Pub Date : 2024-08-23DOI: 10.1186/s12301-024-00443-0
Ahmed Zoeir, Ahmed Eissa, Hussein Mamdoh, Tarek Gameel, Ayman Mousa
Despite the fact that prostate abscess (PA) is a serious condition, no standardized guidelines are available on the best methods for its drainage. The goal of the current study is to compare the outcomes of the three modalities of prostate abscess (PA) drainage: transrectal ultrasound (TRUS) guided aspiration (TRA), transperineal aspiration (TPA), and transurethral de-roofing (TUD). The records of 66 patients diagnosed with PAs were collected between 2015 and 2022 and divided into 3 groups according to the technique of abscess drainage that was used. Group A included 26 patients treated by TRA; Group B included 28 patients treated by TUD; and Group C included 12 patients treated by TPA. The three groups were compared based on demographic data, drainage success, recurrence, complications, and hospital stay. The mean abscess size (cm) was 4.8 ± 1, 5.7 ± 1, and 5.4 ± 1.3 cm in groups A, B, and C, respectively. Central abscesses were detected in 35 patients (53%), peripheral in 21 patients (31.8%), and both central and peripheral in 10 patients (15.2%). The most common clinical presentation was lower urinary tract symptoms (LUTS) in 45 patients (68.18%), followed by fever in 40 patients (60.6%). The mean abscess size (cm) was 4.8 ± 1, 5.7 ± 1, and 5.4 ± 1.3 cm in groups A, B, and C, respectively. Recurrence of the abscess occurred in three (11.5%), one (3.6%), and one (8.3%) patients in groups A, B, and C, respectively (p = 0.496). The mean hospital stay was 4.8 ± 1.7, 5 ± 1.8, and 4.5 ± 1.3 days in groups A, B, and C, respectively (p = 0.763). When compared to the other two groups, the TUD group had a higher rate of complications (32.1%). A TRUS-guided transrectal and transperineal aspiration of PA were comparable to TUD technique regarding the recurrence rate and hospitalization period; however, the safety profile was in favor of the aspiration groups.
{"title":"Outcome of three different techniques of prostatic abscess drainage: a retrospective single-center experience","authors":"Ahmed Zoeir, Ahmed Eissa, Hussein Mamdoh, Tarek Gameel, Ayman Mousa","doi":"10.1186/s12301-024-00443-0","DOIUrl":"https://doi.org/10.1186/s12301-024-00443-0","url":null,"abstract":"Despite the fact that prostate abscess (PA) is a serious condition, no standardized guidelines are available on the best methods for its drainage. The goal of the current study is to compare the outcomes of the three modalities of prostate abscess (PA) drainage: transrectal ultrasound (TRUS) guided aspiration (TRA), transperineal aspiration (TPA), and transurethral de-roofing (TUD). The records of 66 patients diagnosed with PAs were collected between 2015 and 2022 and divided into 3 groups according to the technique of abscess drainage that was used. Group A included 26 patients treated by TRA; Group B included 28 patients treated by TUD; and Group C included 12 patients treated by TPA. The three groups were compared based on demographic data, drainage success, recurrence, complications, and hospital stay. The mean abscess size (cm) was 4.8 ± 1, 5.7 ± 1, and 5.4 ± 1.3 cm in groups A, B, and C, respectively. Central abscesses were detected in 35 patients (53%), peripheral in 21 patients (31.8%), and both central and peripheral in 10 patients (15.2%). The most common clinical presentation was lower urinary tract symptoms (LUTS) in 45 patients (68.18%), followed by fever in 40 patients (60.6%). The mean abscess size (cm) was 4.8 ± 1, 5.7 ± 1, and 5.4 ± 1.3 cm in groups A, B, and C, respectively. Recurrence of the abscess occurred in three (11.5%), one (3.6%), and one (8.3%) patients in groups A, B, and C, respectively (p = 0.496). The mean hospital stay was 4.8 ± 1.7, 5 ± 1.8, and 4.5 ± 1.3 days in groups A, B, and C, respectively (p = 0.763). When compared to the other two groups, the TUD group had a higher rate of complications (32.1%). A TRUS-guided transrectal and transperineal aspiration of PA were comparable to TUD technique regarding the recurrence rate and hospitalization period; however, the safety profile was in favor of the aspiration groups.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"80 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evaluation of the effect of additional surgical margin parameters on biochemical recurrence (BCR) in patients with positive surgical margins (PSM) after radical prostatectomy (RP). Clinicopathological and outcome data from 91 patients with PSM who underwent RP were retrospectively analyzed. Additional surgical margin parameters (PSM length, highest Gleason grade (GG), localization of PSM (apex, bladder neck, or posterolateral), and unifocality or multifocality) were examined and their effects on BCR were investigated. Fifty patients with PSM were included in the study. The mean age of the patients was 63.6 ± 6.9 years. The laparoscopic approach was undertaken more frequently, used for 36 (72%) patients compared to open RP performed in 14 cases (28%). The median follow-up time was 57.0 months (24.0–125.0 months). BCR developed in 14 (28%) patients during the follow-up