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Background & Objective: As bleeding is a serious complication during and after hysterectomy, this paper aims to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy. Materials & Methods: In the present clinical trial, 46 patients who were candidates for abdominal hysterectomy in Hajar Hospital in Shahrekord, were randomly divided into two groups. In group A, superficial cauter and Surgicel were used and in group B, superficial cauter and ChitoHem were used to control bleeding. Hematocrit and hemoglobin levels were determined before, and six and 12 hours after surgery. Drain discharge volume, time to stop bleeding and bleeding volume were also determined. The pain was determined by the VAS scale at the time of recovery, 48 hours postoperatively, and one and three months postoperatively. Data were analyzed by SPSS statistical software. Results: Based on repeated-measures test, the mean of hemoglobin in the studied times showed a significant difference, so that in six and 12 hours after surgery they were significantly less than the ones before surgery, but their mean was not significantly different between the two groups. The mean pain score one month after surgery in group B was significantly lower than group A (P <0.001). The mean volume of drainage and clotting time in group B were significantly lower than group A (P <0.01). The mean volume of intraoperative bleeding, the frequency of vaginal bleeding and cuff-related complications were not significantly different in the two groups. Conclusion: The results of the present study show that ChitoHem is probably effective in reducing bleeding during hysterectomy surgery. [ABSTRACT FROM AUTHOR]

Aim: To compare the acute radiation-induced bowel and bladder toxicities of two hypofractionated radiotherapy (HFRT) regimens in localised prostate cancer (PCa). Materials and methods: This trial consists of patients with histologically confirmed stage T1-T3aN0M0 PCa, a prostate-specific antigen concentration of 40 ng/mL or lower, and Eastern Cooperative Oncology Group performance status of 0–2. Participants were randomly assigned (1:1) to 56 Gy in 16 fractions over 4 weeks (arm A) or 70·2 Gy in 26 fractions over 5 weeks (arm B). Acute bowel and bladder toxicities were assessed using Radiation Therapy Oncology Group criteria. Results: Between June 2018 and December 2019, 40 patients were randomly assigned to treatment with 4-week (n = 20) and 5-week HFRT (n = 20). In the third month after completion of radiotherapy, the cumulative incidence of acute bowel and bladder toxicities of arms A and B was 20 versus 5% and 70 versus 85%, respectively. The cumulative incidence of grade 2 or worse bowel and bladder toxicities of the 5-week regimen was non-inferior to 4-week HFRT [bowel toxicity: 5% (arm A) versus 5% (arm B), bladder toxicity: 50% (arm A) versus 60% (arm B), p = 0·52). Findings: The 5-week regimen of HFRT is non-inferior to 4-week HFRT in terms of acute bowel and bladder toxicities. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the efficacy of transvesical open prostatectomy (OP) compared with transurethral resection of the prostate (TURP) in patients with benign prostate hyperplasia (BPH) with a prostate weight of 40-65 grams. The short-term and long-term complications of these two procedures were also assessed.Materials and Methods: In this retrospective study, we included 160 consecutive patients with BPH who had undergone TURP (n=80) or OP surgery (n=80) from 2006 to 2017. Inclusion criteria were positive history of BPH, definite indication for prostatectomy, and prostate weight between 40 to 65 grams. Patients were evaluated for duration of hospitalization, need for re-operation, short-term and long-term postoperative complications, urinary flow rate, peak flow rate (Q max) and international prostate symptom score (IPSS).Results: The mean age ± Standard Deviation (SD) of patients' age was 62.4 ± 3.7 and 67.2 ± 4.6 years in the TURP and OP groups, respectively. Four (5%) and seven (8.7%) patients required transfusion in the TURP group and OP groups, respectively. Dysuria was significantly more frequent in the TURP group from week two to 12 months after surgery as compared with the OP group (P < .001). Hemodynamic changes and decrease in serum sodium level were not reported in either group. However, the urinary retention and need for urinary catheterization in the first year was significantly different between the two groups with 10 cases (12.5%) in the TURP group and no cases in the OP group (P<0.001). The need for reoperation in the TURP group was reported (27 procedures on 19 patients) (33.7%) of patients. Furthermore, retrograde ejaculation (RE) was reported in 65 (81.2%) and 80 patients (100%) of the TURP and OP group, respectively.Conclusion: Despite the fact that TURP is the standard method of treatment for BPH when the prostate weighs between 40-65 grams, the results of our study showed that OP is a more efficient and safe surgery for these patients and is associated with less complications. Furthermore, the need for re-operation seems to be higher in patients with TURP. [ABSTRACT FROM AUTHOR]

