فهرست مطالب

Urology Journal - Volume:14 Issue: 2, 2017
  • Volume:14 Issue: 2, 2017
  • تاریخ انتشار: 1396/01/15
  • تعداد عناوین: 10
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  • Gokhan Atis, Meftun Culpan, Eyup Sabri Pelit, Cengiz Canakci, Ismail Ulus, Bilal Gunaydin, Asif Yildirim, Turhan Caskurlu Pages 2995-2999
    Purpose
    To compare the outcomes of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in treating renal stones between 20 and 40 mm in diameter.
    Materials And Methods
    146 patients, who were treated with RIRS and 146 patients, who were treated with PCNL for renal stones between 20 and 40 mm in diameter were compared retrospectively using a matched-pair analysis. The operative and post-operative outcomes of both groups were analyzed retrospectively.
    Results
    The mean age, gender, body mass index and stone laterality were similar between the groups. The mean stone size was 28.39 ± 4.67 mm for the PCNL group and 25.08 ± 6.07 mm for the RIRS group (P =.21). The mean operative times were statistically longer in the RIRS group, whereas the fluoroscopy times, hospitalization times and post-operative visual analogue scores were statistically higher in the PCNL group. The stone- free rates (SFR) after a single procedure were 91.7% in the PCNL group and 74% in the RIRS group (P = .04). After auxiliary procedures, the overall SFRs reached 94.4% for the PCNL group and 92.3% for the RIRS group (P = .52). No major complications were observed for both groups. Minor complication (Clavien 1-3) rates were 6.8% and 3.4% for the PCNL and RIRS group, respectively (P =.18).
    Conclusion
    RIRS has some advantages over PCNL such as shorter hospitalization times, shorter fluoroscopy times and less post-operative pain in treating renal stones between 20 and 40 mm in diameter. However, PCNL has a higher SFR with only a single session.
    Keywords: percutaneous nephrolithotomy, nephrolithiasis, retrograde intrarenal surgery
  • Siavash Falahatkar, Ali Ghasemi, Keivan Gholamjani Moghaddam, Samaneh Esmaeili*, Ehsan Kazemnezhad, Seyed Naser Seyed Esmaeili, Reza Motiee Pages 3000-3007
    Purpose
    To compare outcomes and complications of percutaneous nephrolithotomy (PCNL) in the complete supine versus semi supine position in order to select the best position.
    Materials And Methods
    In this clinical trial, between July 2011 and May 2014, a total of 44 patients who presented for PCNL were prospectively enrolled and randomly divided into 2 groups [complete supine (n=22), and semi supine (n = 22)]. The results in both positions were compared regarding the complexity and outcomes. Stone free rate was considered as a main target of the study. However, it was the first study to focus on overlapping the vertebral density during the access.
    Results
    The two groups were comparable in age, gender, body mass index, and preoperative glomerular filtration rate, hemoglobin and creatinine. The mean operative time was significantly shorter for complete supine versus semi supine (36.68 ± 14.12 min versus 47.50 ± 16.45 min, P = .024). At the angle of 0?, overlapping with the spine occurred in 7 patients (31.8%) in semi supine group and just in 1 patient (4.5%) in complete supine group. Also, overlapping with the edge of bed occurred in 10 cases (45.5%) of complete supine and 1 (4.5%) of semi supine; the differences were statistically significant (P = .023, P = .002, respectively). No significant difference was found between the two groups in terms of stone free rate and complications.
    Conclusion
    Although, we had to convert two cases from semi supine into the complete supine position but we have demonstrated that PCNL in both positions is safe, effective and suitable for the patients. The stone free rate was similar in both groups. But the complete supine position is associated with a significantly shorter postoperative hospital stay and operative time, which may improve ease and safety of PCNL for patients.
    Keywords: complexity, fluoroscopy, operative time, percutaneous nephrolithotomy, supine, stone free rate
  • Shady Nafie*, Michael Wanis, Masood Khan Pages 3008-3012
    Purpose
    We have previously demonstrated that transperineal template prostate biopsy (TPTPB) has a significantly higher cancer detection rate compared to transrectal ultrasound guided (TRUS) biopsy in biopsy naive men with a PSA
    Materials And Methods
    42 patients with a background of one previous negative set of TRUS biopsy, persistently elevated PSA (but
    Results
    Mean age was 65 years (range: 50-75), mean prostate volume was 59 cc (range: 21-152), mean PSA is 8.3 ng/L (range: 4.4-19), mean time difference between the study and the previous TRUS biopsy was 33 months (range: 1-150) with mean PSA velocity of 0.7 ng/mL/year (range: 0-8). Out of the 42 patients, 22 (52%) had benign pathology. Of the 20 patients (48%) diagnosed with prostate cancer, 4 (10%) had positive results in both TRUS biopsy and TPTPB, 1 (2%) had positive result in TRUS biopsy with negative TPTPB, while 15 (36%) had negative TRUS biopsy with positive TPTPB. Hence, TRUS biopsy detected cancer in 5/42 (12%) patients versus (19/42) 45% detected by TPTPB (P
    Conclusion
    TPTPB still shows a significantly higher prostate cancer detection rate compared to TRUS biopsy (12% versus 45%, P
    Keywords: biopsy, cancer, prostate, transperineal, transrectal, ultrasonography
  • Afshar Zomorrodi, Hassan Mohammadipoor Anvari*, Farzad Kakaei, Farzin Solymanzadeh, Esmaeil Khanlari, Amin Bagheri Pages 3013-3017
    Purpose
    Furosemide is commonly administered to increase the urinary output in patients with transplanted kidneys. This study compared the two administration routes of furosemide (bolus versus infusion) in kidney transplanted patients.