period. Although mean BCR-free survival was shorter in cases with PSM length ≥ 3 mm compared to those with PSM length < 3 mm (90.4 vs. 108.2 months), multifocality compared to those with unifocality (62 vs. 97.4 months) and surgical margin GG ≥ 4 compared to those with GG 3 (87.4 vs. 97.5 months), the differences were not statistically significant (p = 0.251, p = 0.509 and p = 0.317, respectively). In addition, none of the PSM localizations affected BCR-free survival (p = 0.619). In univariate Cox regression analysis, PSM length affected BCR at a level close to statistical significance (HR = 1.16; p = 0.052). In multiple Cox regression analysis, main tumor Gleason score was determined to be a risk factor associated with BCR (HR = 4.75; p = 0.041). Although BCR-free survival was shortened in the presence of poor prognostic features (multifocal PSM, PSM length ≥ 3 mm, surgical margin GG ≥ 4) at the surgical margin, none of these parameters affected BCR at a statistically significant level. Gleason score of the main tumor was found to be a better prognostic factor for BCR.
{"title":"The effect of surgical margin features on oncologic outcomes after radical prostatectomy","authors":"Mubariz Aydamirov, Mutlu Deger, Nebil Akdogan, Ismail Onder Yilmaz, Sevinc Puren Yucel Karakaya, Tugba Toyran, Seyda Erdogan, Yildirim Bayazit, Volkan Izol","doi":"10.1186/s12301-024-00445-y","DOIUrl":"https://doi.org/10.1186/s12301-024-00445-y","url":null,"abstract":"Evaluation of the effect of additional surgical margin parameters on biochemical recurrence (BCR) in patients with positive surgical margins (PSM) after radical prostatectomy (RP). Clinicopathological and outcome data from 91 patients with PSM who underwent RP were retrospectively analyzed. Additional surgical margin parameters (PSM length, highest Gleason grade (GG), localization of PSM (apex, bladder neck, or posterolateral), and unifocality or multifocality) were examined and their effects on BCR were investigated. Fifty patients with PSM were included in the study. The mean age of the patients was 63.6 ± 6.9 years. The laparoscopic approach was undertaken more frequently, used for 36 (72%) patients compared to open RP performed in 14 cases (28%). The median follow-up time was 57.0 months (24.0–125.0 months). BCR developed in 14 (28%) patients during the follow-up period. Although mean BCR-free survival was shorter in cases with PSM length ≥ 3 mm compared to those with PSM length < 3 mm (90.4 vs. 108.2 months), multifocality compared to those with unifocality (62 vs. 97.4 months) and surgical margin GG ≥ 4 compared to those with GG 3 (87.4 vs. 97.5 months), the differences were not statistically significant (p = 0.251, p = 0.509 and p = 0.317, respectively). In addition, none of the PSM localizations affected BCR-free survival (p = 0.619). In univariate Cox regression analysis, PSM length affected BCR at a level close to statistical significance (HR = 1.16; p = 0.052). In multiple Cox regression analysis, main tumor Gleason score was determined to be a risk factor associated with BCR (HR = 4.75; p = 0.041). Although BCR-free survival was shortened in the presence of poor prognostic features (multifocal PSM, PSM length ≥ 3 mm, surgical margin GG ≥ 4) at the surgical margin, none of these parameters affected BCR at a statistically significant level. Gleason score of the main tumor was found to be a better prognostic factor for BCR.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"61 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1186/s12301-024-00442-1
Sally Mohammed El-Hefnawy, Ibrahim Tantawy Elsayed, Abdel Hamid Abdo Ismaiel, Alshimaa M. Alhanafy, Rania Elsayed Ellaban
The most prevalent malignancy in the urinary tract is bladder cancer, which is becoming more commonplace globally. Circular RNAs, or circRNAs, have a role in cancer pathogenesis as they can be used as biomarkers to help identify new cases and predict the likelihood of recurrence. The current work examined the gene expression of CircANXA2 and CircFBXW7 and evaluated their potential utility in bladder cancer diagnosis. Seventy people with benign urologic diseases, seventy people with bladder cancer, and seventy healthy controls participated in the study. The polymerase chain reaction in real time quantified the gene expressions of CircANXA2 and CircFBXW7. Compared to the benign group and controls, bladder cancer patients had significantly greater levels of CircANXA2 expression (p < 0.001). In contrast to the benign group and controls, bladder cancer patients had significantly decreased levels of CircFBXW7 expression (p < 0.001). CircANXA2 and CircFBXW7 have comparable sensitivity and specificity; CircANXA2 had sensitivity, and specificity (77.14% and 76.43) and CircFBXW7 had sensitivity, and specificity (80.0% and 70.0%) respectively in detecting bladder cancer. CircANXA2 and CircFBXW7 were found to be the risk variables for bladder cancer using multivariate analysis. The odds ratios (OR) for CircANXA2 and CircFBXW7 were 1.240 (1.135–1.354) and 0.026 (0.006–0.107), in that order. In conclusion, CircANXA2 and CircFBXW7 may be highly specific and sensitive diagnostic markers for bladder cancer.
