فهرست مطالب

Urology Journal - Volume:13 Issue: 3, May-Jun 2016

Urology Journal
Volume:13 Issue: 3, May-Jun 2016

  • تاریخ انتشار: 1395/04/24
  • تعداد عناوین: 13
|
  • Chung Jing Wang, Po Chao Tsai, Chien Hsing Chang Pages 2666-2671
    Purpose
    To evaluate the efficacy of silodosin in the medical expulsive therapy for symptomatic distal ureteral stones.
    Materials And Methods
    This prospectively randomized controlled trial was carried out from May 2011 to December 2014. In all, 198 patients with radiopaque distal ureteral stones
    Results
    The final analysis was conducted with 61 control and 62 silodosin patients as the denominator in each randomization arm. The average expulsion times were 6.31 ± 2.13 days for the silodosin group and 9.73 ± 2.76 days for the control group (P
    Conclusion
    Treatment with silodosin proved to be safe and effective, as demonstrated by the increased stone expulsion rate, the reduced expulsion time, and the reduced analgesics consumption.
    Keywords: adrenergic alpha, 1 receptor antagonists, dose, response relationship, drug, follow, up studies, prospective studies, treatment outcome, ureteral calculi, drug therapy
  • Heshmatollah Sofimajidpour, Pooya Kolahghoci, Fardin Gharibi Pages 2672-2676
    Purpose
    To investigate technical problems, complications and stone clearance rate in patients with spinal neuropathy who had undergone percutaneous nephrolithotomy.
    Materials And Methods
    This cross-sectional study was done between 2004 and 2013 on 29 patients with both spinal cord neuropathy and kidney stones who were chosen for percutaneous nephrolithotomy in Sanandaj city, Iran. The data were obtained from patient's medical records and were documented in a researcher-made checklist. Absolute and relative frequency, mean and standard deviation were calculated.
    Results
    A total of 43 percutaneous nephrolithotomies were performed on 32 kidneys. In 51.7% the right kidney, in 37.9% the left kidney and in three patients (10.3%) both kidneys were involved. There were 24 patients (82.8%) with spinal cord injury. Five patients (17.2%) had spina bifida. The mean of operation time was 129.7 minutes and the mean of hospital stay was 8.3 ± 3.1 days. The mean of kidney stone size was 35.7 ± 6.1 mm (25 to 45 mm). In 58.5% of the patients, surgery lasted more than two hours. Stone clearance rates were 53.1% and 78.1% after the first and second percutaneous nephrolithotomy.
    Conclusion
    Although patients with spinal cord injury have problems in terms of surgery and complications, percutaneous nephrolithotomy is an appropriate and safe treatment method for their kidney stones. Pre-operative counseling with a radiologist and an anesthesiologist is recommended.
    Keywords: kidney calculi, surgery, nephrostomy, percutaneous, adverse effects, postoperative complications, etiology, spinal cord injuries, spinal dysraphism, treatment outcome
  • Taha Numan Yikilmaz, Ayhan Dirim, Ebru Sebnem Ayva, Handan Ozdemir, Hakan Ozkardes Pages 2677-2683
    Purpose
    To investigate the role of CD44, cytokeratin 20 (CK20) and survivin for the detection and prognosis of patients with urothelial carcinoma of the bladder.
    Materials And Methods
    The study included 82 patients who underwent transurethral resection of bladder tumors between 2009 and 2014. The patient and tumor characteristics with relevance to age, tumor size and focality, grade and stage, recurrence and progression were noted. Patients with carcinoma in situ, those who had at more than 3 sites of lesions and greater than 3 cm tumors were excluded. All cases were ex-smokers. All histological samples stained with hematoxylin and eosin were re-evaluated according to the 2004 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification system and immunohistochemically stained for CD44, CK20 and survivin.
    Results
    The study group comprised 57 (69.5%) males and 25 (30.5%) females with a mean age of 60 years (range, 26-87 years). All were newly-diagnosed patients with bladder tumors. Immunohistochemical evaluation revealed that there was a statistically significant correlation between the grade and stage of the tumor with CK20 and survivin positivity (P .05).
    Conclusion
    In cases of bladder urothelial carcinoma positivity for CD44, CK20, and survivin has significant relation with the tumor grade and stage while no significant relationship was determined in terms of recurrence and progression.
    Keywords: biomarkers, tumor, analysis, carcinoma, transitional cell, pathology, disease progression, ımmunohistochemistry, neoplasm grading, neoplasm invasiveness, prognosis, urinary bladder neoplasms, mortality
  • Seung Woo Yang, Yong Gil Na, Ki Hak Song, Ju Hyun Shin, Young Seop Chang, Jong Mok Park, Chung Lyul Lee, Jae Sung Lim Pages 2684-2689
    Purpose
    This study was conducted to evaluate lower urinary tract symptoms (LUTS) change in patients with localized prostate cancer after radical retropubic prostatectomy (RRP) and examine the efficacy of anticholinergic drugs to treat patients suffering from storage symptoms.
