فهرست مطالب

Urology Journal - Volume:18 Issue: 2, Mar-Apr 2021
  • Volume:18 Issue: 2, Mar-Apr 2021
  • تاریخ انتشار: 1400/03/20
  • تعداد عناوین: 18
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  • Jianlin Huang, Yu Wang, Yu An, Yong Liao*, Mingxing Qiuu Pages 136-143
    Purpose

    To evaluate the impact of diabetes mellitus (DM) on the recovery of urinary continence (UC) after rad-ical prostatectomy (RP).

    Materials and Methods

    A systematic review of English articles was performed in August 2019, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Trials were identi-fied in a literature search of PubMed, Embase, Cochrane Library and Web of Science using appropriate search terms. All comparative studies reporting diabetes mellitus, study characteristics, and outcome data including the relationship between diabetes mellitus and urinary continence data were included. Continence rates at different time after RP were compared. Odds ratio (OR) was used for the comparison and all the results were presented with 95% confidence intervals (CIs).

    Results

    Seven cohort studies comprising with 5944 participants were included, the percentage of DM patients was 8.7%. The results showed that DM decreased urinary continence rates at 12 months after RP (OR 0.54, 95%CI 0.36 to 0.81, p= 0.003). The continence rates were not significantly different between DM and Non-DM groups at short-term (catheter removal, 3 months, 6 months) and long-term (>12 months). When stratified by the surgical approaches, the pooled results in patients who underwent robot -assisted radical prostatectomy (RARP) were sim-ilar to results of the overall analysis.

    Conclusion

    DM has an adverse impact on the recovery of UC during the intermediate-term after RP. Well-de-signed trials with strict control of confounders are needed to make results more comparable.

    Keywords: urinary continence, diabetes mellitus, radical prostatectomy, prostate cancer, meta-analysis
  • Tuo Deng, Xiaolu Duan, Zihao He, Zhijian Zhao, Guohua Zeng * Pages 144-150
    Purpose

     To explore the association between 5α-reductase inhibitors (5ARIs) use and risk of depression based on published literature through a meta-analysis.

    Materials and methods

     A comprehensive literature search was conducted by searching Pubmed, Embase,
    Cochrane Library, CBM, CNKI, and VIP databases up to June, 2019. Summarized risk ratios (RRs) with 95%
    confidence intervals (CIs) were calculated to evaluate the strength of association between 5ARIs and depression. Subgroup analyses were performed according to population, 5ARI types, degree of depression, and publication date. Registered in PROSPERO under number CRD42018096147.

    Results

     A total of 6 clinical studies with 265672 participants were included in our meta-analysis. The application
    of 5ARIs could significantly increase the risk of depression based on both pooled unadjusted (95% CI: 1.28-2.78,
    RR = 1.89, P = .001) and multivariable adjusted RRs (95% CI: 1.01-1.17, RR = 1.09, P = .03). In subgroup analyses,
    dutasteride was associated with depression significantly (95% CI: 1.37-1.70, RR = 1.53, P < .001), while
    finasteride was not. As to the degree of depression, 5ARIs mainly caused mild depression (95% CI: 1.91-2.33, RR
    = 2.11, P < .001), instead of moderate or severe depression.

    Conclusion

     We concluded that 5ARIs could potentially increase the risk of depression. Clinicians need to carefully consider the use of 5ARIs for benign prostatic hyperplasia and androgenic alopecia patients, especially those exhibiting risk factors for depression or those who have a previous history of depression. More studies with larger sample size and comprehensive study design are needed to further verify our outcomes.

    Keywords: Association 5a-reductase inhibitors Depression Meta-analysis
  • Xiongfa Liang *, Weizhou Wu *, Yapeng Huang, Shike Zhang Jian Huang, Tao Zeng Pages 151-158
    Purpose

    The management strategies of anticoagulant (AC) or antiplatelet (AP) therapy in the preoperative period of benign prostatic hyperplasia (BPH) is still controversial. Therefore, a meta-analysis to systematically evaluate the surgical safety for BPH patients on AC or AP therapy was performed.

    Materials and Methods

    The protocol for the review is available on PROSPERO (CRD42018105800). A lit-erature search was performed by using MEDLINE, Web of Science, PubMed, Cochrane library, and Embase. Summarized odds ratios (OR), mean difference (MD) and 95% confidence intervals (CI) were used to assess the difference in outcomes.