{"title":"Role of circular RNAs (CircANXA2 and CircFBXW7) in bladder cancer","authors":"Sally Mohammed El-Hefnawy, Ibrahim Tantawy Elsayed, Abdel Hamid Abdo Ismaiel, Alshimaa M. Alhanafy, Rania Elsayed Ellaban","doi":"10.1186/s12301-024-00442-1","DOIUrl":"https://doi.org/10.1186/s12301-024-00442-1","url":null,"abstract":"The most prevalent malignancy in the urinary tract is bladder cancer, which is becoming more commonplace globally. Circular RNAs, or circRNAs, have a role in cancer pathogenesis as they can be used as biomarkers to help identify new cases and predict the likelihood of recurrence. The current work examined the gene expression of CircANXA2 and CircFBXW7 and evaluated their potential utility in bladder cancer diagnosis. Seventy people with benign urologic diseases, seventy people with bladder cancer, and seventy healthy controls participated in the study. The polymerase chain reaction in real time quantified the gene expressions of CircANXA2 and CircFBXW7. Compared to the benign group and controls, bladder cancer patients had significantly greater levels of CircANXA2 expression (p < 0.001). In contrast to the benign group and controls, bladder cancer patients had significantly decreased levels of CircFBXW7 expression (p < 0.001). CircANXA2 and CircFBXW7 have comparable sensitivity and specificity; CircANXA2 had sensitivity, and specificity (77.14% and 76.43) and CircFBXW7 had sensitivity, and specificity (80.0% and 70.0%) respectively in detecting bladder cancer. CircANXA2 and CircFBXW7 were found to be the risk variables for bladder cancer using multivariate analysis. The odds ratios (OR) for CircANXA2 and CircFBXW7 were 1.240 (1.135–1.354) and 0.026 (0.006–0.107), in that order. In conclusion, CircANXA2 and CircFBXW7 may be highly specific and sensitive diagnostic markers for bladder cancer.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"39 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1186/s12301-024-00441-2
Ahmed Mohammed Umar, Ismaila Arzika Mungadi, Ngwobia Peter Agwu, Abdullah Abdulwahab-Ahmed, Abubakar Sadiq Muhammad, Abdullahi Khalid
This study aimed to compare serum prostate specific antigen (PSA), Soluble E-cadherin (sE-cad), and Inosine Monophosphate Dehydrogenase-2 in predicting prostate cancer aggressiveness by determining their correlations with Gleason score and International Society of Urological Pathology (ISUP) Grade Groups. This was a hospital-based descriptive quantitative cross-sectional study whereby we enrolled 48 newly diagnosed prostate adenocarcinoma patients in the study. Their serum was analysed for PSA, sE-cad, and IMPDH-2. Pearson correlation coefficient was used to test the correlation between the serum sE-cad and Gleason score while Spearman rho correlation coefficient was used for PSA and IMPDH-2. The correlation coefficient (r) was graded as very weak (< 0.3), weak (0.3–0.4), moderate (0.5–0.6), or strong (≥ 0.7), while the magnitude was determined by calculating the coefficient of determination for the respective analysis (R2). The correlation between the biomarkers and the ISUP Grade groups was determined using the Kendall tau correlation coefficient (τ). All levels of statistical significance were set at p < 0.05. The mean age of the subjects was 69.4 years. The Means of serum PSA, sE-cad, and IMPDH-2 were 47.2 ng/ml, 136.5 ng/ml, and 89.8 pg/ml respectively. Serum PSA weakly correlated with both Gleason score (r = 0.3, p = 0.04) and ISUP grade groups (τ = 0.3, p = 0.02). The magnitude was 0.097. Similarly, serum sE-cad correlated weakly with both Gleason scores (r = 0.4, p = 0.01), and ISUP Grade Groups (τ = 0.3, p = 0.005). The magnitude was 0.134. However, serum IMPDH-2 neither correlated with Gleason score (r = 0.03, p = 0.86) nor ISUP Grade Groups (τ = 0.004, p = 0.97). Serum sE-cad did not outperform both IMPDH-2 (p = 0.91) or PSA (p = 0.23) in predicting the Gleason score. Serum sE-cad best predicted aggressive prostate cancer but did not statistically outperform serum PSA or IMPDH-2. Hence, neither of the three are reliable predictors of aggressive prostate cancer.
