Mini Sling (Ophira) versus Pubovaginal Sling for Treatment of Stress Urinary Incontinence: A Medium-term Follow-up

To compare two different procedures, mid-urethral mini sling (Ophira) and autologous rectus fascia sling, according to their medium-term subjective and objective outcome and satisfaction rates in the treatment of stress urinary incontinence in women. One hundred women with the main complaint of stress urinary incontinence were randomized to be treated with either mini sling (Ophira) or autologous rectus facia pubovaginal sling. Preoperative evaluation consisted of: physical examination, blood biochemistry urine analysis and culture, urinary tract ultrasound scan, conventional multi-channel urodynamic study, cystourethroscopy, cough induced stress test and Incontinence Impact Questionnaire (IIQ). The patients were objectively and subjectively re-evaluated at 1, 3, 6 and 12 postoperative months and the last visit and the collected data of more than one year follow-up were compared with preoperative assessments. Seventy two out of one hundred patients were followed for a mean time of 13.8 ± 4.4 months (12–20 months range). Objective cure rate, according to cough-induced stress test was recorded in 88.6% and 89.2% of the mini sling (Ophira) and the rectus facia sling group respectively (P=1.0). Postoperative mean IIQ score decreased to 42.7 ± 11.4 and 50.2 ± 11.1 in the mini sling (Ophira) group versus rectus facia pubovaginal sling (P=0.007). Twenty eight (80%) and 23 (67%) patients in the mini sling (Ophira) and rectus facia pubovaginal sling were satisfied with the operation (P=0.23). There is no significant difference between the mini sling (Ophira) and autologous rectus fascia sling procedure in the treatment of stress urinary incontinence at medium-term follow-up

Primary Adenocarcinoma of the Urethra: A Case Report and Review of the Literature

Abstract Primary adenocarcinoma of the urethra is rarely reported. We report a case of a 47-year-old male with symptoms of urinary obstruction started 2 years before diagnosis. Video-assisted urethrocystoscopy revealed a papillary mass almost obstructing the entire lumen with bleeding. Pathology report was consistent with primary adenocarcinoma of the urethra

Effects of Preemptive and Preventive intravenous Paracetamol on postoperative pain and opioid consumption in patients undergoing laparoscopic nephrectomy

Background: Adequate pain control is a goal in post operative recovery. However opioids provide good analgesic effects, their side effects such as postoperative nausea and vomiting (PONV) limit their administration. Intravenous Paracetamol as a safe and well tolerated drug with lower side effects can be used instead of opioids for pain management.Objectives: The aim of this study is to compare preemptive or preventive administration of paracetamol with placebo group to investigate its effects on pain control and opioid consumption in patients undergoing laparoscopic nephrectomy.Patients and Methods: Ninety patients were randomly divided to three groups. Preemptive group received 1 gr paracetamol in 100 ml normal saline 30 minutes before induction of anesthesia, Preventive group received 1 gr paracetamol in 100 ml normal saline before closure of the skin and placebo group just received 100 ml normal saline. Post surgical pain was assessed using Verbal Rating Scale (VRS). Pethidine 0.25 mg/kg was administered and repeated each 10 minutes to control pain. Pain scores, total dose of opioid and symptoms like nausea and vomiting were recorded. Results: Preemptive and Preventive groups had lower pain scores than placebo group. Opioid consumption and PONV were significantly higher in placebo group. No significant differences were observed between Preemptive and Preventive groups.Conclusion: IV Paracetamol can provide an adequate pain control with low side effects and may be an effective choice in management of post operative pain in patients undergoing laparoscopic nephrectom

Association between single nucleotide polymorphism in miR-499, miR-196a2, miR-146a and miR-149 and prostate cancer risk in a sample of Iranian population