    Results

    We identified 13 trials with a total of 3767 patients. An intragroup significant difference was found in bleeding complications and blood transfusions when undergoing transurethral resection of the prostate (TURP). For laser surgery, the intragroup significant difference was found in the result of blood transfusion. Bridging ther-apy would not cause a higher risk of bleeding complications and blood transfusion during the perioperative period. Besides, no difference existed in operation time, catheterization time, hospitalization, and thromboembolic events.

    Conclusion

    Patients with BPH on perioperative AC/AP therapy would have a risk of postoperative hemorrhage after TURP or laser treatments. To reduce the risk of hemorrhage, bridging therapy could be a good choice.

    Keywords: Transurethral resection of prostate (TURP), Laser treatment, Benign prostatic hyperplasia (BPH), Anticoagulant, Antiplatelet
  • Kehua Jiang, Musa Male, Xiao Yu, Zhiqiang Chen, Fa Sun, Huixing Yuan * Pages 160-164
    Purpose

    NTrap® stone entrapment and extraction device (NTrap®) is a device used to extract and remove stones from the urinary tract and to minimize retrograde stone migration during ureterolithotripsy (URS). This study aimed to evaluate the efficacy and safety of NTrap® in URS.

    Methods

    From Jan 2014 to June 2017, 148 patients underwent URS with the aid of NTrap® (Group A), and 209 patients underwent standard URS without any anti-retropulsion device (Group B). Their demographics, operation time, complications, stone migration rate, and stone-free rate (SFR) were recorded for comparison.

    Results

    Compared with group B, Group A had a significantly shorter operative and lasering time (P = 0.003, P<0.001, respectively). There was no significant difference between the 2 groups in overall complications, a de-crease in mean hemoglobin, and length of stay (LOS) (P = 0.426, P = 0.097, P = 0.058, respectively). The inci-dence of stone migration was significantly lower in Group A than Group B (P = 0.035). The postoperative auxiliary procedure rate (in patients with stones retropulsion during the operation) was significantly lower in Group A com-pared to Group B (P = 0.024). The SFR was considerably higher in Group A than Group B (P = 0.009).

    Conclusion

    URS, with the aid of NTrap®, is an effective and safe method for treating ureteric stones. It may prevent stones from retropulsion and shorten the operative time.

    Keywords: ureteroscopic lithotripsy, NTrap®, ureteric stones, stone free rate
  • Nasser Simforoosh, MohammadHossein Soltani, Hamidreza Shemshaki*, Milad Bonakdar Hashemi, Mehdi Dadpour, Amir H Kashi Pages 165-170
    Purpose

    Partial adrenalectomy (PA) is an emerging modality typically performed for the treatment of hereditary and sporadic bilateral tumors, to reduce the risk of adrenal failure. In this study, we evaluated the recurrence and functional outcomes after partial and total adrenalectomy (TA).

    Materials and methods

    From March 2005 to July 2018, 284 patients with functional tumor or > 5 cm adrenal mass underwent clipless and sutureless laparoscopic partial or total adrenalectomy (PLA and TLA). Patients with a pathological diagnosis of pheochromocytoma, Cushing or Conn’s disease and more than two year follow up were included in this study. Pre-operative and operative variables were collected retrospectively and functional outcomes and recurrence were gathered prospectively.

    Results

    One hundred forty patients (mean age: 43±5.1years) were included in the study. PLA and TLA were per-formed for pheochromocytoma (total n=78; PLA=12 (15%), TLA=66 (85%)), Cushing syndrome (toal n=17; PLA = 4 (24%), TLA = 13 (76%)), and Conn’s disease (total n=45; PLA=7 (16%), TLA=38 (84%)). In pheochromo-cytoma patients, improvement of hypertension, palpitation, and headache was not different between patients who underwent PLA versus TLA (all P > 0.05). Two recurrences were observed in patients with pheochromocytoma who had undergone TLA. In patients with Cushing disease, central obesity, fascial plethora, and hypertension were improved in all patients six months after treatment, muscle weakness was improved one year after surgery, and acne and hyperpigmentation only improved two years after surgery. The length of time for resolution of symptoms was not different in patients who underwent PLA versus TLA. In Conn’s disease hypertension was resolved in all patients and no patient required potassium supplements post-operatively. In follow up no recurrence was observed in patients with a pathological diagnosis of Cushing or Conn’s disease.

