Journal of Translational Research in Urology
Volume:3 Issue: 1, Winter 2021

Exosomes, extracellular vesicles secreted from cells, are carriers containing proteins, lipids, and nucleic acids. By adhering and releasing their contents to the recipient cells, exosomes play a major role in cellular communication. Based on a variety of their originated cells, cargos, and physiologic state of releasing cell, Exosomes have been attributed an extended range of roles such as signal transduction, reprogramming, epigenetic modification, and inflammation. Recently, it has been shown that exosomes are also involved in pathological mechanisms of diseases, such as neurodegenerative diseases, tumors, chronic inflammation, and cardiovascular diseases. Moreover, exosomes have been used as diagnostic markers for different diseases since their cargos and contents can reflect the physiological or pathological processes of the cells of origin. Because of having features of being carriers, they can be considered as a vehicle to drug delivery or gene therapy.

IntroductionPercutaneous nephrolithotomy (PCNL) is a common urological procedure. Obtaining secure percutaneous access to the collecting system which is usually done under fluoroscopic guidance and tract dilatation is a crucial step toward a successful and safe procedure. This study aims to introduce a novel technique to modify this procedure.MethodCombined Direct Visual and Imaging Guided PCNL is performed by using specific 28 Fr dilatators with a customized central lumen that accepts a 4.5 F semi-rigid ureteroscope to visually confirm the puncture of target calyx and passing a guidewire. This instrument was passed as a one-shot dilator after the withdrawal of the puncture needle. The rest of the procedure was then carried out in a standard manner. This novel technique was introduced in 12 patients in 2020 in Sina hospital, after completing the informed consent.Results The mean age was 53.58±11.96 and the average stone size was 4.1±0.58 cm and the average time from insertion of the needle into target calyx until securing a guide-wire inside the collecting system (pelvis, ureter) was 95 seconds (84-107). Fluoroscopy time (total time required to obtain the access but not the whole operation) was averagely 30.25±8.01 seconds. There were no intraoperative or postoperative complications as a result of this technique.ConclusionsUse of the ureteroscope loaded with the dilator and sheath during PNCL seems to be a feasible and safe technique for dilatation of access tract during one shot PCNL.

IntroductionRenal cell carcinoma (RCC) is one of the most usual kidney’s tumors. The improvement of non-invasive biomarkers will make it feasible to investigate whose have high risk of recurrence after radical or partial nephrectomy and will expand the valuation of tumor response to several treatment strategies. In this perspective, liquid biopsy suggests a talented perception for cancer diagnosis and monitoring, with several benefits versus traditional RCC diagnostic processes and can be taken into account of the present RCC diagnosis and controlling strategies.MethodIn this systematic review, we considered both CTCs count and molecular markers in RCC patient management. A systematic search on several databases like PubMed, Scopus, Embase, and Web of Science was directed which led to the final 24 studies considering the impact of CTCs on both diagnosis and prognosis of RCC.ResultsSeveral primary studies consider the CTCs quantitation as the tumor representing components that are based on immunomagnetic separation procedure. The magnetic cell sorting (MACS) technique, cell search, Tapered-slit filter (photosensitive polymer-based microfilter), CELLection™ Dynabeads® coated with the monoclonal antibodies, and ISET® -Isolation by Size of Tumor cells.  If CTCs wanted to be recruited for the prognosis of RCC and progression-free survival (PFS) it is better to check by gene expression profile through quantitative polymerase chain reaction analysis (Real Time-PCR) or in situ hybridization of CTC’s RNA molecules.  ConclusionsCTCs detection as the main liquid biopsy component has an excessive clinical impact on cancer management. Nevertheless, usual methods have some limitations when directing for the recognition of circulating tumor cells (CTCs) with high efficiency and low cost. Some CTCs molecular markers and gene expression profiling of CTCs should be considered for RCC prognosis.

IntroductionThere are a growing number of unmet kidney donor sources. So, alternative donor sources, such as donation after circulatory determination of death (DCDD), are taken into the consideration.Case presentationIn this study, we represent successful En-Bloc kidney transplantation from a 4-year-Old donor with cerebral palsy to a 60-year old recipient. The kidney of a 4-year-old boy with congenital CP (weight=12Kg; BMI=12) with brain death was transplanted to a 60-year-old man (weight =70Kg; BMI=23.6). Panel-reactive antibody (PRA) to HLA class I (PRA I) and HLA class II (PRA II) were observed less than 5% in the 60-year old recipient. Also, the PRA titer with complement-dependent cytotoxicity (PRA-CDC) and the donor-recipient WBC crossmatch was negative. Our case is reported by a successful EKBT to an adult with the en-bloc kidney of a 4-year-old child with cerebral palsy. The small kidneys of a cerebral palsy child are adapting and functioning well in the adult body.ConclusionsTherefore, CP pediatric donors can be good resources for transplantation whenever available.

