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Introduction: Urethral, penile, and scrotal cancers are rare and represent less than 1% of all malignancies. However, they are associated with a high mortality rate and have a significant effect on patients’ quality of life. Penile and urethral cancers comprise 0.6% of all urological cancers. Because of ethnic, geographical, and cultural diversity, risk factors and cancer patterns vary in different communities. We aimed to provide valid information on the prevalence, incidence, and epidemiology of urethral, penile, and scrotal cancers using the National Registry on Cancer of Iran. Methods: This retrospective study of 465 patients included all known cases of urethral, penile, and scrotal cancers from the Department of National Registry on Cancer at the Ministry of Health and Medical Education in Iran during 2004-2015. This study examined the demographic characteristics of patients and discussed the risk factors and possible causes of the above-mentioned cancers. Results: The mean ±SD age at the time of registration was 58.49±20.82 years. The highest and lowest proportions of cases belonged to Tehran/Alborz (14.2%) and Mazandaran (0.65%) provinces, Iran, respectively. Regarding the distribution of records according to a year of registration, these cancers were more prevalent in 2014, and less prevalent in 2004. Conclusion: Urethral, penile, and scrotal cancers were more common in Tehran and Alborz. There was a strong possibility that the prevalence of these cancers is linked to the industrial nature of Tehran and Alborz and the prevalence of human papillomavirus.

Introduction: We aimed to compare the effect of nettle extract and pumpkin seed on Prostate Specific Antigen (PSA) and international prostate symptoms score (IPSS) in patients taking alfa-blocker for benign prostatic hyperplasia (BPH). Materials and Methods: For this purpose, 90 outpatients were studied in three groups, including men over 40 years of age with benign prostatic enlargement. The first group (Urtidin) contained consumers of nettle extract from Barijessence Company called Urtidin tablets with tamsulosin; the second group took tablets containing pumpkin seed extract called Prosta Barij and tamsulosin; the third group (Control) received only tamsulosin for three months. Patients were not randomly assigned to the groups PSA, IPSS, and related factors were evaluated and analyzed using SPSS software. Results: 89 patients completed the study (30/89 in Urtidin group with a mean age of 62.4±7.39 years, 29/89 in Prosta Barij group with a mean age of 65.9±7.32 years, and 30/89 in the control group with a mean age of 64.7±8.64 years). The results showed that nettle and pumpkin seed extracts affect PSA in patients taking tamsulosin for BPH. Also, after the intervention, IPSS had a significant decrease compared with baseline in both drug treatment groups. There was no significant difference in these three types of treatment. Conclusion: It seems that the desired herbal products did not have a synergistic effect with alpha blockers in the control and treatment of BPH but they can affect the serum PSA level.

Introduction: The lifestyle and learning of trainees from different surgical specialties have been severely affected by the COVID-19 pandemic. Despite the growing body of research, the extent to which their surgical or educational performance is affected is not yet well-understood. We investigated the Iranian multi-specialty surgical residents nationwide to clarify the extent this new pandemic’s has affected their surgical and educational activities. Material and Methods: Our specialized board designed a questionnaire which was sent to residents from the 18th of May to 12th of Jun 2020. The questionnaire comprised demographic data, questions on the clinical, surgical, and educational activities during and before the pandemic. Results: Out of 700 eligible residents, 543 (77%) submitted their answers to all questions. 417 (76.8%) of the respondents declared they had spent their residency program at a hospital that was the main referral center for patients with COVID-19 infection. The weekly number of the outpatient and emergent visits decreased by one third (P

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.

Renal cell carcinoma (RCC) is the third most common genitourinary cancer in the world, and has the highest mortality rates among these types of cancers. In the present cross-sectional assessment, the prevalence of RCC subtypes in a sample of Iranian patients diagnosed with RCC which have undergone nephrectomy surgery between years 2014 to 2019 in a referral medical center has been investigated. We have studied 68 patients, including 47 male and 21 female individuals with an average age of 55. The patients have been studied for demographic and pathologic information such as age, sex, tumor size, tumor subtype, TNM staging, Fuhrman nuclear grading, and other pathological information. The statistical analysis was done via SPSS software version 21. Quantitative data were examined by T test and qualitative data were assessed by Chi square test. As we observed in the results, the most common RCC subtype among these patients was clear cell 53%, followed by papillary 22% and chromophobe 19%, emphasizing the higher rates of chromophobe RCC compared to the statistics worldwide.