    Materials And Methods
    Among 50 patients who underwent RRP for prostate cancer, 40 who did not undergo additional treatment that might affect their urination pattern were included in the analysis. The International Prostate Symptom Score (IPSS), quality of life (QoL) score, and uroflowmetry were analyzed prior to RRP and 12 months after RRP. Twelve months after RRP, patients desiring improvement of storage symptoms were administered anticholinergic drugs for 6 months; the effects of such treatments were analyzed 3 and 6 months later.
    Results
    Preoperatively and at 12 months after surgery, the mean IPSS for patients were 10.9 ± 6.7 and 9.2 ± 5.7, respectively. The mean IPSS for patients desiring improvement of storage symptoms before and after administration of medication were 9.7 ± 5.9 and 9.0 ± 4.4, respectively. In particular, the mean storage symptom composites improved significantly after administration of medication. There were no statistically significant differences in frequency between baseline and 3-month, but frequency was improved significantly after 6 months. Urgency and nocturia were improved significantly after 3 months.
    Conclusion
    In patients undergoing RRP, urinary symptoms change over time, with worsening storage symptoms. Our results suggest that, in patients who had discomfort with storage symptoms after RRP, anticholinergic drugs significantly improved symptoms and QoL.
    Keywords: lower urinary tract symptoms, etiology, prospective studies, prostatectomy, methods, postoperative complications, prostatic neoplasms, surgery, quality of life, urination disorders, drug therapy
  • Kadriye Ozdemir, Nida DinÇel, Afig Berdeli, Sevgi Mir Pages 2690-2696
    Purpose
    We investigated the utility of urinary nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) levels as non-invasive markers for diagnosis and evaluation of treatment efficacy in children with overactive bladder (OAB).
    Materials And Methods
    This prospective study included 24 children with OAB and 30 healthy controls. At the time of diagnosis, micturition disorder symptom scores (MDSS) were determined, blood and urine samples were collected, and anticholinergic therapy was initiated. Clinical responses were evaluated, at the third and sixth month of treatment, by MDSS and urinary NGF, BDNF, and creatinine levels.
    Results
    The patient group had significantly higher urine NGF/Cr ratio (975 ± 827 and 159 ± 84, respectively, P 360 was found to have 87.5% sensitivity and 100% specificity, and BDNF/Cr > 1.288 was found to have 87.5% sensitivity and 83.3% specificity for OAB diagnosis.
    Conclusion
    In conclusion, urine NGF/Cr and BDNF/Cr ratios may be useful markers for diagnosis of OAB. The BDNF/Cr ratio was found to be more significant in monitoring treatment response.
    Keywords: biomarkers, urine, case, control studies, nerve growth factor, urinary bladder, physiopathology, urinary bladder, overactive, etiology
  • Eu Chang Hwang, Sun Ouck Kim, Dong Deuk Kwon Pages 2697-2701
    Purpose
    To assess the reproducibility of the Valsalva leak point pressure (VLPP) based on urodynamics in females with stress urinary incontinence (SUI).
    Materials And Methods
    From October 2008 to December 2009, 65 consecutive women with urodynamically confirmed SUI underwent duplicate VLPP measurements. The intra-individual reproducibility of the VLPP recording obtained by one urologist was determined. The two observations were separated by a 10-min interval.
    Results
    The differences between the repeated measurements were not significant (initial vs. repeat VLPP, 84.8 ± 19.9 vs. 86.7 ± 20.3 cmH2O; P = .094). Repeated VLPP measurements were reproducible. Defining intrinsic sphincter deficiency (ISD) as VLPP
    Conclusion
    In female SUI, the VLPP is a reproducible method for evaluating urethral resistance. For VLPP
    Keywords: urinary incontinence, stress, urodynamics, Valsalva maneuver, physiology, female, pressure
  • Levent Ozcan, Alper Otunctemur, Emre Can Polat, Emin Ozbek, Sinan Levent Kirecci, Adnan Somay Pages 2702-2706
    Purpose
    Nuclear factor kapa b (NFKB) is a transcription factor that is required for cytokine-mediated induction of the human inducible nitric oxide synthase (iNOS) gene. Recent studies have shown that in the pathophysiology of ischemia-reperfusion (IR) injuries NFKB is involved. In our study we aimed to determine the efficacy of the selective NFKB inhibitor, pyrrolidium dithiocarbamate (PDTC), on long-term histological damage in testicular IR injuries.
    Materials And Methods
    Twenty-one adult male Wistar albino rats were divided into 3 equal groups. In groups 1-2, the left testes in rats underwent 4 hours of 720° experimental torsion. In group 2, PDTC (100 mg/kg) was administered intraperitoneally in the last 1 hour before detorsion; and group 3 underwent a sham operation. All rats underwent bilateral orchiectomy 45 days after the experiment. The testes weights were measured and compared to the other groups and their contralateral values. Testes samples were fixed with Bouin solution for histological (Johnsen score) and immunohistochemical examination. Immunohistochemically iNOS and an active subunit of NFKB, p65 were evaluated using mouse primary monoclonal antibodies and were evaluated semi quantitatively.