    Materials And Methods
    Fifty patients who had undergone kidney transplantation in 2015 in a hospital in Tabriz, Iran, were included in this clinical trial. They were divided into two groups: bolus (120 mg stat) and infusion (4 mg/minute) groups. The primary outcome was urine onset time. Secondary outcomes were urine output volume, vital signs (blood pressure, heart rate), and electrolyte level (creatinine, blood urea nitrogen, sodium and potassium). After arterial and venous anastomoses, arterial clamp removal time and diuresis onset were recorded. Finally, the
    urinary output volumes of both groups were measured with regular urine bags for an hour after anastomosis. Then it was repeated each three hours for 24 hours, and eventually two and three days thereafter. Finally, all data were statistically analyzed.
    Results
    Around 72% of the patients were men (mean age of 37.15 ± 14.67 years). Urine output was higher in bolus group but it was not statistically significant. Diuresis duration was measured after arterial declamping and its averages were 5.41 ± 3.7 minutes and 9.36 ± 7.65 minutes in bolus and infusion groups, respectively (P = .040). Furosemide bolus injection and infusion had no significant effect on creatinine, blood urea nitrogen, sodium and potassium.
    Conclusion
    Furosemide bolus injection can reduce diuresis onset time compared to furosemide infusion.
    Keywords: clinical trial, furosemide, infusion, kidney transplantation, loop diuretic
  • Kim Sun Ouck*, Taek Won Kang, Dongdeuk Kwon Pages 3018-3022
    Purpose
    To investigate patient's preferences for the gender of their urologist.
    Materials And Methods
    Patients who visited a urologic center were asked to complete a self-administered questionnaire on the preferences for the gender of their urologist as well as on their age, education level and employment status.
    Results
    Of 270 respondents, 144 subjects (53%) had a preference for the gender of their urologist, whereas 126 subjects (47%) had no preference. Among 154 female respondents, 56 (36.4%) patients had no preference;
    96 (62.3%) patients had preferences for female urologists; and only 2 (1.3%) patient preferred male urologists. Among 116 male respondents, 70 (60.3%) patients had no preference; 30 (25.9%) patients had preferences for male urologists; and 16 (13.8%) preferred female urologists. Of patients that did express a preference, 87.5% (126/144) preferred the same gender urologist, with 65.2% (30/46) of male patients preferring male urologists and 97.9% (96/98) of female patients preferring female urologists (p
    Conclusion
    More than half the female participants had a preference for the same gender of urologist, whereas the majority of male participants expressed no preference for the gender of their urologist. Furthermore, gender preference was not correlated with age and education level.
    Keywords: gender, preference, urologist
  • Increased Level of c-kit in Semen of Infertile Patients with Varicocele
    Guorong Jin, Jianrong Liu, Qin Qin, Songdan Gao, Fang Zhang, Yuehong Ma, Caiyun Ding, Lina Dong, Haizhen Yin, Yimin Wang Pages 3023-3027
    Purpose
    Varicocele is the most common risk factor for male infertility, however, not all males with varicocele experience infertility. In fact, most patients with varicocele have normal spermatogenesis. The molecular mechanism of varicocele-associated infertility is yet to be completely understood. The aim of this study is to assess the association of a number of fertility regulatory factors on varicocele associated infertility and to throw light on the mechanism of varicocele-associated infertility.
    Materials And Methods
    Semen from 30 infertile patients with varicocele and 30 fertile men with varicocele were collected. The concentrations of the following factors in seminal plasma were determined by ELISA: follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), androgen binding protein (ABP), transferrin (Trf), inhibin B (INHB) and stem cell factor (SCF). The expression level of c-kit in seminal precipitate of patients with varicocele was detected by real-time PCR.
    Results
    The concentrations of sexual hormones, FSH, LH and T, had no differences between infertile patients with varicocele and fertile men with varicocele (P > 0.05). Factors secreted by Sertoli cells, ABP, Trf, INHB and
    SCF, showed no significant differences between the two groups (P > 0.05). Interestingly, the expression of c-kit was significant higher in infertile patients with varicocele than that in fertile men with varicocele (P
    Conclusion
    Neither the sexual hormones nor the Sertoli cells was responsible for the infertility induced by varicocele.
