The prevalence of urinary incontinence following radical prostatectomy and its related factors: A national registry based study

Introduction: The purpose of this paper is to evaluate the prevalence and the risk factors of urinary incontinence following radical prostatectomy in Iranian population. This study is conducted based on the available data from the National Cancer Registry. Materials and Methods: In this retrospective study, we extracted the information of all the patients with organ-confined prostate cancer who underwent radical prostatectomy from 2010 to 2014. All the patients were interviewed face to face or via telephone to collect additional data. Urinary incontinence was evaluated by a questionnaire using the definition based on pads use. The effects of risk factors were evaluated using logistic regression models. Results: The details of 13,583 registered patients with prostate cancer were collected. Overall, the prevalence of urinary incontinence was estimated as 10.5% (n=1424). It is important to mention that the highest proportion of cases with urinary incontinence belonged to the age group of 71-80 years old (n=502, 35.2%), as well as patients with elementary education (n=458, 32%) or no education at all (n=333,23.5%). Furthermore, more cases lived in urban settings (n=1159,81.7%), one-fourth of them (n=365) smoked tobacco, and nearly 11% of them reported having been diagnosed with diabetes (n=152). The odds of having urinary incontinence increased by 20% in patients who had undergone radiotherapy as part of their treatment for prostate cancer (AOR=1.20, 95%CI: 1.07,1.36). Conclusion: We estimated the prevalence of urinary incontinence after radical prostatectomy as 10.5% among prostate cancer patients. We found that having been exposed to education, having been diagnosed with diabetes, and receiving radiotherapy, are amongst the significant risk factors for urinary incontinence. We also suggested that more predictor variables should be recorded in the National Cancer Registry

Machine Learning Approaches to predict Intra-Uterine Insemination Success Rate- Application of Artificial Intelligence in Infertility

Introduction: Assisted Reproductive Technology (ART) has been widely utilized for infertility management. Despite its low success rate, Intra-Uterine Insemination (IUI) is one of the first alternatives and most important approaches regarding many cases of infertility treatment. Given the numerous influencing factors and limitations associated with time and resources, the development of a reliable model to predict the success rate of ART methods can significantly contribute to decision-making processes. Materials and methods: We reviewed the demographic, clinical, and laboratory data regarding 157 IUI treatment cycles among 124 women using their partner’s sperm from May2017 to June2019. Primary outcome measures were clinical pregnancy and live birth. Some prediction models were constructed and compared to the logistic regression analysis. Results: Woman’s mean age was 30.1 ± 5.2 years and the infertility had a female cause in 24.3% of the cases, male cause in 32.6% of cases, and combined causes in 32.6% of the cases. Concerning the first IUI cycle, the clinical pregnancy rate per cycle was 16.9% (N= 21). Data were prepared according to cross-industry standard process for data mining (CRISP-DM) methodology, and the following models were fitted to the data: J48 Decision Tree, Perceptron Multilayer (MLP) Neural Network, Support Vector Machine (SVM) with radial basis function (RBF) kernel, K-Nearest Neighbors (KNN) with one neighborhood, and Bayesian Network. J48 Decision Tree, with a sensitivity of 95% and specificity of 98%, had the most optimal performance, and the KNN model was the weakest one. Conclusion: To predict the results of IUI as a simple and less invasive therapy for infertile couples, some models were applied based on artificial intelligence and J48 Decision Tree was recommended

Penoscrotal Low-grade fibromyxoid sarcoma, A case report

Low-grade fibromyxoid sarcoma (LGFMS) is a subtype of sarcoma that commonly arises from the deep soft tissue. We present a case of LGFMS originated from the penoscrotal junction area, which highlights the unusual site of LGFMS presentation.The patient presented with a mass in the left base of the penis, which was resected and the pathology report was compatible with LGFMS. However, local recurrence near the primary tumor site was detected 3 months postoperatively, and re-excision confirmed the same diagnosis. This is the first report of LGFMS in the penoscrotal junction area as an uncommon site of this tumor

The Learning Curves for Laser Application in Urology Procedures: Review of the Literature: Learning Curves for Urological Lasers

Introduction: Currently, a laser is a popular technology in urological surgeries. The important laser-related issue is the time when a surgeon reaches an acceptable level of safety and efficacy using laser technology.Methods: In this review, we aimed to assess the learning curves of three types of surgeries in urology, including photoselective vaporization of the prostate (PVP), holmium laser enucleation of the prostate (HoLEP), and retrograde intra-renal surgeries (RIRSs). Here, we searched Medline, Web of Science, Google Scholar, EMBASE, and Scopus for such keywords as Urology, laser, laser vaporization, prostate, nephrolithiasis, benign prostatic hyperplasia (BPH), and learning curve.Results: We evaluated 14 studies about PVP, 17 about RIRS, and 29 studies about HoLEP. Also, we separately discussed the learning curves of these three kinds of surgeries in detail.Conclusion: All the urologists, even expert surgeons, should attend a formal training course and have a skilled tutor present in their first cases

