The objective of the present retrospective study was to report our experience concerning the effects of cell phone usage on semen parameters. We examined 2110 men attending our infertility clinic from 1993 to October 2007. Semen analysis was performed in all patients. Serum free testosterone (T), follicle stimulating hormone (FSH), luteinising hormone (LH) and prolactin (PRL) were collected from all patients. The information on cell phone use of the patients was recorded and the subjects were divided into two groups according to their cell phone use: group A: cell phone use (n = 991); group B: no use (n = 1119). Significant difference was observed in sperm morphology between the two groups. In the patients of group A, 68.0% of the spermatozoa featured a pathological morphology compared to only 58.1% in the subjects of group B. Patients with cell phone usage showed significantly higher T and lower LH levels than those who did not use cell phone. No significant difference between the two groups was observed regarding FSH and PRL values. Our results showed that cell phone use negatively affects sperm quality in men. Further studies with a careful design are needed to determine the effect of cell phone use on male fertility.

OBJECTIVES To evaluate different clinical parameters in association with the presence and severity of varicocele in a large group of Austrian men.METHODS Records of 716 consecutive patients with clinical varicocele and infertility, who visited our andrology unit from 2001 to 2007, were retrospectively evaluated. The presence, grade, and side of any varicocele were recorded; varicoceles were confirmed by Doppler sonography. Semen samples, serum follicle-stimulating hormone, luteinizing hormone, estradiol, and testosterone levels were also assessed in all patients.RESULTS Mean age was 29.6 +/- 0.3 years; 30% of patients presented with grade I varicocele, 39.0% with grade II, and 30.3% with grade III varicocele. About 33.3% of patients presented with normozoospermia, followed by asthenozoospermia (17.9%), oligoasthenoteratozoospermia syndrome (14.2%), and oligozoospermia (13.2%). Sperm density significantly decreased with increasing grade of varicocele. Body mass index was inversely proportional to varicocele. Serum testosterone levels were higher in grade III varicoceles (5.7 +/- 0.2 nmol/L) compared with grade I (4.9 +/- 0.2 nmol/L) and grade II (5.0 +/- 0.1 nmol/L) varicoceles (P < .001; range, 0.4-16.6 nmol/L).CONCLUSIONS To our knowledge the current report is the first to describe a direct relationship between grade of varicocele and semen quality. Grade III varicocele was associated with decreased semen quality and, interestingly, with higher testosterone levels. Our study confirmed previous reports regarding the relationship between varicoceles and body mass index. UROLOGY 75: 1069-1073, 2010. (C) 2010 Elsevier Inc.

INTRODUCTION AND OBJECTIVES: During epididymal transit, spermatozoa acquire new surface proteins. P34H being one of them, it is implicated in sperm-zona pellucida binding. Absence of this surface protein is associated with inability of sperm to interact with the oocyte. We have previously shown that P34H was present in all fertile men and approximately in 50 % of idiopathic infertile men. We also showed that P34H remains at the same level in different semen from a given individual. Vasovasostomy has a high surgical success rate but fertility is not recovered in a significant proportion of cases. Knowing that vasectomy can cause epididymal damages, we have quantified P34H in vasovasostomized men with regards to the time elapsed between vasectomy and surgical reversal. METHODS: We retrospectively analysed 589 charts of patients between 1997 and 2006 who underwent a modified 1-layer microsurgical vasovasostomy performed by a single surgeon. P34H evaluated by western blot analysis performed on a constant number of spermatozoa was available for 107 patients. Of these, 9 patients were excluded due to protein degradation on western blots. RESULTS: : P34H decrease in a steady fashion for the first 9 years of interval between vasectomy and vasovasostomy. In fact, 94 % of patients that were under vasectomy for less than 3 years had a positive P34H. The decrease of P34H continues to reach 72 % of positivity between 7 to 9 years after vasectomy. Afterward, P34H was positive in 93% and 100% of vasovasostomized men after 10 to 12 years and 13 to 15 years under vasectomy respectively. CONCLUSIONS: Our results show that a decrease of P34H is associated with the time elapsed between vasectomy and its surgical reversal at least for the first 9 years. After this period, a normal value of P34H characterises a high proportion of vasovasostomized men suggesting an adaptive mechanism within the epididymis. For patients with less then 10 years under vasectomy, the time elapsed between vasectomy and its reversal can be a part of the prognostic factors of fertility recovery in men. Supported by CIHR grants to RS