    The aberrant expression of c-kit in infertile patients with varicocele may provide new insight into the mechanism of varicocele-associated infertility.
  • Sahra Kirmusaoglu*, Seyhun YurdugÜl, Ahmet Metin, Suphi Vehid Pages 3028-3034
    Purpose
    The aims of this study were to determine relationship between biofilm producer microorganisms attached to urinary catheters (UCs) and urinary catheter-associated urinary tract infections (CAUTIs), to determine the rate of CAUTI development and the relationship between CAUTI and catheterization period in catheterized patients.
    Materials And Methods
    Urinary catheters from 143 inpatients who were hospitalized in Abant Izzet Baysal University Hospital Urinary Service, and urine samples of these patients before and after catheterization of urinary
    catheter were collected. Culture-based microbiological evaluation of urinary catheters removed from inpatient and urine samples collected from inpatients were performed before and after catheterization of urinary catheter to identify various organisms and determine biofilm production by them.
    Results
    The incidence of CAUTIs was 13% (18/143) in catheterized inpatients. Biofilm producer microorganisms such as Escherichia coli (E. coli ), Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis that were isolated from UCs removed from inpatients were found to cause CAUTI (P
    Conclusion
    Incidence of CAUTIs is increased by the usage of UCs and prolonged catheterization period.
    Keywords: urinary catheter, biofilm, catheter, associated urinary tract infection, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeroginosa, Proteus mirabili
  • Keon Cheol Lee*, Bong Mo Seong Pages 3035-3039
    Purpose
    In overactive bladder (OAB) patients with systemic diseases, dry mouth tends to be more prominent owing to the effects of systemic diseases or related medications. We evaluated how systemic diseases affect dry mouth before and after anticholinergic treatment.
    Materials And Methods
    OAB patients were enrolled in this study. The patients were divided according to the presence or absence of systemic diseases. Patients with systemic diseases were sub-grouped by the number of systemic diseases (only one or more than one disease). OAB symptoms score (OABSS), visual analogue scale (VAS) score for dry mouth, and body mass index (BMI) were measured. The statistical assessments were done
    with independent T-tests and ANCOVAs.
    Results
    One hundred and four OAB patients were enrolled in this study. Seventy (67.3%) patients had systemic diseases and thirty-four (32.7%) patients did not. Age and BMI were higher in the systemic diseases group. The baseline VAS score of OAB in the systemic diseases group (15.9 ± 19.5) was higher than that in the OAB without systemic diseases group (4.1 ± 6.4) (P = .002). Even after age and BMI adjustment, the difference was significant. The follow-up VAS score was also different (P = .028), but the change in VAS score was not different (P = .280). In a sub-analysis, the change in VAS score in the group with two or more systemic diseases (23.6 ± 18.1) was higher than that in the group with only one systemic disease (12.5 ± 13.2) (P = .012).
    Conclusion
    The severity of xerostomia after treatment with anticholinergics in OAB increases in patients with one systemic disease parallel to its severity before starting treatment. However, in patients with two or more systemic disease the magnitude of change in xedrostomia score is higher that we would expect in patients with no or one systemic diasese.
    Keywords: body mass index, cholinergic antagonists, systemic diseases, urinary bladder, overactive, xerostomia
  • Jamal Jafari Nodoushan, Samad Zare*, Seyed Mostafa Tabatabaei, Mojtaba Babaei Zarch, Fatemeh Imani, Fatemeh Ehsani Pages 3040-3042
    Isolated renal hydatid cyst is a rare entity accounting for only 2-4% of cases. A 60-year-old male presented to our clinic complaining of pain in right flank. He had a history of eating raw sheep liver. Imaging revealed an expansive cystic mass measuring approximately
    300×180 mm in the right side of abdomen. The patient was treated by open surgery in combination with perioperative chemotherapy with albendazol. In this case, we reported an unusual presentation of hydatid cyst disease. Physicians should be aware of its clinical presentations and complications.
    Keywords: abdomen, case reports, hydatid cyst, kidney, mass, nephrectomy
  • Roghayeh Norouzi*, Arman Manochehri, Mustafa Hanifi Pages 3043-3045
    A 75-year-old man from Kurdistan province, western part of Iran was diagnosed with a mass in the right kidney by ultrasound and computed tomography. In operation, a parasitic helminth, 30 cm long and 1.2 cm in diameter consistent with D. renale was found in the right kidney. Microscopic examination revealed that the male Dioctophyma renale. Following removal of worm, the symptoms completely resolved within a few hours. Generally, parasitism by D. renale in human is a necropsy finding, nevertheless imaging techniques as ultrasound and computed tomography have been proven to be important tool to achieve diagnosis.
    Keywords: Dioctophyma renale, human infection, Iran