Journal of Translational Research in Urology
Volume:6 Issue: 3, Summer 2024

Most of the present databases in prostate cancer expression studies are in single-cell and bulk RNA sequencing formats. Using these tools, cell-cell interaction could have revealed associated tumor cell profile signatures like RAECs could be determined, and the origin cell level evolution of tumor cells like neuroendocrine cells could be found. They are using ultra-deep RNAseq-enhanced alternative promoter functions found in high-grade prostate tumors. scRNAseq and bulk-RNAseq assisted by new deep learning algorithm models could change the perception of prostate cancer forever.

At our tertiary care center, we have encountered and successfully managed 28 cases of forgotten Double-J (DJ) stents. We are eager to share our experience in handling such cases.

In this paper, situations with Double-J stents that were ignored over two years (2021–2023) are retrospectively analyzed. The patient's information has been carefully gathered and assessed with regard to the length of the indwelling stent, the patient's complaints, the reasons behind their noncompliance, the kind of encrustations, the different treatments administered, the intraoperative complications, their management, and the final result. The mean age was 39.5 years (32-54 years), and the male-to-female ratio was 1.5:1. The average duration of stent indwelling was 18.5m. Based on the modified Kuppuswamy scale, most patients belonged to the lower socioeconomic class. Symptoms of storage and dysuria were the most frequent presentations. The intricate and severely encrusted stents were handled using a combination of endo-urological procedures, with staged treatments performed as needed. Simple retrograde cystoscopic removal was used to remove most of the stents. In our study, there was no mortality.

People from lower socioeconomic classes and those with low educational attainment are more likely to have forgotten DJ stents. Pandemics like COVID-19, when access to elective healthcare was abolished, significantly impacted patient compliance for stent removal—hence the long list of forgotten stents.

The survival rate for young male cancer patients has increased significantly over the last two decades due to early detection and advanced treatment methods. Currently, over 75% of youth with cancer are long-term survivors. With this improved survival rate, the quality of life has become a crucial consideration for both childhood and adult cancer survivors, particularly regarding fertility preservation. The most common cancers affecting individuals of reproductive age include leukemia, Hodgkin's lymphomas, and testicular germ cell tumors. Chemotherapy and radiation therapy often have detrimental effects on fertility. As a result, cryopreserving semen before the beginning of cancer treatment has become the standard method to safeguard future male fertility. It is worth considering that for a significant number of male cancer patients, sperm health could be an issue even before their diagnosis, with research indicating that around 12% may not have viable sperm for freezing. The cytotoxic nature of cancer treatments can cause temporary or permanent damage to spermatogenesis, and the extent of damage depends on the combination and cumulative dose of drugs used. Certain chemotherapy drugs, including cyclophosphamide and procarbazine, can have severe effects on reproductive health, particularly damaging germ cells. Similarly, radiation therapy, particularly whole-body treatments, may lead to irreversible sterility. Various factors, including the tumor type, initial fertility status, and the specific cancer treatment regimen, influence the potential for future fertility in male cancer survivors. Post-treatment, many men turn to artificial reproductive techniques, such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), to achieve fatherhood. It is estimated that approximately 15% of males will make use of their cryopreserved semen due to persistent azoospermia following cancer treatment. The success rates of treatment with cryopreserved semen are typically favorable and comparable to standard IVF and ICSI outcomes..

Hydrochlorothiazide is widely prescribed for managing hypertension. Despite its extensive use, there is a significant lack of scientific literature addressing its impact on 24-hour urine parameters. This study aims to investigate these effects by comparing parameters derived from 24-hour urine collection tests before and after hydrochlorothiazide administration. This prospective before-and-after study was conducted from 2021 to 2022 at the medical facilities affiliated with the Islamic Azad University, Tehran Medical Sciences Branch. Adhering to university-approved research protocols, participants were instructed to provide 24-hour urine samples before initiating hydrochlorothiazide treatment. One week later, a second set of 24-hour urine samples was collected following the administration of hydrochlorothiazide. This methodology allowed for the comparison of urine parameters before and after the intervention. Among the eight variables analyzed—volume, protein, creatinine, albumin, uric acid, citrate, and pH—six showed P-values greater than 0.05, indicating no statistically significant differences between the pre-and post-treatment tests. However, calcium and citrate levels exhibited P-values less than 0.05, indicating a significant decrease in their mean values following hydrochlorothiazide administration. The study findings show a significant impact of HCTZ on urinary calcium and citrate levels, with both parameters demonstrating a statistically significant decrease after treatment.

