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Translational Research in Urology
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ISSN (Online) 2717-042X
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Evaluating the Correlation Between Serum PSA Values and Gleason Score of
Prostate Carcinoma with Ga68-PSMA Uptake in Prostate Tumor in Primary
Staging
- Abstract: Introduction: Ga68-PSMA PET/CT plays a crucial role in staging, evaluating treatment, and diagnosing local recurrence of prostate tumors. Recently, the NCCN guidelines have recommended it as the preferred staging method for unfavorable intermediate and high-risk patients. This study aims to evaluate the correlation between serum PSA levels and Gleason score of prostate tumors with the findings of Ga68-PSMA PET/CT scans in primary staging. Methods: In this cross-sectional study, patients with newly diagnosed prostate cancer referred for Ga68-PSMA PET/CT whole-body scans were enrolled. The scans were performed at three time points (early, whole-body, and late). The standardized uptake value of Ga68-PSMA in the primary tumor and its association with serum PSA levels, tumor Gleason score, and presence of tumor metastasis were evaluated and analyzed. A p-value<0.05 was considered statistically significant in all statistical analyses. Results: A total of 49 male patients with a median age of 65 years (Interquartile range: 59-69) were included in the study. Of these patients, 43.9% were classified as high-risk based on their Gleason score. The median serum PSA level was 17 ng/mL (Interquartile range: 8.02-42.10). PSA levels correlated with the SUVmax of the tumor in the whole-body stage of the scan (P-value<0.05; r=+0.392), but not in the early or late stages (P-value>0.05). Gleason scores showed a positive correlation with tumor SUVmax in all three scan stages (P-value<0.05). Conclusion: Our results indicate that the Gleason score significantly correlates with the SUVmax of the prostate tumor in all three time points of the scan. However, serum PSA levels only correlate with the tumor SUVmax in the whole-body stage of the scan, not in the early and late stages. In the whole-body stage, a higher SUVmax is significantly associated with higher Gleason scores ,bladder wall and seminal vesicle invasion, and lymph node metastasis (P-value<0.05 in all cases).
Neuron-tumor Interaction in Prostate Cancer: Implications and Future
Perspective
- Abstract: Neural elements are essential components of the tumor microenvironment (TME) in various tumors, including prostate cancer. Based on their structure and function, prostate neurons originate from different sources, such as the hypogastric and pelvic nerves. Neuronal factors of TME can lead to tumor development and metastasis based on their specific receptors. Tumor cells can follow a specific path of metastasis through perineural invasion (PNI). However, the mechanisms of PNI as an essential factor associated with poor prognosis have not yet been entirely elucidated. Moreover, the interaction between neural components of TME and the immune system plays a crucial role in tumor progression. Although targeting the neuron-tumor interplay has not yet reached the clinical stages, further studies may pave the way for new therapeutic strategies.
Partial Cystectomy in Sliding Inguinal Hernia with Bladder Gangrene: A
Case Report
- Abstract: Introduction: A sliding hernia is in which one or more organ contents in the body cavity spread simultaneously with the hernia sac into another body cavity. In some cases, sliding inguinal hernia may involve the bladder herniating along with the inguinal hernia sac, which is more commonly diagnosed intraoperatively. The incidence rate is less than 4% of all inguinal hernia cases.Case presentation: We report a case of an 83-year-old man who presented with a painful lump on the crease of both thighs with lower urinary tract symptoms. In the middle of surgery, strangulation of the bladder was found together with extensive, poorly demarcated bladder tissue necrosis and few healthy surrounding tissues. Partial cystectomy was performed by excising the affected bladder, leaving the healthy bladder. Finally, the bladder was sutured with absorbable suture, and a 16 Fr Foley urinary catheter was placed through the urethra. Hernioplasty was continued until all of the layers were sutured completely. Conclusion: Sliding inguinal hernia with bladder involvement is still challenging to date as it can only be recognized intraoperatively. If there is urinary tract organ involvement, especially in the bladder, management in urology needs to be carried out from the beginning.