    Conclusion

    In our experience, PLA can provide excellent control of the symptoms parallel with TLA and with no statistically significant difference in recurrence making PLA an attractive option in patients with an adrenal mass.

    Keywords: adrenalectomy, laparoscopy, partial, adrenal sparing surgery, cortical sparing surgery, recurrence
  • Cao Jian, Zhu Shuai, Ye Mingji, Liu Kan, Liu Zhizhong, Han Weiqing, Xie Yu* Pages 171-175
    Purpose

    This study aimed to explore the security and feasibility of three-dimensional (3D) printing technolo-gy-assisted laparoscopic cryoablation to treat small renal tumors. Patients and

    Methods

    Four patients recruited from our hospital from April 2016 to August 2017 underwent 3D printing technology-assisted laparoscopic cryoablation. Three-dimensional reconstruction technology was used to mimic cryoablation treatment before operations to determine the number of needles needed for the operation and the depth and angle required for needle insertion into the tumor to preserve nephron integrity. CT scans were used to assess the treatment’s efficacy after operation during regular follow-up.

    Results

    The operation was performed successfully in all cases and all patients recovered without major compli-cations. The operation times ranged from 106 to 118 minutes and blood loss ranged from 50 to 100 mL. The fol-low-up times were between 8-16 months and the mean time was 13.3 months. Follow-up surveys were conducted regularly based on a standard outpatient protocol. Results showed no abnormal reinforcing signals in cryoablation treated areas.

    Conclusion

    3D printing technology-assisted laparoscopic cryoablation is a feasible method for the treatment of renal tumors and may be a way to better preserve nephrons, especially in elderly patients and/or those with comor-bidities.

    Keywords: laparoscopy, cryoablation, renal cell carcinoma, three-dimentional-printing
  • Bin Xu, Minhao Zhang, Chunhui Liu, Can Wang, Zonghao You, Yali Wang *, Ming Chen Pages 176-180
    Purpose

    To explore the association between MEG3 polymorphisms and the risk of prostate cancer in the Chinese Han population.

    Materials and Methods

    Two MEG3 single-nucleotide polymorphisms (SNPs) (rs11627993 C >T rs7158663 A>G) were genotyped in a case-control study in which 165 prostate cancer patients and 200 healthy controls were recruited by a Real-Time Polymerase Chain Reaction (PCR) with the TaqMan assay. The odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of association.

    Results

    No statistically significant differences were found in the allele or genotype distributions of the MEG3 rs11627993 C >T and rs7158663 A > G polymorphisms among cases or healthy control subjects (rs11627993: CC vs CA: 95% CI = 0.54-1.95, ORs = 1.03; CC vs AA: 95% CI = 0.67-2.54, ORs = 1.30 ; CC/CA vs AA: 95% CI = 0.81-1.98, ORs = 1.26 , P = .29 ; C vs A: 95% CI = 0.85-1.57, ORs = 1.16, P = .35; rs7158663: AA vs AG: 95% CI = 0.76-5.08, ORs = 1.97, AA vs GG: 95% CI = 0.57-3.29, ORs = 1.37; AA/AG vs GG : 95% CI = 0.56-1.32, ORs = 0.86, P = .49; A vs G: 95% CI = 0.69-1.39, ORs = 0.98, P = .91) Further stratified analysis detected no significant association.

    Conclusion

    The MEG3 polymorphisms (rs11627993 C>T and rs7158663 A>G) does not influence the suscepti-bility to prostate cancer.

    Keywords: maternal-expressed gene 3, polymorphism, susceptibility, prostate cancer, lncRNA
  • Eray Atalay, Aslan Demir *, Huseyin Avni Eroglu Pages 181-185
    Purpose

    The effects of metformin on prostate volume and prostate-specific antigen (PSA) were investigated.

    Materials and Methods

    We enrolled 384 newly diagnosed diabetes mellitus (DM) patients and 152 controls all of whom were >50 years into our prospective cross-sectional observational study. The first group contained patients receiving metformin only, the second group patients were taking a mixture of medications, including met-formin plus other oral anti-diabetics, and the third was the control group. Before beginning treatment, body mass indices (BMI) of all cases were obtained. Prostate volumes were evaluated using transabdominal ultrasonography at the sixth and twelfth months. Insulin, glycosylated hemoglobin (HbA1C), insulin sensitivity index (ISI), insu-lin-rich growth factor (IGF-1), PSA, free PSA, and total testosterone levels were measured.