The purpose of this research is to evaluate the utility and efficacy of the LigaSure system compared to conventional suturing in the management of DVC in RP. The study involved two groups: Group One, consisting of 92 patients who underwent conventional suturing for managing their DVCs (CS-DVC), and Group Two, consisting of 90 patients who received the LigaSure system (SL-DVC). Patient records were collected retrospectively, including age, preoperative hemoglobin (Hb) level, smoking status, and history of opium consumption. The analyzed operative outcomes included total surgical length, postoperative Hb (24 hours after surgery), and the quantity of packed red blood cells administered during and after the procedure (24 hours). Tumor characteristics analyzed included tumor grade, pathologic Gleason score, pathological stage, and margin status. Men who underwent SL-DVC were older than CS-DVC group (67.52±8.29 years and 64.85±7.54 years, respectively). The CS-DVC group experienced longer operative times than SL-DVC patients (3.91±0.76 hours and 3.24±0.8 hours, respectively; P-value<0.001). Preoperative and postoperative Hb levels were significantly higher in the SL-DVC group compared to the CS-DVC group (P-value<0.001). However, there was no significant difference in the decrease in Hb levels between two groups (P-value=0.727). No significant differences were reported in tumor grade, pathological T-stage, pathological Glisson score, and margin positivity between two groups (all P-value>0.05). Continence was better in the SL-DVC group (P-value=0.013), but there were no significant differences in PSA recurrence and urethral stricture between two groups. The use of either a conventional suture or a LigaSure system to control the DVC in RP did not result in differences in the decrease of Hb, positive margin rate, PSA recurrence, and urethral stricture. However, the duration of surgery and the incontinence rate were improved in the LigaSure system group. Therefore, using LigaSure may be a useful alternative method for DVC management.

Infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS-Bx) have been observed to be increasing. This research aimed to assess the incidence of infection in patients who underwent TRUS-Bx and identify the associated risk factors. This prospective cross-sectional study included 439 patients who underwent TRUS-Bx. The frequency of infection and its related risk factors were assessed using a checklist based on various variables. The patients' data were recorded according to the study's inclusion and exclusion criteria. The average age of the patients was 64.6±8.7 years old   —infection after TRUS-Bx was observed in 2.1% of patients (n=9). Lower Age (P-value=0.005) and benign prostatic hyperplasia (BPH) (P-value=0.047) showed a significant association with an increased risk of infection after TRUS-Bx in univariate analysis. However, in multivariate analysis, age was the only factor significantly associated with infectious complications, indicating a decreased risk of infection in older patients (P-value=0.009). We did not find a significant association between infection after prostate biopsy and previous prostate biopsy or surgery, urethral catheterization, prostate cancer or prostatitis pathology report, diabetes mellitus, and serum creatinine level. According to this study, infection after prostate biopsy occurs in 2.1 % of cases, and younger patients are more at risk.

Varicocele, which is defined as varicose veins in the scrotum, is associated with different complications, in particular infertility. However, the definite etiologies have not determined yet. Our objective was to investigate the association between left lumbar, renal, and gonadal veins diameters and varicocele occurrence and grading in kidney donors underwent left-sided nephrectomy. Also, the frequency of varicocele were evaluated three months after the surgery. In this observational study, male kidney donors aged 18 to 65, who underwent open nephrectomy were included between 2022 and 2023. Baseline data on age, body mass index (BMI), and the presence or grade of varicocele were collected through medical records and physical examinations. During the procedure, the diameter of the left lumbar, renal, and gonadal veins was measured using a graded ruler on the back table. Three months after the nephrectomy, the patients were re-evaluated for varicocele recurrence. We included 30 kidney donor with a mean age of 38.2 years and BMI of 23.5 kg/m2. The renal vein diameter decreased with higher grading (p=0.05) and the gonadal vein diameter increased with higher grading (p=0.04). However, there was no significant association between varicocele grading and left lumbar vein diameter. Following three months of nephrectomy, the frequency of varicocele increased from 33.4% to 50.0%. The diameter of the left lumbar vein was almost unchanged in varicocele, while the size of the left renal vein decreased, and the size of the left gonadal vein increased. Furthermore, occurrence of varicocele increased after three months of left-sided nephrectomy. Therefore, people undergoing nephrectomy are at a higher risk of developing varicocele which should be considered in follow-up visits.

According to the effect of hypertension on kidney stone formation and on the other hand, there is no research to evaluate the impact of hypertension on the location of stone formation in kidney, so the aim of present study was assessing the effect of hypertension on the location of stone formation in kidney. Data for present investigation were prepared by Persian Registry for Stones of Urinary System (PERSUS). This investigation was retrospective cohort and the study initially enrolled 5130 participants from 2020 to 2024. Participants with history of hypertension were selected and categorized as exposure group (n= 396). Participants without medical history and norm-tension were categorized as non-exposure group (n=396). Diagnosis of kidney stone was approved by CT-scan and data of medical history were collected by interview with patients. The mean age of participants was 48.83±13.62 years. The distribution of kidney stone location was not significantly difference between two groups (P-value=0.1). The number of kidney stones in left and right kidney were not difference between patients with hypertension history and patients with norm-tension history (P-value=0.72, P-value=0.25).  There were no significant differences in stone formation in various parts of kidney between participants with hypertension and norm-tension history (P-value=0.16).  Hypertension increased the risk of kidney stone formation but did not affect the location of stone formation in kidney.