Introduction: With the obsoletion of the paternalistic model of the doctor-patient relationship, considering public opinion regarding healthcare policymaking seems to be of great necessity. The present study was conducted to determine the educational priorities of male urology specialists and the general male population concerning urological diseases. Materials and methods: In this cross-sectional survey study, 400 male urologists and 400 men from the general population were assessed. Our investigation was carried out using a seven-item questionnaire covering the most important urological conditions. Respondents gathered from all over Iran through the 22nd Congress of Iranian Urological Association (IUA) and street surveys. Results: The mean age of the participants was 40.69 ± 13.23. The mean age for the general population and urologists was 35.8 ± 13.7 and 45.6 ± 10.6 years, respectively (P=0.0001). 56.8% of the respondents from the general population had a university degree. Overall, erectile dysfunction and sexually transmitted diseases (STDs) were the most mentioned diseases as an educational priority (40.1%). Chronic prostatitis was also the least mentioned condition as an educational priority in both groups and overall among all the participants ‎ (20.9%). A significant difference was observed between the general population and urologists in all the examined conditions (P

Introduction: Andropause is a syndrome with a slow progression that is associated with androgen deficiency in older men. This study aimed to collect all scientific data about the factors that cause the occurrence of andropause in Iranian men as well as the aspects of life which can be affected by this disorder. Materials and Methods: Searching was conducted in international databases including MedLine, Scopus, Web of Science, ProQuest, and national database (SID) from inception until December 2019. Retrieved studies were reviewed by two researchers independently and selected studies were summarized in a table. Results: Finally, 21 related studies were included and summarized information showed that andropause can be negatively affected by age, lower testosterone levels, smoking, lower economic status, lower educational level, and poor employment status. Some studies have also implied that there is a significant correlation between andropause and quality of life, sleep quality, depression, anxiety, marital dissatisfaction, urinary incontinence, coronary heart disease, and metabolic syndrome. Conclusion: According to the collected data in this present study, Iranian studies have covered a wide variety of complications and related factors in the field of andropause but, we still lake some studies about other aspects of andropause such as musculoskeletal impairment, erectile dysfunction, memory and cognitive disorders, skin and hair disorders, decreased libido, and other mood disorders.

Background: During the pandemic, Iranian healthcare system had faced many challenges including the continuation of medical education. In this time, almost all elective surgeries have been suspended, outpatient visits have been limited to seriously ill patients, and academic meeting have been cancelled. This process has caused a significant decrease in clinical and surgical practice in the field of urology. In this article, we assess as to what extent and how this pandemic has impacted the urology residency training in Iran. Material and Methods: a 15-item-long questionnaire was designed and sent to all Iranian urology residents via social network and/or email from the 10th of MAY to the 10th of Jun 2020. This questionnaire assessed different training activities, including on-call duty, outpatient visits, diagnostic procedures such as cystoscopy, endoscopic procedures, and open major surgeries, prior and during the pandemic. The results were evaluated using t-test and ANOVA. Results: the percentage of urology resident’s involvement in each training activity, including on-call duty, outpatient visits, diagnostic procedures such as cystoscopy, endoscopic procedures, and open major surgeries, demonstrated a significant decline (p

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.

Background: Prostate Cancer is recognized as the second cause of death due to cancers among men worldwide. Due to the lack of local evidence on the survival rate of patients with prostate cancer, this study aimed to estimate the 5-year survival rate of patients afflicted with this condition in Iran. Materials and Methods: This study made use of information on 9,772 prostate cancer cases who were registered in the National Cancer Registry during 2010-15. A telephone survey, with a response rate of 35%, was conducted to gather additional information such as death status, demographic characteristics, and clinical profile. Kaplan-Meier estimates was used to estimate five-year survival rates. Results: The overall five-year survival rate of prostate cancer was 82% (95% CI: 80-83%). Significantly higher five-year survival rates were observed among retired patients (rate: 94%,95%CI: 92-96), patients receiving a combination of radiotherapy and surgery (rate: 92%,95%CI: 89-94), and patients residing in rural areas (rate: 92%, 95%CI: 90-93). Conclusion: We found that various factors such as occupation, area of residence, and the type of medication, may influence on survival rate of prostate cancer. Careful evaluation and understanding of effective factors are required to adopt proper health policies and treatment options. Due to the importance of etiologic and epidemiological data, inclusion of such data into the national registry system for Prostate Cancer is strongly recommended.

Background and aim: To find if intra-operative local injection of Mitomycin-C after internal Urethrotomy in patients with urethral stricture can improve the outcome of surgery. Materials and Methods: Seventy patients were allocated in two groups randomly and data were analyzed. The case group (n=35) was treated by internal Urethrotomy with intra-operative local injection of Mitomycin-C. The control group (n=35) was underwent standard internal Urethrotomy. The patients were followed after removing catheter and for 6 months after surgery by USS PROM questionnaire and uroflowmetry. Results: A significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.006) and urine flow pattern (p-value=0.025) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, six months after surgery. In the case group, in the six months after operation, only 2.9% of patients had Q-max less than 15 and no one had obstructive pattern, while in the control group, 25.7% of patients had Q- max less than 15 and 17.1% had obstructive pattern. However, the patient's satisfaction history did not show any significant difference in post-internal Urethrotomy voiding status in the local injection of Mitomycin-C group and control group, either immediately after removal of the urethral catheter (p-value=1) and six months after surgery (p-value=0.198). Also, no significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.771) and urine flow pattern (p-value=1) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, immediately after removal of the urethral catheter. Conclusions: Intra-operative local injection of Mitomycin-C after internal Urethrotomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Lower recurrence rate of urethral stricture is the main effect of local Mitomycin-C application that is more prominent after six months follow up.