فهرست مطالب

Urology Journal
Volume:11 Issue: 1, Jan-Feb 2014

  • تاریخ انتشار: 1392/11/17
  • تعداد عناوین: 34
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  • Abdussamet Batur, Serdar Karakose, Giray Karalezli Page 1203
  • Saurabh Vashishtha, Sanjoy Kumar Sureka, Shikhar Agarwal, Alok Srivastava, Sandeep Prabhakaran, Rakesh Kapoor, Aneesh Srivastava, Priyadarshi Ranjan, Sulah Ansari Pages 1204-1210
    Purpose
    The aim of the study was to determine whether the coexistence of urethral stricture and stone influence the treatment modality of each other and to ascertain the best treatment modality for these group of patients. We also tried to speculate whether the stone is an effect or a cause of the stricture.
    Materials And Methods
    Retrospective analysis of prospectively collected data of 35 male patients with coexistent urethral stricture and stone were done between January 1998 and December 2011. Patients were divided in two groups (1 and 2) - limited stone bulk (group 1, n =30) and extensive stone bulk (group 2, n = 5). The former group was treated with endourologic procedures and the latter group managed with open staged procedures. We used ureter scope for endourological management which we think eases the management.
    Results
    Endoscopic management of both stone and stricture were successful in all patients of group 1. Patients of group 2 have been managed by open surgery in two stages. All of them are urologically asymptomatic after a mean of 28 months of follow up. The principle of treatment modality were the bulk of stone, its location and characteristics of stricture. determinants
    Conclusion
    Both stone and stricture can be managed successfully by endoscopic method in most of the patients. Bulk, location of the urethral stone and length of stricture is the main limiting factor for the endoscopic management. A stone can be an «effect» as well as the «cause» of strictured urethra.
  • Murat Gonen, Betul Basaran Pages 1211-1215
    Purpose
    Tubeless percutaneous nephrolithotomy (PCNL) with double-J stenting is a good option for large kidney calculi without increasing blood loss. In many centers tubeless PCNL is performed under general anesthesia. In the present study we evaluated the impact of spinal anesthesia in patients undergoing tubeless PCNL.
    Material And Methods
    Between February 2011 and February 2012, forty six patients with kidney calculi were treated with tubeless PCNL. Of these patients 26 were treated under spinal anesthesia (group 1) and remaining 20 were treated under general anesthesia (group 2). Groups were compared according to patient demographics, stone size, access number, operative time, presence of supracostal access, analgesic requirement, length of hospital stay, and complications.
    Results
    There were not any statistically significant differences between groups in terms of patient demographics, mean stone size, mean access number, operative time, presence of supracostal access, and length of hospital stay. However, the analgesic requirement was significantly less in group 1 (53 ± 39 mg vs. 111 ± 46 mg, intravenous tramadol in groups 1 and 2, respectively P <. 001).
    Conclusion
    Tubeless PCNL under spinal anesthesia is a good alternative for general anesthesia in adult patients. Spinal anesthesia decreases analgesic requirement in patients that were performed tubeless PCNL compared to general anesthesia.
  • Qinglong Chi, Yan Wang, Ji Lu, Xiaoqing Wang, Yuanyuan Hao, Zhihua Lu, Jinghai Hu, Fengming Jiang, Qihui Chen, Haifeng Zhang, Ning Xu, Yuchuan Hou, Chunxi Wang, Yanbo Wang Pages 1216-1221
    Purpose
    To assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) under the guidance of ultrasonography and fluoroscopy.
    Materials And Methods
    We retrospectively analyzed 562 renal calculi patients (313 men and 249 women; mean age 46 years, ranged from 13 to 70 years) who underwent 582 PCNL from March 2004 to October 2011 in our department.
