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Background: Numerous studies have focused on skin damage, the most prevalent physical injury, aiming to improve wound healing. The exploration of biomaterials, specifically eggshell membranes (ESMs), is undertaken to accelerate the recovery of skin injuries. The membrane must be separated from the shell to make this biomaterial usable. Hence, this investigation aimed to identify more about the methods for membrane isolation and determine the most efficient one for usage as a biomaterial. Methods and materials: For this purpose, ESM was removed from eggs using different protocols (with sodium carbonate, acetic acid, HCl, calcium carbonate, and using forceps for separation). Consequently, we have examined the membranes' mechanical and morphological qualities. Results: According to the analysis of microscopic surface morphology, the membranes have appropriate porosity. MTT assay also revealed that the membranes have no cytotoxic effect on 3T3 cells. The results indicated that the ESM had acquired acceptable coagulation and was compatible with blood. Based on the obtained results, Provacol 4 (0.5‐mol HCl and neutralized with 0.1‐mol NaOH) was better than other methods of extraction and eggshell separation because it was more cell‐compatible and more compatible with blood. Conclusion: This study demonstrates that ESMs can be used as a suitable biomaterial in medical applications. [ABSTRACT FROM AUTHOR]

Purpose: Percutaneous nephrolithotomy (PCNL) in the elderly is challenging due to age-related decline in organ function and the general depletion of the physiological reserve. We aimed to compare the efficacy and safety of complete supine PCNL (csPCNL) between young and elderly patients with kidney stones. Materials and Methods: In this cross-sectional comparative study, a total of 656 patients aged 18-64 years (young group) and 83 patients aged =65 years (elderly group) who underwent csPCNL between April 2009 and September 2021 were studied. The two groups were compared in terms of clinical characteristics, stone-related parameters, perioperative parameters, and postoperative outcomes. Results: The mean age of elderly and young patients was 69.87 and 47.1 years, respectively. The female-to-male ratio was 1:1.21. The mean hemoglobin drop was significantly greater in the younger group (1.38 ± 1.08 vs. 1.01 ± 0.84 g/dL, P = 0.007). The stone-free rate was comparable in the two groups (96.8% vs. 91.5%), whereas hospitalization was significantly longer in the younger group (P = 0.014). There was no significant between-group difference regarding the postoperative complication rates (P = 0.36). On multivariate analysis, body mass index, stone burden, and presence of staghorn stone were identified as independent predictors of the success of the operation (P = 0.04, odds ratio [OR] = 1.091; P = 0.000, OR = 0.962; P = 0.045, OR = 0.404). None of these factors had an independent effect on the occurrence of postoperative complications (P > 0.05). Conclusion: CsPCNL in the elderly age group is an effective and safe procedure with high stone-free rates and similar complication rates compared to younger patients. [ABSTRACT FROM AUTHOR]

Despite the benefits of spinal anesthesia and the preference of anesthesiologists for this technique, it is less accepted by urologists due to the proximity of the stone place in the ureter and the possibility of pain, restlessness, and occasional movements of the patient during surgery. The current study investigated the success of bupivacaine plus intrathecal fentanyl in patients undergoing transurethral lithotripsy (TUL). In this randomized clinical trial, from April 2021 to September 2021, 54 patients with proximal urolithiasis candidates for TUL were enrolled. Patients were randomly categorized into two groups: group A received bupivacaine 10 mg and 0.5 ml of normal saline, while group B received bupivacaine 10 mg with 0.5 ml (25μg) of intrathecal fentanyl. According to our findings, about 74% of the patients were men, and the mean age of the patients was 66.14±22.46 years. The onset time of the sensory block, sensory block level, pain score, degree of relaxation, depth of the motor block, occurrence of anesthesia complications, oxygen saturation, and mean arterial blood pressure were not significantly different between the two groups. However, the duration of the motor block in group B was longer than in group A (p<0.001). Also, retropulsion was observed only in five patients (18.5%) in group A, significantly higher than in group B (p=0.019). Bupivacaine with fentanyl 25μg provided adequate spinal anesthesia with lower retropulsion in patients with urolithiasis who are candidates for TUL. [ABSTRACT FROM AUTHOR]