AbstractMicroRNAs (miRNAs) play an important role in regulating gene expression at the post-transcriptional level and are involved in numerous physiological processes. Accumulating evidence suggests that single-nucleotide polymorphisms (SNPs) in human miRNA genes may affect miRNA biogenesis pathway and influence the susceptibility to several diseases such as cancer. The present study aimed to evaluate the impact of miR-499 rs3746444, miR-196a2 rs11614913, miR-149 rs2292832, and miR-146a rs2910164 polymorphisms on prostate cancer (PCa) risk in a sample of Iranian population. This case-control study was done on 169 patients with pathologically confirmed PCa and 182 benign prostatic hyperplasia (BPH). The genotyping assays were done using T-ARMS-PCR or PCR-RFLP methods. The findings indicated that CC genotype of miR-499 rs3746444 polymorphism increased the risk of PCa (OR=1.76, 95% CI=1.12–2.79, P=0.019) compared to TT genotype. No statistically significant association was found between miR-196a2 rs11614913, miR-149 rs2292832, and miR-146a rs2910164 polymorphisms and PCa risk. In summary, the findings indicated that miR-499 rs3746444 polymorphism increased the risk of PCa in an Iranian population. Further studies with larger sample sizes and different ethnicities are necessary to verify the findings of the present study

Traumatic posterior urethral fistula to hip joint following gunshot injury: a case report

<p>Abstract</p> <p>Introduction</p> <p>Urinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury.</p> <p>Case presentation</p> <p>A 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure on the same day. Ten months later, he developed urinary retention. He underwent retrograde urethrography and antegrade cystography which showed a stricture measuring 5 cm in length. There was also a history of progressive pain in the right hip joint accompanied by low grade fever which started 2 months after the initial injury. Hip X-ray showed evidence of an acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty.</p> <p>Conclusion</p> <p>Hip joint contamination with urine following a urethro-acetabular fistula can lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should keep these fistulas in mind as a complication of penetrating urethral injury and every attempt should be made for their early diagnosis and prompt treatment.</p

Solo Sonographically Guided PCNL under Spinal Anesthesia: Defining Predictors of Success

Aim. Sonography has been brought in percutaneous nephrolithotripsy (PCNL) as an adjunct to or substitute for X-ray to restrict radiation exposure. Tis study was designed to investigate the possible predictors for the success of the solo sonographically guided PCNL. Methods. 148 consecutive cases were prospectively enrolled. All steps of PCNL were performed solely with sonography guidance under spinal anesthesia. Residual stones were evaluated the day afer surgery using sonography and plain radiography. Results. Te mean age was 46 ± 15 years; 40% of kidneys had hydronephrosis. Te mean stone burden was 504 ± 350 mm2. Te mean duration of surgery was 43 ± 21 minutes. Te early stone-free rate was 92% in inferior or middle calyceal stones, 89.5% in single pelvic stones, 81.5% in partial staghorn stones, and 61.9% in staghorn stones. Te mean residual stone size was 13 ± 8 mm. Logistic regression showed that a lower age and a larger stone burden signifcantly predicted positive residual stones. Fifeen percent of patients presented with grade I or II and six percent showed grade III complication based on Clavien classifcation. Tere was no cases of organ injury or death. Conclusion. Solo ultrasonographically guided PCNL under spinal anesthesia is feasible with an acceptable stone-free rate and complication rate

Epidemiology of Tuberculosis in the Sistan Region of Iran: A Population-Based Study

ABSTRACT Estimation of the prevalence of tuberculosis is one of the most important needs for the provision of health services i

Association study between rs1571801 and rs16260 with prostate adenocarcinoma predisposition in Iranian population

Abstract Background Prostatic adenocarcinoma is the most frequent malignancy among elderly men after lung cancer, which has the second incidence and the fourth mortality rate in the Iranian population. The primary objective of this study was to investigate how single-nucleotide polymorphisms of the CDH1 gene (rs16260) and DAB2IP (rs1571801) are associated with the risk of prostate cancer through a multi-stage approach. Results In the first stage of the study (58 men), we compared the genotype frequency of polymorphisms rs16260 and rs1571801 in the case group to the control group to determine significant polymorphisms (P value < 0.4). No statistically significant difference was shown between the genotype frequency of rs1571801 in the case and control groups. Thus, rs1571801 polymorphism was eliminated at this stage, and only rs16260 polymorphism evaluated in the next stage. In the second stage, statistical analysis showed a significant difference between genotype frequency of rs16260 (P value = 0.037) in all participants. The effect of rs16260 on prostate cancer was not modified by age or PSA levels. Only the Gleason Score = 7 reveals a significant difference between the risk allele (A) and the allele (C) (rs16260). Conclusions According to the results of this study, rs16260 is associated with prostate cancer predisposition and might be used as a potential biomarker in prostate cancer. It should be noted that these results need to be confirmed in a larger population

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