{"title":"Comparison of serum prostate specific antigen (PSA), soluble E-cadherin (sE-cad), and inosine monophosphate dehydrogenase-2 (IMPDH-2) as aggressive prostate cancer predictors","authors":"Ahmed Mohammed Umar, Ismaila Arzika Mungadi, Ngwobia Peter Agwu, Abdullah Abdulwahab-Ahmed, Abubakar Sadiq Muhammad, Abdullahi Khalid","doi":"10.1186/s12301-024-00441-2","DOIUrl":"https://doi.org/10.1186/s12301-024-00441-2","url":null,"abstract":"This study aimed to compare serum prostate specific antigen (PSA), Soluble E-cadherin (sE-cad), and Inosine Monophosphate Dehydrogenase-2 in predicting prostate cancer aggressiveness by determining their correlations with Gleason score and International Society of Urological Pathology (ISUP) Grade Groups. This was a hospital-based descriptive quantitative cross-sectional study whereby we enrolled 48 newly diagnosed prostate adenocarcinoma patients in the study. Their serum was analysed for PSA, sE-cad, and IMPDH-2. Pearson correlation coefficient was used to test the correlation between the serum sE-cad and Gleason score while Spearman rho correlation coefficient was used for PSA and IMPDH-2. The correlation coefficient (r) was graded as very weak (< 0.3), weak (0.3–0.4), moderate (0.5–0.6), or strong (≥ 0.7), while the magnitude was determined by calculating the coefficient of determination for the respective analysis (R2). The correlation between the biomarkers and the ISUP Grade groups was determined using the Kendall tau correlation coefficient (τ). All levels of statistical significance were set at p < 0.05. The mean age of the subjects was 69.4 years. The Means of serum PSA, sE-cad, and IMPDH-2 were 47.2 ng/ml, 136.5 ng/ml, and 89.8 pg/ml respectively. Serum PSA weakly correlated with both Gleason score (r = 0.3, p = 0.04) and ISUP grade groups (τ = 0.3, p = 0.02). The magnitude was 0.097. Similarly, serum sE-cad correlated weakly with both Gleason scores (r = 0.4, p = 0.01), and ISUP Grade Groups (τ = 0.3, p = 0.005). The magnitude was 0.134. However, serum IMPDH-2 neither correlated with Gleason score (r = 0.03, p = 0.86) nor ISUP Grade Groups (τ = 0.004, p = 0.97). Serum sE-cad did not outperform both IMPDH-2 (p = 0.91) or PSA (p = 0.23) in predicting the Gleason score. Serum sE-cad best predicted aggressive prostate cancer but did not statistically outperform serum PSA or IMPDH-2. Hence, neither of the three are reliable predictors of aggressive prostate cancer.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"5 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ewing’s sarcoma is a rare form of bone cancer that can also affect soft tissues. In some cases, it can spread to other parts of the body, including the testicles, causing testicular metastases. To our knowledge, no testicular metastasis of Ewing’s sarcoma has been reported in the literature. We report an original case of an 18-year-old patient who presented with bilateral testicular masses revealing an exceptional metastasis of metastatic bone Ewing sarcoma under chemotherapy for one year. It was difficult to diagnose synchronous bilateral testicular metastases of Ewing’s sarcoma due to the low frequency of these metastases. However, given the history of metastatic cancer, the data from the clinical examination, and the results of ultrasound, it should be considered and included in the differential diagnosis. Despite the uncommon occurrence of secondary testicular metastasis, it should be considered in the differential diagnosis when encountering such a clinical presentation.