Purpose: There are different approaches to the treatment of urinary incontinence (UI), including pharmacological, nonpharmacological, and surgical methods. Pulsed electromagnetic field (PEMF) stimulation is a nontraditional and noninvasive type of treatment, which is gaining increasing popularity in healthcare departments for UI treatment. Materials and Methods: In this quasi-experimental study, women (age ≥21 years) with lower urinary tract symptoms (LUTS) were assigned to three groups regarding the UI type (urgency, stress, and mixed UI). The Bristol Female LUTS (BFLUTS) questionnaire was used to evaluate the UI severity. The patients were treated with PEMF stimulation twice per week up to 6 weeks. The results were evaluated at three and 6 months posttreatment. Results: Ninety women completed 6 months of follow-up in this study. The mean age of the participants was 58.5 ± 13.9 years. Of 90 patients, 61 (67.8%) had mixed UI, 22 (24.4%) had urge UI, and 7 (7.8%) had stress UI. There were significant differences between the groups regarding the frequency of leakage from baseline to 3 and 6 months after treatment; the reduction of leakage severity was only nonsignificant in the stress UI group (P = 0.368). Based on the results, the number of used pads reduced from 4.18 ± 3.00 to 1.08 ± 2.03 (P < 0.001); this reduction was also significant in each of the groups. The mean BFLUTS score reduced from 7.42 ± 2.53 at baseline to 5.56 ± 2.37 and 3.00 ± 2.33 at 3 and 6 months after treatment, respectively (P < 0.001). No significant complications were detected in the groups. Conclusion: The PEMF stimulation is a safe and effective approach for reducing the symptoms of patients with UI. The best response to treatment was reported at 6 months posttreatment. Therefore, it is recommended to use PMEF stimulation as a noninvasive treatment along with routine therapies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the breastfeeding outcome between those who conceived via assisted reproduction techniques (ART) and those who had spontaneous conception.Methods: This case-control study was conducted during a 2-year period between 2014 and 2016 in a tertiary healthcare center in Tehran, capital of Iran. We included a total number of 80 women with ATR conception and 81 women with spontaneous conception. The two study groups were matched regarding the age, parity and the gestational age. Those with contraindication of breastfeeding and history of psychiatric disorders were excluded. The breastfeeding outcome was measured using a structured-based interview and the results were compared between the two study groups.Results: The exclusive breastfeeding was significantly higher in spontaneous conception (p < .001). The duration of the breastfeeding was significantly higher in those with spontaneous conception (p < .001). In the same way, the exclusive breastfeeding within the first week was significantly higher in the spontaneous conception group (p = .002). The ATR conception was associated with higher bad feeling during the breastfeeding (p < .001), higher breastfeeding dysfunction (p < .001) and higher experience with difficult breastfeeding (p < .001). The return of the work after 3 months was significantly higher in spontaneous conception (p = .004).Conclusions: The results of this study demonstrate that ATR conception is associated with worse breastfeeding outcome determined by lower rate of exclusive breastfeeding and higher rate of breastfeeding dysfunction and bad feeling during breastfeeding. [ABSTRACT FROM AUTHOR]

A sol-gel method was employed to synthesize uniform micro-sized spheres of silica coated with MCM-41 or Ti-MCM-41 mesoporous shells. Some sensitive dyes including alizarin, phenolphthalein and malachite green were loaded into these core-shells to achieve a solid-state colorimetric gas sensor for ammonia sensing via tracking the emerged signals (change of color) by either naked eye or digital camera. Several analytical standard techniques were applied for characterization of the structure and texture of the prepared ammonia sensor. An instantaneous response was observed using alizarin-loaded core-shell for a low concentration of ammonia gas. The other two dyes were only responsive upon exposure to high concentrations of the gas. Using a six-element sensor array and applying a color analysis technique, a large range of ammonia gas concentrations from 10 to 1000 ppm were sensed and recorded. Although a digital approach was used to quantize the extent of responses to ammonia, but all changes were also detectable with naked eye even for low concentration of ammonia. A detection limit of 0.6 ppm was calculated for the produced sensor array. [ABSTRACT FROM AUTHOR]

Background Several studies have reported that cigarette smoking affects sperm parameters, especially semen quality, but their results are contradictory. Objective This retrospective study aims to evaluate the relationship of sperm parameters with smoking in men with idiopathic infertility. Materials and Methods This retrospective study was conducted on 1744 infertile men with at least one year of idiopathic infertility. They were divided into two groups of smokers (n=379) and non-smokers (n=1365) according to their smoking habits and based on their inclusion and exclusion criteria. The semen analysis was extracted from subjects' medical records, and the collected data were analyzed in SPSS V. 19 software. Results Smoking significantly reduced semen volume in smokers (2.88±1.50 mL) compared to non-smokers (3.28±1.77 mL) (P=0.002). There was a significant decrease in sperm motility in smokers (36.1±21.9%) compared to non-smokers (34.4±19.6%) (P=0.009). However, the association of smoking with sperm motility between men with normal and abnormal semen volumes was not statistically significant, and there was no significant difference in sperm count and morphology between infertile smokers and nonsmokers (P>0.05). Conclusion Smoking causes a significant reduction in semen volume, but has no significant effect on sperm count, morphology, and motility in men with abnormal and normal semen volume. [ABSTRACT FROM AUTHOR]

