Journal of Translational Research in Urology
Volume:3 Issue: 2, Spring 2021

Retrograde Intrarenal Surgery (RIRS) and Minimally invasive PCNL (also termed mini-PCNL or mini-Perc or mPCNL) mini-perch surgery are two methods of residual stone treatment. We aim to compare the results of mini-perch and RIRS to treat residual stones after PCNL with Hounsfield unit over 1000. In this retrospective cohort study patients with residual stones after PCNL with Hounsfield unit above 1000 or a stone-to-skin distance greater than 10 cm divided into two groups of mini perch or RIRS.

Total number of 32 patients in the RIRS group (mean age 38.68±8.00) and 35 patients in the mini-perc group (mean age 42.05±13.22) were studied. The hemoglobin loss (p-value=0.01), need for blood transfusion (p-value=0.04), hospital stay (p-value=0.006) and surgery time (p-value=0.001) were significantly lower in RIRS group.

Although the percentage of success (p-value=0.17) and Stone Free Rate (SFR) (p-value=0.401) were higher in the mini-perc group, it was not significantly different from RIRS. Complications in the mini-perc group were significantly higher than in the RIRS group (p-value=0.05).

The RIRS method has no significant difference in comparison with mini-perc. RIRS have lower operation time, shorter hospitalization, and less complication.

The urological malignancies are among the most important neoplastic diseases imposing a significant burden on health care systems globally. The current therapeutic measures for these cancers have unsatisfactory results, and comprehensive knowledge of pathways involved in carcinogenesis and progression of these cancers is of utmost importance. Circular Ribonucleic Acids (circRNAs) are a class of non-coding RNAs characterized by their single-stranded covalently closed loops, exert their regulatory effects mainly by sponging the microRNAs (miRNAs) associated with the regulation of gene expression. In the past few years, several circRNAs have been identified to be implicated in the malignancies of the urinary system. A number of these circRNAs are involved in the common carcinogenic pathways, such as MAPK/ERK, TGF-β, and PI3K-Akt pathways. However, further studies are required to ascertain the exact mechanism of numerous circRNAs in urological cancers and determine their diagnostic, prognostic, and therapeutic roles in patients with these cancers.

Overactive bladder (OAB) is defined as bladder storage dysfunction, which results in a frequent and sudden urge to urinate. OAB is a prevalent disorder, and its symptoms have a detrimental effect on health-related quality of life and increase social problems. Treatment of OAB includes first-line behavioral therapies and second-line anti-muscarinic drugs. However, the rate of drug discontinuation due to drug side effects is high. Acupuncture is considered an effective therapy to suppress contractions and excessive detrusor muscle activity, improve bladder adaptation, maintain normal urination, and improve pathological changes in bladder tissue based on several preclinical and clinical investigations. Therefore, as one of the complementary and alternative medicine methods, acupuncture can play a pivotal role in the treatment of patients with OAB.

Stenting in the ureter following RIRS (Retrograde Intrarenal Surgery) and stone removal is recommended to prevent edema and colic pain. This study aims to find the optimal time for ureteral stent removal after RIRS with fewer complications. This study was run under Tehran University of Medical Sciences Ethical Committee (IR.TUMS.VCR.REC.1398.750). In this retrospective study, demographic and clinical information of patients from 2013 to 2019 were investigated.  The patients were classified based on the duration of ureteral catheter placement: group A less than 24h, group B 24-72h and group C Removed after 72h.  From our 80 patients who met inclusion criteria in A and B groups, urologists had to insert a DJ stent for 16 of 19 (84%) (Due to pain and hydronephrosis) and 9 of 27 patients (33%), respectively. In group C, however; only 5 (15%) in 33 patients required DJ stent following the removal of the simple ureteral catheter. Hence, 84% of the patients with a simple ureteral catheter for over 72h in their ureter did not need re-stenting (P-value < 0.001). We concluded that the optimal time of stenting for a simple ureteral catheter is 72 hours. Catheter removal after this time would lead to the least complications.