    Results
    Of participants, 89.6% experienced less than 3 puncture times; 2 patients (0.4%) experienced puncture failures; percentage of single or multiple tracts was 89.7% and 10.3%, respectively, 55 patients (9.5%) needed auxiliary measures after one PCNL (24 second PCNL and 31 extracorporeal shock wave lithotripsy). The mean operative time was 82.3 min (range, 45-190 min). The stone free rate was 90.5%. Thirty five patients (6.0%) had postoperative fever and responded to antibiotics. Three patients (0.5%) developed pleural effusion and recovered after closed drainage of thoracic cavity. Thirteen patients (2.2%) needed blood transfusion. Twelve patients (2.1%) developed septic shock and were given anti-shock therapy. Two patients (0.3%) needed angiographic renal embolization or nephrectomy.
    Conclusion
    With its high success rate for achieving access to the targeted calyx and high stone clearance rate, the guidance of ultrasonography and fluoroscopy should be the first option in PCNL.
  • Omer Bayrak, Ilker Seckiner, Sakip Erturhan, Gokhan Cil, Ahmet Erbagci, Faruk Yagci Pages 1222-1227
    Purpose
    To compare the complications and the cost analysis of open radical nephrectomy (ORN) versus laparoscopic radical nephrectomy (LRN) in patients with renal tumors larger than 7 centimeters (cm).
    Materials And Methods
    A retrospective analysis was performed in 173 patients (ORN group, n = 140; LRN group, n = 33) who underwent surgery for kidney tumors between 2008 and 2011. Patients'' age, tumor size, pre-operative surgical risk score (American Society of Anesthesiologists score), duration of hospitalization, complications and the costs of hospitalization were recorded. The complications in ORN group and LRN group were specified with Modified Clavien System in five grades.
    Results
    The mean age was found 58.52 ± 13.74 years in ORN group, and 58.15 ± 12.81 years in LRN group (P =. 847). Post-operative pain necessitating analgesics was observed in all patients (100%) after early post-operative period in both groups (Grade 1 complications). Blood transfusions were required in 51 patients (36.42%) in the ORN group, and 7 (21.21%) patients in the LRN group (Grade 2 complications) (P =. 185). Grade 3 complication was not observed in each groups. Grade 4 complications were occurred in 6 (4.28%) patients [aortic injury, acute tubular necrosis, the need for dialysis, respiratory arrest (2), atrial fibrillation] in the ORN group, and in 1 (3.03%) patient (pulmonary embolism) in the LRN group. Grade 5 complication was occurred in 1 (0.71%) patient (death) in the ORN group. By the cost analysis, the average cost of ORN group was €1328, whereas €1508 in LRN group (P <. 05).
    Conclusion
    Laparoscopy is used in many clinics with an increasing frequency because of the improved patient comfort, better cosmetic results, less post-operative pain, lower transfusion rates, and early return to the daily activities. Besides these advantages, the negligible difference in the costs compared to the open surgery (mean difference = €180 per case) makes it even more attractive.
  • Nasser Simforoosh, Ali Ahanian, Amin Mirsadeghi, Alireza Lashay, Seyed Hossein Hosseini Sharifi, Mohammad Hossein Soltani Pages 1228-1231
    Purpose
    Laparoscopy is the gold standard approach for management of some adrenal masses in adult cases. Still there have not been many findings in case of children. We present our experience with clipless laparoscopic adrenalectomy in pediatric cases for the first time.
    Materials And Methods
    From January 2007 to January 2011, thirteen laparoscopic adrenalectomy were performed in patients 5-18 years old. The first port (10 mm) was inserted using open approach above the umbilicus and three 5 mm trocars were inserted under direct vision. On the left side, the colon was mobilized medially, then the renal vein exposed. Adrenal vein was coagulated using bipolar cautery after separating from renal vein. No endoscopic clips were used.
    Results
    Eight girls and five boys with the mean age of 14.4 years old (ranging from 5 to 18 years old) underwent laparoscopic adrenalectomy. The mean operative time was 151 ± 47 (80- 240) minutes. The mean size of adrenal lesions in greatest diameter was 6.9 ± 2.4 cm (3.5 to 10). The mean hospital stay was 3.7 days (2-5) and average follow-up time was 21 months (6-27).