Different post‐synthesis approaches were used to increase the adsorption abilities of zeolite mordenite and Y in removal of cationic dye molecules as typical dyestuff pollutants. Various methods including acid leaching, alkaline treatment, dealumination with hexafluorosilicate, sonication and combination of them were employed to alter the porous structure of various types of selected zeolites. The dealumination (due to acid leaching), desilication (due to alkaline treatment) and disintegration (due to shear forces generated by ultrasound waves) were responsible for the alteration of pores size and accessibility in mordenite. Acid leaching combined with irradiation of ultrasound was found to be most effective technique in adsorption of rhodamine B as a large dye molecule into mordenite. In the case of zeolite Y, a chemical treatment with ammonium hexafluorosilicate resulted in considerable improvement of adsorption of rhodamine B. [ABSTRACT FROM AUTHOR]

Joint diagonalisation (JD) of a set of target matrices is a common approach to solve the blind source separation (BSS) problem. In fact, the separating matrix (the inverse of the mixing matrix) of the sources is the joint diagonaliser of the target matrices. In this study, the authors show that each row of the separating matrix maps the target matrices using a linear mapping into the new vectors which are located on a direct line along the corresponding column of the mixing matrix. Based on this geometrical interpretation, the authors propose a method for solving JD problem, which let us estimate the rows of the separating matrix and the columns of the mixing matrix, (i) independently and in parallel, (ii) consecutively or (iii) simultaneously. Simulation results in different scenarios such as additive noise, ill‐posed mixing matrix, and high‐dimensional data demonstrate the effectiveness of the proposed method relative to state‐of‐the‐art JD methods. The authors also propose an approach to omit the effect of outlier data, which severely degrades parameters estimation. The proposed approach can be used in JD algorithms to improve their performance in the presence of outlier data. [ABSTRACT FROM AUTHOR]

Objective: This study compared the stone opacity effect in patients who had radiopaque and radiolucent stones in percutaneous nephrolithotomy (PCNL) results. Material and methods: The medical records of 171 complete supine PCNL procedures were gathered. Patients were categorized into two groups: those with radiopaque (n=141) and those with radiolucent (n=30) stones. Kidney, ureter and bladder x-ray was done a day after PCNL and Ultrasound imaging was done two weeks later to evaluate the stone free rate. A stone free result was defined as having less than 4 mm residual stone size. Outcome parameters were compared by univariate analysis and those which were significantly different between the two groups were assessed by multivariate binary logistic regression analysis. Results: There were no significant differences in age, sex, body mass index, hypertension, diabetes mellitus, pre-surgery hemoglobin, pre-surgery serum creatinine, stone and also surgery-related parameters between the two groups. Stone free rate, surgery time, complication-related parameters, hemoglobin drop, serum creatinine and glomerular filtration rate (GFR) changes were similar in both groups based on univariate analysis. The radiopaque group had higher post-surgery GFR (p=0.04) and longer hospital stay (p=0.009). However, opacity had no effect on these outcomes after multivariate analysis. Higher post-surgery GFR was seen in patient with higher GFR before surgery (p<0.0001). Also, higher hemoglobin before surgery was correlated with less hospital stay (p=0.001). Conclusion: The complete supine percutaneous nephrolithotomy outcomes are similar in patients with radiopaque and radiolucent stones. [ABSTRACT FROM AUTHOR]

Bladder squamous cell carcinoma (SCC) may lead to gross hematuria. However, the metastasis of head and neck cutaneous SCC to the urinary bladder has not been described in literature. Nowadays, noninvasive methods such as embolization, are considered as an appropriate choice for controlling life-threatening hematuria in patients with high operative risk. However, few reports exist on the effectiveness of this approach in managing the hematuria secondary to metastatic bladder SCC. Here we report a case of bladder SCC originating from the forehead cutaneous SCC. An 83-year-old man, a known case of forehead cutaneous SCC with distant metastasis, referred to our clinic with a chief complaint of hematuria. Pathology confirmed the diagnosis of metastatic urinary bladder SCC. Angiography and embolization were undertaken and resulted in complete alleviation of the symptoms. The recurrence of hematuria or embolization-related complications were not observed during 3-month follow-up. Selective embolization of the bilateral internal iliac artery is a safe and efficient procedure for controlling severe hematuria in patients with primary or metastatic bladder SCC. [ABSTRACT FROM AUTHOR]