{"title":"Unusual testicular metastatic localization of Ewing’s sarcoma: case report","authors":"Youness Aboulaich, Youssef Kharbach, Abdelhak Khallouk","doi":"10.1186/s12301-024-00440-3","DOIUrl":"https://doi.org/10.1186/s12301-024-00440-3","url":null,"abstract":"Ewing’s sarcoma is a rare form of bone cancer that can also affect soft tissues. In some cases, it can spread to other parts of the body, including the testicles, causing testicular metastases. To our knowledge, no testicular metastasis of Ewing’s sarcoma has been reported in the literature. We report an original case of an 18-year-old patient who presented with bilateral testicular masses revealing an exceptional metastasis of metastatic bone Ewing sarcoma under chemotherapy for one year. It was difficult to diagnose synchronous bilateral testicular metastases of Ewing’s sarcoma due to the low frequency of these metastases. However, given the history of metastatic cancer, the data from the clinical examination, and the results of ultrasound, it should be considered and included in the differential diagnosis. Despite the uncommon occurrence of secondary testicular metastasis, it should be considered in the differential diagnosis when encountering such a clinical presentation.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"371 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141937555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1186/s12301-024-00439-w
Reza Valipour, Behzad Narouie, Sajedeh Jadidi, Mehdi Dadpour, Mohammad Mehdi Darzi, Parham Torabinavid, Negar Radpour, Hamidreza Momeni
Ensuring the integrity of sperm DNA is of paramount importance for the production of healthy offspring. The process of sperm formation involves intricate molecular adjustments that condense and safeguard its genetic material. However, the risk posed by sperm DNA fragmentation (SDF) can impede natural and assisted fertility and may arise from various testicular and post-testicular factors. While there are recommendations against routine SDF testing, recent research has sparked debate by demonstrating the positive impact of such testing on fertility outcomes. To identify the factors associated with SDF among infertile individuals. The medical records of infertile men referred to our hospital were comprehensively reviewed and included in the study as they met the inclusion criteria. Patients dissatisfied with participation in the study or those with incomplete medical records were excluded. The association of SDF, sperm analysis, and demographic characteristics were evaluated for further investigation. The average age of participants was 36.1 ± 8.1 years. The average semen volume was 2.5 ± 0.3 cc with a semen pH of 7.4 ± 0.2. The average sperm count was 10.9 ± 0.7 million, sperm motility was 36.9 ± 2.4%, and normal sperm morphology was 41.7 ± 2.7%. SDF levels below 15% were seen in 27.9%, between 15 and 30% in 32.4%, and above 30% in 39.7% of patients. Significant associations were found between the SDF and various factors in sperm analysis, including sperm count (P < 0.001), semen volume (P < 0.001), semen pH (P < 0.001), sperm motility (P < 0.001), normal sperm morphology (P < 0.001), and age (P < 0.001). Moreover, alcohol consumption (P = 0.04), smoking (P = 0.01), and the presence of varicocele (P = 0.03) were significantly associated with. This study emphasizes the significance of SDF among individuals experiencing infertility and investigates its correlation with various sperm test parameters. It also sheds light on the vital roles played by factors such as age, smoking, alcohol consumption, and the presence of varicocele, which are highly likely to cause variations in SDF levels. The results of our research will add to the existing pool of knowledge on infertility and potentially have implications for clinical practice and the care of patients.
{"title":"Evaluation of sperm DNA fragmentation index among infertile individuals: a comprehensive analysis of the associated factors—a cross-sectional study","authors":"Reza Valipour, Behzad Narouie, Sajedeh Jadidi, Mehdi Dadpour, Mohammad Mehdi Darzi, Parham Torabinavid, Negar Radpour, Hamidreza Momeni","doi":"10.1186/s12301-024-00439-w","DOIUrl":"https://doi.org/10.1186/s12301-024-00439-w","url":null,"abstract":"Ensuring the integrity of sperm DNA is of paramount importance for the production of healthy offspring. The process of sperm formation involves intricate molecular adjustments that condense and safeguard its genetic material. However, the risk posed by sperm DNA fragmentation (SDF) can impede natural and assisted fertility and may arise from various testicular and post-testicular factors. While there are recommendations against routine SDF testing, recent research has sparked debate by demonstrating the positive impact of such testing on fertility outcomes. To identify the factors associated with SDF among infertile individuals. The medical records of infertile men referred to our hospital were comprehensively reviewed and included in the study as they met the inclusion criteria. Patients dissatisfied with participation in the study or those with incomplete medical records were excluded. The association of SDF, sperm analysis, and demographic characteristics were evaluated for further investigation. The average age of participants was 36.1 ± 8.1 years. The average semen volume was 2.5 ± 0.3 cc with a semen pH of 7.4 ± 0.2. The average sperm count was 10.9 ± 0.7 million, sperm motility was 36.9 ± 2.4%, and normal sperm morphology was 41.7 ± 2.7%. SDF levels below 15% were seen in 27.9%, between 15 and 30% in 32.4%, and above 30% in 39.7% of patients. Significant associations were found between the SDF and various factors in sperm analysis, including sperm count (P < 0.001), semen volume (P < 0.001), semen pH (P < 0.001), sperm motility (P < 0.001), normal sperm morphology (P < 0.001), and age (P < 0.001). Moreover, alcohol consumption (P = 0.04), smoking (P = 0.01), and the presence of varicocele (P = 0.03) were significantly associated with. This study emphasizes the significance of SDF among individuals experiencing infertility and investigates its correlation with various sperm test parameters. It also sheds light on the vital roles played by factors such as age, smoking, alcohol consumption, and the presence of varicocele, which are highly likely to cause variations in SDF levels. The results of our research will add to the existing pool of knowledge on infertility and potentially have implications for clinical practice and the care of patients.