    Conclusion
    Laparoscopic adrenalectomy in children and young adults is effective and safe if the cases are selected appropriately. Clipless laparoscopic approach by an expert surgeon has acceptable outcomes.
  • Hassan Jamshidian, Mohsen Hashemi, Mohammad Reza Nowroozi, Mohsen Ayati, Mahdieh Bonyadi, Vahid Najjaran Tousi Pages 1232-1237
    Purpose
    To the assess sensitivity and specificity of urinary levels of hyaluronic acid (HA) and hyaluronidase (HAase) as an individual or a combined test to diagnose bladder transitional cell carcinoma (TCC).
    Materials And Methods
    One hundred and ninety-four urine specimens were collected from individuals between July 2007 and March 2008. The urinary level of hyaluronic acid (HA) was measured by Enzyme-linked immunosorbent assay. Thereafter, the urinary levels of HA and HAase were normalized to urinary creatinine level and expressed as ng/mg and μ/mg.
    Results
    Eighty percent of patients with bladder cancer had urinary HA level < 500 ng/mg, and 90% of controls showed HA level < 500 ng/mg (P <. 001). The mean urinary levels of HA in controls did not vary significantly (P <. 05), whereas they significantly increased (2.5 to 6.5 folds) in all grades of TCC. More than 80% of patients with grades 2 and 3 TCC had urinary HAase level < 10 μ/mg and over 80% of controls showed HAase level < 10 μ/mg (P <. 05). Hyaluronidase levels increased in patients with grades 2 and 3 bladder TCC.
    Conclusion
    Measurement of urinary levels of HA and HAase (with 89% sensitivity and 83% specificity) appears to be a highly accurate and non-invasive method for detecting bladder TCC and evaluating its grade.
  • Surbhi Goyal, Usha Rani Singh, Sonal Sharma, Navneet Kaur Pages 1238-1247
    Purpose
    To evaluate the mutual inter-relationship of mitotic indices, argyrophilic nuclear organizer regions (AgNOR) count, Ki-67 and B-cell lymphoma 2 protein (bcl-2) in papillary urothelial bladder cancer (pUBC), and their correlation with grade and stage. To establish the cut-off values of these markers to detect high grade and muscle invasive bladder cancer.
    Materials And Methods
    Fifty-four patients with primary pUBC who underwent transurethral resection / radical cystectomy were analyzed retrospectively. Cell proliferation was assessed by Ki-67 labelling index, mean AgNOR count, mitotic count, mitotic activity index and mitosis/ volume index. Immunohistochemistry was done to see bcl-2 and Ki-67 expression. Correlation of these indices with tumor grade and stage and amongst themselves was assessed. The receiver operating characteristic (ROC) curves were drawn to establish the cut-off values.
    Results
    We found a strong positive correlation of mitotic indices and Ki-67 with tumor grade (P =. 000), stage (P <. 05) and bcl-2 (P =. 000). AgNOR count correlated positively with the grade (P =. 006), mitotic indices and Ki-67 (P =. 032) but not with tumor stage and bcl-2. Cytoplasmic bcl-2 immunopositivity was seen in 42.3% of low grade pUBC and 85.7% of high grade pUBC cases (P =. 001). bcl-2 positivity was seen in 85% of muscle invasive pUBC as compared to only 52.9% of superficial cases. Ki-67 ≥ 32.5%, ≥ 14 mitoses/10 high power fields (hpf), ≥ 11.20 mitoses/mm2, ≥ 0.75 mitoses/100 tumor cells and AgNOR ≥ 11.55 are 100% specific for high grade bladder carcinoma. Ki-67 ≥ 59% and mitoses ≥ 36.50 per 10 hpf can indicate muscle invasion with 100% specificity.
    Conclusion
    Cut-off values for Ki-67, mitotic indices and AgNOR can confirm high grade bladder carcinoma in equivocal cases. Ki-67 and mitotic count can serve as potential and reliable indicators of muscle invasion.