Urinary lithiasis in transplanted kidney is a relatively uncommon complication. However, it may lead to a significant morbidity and loss of renal function. The report presents the case of a 32-year-old male renal-transplant recipient, with a stone in renal pelvis who was treated successfully by tubeless percutaneous nephrolithotomy (PCNL). The patient is currently stone free with no complication. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed, it could be noticed that PCNL is a safe and feasible procedure for treating nephrolithiasis in a transplanted kidney. [ABSTRACT FROM AUTHOR]

Background and Purpose: Operative time influences surgical outcomes, operation-related and indirectly anesthesia-related complications. We investigated variables that affect operative time during percutaneous nephrolithotomy (PCNL) with the complete supine position. Patients and Methods: We reviewed data of 120 patients who underwent complete supine PCNL by one surgeon. Correlation between age, sex, body mass index (BMI), preoperative serum creatinine and hemoglobin levels, history (stone surgery, shockwave lithotripsy (SWL), hypertension, diabetes), stone (side, opacity, burden, complexity), imaging for access, calix for access, number of tracts, and tubeless approach with operative time were assessed by univariate and multivariate statistical tests. Results: Mean operative time was 60.62±30.70 minutes. In univariate analysis, age, sex, groups of BMI, hypertension, diabetes, previous stone surgery and SWL, stone opacity, operation side, number of tracts, and tubeless approach had no effect on operative time. BMI ( P=0.029, negative correlation), stone burden ( P=0.001, positive correlation), imaging for access ( P=0.001, fluoroscopylower>middle) and probably complex stones ( P=0.057, complex>noncomplex) were effective factors on operative time. Multiple linear regression revealed association between BMI ( P=0.000, negative correlation), stone burden ( P=0.005, positive correlation), imaging for access ( P=0.000, fluoroscopy

Objective: We evaluated the effect of terazosin in the improvement of lower urinary tract symptoms and flank pain in patients with internal ureteral stents. Methods: In this double-blind randomized clinical trial, 73 patients with unilateral ureteral stone and hydroureteronephrosis who underwent insertion of an internal ureteral stent after transureteral lithotripsy (TUL) were randomized into two groups. 37 patients received terazosin 2 mg (once nightly) for 4 weeks and 36 patients received placebo for the same time duration. After 4 weeks, all patients were asked about the incidence of frequency, nocturia and urgency by an International Prostate Symptom Score (IPSS) questionnaire, flank pain and pain during urination by a visual analog scale (VAS) score, and hematuria. Results: The mean VAS score was 2.21 in the terazosin group compared with 4.93 in the control group (p < 0.001). Nearly all the patients in the placebo group reported flank pain during urination but this was only reported in 54.5% of the patients in the terazosin group (p < 0.001). All criteria measured by the IPSS in the terazosin group were significantly lower than those in the placebo group (p = 0.0001). Conclusions: Administration of terazosin for patients with an internal ureteral stent relieved some stent-related symptoms such as flank pain, pain during voiding, frequency, nocturia and urgency, but had no effect on hematuria. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Poor ovarian response and diminished ovarian reserves (DOR) significantly contribute to female infertility. Previous attempts have been made to enhance follicular growth and improve pregnancy outcomes in these participants. Objective: This study aimed to assess the efficacy of the in vitro drug-free activation technique of the ovarian reservation and in vitro fertilization stimulation cycle outcomes in DOR participants. Materials and Methods: This pilot phase study investigated the impact of in vitro activation (IVA) on ovarian reservation and in vitro fertilization outcome in 10 infertile women with DOR from May to December 2023 at Taleghani Infertility Center, Tehran, Iran. Participants underwent general surgery and laparoscopy, involving the removal of a portion of one ovary, immediate transfer to the laboratory, dissection into small cubes, and subsequent re-implantation into the cases's ovary. The primary outcomes, include the count of retrieved oocytes, the number of oocytes reaching metaphase, and the secondary outcomes were the quantity and the number of embryos transferred, implantation rate, and occurrence of clinical pregnancy. Results: The study revealed a significant increase in the antral follicle count before and after IVA (p = 0.033). Before IVA, the median estradiol level was 93.5 (57.0), which reduced to 79.0 (35.0) after IVA, indicating a statistically significant difference. On average, 2.3 (0.8) oocytes were retrieved, among which 1.5 (0.7) were metaphase II oocytes. The observed pregnancy rate among the 2 cases was 22.2%. Conclusion: The current study suggests that IVA may positively impact follicular growth and pregnancy outcomes among women with DOR. [ABSTRACT FROM AUTHOR]