IntroductionTo compare the effectiveness of tamsulosin and Tolterodine in reducing stent-related symptoms with each other and with the control group we performed this randomized clinical trial.Methods150 patients after successful first-time transurethral lithotripsy (TUL) for unilateral ureteral stones were elected for the study 17 patients were excluded in the first allocation. Other patients were randomized (With balanced blocked randomization) into three groups. In group 1, 41 patients received Tamsulosin (Omnic) 0.4mg once a day for a month and in group 2, 42 patients received tolterodine (Detrusitol) 2mg once a day for a month. In group 3, which was our control group, 50 patients received a placebo once a day for a month. Clinical stent-related symptoms questionnaires at the first visit (day 10) and before removing themes stent were completed. Two urine tests and an x-ray of the abdomen in the first visit have been performed.ResultsDespite the remarkable decrease in the severity of stent-related symptoms other than urine urgency in the control group  (p-value<0.05), solitary use of neither tamsulosin nor tolterodine was superior to the control group, and also, they were not superior to each other with respect to improving double-J stent-related symptoms (p-value>0.05).ConclusionThe results of our study show that administration of tolterodine and tamsulosin to reduce stent-related symptoms do not have superiority to each other and the control group.

IntroductionThe current study examined the clinical impacts of phosphatase and tensin (PTEN) expression in prostate cancer (PCa) using immunohistochemistry.Methods50 patients with mean age of 66.4±7.3 years who had undergone prostatectomy surgery with the diagnosis of PCa, were enrolled in the study. We collected 50 paraffin blocks from the malignant part and 50 paraffin blocks from the healthy part of each patient’s prostate. We considered malignant and healthy parts as the case and the control, respectively. Clinical and pathological information of the patients were gathered and their associations with PTEN status were assessed using odds ratios (ORs) analysis.ResultsThe significant associations between tumor stage, perivascular invasion, perineural invasion, marginal involvement, extraprostatic extension, and biochemical recurrence (as assed by post-surgical prostate-specific antigen (PSA)) and PTEN expression were detected. For patients negative for PTEN, the odds ratio of the higher stage, perivascular invasion, perineural invasion, marginal involvement, and extraprostatic extension in comparison to patients positive for PTEN were estimated 7.5 (95%CI: 2.01,27.86), (95%CI: 1.65-25.57), 7.8 (95%CI:1.54-40.09), 9.78 (95%CI:2.33-41.08), and 4.84 (95%CI:1.07-21.84), respectively. Concerning biochemical recurrence, ORs was calculated 0.30 (95%CI:0.09-1.02) for PTEN positive patients compare to PTEN negative patients.Conclusions Since PTEN loss was associated with fe atures of aggressive PCa, it can be concluded that loss of PTEN would lead to more aggressive PCa and thereby, lower clinical outcomes.

IntroductionLaparoscopic ureterolithotomy (LU) is a viable option for large ureteral stones (1, 2). The lost stone during laparoscopy is a rare event and most reports are in gallstone surgeries. Most experts recommended that the lost gallstone should be extracted from the abdominal cavity to prevent abscess formation  but in laparoscopic ureterolithotomy with lost stone the optimal management is controversial (3-5). We report our experience with a lost ureteral stone during laparoscopy and the technique that was successful to find it.Case presentationThe patient was a 28-year-old man, presented with a 22 millimetres stone in the proximal part of the left ureter. The spiral computed tomography scan revealed severe hydronephrosis. The patient was positioned in the left flank and camera port inserted in the lateral border of rectus muscle then two 5 mm working ports inserted in the left upper quadrant and left lower quadrant, respectively. The ureterolithotomy process was performed uneventfully with Double-J stent insertion, but during the extraction of stone from 10 mm port, the stone was lost in abdominal space due to rupture of our endobag (which was a finger of a surgical glove). We extract the lost stone with stepwise searching of the dependent part of the abdominal cavity and found the stone in the dependent part of the right lower quadrant. The operative time was 165 minutes. The patient had no complication in the Post-operative course, the Foley catheter was removed on post-operative day 2 and the drain was removed on post-operative day 3. The patient was discharged home at post-operation day 4 and stent removed four weeks later.ConclusionsWe believe that any effort should be performed to extract lost stone in laparoscopic ureterolithotomy cases due to the potential risk of abscess formation and the probability of misleading imaging in the future follow-up of patients.