Journal of Translational Research in Urology
Volume:2 Issue: 4, Autumn 2020

Opium is an opiate substance with a significant effect on human physiology and behavior. Ancient priests used opium as a powerful healing drug and many medical texts have referred to opium as medication, especially during the nineteenth century. In old days, the medical use of opium was popular and was called "God's medicine". On the other hand, understanding the molecular pathway of opium function within cells is very essential from pathophysiological views and clinical applications. The current literature shows that opium can initialize cell death through activation of apoptotic events, which in turn induces cascade pathways of angiogenesis. In this review article, we attempt to investigate the effects of opium on cell apoptosis and angiogenesis.

IntroductionPercutaneous nephrolithotomy (PCNL) is the preferred treatment for large kidney stones. Second-look nephroscopy is one of the methods for removing residual stone fragments after PCNL. During second-look nephroscopy, we pass a guidewire through the previously established nephrostomy tract, which was impossible in this case. Thus, we performed the procedure with direct tract ureteroscopy and simultaneous fluoroscopy. Case presentationA 45-year-old man with full staghorn calculi was the case of this study. We performed PCNL surgery on him, but because of tachycardia and a fall in the patients’ blood pressure, we terminated the surgery after 3 hours. Because of the high possibility of remaining stones, we inserted a Foley 16 catheter as a nephrostomy. In the performed computerized tomography (CT) scan two days after the surgery, a significant volume of stone residue was observed. Four days after surgery, the patient was transferred to the operating room after the improvement of clinical status and hematuria resolved. The procedure was done when the patient was in the prone position and under general anesthesia. After cutting the nephrostomy tube, the attempt to insert the wire was not successful. So, we removed the nephrostomy tube. After retrograde injection of the contrast agent and fluoroscopy, we observed the contrasting agent passage through the nephrostomy tract to the skin surface. We found the main tract with simultaneous ureteroscopy and fluoroscopy. then insert guidewire in the renal pelvis and nephroscopy through the wire. ConclusionsWith the help of ureteroscopy and direct vision and fluoroscopy, we found the previous tract, entered the pyelocaliceal system, and embedded the guidewire. Thus, we performed nephroscopy from the same tract site without the need to get re-access.

An increasing number of prepubertal boys encountering infertility due to cancer treatment has prompted a range of studies to set up new methods for fertility restoration and male germ cell maturation. In this regard, cryopreservation of immature testicular tissue (ITT) from biopsy samples is being progressively advised in infertility centers. Different strategies to in vivo or in vitro male germ cell development using stored testicular tissues have been followed: autotransplantation or Xenotransplantation of testicular tissue pieces, spermatogonial stem cells (SSCs) isolation, and transplantation, in vitro spermatogenesis using three-dimensional (3D) culture and tissue culture. Combination of these strategies with assisted reproductive techniques (ART) like intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF) has resulted from complete spermatogenesis resulting in offspring in several animal models but no achievement in producing mature spermatozoa from human prepubertal SSCs has yet been reported. This review describes studies done by researchers making effort on fertility restoration from ITT containing SSCs, Considering the limitations and specific concerns of each strategy.

The establishment of good efficacy and safety of non-invasive methods in comparison with conventional methods would be the result of a higher ability for decision-making about the best therapeutic approach in patients with large ureteral calculi. Accordingly, this study was carried out to compare the efficacy of minimally invasive surgical ureterolithotomy (MISU) versus Transurethral Lithotripsy (TUL) plus Retrograde Intrarenal Surgery (RIRS) in patients with ureteral stones larger than 15 mm.

 In this single-blind randomized clinical trial, 74 consecutive patients with ureteral stones larger than 15 mm attending to Urology Clinic, Sina Hospital, and Tehran, Iran in 2017 were enrolled. Patients were randomly assigned to undergo minimally invasive surgical ureterolithotomy or TUL plus RIRS. Then the cases with remained stones over 2 mm after treatment were recognized by imaging and stone-free rate (SFR) was determined and compared across the groups.

Longer hospital stay, larger Apotel Infusion dose, and longer operation time were seen in the MISU group (P-value ≤ 0.00). The stone-free rate was 94.6% and 97.3% in TUL plus RIRS and MISU groups, respectively (P-value = 1.00). The rates of adverse effects were alike across the groups (P-value = 0.95) with considering fever that was higher in TUL plus RIRS group.

Laparoscopic ureterolithotomy is an effective and safe surgical procedure for minimally invasive strategy when first-line therapeutic approaches were unsuccessful in patients with larger ureteral stones.

Nowadays the common use of diagnostic and therapeutic ionizing radiation increases worries about excessive occupational and patient exposure. The novel fluoroscopic-guided endoscopic procedures can diminish radiation dose during urologic procedures. A “two-point technique (TPT)” is defined in which the fluoroscope image intensifier (c-arm) is shifted among caudal and cephalad set points of the operative field. Maybe patient radiation exposure is less with TPT than with a non-structured conventional technique, stated as the cognitive fluoroscopic technique (CFT). As we could see the urethral lumen clearly by Ureteroscope and endoscopic visions, we use rarely x-ray during our routine procedures in our center, except for percutaneous nephrolithotripsy.

Air pollution has been a common problem of recent decades, across various parts of the globe. The air pollution impact on health outcomes such as cardiovascular incidences and mortalities and lung and child cancers has been widely investigated and recognized. However, the effect on urological cancers is less studied and still under controversy. The performed studies are mainly implemented in the occupational environments, and there is a lack of knowledge, in the general population. Moreover, the few studies in the general population suffer from short follow-ups and a limited set of controlled confounders. Accordingly, future studies on the air pollution-urological cancers association need to overcome the follow-up and confounding inadequacies and being carried out in the general population.

Prostate cancer involves a considerable percentage of men worldwide and as be postulated; prostate cancer epidemiology is not restricted to a specific country. Despite tremendous efforts that have been made regarding prostate cancer diagnosis and treatment, this issue remains challenging for urologists and oncologists by far. The routine method for the diagnosis of prostate cancer is a prostate biopsy, which may accompany by several complications that may be detrimental to patients’ health. Consequently, an alternative method with lower rates of complications is necessitating. For almost two decades liquid biopsy, an alternative method for cancer diagnosis with obvious benefits in comparison with previous methods of cancer diagnosis, has been at the center of interest of many studies, in particular, studies with prostate cancer subjects. The applicability of liquid biopsy which primarily includes cell-free DNA, circulating tumor cells, RNAs, and exosomes in prostate cancer is the main area of research of recent research. However, using liquid biopsy in routine clinical practices yet has not occurred and further studies with more firm evidence are warranted. Herein, we provided a brief report of advancements that have occurred in prostate cancer.