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Abstract Prostate cancer is one of the most common and fatal diseases among men, and its early diagnosis can have a significant impact on the treatment process and prevent mortality. Since it does not have apparent clinical symptoms in the early stages, it is difficult to diagnose. In addition, the disagreement of experts in the analysis of magnetic resonance images is also a significant challenge. In recent years, various research has shown that deep learning, especially convolutional neural networks, has appeared successfully in machine vision (especially in medical image analysis). In this research, a deep learning approach was used on multi-parameter magnetic resonance images, and the synergistic effect of clinical and pathological data on the accuracy of the model was investigated. The data were collected from Trita Hospital in Tehran, which included 343 patients (data augmentation and learning transfer methods were used during the process). In the designed model, four different types of images are analyzed with four separate ResNet50 deep convolutional networks, and their extracted features are transferred to a fully connected neural network and combined with clinical and pathological features. In the model without clinical and pathological data, the maximum accuracy reached 88%, but by adding these data, the accuracy increased to 96%, which shows the significant impact of clinical and pathological data on the accuracy of diagnosis.

BackgroundBladder cancer (BCa) is a significant public health concern. This study aimed to analyze the incidence trends, histological subtypes, and topographical distribution of BCa in Iran over a decade.MethodsThis retrospective registry-based study analyzed data on BCa patients diagnosed between March 20, 2006, and March 20, 2015. Following data quality control, age-standardized incidence rates (ASIRs) were calculated for BCa overall, by sex and histological subtype using the new World Health Organization (WHO) standard population.ResultsWe identified 51,379 BCa cases (81.97% male) with a mean age of 65.10 ± 14.89 years. The overall ASIR was 8.92 per 100,000 (95% CI: 8.84-9.00). While a modest increase in ASIR was observed overall (8.77 in 2006 to 9.64 in 2015) and among males (14.13 in 2006 to 15.95 in 2015) during the study period, males consistently had a significantly higher ASIR compared to females (approximately 4.5:1 ratio). BCa incidence showed a progressive increase across older age groups, particularly those aged 40-44 to 80-84 years. Urothelial cell carcinoma (UCC) was the most prevalent histological type (ASIR: 8.19 to 7.93), followed by adenocarcinoma (AC; ASIR: 0.13 to 0.11). Squamous cell carcinoma (SCC) displayed a decreasing trend (ASIR: 0.11 to 0.06). Both UCC and AC were more frequent in males (approximately 5 and 3 times higher than females, respectively). Malignant neoplasm of the bladder, unspecified, constituted over 95% of BCa topography classifications.ConclusionThis study identified a modest rise in BCa incidence, with male predominance and a higher burden in older adults. Further investigation into potential risk factors contributing to this increase is warranted.

Introduction: Fournier’s gangrene (FG) is a type of necrotizing fasciitis affecting the external genitalia or perineum. The Geriatric Nutritional Risk Index (GNRI) has been reported as a prognostic factor to evaluate the outcomes of various diseases. This study aimed to investigate the utility of GNRI in predicting the mortality of FG patients. Methods: This retrospective cross-sectional study evaluated the patients admitted to a referral hospital, during 14 years, with diagnosis of FG. The role of GNRI in predicting the mortality of these patients was studied. To further investigate the relationship of the GNRI score with patients’ prognosis, we controlled for the scores of Fournier's Gangrene Severity Index (FGSI) and Charlson Comorbidity Index (CCI). Result: 78 patients with the mean age of 60.79 ± 13.76 (range: 24 -85) years were included in the study (89.74% male). The mortality rate in this series was 23 (29.5%) cases. The survived cases had significantly higher GNRI score (p < 0.001), higher Albumin level (p < 0.001), higher weight (p = 0.04), and lower mortality risk based on FGSI score (p < 0.001). In patients with low mortality risk according to FGSI score (p = 0.036) and mild comorbidities based on CCI score (p = 0.030), the association between GNRI and final prognosis was significant. In contrast, in patients with high mortality risk according to FGSI score (p =0.074) and moderate (p = 0.118) and severe (p = 0.215) comorbidities by CCI score this association was not significant. The independent predictors of mortality in FG patients were GNRI score (OR: 1.242, 95%CI: 1.08, 1.41; p =0.001) and FGSI score (OR: 54.614, 95%CI: 6.89, 432.31; p < 0.001). The area under the receiver operating characteristic (ROC) curve of GNRI score in predicting the mortality of FG patients was 0.84 (95%CI: 0.75 - 0.93). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of GNRI score at the optimal cut-off point (78.5) were, 80%, 77.9%, 60.6%, 90.4%, 3.69, and 0.255 respectively. Conclusions: Our findings indicate that among patients with mild FG, as assessed by FGSI score, and those with low comorbidities based on CCI score, the GNRI score in survivors was significantly higher than that in non-survived. Additionally, multivariate regression analysis demonstrated that the GNRI score serves as an independent predictor of patient outcomes.