Objective: We report our own experience with the use of hyperbaric oxygen (HBO) for the management of postradiation hemorrhagic cystitis. Methods: We reviewed retrospectively 14 patients from 2001 to 2007 with different pelvic organ malignancies who developed radiation cystitis after irradiation. Patients received 100% oxygen in a hyperbaric chamber at a pressure of 2.5 atmospheres absolute, 60 min bottom time, once a day, 7 days a week for at least 1 month. In principle, 30 HBO treatments per course were performed. After every course of HBO treatments, therapeutic effect was evaluated. The mean duration of follow-up of all patients was 18 months (range: 1–6 years). Results: Patients were divided into 2 groups, group 1 (treatment group, n = 10) and group 2 (without treatment, n = 4). The mean duration between the onset of hematuria and the beginning of HBO therapy was 8.9 months (range: 3–34). Group 2 did not receive HBO because they were not healthy enough. Only 2 patients (20%) of group 1 recovered from their hemorrhagic cystitis. Group 1 had a significantly lower cure rate of postirradiation hemorrhagic cystitis in comparison to group 2. Conclusions: Our experience with the use of HBO did not yield favorable results. Randomized well-controlled studies are needed.

BACKGROUND:To investigate whether body mass index (BMI) is an independent risk factor for nonorgan-confined disease in patients with clinically localized prostate cancer.PATIENTS AND METHODS:Overall, 735 patients undergoing radical prostatectomy formed the study cohort. Pathological and clinical factors with special emphasis to BMI were used to determine a model for the prediction of nonorgan-confined disease.RESULTS:359 patients had pathologically nonorgan-confined prostate cancer. These patients showed a significantly higher BMI than those with organ-confined disease (26.7 vs. 26.2; p = 0.0012). In multivariate analysis, age (p = 0.049), prostate-specific antigen (PSA) (p < 0.001), clinical stage (p < 0.001), prostatectomy grade (p < 0.001), and BMI (p = 0.004) were independent risk factors for nonorgan-confined disease. In patients with a serum PSA between 10.1 and 20 ng/ml only prostatectomy grade (p < 0.001) and BMI (p = 0.005) remained independent predictors.CONCLUSION:Patients with nonorgan-confined disease showed a significantly higher BMI than those with organ-confined stages. Moreover, BMI was an independent predictor for nonorganconfined prostate cancer. This knowledge might be helpful in patient counseling to choose between various options for the treatment of clinically localized prostate cancer.

PURPOSE To retrospectively measure the adrenal gland attenuation and the percentage loss of adrenal gland enhancement at delayed contrast medium-enhanced computed tomography (CT) in patients with adrenocortical carcinomas and pheochromocytomas and to compare these data with those in patients with adenomas and metastases. MATERIALS AND METHODS The study protocol was approved by the ethics committee, which waived informed consent. Eleven patients with proved adrenocortical carcinoma, 17 with proved pheochromocytoma, 23 with adrenal adenoma, and 16 with metastasis to the adrenal gland underwent helical CT. Nonenhanced CT was followed by contrast-enhanced CT 1 minute and 10 minutes later. Attenuation and enhancement loss values were calculated. RESULTS The mean attenuation of adenomas (8 HU +/- 18 [standard deviation]) was significantly lower than those of adrenocortical carcinomas (39 HU +/- 14), pheochromocytomas (44 HU +/- 11), and metastases (34 HU +/- 11) on nonenhanced CT scans (P < .001). Although the mean attenuation values for nonadenomas (ie, adrenocortical carcinomas, pheochromocytomas, and metastases) were significantly higher than the value for adenomas on the 1-minute contrast-enhanced CT scans (P < .001), there was more overlap in attenuation between adenomas and nonadenomas on contrast-enhanced scans than on nonenhanced scans. On the 10-minute delayed contrast-enhanced scans, the mean attenuation of adenomas (32 HU +/- 17) was significantly lower than the mean attenuations of carcinomas (72 HU +/- 15), pheochromocytomas (83 HU +/- 14), and metastases (66 HU +/- 13) (P < .001). At optimal threshold values of 50% for absolute percentage of enhancement loss and 40% for relative percentage of enhancement loss at 10 minutes, both the sensitivity and the specificity for the diagnosis of adenoma were 100% when adenomas were compared with carcinomas, pheochromocytomas, and metastases. CONCLUSION The enhancement loss in adrenocortical carcinomas and pheochromocytomas is similar to that in adrenal metastases but significantly less than that in adrenal adenomas. The percentage change in contrast material washout is a useful adjunct to absolute CT attenuation values in differentiating adrenal adenomas from adrenocortical carcinomas and pheochromocytomas.

