BackgroundProstate cancer is the second most common malignancy among men worldwide and the sixth cause of cancer-related death. Some authors have reported a relationship between perineural invasion (PNI), Gleason score, and the invasion of peripheral organs during prostatectomy. However, it is not yet clear whether pathological evidence of PNI is necessary for risk stratification in selecting treatment type.ObjectivesThe clinical and pathological stages of prostate cancer are compared in patients under radical prostatectomy and in patients without perineural invasion.Patients and MethodsThis cross-sectional study was conducted using a sample of 109 patients who attended a tertiary health care center from 2008 to 2013. The selection criteria were PNI in prostate biopsy with Gleason scores less than six, seven, and eight to ten. The participants were enrolled in a census manner, and they underwent clinical staging. After radical prostatectomy, the rates of pathological staging were compared. The under-staging and over-staging rates among those with and without perineural invasion in biopsy samples were compared.ResultsThe concordance between Gleason scores according to biopsy and pathology was 36.7% (40 subjects). The concordance rate was 46.4% and 33.3% among those with and without PNI, respectively. The concordance rates were significantly varied in different subclasses of Gleason scores in patients without PNI (P = 0.003); the highest concordance rate was a Gleason score of 7 (63.6%) and the lowest was a Gleason score of eight to ten (25%). However, there were no significant differences in patients with PNI (P > 0.05).ConclusionsAlthough the presence of PNI in prostate biopsy is accompanied by higher surgical stages, PNI is not an appropriate independent factor in risk stratification.

Objective: To report the results from an Iranian large population-based randomized study of screening using prostate-specific antigen (PSA) to detect prostate cancer. Materials and Methods: A total of 3758 Iranian men older than 40 years were mass checked by PSA-based screening. Men with an abnormal digital rectal examination (DRE) and serum total PSA level of greater than 4 ng/mL, underwent transrectal ultrasonography (TRUS)-guided extended prostate biopsy. Results: The PSA value (mean Ϯ standard deviation, SD) in all men without prostate cancer was 1.6 Ϯ 1.1 ng/mL and in those with cancer 18 Ϯ 44.8 ng/mL (P = 0.001). PSA values increased with age. In those aged 40-49, 50-59, 60-69 and Ն70 years, the mean Ϯ SD PSA values were 1.3 Ϯ 0.7, 1.4 Ϯ 0.8, 1.8 Ϯ 1 and 2.2 Ϯ 1.6 ng/mL, respectively. Among the screened men, 323 (8.6%) had a serum PSA concentration greater than 4 ng/mL. Of patients who underwent prostate biopsy (230, 71.2%), 129 (positive predictive value, 56.1%) had prostate cancer. Additionally, nine cancers were detected among 16 patients with PSA of less than 4 ng/mL who had a doubtful DRE finding. The overall cancer detection rate was 3.6%; 1.4% at 40-49, 1.6% at 50-59, 4.2% at 60-69 and 12.9% at Ն70 years. Conventional systematic sextant biopsies, which accounted for six of the 10 cores in our biopsy scheme, detected 98 (71%) of the cancers. Conclusions: The Iranian male population develops prostate cancer quite commonly if their serum PSA levels are greater than 4.0 ng/mL. In this study, 65.9% of the detected cancers were clinically significant. The conventional systematic sextant technique may be inappropriate for detection of all prostate cancers. The results need to be confirmed in other randomized trials.

BackgroundThe most important surgical complications of renal transplantation are stenosis and obstruction of the ureterovesical anastomosis. Routine use of ureteral stents can prevent this complication, but the optimal time for ureteral stent use is still controversial.ObjectivesThe purpose of this study is to compare the benefits and complications of early and delayed stent removal after surgery. Early ureteral stent removal can decrease some complications, such as urinary tract infections (UTIs), bladder irritation symptoms, persistent hematuria, and the risk of stent crusting; its benefits include easier stent removal and shorter hospitalization time.Patients and MethodsAll patients who underwent kidney transplantation from May 2011 until March 2012 in Modarres Hospital were included in this study. We classified the patients into three groups, based on time of stent removal (10, 20, and 30 days after transplantation).ResultsNinety-one patients were studied; urologic complications (hydroureteronephrosis and urinoma) in these three groups were analyzed and showed no statistical significant difference.ConclusionsWe can remove the ureteral stent earlier after kidney transplantation with no increase in the prevalence of surgical complications.

