Urology Journal
Volume:16 Issue: 6, Nov-Dec 2019

This study aimed to evaluate the anti-inflammatory effect of E. campestre using the aqueous extracts, obtained from the aerial parts, on Ethylene Glycol (EG)-induced calcium oxalate kidney stone in rats.

64 male Wistar rats were randomly divided into 8 groups. Group I was considered as negative control and received normal saline for 30 days, group II as kidney stone control received EG for 30 days, groups III to VI as prophylactic treatment received EG plus 100, 200 or 400 mg/kg extracts for 30 days and groups VI to VIII received EG as therapy from day one and 100, 200 or 400 mg/kg extract from the 15th day. On the 30thday from the start of induction, rats were euthanized. Blood was collected and the kidneys were immediately excised. Slides from each one’s kidneys were prepared and stained with Hematoxylin & Eosin method. Also levels of interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) were determined in rat’s serum by competitive ELISA kit.

E. campestre reduced IL-1β and IL-6 levels, showing a significant reduction for both cytokines in all prophylactic groups, especially at the dose of 400 mg/kg (P-value < .001). Moreover, IL-1β (p = .011) reduced significantly in the therapy groups in 400 mg/kg dose. Crystal count reduction was seen in all prophylactic and therapy groups in comparison with group II.

These results suggest that the E. campestre extract has potent suppressive effect on pro-inflammatory cytokine production in rat. Also, E. campestre decreases crystal deposition in the kidney of the hyperoxaluric rat.

Many factors affecthypothermia and shivering during percutaneous nephrolithotomy and in recovery. Hence this study was carried out to determine the effect of irrigation solution temperature on complications of percutaneous nephrolithotomy.

In this randomized clinical trial, 60 patients undergoing PCNL in Sina University Hospital were enrolled. The patients were randomly assigned in three groups according to simple random manner. The groups included three groups of room temperature fluid (24 degree), warm solution (37 degree), and cold fluid (20 degree) during nephroscopy.

Although the initial core temperature was alike across the groups (P > .05); the hypothermia rate occured in all 20 patients in the cold fluid group (P = .012). There was significant difference between the groups in terms of final temperature and alteration amount (P = .001). The mean VAS scores were significantly lower in the warm fluid group compared with the others groups at recovery, and 8hrs post-operatively (P = .03). Assessment of shivering rates revealed that 3(15%) patients in warm solution group shivered compared to8 (40%) patients in cold fluid group (P = .018).

Warm irrigation solution during PCNL results in significantly decreased hypothermia, mean postoperative pain score and shivering. Hence use of warm irrigation fluid for this matter is recommended.

To analyse the changes in renal function and serum electrolytes in the early post-operative period of percutaneous nephrolithotomy (PCNL).

A total of 110 patients with normal renal function, who underwent PCNL in our institute were evaluated prospectively. Haemoglobin percentage, packed cell volume, blood urea nitrogen, serum creatinine and serum electrolytes, namely sodium, potassium, chloride and ionized calcium were measured on the day before surgery and after 72 hours of the procedure. Renal function was assessed by Cockcroft-Gault formula and estimated glomerular filtration rate was calculated by modification of diet in renal disease formula.

Serum creatinine increased significantly from a mean value of 0.89 ± 0.199 mg/dL to 0.96 ± 0.252 mg/dL (P = 0.0002) and both creatinine clearance and estimated glomerular filtration rate experienced a significant fall - from a median value (interquartile ranges) of 82.99 (72.37 to 96.88) mL/min to 75.38 (63.89 to 94.05) mL/min in case of creatinine clearance (P = 0.0004) and from a mean value of 95.18 ± 19.87 mL/min/1.73 m2 to 89.30 ± 23.14 mL/min/1.73 m2 in case of estimated glomerular filtration rate (P = 0.003). Furthermore, there were significant drops in both haemoglobin percentage and packed cell volume. There were no significant alterations in serum electrolytes - sodium and potassium (mmol/L) [Median (IQR)] changed from a pre-operative figure of 137.5 (134.0 to 140.0) and 3.85 (3.60 to 4.10) to a post-operative value of 138 (135.0 to 140.0) and 3.85 (3.50 to 4.10) respectively.

Even though there is no significant variation in serum electrolytes, PCNL causes significant reduction in renal function in the early post-operative period.

The miniaturized percutaneous nephrolithotomy (mPNL) can be performed by using a very wide range of different access sheaths (14-22 Fr). It has been well known that tract size is one of the main parameters affecting the complication rates in PNL. We aimed to compare 21 Fr with 16.5 Fr mPNL tract sizes in adult patients.