    Results

    The differences in BMI between the first and third groups were statistically significant (P < 0.05). There were no statistical differences among the groups in terms of prostate volumes (P > 0.05). The differences between the groups for insulin, HbA1C, ISI, IGF-1 (somatomedin), PSA, free PSA, and total testosterone levels were not statistically significant (P > 0.05). Free PSA and total testosterone levels in groups 1 and 2 were not statistically different at the beginning of treatment and the sixth month (p >0.05), but within groups 1 and 2, only PSA levels were different at the start of the study until completion. No differences were seen in the third group.

    Conclusion

    Metformin appears to cause a decrease in PSA levels. The mechanism and any effects on prostate tissue will be studied in future randomized, prospective studies.

    Keywords: metformin, Prostate, PSA, prostate biopsy
  • Samira Bahrami, Ali Gheysarzadeh, Mehdi Sotoudeh, Mojgan Bandehpour, Reza khabazian, Hakimeh Zali Mehdi Hedayti, Abbas Basiri *, Bahram Kazemi Pages 186-193
    Purpose

    Muscle-invasive bladder cancer (MIBC) is associated with disease progression and metastasis leading to poor prognosis. Current chemotherapy approaches have not adequately increased patient survival. Therefore, in this study, tissue proteome of patients with MIBC was performed to introduce possible protein candidates for bladder cancer prognosis as well as targeted therapy.

    Materials and Methods

    After obtaining tumoral and non-tumoral tissues of MIBC patients, and normal blad-der tissue of non-bladder cancer patients, two-dimensional gel electrophoresis (2-DE) and liquid chromatogra-phy-mass spectrometry (LC-MS/MS) were used to analyze tissue proteome. Gelsolin-like Actin-capping (CAPG) protein was further examined using Real-time PCR and western blot analysis.

    Results

    The 2-DE analysis and LC-MS/MS identified CAPG protein as differentially expressed protein in tumor and non-tumor tissues of bladder cancer compared with normal tissues. Western blot analysis showed the CAPG overexpression in tumor tissues compared with normal tissues in a stage-dependent manner. Correspondingly, Real- time PCR showed a higher mRNA expression in tumoral bladder tissues than normal ones. CAPG mRNA overexpression had significantly a positive relation with tumor size (P = 0.019), the TNM staging (P = 0.001), and tumor differentiation (grade) (P = 0.006). Patients with lower levels of CAPG had higher recurrence-free survival in comparison with patients with higher levels (P = .027).

    Conclusion

    CAPG overexpression was correlated with size, stage, grade, and shorter time to recurrence of blad-der cancer. Therefore, CAPG overexpression could be related to poor prognosis of bladder cancer. These results suggest that CAPG may be considered as a prognostic factor and also for targeted therapy in bladder cancer. More-over, it could be concluded that cancerous and noncancerous tissues of MIBC have the same protein expression because 2-DE results showed the CAPG expression in cancer and adjacent cancer tissues of bladder while CAPG was not detectable in normal tissues of bladder

    Keywords: bladder cancer, CAPG, prognosis, proteome, targeted therapy
  • Yavuz Güler, Akif Erbin *, Gokhun Ozmerdiven Pages 194-198
    Purpose

    To present the medium-term results for the modified Lich-Gregoir (LG) reimplantation technique in the treatment of unilateral primary vesicoureteral reflux (VUR) by comparing patients under and over 12 months of age.

    Materials and Methods

    Data for patients who underwent modified LG surgery between January 2006 and De-cember 2018 were retrospectively reviewed from the hospital data-recording system and patients under the age of 18 years were included in the study. After exclusion criteria, 55 patients in total were included in advanced analysis. The patients were grouped as ≤12 months and >12 months. Demographic characteristics, operative, and postoperative follow-up data were comparatively analyzed.

