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*Minia University Hospital, Minia Egypt.and **Dept of Urology Case western Reserve University, University hospiital Of Cleveland, Cleveland OH.

Aim of the study: The primary study end-point of this study was the determination of the prevalence of different types of serum testosterone deficiency in men presented for office evaluation of ED and low libido.

Patients and Methods: To determine the prevalence of differrent testosterone deficiency in men presented for office evaluation of their erectile dysfunction[ ED] ,total,free and % free serum testosterone levels were obtained from 69 patients presenting to out patients urology clinics at Urology Dept. Minia Uinversity Hospital Mini Egypt with a chief complaint of ED in the period between June 2008 and May 2010. Samples were drawn between 8-11 Hs in all patients. All men in this study had ED and low sex drive (libido), several validated questionnaires (SHIM and ADAM) were I filled in the office prior to the examination. Sixty nine men were included in this study with average age 63 (mean 56 ± 12) were evaluated over a 12 month period met criteria for inclusion. The patients completed these questionnaires in the office, prior to physician interview. All men had serum testosterone levels drawn. [total, free and % free testosterone]. Hypogonadism, defined as total serum T<300 mg/dl, free T<2.5 ng/dl or r < 4.50 ng /dl depending on the laboratory kits), and %free T <0.62ng/dl or < 4ng/dl).

Results: All 69 men had ED, with an average SHIM score of 11+, Low serum testosterone level (Hypogonadism) was seen in 28 patients out of 69 patients (40.57%); of those 28 men ,13 patients had low total testosterone (18.45%), 17 patients had low free testosterone (24.63%), and 11 patients had low % free testosterone level (15.94%). 6. While low libido was noted in 97% of men using ADAM questionnaire for the detection of men with low sex drive.

Conclusion: These data support the concept that male erectile dysfunction now must be considered in the office evaluation of male erectile dysfunction, all types of serum testosterone either total, free and % free shoud be put in mind for diagnosis of men with ED and low libido.



 Urology Department, Minia University Hospital, Minia Egypt

Aim Of The Work: Our primary end point of this prospective study was to evaluate the bioeffects of SWL for treatment of renal stones using different frequencies of shock wave lithotripsy to determine the optimal frequency required, not only for stone fragmentation, but also for safety concerning its bioeffects.


Patients And Methods: This prospective study was conducted upon 100 patients (64 male and 36 female) aged 17- 60 years with mean age 35.92 years. All patients had symptomatic renal calculi at the SWL unit, Urology Depart, Minia University Hospital, in the period between July 2008 and Aug. 2009. Extracorporeal shock wave lithotripsy (SWL) was used as primary treatment option for all patients. All patients subjected to complete history taking, clinical examination, laboratory and imaging studies. Patients were randomly classified into 3 groups according to the frequency of shock waves used: Group 1 included 30 patients in whom we used 60 shock waves per minute. Group 2: included forty patients in whom we used 90 shock waves per minute. Group 3: included thirty patients using shock waves 120 shock per minute. All patients were followed up within the first week, 3 months after SWL for the above mentioned laboratory and imaging study to assess the bioeffects of SWL in this group of patients.


Results: This study included 100 patients presented with symptomatic renal stones, in those group of patients in this work we noticed some degree of transient renal damage had occurred as a result of stone disintegration by SWL in the first week in the form of a varying degree of intra and peri-renal edema and hemorrhage as well as some degree of impaired renal function,also,there is a decreased in the intra renal blood flow within the first 24 hours after SWL which evidenced by increased renal vascular resistive index. Shock wave lithotripsy (SWL), not only produce renal damage but also has extra renal damaging effects to other organs such as liver (transient rise in the liver enzymes as well as bilirubin), pancreas (rise in the blood glucose level in the first 24 hours following SWL) and cardiovascular system (decrease pulse rate in the first 24 hours after SWL).These bioeffects of ESL not affected by the change in the frequency of shock waves between 60, 90, 120 shock/min except for hematuria which is markedly significant using high frequency shock waves? All of these bio effects produced by SWL disappeared three month after SWL.


Conclusion: All the bioeffects produced by SWL either physical and/or chemical are not influenced by changing the frequency of shock waves used for disintegration of renal calculi between 60, 90, 120 shock/min except for heamaturia which was markedly significant with the use of higher frequency shock waves. All the bioeffects produced by SWL disappeared three months after SWL.


Key Words: Extracorporeal, Shock waves lithotripsy, bioeffects, frequency, renal calculi, resistive index.


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