Context: Coactivation of abdominal and pelvic-floor muscles (PFM) is an issue considered by researchers recently. Electromyography (EMG) studies have shown that the abdominal-muscle activity is a normal response to PFM activity, and increase in EMG activity of the PFM concomitant with abdominal-muscle contraction was also reported. Objective: The purpose of this study was to compare the changes in EMG activity of the deep abdominal muscles during abdominal-muscle contraction (abdominal hollowing and bracing) with and without concomitant PFM contraction in healthy and low-back-pain (LBP) subjects. Design: A 2 × 2 repeated measures design. Setting: Laboratory. Participants: 30 subjects (15 with LBP, 15 without LBP). Main Outcome Measures: Peak rectified EMG of abdominal muscles. Results: No difference in EMG of abdominal muscles with and without concomitant PFM contraction in abdominal hollowing (P = .84) and abdominal bracing (P = .53). No difference in EMG signal of abdominal muscles with and without PFM contraction between LBP and healthy subjects in both abdominal hollowing (P = .88) and abdominal bracing (P = .98) maneuvers. Conclusion: Adding PFM contraction had no significant effect on abdominal-muscle contraction in subjects with and without LBP. [ABSTRACT FROM AUTHOR]

Canthariasis is a human disease caused by infestation of beetle larvae. We report here an unusual cause of urogenital infection due to Tenebrio molitor in a 10-year-old boy suffering from severe and intermittent suprapubic pain from Nehbandan City, Northeastern Iran in 2018. After 9 months, three larvae were excreted. Keratinization of bladder wall was observed in histopathology. All laboratory evaluations were normal except for presence of microscopic hematuria. This report implicated that T. molitor could infest bladder accidentally and cause canthariasis and clinical symptoms that may lead to severe pain and bladder inflammation and hyperemia. [ABSTRACT FROM AUTHOR]

Hydatidosis is an important zoonotic parasite disease in several herbivorous mammals. Human cystic echinococcosis (CE) caused by infection with larval stage of Echinococcus granulosus has been frequently reported from different organs. Here, we report the first case of a urinary echinococcosis in Iran with a pain in the lower left abdominal quadrant and severe frequent urination (pollakiuria). We detected a cyst 120 x 15 mm dimensions with heterogeneous mass contain fluid in the back of the urinary bladder neck between the umbilical region and external urethral sphincter. The patient was candidate for open-abdomen surgery and cysts were resected. The isolated cysts from liver and urinary bladder were referred to pathology laboratory, and the tissue sections were stained with Tri-chrome and Hematoxylin/eosin staining methods. Microscopic examination of prepared tissue sections showed protoscoleces of E. granulosus with specific and thick laminated hyaline layer (non-cellular membrane), with covers the thin activate germinal epithelium, which revealed the diagnosis of a hydatid cyst. This rare case illustrates that CE is the necessity of considering in the differential diagnosis from cysts, abscesses, malignant and benignant tumors, especially is essential in endemic areas of CE. [ABSTRACT FROM AUTHOR]

