UROLOGY JOURNAL
Year:2017 | Volume:14 | Issue:1|Papers Count:11

Purpose: The aim of the present study was to investigate the correlation between Klotho gene polymorphisms and calcium oxalate stones in Xinjiang Uyghur people. Materials and Methods: We compared 128 patients with calcium oxalate stones (case group) and 94 healthy people (control group), detected the genotype and allele distributions of single-nucleotide polymorphisms (SNPs) of the Klotho gene (rs3752472, rs650439, and rs1207568) by reverse transcription polymerase chain reaction. Results: The distributions of the genotype and allele frequencies of the SNPs were consistent with the Hardy– Weinberg equilibrium in the two groups. There were statistically significant differences between the genotype and allele distributions of rs3752472 between the case and control groups; the allele frequencies in the case/control groups were C = 240 (93. 7%)/151 (80. 3%) and T = 16 (6. 3%)/37 (19. 7%). There was no statistically significant difference in the genotype distribution of rs650439 between the case and control groups, but there was a difference in the allele distribution; the allele frequencies in the case/control groups were A = 202 (78. 9%)/143 (57. 2%) and T = 54 (21. 1%)/107 (42. 8%). There were no statistically significant differences in genotype and allele distributions between the case and control groups of rs1207568; the allele frequencies in the case/control groups were C = 194 (71. 3%)/145 (77. 1%) and T = 78 (28. 7%)/43 (22. 9%). In rs3752472, the risk for patients with the C and A alleles increased by 3. 675 and 2. 799 times, respectively. Conclusion: The rs3752472 and rs650439 SNPs are related to the risk of calcium oxalate stones in Xinjiang Uyghur people, and might be one of the risk factors.

Purpose: We aimed to investigate the efficacy of silodosin 4 mg/day and 8 mg/day for medical expulsive therapy (MET) of lower ureteral stones. Materials and Methods: We retrospectively analyzed the medical records of 161 patients admitted to urology clinics of Ahi Evran University Medical Faculty and Ankara Training and Research Hospital with distal ureteral stones and treated with MET with different doses of silodosin between January 2013 and August 2015. 81 patients were treated with silodosin 4mg/day in group-1 and 80 patients with silodosin 8mg/day in group-2. Age, gender, complaints on admission, stone size, the distance between the stone and ureterovesical junction, stone passage rate, duration of stone passage after starting MET, and adverse effects were noted from the charts of the patients, and the groups were compared. Results: There were 81 patients in group-1, and 80 patients in group-2. Two groups were similar for age (P =. 38) and gender (P =. 92). Spontaneous stone passage was seen in 41 (50. 9%) patients in group-1, and in 59 (73. 8%) patients in group 2. The groups were different for spontaneous stone passage rate (P =. 002). In group-1, 10 (25%) patients that could not pass their stones spontaneously and were treated with extracorporeal shockwave lithotripsy (SWL), and 30 (75%) of them were treated with ureterolithotripsy. Eight (38%) patients that could not undergo ureterolithotripsy and/or anesthesia and were not able to pass their stones were treated with SWL, and 13 (62%) patients were treated with ureterolithotripsy in group-2. All of the patients were stone free at the end of the treatment. Conclusion: A dose of 8 mg/day should be preferred if silodosin is to be preferred for MET in lower ureteral stones.

Purpose: In this retrospective study, we aimed to compare the outcomes in patients who have been treated with percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) on renal stones ≥ 2 cm size. Materials and Methods: We evaluated patients who underwent PNL or RIRS for renal stones ≥ 2 cm size between November 2011 and November 2014. Stone size, operation, fluoroscopy and hospitalization time, success rates, stone-free rates and complication rates were compared in both groups. Patients were followed for three months. Results: 254 patients were in the PNL Group. 185 patients were in the RIRS Group. The mean age was 46. 88 and 48. 04 years in PNL and RIRS groups, respectively. The patient and stone characteristics (age, gender, Body Mass Index, kidney anomaly, SWL history and stone radioopacity) were similar between two groups. The mean stone size preoperatively was significantly larger in patients who were treated with PNL (26. 33mm. vs 24. 04 mm.; P =. 006). In the RIRS group, the mean stone number was significantly higher than PNL group (P <. 001). The mean operative, fluoroscopy and hospitalization time were significantly higher in PNL group (P <. 001). The stone-free rate was 93. 3% for the PNL group and 73. 5% for the RIRS group after first procedure (P <. 001). No major complication (Clavien III– V) occurred in the RIRS group. Conclusion: Although the primary treatment method for renal stones ≥ 2cm size is PNL, serious complications can be seen. Therefore, RIRS can be an alternative treatment option in the management of renal stones ≥ 2 cm size.

