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Resumen Introduccion y objetivos Evaluar la capacidad del endourologo para evaluar la composicion del calculo mediante la observacion de imagenes endoscopicas. Materiales y metodos Una serie de 20 videoclips de tratamientos endoscopicos de calculos urinarios que tambien estaba disponible el resultado de la espectroscopia infrarroja se cargo en un sitio de YouTube accesible solo a miembros del South Eastern Group for Urolithiasis Research (SEGUR) a quienes se les pregunto para identificar la composicion de los calculos. Resultados Un total de 32 endourologos de 9 paises diferentes participaron en el estudio. El numero promedio de detecciones correctas de participantes fue de 7.81 ± 2.68 (1–12). La precision general fue del 39% (250 de 640 predicciones). Calculos de dihidrato de oxalato de calcio se han detectado correctamente en el 69.8%, monohidrato de oxalato de calcio en el 41.8%, acido urico en el 33.3%, oxalato de calcio / acido urico en el 34.3% y cistina en el 78.1%. Las tasas de precision para estruvita (15.6%), fosfato de calcio (0%) y oxalato de calcio / fosfato de calcio (9.3%) fueron bastante bajas. Conclusiones La observacion del calculo durante el procedimiento endoscopico no fue confiable para identificar la composicion de la mayoria de los calculos, aunque los calculos de oxalato de calcio dihidrato y cistina pueden identificarse con buena precision. Sin embargo, se debe alentar la presentacion de fotos o videos de calculo intacto y su estructura interna para implementar los resultados del analisis de calculo despues de la cirugia. Los endourologos deben mejorar su capacidad de identificacion visual de los diferentes tipos de calculos.

Introduction and objectives Although nocturnal emission (NE) is an integral part of normal sexual function of males, little information has been documented in the literature. We aimed to assess masturbation habits and frequency of NE among virgin male religious Muslim teenagers. Materials and methods A questionnaire was administered to students staying in a religious dormitory or attending a religion course. Data of 113 male-respondents including demographic characteristics, masturbation habits and frequency of NE were collected. Results The mean age of students was 15.88 ± 1.47 (range: 13–20) years. Of the students, 46(41.4%) reported that they never masturbated and 19 (17.3%) never experienced NEs. NE frequency was not correlated with age (p = 0.092). Having NEs was not related to the time since last masturbation either (p = 0.479). Subjects watching TV more than 3 h/day had more NEs than the ones watching less (p = 0.006). Of the subjects 13.6%, 12.6% and 67% believed that masturbation is halal, permissible and forbidden by religion, respectively whereas these rates were 59.1%, 20.4% and 7.5% for NE. Conclusions Although masturbation and NE are frequent among virgin male religious Muslim teenagers, a significant proportion of young men believe that only masturbation, but not NE, is forbidden by religion. Watching TV seems to be associated with the frequency of NEs. Further studies are required to elicit the factors affecting frequency of NEs.

INTRODUCTIONIschemic hepatitis (IH) is the necrosis of the centrilobular hepatocytes of liver and is secondary to liver hypoperfusion in most of the cases. The diagnosis is usually based on biochemical findings due to the absence of symptoms and signs. Although the disease course is often mild, and sometimes is even not diagnosed, the outcome is poor if the etiology of hypotension and liver anoxia is not promptly corrected.PRESENTATION OF CASEA 64-year-old patient who underwent percutaneous nephrolithotomy (PNL) for right renal pelvic stone developed acute IH at first postoperative day as a result of hemorrhage related severe hypotension. After restoring hemodynamic parameters, she completely recovered 2 weeks after the operation.DISCUSSIONIH is a frequent cause of marked serum aminotransferase elevation and most commonly occurs as a result of arterial hypoxemia and insufficient hepatic perfusion. Although no specific treatment of IH exists, stabilizing the hemodynamic parameters of the patient resolves the problem in most of the cases.CONCLUSIONThis case is presented to demonstrate that ischemic hepatitis should be kept in mind if severe hemorrhage occurs during PNL.

Summary Objective To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) in the treatment of pediatric cystine stones. Study design Data of the pediatric patients who underwent RIRS for kidney stones were retrospectively evaluated. A total of 14 children with cystine stones managed with RIRS were identified. In addition to the patient demographics and stone characteristics, all retrospectively obtained operative data were evaluated and discussed in detail, with an emphasis on the success and complication rates. Results Mean age of the 14 cases was 10.9 ± 2.2 years (range: 7–15). Mean stone size was 13.6 ± 2.4 mm (range: 10–18) (Summary table). Of these stones, four were located in the renal pelvis, three were in the lower, three were in the middle and the remaining four were located in upper calyx. Ureteral access sheath was used in 12 (85.7%) patients. The double-J ureteral stent was placed pre-operatively in one case and was inserted postoperatively in 12 cases. Mean operation time was 38.2 ± 7.2 min (range: 30–50). Complications were observed in two cases: mild ureteral laceration in the first and fever on the second postoperative day in the second patient. All of the patients were stone free on sonographic evaluation at the 4-week follow-up evaluation. Although potassium citrate treatment was initiated in 11 patients, tiopronin treatment was initiated in four patients for recurrence prophylaxis during long-term follow-up. During a mean follow-up period of 25.7 ± 5.2 months, stone recurrence was noted in one patient. Discussion Treatment of patients with cystine stones is challenging, due to high risk of rapid recurrence in the presence of residual fragments. Besides allowing complete stone clearance in all cases in the current series, RIRS is a highly reproducible method that can be safely performed, even in recurrences. The major limitations of the current study were low number of patients and short follow-up period. Conclusion The results clearly indicated that RIRS is a safe treatment modality in the management of pediatric cystine stones. Summary table . Stone characteristics and operative findings. Number of patients 14 Mean stone size (mm) 13.6 ± 2.4 (range: 10–18) Stone location Renal pelvis 4 Upper calyx 4 Middle calyx 3 Lower calyx 3 Mean operation time (minutes) 38.2 ± 7.2 (range: 30–50) Postoperative fever 1 (7.1%) Stone-free rate 100%