1. ASSESSMENT OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) THERAPEUTIC EFFICIENCY IN MONGOLIA
Sarantsetseg N ; Nyambayar N ; Erdenesaikhan M ; Javkhlantugs D ; Myagmarsuren P ; Sodgerel B ; Ganbold G ; Ariunaa S ; Bayan-Undur D
Journal of Surgery 2016;20(2):42-45
Introduction: Extracorporeal shockwave lithotripsy (ESWL) revolutionizedthe treatment of urolithiasis and graduallybecame the favorite treatment option sothat today it is considered to be the first lineof treatment for patients with urolithiasis.The purpose of this study was assessment oftherapeutic efficacy, complications of ESWLin urolithiasis in Mongolia.Material and methods: A total of46 patients harboring renal and ureteralstones underwent ESWL between March2016 and September 2016 at First CentralHospital of Mongolia. Karl Storz ModulithSLK electromagnetic machines were usedto impart shock waves. All collected stonefragments sent for biochemical analysis.Results: A total of 46 patients 23 weremales (50%). Patients were mean age of34. The stone size distribution was 0.5cmto 3.1cm. The average treatment time wasranging from 75-110 minutes. The averagenumber of shock waves per treatmentwas 3172±378 (range 1500-4000). Theoverall success rate was 75.73%. All calculidisintegrated satisfactorily except for 3stones, which is located lower 1/3rd ofureter. Stone composition analysis proved tobe composed entirely or predominantly ofcalcium oxalate monohydrate. These patientsrequired to have ureterolithoextraction. Calculicomposition for remaining patients 12 werecalcium oxalate monohydrate, 17 calciumoxalate dehydrate, 6 uric acid and 1 struvite.Complications were mostly minor and rare.Most of the patients (90.7%) developedmacroscopic hematuria after treatment; fewpatients developed mild bruising at the entryand exit sites of the shockwaves on the bodywall. Severe complications such as renalhematoma and steinstrasse were diagnosedfor one patient each and their managementwas non-surgical.Conclusion: ESWL is therefore the firstline treatment for urolithiasis with stonesize smaller than 2cm. It has an efficiencyrate above 75, low procedure time, highsafety and good tolerability and minimalcomplication.
2.Impact of Spermatogenic Activity on the Outcome of Sperm Retrieval Procedures in Azoospermic Patient
Myagmarsuren P ; Narantsog Ch ; Sayamaa L ; Javkhlantugs D ; Bayarmaa E ; Bayan-Undur D ; Munkhzol M ; Odkhuu E
Mongolian Journal of Health Sciences 2025;87(3):136-140
Background:
Azoospermia is the most severe form of male infertility,
affecting approximately 1% of male population and 10–15% of infertile
men. In azoospermia cases, sperm retrieval from the testis or epididymis
through surgical procedures is used for assisted reproductive treatments.
When no sperm is retrieved, recent approaches in medicine
suggest using immunohistochemical methods to evaluate spermatogenesis
in testicular tissue and plan further treatments.
Aim:
To evaluate spermatogenesis in testicular tissue of azoospermic
patients using immunohistochemistry and compare the findings with
the clinical outcomes of sperm retrieval procedures.
Materials and Methods:
This study included 71 azoospermic men who
underwent micro-TESE procedures at the IVF center (RMC) between
2019 and 2023. The excised testicular tissues were fixed, processed
histologically, and evaluated using Johnson’s score. The presence of
spermatozoa in seminiferous tubules was detected by immunohistochemical
and immunofluorescence staining, using markers such as
TEX101 and LDHC.
Results:
Johnson’s score was categorized into three groups: poor,
moderate, and good spermatogenesis. These were statistically compared
with hormonal levels and surgical sperm retrieval outcomes.
There were significant differences in Johnson’s scores and serum FSH
and LH levels among the three groups (p < 0.005). TEX101 and LDHC
proteins were strongly expressed in the good group, weakly in the moderate
group, and absent in the poor group. The success rate of sperm
retrieval was 100% (17/17) in the good group, 96.29% (26/27) in the
moderate group, and only 29.62% (8/27) in the poor group.
Conclusion
Histological evaluation of spermatogenesis in azoospermic
patients can help predict the outcome of surgical sperm retrieval,
indicating its clinical value in treatment planning.