    Results

    The mean±SD (range) of age was 10.4 ± 2.8 (6-12) and 41.4 ± 18.5 (13-96) months in the ≤12 months and >12 months groups, respectively. Mean operation time and hospitalization time were not significant between the groups. Mean follow-up times were 39.5 ± 14.1 and 38.4 ± 13.2 months, in the ≤12 months and >12 months groups, respectively. There was no difference in terms of complications between the groups and all of the com-plications in both groups were in grade 1 category according to the Modified Clavien complication classification. One (6.6%) patient in the ≤12 months group and 3 (7.5%) patients in the >12 months group had late (>30 days) febrile UTI, but none of them had a recurrence of VUR. Febrile infection did not recur during the follow-up period in these patients. While recurrent VUR was not seen in any patient in the ≤12 months group (success: 100%), it was observed in 2 (5%) patients in the >12 months group (success rate: 95%) (p = 0.38).

    Conclusion

    The open LG ureteral reimplantation technique is an effective procedure for the treatment of unilater-al primary VUR in children both under 12 months and over 12 months of age with minor morbidity

    Keywords: extracapsular extension, localized prostate cancer, partin table, PSA, PSAD, radical prostatectomy
  • Azar Nickavar, Baranak Safaeian *, Ehsan Valavi, Homa Davoodi Pages 199-202
    Purpose

    Vesicoureteral reflux (VUR) is the most common risk factor of urinary tract infection in children. Cur-rently, diagnosis of VUR depends on invasive imaging studies, with a high radiologic burden. Therefore, different biomarkers have been introduced for the evaluation of these patients. The objective of this study was to identify alteration of urinary interleukins (ILs) excretion in children with primary VUR and renal parenchymal damage, for further clinical application.

    Materials and methods

    Urinary concentrations of IL-1α, IL-1β, IL-6, and IL-8 were evaluated in 34 children with VUR (cases) and 36 without VUR (control), during 2018-2019. Urinary concentrations of IL-1, IL-1, IL-6 and IL-8 were measured, using polyclonal antibody ELISA kit, and standardized to urine creatinine (Cr). Patients with infectious or inflammatory disorders, urolithiasis, immune deficiency, acute or chronic kidney disease, and secondary VUR were excluded from the study.

    Results

    Mean age of cases (36.00 ± 27.66) had no significant difference with the control (32.86±29.31) group (p=0.44). The majority of patients had moderate VUR (58.8%), followed by severe (35.3%) and mild (5.9%) grades. Urinary concentration of all ILs/Cr were significantly higher in patients with VUR, compared with those without VUR. There was no significant correlation between urine ILs/Cr with age, gender, serum electrolytes, urine specific gravity, renal ultrasound, laterality or severity of VUR, and DMSA renal scan. All urine ILs/Cr had acceptable sensitivity and accuracy for workup of children with primary VUR.

    Conclusion

    Urine IL-1α, IL-1β, IL-6 and IL-8/Cr were sensitive and accurate additionary screening biomarkers in children with primary VUR.

    Keywords: vesicoureteral reflux, interleukin, cytokine, renal damage
  • Mahtab Zargham *, Mahdieh Mahmoodi, Hamid Mazdak, Farhad Tadayon, Mansooreh Mansori, Maryam Kazemi, MohamadHatef Khorami, Narjes Saberi Pages 203-208
    Purpose

    There are two brands of BotulinumtoxinA(BTXA) that are commonly used in the treatment of Lower Urinary Tract Disease: OnabotolinumtoxinA(Ona-BTXA) and AbobotulinumtoxinA (Abo-BTXA). The present study was conducted to assess the potential therapeutic and adverse effects of Abo-BTXA or Dysport for interstitial cystitis/bladder pain syndrome (IC/BPS).

    Materials and Methods

    Twenty-two out of 52 women diagnosed with IC/BPS who were refractory or had a low response to oral treatments of IC/BPS after 6 months, were included in the study. The end-point was O'Leary-Sant Score (OSS) including “symptoms” and “problem” indexes (ICSI and ICPI respectively) assessment after 1,3and 6 months after Abo-BTXA injection. Each patient underwent cystoscopy and immediately after hydrodistention received intratrigonal injections of 300 IU of Abo-BTXA (Dysport®) in 30 sites. The effect and side effects of this treatment over time have been investigated. Complications including high post void residual urine (PVR), bladder rupture, and urinary tract infections (UTI) were also assessed.

    Results

    The mean age of patients was 46.2 ± 13.7 years and the median OSS was 27.8 ± 5.8.: After a single injec-tion ICSI, ICPI, and total OSS significantly reduced in 1, 3, and 6 months follow up; rate of decreased total OSS was 39.5%, 36%, 18%, respectively. Its effect lasted up to six months and started to decrease after 1 month (p-value < 0.05). Complications included urinary retention (PVR > 200ml), bladder rupture, and UTI in 13.5%, 4.3%, and 18% of the patients, respectively.