  • Zeki Tuncel TekgÜl, Rauf Taner Divrik, Murat Turan, Ersin Konyalioglu, Esen Simsek, Mustafa G., Ouml, NÜllÜ Pages 1248-1252
    Purpose
    The aim of this study was to compare the recurrence rates of patients with bladder tumors on the lateral wall undergoing transurethral resection of bladder tumor(TUR-BT) with or without obturator nerve block (ONB) and to investigate the impact of ONB on the effective tumor resection on the lateral bladder wall.
    Materials And Methods
    All patients who underwent TUR-BT under spinal anesthesia within the three-year study period in the study center were reviewed retrospectively. Among these, 68 patients who had been diagnosed with de novo lateral bladder wall tumor and included in low risk group 1n accord with European Organization for Research and Treatment of Cancer (EORTC) classification, undergone complete resection were enrolled into the study. Group 1 (36 patients who underwent TUR-BT with only spinal anesthesia) and group 2 (32 patients who underwent TUR-BT with spinal anesthesia plus ONB) were evaluated with respect to tumor recurrence rates and disease-free time to recurrence, if any.
    Results
    Follow-up periods (range, 19 to 41 months for group 1 and 19 to 39 months for group 2) and overall recurrence rates (group 1, 27.8% and group 2, 18.8%) were also found to be similar. Mean time to recurrence was significantly higher in group 2 (15 ± 5.5 months) than in group 1 (7.8 ± 4.5 months) (P =. 009)
    Conclusion
    ONB employed in addition to spinal anesthesia in TUR-BT involving the lateral wall can prolong time to recurrence and increase the chance to lengthen disease-free survival in low-risk superficial bladder tumors.
  • Can Tuygun, Ufuk Ozturk, Hasan Nedim Goksel Goktug, Kursad Zengin, Nevzat Can Sener, Hasan Bakirtas Pages 1253-1257
    Purpose
    To report our experience with patients who have suspected testicular masses (STM) managed by ex vivo technique of testicular sparing surgery (TSS) after radical orchiectomy.
    Materials And Methods
    Between 2007-2011 years, 10 patients with STM were evaluated by history, physical examination, testicular ultrasound and serum tumor markers. STM were defined as; no paratesticular lesions, size of the lesion smaller than 20 mm, and no known presence of elevated tumor markers or metastatic disease. The principles of TSS followed by radical orchiectomy were applied to the removed surgical specimen. Excised mass, multiple biopsies of the adjacent parenchyma and the remaining testis were sent for frozen-section analysis (FSA). Histopathologic sections were re-reviewed for definitive pathologic diagnosis.
    Results
    The mean patient age, mean size and mean length of history of STM were 37 years (25-64), 17.5 mm (10-20) and 6 months (2-12). All STM were palpable and painless. Tumor markers were negative in all patients. Six tumors were benign (2 adenomatoid tumor, 1 epididymitis nodosa, 1 leydig cell tumor, 1 sertoli cell tumor, 1 fibrous pseudotumor) and 4 tumors were malignant (3 seminoma, 1 embryonal carcinoma) on definitive pathologic diagnosis. Excluding one benign lesion, FSA correctly determined 9 lesions and all malignant lesions. Three patients had testicular intraepithelial neoplasia (ones seminoma, ones embryonal carcinoma, ones adenomatoid tumor).
    Conclusion
    Our preliminary report reveals that STM tend to be benign rather than malignant in nature. Also, a careful patient selection and an accurate FSA are crucial points for TSS and it has the potential to become the primary option in selected patients who have testicular lesions instead of the traditional method.
  • Dongrong Yang, Boxin Xue, Yachen Zang, Xiaolong Liu, Jin Zhu, Yibin Zhou, Yuxi Shan Pages 1258-1263
    Purpose
    Although transurethral resection of the bladder tumor (TURBT) is still regarded as thegold standard for the treatment of clinical non-muscle invasive bladder cancer, alternative surgical options remain investigating. Our aim was to evaluate the efficacy and safety of potassium- titanyl-phosphate (KTP) laser for the treatment of primary, clinically non-muscle invasive bladder cancer compared with standard transurethral resection of bladder tumor.