With increasing antimicrobial resistance to common antibiotics, the development of alternative therapeutic strategies is necessary. Also, an antibacterial peptide with numerous behavior and different properties such as net charge, hydrophobicity, length, etc. could act against pathogenic microorganisms. In recent years, novel peptides with activity against a wide range of bacteria have been introduced. In this study, seventeen pathogenic bacteria were chosen to study the antibacterial effect of K4 peptide using MIC and MBC assays. The therapeutic index (TI) of this peptide was experimentally calculated by the ratio of HC50 to MIC as a parameter to represent the specificity of AMP. In silico analysis was performed to predict the physicochemical properties, structures, and behavior of this peptide. In vitro cytotoxic effect of peptide was evaluated on the Hela cell line using MTT assay, and the amount of macrophage nitric oxide production was measured by the Griess method on the J774 cell line. Peptide concentrations of 25-400 µg/ml were seen as the MIC value results for different bacteria. MBC assay showed such a result with a concentration of more than 25-400 µg/ml. The result of the hemolysis assay was 24 percent at a 1 mg/ml concentration. The amount of nitric oxide production of macrophage cell line J774 was 25.9873 µM at a 6.3 µg/ml peptide concentration. K4 peptide had a strong antibacterial effect on some bacteria such as B. melitensis. This peptide may have a role in immunity with nitric oxide production. Additionally, it enhances the bacterial killing mechanism of macrophages, making this peptide a potential agent against pathogens.

Urinary tract infection (UTI) is a common bacterial infection and usually requires antibiotics for treatment. But the antibiotic resistance is always a serious concern. So, developing some alternative medication strategies such as herbal medicine is an extreme need. Several studies have confirmed the prophylactic and also therapeutic effects of a variety of anthocyanin-containing berries for UTIs. Cornus mas which is native to Southern Europe and Southwestern Asia is also rich in anthocyanin but its effect on UTI has been not yet studied. This study aims to evaluate the effect of Cornu's mas extract in treating UTI in rat models. After inducing UTI in 18 Wistar rats, they were sub-grouped into three groups: control group, nitrofurantoin treated group (case I) and Cornus mas treated group (case II). After seven days of treatment, the UTI indicators like fever, microscopic analysis of urine, and pathological examination of the bladder were investigated. Actually, UTI indicators were resolved after treatment in both treated groups (nitrofurantoin and case II). Comparison of the results between the control group and the other three groups confirmed the development of UTI in the rat model. Clinical, laboratory, and pathologic results proposed that the Cornus mas extract effects in treating UTI are not inferior to that of nitrofurantoin. In addition to its anti-inflammatory effects, Cornu's mas extract can be a gifted potential substitute for antibiotics in treating UTI in rat models.

For erectile dysfunction (ED) treatment, Vacuum therapy (VT) utilizes negative pressure to distend the corporal sinusoids and to increase the blood inflow to the penis. In the current study, we evaluated the vacuum constrictive device (VCD) and intracavernosal injection (ICI) of papaverine for the treatment of ED.

A total number of 80 erectile dysfunctions (ED) were divided into 4 groups of 20 couples. The first group was treated with Papaverine who had a virgin wife (a). The second group was unconsummated marriage couples who were treated with vacuums (b). The third group was and the couples with experience of sexual intercourse who had been treated with Papaverine injection (c). The fourth group was the couples with experience of sexual intercourse that were treated with a vacuum device (d).

After 4 months of treatment, all patients were able to have sex. In the unconsummated couples group treated with papaverine and consummated couples treated with papaverine, all of the indicators of the erectile function were significantly increased compared to pre-treatment (p-value<0.05). There were no significant differences between the two methods in terms of other complications such as ecchymosis, blisters, headache, cutaneous rash, and vaso-vascular shock (p-value>0.05).

This study showed that in patients with erectile dysfunction who are having virgin spouses and who are not responding to the first line of oral medication that 5-inhibitors phosphodiesterase can be the excellent candidate for ICI of vasoactive drugs therapy.

 Fournier gangrene is a surgical emergency that presents as necrotizing fasciitis. It mainly involved the genital and perineal regions. The predisposing factors are immunosuppression, diabetes mellitus, alcoholism, and surgical procedures. The underlying source of infection is usually recognizable in the anorectal and genitourinary systems. The physical exam may be misleading as findings in early evaluation is minimal compared to the exact spreading of infection. A high index of suspicion is needed for early diagnosis of this condition and management with broad-spectrum antibiotic therapy and prompt surgical debridement.

 In this case report, a case of Fournier gangrene that occurred after colostomy closure in a patient with a previous history of colostomy due to bowel obstruction was presented.

 The patient had extensive gas formation from chest to mid-thigh proximally and distally respectively but managed with surgical debridement and planned for future reconstructive surgery.