Background: Several medical therapies have been proposed for the treatment of premature ejaculation (PE). Paroxetine and tramadol were both reported to be effective in treatment of PE. In this study, the therapeutic effects of tramadol, paroxetine and placebo were compared in treatment of primary PE. Methods: In this randomized, double-blind, placebo-controlled clinical trial, 150 patients were divided into 3 groups. One group was treated with tramadol 50 mg ondemand, the other group took paroxetine 20 mg on-demand and the third group was treated with placebo. Before starting treatment and after 12 weeks, patients were asked to measure their average intravaginal ejaculation latency time (IELT) and fill the PEP (Premature Ejaculation Profile) questionnaire. Results: At the end of the 12th week, the mean IELT and average of PEP scores improved in all 3 groups. The increase in tramadol group was significantly higher than the paroxetine and placebo groups (p<0.0001). There were no significant differences in terms of side effects between the 3 groups. Conclusion: The results showed that despite an increase in mean IELT and PEP scores in all 3 groups, the rate of improvement in tramadol group was significantly more than the others. Thus, tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE. [ABSTRACT FROM AUTHOR]

Purpose: To compare outcomes and complications of percutaneous nephrolithotomy (PCNL) in the complete supine versus semi supine position in order to select the best position. Materials and Methods: In this clinical trial, between July 2011 and May 2014, a total of 44 patients who presented for PCNL were prospectively enrolled and randomly divided into 2 groups [complete supine (n=22), and semi supine (n = 22)]. The results in both positions were compared regarding the complexity and outcomes. Stone free rate was considered as a main target of the study. However, it was the first study to focus on overlapping the vertebral density during the access. Results: The two groups were comparable in age, gender, body mass index, and preoperative glomerular filtration rate, hemoglobin and creatinine. The mean operative time was significantly shorter for complete supine versus semi supine (36.68 ± 14.12 min versus 47.50 ± 16.45 min, P = .024). At the angle of 0°, overlapping with the spine occurred in 7 patients (31.8%) in semi supine group and just in 1 patient (4.5%) in complete supine group. Also, overlapping with the edge of bed occurred in 10 cases (45.5%) of complete supine and 1 (4.5%) of semi supine; the differences were statistically significant (P = .023, P = .002, respectively). No significant difference was found between the two groups in terms of stone free rate and complications. Conclusion: Although, we had to convert two cases from semi supine into the complete supine position but we have demonstrated that PCNL in both positions is safe, effective and suitable for the patients. The stone free rate was similar in both groups. But the complete supine position is associated with a significantly shorter postoperative hospital stay and operative time, which may improve ease and safety of PCNL for patients. [ABSTRACT FROM AUTHOR]

Background: Estimating prostate volume using less invasive transabdominal ultrasonography (TAUS) instead of transrectal ultrasonography (TRUS) is of interest in terms of identifying their agreement level. Previous reports on this subject, applied general correlation coefficient as the level of agreement. This study uses Bland-Altman method to quantify TAUS and TRUS agreement on estimating prostate volume. Methods: Total prostate gland volume of 40 patients with signs and symptoms of benign prostatic hyperplasia were measured using TAUS and TRUS. The study was carried out at the Urology Research Center, Razi Hospital, Guilan University of Medical Sciences (Rasht, Iran) from March to October 2010. Both methods were performed in one session by the same experienced radiologist. Data were analyzed using Pearson correlation coefficient and Bland-Altman method. Results: Total prostate volume estimated by TAUS and TRUS were 50.30±23 and 50.73±24.6 mL, respectively. The limits of agreement for the total prostate volume were -6.86/9.84 that was larger than predefined clinical acceptable margin of 5 mL. Conclusion : There is a lack of agreement between TAUS and TRUS for estimating the total prostate volume. It is not recommended to apply TAUS instead of TRUS for estimating prostate volume. [ABSTRACT FROM AUTHOR]

Purpose: To determine the frequency of human leukocyte antigen (HLA)-B5 in patients with bladder cancer compared with normal population.Materials and Methods: In this cross sectional study, from November 2009 until November 2010, 35 patients with pathologic diagnosis of bladder cancer who referred to urology clinic of Razi Hospital were studied. Also, 130 healthy transplant donation volunteers who referred for HLA-typing to Guilan Blood Transfusion Organization, were selected. Inclusion criterion was pathologic diagnosis of bladder cancer regardless of stage and grade of tumor. Exclusion criteria were presence of other urologic diseases. The information of these cases was extracted from medical records, collected and analyzed.Results: HLA-B5 was positive in 34.3% of the patient group and in 39.2% of the controls. Statistical analysis showed no significant association between HLA-B5 and bladder cancer (P = .15). There were no significant differences between grade (P = .107) and relapse (P = .327)of bladder tumor with presence of HLA-B5.Conclusion: There was no significant association between HLA-B5 and bladder cancer. The grade and the relapse of tumor had no association with presence or absence of HLA-B5. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 52-year old man with multiple stones in the kidney. He underwent ureteral catheterization and change the position of his leg for a complete supine position. It highlights the differences between the complete supine position and the prone position for percutaneous nephrolithotomy (PCNL) for a better access to the airway of the patients. It notes that the anaesthesia time in the supine position is shorter than the prone position.