    Conclusion

    Intravesical injection of 300IU Abo-BTX(Dysport) could be a useful approach for the treatment of patients with refractory IC/BPS in a period of six months.

    Keywords: AbobotilinumtoxinA, bladder pain syndrome, Botulinum toxin, Dysport, refractory interstitial cystitis, intravesicle injection
  • Azar Daneshpajooh, Mahboubeh Mirzaei, Tania Dehesh Pages 209-213
    Objectives

     Pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS) usually coexist and are common among women. Since the efficacy of urodynamic studies (UDS) in evaluating these conditions is subject to controversy, this study aimed to assess the accordance between urodynamic findings and LUTS and to determine the importance of UDS in women with POP.

    Methods

     This cross-sectional study was conducted on women over 18 years with symptomatic POP referred to the female urology clinic of Kerman University of Medical Sciences, Kerman, Iran, during 2017-2018. Patients who met the inclusion criteria were included in the study with informed consent. The Pelvic Floor Disability Index (PFDI-20) was completed for each patient. Pelvic examination was performed using the Pelvic Organ Prolapse Quantification System (POPQ). Subsequently, multi-channel UDS was performed, and the findings were analyzed in SPSS 20, using Chi-square or Fisher’s test.

    Results

     A total of 200 women with symptomatic POP were included in the study. Stress, urge, and mixed urinary incontinence showed significant accordance with the urodynamic findings (urodynamic stress incontinence and/or detrusor overactivity). However, there was no significant relationship between urinary voiding LUTS and urodynamic findings.

    Conclusion

     UDS should be performed for selective patients with POP. According to the results of the present study, UDS can help us provide consultation for POP patients with voiding LUTS. However, in POP patients with urinary incontinence, this test cannot provide further information and should be performed based on the patient’s condition.

    Keywords: Pelvic organ prolapse, Urodynamic study, Urinary incontinence, Voiding dysfunction
  • Maria Zahiri, Mansoureh Movahedin *, Seyed Javad Mowla, Mehrdad Noruzinia, Morteza Koruji, MohammadReza Nowroozi, Zahra Bashiri Pages 214-224
    Purpose

    Generating functional gametes for patients with male infertility is of great interest. We investigated dif-ferent cultural systems for proliferation of SSCs derived from obstructive azoospermic patients.

    Materials and Methods

    Testicular cells were obtained from men with obstructive azoospermia. After enzymatic digestion process, cells were assigned to various groups: culture of SSCs in the dish without cover (control group), co-culture of SSCs with infertile Sertoli cells (I), co-culture of SSCs with fertile Sertoli cells (II), culture of SSCs on nanofiber (covered with laminin) (III), culture of testicular cell suspension (IV). Then cells were cultured and colony formation, gene-specific methylation (by MSP), quantitative genes expression of pluripotency (Nanog, C-Myc, Oct-4) and specific germ cell (Integrin α6, Integrin β1, PLZF) genes were evaluated in five different culture systems.

    Results

    Our findings indicate a significant increase in the number and diameter of colonies in IV group in com-pare to control group and other groups. Expression of germ specific genes in IV group were significantly increased (P≤ 0.05) and levels of expression of pluripotency genes were significantly decreased in this group (P≤ 0.05) compared with other groups. Gene-specific pattern of methylation of examined genes showed no changes in cul-ture systems during the culture era.

    Conclusion

    A microenvironment capable of controlling the proliferation of cell colonies can be restored by tes-ticular cell suspension.

    Keywords: spermatogonial stem cells, proliferation, epigenetic, testicular cell suspension, obstructive azoospermia
  • Yong-Zhi Li, Ben Kang Shi, Jing Yu Li, Xing Wang Zhu, Jia Liu, Yi Li Liu* Pages 225-229
    Purpose

    Using a rat model of hyperinsulinemia, the present study investigated the role of p-ERK1/2 in benign prostatic hyperplasia (BPH).

    Materials and Methods

    Forty male Sprague-Dawley rats were randomly selected and assigned to four groups: high fat diet (HFD)+BPH (n=10), HFD (n=10), BPH (n=10), and control (n=10) groups. Hyperinsulinemia was in-duced by HFD feeding, while BPH was induced using testosterone propionate. Plasma glucose, plasma insulin and bodyweight were examined weekly. Immunohistochemistry (IHC) and western blot analysis were used to analyze the expression of ERK1/2 and p-ERK1/2 in rat prostates.

