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Background and Objective: Computerized tomographic angiography (CTA) is a minimally invasive modality to image the vasculature without the morbidity of direct large vessel vasculature access and its major indications in urology are assessment of the renal vasculature in preparation for donor nephrectomy, identification of extravessel in evaluation of ureteropelvic junction obstruction and for diagnosis of renal artery stenosion. This study was done to evaluate vescels of kidney donors using CTA and formal angiography and comparison with intraoperative findings. Materials and Methods: In this descriptive study, kidney vessels of 70 and 30 living kidney donor were assessed with computerized tomographic angiography and formal angiography respectively. The pattern of vessels of kidney during operation were examined. Two observers assessed the findings of preoperative CTA and formal angiography with intra operation observations. Results: In CTA group there were two patients each with two main renal veins which were observed during operation was not recorded on computerized tomographic angiography. In formal angiography group there was one patient with unrevealed two main renal veins prior to surgery. In both groups, the accuracy of anatomical diagnosis of the main kidney artery were 100%. Conclusion: This study showed that kidney vascular assessment by either the computed tomography angiography or formal angiography have similar clinical diagnostic accuracy.

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Background and Objective: Lower ureter is the most common site of stone traped causing renal colic and hydroureteronephrosis. If medical therapy is not effective , the treatment consist of extracorporeal shock wave lithotripsy (ESWL), transurethral lithotripsy (TUL) or on rare cases, open surgery. This study was done to compare the ESWL with TUL in sixty patients with lower ureteral stones which did not responed to thraputic regiment. Materials and Methods: This prospective cohort study was done on sixty patients with obstructive lower ureteral stones for more than 3 weeks, that have not been responded to the thraputic regiment in Imam Reza hospital, Mashhad, Iran during 2004-06. According to treatment indications sixty patients divided in two equal ESWL and TUL groups. Success of procedure were evaluated by ultrasonography and KUB radiography. The success rate of two different technique and the side effects in each patients was recorded. Results: In ESWL group in 14 patients (46.66%) the stone was broken and its particles were removed but in 13 patients (43.33%) the stone was not broken and they became candidates for TUL. In 3 patients (10%) the stone was broken but the particles did not pass. The only complication of ESWL was renal colic which was in 15 patients (50%) and cured by medical treatment. In TUL group, in 93.5% of patients, the stone was broken and particles were removed, but in 6.5% the procedure was not successful and the patients underwented ESWL or open surgery. 10% of patients experienced fever and colic pain, who underwented medical treatment. Conclusion: This study showed that TUL technique has higher successful rate than ESWL technique in lower uretaral stones.

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Buschke–Lowenstein Tumor (BLT) or Giant Condyloma Acuminatum (GCA) is a slow-growing, locally aggressive, cauliflower-like tumor of great size that usually arises in the perineal region. Buschke–Lowenstein Tumor is triggered by human papilloma virus (HPV), usually either genotype 6 or 11. Buschke–Lowenstein Tumor is usually preceded by condyloma acuminatum and occurs at any age after puberty, usually between the 4th and 6th decades. Invasive overgrowth and recurrence after treatment are its characteristics and malignant transformation is also possible. Here, we have reported a case of a 33 year-old man with penile Buschke–Lowenstein Tumor arising from common genital warts.

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Background and Objective: Intercostal and supracostal access tract are usual access for percoutaneous nephrolithotripsy (PCNL) for upper calices stones. But pleural complication of these tracts are high. This study was done to evalute percutaneous nephrolithotomy (PCNL) of upper calices with subcostal access. Materials and Methods: Seventeen patients (12 males, 5 females) with stones limited to upper calices with diameters of 11-27 mm and 1-5 in numbers, candidated for PCNL. Ultrasonography and intravenous urography were performed for all patients prior to surgery. In all patients PCNL performed in prone position and access is made at prolonged and deep inspiration from subcostal with fluoroscopic guidance. Following access to upper calices, guide wire inserted and dilatation of tract up to 28 or 30 Fr informed. After insertion of 28 or 30 Fr Amplatz sheat nephroscopy performed. Results: Two patients excluded and finally 15 patients were accounted. In 15 patients subcostal access performed successfully (88.2 %) . In 5 patients stones of less than 10 mm extracted with grasps. In 10 patients after pneumatic lithotripsy, particles of tones removed. 11 patients rendered stone free (73.3%). 4 patients had residual stones of greater that 5 mm in minor calices that in 3 patients after single ESWL resolved. 3 patients needed infandibular dilatation for complete stone extraction. No infection, transfusion, pneumothorax, hydrothorax, respiratory discomfort in operation and post operation period were seen. In one patient a perirenal collection of liquid with diameter of 5 cm was detected. Perirenal collection of liquid was removed with preventional treatment and antibiotics regiments. Conclusion: PCNL with subcostal access for upper calices stones is a feasible and safe with low complication and can be performed instead of supracostal access tracts.

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Varicocele is a deficiency of the testicular veins which is recognized by elongation and tortuosity of the pampiniform or cremasteric venous plexus and can lead to impaired spermatogenesis. Varicocele intensity is associated with the reduction of male fertility potential. This review article discusses the effects of varicocele on spermatogenesis process and fertility potential, etiology of varicocele, therapeutic approaches, and the result of treatment. All the published papers from 1975 to 2018 from databases bank such as Science Direct, Google Scholar, Scopus, and PubMed with keywords; infertility, varicocele, varicocelectomy, spermatogenesis, clinical outcome were collected and within these papers, only 74 papers were included for this study. Increased of testicular temperature, backflow of toxic metabolites from the kidney or adrenal glands, hypoxia, hormonal disturbances and oxidative stress are the most prevalent pathogenic cause of varicocele that they can alter testis and sperm functions. Several studies show that varicocelectomy can improve sperm parameters, chromatin statue and fertility potential in infertile men with varicocele. Possibly, treatment of varicocele before assisted reproduction technologies could increase the chance of spontaneous pregnancy in these infertile men.

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Renal cavernous hemangioma is a rare benign tumor. This case report describes a 44-year-old male who was incidentally found to have a renal mass during an abdominal and pelvic ultrasound. The patient's abdominal ultrasound revealed a mass, which was further evaluated with a CT scan. The CT findings suggested renal cell carcinoma. Suspecting malignancy, the patient underwent radical nephrectomy. Histopathological and immunohistochemical examinations ultimately diagnosed the mass as a cavernous hemangioma. Despite its benign nature, the patient was followed up with a control ultrasound three months post-surgery. This case is presented due to the significant clinical and radiological resemblance of this tumor to renal carcinomas, highlighting the importance of considering benign tumors in differential diagnoses.