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Background: Radical cystectomy (RC) with urinary tract reconstruction currently remains the gold standard treatment for invasive bladder cancer. RC associated with many com-plications, postoperative ileus is the most common one which lead to increasing length of hospital stay. Multiple perioperative care plans was put aimed to decrease POI.Aim of Study: Evaluation of the different factors that can help to accelerate recovery of intestinal motility after radical cystectomy and urinary diversion in order to decrease the length of hospital stay.Patients and Methods: A total of 37 patients who under-went radical cystectomy with urinary diversion using intestinal segments were divided into 2 groups. In group A (n=23), our new protocol of perioperative preparation applied, in group B (n=14) classic way of perioperative preparation applied. The main differences between both ways are one day intestinal preparation with use of fortrans preoperative, anal dilatation intraoperative and chewing gums postoperative.Results: There was statistical significance in first intestinal sound first passage of flatus, beginning of soft diet, time to regular diet and hospital stay in favor of group A as compared to the group B (p-value

Aging is associated with a series of morphological and functional modifications that leads to reduced physiological efficiency and atrophy of various organs and systems. Tribulus terrestris induces its effect in fertility and sexual functions through the steroidal saponins, particularly the dominant saponins protodioscin. We aimed in this study to evaluate the efficacy and safety profiles of Tribulus terrestris in aging males with partial androgen deficiency who suffered from erectile dysfunction and lower urinary tract symptoms. A total of 70 randomized aging patients with erectile dysfunction and lower urinary tract symptoms were recruited from June 2017 to March 2018 from our andrology outpatient clinic. Thirty-five patients (group A) received Tribulus terrestris three times daily for 3 months and the other 35 patients (group B) received placebo. The mean of aspartate transaminase was elevated in group A after 3 months of receiving Tribulus terrestris (26.5 (before), 27.8 (after), respectively, p = 0.03). Moreover, there were significant elevations in the means of both total testosterone together with the score of the validated Arabic index of erectile function (5-item version of the International Index of Erectile Function) (2.2, 10.7 (before), 2.7, 16.1 (after), p

Congenital anomalies of the male urogenital tract include a variety of structural abnormalities. These abnormalities could affect either the male external genitalia, internal genitalia or both. Congenital anomalies of the vas deferens are rare and may include unilateral or bilateral (agenesis, atresia, duplication, ectopy or diverticulum) that could be complete or segmental. In addition, they may be isolated anomalies of the vas deferens or may be associated with other congenital anomalies elsewhere especially in the male urogenital tract. Those anomalies may be discovered during genital examination (either clinically or radiologically) or even during inguinal surgeries as in hernia repair, vasectomy, orchiopexy and varicocelectomy. Thus, proper evaluation should be made for the cases of duplicated vas deferens to avoid the accidental injury during the operation and to exclude other associated congenital anomalies. Besides that, the undiagnosed cases may lead to failure of vasectomy procedure. Here, we report a case of duplication of the vas deferens in a 33-year-old male that was accidentally discovered during spermatic cord dissection for varicocelectomy.

Na+, K+-ATPase is a ubiquitous membrane enzyme that plays an important role in maintaining neuronal excitability, ionic homeostasis and cell survival. Although failure of the Na+, K+-ATPase pump has been implicated in the pathophysiology of a variety of neurological conditions, the timeline and precise sequence of events at the cellular and subcellular levels that follow failure of the pump remain elusive, particularly in the in vivo environment. To this end, we developed an animal model and a set of fluorescence-based cell tagging methods during this thesis research. The methodology involves stereotactically coinfusing the Na+, K+-ATPase pump blocker, ouabain with a set of fluorescent tags into the hippocampal dentate gyrus. These fluorescent tags, by undergoing fluorescence enhancement upon binding to specific subcellular targets, therefore allow the probing of subcellular dynamics in vivo following inhibition of the Na+, K+-pump. Based on this original methodology, we describe several novel types of tissue injury in the rat dentate gyrus following pump failure, which can be summarized as follows: (1) Pump inhibition results in an increase in membrane porosity that occurs as early as the 1-hour time point. Furthermore, pump inhibition enhances uptake of the lipophilic probe, DiI into plasma membranes of dentate granule cells. This increase in DiI incorporation is associated with the appearance of reactive changes characterizing early neuronal injury. Our results suggest that pump inhibition leads to an early increase in membrane permeability followed by a change in membrane phospholipid structure. (2) Pump inhibition triggers a form of cell death with "mixed" apoptotic and necrotic features. The broad-spectrum K+ channel blocker, charybdotoxin is capable of significantly attenuating the neuronal damage associated with inhibition of the Na+, K+ pump, indicating that loss of intracellular K+ plays an important role in cell death associated with pump inhibition. (3) We describe a novel tissue response whereby pump inhibition triggers the appearance of a radial glia-like cell population that undergoes time-dependent cell dispersion and rearrangement. (4) We found that pump inhibition can simultaneously trigger cell death as well as upregulate progenitor cell proliferation. Migration of such newly born progenitor cells was also enhanced towards areas of cell injury and tissue damage. We suggest that such a host of tissue responses may represent an early endogenous attempt at restoring tissue structural integrity, through the enhancement of proliferation and migration of neural precursor cells as well as re-expression of the radial glial scaffold necessary for progenitor cell migration. The experimental data reported in this thesis may therefore have important implications in the future development of therapeutic strategies aimed at restoring tissue structural integrity and possibly functional outcome following central nervous system injury.