Percutaneous re-surgical approach for delayed bleeding caused by pseudoaneurysm following percutaneous nephrolithotomy

Post percutaneous nephrolithotomy (PCNL) vascular complications included arteriovenous fistula and pseudoaneurysm can cause early or late bleeding and result in unstable condition. Selective trans-arterial embolization is the gold standard technique to manage arterial pseudoaneurysm. Herein, we present a case of pseudoaneurysm following PCNL and describe an alternative technique for its removal using a grasper under C-arm vision. Percutaneous re-surgical approach to post-PCNL hemorrhage due to pseudoaneurysm by using a nephro-grasper to pick up the renal artery pseudoaneurysm would be safe, effective and can provide a direct view of pyelocaliceal system for surgeons; And can be a proper alternative for angioembolization

Urodynamic findings in children with primary refractory nocturnal enuresis: 10 years' experience of a tertiary center

Abstract Background/Aim To identify correlations between urodynamic study (UDS) findings and urinary symptoms in children with refractory monosymptomatic and nonmonosymptomatic primary nocturnal enuresis. Materials and Methods A total of 96 neurologically normal children were enrolled, 44 consecutive boys and 51 consecutive girls, aged 5–18 years, of whom 41 (38.8%) had refractory monosymptomatic nocturnal enuresis (MNE) and 55 (61.2%) had refractory non‐MNE (NMNE). We assessed the urodynamics of all children to detect any underlying bladder overactivity. A comparative analysis was carried out between the two groups of patients. Results Detrusor overactivity (DO), low bladder capacity, low compliance, and increased postvoid residual (PVR) were identified in 70 (72.9%), 35 (36.5%), 43, and 76 (79.2%) patients, respectively. The mean bladder compliance was 21.66 ± 14.52 mL/cmH2O (2–75 cmH2O). Of the NMNE patients, 50 (90.9%) had abnormal urodynamic findings, while 40 (97.5%) had abnormal urodynamic findings in the MNE group. There was a statistically significant relationship between NMNE and both increased PVR and abnormal voiding patterns. Both high PVR and DO were significantly associated with obstructive urinary symptoms. Constipation and history of urinary tract infection (UTI) did not significantly correlate with UDS abnormality (p = 1.0 and p = 0.49, respectively). Conclusion There was a high prevalence of bladder function disorders in both refractory MNE and NMNE patients in our study. This included small functional capacity, low bladder compliance, and marked DO. A nocturnal enuresis may be the only presenting symptom, however, it may be associated with bladder overactivity, UTI, and constipation; the UDS findings may aid in guiding the assessment and treatment of children suffering from primary refractory nocturnal enuresis and its association with bladder and bowel symptoms

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Background: It is estimated that 75% of urothelial bladder cancers are non–muscle-invasive cancers (NMIBCs). The development of more effective methods for optimizing the management of this subset of patients is of paramount importance. This study aimed to evaluate the effectiveness and side effects of modified maintenance Bacillus Calmette-Guérin (BCG) therapy in patients with high-risk NMIBC. Methods: A total of 84 patients with NMIBC who met the inclusion criteria were randomly divided into 2 groups of 42 patients after receiving intravesical BCG weekly, 1 month after transurethral resection of the bladder tumor (TURT) for 6 weeks as the induction. In group I, patients continued monthly intravesical instillation of BCG for 6 months as maintenance, whereas group II patients did not. All patients were followed up for recurrence and progression for 2 years. Results: Although the recurrence rate was lower in group I (16.7% vs 31%), there was no significant difference among groups (P = .124). Pathology progression was also lower in group I (7.1% vs 11.9%) with no significant difference among groups (P = .713). Complications were not statistically different among groups (P = .651). A statistically significant difference was not observed between the groups in the acceptance rate of patients (97.6% in group I vs 100% in group II). Conclusions: The recurrence rate and progression rate in NMIBC patients with maintenance-free induction therapy after TURT were almost twice as high as those with 6-month maintenance therapy; however, it was not statistically significant. Modified BCG maintenance protocol made favorable compliance for patients. Trial registration: This study was retrospectively registered at Iranian Registery of Clinical Trials with the code IRCT20220302054165N1

Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations

Objective: Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation. Methods: A cross-sectional study of 517 multiple sclerosis patients at Tehran’s referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science. Results: Among all participants, the prevalence of lower urinary tract symptoms was 73% ( n  = 384), with urgency (44.8% n  = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women ( p  = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms ( p  > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability ( p  < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography. Conclusion: Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease