فهرست مطالب محمد هاتف خرمی

The aim of this study was to assess the effect of diabetes mellitus on Prostate Specific Antigen (PSA) serum levels among diabetic males without urinary tract complaints.

This is a case-control study conducted on 75 diabetic cases and 75 age-matched non-diabetic ones in 2016-17. Patientschr('39') demographics including age, duration of diabetes mellitus, presence of diabetic nephropathy, serum PSA (total and free) were recorded and cases were compared with controls.

Diabetic patients and controls were not statistically different regarding their age (P=0.61). Level of total and free PSA and their ratio were significantly less in diabetic group (P<0.001). Pearson coefficient correlation test showed no statistical association between duration of diabetes mellitus with PSA indices (P>0.05). There was significant association between HbA1C with total and free PSA and their ratio. Insulin therapy was in association with total and free PSA and their ratio (P<0.05) but oral remedies were not (P>0.05).

Diabetic persons have lower levels of all PSA indices. Findings of this study showed inverse statistical association of HbA1C with PSA indices while no association was found with duration of diabetes. PSA indices were significantly lower among patients under insulin therapy but no difference was found considering routine oral therapies.

hypothyroidism, neuropathy and myopathy caused by it can have a significant impact on the performance of the lower urinary tract because the bladder muscle activity and proper function of sphincters are strongly controlled by autonomic and somatic reflexes, and are vulnerable to any kind of neuropathy. It is important that despite the high prevalence of hypothyroidism in reports limited extent (Case report) urodynamic pattern in these patients are available. Between April 2010 and April 2013, from among all female patients who visited the urology clinics of Alzahra and Noor Hospitals, 1058 of the patients had complains of chronic urinary symptoms. Approximately 68 of patients had hypothyroidism and urodynamic test was performed for 43 patients whose results were analyzed. Reduced urination rate (Qmax) was observed in 37.2% of patients. In 21.3% of patients, bladder outlet obstruction was existed. Bladder sensory impairment was observed in 33.3% of patients. 37.2% of patients were with residual urine (PVR) higher than normal. The most common disorders of unloading phase (voiding phase) were reduced power of drain, increase remained of the urine (PVR) and bladder outlet obstruction (BOO). The most common problems of filling phase were reduced bladder sensation (hyposensitivity) and OAB.

Stress urinary incontinence (SUI) is very prevalent in middle-aged women. Minimal invasive anti-incontinence surgery is the most common surgery for treating the problem. The purpose of this study was to compare the therapeutic results and complications of minimally invasive anti-incontinence operative procedures for middle-aged women with SUI. We prospectively evaluated 146 women with SUI, who underwent suprapubic arc (SPARC) or transobturator (TOT) sling by the same surgeon. Concurrent anterior prolepses repair was performed in 43 (59.7%) and 29 (39.2%) patients in the SPARC and TOT groups, respectively. Objective cure rate was 90% and 93% respectively in the SPARC and TOT groups. Voiding difficulties were observed in 8 (11.1%) cases of the SPARC group and 13 (17.6%) patients of the TOT group. Urethrolysis and complete mesh removal were necessitated in 2 cases of the SPARC group. Regional and pelvic pains were observed in 3 (4.2%) and 10 (13.5%) patients of the SPARC and TOT groups, respectively. Vaginal erosion occurred in 8 (11.1%) and zero individuals of the SPARC and TOT groups, respectively The short-term anti-incontinence effects of SPARC and TOT were much similar. However, chronic pelvic and groin pain (with movement) occurred in 13.5% of women in the TOT group which implies the need for further study to determine the best technique in active women.

Secondary prevention, as defined by early diagnosis, has very important role in response to treatment and reduction of complication of bladder cancer. In this study we sought to investigate the interval between onset of symptoms and definite diagnosis and their related factors. This study was done on 82 patients extracted from cancer registry. Mean interval between onset of symptoms and definite diagnosis was 3.8 months. Mean delay from onset of symptoms to first medical visit was 2.76 months and mean GPs delay in making a patient refer to urologist was 0.98 months. The present study revealed patient's late referral to physicians and general physician's delay in referring the patients as two major factors in delayed diagnosis. This finding emphasizes the importance of public information provision about early referral after the onset of symptoms, as well as promoted education for general physicians.

Varicocele is defined as elongation and enlargement of of veins leaving the testis which join to form the pampiniform plexusis in the scrotum and can influence the testicular function. Testis is the main source of testosterone that any effect on it can affect this hormone too. Premature ejaculation is defined as to reach orgasm before the desired time or ejaculation before or immediately after sex and is determined by proximity and ejaculation before two minutes after intercourse. This study aimed to investigate the effect of varicocele on serum testosterone levels and premature ejaculation. In this case-control study, 38 patients with varicocele and 38 healthy individuals, as controls, were selected and their testosterone levels (blood sample before 11 AM), frequency of ejaculation, despite testicular atrophy, and grade of varicocele were assessed and compared. In patients group 28.9% and in control group 10.5% were suffering from premature ejaculation (P < 0.05). Mean testosterone level was 6.5 ± 1.9 and 7.8 ± 2.1 ng/ml in patients and control groups, respectively. Varicocele grade and testicular atrophy was correlated (05 / 0> P). Despite the testosterone level was lower in patients with varicocele, no significant correlation between testosterone levels and varicocele grade was observed. This study shows a significant relationship between varicocele and premature ejaculation; it seems that in patients with varicocele, testosterone serum level should be measured regularly and And if reduced, to be corrected.

Bladder tumors have a high incidence and despite being superficial in a majority of cases, the amount their relapse after transurethral resection of bladder tumour (TURBT) surgery is high. Treatment after TURBT with in vesicular methods is a way to overcome relapse. The purpose of this study was to determine the effect of implementation of adding a dose of mitomycin into the vesicular delayed six-week treatment of patients with superficial bladder cancer on the rate and degree of tumor recurrence in patients referred to Alzahra and Noor hospitals in Isfahan. In this prospective study, patients with superficial bladder tumors were selected and randomly devided in one of case or control groups. The sample size for each group was 18 patients. Patients in case group received a dose of mitomycin C after TURBT; then, both groups underwent delayed six-week treatment. Results in terms of numbers, time, grade, and stage of recurrence were analyzed using chi-square, Mann-Whitney, and Independent-t tests. 33.3% of patients in case group and 66.7% of controls experienced relaps (P = 0.04). The grade of relapsed tumor was significantly difference between the two groups (P = 0.001). The mean frequency of relapse was 0.5 ± 0.78 in case group and 1.1 ± 1.0 in control group (P = 0.04). The stage of relapsed tumors in the control group with the larger proportion was of type T1 (P = 0.006) but the time of relapse was not significantly difference between groups (P = 0.09). The relapse time was 12.5 ± 14.1 months in case group and 6.7 ± 3.7 months in control group. Considering the reduced number, stage, and grade of relapse in case group, the positive effect of immediately mitomycin after TURBT was proved. Studies with more patients and further follow-up period are necessary to review late relapses.

This study was designed to evaluate the correlation of superficial, low grade, unifocal bladder TCC recurrences and the level of tumor markers P53 and CD44 in the tumor tissue.In 95 patients with primary diagnosis of unifocal superficial TCC of the bladder TURBT was done. Sixty patients (M = 49, F = 11) with unifocal, superficial (stage Ta or T1), low grade (grade 1 or 2) papillary TCC of the bladder without carcinoma in situ were enrolled to the study and completed it. Tumor tissue sections were immunohistochemically stained for P53 and CD44 separately. Follow up cystoscopy was performed every 3 months for the first year and every 6 months for the second year. Recurrence rate of tumor was compared between P53 positive and p53 negative groups and between CD44 positive and CD44 negative groups. The mean age of the patients was 59.7 years. The overall recurrence rate was 53%. It was 64.5% in P53 positive and 41.2% in P53 negative group (P = 0.07). Recurrence rate in CD44 positive and CD44 negative group was 72% and 40% (P < 0.02) and recurrence rate in both positive marker (CD44 and P53) groups was 87.5% and in both negative marker groups was 40 % (P < 0.02). Our results suggest that there is a remarkable relationship between CD44 positive group, specially CD44 and P53 positive group and recurrence rate in low risk superficial TCC, but the relationship between P53 positive group and recurrence is not statistically significant.