, there was a statistically significant difference in the contralateral testicular volumes between the AIR group and those with testes remote from the internal inguinal ring (RIR) (p = 0.03).

Conclusion: The preoperative ultrasonographic measurement of the contralateral testicular volume in children with a unilateral non-palpable testis can provide valuable information about the nature of the intra-abdominal testis. The presence of a hypertrophic contralateral testis can guide surgeons prior to laparoscopy and is valuable for counseling parents about potential diagnoses.

Purpose: Non-obstructive urinary retention (NOUR) is the inability to empty the bladder with no physical obstruction to urine flow. It can occur as a result of neurological disorders or be idiopathic. In younger women, it may be caused by Fowler’s syndrome (FS), a rare disorder in which the urethral sphincter fails to relax to allow urine to pass normally. This study covers both idiopathic NOUR and FS. Sacral neuromodulation (SNM) has been introduced as an effective option for patients with NOUR.

Materials and Methods: Forty-two patients (aged 17 to 61 years) suffering from refractory NOUR who had a successful first-stage SNM with the Interstim II device, and in whom the second stage was completed, were prospectively studied in the department of neurogenic bladder and neuromodulation in our hospital from February 2016 to August 2019 to evaluate the efficacy and safety of SNM.

Results: The study included forty-two women with NOUR: 20 (47%) with FS and 22 (53%) with idiopathic NOUR. Their mean age was 27.2 ± 12.4 years. Thirty-eight (90%) of them had a successful trial phase (responders) with more than 50% improvement in their voiding parameters. After continued follow-up, a clinical success rate of 79% (30 out of 38 cases) was achieved, with a median follow-up period of 28 ± 8 months. The voiding parameters of these 38 patients showed statistically significant improvement after SNM. Their post-void residual volume dropped significantly from 330 ± 77 mL to 97 ± 55 mL (P < 0.001), average voided volume increased from 60 ± 23 mL to 265 ± 99 mL (P < 0.001), and the number of clean intermittent catheterizations per day fell from 5.6 ± 1 to 1.3 ± 1.6 (P < 0.001). The total number of patients who required surgical revision was 10 (26.4%), for reasons including malfunction due to external trauma in four patients (10.5%), continuous pain in four (10.5%), and device infection in two (5%).

Conclusion: SNM is an effective and safe option for women with refractory idiopathic non-obstructive urinary retention and Fowler's syndrome.

We conducted a retrospective cross-sectional analysis of 288 complaints filed against urologists between 2017 and 2023 at the Forensic Medicine Organization in Shemiranat, Tehran.

The number of complaints increased steadily, peaking in 2023 (n = 66) and reaching a nadir in 2020 (n = 13), likely reflecting the impact of the COVID-19 pandemic. Most complainants were male (89.6%), and patients aged >60 years comprised the largest group (31.3%). Complaints were overwhelmingly directed at specialist urologists (97.6%), with subspecialists accounting for only 2.4%. Cases more frequently originated from public hospitals (66.3%) than from private institutions (33.7%).