مجله تحقیقات در ارولوژی
سال سوم شماره 1 (بهار و تابستان 1398)

Prostate cancer is considered to be the most prevalent malignancy among males. Prostate specific antigen (PSA) is used for screening this malignancy. Serum levels of PSA is influenced by liver function. This study evaluated variations of serum levels of PSA amongst cirrhotic patients, before and after receiving liver transplantation.

All cirrhotic males older than 45 y/o in the waiting list of liver transplant, were enrolled in the study. After receiving a medical history and checking a total PSA (tPSA), patients who had abnormality were excluded from the study. So, 60 patients who underwent liver transplantation surgery, with a normal 3 month follow up liver function tests (LFT) participated in this study. Thereafter the tPSA level was checked again. Ultimately 30 patients performed the tPSA after a successful liver transplant.

The mean age of these 30 patient was 57, and average tPSA before liver transplant was 0.4 ng/dl (range: 0.07-1.6), and was 1.6 (range: 0.2-7.3) after transplant. Wilcoxon test revealed significant differences between pre and post-transplant PSA levels (P˂0.001, Z= -4.68).

Serum levels of PSA, rises after a successful liver transplant. In cirrhotic patients, PSA levels may not be authentic. In this study, PSA levels rose by 1.2 ng/dl post-transplant. This study revealed that tPSA may be neither reliable nor sensitive enough as a routine screening test for cirrhotic patients; and seems to do the screening there is a need for lower levels comparing to healthy people for the test.

Nowadays, partial nephrectomy (PN) has specific indications in renal tumors. There are challenges regarding the remaining and seeding of malignant cells after surgery due to increasing tendency to do laparoscopic PN (LPN) and consequently increased manipulation of the surrounding tumor tissue. The objective of this study was to investigate the frequency of renal capsule invasion (RCI) and perinephric fat infiltration (PFI) in patients with renal cell carcinoma (RCC) who had underwent PN.

Clinical data and pathologic samples of 101 patients who underwent PN and had RCC from 2011 to 2012 were elicited. Sixty one patients underwent LPN and 40 patients underwent open PN (OPN). All pathologic samples were reviewed by an uropathologist. Fuhrman nuclear grade, surgical margin and prevalence of RCI and PFI were also determined.

The mean tumor size was 40.7 mm (range: 15mm to 120mm). In all cases, the renal capsule and perinephric fat were left intact. Surgical margin was involved in four cases of LPN. Three patients had recurrence during follow up time (follow up durations were 12, 16, and 24 months for each). The fourth one was expired during 30 months follow up despite performing radical nephrectomy.

Based on the results obtained in this study, the probability of RCI and PFI is low and hence manipulating and removing the perinephric fat to achieve better exposure to tumor will not increase the risk of seeding malignant cells.

Nephrectomy is the last step in the treatment of renal disease and has several causes. Removing the kidney tissue is a great blow to the patient’s health. The purpose of this study was to survey the causes of nephrectomy in 2018 in Shiraz.

A total of 78 records of nephrectomy were reviewed in 2018 at Shiraz Namazi Hospital. The records were extracted from the archives and the specifications were written in the researcher-designed questionnaire. Patients’ information was evaluated by SPSS 16.

The mean age of the patients was 46.29±12.46 years. Of the patients under study, 53.85% were male and 69.23% were married. More than half of the cases were related to the left kidney (52.56%); and the nephrectomies were simple (41.03%), radical (26.92%) and partial (23.08%) respectively. In the study, the causes of nephrectomy in patients were chronic pyelonephritis (33.33%), renal tumors (28.21%), homonfrosis (19.23%), and other cases with a low prevalence (19.23%), respectively.

Chronic pyelonephritis was the most common cause of nephrectomy. The most important causes of nephrectomy in renal disease were infections. Therefore, the diagnosis and treatment of renal infections in a timely manner can prevent kidney damage and breakdown. Nephropathy can be controlled by controlling renal infections.

 Satisfaction is one of the health aspects of human. Without attention to people's satisfaction in the health services, the health system act contrary to its mission. The aim of this study is to evaluate the patient's satisfaction in the urology ward at Shahid Beheshti Hospital in Hamadan University of Medical Sciences in second half of 2018, for investigate the strengths and weaknesses with provide guidance and better quality treatments.

In this cross-sectional study, 170 hospitalized patients in the Urology ward in shahid beheshti hospital during the second half of 1397 were studied. Data were analyzed with spss-16 software.

The results showed that the average satisfaction rate of all services was 77.25%. However, the highest satisfaction with nursing services is 80.8 and the lowest satisfaction with public services is 72.6. There were significant relationships between demographic variables such as age, sex and level of education with total satisfaction.

From the viewpoint of patients at Shahid Beheshti Hospital in Hamadan, the total services and facilities that report, are to be desirable.

We report a patient with pain, abdominal palpable mass and a history of previous open renal stone surgery. Imaging studies showed a right pelvic kidney with multiple calyceal stones. We aim to describe the successful management through laparoscopic assisted percutaneous nephrolithotomy with ultrasonography (PCNL) in ectopic pelvic kidney, stressing that this method is a minimally invasive therapeutic option in such cases; especially ultrasound was used for locating the stones and getting access to the collecting system instead of the fluoroscopy.