    Materials And Methods
    The data of primary non-muscle invasive bladder cancer patients treated by either KTP laser vaporization (PVB group) or TURBT were analyzed retrospectively. The preoperative conditions and intraoperative complications such as obturator nerve reflex and bladder perforation and postoperative characteristics such as catheterization time and tumor recurrence were compared.
    Results
    The patients'' demographics and tumor characteristics in the two groups were comparable. PVB was superior to TURBT in terms of intraoperative complications such as obturator nerve reflex (P =. 0289), postoperative bladder irrigation (P =. 038) and postoperative catheterization time (P <. 0001). Recurrence rate after PVB was also lower than that after TURBT.
    Conclusion
    Our results indicated that PVB is a feasible, safe and effective alternative surgical approach for the management of primary, clinically non-muscle invasive bladder cancer, especially for those with lifetime oral taken anticoagulation medicine, with fewer perioperative complications and lower recurrence.
  • Qigui Liu, Weiqing Ma, Xin Li, Wentao Zhang, Wei Cao, Qingyu Zhou, Juan Duan Pages 1264-1270
    Purpose
    Long-segment urethral strictures (LSUS) are refractory to urethrotomy and urethroplasty. Holmium laser urethrotomy has shown favorable therapeutic outcomes in short-segment urethral stricture. We therefore evaluated the therapeutic effectiveness and safety of holmium laser endourethrotomy in the treatment of LSUS.
    Materials And Methods
    Holmium laser endourethrotomy was used to treat 190 consecutive male patients with LSUS. A urethrocystoscopic poking maneuver incorporating holmium laser ablation was used to eliminate the urethral strictures completely. Maximum flow rate (Qmax) on retrograde uroflowmetry, International Prostate Symptom Score (IPSS) and the Expanded Prostate Cancer Index Composite (EPIC) quality of life (QoL) index were assessed at baseline and at 1-, 3- and 6-months postoperatively.
    Results
    Holmium laser urethrotomy was successfully completed in all 190 patients. The mean operation time was 25 ± 17.8 min (range, 6-69 min). No significant intraoperative complications occurred, except that 23 patients (12.1%) experienced controllable scrotal and penile edema. None of these LSUS patients experienced recurrent strictures during a follow-up period of 6-36 months. From baseline to 6 months postoperatively, the mean Qmax increased significantly, from 1.4 ± 2.7 mL/sec to 19.7 ± 4.1 mL/sec (P <. 001); mean IPSS decreased significantly, from 31.3 ± 7.2 points to 9.3 ± 3.1 points (P <. 001); and mean QoL score showed significant improvement, from 5.7 ± 1.6 points to 1.8 ± 0.4 points (P <. 001).
    Conclusion
    Holmium laser endourethrotomy with the poking maneuver is a therapeutically effective and minimally invasive treatment for LSUS
  • Sinharib Citgez, Oktay Demirkesen, Fatih Ozdemir, Fethullah Gevher, Cetin Demirdag, Bulent Onal, Bulent Cetinel Pages 1271-1277
    Purpose
    To determine the results and satisfaction of the patients underwent transvaginal repair of cystocele in our clinic.
    Materials And Methods
    From January 2006 to October 2010, 15 patients with a mean age of 64 years (ranged 47-85 years) underwent transvaginal cystocele repair using acellular collagen biomesh. The patients were presented with vaginal mass in 10, dyspareunia and urge incontinence in 5 while 4 of them had both stress and urge incontinence. Grade 4 cystocele was determined in 2 patients, grade 3 in 9 and grade 2 in 4. Concomitant transobturator tape (TOT) was performed in 4 patients. Patient satisfactions were determined after the operation.