Inguinal bladder hernia is a rare clinical condition, with 1-3% of all inguinal hernias involving the bladder. Any portion of the bladder may herniate, from a small portion or a diverticulum to most of the bladder. We present a 55-year-old male with an intermittent right scrotal mass of 6 months' duration. The mass lesion protruded through the right inguinal canal before voiding and reduced after that. Scrotal sonography revealed a hypoechoic lesion in the scrotum that stretched cranially to the intra-abdominal portion of the bladder. Excretory urography showed a duplicated system in the left kidney and deviation of the left orifice to the right side of the trigon. Finally, cystography illustrated herniation of the bladder to the right scrotum. Surgical repair of the hernia was done with mesh. Follow-up cystography one month postoperatively revealed no herniation. [ABSTRACT FROM AUTHOR]

Empty follicle syndrome is a rare condition characterized by failure to retrieve oocytes despite repeated careful aspiration of mature precursor follicles during controlled ovarian stimulation. This report presents a case of empty follicle syndrome in a patient with polycystic ovary syndrome using a gonadotropin-releasing hormone agonist as a trigger for final oocyte maturation. No oocytes were retrieved from the right ovary and the procedure was discontinued. The patient was administered an injection with 10,000 units of HCG and 3 oocytes were obtained after 24 hours. All oocytes were mature (MII); fertilization was performed with sperm from the patient's husband resulting in 3PN zygotes. The formation of 3PN zygotes from ICSI might be due to oocyte cytoplasmic disorders caused by long-term exposure to gonadotropins and increased duration of stimulation. Although our patient had false empty follicle syndrome and the hCG rescue protocol led to the retrieval of oocytes, the oocytes were not of good quality. As previously described, empty follicle syndrome is not a predictor of success in subsequent cycles. Our patient's next cycle was uneventful.

Purpose: Detecting prostate cancer, developing therapeutic plans after negative biopsies, and prognosis-based patient counseling can be challenging for many urologists dealing with prostate cancer-specific antigens. New Biomarkers advances made improvement for prediction of responses to therapeutic option and can tell us about survival and recurrence. In this review, we have assessed current and upcoming biomarkers that are opening a new era in diagnosing the disease., Materials and Methods: We conducted a comprehensive literature review of studies describing prostate cancer biomarkers. Two independent investigators searched PubMed, Embase, Web of Science, and Cochrane Databases to identify biomarkers in prostate cancer conducted a literature review., Results: Recently, combining prostate cancer-specific biomarkers into a single test has gained increasing attention, especially since the introduction of genomic and molecular tools. The development of the Prostate Health Index (PHI), SelectMDx, and Confirm MDx have shown promising results for prostate cancer detection, in addition to risk stratification and biopsy avoidance., Conclusion: Despite major improvements and innovations in prostate cancer biomarkers, application in current clinical practice is limited. However, these biomarkers have an important role in determining risk, preventing unnecessary prostate biopsies, and predicting prognoses. Additional confirmatory studies will be needed to fully understand the impact of prostate cancer-specific biomarkers.