Background: During the Coronavirus disease 2019 (COVID-19) pandemic, there was always concern about damageto different organs of the body. In this study, we aimed to determine if coronavirus 2 (SARS-CoV-2) could influencethe sperm parameters in inpatient adult men with COVID-19.Materials and Methods: In this prospective study during 2021, 22 patients with COVID-19 diagnosed with polymerasechain reaction (PCR) test and clinical symptoms and history of admission and 19 volunteer healthy menas the control group participated. They were asked to provide semen samples at 2 and 6 months after hospital dischargeand the same time for the control group. The following parameters were measured in all semen samples andbeside the demographic data, they compared between the two groups: volume (mL), sperm concentration (106/mL),total motile sperm percentage, progressive percentage, normal morphology percentage, and DNA fragmentationindex (DFI).Results: The mean ± SD age of the participants in the COVID and control groups was 46.36 ± 9.94 and 45.84 ±10.21 years, respectively (P=0.869). The mean ± SD body mass index (BMIs) of the participants in the COVID andcontrol groups were 28.6 ± 5.460 and 29.6 ± 6.092, respectively (P=0.579). The mean ± SD number of children was1.41 ± 1.054 in the COVID group and 1.47 ± 1.073 in the control group (P=0.847). All the sperm parameters weresignificantly impaired after 2 months in the COVID group in comparison with the control group (P

Fournier's gangrene is a rapidly spreading multi-microbial infection. Rapid diagnosis and treatment of the disease is important in saving patients. This disease usually occurs in adult men with immunodeficiency. In this study, a seven-year-old boy with Fournier's gangrene is presented. During debridement, we noticed a stone on the left side of the scrotum. The result of culture of scrotal secretions was Perteus.

Sertoli cell tumor is a rare type of testicular tumor. In this study, a 70-year-old man was presented with a Sertoli cell tumor with non-classical findings. The patient noticed progressive swelling on the left hemiscrotum. Preoperative ultrasound findings were not consistent with the classic findings of the Sertoli cell tumor. Patients underwent radical left orchiectomy. The testis was multicystic and no clear parenchyma was seen. The pathology report confirmed the diagnosis of a Sertoli cell tumor.

Transurethral lithotripsy (TUL) surgery, which is used to crush ureteral stones, can have complications, including bleeding, infection, ureteral stenosis, ureteral rupture, and ureteral avulsion. In this study, we present a 45-year-old woman who was referred, due to a right ureteral rupture during transurethral lithotripsy surgery. At first, the patient underwent ureteroneocystostomy surgery by a combination of boari flap and psoas hitch techniques. Due to the obstruction and necrosis at the anastomosis site, the patient underwent calicovesicostomy surgery.

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.

Priapism is a condition in which a person has an erection without sexual arousal and lasts for at least 4 hours. High flow priapism (HFP) usually follows blunt trauma to the penis or perineum, causing arterial-lacunar fistula. HFPs are rare after sexual intercourse, and early treatment by embolization can prevent erectile dysfunction (ED). The use of gel foam has good results and has shown the least side effects.