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Introduction: Urinary system malignancies are considered as one of the main public health concerns with high morbidity and mortality. These cancers have various patterns in different regions over time. This study aims to determine the incidence of these malignancies in the northern part of Iran (Mazandaran Province). Materials and Methods: This cross-sectional study carried out among patients with urologic cancers in 2014. A population-based cancer registry in Mazandaran University of Medical Sciences was the source of information. Stata software version 14 was applied for descriptive statistics and analysis. The WHO standard population was used for estimating the age and sex-standardized incidence of urologic cancers. Results: In 2014, 261 patients with cancers of the urinary system have been registered in Mazandaran Province, northern Iran. Mean, standard deviation, minimum, and maximum age of patients were 64.4, 15.6, 1, and 94, respectively. More than two-thirds of patients aged over 60 and most of them were male. The standardized incidence of cancers of the bladder, kidney, ureter, and other parts of the urinary system among men was estimated as 7.98, 1.54, 0.05, and 0.3 per 100,000, respectively. The standardized incidence of cancers of the bladder, kidney, pelvis, and ureter among women were 0.09, 0.14, 0.09, and 0.39, respectively. Conclusion: The majority of urologic cancers in the northern part of Iran are among men and those aged over 60. Moreover, bladder and renal cancers are the most common cancers in both genders. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the association between the overexpression of tumor protein (P53), cytokeratin 20 (CK20), fibroblast growth factor receptor 3 (FGFR3), biomarkers and the grading, prognosis, heterogeneity, and relapse tendency of urothelial cell carcinomas (UCCs) of the bladder., Methods: A cross-sectional study was conducted using 413 samples of Iranian patients diagnosed with UCC of the bladder. The tissue microarray technique was used to evaluate the patterns of tumor tissue. Two pathologists scored tissue staining using a semi-quantitative scoring system., Results: The results showed that P53 was a predictor of a high-grade pattern (the area under the curve (AUC)=0.620) with a best cut-off value of 95.0 using the receiver operating characteristic (ROC) curve. CK20 was another predictor of a high-grade pattern (AUC=0.745) with a best cut-off value of 15. However, the overexpression of both biomarkers was not associated with a heterogeneous pattern and could not predict tumor-associated death or relapse. The heterogeneous (odds ratio (OR)=4.535, p-value=0.001) and non-papillary (OR= 6.363, p-value= 0.001) patterns were effective predictors of tumor recurrence among all baseline variables, including patient and tumor characteristics. FGFR3 was positive in all specimens and was not a valuable biomarker for differentiating patterns. None of the variables predicted tumor prognosis., Conclusion: The study findings indicate that the intensity and percentage of cell staining for P53 and CK20 in the UCC of the bladder can aid in differentiating the grading patterns. The tendency of tumor relapse can be predicted by demonstrating heterogeneous and non-papillary patterns.

Background: Bladder cancer is the ninth most commonly diagnosed malignancy worldwide. The trend of bladder cancer incidence and mortality is rising in Iran. This study was aimed to evaluate the survival rate of patients with bladder cancer in Yazd province, Iran. Methods: In this retrospective cohort study, data were collected from 340 patients suffering from bladder cancer referred to Shahid Rahnemon and Shohada-Kargar Hospitals in Yazd province, Iran between April, 2001 and March, 2012. Variables included age, gen- der, stage of cancer, place of residence and type of treatment. The Kaplan-Meier and Cox regression analyses were used to evaluate the relationship between each variable and survival time. A P value less than 0.05 was considered significant. Results: The mean age of total patients was 65.8 13.6 years, and their mean survival time was 68.55 - 6.05 months. Cumulative survival rates at the end of 1, 3, and 5 years in bladder cancer patients were 91%, 58%, and 51.4%, respectively. A statistically significant association was found between age (P = 0.005), stage of disease (P = 0.0003), type of treatment (P = 0.0003) and survival time of patients. Data showed no significant correlation between age, gender, place of residence and patients' survival. Conclusions: The survival of patients suffering from bladder cancer in this study was less than other reports. Patients' age and cancer stage were the effective factors in survival time. Continuous screening of older people for cancer diagnosis in early stages is seemed to improve survival in patients. [ABSTRACT FROM AUTHOR]

Background: Electrical stimulation has been used as an alternative therapy for adult urinary syndromes and for children with constipation. We have evaluated the safety and efficacy of interferential (IF) electrical stimulation in children with nocturnal enuresis (NE). Methods: This was a randomized clinical trial in which 54 children (23 girls, 31 boys) aged 6-14 years with primary NE were recruited and randomly divided into two groups. Children in the control group underwent standard urotherapy only (hydration, scheduled voiding, toilet training, diet), whereas children in the IF group (cases) were treated with standard urotherapy + 15 sessions of IF electrical stimulation for 20 min twice per week. An improvement score was calculated to identify relative decrease in wet nights after the treatment for each child. All children were followed for 1 year. Results: Overall, 15/27 (55.5 %) and 6/27 (22 %) of children in the IF and control groups responded to treatment at the 1-year follow-up ( P = 0.01). The mean number of wet nights per week in the control and IF groups decreased from 5.4 ± 2 and 5.7 ± 2 to 3.3 ± 3 and 1.1 ± 2, respectively, at first evaluation ( P = 0.003). The mean improvement score in the IF group was significantly higher than that of the control group after 1 year (78 vs. 46 %, respectively; P = 0.004). Conclusion: Interferential therapy can be applied as a safe, effective and well-tolerable alternative therapy in the treatment of children with NE. [ABSTRACT FROM AUTHOR]