From May 2013 to April 2018, 604 patients with kidney stone underwent mPNL in our department. The study was designed as retrospective and match-pair analysis was the preferred method for the formation of groups. The 21 Fr mPNL cases were matched with 16.5 Fr mPNL cases at a 1:1 ratio, according to the patients’ age, gender, body mass index, American Society of Anesthesiologists (ASA) score, stone characteristics (stone size, opacity and localization) and hydronephrosis. Patients with solitary kidney, renal anomalies, musculoskeletal abnormalities, and pediatric patients (< 18 years old) were excluded from the study. Both groups (21 Fr and 16.5 Fr) were compared in terms of demographics, stone characteristics, operative data and post-operative outcomes.

A total of 260 patients were included in the study (130; 21 Fr mPNL group and 130; 16.5 Fr mPNL group). The operation time was significantly shorter in 21 Fr group (21 Fr; 85.2 ± 37.5, 16.5 Fr; 101.7 ± 37.7 minutes, p = 0.001). Complete stone clearance rates were 76.9% and 62.3% in 21 Fr and 16.5 Fr mPNL, respectively (p = 0.01). There was no significant difference between the groups in terms of overall operative and post-operative complications. However, in subgroups analysis, post-operative fever was higher in 16,5 Fr mPNL (4 patients in 16.5 Fr, no patients in 21 Fr group, p = 0.044); steinstrasse, renal colic and post-operative JJ stent requirement rates were higher in 21 Fr mPNL procedure (p: 0.018, p: 0.031 and p: 0.046, respectively). The hospitalization time was significantly higher in 21 Fr (p = 0.01).

Although 21 Fr mPNL procedure has advantages such as better success rates and shorter operation time, some post-operative complications (steinstrasse, renal colic, post-operative JJ stent requirement) are against of 21 Fr mPNL when compared with 16.5 Fr mPNL procedure. Further randomized prospective studies with larger patient volume are needed to confirm these results.

This study was designed to evaluate the effectiveness and safety of retrograde intrarenal surgery (RIRS) following retrograde laser endopyelotomy (rLEP) in concomitant ureteropelvic junction obstruction (UPJO) and stone disease.

Patients with concomitant UPJO and renal stone disease who were first treated in our clinic by rLEP for obstruction and then RIRS for stone disease were enrolled. Study period went from 2012 to 2017. RIRS following rLEP was performed earliest at the sixth week. Patients who underwent rLEP were matched with those with normal anatomy at a 1:1 ratio based on the propensity scores. Additionally, clinical results were compared in order to evaluate the effects of rLEP surgery on RIRS. Subsequently, patients who underwent RIRS following rLEP were independently evaluated and factors affecting the success of sequential procedures were investigated.

The sole difference between those that underwent RIRS following rLEP (n=27) and controls with normal anatomy that underwent RIRS was in operative times (p = .011). Evaluation of potential success factors in the sequential rLEP-RIRS group revealed that primary etiology, obstruction length less than 1cm, smaller stone size and presence of single stone showed significant effects (p = .047, p = .030, p = .040, p ≤ .001, respectively). RIRS following rLEP generated an 81.5% stone-free and, after a median follow-up time of 32 months, a 74.1% obstruction-free rate.

RIRS following rLEP in patients with UPJO and renal stones is an effective treatment method. It can be used safely in patients with single stones < 2cm, short obstruction lengths, and presence of primary etiology.

This study was to introduce the modified mini-laparoscopic surgery for renal cyst and investigate its advantages on operative time, cosmetic effect and pain reduction by comparison with laparo-endoscopic single site surgery (LESS) and conventional laparoscopic surgery. Methods and patients: Between May 2015 and October 2018, 140 consecutive patients with benign renal cyst underwent laparoscopic decortication of renal cyst. Of which, 48 cases were in mini-laparoscopic surgery group (M group), 56 cases in LESS group and 36 cases in conventional laparoscopic surgery group (C group). The operative time, blood loss, visual analog scale (VAS) and Scar Cosmesis Assessment and Rating (SCAR) Scale was recorded.

The mean operative time in M group (26.08±7.70 min) and C group (28.56 ± 7.99 min). was significantly less than that in LESS group (47.32 ±10.53 min) (P < 0.01). Mean blood loss did not differ between the 3 groups (P > 0.05). Mean VAS pain scores in M group were significantly lower than that of LESS group and C group on postoperative day (POD) 1 and 3 (P < 0.01). The SCAR scale of POD 30 in C group (6.25 ± 1.0) was significantly higher than that in M group (0.77 ± 0.59) and LESS group (0.98 ± 0.70). The postoperative course was uneventful with no morbidity within 1to 6 months of follow-up.

Modified mini-laparoscopic decortication of renal cyst have more comprehensive advantages comparing with LESS and conventional laparoscopic surgery. It is convenient and offered significant cosmetic benefit and reduced incisional pain.

The current study aimed to evaluate multiparametric MRI for the diagnosis of type of tumor (benign or malignant) in patients suspicious of inner gland prostate cancer.

This cross-sectional study was conducted on 44 consecutive patients with a clinical impression of prostate cancer who were referred to the MRI department of Payambaran Hospital, Tehran, Iran for confirmative diagnostic evaluation. Cases suspected of tumor relapse and those who previously underwent treatment for prostate cancer were excluded. Multiparametric MRI was performed for every patient by using a 1.5 Tesla device with an integrated endorectal and pelvic-phased array coil. All patients subsequently underwent MRI- transrectal ultrasound fusion biopsy. The diagnostic value of each sequence was then investigated individually and in combination with other techniques by comparing the results with histological findings from MRI–TRUS fusion biopsy.

Among the techniques, T2-weighted imaging (T2W) had the highest sensitivity and specificity while dynamic contrast enhanced (DCE) technique had the least. Diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) had a similar sensitivity and specificity and did not significantly differ from T2W. Adding functional techniques to T2W did not improve diagnostic indices compared to T2W alone. Quantitative evaluation of apparent diffusion coefficient (ADC), DWI, and MRS showed that all techniques were able to differentiate between benign and malignant tumors. However, the quantitative combination of these sequences decreased diagnostic performance.

T2W is the best technique for the diagnosis of type of tumor in terms of benignancy or malignancy in patients suspicious of inner gland prostate cancer. Adding functional imaging measurements to T2W does not improve its diagnostic value

To identify clinically useful predictors for the recurrence of papillary urothelial neoplasm of low malignant potential (PUNLMP), we reviewed the clinical information of patients who were diagnosed and treated in multiple tertiary-care academic facilities.

Between February 2007 and April 2015, 95 patients diagnosed with PUNLMP after transurethral resection of bladder (TURB) were included in this study. Age, gender, body mass index, smoking history, the presence or absence of previous history of urothelial neoplasm, the presence or absence of gross hematuria, cytological results at the time of diagnosis, tumor diameter, and multiplicity of tumor were estimated as variables for analysis. Cox regression tests were used for identifying predictive factors for recurrence of PUNLMP.

Sixty-nine cases of PUNLMP were de novo primary bladder PUNLMPs without known urothelial lesions in the urinary tract, and 26 PUNLMPs were identified on surveillance biopsies of patients with a previous history of urothelial neoplasm. During the follow-up period, recurrences developed in 13 patients (13.7%). Recurrence rates were 4.2% and 9.5% at 12 and 24 months, respectively. On univariate and multivariate Cox regression analyses, previous history of urothelial neoplasm [95% confidence interval (CI): 0.057-0.604, hazard ratio (HR) = 0.185, P = .005] and multiplicity of tumors [95% CI = 0.064-0.584, HR = 0.193, P = .004] were identified as independent predictors for recurrence-free survival of patients with PUNLMP.

Tumor multiplicity and previous history of urothelial neoplasm are independent prognostic factors for prediction of recurrence of PUNLMP. More careful and closer follow-up should be recommended for PULNMP patients with tumor multiplicity or a previous history of urothelial neoplasm.

Biochemical failure after radical prostatectomy has been defined based on retrospective studies in men who underwent RP for localized prostate cancer. Nevertheless, retrospective strategy and possibility of extra-prostatic extension overshadowed the accurateness of the aforementioned cut-off value. To define a more precise PSA nadir value, we estimated serum PSA after cystoprostatectomy in cases with bladder urothelial cancer and no evidence of prostate cancer.

Study population consists of 52 subsequent patients who underwent radical cystoprostatectomy for muscle-invasive bladder cancer between December 2010 and December 2013. Patients with prostate adenocarcinoma and/or high grade prostate intraepithelial neoplasia were excluded from enrollment. Other exclusion criteria were prostate involvement with urothelial carcinoma, neoadjuvant or adjuvant chemotherapy and radiation therapy. Between all cases, 41 were enrolled for study. Serum PSA level was measured using immunochemiluminescence method from 6 months to 3 years after operation in study participants.