Clinical and Public Health Considerations for HPV Infection in Men: A
Narrative Review
- Abstract: Genital wart is the most common sexually transmitted disease which is a result of infection with human papillomavirus (HPV), mostly type 6 and 11. Despite its usually benign characteristic, HPV infection can pose considerable psychological, social, and economic burdens on patients and society. Here, we focused the existing data in this regard through searching on PubMed, Google Scholar, and Scopus and tried to provide a comprehensive review of the vast range of presentations and complications of HPV infection in the male population. HPV infection most commonly manifests with benign lesions including skin and genital warts, oral lesions, and laryngeal papillomatosis in men. Genital warts are the most important epidermal manifestations of the epidermotropic HPV. Non-oncogenic HPVs (types 6 and 11) cause the majority of genital warts in men. Interestingly, HPV can decrease sperm motility by binding to the head of the human spermatozoa and reducing sperm's normal morphology rate which can lead to infertility. Moreover, several male-specific malignancies like penile cancers are associated with HPV infection, especially inmunocompromised individuals. Despite a relatively benign course of HPV infection in men versus women, its role in anogenital warts, infertility, and malignancies warrants the prompt inclusion of the male population in the vaccination programs, not only to decrease HPV-related disorders, infertility, and deaths in men but also to improve the quality of life of women, considering the main route of virus transmission.
Exploring Link Between Erectile Dysfunction and COVID-19: A Comparative
Analysis Across Two Distinct Regions
- Abstract: Introduction: There is speculation that erectile dysfunction (ED) may be a possible manifestation of COVID-19 symptoms. Our research aimed to assess the frequency of ED and explore potential contributing factors including different climates, etc. among male patients with COVID-19 infection history.Methods: In this study, a sample size of 383 cases were examined from two cities Tabriz and Ahvaz with completely different climates. We had a control group of 148 patients with a negative COVID-19 infection history and 245 patients with a positive COVID-19 infection history. The cases were analyzed by utilizing the IIEF-5 questionnaires. Data regarding demographics and the history of COVID-19 infections was gathered.Results: The study included 383 male patients with ages ranging from 21 to 63. Of these patients, 48.4% were from Tabriz and 51.7% were from Ahvaz. The average erectile function for males with a positive history of COVID-19 infection in Tabriz was 47.9 whereas for those with a negative history, it was 50.51. In Ahvaz, the average erectile function for males with a positive COVID-19 infection history was 38/68 while for those with a negative history, it was 57.37.Conclusions: Recent research indicates that a person’s history of COVID-19 infection has considerable effects on male sexual function; with psychological factors playing a role in this impact; nevertheless, the effect of the cities with different climates was not proved. These findings highlight the potential connection between COVID-19 infections and sexual health in men, suggesting that various factors contribute to the observed effects
Identification of Common Hub Genes and Key Molecular Pathways between
Multiple Sclerosis and Urological Disorders
- Abstract: Introduction: The immune system plays a vital role in affording protection for the body against a wide variety of diseases and infections. On occasion, the system malfunctions and attacks intact cells, tissues, and organs influencing any part of the body, tapering off bodily function, and leading to life-threatening. multiple sclerosis (MS) is characterized by inflammatory demyelination with a diverse range of urologic indications.Methods: To extract the overlapped genes and single-nucleotide polymorphisms (SNPs; until November 2022) between MS and several urological disorders, we searched the DisGeNET database. Furthermore, to identify significant Gene Ontology (GO) terms and the Kyoto Encyclopedia of Genes and Genome (KEGG) pathway, the Enrichr assessment was used.  Additionally, in the case of overlapped genes, the maximum level of linkage hub genes was investigated by the protein-protein interaction (PPI) network construction via cytoHubba.Results: 1362 common genes between MS and urological disease were recognized, of which 154 genes have SNPs linked with MS susceptibility. Three DisGeNET-indexed MS-associated SNPs, including rs653178, rs10936599, and rs4976646 were shared between MS and urological disorders. TNF, AKT1, IL1B, IL6, VEGFA, INS, C-C CCL5, TP53), RELA proto-oncogene, STAT3, and EGFR were detected as hub genes overrepresented in the identified pathways.Conclusion: Of 1362 common genes, 11 key genes, and 3 SNPs were shared between MS and urology-related diseases. These identified features might serve as potential therapeutic targets in both disorders, with a probable role in the management of urological complications in MS patients. 