    Results

    Plasma glucose and plasma insulin levels were significantly greater in the HFD+BPH and HFD groups, when compared to the other two groups (P < 0.05). Prostate weights were significantly greater in the HFD+BPH, HFD and BPH groups, than in the control group (P < 0.05). IHC and western blot analysis revealed that p-ERK1/2 expression was greater in the HFD+BPH group than in the other three groups (P < 0.05).

    Conclusion

    Androgens plus a hyperinsulinemic condition induced by HFD can result in prostatic cell hyperplasia, and this mechanism may be correlated to the upregulation of p-ERK1/2. Further investigations of this possibility are required.

    Keywords: p-ERK1, 2, Hyperinsulinemia, BPH, Androgen, ERK1
  • Jong Mok Park, Ji Yong Lee, Yong gil Na, Ki Hak Song, Jae sung Lim, Seung Woo Yang, Seung Hwan Lee, Gun Hwa Kim *, Ju Hyun Shin Pages 230-236
    Purpose

    To compose a comprehensible and fluent Persian translation of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and to determine its linguistic validity in a Persian sample population.

    Methods

    The standard double-back translation method, provided by the previous studies were utilized by three professional linguists to translate the English version of the NIH-CPSI to Persian, and a group of 10 urologists fur-ther reviewed and translated questionnaire. The questionnaire was then presented to the sample study, comprised of 60 men with CP/CPPS and 60 controls with adverse urological history, and the collected data was analyzed through IBM-SPSS software to test its validity, evaluative, and discriminatory power, psychometric qualities and internal consistency.

    Results

    A total of 80 subjects (42 CP/CPPS patients and 38 healthy controls) were considered eligible for this study. The total Persian NIH-CPSI scores and each subdomain showed significant difference (P < 0.001) between the two study groups, indicating a satisfactory discriminant validity for the index. Psychometric analysis estab-lished the index to benefit from a high internal consistency. The translation was also considered by both the sub-jects and the physicians to be easily comprehensible.

    Conclusion

    The Persian NIH-CPSI is a reliable and valid instrument for evaluating CP/CPPS symptoms in gener-al population, while also benefitting from high discriminatory power, and can be utilized with ease in both clinical practice and laboratory studies

    Keywords: asymptomatic inflammatory prostatitis, asymptomatic inflammatory prostatitides, chronic prostatitis with chronic pelvic pain syndrome, national institute of health chronic prostatitis symptom index, prostatitis, pros-tatitides
  • Massimiliano Silveri *, Antonio Zaccara, Marco Cappa Pages 237-239

    Persistent müllerian duct syndrome (PMDS) in the majority of cases is discovered during surgery for inguinal hernia or cryptorchidism. A transverse testicular ectopia (TTE) with cryptorchidism may be very rarely associated to PMDS. Assuming that müllerian remnants have a very low malignant degeneration potential if compared to the malignancy risk of an undescended and not relocated testis, we describe a simplified surgical technique of orchiopexy that avoids an extensive anatomical dissection, in this way minimizing the risk of losing the deferential blood supply to the testis.

    Keywords: radical cystectomy, ileal conduit, cutaneous ureterostomy, orthotopic neobladder, appendix
  • Abbas Basiri*, Milad Bonakdar Hashemi, Arsalan Aslani Pages 240-246

    This study presents initial experience in endoscopic meatal dilatation of obstructive ureterocele in adult patients. During cystourethroscopy, we tried to find the orifice of ureterocele, passed a guide wire and introduce an 8 Fr ureteroscope in to the ureterocele orifice, going up to the renal pelvis as under vision dilatation of ureterocele me-atus. Two Double-J stent were inserted and remained for six weeks to keep the meatus dilated. Adverse effect of endoscopic management was decreased due to minimal anatomic changes. Patients’ symptoms were relieved and no evidence of new onset vesico-ureteral reflux and obstruction were seen after up to one-year follow-up. Endo-scopic meatal dilatation of stenotic ureterocele in adult patients is safe and effective thus, trying to find the orifice of ureterocele is suggested

    Keywords: meatal dilatation, ureterocele, ureteroscope