Forty-one patients with mean age of 66.4 ± 8.9 years were assessed in this study. Average serum PSA level after radical cysto-prostatectomy was: 037 ± .031 ng/mL (from .002 to .1). Serum PSA level was not impressed with type of diversion or interval between operation and PSA measurement. Average serum PSA level in this study was meaningfully lesser than .2 ng/mL which is contemplated as PSA nadir value after RP.

Serum PSA level of 0.2 ng/mL as the definition for biochemical recurrence after RP may delay salvage treatment. Our results showed that cut off value of （0.1 ng/mL may be more precise in the era of early salvage treatment.

We aimed to investigate the potential early diagnostic value of ischemia modified albumin (IMA) and D-dimer in testicular torsion.

A total of 42 prepubertal Wistar-Hannover rats (26-30 days old, weighing 75-125 grams) were used in the study. They were randomly divided into 2 groups as torsion (21 rats) and control (21 rats). Both torsion and control groups were subdivided into three subgroups as 30th, 120th and 240th minutes. Intraperitoneal injection of 70 mg/kg ketamine (Ketalar, Pfizer, Istanbul, Turkey) plus 10 mg/kg of xylazine (Rompun, Bayer, Istanbul, Turkey) were used for general anesthesia. In the control group, scrotal incision was made and the left testis gently extracted. Then, intracardiac blood and testicular tissue were obtained at 30th, 120th and 240th minutes. In torsion group, testicular ischemia was achieved by rotating left testis 720° clockwise and maintained by fixing the testis. Blood and testicular samples were obtained at 30th, 120th and 240th minutes. All animals were sacrificed after completion of the study.

There was a statistically significant difference between the IMA and D-dimer levels at 30th, 120th and 240th minutes of torsion group when compared with the control group (p = .001). When compared in terms of pathological changes at 30th, 120th and 240th minutes, significant difference was found for all 3 periods (p = 0.039, p = 0.014, p = 0.03, respectively). The D-dimer and IMA estimated torsion with reasonable accuracy [Area under the curve (AUC)= 0.771 (p = 0.003, 95% confidental interval: 0.620-0.922) and AUC = 0.706 (95% confidental interval: 0.549-0.863, p = 0.022), respectively.

The elevated D-dimer and IMA serum levels observed in the experimental testicular torsion model seem to have a potential role as a serum marker in the early diagnosis of testicular torsion.

Long non-coding RNAs (lncRNAs) include a vast portion of human transcripts. They exert regulatory roles in immune responses and participate in diverse biological functions. Recent studies indicated dysregulation of lncRNAs in the process of transplant rejection. In the current study, we aimed at identification of the expression of five lncRNAs (OIP5-AS1, FAS-AS1, TUG1, NEAT1 and PANDAR) in association with the process of transplant rejection.

We assessed expression of these lncRNAs in the peripheral blood of 61 kidney transplant receivers including 29 transplant rejected patients and 32 transplant non-rejected patients using real time PCR technique.

Expression of FAS-AS1 was significantly higher in rejected group compared to non-rejected group in males, however, differences between case and control groups were insignificant among females. For other lncRNAs no significant differences were detected between two study groups. Quantile regression model showed that patients’ gender was an important parameter in determination of FAS-AS1 expression (Beta = - 9.46, t =- 2.82, P = 0.007) but not for other lncRNAs expressions. Significant pairwise correlations were detected between expression levels of lncRNAs in a disease related manner.

Based on the higher expression of FAS-AS1 in patients with transplant rejection, this lncRNA might be associated with the pathogenesis of renal transplant rejection.

Due to high prevalence of diabetes mellitus and subsequent nephropathy, the need for access to start and continue dialysis has been increased. In this study, we aim to study the efficacy and complications of non-tunneled catheters (NTC) till fistula maturation because of being easy and cheap implementation as well as similar complications compared to tunneled catheters (TC).

In this retrospective observational study, 247 patients with first-time AVF creation referred to Vascular Surgery Centre of Mashhad University of Medical Sciences, Iran, were recruited since March 2016 to December 2017. Only 153 patients who have completed the study, and were monitored every two weeks in case of un-maturation along with the status of temporary catheters.