Purpose: To assess and compare the surgical, oncological and functional outcomes of robotic and open radical prostatectomy (RP) in patients with history of transurethral resection of prostate (TURP). Material and Methods: Total of 48 patients with mean ± SD age of 64. 5 ± 6. 0 years who had undergone TURP prior to RP were included. Thirty-one (64. 58%) patients underwent robotic RP (group I) and 17 patients underwent open RP (group II). Variables evaluated included demographic characteristics, perioperative complications, functional and oncological outcomes. Biochemical recurrence (BCR) was defined as a detectable level of serum PSA after RP. Continence was defined as being pad free and potency as erection with or without medication enough for penetration. Results: All patients had undetectable PSA after RP. Four patients (12. 9%) from group I and 2 patients (11. 8%) from group II had positive margins (P =. 9). The rates of continence were 70% and 80. 81% for group I and group II respectively (P =. 47). Potency rate was 68. 2% in group I and 46. 1% in group II (P =. 31). The PSA value at the last follow-up was undetectable except in 2 patients who had PSA values of 0. 2 and 1ng/mL respectively. Conclusion: Robotic or open RP can be performed safely and effectively after TURP without compromising the oncological results. The outcomes of robotic RP are comparable to that of open RP. The patients who undergo robotic or open RP should be informed about increased likelihood of intra operative complications and worse post operative functional outcomes with respect to continence and erectile function.

Purpose: To determine the rational surgical margin for pathological T1b renal cell carcinoma (RCC). Materials and Methods: This retrospective study included surveys of 60 patients with T1bN0M0 RCC who underwent radical nephrectomy (RN, n = 40) or partial nephrectomy (PN, n = 20) between October 2008 and December 2014 at the Sun Yat-sen Memorial Hospital affiliated with Zhongshan University. Specimens were collected from 6 sites at the tumour periphery for RN and PN, and at suspected sites on the tumour surface for PN in addition. The histological subtype, pathological grade, surgical margin, pseudocapsule completeness, distribution of satellite foci, and largest distance between the extra-pseudocapsule lesion and primary tumour (DEP) were evaluated. This paper will analyse the relationships between these factors. Results: The positive surgical margin rate was 10% in patients undergoing PN. The study found no significant relationships between the incidence of satellite foci and tumour diameter, Fuhrman grade, or histological subtype (all P > 0. 05). However, male sex, positive surgical margins, and an incomplete pseudocapsule were associated with the incidence of satellite foci (P < 0. 05). Cases with satellite foci tended to show positive surgical margins. The DEP was <1. 0 mm for all tumours, but there were no significant relationships between the DEP and the tumour diameter, pathological grade, or histological subtype (P > 0. 05). Conclusion: In T1b RCC, a 1-mm surgical margin would be sufficient to attain integrated resection of the primary tumour and its cancerous tissue beyond the pseudocapsule. PN was insufficient to prevent a positive surgical margin, most likely due to the presence of satellite foci.

Purpose: The present study was conducted with the aim of identifying the frequency of comorbid psychiatric disorders in children and adolescents with nocturnal enuresis (NE). Materials and Methods: In this descriptive-analytical study, 183 children and adolescents aged 5-18 years with NE referred to psychiatric clinics at Tabriz University of Medical Sciences were selected in 2015. A structured clinical diagnostic interview, the kiddie-schedule for affective disorders and schizophrenia (K-SADS), was employed based on the diagnostic and statistical manual of mental disorders (DSM-IV-TR) for the diagnosis of NE and comorbid psychiatric disorders. Results: In this study, 39 participants (21. 3%) were female and 144 (78. 7%) were male. The mean age of participants was 8. 69 ± 2. 34 years. The lifelong incidence of mental disorders among enuretic children and adolescents was 79. 23%. The highest incidence belonged to attention deficit/hyperactivity disorder (ADHD) with 74. 9%, oppositional-defiant disorder (ODD) with 53%, and tic disorders with 12% (motor tics together with a single case of vocal tic). The lowest incidence was for conduct disorder, bipolar affective disorder, and post-traumatic stress disorder (PTSD) with 5%. Based on the Fisher exact test, there was no significant difference between girls and boys in terms of psychiatric disorders incidence (P >. 05). Conclusion: Comorbid psychiatric disorders with NE are common among children and adolescents. Therefore, in-depth examination of other psychiatric disorders needs to be carried out in enuretic children and adolescents, which will affect the treatment and prognosis of NE.