Simultaneous herniation of the bladder and ureter into the scrotum is a rare condition. In this study, we present a 60-year-old man who has been suffering from pain and swelling in the right hemi-scrotum. The patient needed to squeeze his scrotum for urination and he had difficulty in emptying his bladder. Ultrasound and Computed Tomography(CT) was performed for the patient, which confirmed the diagnosis. The patient underwent herniorrhaphy and partial cystectomy. His urinary problems were completely eliminated with surgery.

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.

Background Two-six percentage of vasectomized men will ultimately seek vasectomy reversal, which late stricture and obstruction after operation are relatively common. To find a method for improving vasovasostomy outcomes, we used intra-operative local mitomycin-C (MMC) preventing possible fibrosis and stricture. Materials and Methods In this randomized clinical trial, 44 patients were assigned to two groups randomly during a one-year study and the data of 40 patients were analyzed. The patients were followed up for 6 months after surgery. The case group (n=19) was treated by vasovasostomy with intra-operative local MMC. The control group (n=21) underwent standard vasovasostomy. Results Mean sperm count in MMC group was significantly higher than the controls. The sperm count of more than 20 million/ml was respectively 53% and 14% in MMC and control groups. In a subgroup where the interval between vasectomy and reversal was 5-10 years, post-reversal azoospermia was absent in MMC group, but 50% of the controls were still azoospermic. In addition, 80% of MMC group had more than 20 million/ml sperms, but all of the controls had less than 20 million/ml sperms. No significant complication was seen. Conclusion Intra-operative local MMC in vasovasostomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Increase of sperm count is the main effect of local MMC applica- tion that is more prominent when the interval between vasectomy and reversal is 5-10 years (Registration number: IRCT2015092324166N1).

Background and Objective: Infertility refers to the failure in achieving pregnancy of a couple after one year of regular sexual intercourse without using a protection method. The purpose of this research work was to evaluate the current status of the test and quality control performance in semen analysis in selected laboratories. Material and Methods: The semen analysis was performed in the Laboratory of Andrology in terms of macroscopic examination which include volume, color, viscosity, pH and acidity, and in terms of microscopy: the rate of sperm movement, the exact number of sperms per ml of semen, the percentage of sperm viability and movement, the presence of germ cells and white blood cells. Several questions for each part of the test were selected and answered by the director of the laboratories or andrology section supervisor. Results: There was a wide range in the performance of selected medical laboratories in Tehran regarding the standards of semen analysis according to the World Health Organization (WHO) Laboratory Manual for the examination and processing of human semen, fifth edition in 2010. They followed the instructions related to the sample collection in about 70% of the evaluated parameters, initial macroscopic examination in about 87% of the selected subjects, and the microscopic evaluation of sperm in about 65% of the test parameters. Conclusion: some laboratories do not follow the instructions of the WHO in performing semen analysis, and most of them do not follow the suggested methods in all parts of the test.

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

A 34-year-old man presented with bloody urethral discharge, dysuria, cough and right testicular mass. He had a history of anterior urethral stricture and multiple urethral dilation procedures. Radical orchiectomy and urethral mass biopsy were performed. The pathologist reported both of specimens revealed embryonal carcinoma. Abdominal and chest CT scan showed multiple metastasis. chemotherapy was started with the Bleomycin, Etoposide, and Cisplatin (BEP) regimen and this cycle was repeated every 3 weeks up to four times. Unfortunately, this patient died of brain metastasis.

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.

A thirteen-year-old boy with a right flank mass and painless gross hematuria is presented. The patient underwent open biopsy and the result was a huge primitive neuroectodermal tumor (PNET) of right kidney. Radical nephrectomy was performed for him and the treatment process continued with systemic chemotherapy.