Mean age of patients was 49.9 ± 7.74 years, and 75 (49%) were females, which was comparable with literature. Preference of NTC implementation was at right jugular because of the easy access to central vein and less chance of complications. Catheter location was at right internal jugular in 61.4% of the patients. Out of 24 femoral cases, 18 was done at femoral. AVF location was done at left/right cubital in most cases (52.3%). The rate of infection was 15.0%, which was less than NTC’s infections reported in the literature.

Use of non-tunneled catheter in the form of outpatient in the period of AVF maturation time is recommended due to similar complication rate.

We retrospectively reviewed the postoperative outcomes of patients who underwent tension-free vaginal mesh (TVM) surgery in our institution.

In total, 195 TVM surgeries were performed at the Shimane University School of Medicine from January 2010 to May 2016 in patients with Pelvic Organ Prolapse–Quantification (POP-Q) stage II or higher. Perioperative complications and problems arising following surgery were assessed from medical charts.

Among the 195 patients, only 1 patient required blood transfusion due to massive intraoperative blood loss. None of the patients experienced intraoperative complications, such as injury to the bladder or rectum during surgery. Mesh exposure was observed in 10 patients (5.1%). Overall, 6 of these 10 patients were asymptomatic, and surgical treatment was required in only 1 patient. Mesh exposure occurred at significantly higher frequencies in patients aged less than 60 years. Postoperative recurrence of POP, which was defined as recurrence over POP-Q stage 2, was noted in 13 of the 195 patients (6.6%). Re-operation was performed in 1 patient in whom recurrence was observed within 3 months postoperatively. Recurrence of POP was likely to occur in patients with higher POP-Q stages. Overall, 31 of the 195 patients (15.9%) required medication for postoperative stress urinary incontinence (SUI) after surgery. Among these, 2 patients underwent surgical treatment for SUI.

Outcomes following the TVM procedure were satisfactory. However, caution should be exercised against mesh exposure in younger patients and recurrence of POP in patients with advanced POP-Q stage

The role of male infertility is important in human infertility pathology. Spermatogenesis is a complex developmental process which is regulated by a number of genes. Methylenetetrahydrofolate dehydrogenase1 (MTHFD1) is involved in the synthesis of purine, pyrimidine, and methionine. The aim of this study was to identify the MTHFD1, G1958A polymorphism and its association with idiopathic male infertility in Iranian population.

This case-control study was conducted on 200 Iranian men, 100 cases with idiopathic infertility (experimental group) and 100 normal men (control group). The subjects were assessed for the MTHFD1 G1958A polymorphism, using the polymerase chain reaction-restriction fragment length polymorphism technique (PCR-RFLP). The chi-square test was used to determine the association between MTHFD1 G1958A polymorphism and male infertility, using SPSS software. P ≤ 0.05 was considered significant.

Totally, the frequency of A allele and AA homozygous genotype was found 51% and 47.3% respectively, with 52.5% and 30% in the experimental group versus 42% and 21% in control group. There was a statistically significant correlation between the frequencies of A allele (95 % CI = 1.028- 2.265, OR = 1.526, p = 0.035) and AA homozygous (% CI = 0.995- 4.494, OR = 2.114, 95 p = 0.05) genotype with the MTHFD1 G1958A polymorphism (P ≤ 0.05).

These results suggest that the polymorphism in MTHFD1 G1598A gene could be considered as an important genetic disorder associated with the etiology of male infertility.

The present study aims to investigate the effects of aerobic training on adiponectin, sex hormones, and sperm parameters in streptozotocin–nicotinamide induced diabetic rats.

In this experiment, 52 eight-week-old Sprague Dawley rats (200-250 g) were randomly assigned to four groups: healthy control, diabetic control, diabetic with aerobic training and healthy with aerobic training. Diabetes was induced by intraperitoneal injection of nicotinamide and streptozotocin solution. The aerobic training protocol was performed for ten weeks. Finally, blood serum samples were obtained to assess FSH, LH, testosterone, and adiponectin levels.

Results showed an increase in serum adiponectin levels in aerobic training group which led to a significant difference between aerobic training group and diabetic control group. In addition, aerobic training caused significant increase in serum testosterone level and LH in diabetic aerobic training group, so that significant differences were observed between serum testosterone, LH and FSH of diabetic aerobic training group and healthy control group. Sperm parameters in the diabetic aerobic training group including sperm count, motility and viability presented significant differences compared to diabetic control group.

Short term aerobic training can improve serum adiponectin levels and sperm parameters, including sperm count and sperm motility through increasing serum testosterone, LH and FSH levels in type 2 diabetic rats.