    Results
    The mean follow-up time was 23.5 (12-60) months. There was no postoperative complication in early follow- up period. Cystocele was recurrent in 1 patient. The success rate was 93.4%. Urinary incontinence was continued in 1 patient after TOT. Nearly all of the patients (14/15) were satisfied from the operation.
    Conclusion
    Transvaginal cystocele repair with using acellular collagen biomesh appears to be a safe and effective method. Further prospective and randomized controlled studies including large series of patients are needed.
  • Tahir Durmaz, Huseyin Ayhan, Telat Keles, Emine Bilen, Murat Akcay, Nihal Akar Bayram, Engin Bozkurt Pages 1278-1286
    Purpose
    Interestingly, prostate-specific antigen (PSA), which is used to monitor prostate disorders, has been suggested to be beneficial in estimating prognosis associated with coronary artery disease (CAD). The aim of the present study was to investigate the relationship of serum levels of PSA and free PSA (fPSA) with prognosis of acute coronary syndromes (ACS), extent of CAD and major adverse cardiac events in patients with acute coronary syndromes.
    Materials And Methods
    Sixty-seven male patients who were diagnosed with acute coronary syndromes were included. All patients were assessed according to the Thrombolysis in Myocardial Infarction (TIMI) classification [ST elevation myocardial infarction (STEMI) and non-ST elevation (NSTE)-ACS groups, separately], the Global Registry of Acute Cardiac Events (GRACE) (difference between PSA and fPSA) risk score and the Killip classification. All patients underwent angiography. The degree of stenosis was scored using the Gensini score to assess the extent of CAD.
    Results
    Serum PSA, fPSA, fPSA/PSA levels, and alpha 1-antichymotrypsin-PSA (ACT-PSA) (difference between PSA and fPSA) results were found to be moderately correlated with the TIMI and GRACE risk scores, which are predictors of short- and mid-term prognosis. While there was no correlation between the Gensini score and PSA and ACT-PSA, the Gensini score was moderately correlated with fPSA and fPSA/PSA. There were no significant differences between patients with major adverse cardiovascular events (MACEs) and those without MACEs at the 6-month follow-up in terms of PSA, fPSA, fPSA/PSA, and ACT-PSA results.
    Conclusion
    There may be a relationship between serum PSA and fPSA levels and prognosis of ACS and extent of CAD. It should be kept in mind that additional biomarkers could be used together with current scoring systems in risk classification in cases for which clinical decisionmaking is challenging. Moreover, PSA and fPSA results should be approached with caution in patients to be screened for prostate cancer as their serum levels may be influenced from several factors (ACS, infection, etc.).
  • Success Rate and Patient's Satisfaction Following Intradetrusor Dysport Injection in Patients with Detrusor Overactivity: A Comparative Study of Idiopathic and Neurogenic Types of Detrusor Overactivity
    Saeed Shakeri, Reza Mohammadian, Alireza Aminsharifi, Ali Ariafar, Jalal Vaghedashti, Maryam Yazdani, Mahnaz Yadollahi, Vahid Emadmarvasti, Amir Baharikhoob Pages 1289-1295
    Purpose
    To evaluate the efficacy of intradetrusor Dysport (a type of botulinum toxin type A) injection in patients with idiopathic or neurogenic detrusor overactivity, who were refractory to antimuscarinic drugs, and to compare the efficacy of Dysport injection in both groups.
    Materials And Methods
    Twelve patients with neurogenic detrusor overactivity (NDO) and 18patients with idiopathic detrusor overactivity (IDO) participated in this study. All the patientsreceived intravesical injection of 500 units of Dysport. They were followed up for 3 monthsafter injection with maximum cystometric capacity, maximum detrusor filling pressure, andnumber of catheterization or pad usage.