In infertile men thyroid hormone and antibody testing was performed and correlated with the results of semen analyses. Evaluation included semen analyses, physical examination, evaluation of sex steroid hormones, thyroid hormones (bTSH, fT4, fT3) and thyroid antibody testing (TGA, TPO-Ab, TRAK). Furthermore 45 men with normal thyroid function were scheduled for TRH testing. No one was diagnosed as having manifest hypo- or hyperthyroidism. Latent thyroid dysfunction had no effect on semen parameters. Elevated TPO-Ab were significantly correlated with reduction in motility of spermatozoa. The routine assessment of thyroid hormones and antibodies in infertile men is not recommended. Subclinical hypothyroidism as a result of TRH testing, is a rare finding in infertile men.

We report the case of a female patient presenting with flank pain. Abdominal ultrasound revealed a tumor of 8 cm in diameter. After abdominal computerized tomography, the tumor was classified as angiomyolipoma with a tumor thrombus in the inferior vena cava. After nephrectomy, the diagnosis was confirmed histologically. To our knowledge, this is the 11th case of a renal angiomyolipoma extending into the vena cava.

Introduction: The aim of this study is to assess the efficiency of extracorporeal shock wave lithotripsy (ESWL) as initial therapy for isolated lower pole kidney stones smaller than 20 mm. Patients and Methods: During a 24-month period 116 patients with previously untreated single stones under 20 mm in diameter were treated with a Dornier lithotripter S. They were analyzed with regard to stone site and size, number of ESWL sessions, auxiliary measures, retreatment rates, complications and the time taken for stone clearance. Results: 76 patients (65.5%) became stone free, 50 of them (43.1%) within 3 months after ESWL. Depending on stone size the stone-free rates were 67.1% for patients with a stone diameter of <10 mm (59 of 88 patients), and 60.7% for stone diameters between 10 and 20 mm (17 of 28 patients). Complications during and after treatment were rare, i.e. the necessity of ureteral stent insertion due to colic (n = 10), endoscopic stone removal (n = 2), acute pyelonephritis (n = 1), stonestreet (n = 1) and 1 case of hematoma not requiring intervention. The recurrence rate during follow-up (13.2–36.9, mean 25.0 months) was low: 16 patients (13.8%) had recurrent or persistent stones, and 74 patients (63.8%) had no evidence of urolithiasis. Conclusions: ESWL is a safe and efficient first-line therapy for treatment of isolated small lower pole kidney stones with acceptable stone-free rates, low morbidity, few complications and a low stone recurrence rate.

In infertile men thyroid hormone and antibody testing was performed and correlated with the results of semen analyses. Evaluation included semen analyses, physical examination, evaluation of sex steroid hormones, thyroid hormones (bTSH, fT4, fT3) and thyroid antibody testing (TGA, TPO-Ab, TRAK). Furthermore 45 men with normal thyroid function were scheduled for TRH testing. No one was diagnosed as having manifest hypo- or hyperthyroidism. Latent thyroid dysfunction had no effect on semen parameters. Elevated TPO-Ab were significantly correlated with reduction in motility of spermatozoa. The routine assessment of thyroid hormones and antibodies in infertile men is not recommended. Subclinical hypothyroidism as a result of TRH testing is a rare finding in infertile men.

Following the National Institutes of Health (NIH) consensus conference in 1988, erectile dysfunction is defined as the consistent inability to maintain a penile erection sufficient for adequate sexual relations (1). The advances in basic and clinical research during the last two decades have led to the development of several new treatment options for erectile dysfunction, including new pharmacological agents for intracavernosal, intraurethral and oral use. The recent advent of medical therapy and the poor results of long-term follow-up in reconstructive vascular surgery, have significantly modified the medical management of this disorder. Discussion of erectile dysfunction has increased, information about erectile dysfunction is increasingly available, training in erectile dysfunction was improved and last, but not least, the number of patients seeking help for erectile dysfunction is growing, because satisfactory sexual function is an important part of a couple's healthy relationship and ongoing quality of life.