Primary signet-ring cell adenocarcinoma of bladder is a rare neoplasm, usually seen in middle age adults. We report the case of an 18-year-old man who presented with intermittent gross hematuria. Computed tomography imaging showed multifilling defects in the bladder. The patient underwent a transurethral resection of the bladder tumor. Histological findings were consistent with poorly differentiated mixed mucinous and signet-ring cell adenocarcinoma. We ruled out other possible origins of tumor by gastrointestinal endoscopy and colonoscopy. The patient was treated with radical cystectomy with prostate and seminal vesicle sparing technique and orthotopic diversion using “W” ileum pouch with pelvic lymphadenectomy to the bifurcation of the aorta was done. Six-month follow-up of patient showed normal conditions without metastatic spread or any recurrence.

Coronary artery disease (CAD) and vascular insufficiency are consequences of modern lifestyle, and vasogenic erectile dysfunction (ED) is one of the leading causes of sexual dysfunction which could be prevented like ischemic heart disease if the risk factors are discovered and managed. Seventy-five men scheduled for coronary angiography were asked to fill out the IIEF5 questionnaire and underwent serum lipoprotein-a, uric acid, lipid profile, testosterone, Sex Hormone Binding Globulin (SHBG), dehyderoepiandrostendion sulfate (DHEAS) tests; and the results were compared with those of erectile dysfunction patients with and without coronary artery disease. Ten out of 32 CAD patients (30%) and 6 of 43 normal coronary men had ED Prevalence (P=0.04). The average serum uric acid in ED patients with normal coronary was 5.6 (± 0.68) 6.5 ±078 mg/dl in ED patients of CAD group P=0.034. Men with both ED and CAD had significantly higher levels of lipoprotein-a compared to those CAD patients with normal sexual function. Higher uric acid and lipoprotein-a levels are correlated with the presence of ED in patients with CAD.

Background: The aim of the study was to evaluate the relationship between the serum levels of androgens and Coronary Artery Disease (CAD) in an Iranian population. Methods: Male individuals admitted to Tehran Heart Center and Sina Hospital, Tehran, Iran from 2011-2012 were categorized into CAD and control groups based on selective coronary angiography. Baseline demographic data, including age, BMI, diabetes, and a history of hypertension were recorded. Patients were also assessed for their serum levels of total testosterone, free testosterone, estradiol, dehydroepi and rosterone sulfate (DHEA-S), and Sex Hormone Binding Globulin (SHBG). Data analysis was carried out chi-square and ANOVA tests as well as logistic regression analysis. Results: Two hundred patients were in the CAD group and 135 individuals in control group. In the CAD group, 69 had single-vessel disease, 49 had two-vessel diseases, and 82 had three-vessel diseases. Statistically significant differences were observed between the individuals in the two groups with respect to age (P

Purpose: To determine the probability of having prostate cancer (PCa) using the combination of serum level of prostate-specific antigen (PSA) and age. Materials and Methods: A total of 160 patients and 190 controls were enrolled in this hospital-based case-control study. Using a logistic regression model and the odds ratio of age and PSA level, the probability of PCa was estimated based on serum level of PSA and age of the participants. Results: The mean age of patients with PCa and benign prostatic hyperplasia (BPH) was 67.75 ± 8.81 and 62.07 ± 8.71 years, respectively (P< .000). Using univariate analysis, we found that increase in life decades of the cases almost doubles the risk of having PCa (odds ratio = 1.95; P = .00), and the probability of developing cancer may increase by 74% in ketchup consumers. After multiple variable regressions, it was revealed that the odds of developing PCa increase by 90% only for every decade, and other variables did not have any significant association with PCa. Conclusion: In clinical practice, PSA level combined with the age at presentation can be used as predictors of PCa probability and the necessity of biopsy.

A man with a history of urothelial carcinoma is presented here. According to investigations, he had bilateral hydronephrosis due to the pressure effect of a large mass in his bladder. The patient underwent surgical procedure including mass resection and ureter reimplantation. The final pathology report was only fat necrosis.