    Results
    After 3 months, the mean maximum cystometric capacity increased from 109.36 ± 24.11 mL to 266.81 ± 97.18 mL (P =. 000) in the NDO group and from 192.24 ± 36.21 mL to 272.61 ± 63.37 mL (P =. 000) in the IDO group. The mean maximum detrusor filling pressure decreased from 48.14 ± 26.51 cmH2O to 28.91 ± 9.01 cmH2O (P =. 005) in the NDO group and from 39.22 ± 9.92 cmH2O to 29.64 ± 10.14 cmH2O (P =. 003) in the IDO group.
    Conclusion
    Intradetrusor Dysport injection improved urodynamic parameters and quality of life (QoL) in both groups significantly. We did not find significant difference in QoL or urodynamicparameters between both groups.
  • Orhun Sinanoglu, Isin Dogan Ekici, Sinan Ekici Pages 1296-1300
    Purpose
    To investigate beneficial effect of the readily available colchicine through its intravesical application on protamine/lipopolysaccharide induced interstitial cystitis model in rat and to compare its efficacy to the chondroitin sulphate available for clinical use.
    Materials And Methods
    Twenty-four Wistar female rats were assigned to control (C), interstitial cystitis (IC), chondroitin sulphate (CS) and colchicine (Col) groups. IC, CS and Col groups received protamine sulphate and lipopolysaccharide (PS/LPS) instillation. Testing agents CS and Col were administered a day after PS/LPS inoculation into the bladders. Rats in Group C received saline solution. CS and Col groups received 1 mL CS (0.2%) and 1 mL Col (0.05 mg/mL). The treatment agents were left in bladders for one hour''s duration. Animals were sacrificed 5 days after the inoculation and the bladder tissues were examined histologically to evaluate the amount of extravasated leucocytes, mast cell concentration (by counting total number of cells per 10 high power field (hpf; 1 hpf = ×400 magnification) as well as interstitial tissue edema for each bladder.
    Results
    Intravesical application of CS reduced significantly the leucocyte and mast cell infiltration as well as interstitial edema compared to group C. The level of reduction in leucocyte and mast cell infiltration in Col group was comparable to that of CS, although the interstitial edema was not resolved.
    Conclusion
    Intravesical administration of Col decreased leucocyte and mast cell infiltration to the same extent of CS in PS/LPS induced bladder inflammation in rat. Col may be an alternative to other treatment modalities for painful bladder conditions such as IC.
  • Farzaneh Sharifiaghdas, Mahboubeh Mirzaei, Babak Ahadi Pages 1301-1307
    Purpose
    To evaluate the results of percutaneous nerve evaluation (PNE) implantation in the treatment of non-obstructive urinary retention and report the changes in the urodynamic parameters.
    Materials And Methods
    Patients with non-obstructive urinary retention or incomplete bladder emptying were included. All patients filled a 7 days voiding diary chart and underwent PNE for one week, and the patient was asked to record the second voiding diary chart and repeat urodynamic study in this period. Then the PNE lead was removed from the S3 foramen, but the connections remained fixed in place for another 3 days to exclude the placebo effects and the third voiding diary chart was completed by the patient. The patient wasn''t aware of lead removal. Success was defined as, more than 50% improvement in at least one of the urinary tract symptoms.
    Results
    Forty five patients with a mean age of 37.1 years (ranged 9-83 years) were treated with PNE for refractory, non-obstructive urinary retention. Of study subjects 28 complained from complete urinary retention, and 17 had incomplete emptying. Of participants, 28 (62.2%) demonstrated greater than 50% improvement in the urinary symptoms. Urodynamic data, showed a statistically significant increase in maximum flow rate (8 ± 2.2 mL/sec to 16 ± 3.6 mL/sec, P =. 06) and voided volume (35 mL to 187 mL, P =. 032) in the responders. Any placebo effects in PNE have not been seen.
    Conclusion
    Patients with complete non obstructive urinary retention were good responders to PNE. The placebo effect in sacral nerve stimulation was negligible.
  • Ergun Alma, Alper Eken, Hakan Ercil, Kazim Yelsel, Nebile Daglioglu Pages 1308-1315
    Purpose
    To evaluate the effects of orally administered dehydrated garlic powder on cytokine excretion in the urinary tract.
