|Year : 2017 | Volume
| Issue : 3 | Page : 181-182
Editor, Indian Journal of Urology, All India Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||30-Jun-2017|
Editor, Indian Journal of Urology, All India Institute of Medical Sciences, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar R. What's inside. Indian J Urol 2017;33:181-2
| Male Infertility and Its Therapy|| |
Treating idiopathic abnormalities in the semen of men with infertility is a difficult problem. A number of empirical therapies are used with varying outcomes. Two reviews in this issue discuss these therapies and the evidence for their use. Majzoub and Agarwal  reviewed antioxidants for idiopathic infertility and suggested that while data on pregnancy and live-birth rates are limited, oral antioxidants may have a beneficial role, at least for an initial trial. Tadros and Sabanegh  reviewed gonadotropins, androgens, aromatase inhibitors, and selective estrogen receptor modulators and concluded that while data are insufficient for conclusive statements, testosterone should never be used while the other agents should be used selectively. A third article looks at the utility of routine semen cultures in male infertility evaluation. The authors suggested that screening with semen cultures should not be done and testing should be done only if there are clinical features and signs of infection.
| Complications of Laparoscopic Nephrectomy|| |
This prospective study reports the complications of laparoscopic nephrectomy in a mixed population of patients. Agrawal et al. reported a high (46%) incidence but suggested that this is not a cause for alarm as the majority of these are minor and the high rate is a result of the low threshold for reporting an event as a complication.
| Outcomes of Pediatric Renal Transplants|| |
Another article on surgical outcomes looks at live-related renal transplants in children below 18 years of age. In 32 subjects reviewed, the authors found a 97% 1-year graft survival. It is interesting that over 85% donors were female.
| Three-dimensional Laparoscopy|| |
Three-dimensional (3-D) laparoscopy is a relatively new technology that aims to bridge the gap between conventional laparoscopy and robot-assisted surgery by providing the benefit of depth perception. This randomized study included 108 patients in each of the two arms: two-dimensional and 3-D laparoscopy. The authors evaluated a number of surgical parameters and outcomes and concluded that depth perception allows improvement in operative time and lowers the surgeon's stress.
| Robot-assisted Partial Nephrectomy|| |
The introduction of renal nephrometry scores for tumors has allowed classification of operative difficulty and predicting outcomes for partial nephrectomies. This report of 18 patients in a cohort of 79 had “high” nephrometry scores. However, the outcomes of surgery were no different from relatively easier tumors, further supporting the limited role of scoring system in decision-making processes.
| Androgen Deficiency and Its Treatment|| |
Age-related hypogonadism is being increasingly diagnosed and treated with testosterone supplementation. However, improvement in testosterone alone may not alleviate symptoms of hypogonadism. In this prospective study, Dadhich et al. compared testosterone and clomiphene in improving testosterone levels and symptoms in hypogonadal men and concluded that while both improved levels and alleviated symptoms, testosterone had better outcomes than clomiphene.
| Contrast-induced Nephropathy|| |
The use of iodinated contrast material is ubiquitous in urological practice. However, it is always associated with a fear of adverse effects including renal impairment. This prospective study compared the incidence of contrast nephropathy in 339 patients, 168 urologic studies and 171 cardiology procedures. The incidence of nephropathy in urology studies was 8.3%. Although this is lower than the 30% in cardiology, this is related to the age, comorbidities of the patients, and the amount of contrast used. However, 8% itself should be a cause for caution in ordering investigations.
| Working Without Tools|| |
“Necessity is the mother of invention” is an adage that is frequently proven in the resource-limited environment encountered in the Indian health-care systems. Oswal et al. described their technique of using a guidewire loop to remove stents cystoscopically when stent-removal forceps are not available.
Financial support and sponsorship: Nil.
Conflicts of interest: There are no conflicts of interest.
| References|| |
Majzoub A, Agarwal A. Antioxidant therapy in idiopathic oligoasthenoteratozoospermia. Indian J Urol 2017;33:207-14. [Full text]
Tadros NN, Sabanegh ES. Empiric medical therapy with hormonal agents for idiopathic male infertility. Indian J Urol 2017;33:194-8. [Full text]
Solomon M, Henkel R. Semen culture and the assessment of genitourinary tract infections. Indian J Urol 2017;33:188-93. [Full text]
Agrawal T, Kumar R, Singh P, Saini A, Seth A, Dogra P. Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale. Indian J Urol 2017;33:216-20. [Full text]
Bijalwan P, Sanjeevan KV, Mathew A, Nair TB. Outcome and complications of living donor pediatric renal transplantation: Experience from a tertiary care center. Indian J Urol 2017:33;221-5.
Patankar SB, Padasalagi GR. Three-dimensional versus two-dimensional laparoscopy in urology: A randomized study. Indian J Urol 2017;33:226-9. [Full text]
Bora GS, Mavuduru RS, Sharma AP, Devana SK, Kakkar N, Lal A, et al
. Initial experience of robotic nephron sparing surgery in cases of high renal nephrometry scores. Indian J Urol 2017;33:230-5. [Full text]
Dadhich P, Ramasamy R, Scovell J, Wilken N, Lipshultz L. Testosterone versus clomiphene citrate in managing symptoms of hypogonadism in men. Indian J Urol 2017;33:236-40. [Full text]
Babu M, Bansal D, Mehta SB, Pillai B, Krishnamoorthy H, Attacharil T. Contrast-induced nephropathy in urological imaging: A comparison with cardiology interventions. Indian J Urol 2017;33:241-5. [Full text]
Oswal AT, Maheshwari PN, Amlani D. Cystoscopic stent removal using a guidewire loop. Indian J Urol 2017;33:253-4. [Full text]