مجله تحقیقات در ارولوژی
سال پنجم شماره 1 (بهار و تابستان 1400)

The present study aimed to assess the association between stone chemical compositions and Percutaneous Nephrolithotomy (PCNL) outcomes (stone-free result, operative time).

In this analytical cross-sectional study, the data of 113 patients who underwent PCNL, including stone chemical composition, stone-free result, and operative time, were recorded and analyzed.

In univariate analysis, no significant differences were observed between the group with the stone-free result and the group without stone-free result in mean percentages of calcium phosphate, calcium oxalate, uric acid, and the frequency of infectious stones time (P>0.05). Moreover, operative time was not significantly correlated with the percentages of calcium phosphate, calcium oxalate, and uric acid components (P>0.05). In addition, no significant difference was detected between the two groups (with and without infectious stones) in terms of mean operative time (47.00±17.38 vs. 45.99±20.98; P=0.817). In multivariate regression analysis, none of calcium phosphate, calcium oxalate, uric acid, and infectious stone were the predictive factors affecting stone-free result and operative time.

As evidenced by the obtained results, the compositions of upper urinary tract stones had no effect on the stone-free result and operative time in PCNL.

Benign Prostatic Hyperplasia (BPH) is defined as the enlargement of the prostate gland in the presence of urinary symptoms without any evidence of malignancy. For patients who have failed medical treatment as the first line of therapy, surgical intervention will be administered as the treatment. Hemorrhage is one of the most dreadful and serious complications of prostate surgery. Bleeding can often be significant and lead to increased morbidity and occasionally mortality. If it persists, it may necessitate blood transfusion and can lead to clot retention in the postoperative period.

This study was conducted on 87 patients with benign prostatic hyperplasia, who underwent surgical intervention (open prostatectomy and transurethral resection of the prostate) for a year. The volume of packed cell transfusion in these patients was determined and compared based on the surgical method and other variables. The collected data were analyzed in SPSS (version 24).

The mean age of the patients was 71.3±9.56 years, and 26.4% of the subjects were under 65 years old. Among the cases, 93.1% of patients underwent transurethral resection of prostate surgery and 7.7% received a blood transfusion. It was found that 41.4%, 12.6%, 10.3%, 3.4%, and 1.1% of the participants had high blood pressure, diabetes, ischemic heart disease, hypothyroidism, and dyslipidemia, respectively. The means of pre- and post-operative hemoglobin were obtained at 13.16±1.83 and 12.33±2.17, respectively, and those of pre- and post-operative hematocrit were estimated at 38.64±4.84 and 36.72±5.72, respectively.

Transurethral resection of prostate surgery had a lower rate of blood transfusion, compared to open surgery. The age of the patients and a history of underlying diseases were not significantly related to blood transfusion percentage in these patients. However, the frequency of blood transfusion was higher in patients with hypertension than in those with other diseases; nevertheless, it was not significant.

Determining the efficiency of kidney transplantation, the survival rate of patients after surgery, and the role of factors affecting this survival is of particular importance. The present study aimed to assess the survival rate of recipients of cadaveric-donor kidneys in the transplant unit of Imam Reza (AS) Hospital in Tabriz during the last five years.

This descriptive-analytical study was conducted on the recipients of cadaveric-donor kidneys. The data were collected from documents of donor patients, evaluation of blood and urine tests, and follow-up. The required examinations included height, weight, body mass index, age of recipient and donor, blood group, and RH of donor and recipient, donor-recipient kinship, duration of dialysis, year of transplantation, duration of transplantation, duration of patient survival, other drugs (aspirin, heart, hypertension, and cholesterol-lowering medications).

In the present study, the survival rates of kidney transplantation at 1, 2, 3, and 5 years were 97%, 90.9%, 79.1%, and 67%, respectively. Moreover, 1, 2, 3, and 5-year survival rates of patients were reported as 98%, 95.5%, 90.9% and 87.4%, respectively. Furthermore, gender and age of kidney donor and recipient were not significantly correlated with renal transplant survival.