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"505 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141937550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1186/s12301-024-00437-y
T. K. Aravind, Siddharth Yadav, Harshdeep Singh
Complex vesico-vaginal fistulae (VVF) pose unique surgical challenges and necessitate the use of interposition tissue to ensure surgical success. Herein, we describe a case of complex VVF with right uretero-vaginal fistula post radical surgery for locally advanced ovarian cancer and chemotherapy in which the rectus abdominis muscle flap was used as the interposition tissue, as the more routine used options such as omentum and peritoneum were removed in the prior radical surgery. We describe a case report of a vesico-vaginal and right uretero-vaginal fistula in a 34-year-old female post ovarian cancer radical surgery managed surgically with the traditional transvesical technique of repair and ureteric reimplantation with a unique interposition with rectus abdominis muscle considering the absence of the more routine options. Complex VVFs pose unique surgical challenges and necessitate the use of interposition tissue to ensure surgical success. The inferior pedicle based rectus abdominis muscle flap is an excellent interposition tissue for repairs via the transabdominal approach especially in scenarios where the more routine options are unavailable.
{"title":"Rectus abdominis muscle flap in complex vesico-vaginal fistula repair: unique situation, uncommon option","authors":"T. K. Aravind, Siddharth Yadav, Harshdeep Singh","doi":"10.1186/s12301-024-00437-y","DOIUrl":"https://doi.org/10.1186/s12301-024-00437-y","url":null,"abstract":"Complex vesico-vaginal fistulae (VVF) pose unique surgical challenges and necessitate the use of interposition tissue to ensure surgical success. Herein, we describe a case of complex VVF with right uretero-vaginal fistula post radical surgery for locally advanced ovarian cancer and chemotherapy in which the rectus abdominis muscle flap was used as the interposition tissue, as the more routine used options such as omentum and peritoneum were removed in the prior radical surgery. We describe a case report of a vesico-vaginal and right uretero-vaginal fistula in a 34-year-old female post ovarian cancer radical surgery managed surgically with the traditional transvesical technique of repair and ureteric reimplantation with a unique interposition with rectus abdominis muscle considering the absence of the more routine options. Complex VVFs pose unique surgical challenges and necessitate the use of interposition tissue to ensure surgical success. The inferior pedicle based rectus abdominis muscle flap is an excellent interposition tissue for repairs via the transabdominal approach especially in scenarios where the more routine options are unavailable.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"40 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141937551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1186/s12301-024-00436-z
Essmat A. H. Allam
Urolithiasis is a multifaceted and common urological disorder characterized by the development of renal calculi. Calcium oxalate stones are the most prevalent type of calculi, forming when calcium and oxalate combine to produce crystalline structures in the urine. The incidence rates of urolithiasis exhibit geographical variations, which are determined by factors such as geographic location, age, sex, dietary habits, and genetics. The increasing trend of urolithiasis has emerged as a noteworthy public health issue, potentially attributed to shifts in dietary and lifestyle habits. In response to this challenge, various inhibitors of calcium oxalate crystal formation, including small molecules, peptides, and proteins, have been developed. Moreover, substances such as citrate, magnesium, inter-alpha-trypsin inhibitors, phytate, potassium, and pyrophosphates show promise in preventing kidney stones. A comprehensive metabolic assessment is crucial, customized for each patient, to effectively manage and avoid the recurrence of urolithiasis. Although specific pharmacological treatments for urolithiasis are currently unavailable, some drugs can reduce pain. Some drugs, including calcium channel blockers like nifedipine, phosphodiesterase-5 inhibitors like tadalafil, and alpha-blockers like tamsulosin, are thought to lower ureteral contractions by making the ureteral smooth muscle relax. In acute and severe pain cases, intravenous administration of narcotic analgesics and anti-inflammatory agents may be employed in emergency medical settings. To enhance therapeutic approaches, it is essential to gain more knowledge about the pathophysiology of renal calculi. The development of inhibitors targeting calcium oxalate crystal formation offers a promising avenue for urolithiasis prophylaxis. Identifying and investigating potential inhibitors lays the framework for the creation of more effective and targeted therapeutic options.