Purpose: The aim of study was to evaluate reactive oxygen species (ROS), total antioxidant capacity (TAC) and ROS-TAC score as indicator for oxidative stress status as well as 8-hydrodeoxyguanosine (8-OHdG) levels as a marker for DNA damage in the seminal plasma of asthenozoospermia patients compared to normozoospermia samples. Materials and Methods: The semen samples of 28 fertile normozoospermic donors and 25 infertile men with asthenozoospermia were analyzed according to World Health Organization (WHO) criteria. ROS production was measured in neat semen samples by the chemiluminescent assay. Plasma levels of TAC was measured by commercially available colorimetric assays. The levels of DNA oxidative damage were measured by seminal plasma levels of 8-OHdG using ELISA method. ROS-TAC score was measured using principal component analysis. Results: Asthenozoospermic men had a higher ROS levels compared to the normozoospermic men (P =. 01). However, no significant difference was observed in TAC levels between the groups. ROS-TAC score in asthenozoospermic men was lower than normozoospermic men (P =. 02). The levels of 8-OHdG in the asthenozoospermic men were higher than normozoospermic men (P =. 01). Conclusion: The present study demonstrated a decrease in ROS-TAC score and, a high DNA damage in asthenozoospermia compared to normozoospermia. ROS-TAC score can predict the oxidative damage of semen samples of astenozoospermic infertile males.

Renal cell carcinoma is one of the most common tumors of the urinary tract. This tumor may appear as Para neoplastic syndromes or distant metastasis. Metastases in uncommon areas are one of the characteristics of renal tumors. One of the uncommon metastatic renal masses areas is the mandible. In different studies, patient survival after metastasis diagnosis is usually one year or less. In this study we introduce a patient with mass of the right mandible which existed four years before his referral, and in examinations it was diagnosed as metastasis with renal origin.

Bladder metastases from remote primary sites are rarely reported. We present a case of haematuria caused by infiltration of the urinary bladder wall by a nodule resulting from peritoneal dissemination of a primary gastric tumour. The nodule was detected by computed tomography, magnetic resonance imaging and cystoscopy. Transarterial embolization or haemostasis could not be performed because of the haematuria, thus the vesical bleeding was treated with a low irradiation dose of 3 Gy/fraction for a total of 30 Gy administered to the dome of the urinary bladder. No adverse effects occurred, and the gross haematuria and nodule resolved within 1 week. Thus, radiotherapy should be considered for treatment of visceral bleeding caused by peritoneal dissemination of gastric cancer when other methods of haemostasis cannot be performed.

Penile metastases are extremely rare events and generally occurs at a late stage of primary disease. They mostly originate from prostate and bladder in the genitourinary tract. Penile metastases have a dismal prognosis and very low survival rates. We report a case of penile metastasis in 70-year-old geriatric male patient with prostatic adenocarcinoma who was treated with cabazitaxel chemotherapy beyond 20 cycles with a good response and acceptable minimal toxicity.

A 43 year-old spinal injury patient was found to have asymptomatic hydronephrosis of his transplant during annual surveillance (Figure 1). Prior to presentation, he had developed urinary tract infection and serum creatinine was measured at 159µ mol/l. His past history was remarkable for type 1 diabetes since the age of 5, spinal artery thrombosis aged 19 culminating in a C6 incomplete tetraplegia and diabetic nephropathy for which he received a live donor transplant at the age of 37. Bladder management involved convene drainage and he had undergone two previous sphincterotomies. Videourodynamics revealed a stable bladder during filling but high pressure sustained contractions during voiding resulting in grade V reflux into the transplanted kidney (Figures 2a & b). The bladder emptied completely with no evidence of dyssynergia. The patient was counselled regarding his treatment options and was listed for repeat videourodynamics in 6 months...