Kidney transplantation is the most appropriate treatment option for end-stage renal disease patients, leading to better survival and improved quality of life.

Bladder cancer is one of the most common cancers in the world. In some studies, vitamin D deficiency has been reported in patients with bladder cancer. Vitamin D deficiency may increase the risk of bladder cancer by disrupting the responses of bladder wall cells to abnormal cells.

This case-control study included 226 patients with gross hematuria who were referred to the urology clinic of Shahid Beheshti Hospital in Hamadan. The patients were divided into two groups of patients (n=76) with bladder cancer (case group) and those (n=150) without bladder cancer (Control group). The data were analyzed using SPSS software (Version 16) and at a confidence level of 95%.

The mean serum level of vitamin D in the case and control groups was obtained at 23.78 and 27.20 ng /mL, respectively (P=0.69). In total, 50% and 34% of patients had moderate and severe vitamin D deficiency in the case and control groups, respectively (P=0.020). The mean tumor size was 2.66 cm and 4 cm in moderate and severe cases of vitamin D deficiency, respectively (P=0.007).

Vitamin D deficiency is also associated with increased tumor size in patients with bladder cancer, other than increasing the chance of developing bladder cancer.

In spite of adult renal stones, in pediatric renal stones, most cases have a hereditary background. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of preexisting calculi. Therefore, this study was conducted to investigate metabolic risk factors among infants and children with kidney stones in Hamadan Province, Iran, so that it can be the basis for further studies to suggest the elimination of unnecessary diagnostic tests.

A total of 270 children diagnosed with urinary stones were entered into the study. After recording demographic information, laboratory tests of patients' serum for calcium, phosphorus, sodium, potassium, bicarbonate, uric acid, magnesium, creatinine, and alkaline phosphatase were performed. Moreover, patients' urine was measured for the excretion of random morning samples, such as calcium, oxalate, magnesium, sodium, and uric acid.

It was revealed that the male gender had a significant relationship with hypercalciuria and hyperoxaluria. Furthermore, there was a significant relationship of stone size with impaired urine analysis and positive urine culture.

Based on the results of this study, urinary metabolic risk factors were widely present in children with urinary stones, and hypercalciuria was the most commonly found disorder.  It is recommended that in the evaluation of kidney stones in children, after ruling out the urinary tract abnormalities and infections, metabolic examination of urine be performed, including random measurement of calcium to creatinine in the morning urine, in order to reduce the economic consequences of extensive testing.

Distal ureterolithiasis is one of the most common urinary tract problems and can be accompanied by such symptoms as abdominal pain, nausea, vomiting, dysuria, frequent urination, and hematuria.

The ureteral stone might be misdiagnosed in the presence of atypical symptoms. We reported a 31-year-old man with clinical signs of prostatitis, normal laboratory tests, and normal ultrasonography who had received treatment for acute prostatitis for several weeks, however, had no improvement.  

Further assessments by intravenous pyelography revealed distal right ureteral stone. Complete recovery was achieved immediately after transurethral lithotripsy.

Hypospadias failure is a challenging problem requiring much expertise and perseverance for repair. Most of the time a healthy tissue must be grafted in the place of scarred tissue. These techniques are usually accomplished in multiple surgical sessions since primary graft tubularization has been linked with increased complications

A total of 11 patients with the mid shaft to distal hypospadias underwent repair. Each patient had undergone two or three unsuccessful surgical attempts for hypospadias repairs. All salvage reconstructive operations were performed on the chief responsibility of a single surgeon. The average follow-up was 2.5 years. The surgical technique was improvisatory called Buccal inlay, Skin Onlay (BISO).

In this study, nine patients had tip meatus and straight voiding. In two cases, glandular regression and spraying of urine stream were observed. In both of these cases, Perimeatal-based rhomboid flaps had been used. No fistula or stricture happened during follow-up. In all nine cases, the parents were consent although we did not apply any scoring system, standardized questionnaire, or reference pictures with which parents could compare cosmetic results.

It can be concluded that BISO is a viable option in distal hypospadias cases with scarry plate sparing them a second session of surgery in many instances.