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Background: Prostate is an important male reproductive system gland and its disorders can affect men's quality of life and health. Prostatitis, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma are major disorders that can be found in all men in different ages., Objectives: The aim of this study was to investigate the association of diet with serum prostate specific antigen (PSA) level as well as prostate volume., Patients and Methods: In this cross-sectional study, 950 men older than 40 years of age who had attended our clinic for a screening program for prostate cancer were enrolled. Data was extracted from the program database. The eligible cases included all noncancerous subjects with available data concerning serum PSA level and prostate volume; the patients had completed a 50-item self-administered food frequency questionnaire about their diet during the preceding two year., Results: No overall association was found between the consumption of foods and prostate volume as well as serum PSA level. There was a significant correlations between age and serum PSA level (r = 0.24) as well as with prostate volume (r = 0.22) (P < 0.001). In addition, there was a significant correlation between serum PSA level and prostate volume (r = 0.41 and P < 0.001)., Conclusions: The results of this study confirmed the previous reports regarding the serum PSA level correlation with prostate volume. There was no evidence that dietary patterns might have any important effect on prostate volume and serum PSA in this Iranian population.

Background: Bladder cancer is the second most common malignancy of the genitourinary tract worldwide after prostate cancer. However, in Iran it is the most common cancer of the genitourinary system and the third most common cancer in males. The increasing trend in bladder cancer incidence in recent decades, along with the lack of research on this malignancy in Iran, make epidemiologic research important in light of its preventability through early recognition and limiting exposure to risk factors. The present study aimed to assess the epidemiology of bladder cancer in Shiraz, a large city in southern Iran, during a 2-year period., Methods: The data for this study were obtained from the population-based cancer registry of the Vice-Chancellery for Health Affairs of Shiraz University of Medical Sciences and Shiraz hospitals between March 1, 2007 and March 1, 2009. Demographic, clinical and pathological aspects of 216 patients with bladder cancer were investigated through careful review of their medical records. Statistical analyses were performed with SPSS software. P values less than 0.05 were considered statistically significant., Results: We analyzed data for 179 (82.9%) men and 37 (17.1%) women (mean age of 65.1∓12.7 years). Tobacco and opium use were found in 109 (65.3%) and 44 (34.1%) patients, respectively. Cigarette smokers and water pipe smokers were mostly men (P=0.001 and P=0.04, respectively). The most common type of tumor was transitional cell carcinoma (95.7%) and most tumors were of low malignant potential grade (39.7%). Nearly half of the patients suffered recurrence., Conclusion: Comparisons with previous studies showed that bladder cancer tends to appear slightly more often in the elderly and that the tumors tend to have a higher grade of malignancy in our region. There is a need for more epidemiologic studies on the trends in the incidence and other epidemiologic indices.

Background: It is relevant to highlight that there is not a precise and perfect report on either 95 percentile value (upper limit of normal range) or on appropriate reference intervals for serum PSA in Iranian population., Objective: To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and PSA density (PSAD) and prostate volumes in a population of healthy Iranian men., Methods: Nine-hundred and thirteen healthy Iranian men, aged 50-79 years, underwent a detailed clinical evaluation including a digital rectal examination, a serum PSA determination (DRE) and transrectal ultrasound (TRUS). PSA test was performed on 666 of the subjects and TRUS was done on 633 of them. None of the subjects had any evidence of prostate cancer by any one of the three diagnostic tests and had no history of Lower Urinary Tract Symptoms (LUTS). Age specific ranges for PSA levels, PSA density and prostate volume were determined., Results: The serum PSA concentration correlated directly with the subjects' age (r=0.280; p<0.001) and prostatic volume (r=0.327; p<0.001). Also prostatic volume was directly proportional to age (r=0.197; p<0.001).The serum PSA ranges (95th percentile) for each age range in Iranian men were: 0.00-2.61 ng/ml for 50-59 years; 0.00-3.59 ng/ml for 60-69 years; and 0.00-4.83 ng/ml for 70-79 years. The respective prostate volumes were: 14-59, 16-66 and 18-73ml. Also respective PSA densities were: 0.00-0.076, 0.00-0.10 and 0.00-0.14 ng/ml/ml., Conclusion: The present study confirms earlier reports that serum PSA levels and prostate volume and PSAD are age- and race- dependent, so it is appropriate to have age- specific reference ranges for these variables in various communities around the world. This will increase the positive predictive value of PSA estimation in the diagnosis of prostate cancer in different communities.

Purpose: To evaluate the efficacy and safety of intravesical Bacillus Calmette-Gurein injection in the treatment of female patients with interstitial cystitis., Materials and Methods: Thirty women meeting the National Institute of Arthritis, Diabetes, digestive and kidney diseases criteria for interstitial cystitis, were randomized in a double-blinded fashion in two groups each consisted of 15 patients to receive six, weekly instillation of 120 mg BCG vaccine of Iranian Institute of pastor or placebo. Periodic questionnaires on symptoms of interstitial cystitis, voiding diaries, bladder capacity at first desire to void, and maximum bladder capacity were obtained. Adverse events were closely monitored during the treatment and follow-up phases of the study. Subjective and objective baseline values were compared with the follow-up data., Results: With a mean follow-up of 24 (range 6 to 33) months 11 out of 15 (73%) in BCG group, and 3 out of 15 (20%) in placebo group responded to the treatment (p<0.002). Responders were defined the patients with more than 40% improvement in the symptoms of interstitial cystitis. The global improvement in symptoms and signs of interstitial cystitis was 62%. Adverse events were similar in both groups, mostly irritative in nature and no significant systemic event was noted. BCG did not worsen interstitial cystitis symptoms., Conclusion: We concluded that intravesical BCG is safe, effective, available, and inexpensive with relatively durable results in the treatment of interstitial cystitis.

