JOURNAL OF RESEARCH IN UROLOGY
Year:2018 | Volume:2 | Issue:1 |Papers Count:5

Background and Objective: The present study investigated the effect of donor stem cells on improving transplant survival and reducing the need to use repressive drugs in patients with kidney transplant. Methods: The clinical trial included two groups of patients. A total of five patients received stem cells prepared from the peripheral blood (18– 23 ×109 cells/case) four times before and after the transplantation (intervention group). This was in addition to renal transplantation from an unrelated donor. The control group comprised eight patients who received renal transplantation from non-relative recipients. The level of peripheral blood chimerism was determined by the incompatibility of HLA and using a PCR-flow cytometry combined method in the first, third, and twelfth-month after the transplantation. Results: CMV infection was present in 12. 5% of patients in the control group whereas 37. 5% had urinary tract infection and 12. 5% had digestive problems. Five out of eight patients in the control group acutely rejected the transplant in comparison with two out of five patients in the intervention group. Additionally, in each group, a case of exponential rejection was reported. The evaluation of peripheral active chimerism in two patients with stable transplant and normal function showed that peripheral chimerism was detectable up to 3 months after transplantation. No sign of transplant rejection was observed in the presence of chimerism. Conclusion: Injection of donor stem cells can cause peripheral chimerism in kidney transplant recipients. The injection has a direct relation to the improvement of transplant function and increases in its survival.

Background and Objective: Significant advances in the endourology and utilization of minimally invasive procedures have resulted in the improvement of the management of cases with ureteropelvic junction obstruction (UPJO). However, the effectiveness and successfulness of this technique have not been evaluated in children. Hence, the present study assessed the efficacy and safety of antegrade endopyelotomy in children. Methods: We retrospectively reviewed a case series study from 2001 to 2012 consisting of 58 patients, aged two days to seven years, who were diagnosed with UPJO and treated with antegrade endopyelotomy. The study endpoint was to assess the necessity for scheduling repeated endopyelotomy, performing open pyeloplasty as well as recording any damage to parenchyma and length of hospital stay. Results: Antegrade endopyelotomy was successfully performed in 53 out of 58 studied children (91. 3%) without any complications or necessity for further interventions. However, repeated endopyelotomy was scheduled for five cases, and open pyeloplasty was conducted in two cases because of the large size of pelvis and delay in urine drainage. DMSA scanning before and after antegrade endopyelotomy for all patients revealed no parenchymal damage. The mean hospital stay was also 2. 5 days. DTPA was performed in all patients to evaluate the success of endopyelotomy before and after the operation. Conclusion: Antegrade endopyelotomy is a safe and efficacious method for treating UPJO in children. It, therefore, provides a minimally invasive alternative to conventional open pyeloplasty.

Background and Objective: The present study evaluated the efficacy of services provided by the caregivers to the hospitalized patients in the Urology ward and compared it with that provided to patients in other wards at the Hamedan Shahid Beheshti Hospital in 2013. As patient satisfaction is a multifactorial process, hospital authorities should focus on patient’ s suggestions and feedback to conduct necessary educational courses for healthcare personals with an aim to improve satisfaction rate among patients. Methods: In this descriptive study, 531 hospitalized patients were selected using the quota sampling method during the first and second halves of the year. The data were collected through questionnaires and analyzed using the chi-square test and Spearman’ s correlation and descriptive statistics with SPSS– 16 software and MS Excel. Results: We obtained a satisfaction of 71. 6 in the first half of the year and 69. 8 in the second half. Maximum satisfaction rate was the time of Medical services, and maximum dissatisfaction rate was for the education of patients. The satisfaction rate in the Urology ward was 68. 8 and 67. 8 in the first and second halves of the year, respectively. The results show that the satisfaction rate for Urology ward during first and second halves of the year was lower than the average rate of satisfaction at the hospital. No analytic correlation existed between complete satisfaction rate with age and sex of the patient. However, the study reported a relationship between the satisfaction rate and level of education. Conclusion: It is crucial to utilize patient’ s feedback for increasing the level of medical services provided by the staff and developing the hospital’ s receptivity to improve the overall satisfaction rate.

Background and Objective: A deficiency of the enzyme pseudo cholinesterase (PChE) leads to slow hydrolysis of drugs having choline ester structure such as succinylcholine. The patients with this enzymatic disturbance should be provided long-term mechanical ventilation support until the return of normal muscle tonicity. Case presentation: The current study was performed on two female patients with family relation (cousins). The first operation was an emergent transurethral lithotripsy (TUL), and the second operation was an elective ovarian cystectomy. All operations were performed under general anesthesia. At the end of operations, the patients still suffered from long-time apnea and muscle weakness such that complete muscle relaxation occurred 8 h after one dose of succinylcholine. No additional dose or use of another nondepolarization muscle relaxant was required. The investigation reported a deficiency in PChE. Therefore, the patients were treated with conventional therapies, including FFP injection and newly cross-matched blood (vessel-tovessel). Conclusion: PChE deficiency is a familial trait and can occur not only in the first but also in the second generation of a family. The best treatment includes supporting mechanical ventilation and patience until complete succinylcholine hydrolysis by PChE is achieved. It is recommended to avoid using succinylcholine except for emergency situations; instead, depolarization muscle relaxants should be utilized.

Background and Objective: Prostate cancer is reported to affect approximately 70% of men and is the second leading cause of death in men. An early diagnosis and screening can reduce the associated complications and mortality rate. Case Presentation: A 52-year-old man complaining of a backache for eight months reported to the hospital. The initial examination showed him to be suffering from an infiltrative bone tumor. The patient was initially diagnosed with multiple myeloma and was provided chemotherapy. Owing to a lack of response of the patient to the treatment, he was referred to an oncologist. Further evaluations showed him to be suffering from metastatic prostate cancer, and appropriate treatment was initiated. Conclusion: Despite the advances in diagnostic tools and increasing accuracy of tests, clinical examination is important and considered a key component of the diagnosis of prostate cancer.