To evaluate the efficacy of oral anticholinergics as a preventive strategy of storage symptoms and urinary incontinence associated with the early postoperative period after Greenlight laser photovaporization of the prostate (PVP). To analyze potential variables related to the onset of these symptoms.

Retrospective study of 105 patients who underwent PVP using a 180-W Greenlight laser (XPS). Patients were divided into two groups, depending on whether they were or weren´t prescribed anticholinergics when discharged (oral solifenacin 5 mg for 1 month after surgery). Differences between both groups were analyzed according to IPSS, ICIQ-SF and OABq-SF scores at 1 and 6 months. The potentially predictive variables of the symptomatology after undergoing PVP that we analyzed included age, prostate volume, PSA, IPSS, ICIQSF, OABq-SF, Qmax, previous use of a permanent urinary catheter, energy used, and laser application time.

58 patients in the group with anticholinergics and 47 in the group without anticholinergics were compared. No significant differences were observed between both groups in IPSS (p = .521), ICIQ-SF (p = .720) or OABq-SF (p = .851) at 1 and 6 months after surgery. Regardless of the use of anticholinergics, there was a significant score improvement between the first and second checkup in all the questionnaires: there was a significant decrease in the mean IPSS (p < .001) and the mean score of the eighth IPSS question on patient’s quality of life (p = .026), ICIQ- SF (p = .010) and OAB-q related to symptoms (p = .001) as well as a significant increase in the mean OAB-q score regarding quality of life (p = .005). None of the variables analyzed showed a significant relation to the storage-symptom rate, rate of incontinence, or ICIQ-SF and OABq-SF scores.

The use of solifenacin 5 mg after Greenlight laser PVP is not an effective preventive treatment for storage and incontinence symptoms associated with this procedure, which seem to self-limit over time.

To research on clinical and bacterial risk factors and their relationship with post-prostate biopsy infection (PBI).

In this prospective cohort study, rectal swabs were collected from 158 men prior to prostate biopsy and cultured selectively for identify ciprofloxacin-resistant (FQ-R) gram-negative bacteria. The patient characteristics, phylogenetic background, sequence typing and pulsed field gel electrophoresis (PFGE) pattern were compared in two groups of FQ-R Escherichia coli rectal and clinical isolates.

In total, PBI was observed in 20 (12.5%) cases; the most of these subjects were FQ-R-colonized. (17/73 [24%] vs 3/85 [3.5%]; P < 0.001). FQ-R colonization, diabetes, hospitalization and UTI were independent risk factors (95% CI: 1.1-20.1, OR = 4.73; 95% CI: 1.7-25.3, OR = 6.57; 95% CI: 1.9-27.5, OR = 7.22; and 95% CI: 1.2-14.3, OR = 4.05; respectively), that increased the rate of PBI (All P < 0.05). Despite the increase in infections among patients colonized with strains of E. coli ST131, its prevalence was near significance between colonized and infected groups (P = 0.07). The PFGE patterns and antimicrobial susceptibility profiles of rectal and clinical isolates in 13 patients were similar which is remarkably important and informative.

The most PBIs originate from FQ-R E. coli rectal colonization. Rectal culture screening and assessment of clinical risk factors can predict the incidence of PBI in patients.

Recurrent bacterial cystitis is a common infection in women and there are concerns about its antibiotic therapy. Platelet rich plasma has antimicrobial and tissue repairing effects. We investigated the effect of platelet rich plasma as an intravesical therapy to prevent recurrence of bacterial cystitis.

Thirty women with a history of recurrent bacterial cystitis were randomly assigned into two groups: 1) platelet rich plasma and 2) control groups. The first group received 10 mL of platelet rich plasma with intravesical instillation plus 40 mL of normal saline. The control group only received 50 mL of normal saline. We did the instillation once a week for four weeks in both groups. We followed up the participants two and 12 months after the last instillation with a questionnaire (the international consultation on incontinence questionnaire in overactive bladder) and result of their urine culture.

A significant decrease was observed in the number of bacterial cystitis recurrences in the platelet rich plasma group compared to the control group 12 months after the instillation (4 vs. 1, P = 0.004). Also, there was a significant improvement in the questionnaire’s score two (3.6 ± 2.58 vs. 0.66 ± 1.63, P = 0.002) and 12 months (3.4 ± 2.77 vs. 0.006 ± 1.83, P < 0.001) after instillation in the platelet rich plasma group compared to control group. There was no adverse effect 12 months after instillation.

Platelet rich plasma can significantly decrease the recurrence of bacterial cystitis up to a year after instillation without any side effect