Purpose: To investigate the efficacy of "dermal patch graft" in surgical management of Peyronie's., Materials and Methods: Eighteen of Peyronie's disease cases, with a mean age of 49 and a history of penile curvature and painful erection were enrolled in this study. Diagnosis was made clinically by plaque palpation. All of them were in the chronic stage of disease with symptom duration of at least 6 months. We also evaluate their potency through Brief Sexual Function Inventory (BSFI) questionnaire before and after the operation, meanwhile the degree of penile curvature was measured with goniometry while artificial erection status was induced., Results: Mean penile curvature, before and after the operation (58 and 5 degrees respectively), showed significant improvement (p<0.001). The improvement of curvature was irrespective of the plaque size. All of our patients suffered from inability to intercourse due to significant penile curvature but after the procedure 11 of them (66.1%) could do so. Also the BSFI score improved significantly in this subgroup (p<0.05). The remaining 7 cases (39%) already suffered from erectile dysfunction despite of operation; however, the penile curvature improved significantly in them. Six of this latter group had a plaque size greater than 4 cm2 and BSFI score was not significantly improved., Conclusion: Dermal patch graft as a cost effective method in the management of Peyronie's disease significantly corrects the curvature irrespective of plaque size and curvature severity. We found that if the fibrous plaque is less than 4 cm2 and the patient has no severe erectile dysfunction, this procedure will significantly improve his potency; however, if the patient suffers from a plaque sized greater than 4 cm2 and/or severe erectile dysfunction, to reach satisfactory erection, implantation of penile prosthesis or applying other methods of artificial erection in addition to dermal patch graft is suggested.

Objective: To study the role of the fine needle aspiration cytology (FNAC) in the diagnosis of testicular lesions., Study Design: Seven adult males (55-68 years) presented to the clinic with unilateral enlargement of the testis for the previous few months. Clinically, a malignant tumor was suspected. Fine needle aspiration was performed for rapid diagnosis., Results: The smears revealed many groups of epithelioid histiocytes, giant cells, a few plasma cells and occasional spindle-shaped fibroblasts. Acid-fast stain revealed a few acid-fast bacilli. The cases were diagnosed as tuberculosis and treated with orchiectomy and antituberculous drugs. The patients did well. Histologic sections confirmed the cytologic diagnosis., Conclusion: FNAC is useful in the diagnosis of tuberculous orchitis.

A-strain mice received 1 X 10(5) A-strain mammary carcinoma, B72, cells iv on Day 0. At the same time fragments of the same tumor were implanted into the ileal mesentery of a pig together with fragments of cellulose sponge. The middle third of the pig mesenteric lymph node chain was resected. Sponge fragments of equivalent size, shape, and total weight were implanted alone into the jejunal mesentery. Seven days later, separate cell suspensions were made from the (disconnected) proximal (nonimmune) and distal (tumor-immune) segments of lymph node chain. Cells were also expressed by digital pressure from the sponges removed from the jejunal (nonimmune) and ileal (immune) segments of mesentery. A comparison was made between the antitumor action of immune lymph node cells and the two categories of sponge cell. Cells (4 X 10(6] were injected iv into the mice on Day 7 and the number of pulmonary tumors counted after killing the mice on Day 14. Cells obtained from the "immune" sponges were significantly more effective in reducing the number of pulmonary tumors than cells from the "nonimmune" sponge, or from the immune lymph nodes. The antitumor action of all cell suspension was abolished when 4 X 10(6) cells from the "interface" layer, following centrifugation on a Ficoll-triosil column, were injected into the mice. Antitumor activity was found to be correlated with the presence of "blast" cells in the pig mononuclear cell suspensions.

Twenty patients with histologically proven balantis xerotica obliterans have undergone different forms of treatment; their progress has been reviewed and discussed. Balanitis xerotica obliterans involving only the foreskin was best treated by circumcision. The patients in whom meatal stenosis was present responded well to regular meatal dilatation, meatotomy followed by regular dilatation and, in advanced cases, to meatoplasty. At present there is no evidence to indicate that associated urethral strictures, proximal to the fossa navicularis, are due to balanitis xerotica obliterans.

Two cases of primary malignant melanoma of the penis are reported and 35 cases from the world literature are reviewed. The tumour most commonly started in the glans penis and less frequently from the prepuce. The microscopic appearances were identical with those of tumours arising elsewhere in the skin. A comparison is made between the incidence of melanoma of the penis and melanoma occurring elsewhere on the body surface. Evaluation of the best treatment was difficult because the total number of cases was small and the methods of treatment and results so variable. It would seem that the prognosis of malignant melanoma of the penis is generally poor, although there are sufficient examples of long-term survival after total amputation in Stage I disease to suggest that this radical treatment is justified.

Sixty-three patients with squamous cell carcinoma of the penis have been reviewed. The 3 year survival was 77%, and the 5 year survival was 59%. Prognosis was related to both clinical staging and histological grading. Stage I and II carcinomas were best treated by surgery alone. Stage III and IV carcinomas were best treated by local amputation of the penis combined with radiotherapy to the inguinal nodes. Surgery as a primary treatment for clinically positive nodes was successful in less than half the cases treated, and in this series was always followed by wound infection and lymphoedema. Tender, enlarged inguinal lymph nodes should be observed for up to 3 months following primary treatment, as a large percentage of these nodes are inflammatory and subside spontaneously.