مجله تحقیقات در ارولوژی
سال چهارم شماره 1 (بهار و تابستان 1399)

Prostate cancer is one of the most common cancers of the urinary system. The most used method for diagnosis is transrectal ultrasonography-guided biopsy. The purpose of this study is a statistical analysis with the aim of reducing unnecessary biopsies based on individual, geographical and genetic patterns in our region.

The medical records of all patients who underwent prostate biopsy in Shahid Beheshti Hospital, Hamadan, Iran, during 2015-2017 were reviewed and the data obtained from their study were evaluated by the researcher.

Of patients 72.4% had total prostate-specific antigen (PSA) equal to or greater than 10 ng/mL. the majority of patients had benign prostatic hyperplasia (67.4%). Most of the patients had PSAD and F / T above 15% (61.3%) and 18% (52.3%), respectively. By the increasing of total PSA, the percentage of people with prostate cancer increased, and there was a significant relationship between total PSA and the presence of prostate cancer. But for PSAD and F/T there was no significant relationship with prostate cancer. The minimum total PSA in the prostate cancer group was 5.40.

In order to reduce unnecessary biopsies and related complications as well as stress imposed on the patient and his family, in this geographical area, we may be able to avoid biopsy in PSA level below 5/4, especially in older ages with normal physical examination and no risk factor. Certainly, to achieve a practical regional guideline, we will need more comprehensive and prospective studies in future.

Due to the importance of acute kidney injury associated in patients with sepsis and the impact of various factors on mortality and hospital stay of these patients, this study was conducted to investigate the clinical features and risk factors for acute kidney injury in patients with sepsis. In addition, we examined whether the severity of acute kidney injury affected clinical outcomes.

This was a cross-sectional study performed on patients admitted with sepsis in Firoozgar Hospital between 2018 and 2020. Patients were divided into two groups, those with and without acute kidney injury, to compare baseline and laboratory characteristics.

In total, 380 patients entered. Acute kidney injury (AKI) occurred in 41.1% of patients with sepsis. Analysis of multivariate logistic regression showed that the risk of acute kidney injury significantly was associated with older age, history of ischemic heart disease, hypertension and diabetes, smoking and drug abuse, use of ACEI and ARB medications, presence of bacteremia, presence of tissue infection as sepsis etiology, low serum albumin, and high AST levels, delayed antibiotic and fluid therapy, and vasopressor administration. Hospital mortality and length of hospital stay were higher in the AKI group.

Septic AKI had a negative effect on clinical outcomes. Also, the severity of acute kidney injury was associated with increased short-term mortality, length of hospital stay, and the need for dialysis.

Foreign bodies in the bladder are uncommon. Because of limiting diameter of urethra, stuffing and packing drugs into the bladder is even rarer. We introduce a case of self-insertion of drugs into urethra and further into the bladder which stayed there for 2 years due to fear of arrestment during interrogation. Surgical removal of foreign body and stones formed on it was carried out. This confirms that small amounts of drugs can be inserted in the urethra to escape prosecution; this can be of rare differential diagnoses for physicians and a noteworthy incident for law enforcement.

Despite a long history of drug treatment for BPH, the side effects and costs associated with current drugs have led to efforts for finding drugs with the same effectiveness and fewer side effects. Also, in recent years, the tendency to use herbal drugs in BPH treatment has increased significantly. Alphablockers are currently the most commonly used chemical drugs in the treatment of BPH, the most common of which is Tamsulosin. Although few studies have compared the role of Tamsulosin and pumpkin seeds oil in BPH patients, this study has never been done in Iran.

This is a randomized clinical trial study, which was performed on 80 male patients referred to the urology clinic of Shahid Beheshti Hospital in Hamadan, Iran, in 2019. Patients were randomly divided into two groups. The first group was given pure Pumpkin Seed Oil capsules and the second group was given Tamsulosin capsules for three months. Patient follow-up was based on IPSS, PSA level, ultrasonography, and uroflowmetry.

Statistical analyzes showed a significant decrease in the mean IPSS of both groups during the three months of treatment. Side effects were observed more in the Tamsulosin group than in the pumpkin seed Oil group. Post void residue was significantly reduced in the Pumpkin Seed Oil group compared with the Tamsulosin group. The quality of life improved significantly in both groups.

It seems that consumption of pumpkin seed oil can play an important role in the treatment of BPH as the main drug to replace Tamsulosin, with same efficacy and fewer side effects, but for definitive prescription of this herbal drug, extensive and long-term studies are necessary. comprehensive and prospective studies in future.

Today’s, the Gleason grading system is well known as the world’s most commonly used histological system for prostate cancer. It provides significant information about the prognosis. This prospective paper assessed the correlation of transrectal ultrasound (TRUS) guided biopsy and radical prostatectomy specimens in terms of Gleason scores. In this matter, the effect of PSA density (PSAD) and prostate size on the Gleason scores were explored.

This paper is conducted as a prospective study in which the medical records, comprised the pathology reports, of 68 patients with prostate cancer who underwent radical retropubic prostatectomy. Then, the preoperative Gleason score was compared to the Gleason score of the prostatectomy specimen.

Patients age ranged from 59 to 79 years, in which the median was 64 years. The comparison of the Gleason scores from the biopsy and radical prostatectomy specimens revealed that it was only identical in 24 out of 68 (35.3%) cases. On the other hand, the mean Gleason score obtained from the TURS biopsy was 6.4, compared with a mean score of 7.1 on the radical prostatectomy specimens. Meanwhile, there was a significant difference between Gleason scores (P<0.001). The experimental results confirmed that PSAD in 0.195, 0.22, 0.23, 0.25 cut of points had both high specificity and sensitivity for concordance of TRUS biopsy result using the Radical prostatectomy.

This study provides evidence that the Gleason scores of the needle prostate biopsies and those of the radical prostatectomy specimens were concordant in some cut off points of PSAD especially between 0.195 -0.28. Therefore, it has seemed that PSAD can be a proper scale to determine the concordance of TRUS biopsy result using the Radical prostatectomy.