Purpose: To compare the effects of tadalafil, tamsulosin, and placebo as a medical expulsive therapy (MET) for distal ureteral calculi., Materials and Methods: This prospective randomized double-blind clinical trial was conducted on 132 renal colic patients with distal ureteric stones (≤10mm) over a period of 12 months. Patients were randomly divided into three groups. Patients in group A received tamsulosin 0.4mg, in group B received tadalafil 10mg, and in group C received placebo. Therapy was given for a maximum of 4 weeks. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded., Results: Demographic profiles were comparable between the 3 groups. Although the stone expulsion rate in group A (72.7%) was higher in comparison to group B(63.6%) and group C(56.8%), it was not considered statistically significant (P=0.294). Shorter mean time to stone expulsion was significantly observed in group A (17.75±75), than group B(21.13±1.17) and group C(22.25±1.18) (P=0.47). The mean number of analgesic use was 9.8±5.09 days in group A, 14.6±7.9 days in group B, and 12.6±22.25 days in group C, this difference was significant (P=0.004). The analgesic requirement (doses of NSAIDs and pethidine) in group A was significantly lower than other groups (P< 0.05). Also, patients in group A reported fewer headaches compared to other groups (P=0.011)., Conclusion: Tamsulosin as medical expulsive therapy is more effective for distal ureteric stones with less need for analgesics and less stone expulsion time than tadalafil., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Background: Many medical therapies have been tested to deal with urinary stent-related symptoms (USRS). Several preventive and pharmaceutical methods have been already used for better compatibility of stents. However, the existing evidence for pharmacological treatment is still controversial. This study aims to evaluate the effects of pregabalin, solifenacin, and combination therapy on ureteral double-J stent-related symptoms following ureteroscopy and transureteral lithotripsy (TUL)., Materials and Methods: In a randomized controlled clinical trial, from November 2017 to March 2019, 256 patients who underwent ureteroscopy were enrolled. Patients were randomly divided into four groups including: group A received pregabalin 75mg BID (twice daily), group B received solifenacin 5mg orally once daily, group C received combination of pregabalin and solifenacin and the group D (control) given no drugs., Results: One hundred and fifty-one (58.9%) males and 101 (41.1%) females were enrolled in this study with a mean age of 43.47±7 (p=0.32, p=0.67). USSQ domains score such as urinary symptoms, pain, general condition, work performance, sexual matters and additional problems were significantly differenced during second and fourth week of follow-up among study groups (p <0.0001). In Tukey's multiple comparison test, urinary symptoms (p=0.735), pain (p=0.954) and sexual matters (p=0.080) in second week and work performance in forth week in group B was not significantly better than group D. Only group C in all indexes of USSQ showed significantly beneficial effects over group D (p <0.0001)., Conclusion: Combination therapy of pregabalin and solifenacin has a significant effect on stent-related symptoms and is preferred over monotherapy of the respected medications., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Background: High incidence of premature ventricular contractions (PVCS) and arrhythmia during and soon after dialysis have been demonstrated by Holter monitoring., Objectives: In this study, the effects of dialysis and renal transplantation on Tpe, Tpec (corrected Tpe), QTc (corrected QT), QTd (QT dispersion), and Tpe/QT parameters as known factors in arrhythmogenicity, and also the correlation between electrolyte and arterial blood gas changing within these parameters will be assessed., Patients and Methods: In a retrospective study, 42 renal transplant recipients were selected. Under the supervision of an electrophysiologist, information related to Tpe, Tpec, Tpe/QT, QTd, and QTc parameters before dialysis (pre-HD), after dialysis (post-HD), and two weeks after transplantation (RTX) were analyzed. Electrolyte and arterial blood gas information were also recorded. Bonferroni adjustment, repeated measures ANOVA, generalized linear models, and generalized estimating equations were used for analysis., Results: Two weeks after transplantation, the mean Tpe decreased to 0.052 ± 0.002, which was significant compared to pre-HD (P < 0.001) and Post-HD (P = 0.019). The mean Tpec was 0.059 ± 0.002, which, just in comparison to pre-HD, was significant (P = 0.005). In addition, the mean Tpe/QT decreased to 0.143 ± 0.005, which was significant compared to pre-HD (P = 0.018). The mean QTd was 0.066 ± 0.004, which wasn't significant compared to before or after dialysis. The mean QTc decreased to 0.386 ± 0.004, which was significant compared to post-HD (P = 0.0003)., Conclusions: Taking the role of Tpe and Tpe/QT in arrhythmia into account and amending it by a successful transplantation can be considered as a factor that decreases arrhythmia after renal transplantation compared to ESRD patients.

Isolated renal hydatid disease is a rare endemic infestation caused by larval form of Echinococcus granulosus. Hydatiduria is an uncommon presentation of renal hydatid disease. In 2012 a 34-year-old female referred to Razi Hospital, Rasht, Iran with complaints of right flank pain and grape-like material in urine. Diagnosis was made by ultrasonography and CT scan. The patient was treated surgically with nephrectomy in combination with perioperative chemotherapy with albendazol.

Background: Estimating prostate volume using less invasive transabdominal ultrasonography (TAUS) instead of transrectal ultrasonography (TRUS) is of interest in terms of identifying their agreement level. Previous reports on this subject, applied general correlation coefficient as the level of agreement. This study uses Bland-Altman method to quantify TAUS and TRUS agreement on estimating prostate volume., Methods: Total prostate gland volume of 40 patients with signs and symptoms of benign prostatic hyperplasia were measured using TAUS and TRUS. The study was carried out at the Urology Research Center, Razi Hospital, Guilan University of Medical Sciences (Rasht, Iran) from March to October 2010. Both methods were performed in one session by the same experienced radiologist. Data were analyzed using Pearson correlation coefficient and Bland-Altman method., Results: Total prostate volume estimated by TAUS and TRUS were 50.30±23 and 50.73±24.6 mL, respectively. The limits of agreement for the total prostate volume were -6.86/9.84 that was larger than predefined clinical acceptable margin of 5 mL., Conclusion: There is a lack of agreement between TAUS and TRUS for estimating the total prostate volume. It is not recommended to apply TAUS instead of TRUS for estimating prostate volume.