Objective: Excessive bleeding is an important complication of radical cystectomy. We aimed to assess whether preoperative administration of fibrinogen decreases perioperative bleeding and improves the outcome of radical cystectomy., Design: Double-blinded randomized trial with two parallel arms., Setting: The study was conducted in the department of surgery at a teaching hospital affiliated with a University of Medical Sciences., Patients: In total, 70 men undergoing radical cystectomy were randomized to fibrinogen (n = 35) and placebo-control groups. Mean (SD) age was 64.7 (7.4) years., Interventions: The intervention group received 2 g fibrinogen concentrate diluted in 100 ml distilled water, and the control group received 100 ml normal saline; both intravenously 15 ̶ 30 min before the start of the surgery., Outcome Measures: The primary outcome was the amount of perioperative blood loss. The secondary outcomes were hemodynamic features and vital signs., Main Results: Fibrinogen significantly decreased the volume of blood loss (p < 0.001) and the total number of transfused packed-cell units per group (38 vs. 115 units); and compensated the decrease of HCO3 (p = 0.030), the mean arterial pressure (p < 0.001), hemoglobin O2 saturation (p = 0.001), heart rate (p < 0.001), and temperature (p < 0.001) throughout the surgery compared with the placebo. Patients in the fibrinogen group had shorter Intensive Care Unit (p = 0.001) and hospital (p < 0.001) stay. We did not find any adverse reaction in our patients receiving fibrinogen concentrate., Conclusion: Fibrinogen concentrate reduces perioperative bleeding and the need for blood transfusion in radical cystectomy. It improves the outcomes of the surgery and decreases patients' length of stay in the healthcare system following radical cystectomy., Registration: Iranian Registry of Clinical Trials (IRCT) http://www.irct.ir/, reference number: IRCT20191013045091N1., Ethics Code: Shahid Beheshti University of Medical Sciences, reference number: IR.SBMU.RETECH.REC.1398.033., (Copyright © 2021 Elsevier Inc. All rights reserved.)

This is a case report concerning a 60 years old man who lived for a short period in an endemic area of Khuzestan Province (neighboring province of Persian Gulf in Iran) for approximately 20 years ago. Recently he referred to the Urology Department of Kerman University of Medical Sciences with hematuria and dysuria. In the sonography a polypoid mass on the bladder floor was observed. In the cystoscopy and biopsy a bladder tumor (Simultaneous squamous cell carcinoma and Transitional Bladder Cell Carcinoma) and schistosomiasis (Schistosoma haematobium) was diagnosed. [ABSTRACT FROM AUTHOR]

Objective. The intrauterine device (IUD) is a popular contraceptive instrument with reported complications. IUD migration to the urinary bladder, a rare genitourinary tricky situation, may cause stone formation and result in urinary system sequels such as a stone formation and a recurrent infection. Case Report. This is a case report of IUD migration to the urinary bladder, mineralization, and subsequent complications. We report the case of a 35-year-old woman with a copper IUD nidus stone in her urinary bladder. She received a Persian medicine formulation including goat's head, cornflower, silk corn, field horsetail, cumin, black Spanish radish, and common dandelion. She passed an oxalate stone 3 days later. Conclusion. Inexpensive common traditional recommendations might be helpful in current obstetrics and gynecology practice in our region. [ABSTRACT FROM AUTHOR]

The article presents two cases of urinary bladder neoplasia found in a study of goats in Iran. In the first case, transitional cell papilloma and two traction diverticula were found, and in the second case, leiomyoma was revealed. The findings were characteristics of transitional cell papilloma. The study suggests that the greater susceptibility of the goat bladder to the carcinogenic effects may cause the higher frequency of bladder neoplasms.