{"title":"Urolithiasis unveiled: pathophysiology, stone dynamics, types, and inhibitory mechanisms: a review","authors":"Essmat A. H. Allam","doi":"10.1186/s12301-024-00436-z","DOIUrl":"https://doi.org/10.1186/s12301-024-00436-z","url":null,"abstract":"Urolithiasis is a multifaceted and common urological disorder characterized by the development of renal calculi. Calcium oxalate stones are the most prevalent type of calculi, forming when calcium and oxalate combine to produce crystalline structures in the urine. The incidence rates of urolithiasis exhibit geographical variations, which are determined by factors such as geographic location, age, sex, dietary habits, and genetics. The increasing trend of urolithiasis has emerged as a noteworthy public health issue, potentially attributed to shifts in dietary and lifestyle habits. In response to this challenge, various inhibitors of calcium oxalate crystal formation, including small molecules, peptides, and proteins, have been developed. Moreover, substances such as citrate, magnesium, inter-alpha-trypsin inhibitors, phytate, potassium, and pyrophosphates show promise in preventing kidney stones. A comprehensive metabolic assessment is crucial, customized for each patient, to effectively manage and avoid the recurrence of urolithiasis. Although specific pharmacological treatments for urolithiasis are currently unavailable, some drugs can reduce pain. Some drugs, including calcium channel blockers like nifedipine, phosphodiesterase-5 inhibitors like tadalafil, and alpha-blockers like tamsulosin, are thought to lower ureteral contractions by making the ureteral smooth muscle relax. In acute and severe pain cases, intravenous administration of narcotic analgesics and anti-inflammatory agents may be employed in emergency medical settings. To enhance therapeutic approaches, it is essential to gain more knowledge about the pathophysiology of renal calculi. The development of inhibitors targeting calcium oxalate crystal formation offers a promising avenue for urolithiasis prophylaxis. Identifying and investigating potential inhibitors lays the framework for the creation of more effective and targeted therapeutic options. ","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"26 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corpus cavernosum abscess is an uncommonly described urological condition. We report a case of bilateral corpus cavernosum abscess in a 49-year-old man with a history of the left scrotal abscess. A 49-year-old man was present with 10 days history of painful and swollen penis. He had a history of an abscess in the left scrotum. The examination revealed non-erythematous palpable edema and tenderness on the shaft of the penis. Laboratory results showed leukocytosis. He was diagnosed with bilateral corpus cavernosum abscess and right testicular hypotrophy after an MRI examination. He underwent a bilateral corporotomy, debridement with Mulcahy salvage solution, and placement of a Penrose drain. A penile abscess can be caused by a variety of factors. Treatment includes intravenous antibiotics, radiologically guided needle aspiration, or open surgical drainage. In addition to antibiotic treatment, surgical debridement is required for the majority of penile abscess cases.
{"title":"Bilateral corpus cavernosum abscess: a case report and a review of the literature","authors":"Steven, Nur Rasyid, Ponco Birowo, Doddy Widyawan Hami Seno, Indri Aulia, Widi Atmoko","doi":"10.1186/s12301-024-00433-2","DOIUrl":"https://doi.org/10.1186/s12301-024-00433-2","url":null,"abstract":"Corpus cavernosum abscess is an uncommonly described urological condition. We report a case of bilateral corpus cavernosum abscess in a 49-year-old man with a history of the left scrotal abscess. A 49-year-old man was present with 10 days history of painful and swollen penis. He had a history of an abscess in the left scrotum. The examination revealed non-erythematous palpable edema and tenderness on the shaft of the penis. Laboratory results showed leukocytosis. He was diagnosed with bilateral corpus cavernosum abscess and right testicular hypotrophy after an MRI examination. He underwent a bilateral corporotomy, debridement with Mulcahy salvage solution, and placement of a Penrose drain. A penile abscess can be caused by a variety of factors. Treatment includes intravenous antibiotics, radiologically guided needle aspiration, or open surgical drainage. In addition to antibiotic treatment, surgical debridement is required for the majority of penile abscess cases.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"15 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141506231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1186/s12301-024-00434-1