Objective: To compare the outcomes of bipolar transurethral vaporization of the prostate (TUVP) with bipolar transurethral resection of the prostate (TURP)., Materials and Methods: In a prospective randomized trial, 88 patients with moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) underwent bipolar TUVP (N = 39) or bipolar TURP (N = 49) from October 2010 to November 2011. The inclusion criteria were age > 50 years, prostate volume of 30-80 mL, serum PSA < 4 ng/mL, IPSS ≥ 20, Qmax ≤ 10 mL/s and failed medical therapy. The perioperative and postoperative outcomes were evaluated and the IPSS and Qmax were assessed preoperatively and 3 months after procedure in all cases., Results: Both groups were similar in patient age, prostate volume, preoperative IPSS and Qmax. The TUVP group had significantly lower mean values of operative time, hospital stay, catheterization period, irrigation fluid volume and serum hemoglobin, creatinine, sodium and potassium changes compared with TURP group. No significant differences were seen between two groups regarding complications (TUVP = 10.3%; TURP = 12.2%) and modified Clavien classification of complications. No TUR syndrome, obturator reflex or epididymitis occurred in both groups. Re-hospitalization and transfusion due to clot retention (N = 2) and urethral stricture (N = 1) were reported only in the TURP group. Three patients experienced urinary retention after catheter removal in the TUVP group. Two patients were re-catheterized temporarily and one patient required repeat bipolar TUVP. Three months after surgery, two groups had significant improvement in IPSS and Qmax. But the TUVP group had significantly lower IPSS and higher Qmax than TURP group., Conclusions: Bipolar TUVP is a safe, effective and low cost procedure among minimally invasive surgeries of BPH. Compared with bipolar TURP, the bipolar TUVP had similar complications, better perioperative and postoperative outcomes, superior hemostasis and higher efficacy.

Purpose: To determine the frequency of human leukocyte antigen (HLA)-B5 in patients with bladder cancer compared with normal population., Materials and Methods: In this cross sectional study, from November 2009 until November 2010, 35 patients with pathologic diagnosis of bladder cancer who referred to urology clinic of Razi Hospital were studied. Also, 130 healthy transplant donation volunteers who referred for HLA-typing to Guilan Blood Transfusion Organization, were selected. Inclusion criterion was pathologic diagnosis of bladder cancer regardless of stage and grade of tumor. Exclusion criteria were presence of other urologic diseases. The information of these cases was extracted from medical records, collected and analyzed., Results: HLA-B5 was positive in 34.3% of the patient group and in 39.2% of the controls. Statistical analysis showed no significant association between HLA-B5 and bladder cancer (P = .15). There were no significant differences between grade (P = .107) and relapse (P = .327)of bladder tumor with presence of HLA-B5., Conclusion: There was no significant association between HLA-B5 and bladder cancer. The grade and the relapse of tumor had no association with presence or absence of HLA-B5.

Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention., Materials and Methods: In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant., Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups., Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

Background: Middle calyx access has been underused in percutaneous nephrolithotomy (PCNL), especially in the supine position. We compared the safety and efficacy outcomes between middle calyx and lower calyx accesses in the complete supine PCNL in a non-randomized single-surgeon clinical study., Methods: Between February 2008 and October 2011, 170 patients underwent posterior subcostal single tract complete supine PCNL with one-shot dilation and middle calyx (n = 48) and lower calyx (n = 122) accesses. Stone location and surgeon decision determined target calyx for access. Inclusion criteria were pelvis stones, staghorn stones and multiple location stones. Exclusion criteria were renal anomalies, only upper calyx stones, only middle calyx stones and only lower calyx stones. Important parameters were compared between the two groups. A p value of <0.05 was considered significant., Results: Two groups were similar in important patient- and stone-related parameters. Mean operative time (60.7 minutes), mean postoperative hospital stay (1.84 days) and mean hemoglobin drop (0.67 g/dL) in the middle calyx group were significantly lesser than in the lower calyx group (80.1 minutes, 2.19 days, 1.36 g/dL). The middle calyx group (89.6%; 79.6%) had a higher stone-free rate (p = 0.054) and efficiency quotient than the lower calyx group (76.2%; 61.6%). In the middle calyx group (10.4%; 2.1%), complication and transfusion rates were lesser (p > 0.05) than lower calyx group (14.8%; 7.4%). No significant difference (p = 0.40) was seen between two groups using the modified Clavien classification of complications., Interpretation: Middle calyx can be an optimal access in PCNL with the complete supine position for many of upper urinary tract stones due to its superior outcomes.