Age Limit of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte
Ratio in Correlation of Bladder Cancer Tumor Stage and Grade
- Abstract: Introduction: This study was conducted to investigate the predictive value of NLR and PLR with staging and grading of bladder tumors in Iran for the first time; as well as producing comprehensive data to attain defined cut-offs.Methods: The medical records of 454 patients between 2016 and 2022 have been collected and diagnosed with bladder cancer by cystoscopy and transurethral resection of bladder tumor (TURBT). Clinical and demographic parameters including age, weight, diabetes, smoking, opium usage, and hematuria were registered. The stage of BC was defined based on the results of physical exams, biopsies, and imaging tests.Results: The study comprised 393 males and 61 females ranging from 28 to 97 years old. The cut-off of NLR as a predictor of grade was 3.09 and 3.78 for the stage, which was 100.8 and 109.6 for PLR respectively. Taller people had lower PLR. There was a relationship between PLR and smoking with non-smokers having significantly higher levels of PLR (P-values=0.039 and 0.025 for grade and stage respectively). Overall NLR (AUC=71.4 and 72.4% for grade and stage respectively) and PLR (70.6 and 73.8% for grade and stage respectively) have shown predictive value for stage and grade of BC in patients younger than 65.Conclusion: Our findings suggest that PLR and NLR can be reliable predictors of the stage and grade of BC in patients under 65 years old, however, their predictor values increase when data are stratified. Higher NLR was associated with opium usage and non-O blood type.
The Impact of Liraglutide on the Urogenital and Reproductive System in
Mice
- Abstract: Introduction: We aimed to evaluate whether Liraglutide can remove the deteriorating impact of a high-fat diet (HF) diet on the genitourinary system.Methods: Fifty-six C57 mice were recruited of which received an HF as the intervention group, and a chow diet (CH) as a control group. After two months the case group was sub-grouped into three groups; 1: group HF with a daily injection of 0.4mg/kg liraglutide (HF+Lir), 2: CH with a daily injection of 0.4mg/kg liraglutide (CH+Lir), and 3:  HF diet with an infusion of normal saline (HF+NS). After two months, all mice were sacrificed for additional testing.Results: Serological analysis showed no significant difference for lipid profile (P-value>0.05) and hormones except for PSA in males (P-value=0.019). This significance was seen when comparing CH+Lir and HF+NS to the control group (P-values=0.014 and 0.025, respectively). Liraglutide decreases testosterone in both genders and adiponectin and insulin in males. Total sperm count was decreased, and the difference between the groups was significant (P-value=0.013).Conclusions: Liraglutide cannot recover the deteriorating impact of an HF diet on sperm morphology and motility but can improve the sperm DFI and the total number of sperm.     
Intracavernosal Injection of Autologous Adipose-Derived Mesenchymal Stem
Cells as an Efficient Alternative Treatment for Patients with Erectile
Dysfunction
- Abstract: Introduction : This study aimed to evaluate the treatment efficacy of autologous adipose-derived mesenchymal stem cells (MSCs) in patients with erectile dysfunction (ED).Methods: This study included 14 ED patients (aged 29-75 years) referred to our ED clinic from 2020 to 2022. The patients had a healthy mental status, no history of malignancies, and no prior use of psychiatric medications. Papaverine was used to achieve an erection to improve the efficacy of stem cell injection. The clinical assessment of the patients was conducted using the International Index of Erectile Function (IIEF) and the Erection Hardness Score (EHS) before and 3 months after the injection of stem cells. The follow-up visit was performed 3 months after the injection of stem cells.Results: The mean age of the study participants was 46.42± 10.62 years. Ten patients had a history of treatment with platelet-rich plasma (PRP) for ED. The EHS and IIEF scores of the patients were significantly higher 3 months after the injection compared to the pre-treatment period (P-value=0.000 and P-value=0.001, respectively). Only three patients had minor ecchymosis on their penises.Conclusion: The treatment of ED using autologous adipose-derived MSCs with the injection of papaverine is an effective and safe method. The main goal of this treatment method is to repair the damaged tissues or the vascular system of the corpus cavernosum to improve the erectile function of the patients.