Recent studies on the pathophysiology of COVID-19 are indicating that the Angiotensin convertase enzyme 2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) can act as a major component in the fusion of SARS-Cov-2 with target cells. It has also been observed that the expression of ACE-2 and TMPRSS2 can be altered in malignancies. Shedding light on this matter could be crucial since the COVID-19 pandemic interfered with many gastrointestinal cancer screening programs. Herein we discuss the possibility of severe forms of COVID-19 in patients with gastrointestinal cancers due to the gastrointestinal entry route of SARS-CoV-2 into the human body. The disruption of cancer screening programs caused by the current COVID-19 pandemic could therefore have massive negative health impact on patients affected by gastrointestinal malignancies.

BackgroundThe most important surgical complications of renal transplantation are stenosis and obstruction of anastomosis of the ureter to the bladder. Although the routine use of the ureteral stents to prevent such complications seems rational, the optimal time to keep the ureteral stent is still controversial.ObjectivesThis study presents the benefits and complications of removing the ureteral stent based on the elapsed time after the surgery.Patients and MethodsAll patients who underwent kidney transplantation between May 2011 and August 2014 in Modarres hospital, Tehran, Iran, were enrolled in the study. The patients were classified into three groups. The ureteral stent was removed 10, 20, and 30 days after the transplantation in these groups.ResultsA total of 529 patients underwent kidney transplant surgery in our center. Urologic complications among the three groups consisting of hydronephrosis, urinoma and collection did not have statistically significant differences.ConclusionsUreteral stent can be picked up with no increased risk of urologic complications at shorter intervals after the kidney transplantation surgery.

Testicular torsion is one of the most significant urological disorders in which the spermatic cord is twisted along the longitudinal axis and affects the male gender at any age; however, newborns, children and adolescent boys are the main target of the disease (Fehér & Bajory, 2016). Epidemiological studies indicated that testicular torsion occurs between the ages of 13 and 16 years and/or during the first year of life (Pogorelic, Mrklic, Juric, Biocic, & Furlan, 2013). The incidence of the spermatic cord torsion, in males with the age range of 1-25 years old, is estimated at 4.5 per 100,000 (Pogorelic et al., 2013). In this pathological condition, the blood flow to testes is considerably decreased, causing severe scrotal pain and tissue ischaemia. As widely accepted, both the duration and degree of twisting are the two most essential factors involved in testicular tissue damage. Therefore, early diagnosis and surgical interventions (i.e. testicular detorsion to retrieve the normal blood flow to the organ) are effective strategies to prevent (a) testicular injury, (b) loss of testicular germ cells and (c) finally infertility (Mellick, Sinex, Gibson, & Mears, 2019). In this regard, if the surgical procedure is carried out within 6 hr of pain onset, it would be feasible to save testicles by 90%-100%, while 12 and 24 hr after torsion, the survival rate of testicles would be reduced by 50% and 0%-10% respectively (

Background:The treatment of urethral stricture in female patients is through dilatation of the urethra by tubes of increasing diameter. There are two main methods: intermittent dilatation and on demand dilatation.Objectives:The main aim of this study was to compare the results of these two methods, and to determine the best one.Patients and Methods:In this clinical trial study, we reviewed the documents of women diagnosed with urethral stricture, who came to the Baqiyatallah Clinic from 2007 and 2012. According to the method of dilatation, the patients were divided into two groups: intermittent dilatation and on demand dilatation. Patients’ data were then collected and analyzed.Results:Eighty-six patients were enrolled in the study. The mean age of the participants was 48.13 years (between 44 and 79 years). The mean urinary residual and maximum urinary flow speed changes, before and after on demand dilatation, were higher than in the intermittent method.Conclusions:For treating urethral stricture, on demand urethral dilatation is more effective than intermittent dilatation.

BackgroundUrologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly.ObjectivesWe designed this study to evaluate the association between ureteral length and postoperative complications.Patients and MethodsWe recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it.ResultA total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off.ConclusionsThe length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon’s skillfulness and development in use of immunosuppressant’s postoperatively.