Abdelaali Belhachem, S. Makhloufi, R. Lecheheb, D. Mediouni, A. Bennekrouf, A. Amiar, A. Bengueddach, W. Belkacem, F. Boudia, M. J. Yousfi, H. Toumi
This study explores the potential litholytic activity of medicinal plant infusions, specifically Arenaria rubra, Hordeum vulgare, and Zea mays, as well as a combination of these infusions, on various types of urinary calculi. Given the traditional use of these plants in managing kidney stones and the need for alternative treatments, this investigation aims to assess their efficacy in dissolving different types of calculi. Samples representing calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), cystine (Cy), uric acid (UA), and calcium phosphate (CP) calculi were analyzed using FTIR and optical microscopy. Herbal infusions were prepared at a concentration of 14 g/l, and the dissolution capacity was evaluated by incubating the calculi samples in the infusions for eight weeks. Microscopic examination and statistical analysis were conducted to assess the efficacy of the infusions. Limited dissolution of COM and COD calculi was observed with the infusions, consistent with their known resistance to dissolution. Significant dissolution effects were observed for Cy, UA, and CP calculi, especially with infusions of A. rubra and H. vulgare. These findings suggest the potential of plant infusions as complementary therapeutic agents for certain types of kidney stones. This study highlights the promising litholytic activity of medicinal plant infusions, specifically A. rubra and H. vulgare, which indicates a significant dissolution of various urinary calculi. While further research is needed to validate these findings, integrating plant infusions, extracts, or essential oils into clinical practice could offer additional treatment options for managing kidney stones and preventing recurrence.
本研究探讨了药用植物输液（特别是红叶石蒜、大麦和玉米）以及这些输液的组合对各种类型泌尿系统结石的潜在溶石活性。鉴于这些植物在治疗肾结石方面的传统用途以及对替代疗法的需求，这项调查旨在评估它们在溶解不同类型结石方面的功效。使用傅立叶变换红外光谱和光学显微镜分析了代表一水草酸钙（COM）、二水草酸钙（COD）、胱氨酸（Cy）、尿酸（UA）和磷酸钙（CP）结石的样本。草药输液的浓度为 14 克/升，通过将结石样本在输液中培养八周来评估其溶解能力。通过显微镜检查和统计分析来评估输液的功效。输液对 COM 和 COD 结石的溶解有限，这与它们已知的抗溶解性一致。对 Cy、UA 和 CP 结石的溶解效果显著，尤其是红叶石楠和 H. vulgare。这些研究结果表明，植物输液具有辅助治疗某些类型肾结石的潜力。这项研究强调了药用植物输液，特别是红叶石楠和芸香石楠具有良好的溶石活性，能显著溶解各种泌尿系统结石。虽然还需要进一步的研究来验证这些发现，但将植物输液、提取物或精油融入临床实践，可为控制肾结石和预防复发提供更多的治疗选择。
{"title":"Morpho-constitutional analysis of urolithiasis and in vitro litholytic evaluation of select plants against diverse renal calculi variants","authors":"Abdelaali Belhachem, S. Makhloufi, R. Lecheheb, D. Mediouni, A. Bennekrouf, A. Amiar, A. Bengueddach, W. Belkacem, F. Boudia, M. J. Yousfi, H. Toumi","doi":"10.1186/s12301-024-00434-1","DOIUrl":"https://doi.org/10.1186/s12301-024-00434-1","url":null,"abstract":"This study explores the potential litholytic activity of medicinal plant infusions, specifically Arenaria rubra, Hordeum vulgare, and Zea mays, as well as a combination of these infusions, on various types of urinary calculi. Given the traditional use of these plants in managing kidney stones and the need for alternative treatments, this investigation aims to assess their efficacy in dissolving different types of calculi. Samples representing calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), cystine (Cy), uric acid (UA), and calcium phosphate (CP) calculi were analyzed using FTIR and optical microscopy. Herbal infusions were prepared at a concentration of 14 g/l, and the dissolution capacity was evaluated by incubating the calculi samples in the infusions for eight weeks. Microscopic examination and statistical analysis were conducted to assess the efficacy of the infusions. Limited dissolution of COM and COD calculi was observed with the infusions, consistent with their known resistance to dissolution. Significant dissolution effects were observed for Cy, UA, and CP calculi, especially with infusions of A. rubra and H. vulgare. These findings suggest the potential of plant infusions as complementary therapeutic agents for certain types of kidney stones. This study highlights the promising litholytic activity of medicinal plant infusions, specifically A. rubra and H. vulgare, which indicates a significant dissolution of various urinary calculi. While further research is needed to validate these findings, integrating plant infusions, extracts, or essential oils into clinical practice could offer additional treatment options for managing kidney stones and preventing recurrence.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"86 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141506232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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