    Materials And Methods
    A total of 60 healthy volunteers, randomized into 3 groups, were given a single oral dose of 1 g or 3 g of dehydrated garlic powder or placebo. Urine samples were obtained 6.0 and 24.0 h after garlic intake and assayed for interleukin-8 (IL-8), interleukin- 12 (IL-12), tumor necrosis factor-alpha (TNF-α), diallyl disulfide (DADS) and diallyl sulfide (DAS).
    Results
    Significant increases in IL-12 levels over baseline were noted in urine samples obtained after oral intake of 1 g and 3 g of garlic powder (P <. 001). In the 1 g and 3 g garlic powder treatment groups, time-dependent variations in IL-12 levels over the study period were significantly different from the placebo group (P <. 001). In both garlic treatment groups, urinary levels of IL-8 and TNF-α were not significantly different from baseline andplacebo levels (P >. 017). DADS and DAS were not detected in the urine samples at any time after garlic powder intake.
    Conclusion
    Oral intake of doses of garlic traditionally used for daily supplementation increases urinary levels of IL-12, which is a potent stimulator of T helper cell 1 (Th-1) immune responses. This observation encourages further studies investigating the immunostimulatory role of garlic in the urinary tract.
  • Qi Zhang, Zaiyuan Ye, Feng Liu, Xiaolong Qi, Yuelong Zhang, Dahong Zhang Pages 1316-1319
  • Deepak Sharanappa Nagathan, Divakar Dalela, Satyanarayan Sankhwar, Apul Goel, Amod Kumar Dwivedi, Rahul Yadav Pages 1320-1324
    Voiding cystourethrogram (VCUG) is needed to ascertain the upper end of urethral stricture. Occasionally, a patient is unable to open the bladder neck with resultant failure of the test. Realizing the strong and prompt alpha antagonistic action of silodosin, we evaluated single 8 mg dose as a pharmacological adjunct prior to VCUG to overcome this problem.
  • Tanveer Iqbal Dar, Abdul Rouf Khawja, Ajay Kumar Sharma, Mohammad Sajid Bazaz, Manu Gupta Pages 1325-1327
  • Necmettin Penbegul, Yasar Bozkurt, Kadir Yildirim, Ahmet Ali Sancaktutar, Haluk Soylemez, Murat Atar, Yasin Bez Pages 1331-1334
  • Dianne Mortelmans, Nouredin Messaoudi, Joris Jaekers, Raymond Bestman, Steven Pauli, Marc Van Cleemput Pages 1338-1340
  • Priyadarshi Ranjan, Saurabh Sudhir Chipde, Abhishek Yadav, Rakesh Kapoor Pages 1341-1342
  • Intra Urethral Intercourse: A Report of Two Cases
    Mahtab Zargham, Homayon Abbasi, Farshid Alizadeh, Mohammad Hatef Khorami, Farhad Tadayon, Mohammad Reza Gharaati, Mohammad Hosein Izadpanahi Pages 1343-1346
  • Filiz Cebeci, Levent Verim, Nahide Onsun, Adnan Somay Pages 1347-1349
  • Tansu Degirmenci, Alpay Ar, Zafer Kozacioglu, Bumin Ors, Bulent Gunlusoy Pages 1350-1352
  • Yeng Kwang Tay, Scott Donnellan, Dan Spernat Pages 1353-1355
  • Yasushi Yumura, Kazumi Noguchi, Masatoshi Moriyama, Akira Iwasaki Pages 1356-1358
  • Woong Jin Bae, Seol Kim, Yong Sun Choi, Su Jin Kim, Hyuk Jin Cho, Sung Hoo Hong, Ji Youl Lee, Tae, Kon Hwang, Sae Woong Kim Pages 1359-1361
  • Abbas Basiri, Nasser Shakhssalim, Mahmood Reza Nasiri, Mohammad Hadi Radfar Pages 1362-1365