Journal of Translational Research in Urology
Volume:2 Issue: 3, Summer 2020

Coronavirus disease 2019 (COVID-2019) is a viral infection that mainly causes pulmonary infection but mortality usually occurred in patients have comorbidities, such as chronic kidney disease (CKD) that accounts for over 20% of mortalities, morbid obesity, immunosuppression, diabetes mellitus, hypertension, and cancer. Also, the incidence of acute kidney failure reported 5-10% in outpatient series and up to 50% in patients that need to be admitted to the intensive care unit. It is important to know that acute kidney injury (AKI) is associated with increased mortality, so this essay is going to review possible mechanisms that result in AKI. Based on the multifactorial mechanism of AKI, we should have considered probable causes of AKI and act in a stepwise manner to tackle these mechanisms and improve the ultimate prognosis of patients. Although most of the measures are supportive, in some patients such as severely ill cases cytokine storm may be attributed to the severity of symptoms, so immunomodulatory treatments could be considered to decrease AKI and consequently mortality. Among hypotheses that propose AKI; pre-renal and direct renal involvement by a virus are discussed in detail.

Bladder injury is an urgent emergency case requiring urgent treatment in order to restore the normal function of the urinary system.

Here we present a 38-year-old woman with a history of primary infertility with a twin pregnancy following in vitro fertilization (IVF). Because of the high adhesion, the anterior wall of the bladder cut transversely instead of the anterior wall of the uterus. In this case, of twin cesarean section, the anterior wall, posterior wall, and uterine wall were opened. The twins removed from the bladder by two incisions and then an expert urologist repaired posterior and anterior wall of the bladder as well as uterus followed by medication by anticholinergic and antibiotics.

Bladder injury is the most common complication during gyneco-genital surgery. Most of this damage is intraperitoneal that need repair during the surgery and prolonged bladder catheterization.

Current hemostatic agents are needed to reduce bleeding and transfusion during several surgery processes. Plant-based absorbable surgical hemostatic agents (microporous polysaccharide hemospheres) are proposed for use in surgical wound sites as an absorbable hemostat and in this study, we checked its efficacy.

This study was run under the Tehran University of Medical Science Ethics Committee observation based on the clinical trial registry criteria (IRCT20190624043991N1). Total numbers of 42 percutaneous nephrolithotomies (PCNL) patients were enrolled, 21 cases hemostatic powder and 21 controls. Hemostatic powder pumped into Amplatz sheath before its extraction.

The mean age of the case and control groups was 42.1±19.5, and 42.1±18.5 years, respectively. The median stone size was 11.3±1.85cm. Overall, the differences between sex, age, stone size, and location were not statistically significant in the two groups (p-value˃0.05). Serum hemoglobin reduction following PCNL was significant in both groups compared to the serum level before surgery (p-value<0.001). However, the difference was not significant between case and control groups postoperatively (p-value=0.727). Yet, postoperative serum creatinine reduction was not significantly different between the two groups compared to preoperative serum levels (p-value>0.05).

The present study showed that microporous polysaccharide hemosphere (MPH) did not affect bleeding reduction, hemoglobin decline, and postoperative blood transfusion, and hospital stay.

Ureter duplication is a common anomaly of the urinary tract in which both ureters drain one kidney. In bipolar renal duplication, the Meyer-Weigert-Rule describes the duplex ureters draining pattern. Owing to obstruction, the upper pole is usually seen as dysplastic, while the lower pole is associated with vesicoureteral reflux.

Herein, we report a rare case of renal duplication in which the lower moiety is dysplastic. A 30-year-old woman with a right single kidney with atrophic and dysfunction without secretions.

Radiologists and urologists should always be aware because if the lower moiety is obstructive, this newly implemented variation can require individualized care.

The current screening test for prostate cancer (PCa) has the weak point of a high false-negative rate and a low true positive rate. There is an extreme need for a new and accurate testing system. Circulating Tumor Cells (CTCs) as the main liquid biopsy components provide excellent biomarkers for early diagnosis of PCa, prognosis, recurrence risk, and treatment efficacy. These tumor cells can get the release of tumor and freely circulate in the patient’s body fluids and easily are traceable to answer the presence of the tumor more than its stage.  The new gifted ISET®-CTC Test is a simple blood test with high sensitivity and specificity for the detection of CTC in PCa. As a novel idea, it is a  challengeable point nowadays that it needs further studies.

A new coronavirus recognized as 2019 novel coronavirus (COVID-19) is the etiological cause in charge of the 2019-2020 viral pneumonia worldwide outbreak. The molecular structure and genome of this virus are identical to SARA-CoV and for an unknown reason, it is highly transmittable. The spike protein is responsible to attach to the host cell and viral single-stranded RNA (ssRNA) entrance to the cells. Upon binding of the Spike proteins to the host cell ACE2 receptor and merging with the membrane, COVID-19 ssRNA goes to the host cells. The viral RNAs are recognized as the foreign element by TLR3, TLR7, TLR8, and TLR9 in the host cell. The viral genome receptor retinoic-acid inducible, cytosolic receptor melanoma differentiation-associated gene and nucleotidyltransferase cyclic GMP-AMP synthase (cGAS) is in charge of viral RNA representation in the cytoplasm.  Now there is no targeted therapeutics with high efficacies for the treatment of Covid 19 disease. More than usual medication some interfering RNA molecules are under debate.  The reason for being high transmission of COVID-19 is not recognized. This virus pandemic is now all over the world.

Intravesical Bacillus Calmette-Guerin (BCG) is approved for non-muscle invasive bladder cancer treatment a long time ago. Its effect is mostly achieved using activating the immune system; the same mechanism proposed is likely for chimeric antigen receptor (CAR) T cells. Hence CAR-T cell therapy could be considered for bladder cancer treatment.