    Results
    Testicular weights and Johnsen scores in ipsilateral testes were 0.67 ± 0.85, 1.54 ± 0.11, 1.84 ± 0.64 and 1.63 (1-4), 6.94 (4-10), 5.29 (1-9) in the torsion, sham and PDTC groups, respectively. In contralateral testes the same values were 1.74 ± 0.84, 1.59 ± 0.13, 1.50 ± 0.54 and 5.38 (2-8), 7.17 (5-10), 6.30 (4-9). Testicular weights and Johnsen scores were significantly different in the ipsilateral torsion group (P .05). Immunohistochemically there was marked staining in the iNOS and p65 expressions in the torsion group compared with group 2 and 3. In rats administered PDTC, iNOS and p65 expressions were significantly reduced compared with the torsion group. There were no significant differences between the histological and immunohistochemical results of groups 2 and 3.
    Conclusion
    This data suggests that IR induces iNOS expressions through the activation of NFKB, p65. The NFKB pathway plays major role in testicular reperfusion injuries. It is possible to prevent reperfusion injuries using selective the NFKB inhibitor.
    Keywords: torsion abnormality, reperfusion ınjury, pathology, rats, wistar, antioxidants, therapeutic use, testis, blood supply, testis, metabolism
  • Azam Abedi, Mahnaz Azarnia, Mansor Jamali Zahvarehy, Tahereh Foroutan, Sara Golestani Pages 2707-2716
    Purpose
    This study examined the effect of mesenchymal stem cell's conditioned media on the severity of acute kidney injury.
    Materials And Methods
    Acute kidney injury was induced in male rats with 100 mg/kg of gentamicin for six consecutive days intraperitoneally. After inducing the standard model of acute kidney injury, the conditioned medium of 5 × 106 cells was calculated for each kilogram of body weight of the rats. Then, it was injected in three different injection patterns other than the baseline injection of gentamicin. The rats were randomly divided into four groups: control group (n = 18) that did not receive any treatment, gentamicin group (n = 18) that received gentamicin at a dosage of 100 mg/kg for six consecutive days intraperitoneally, sham group (n = 54) that received gentamicin for six consecutive days, and an experimental group (n = 54) that received gentamicin for six consecutive days. Serum biochemical analysis and histological changes were studied and analyzed in all groups.
    Results
    Although human mesenchymal stem cell's conditioned media did not improve serum and tissue markers in the treatment groups, a relative improvement was observed in some indicators of tissue damage.
    Conclusion
    Secretory factors of human mesenchymal stem cells can be partly protective against gentamicin-induced nephrotoxicity.
    Keywords: acute kidney injury, gentamicin, mesenchymal stem cells, conditioned culture media, secretory factors
  • Sicong Zhao, Chao Chen, Zongping Chen, Ming Xia, Jianchun Tang, Sujun Shao, Yong Yan Pages 2717-2726
    Purpose
    To investigate the association between metabolic syndrome (MetS) and the predictors of the progression of benign prostatic hyperplasia (BPH) and the corresponding frequency and severity of lower urinary tract symptoms (LUTS).
    Materials And Methods
    A total of 530 men with moderate to severe International Prostate Symptom Score (IPSS) > 7 were recruited in the present study. The predictors for clinical BPH progression were defined as the total prostate volume (TPV) ≥ 31 cm3, prostate-specific antigen level (PSA) ≥ 1.6 ng/mL, maximal flow rate (Qmax)
    Results
    The percentage of subjects with ≥ 1 predictors for clinical BPH progression, the percentage of subjects with a TPV ≥ 31 cm3, the percentage of subjects with a PVR ≥ 39 mL, and the percentage of subjects with a Qmax 19, all P
    Conclusion
    Our data have shown that the MetS significantly associated with the predictors for clinical BPH progression and the frequency and severity of LUTS, especially the voiding symptoms. The prevention of such modifiable factors by promotion of dietary changes and regular physical activity practice may be of great importance for public health.
    Keywords: metabolic syndrome X, complications, prostatic hyperplasia, pathology, humans, male, prostate, pathology, urination
  • Gaurav Prakash, Bhupendra Pal Singh, Satya Narayan Sankhwar, Ankur Jhanwar Pages 2727-2728
  • Delayed Diagnoses of Retroperitoneal Cystic Adenocarcinoma Mimicking Renal Cyst
    Myung Geun Noh, Sang Soo Shin, Yoo Duk Choi, Taek Won Kang Pages 2729-2731
  • Ioannis Efthimiou, Zacharias Chousianitis, Kostadinos Skrepetis Pages 2733-2734