Assessment of Prevalence and Clinical Features of COVID-19 in Patients
Undergoing Maintenance Hemodialysis: Reports from Two Hemodialysis Centers
in Iran
- Abstract: Introduction: Since the outbreak of COVID-19 in December 2019, patients with End-Stage Kidney Disease (ESKD) have been deemed one of the most vulnerable populations due to their numerous comorbidities.Methods: The study was a retrospective cohort study conducted between March 2nd, 2020, and September 21st, 2020. It included 240 patients who underwent MHD at Shahid Beheshti and Vali-Asr Hospitals affiliated with Abadan University of Medical Sciences. Out of these patients, 44 were diagnosed with COVID-19 based on their Reverse transcriptase polymerase chain reaction (rRT-PCR) test results or chest CT scan findings. Demographic, clinical, laboratory and radiologic findings of these patients were collected.Results: COVID-19 was diagnosed in 44 individuals, which accounts for 18.33%, and eight patients have died, which is 18.1% of the total COVID-19 cases. A total of 39 patients were tested through rRT-PCR, out of which 15 (34.09%) tested positive. Among the 44 patients, 26 were males (59.09%), and 18 were females (40.9%). The most common symptoms were fever (36.36%), shortness of breath (34.09%), cough (25%), and fatigue (13.63%). Additionally, 18.18% of patients were asymptomatic. Chest CT scans revealed ground glass opacity, consolidation, and pleural effusion in 54.83%, 48.38%, and 29.03% of cases, respectively. However, it was normal in 9.67% of patients. Peripheral and central pulmonary involvement was found in 70.96% and 19.35% of patients, respectively. The mean single pool KT/V (SpKT/V) was calculated as 1.10±0.39.Conclusions: Based on our findings, the COVID-19 outbreak is a significant cause for concern for in-center hemodialysis patients. These individuals are particularly vulnerable due to their underlying health conditions. Furthermore, the limitations in maintaining social distancing, increased public exposure, and pre-existing lung involvement in these patients can further complicate their management and potentially impact their overall outcome.
Redox-Active Bacteria Alleviated Ethylene Glycol-Induced Kidney Calculi in
Rats
- Abstract: Introduction: Impaired antioxidant capacity in the kidneys and urinary tract of animals suffering from kidney stones is a key pathological finding in urolithiasis. Bacteria with extracellular electron transfer (EET) ability can alter the oxidation and reduction potential of the surrounding environment. This article considered the preventive impact of an EET bacterium, Shewanella oneidensis MR-1 (Sh. O) on renal calcium oxalate crystal deposition and stone formation in a rat model.Methods: Male Wistar rats were randomly categorized into 3 experimental groups (n = 7–9). One group was left untreated, and the other received ethylene glycol (1% v/v) in drinking water for 4 weeks. In the treatment group, in addition to drinking ethylene glycol, 0.5 ml of the Sh. O suspension (3.5 × 1010 CFU/ml) was gavaged orally 2–3 times per week. After 29 days, the kidneys were removed and tested for histopathological findings and the number of CaOx deposits in the microscopic fields.Results: The rats treated with Sh. O significantly reduced the number of CaOx deposits in the kidneys compared to the ethylene glycol group. Sh. O significantly increased kidney weight without significantly changing the total body weight. The bacterium Sh. O indicated a positive impact in preventing and removing CaOx deposition in the rat kidneys.Conclusions: These results suggest a new approach for the prevention and treatment of kidney stone disease using electrogenic bacteria.
Laparoscopic management of huge adrenal cyst: case report and literature
review
- Abstract: Introduction: Cystic lesions in adrenal glands are not common and have a wide range in diameter, even to 30 centimeters in the reports. They may have some hormonal activities, but most of them do have not hormonal functions. Simple adrenal cysts often have four pathologic types, and endothelial cysts are the most common. It seems that the best treatment for these cysts is complete excision of them because of the slight risk of malignancy, and of course, it is better to be done in a laparoscopic manner with fewer complications, post-surgery pain, and blood loss. Case presentation: We reported two cases with adrenal cystic lesions, a 35 y/o woman and a 30 y/o man with a large cystic mass in the upper pole of the left kidney (80 mm and 90 mm respectively), who were referred to our center. Both patients underwent intraperitoneal laparoscopic partial adrenalectomy and the pathology reports of both masses were endothelial adrenal cysts, and in 12 months of follow-up, no complication or recurrence was reported.Conclusion: In symptomatic patients with no malignancy evidence, laparoscopic surgery inclusive of cyst excision, partial or total adrenalectomy is a safe procedure and excellent result besides open surgery.

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