Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190810Arsenic Trioxide; a Novel Therapeutic Agent for Prostate and Bladder Cancers1710500110.22034/au.2020.223726.1011ENAkram MirzaeiUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-2219-999XLeila Zareian BaghdadabadUrology Research Center, Tehran University of Medical Sciences, Tehran, IranMohammad Hatef KhorramiDepartment of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1246-6345Seyed Mohammad Kazem AghamirUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1611-0362Journal Article20190610The effectiveness of arsenic trioxide (ATO) in treating blood diseases is one of the most striking developments in modern medicine. One of the most essential benefits of ATO is the failure of bone marrow suppression. ATO has been proposed as a novel and effective medicine for cancer prevention and treatment with various functions, including induction of apoptosis through re-activating the Wnt inhibitor, growth inhibition via activation of phosphatidylinositol 3-kinase (PI3K)/AKT pathway, autophagy stimulation, induction of cell differentiation and angiogenesis via vascular endothelial growth factor A (VEGFA)-VEGFR2-PI3K/ extracellular signal‐regulated kinase (ERK) signaling path in cancer cells and ATO may be involved in the acetylation of histones and interfering with gene transcription. ATO can increase the synergistic effect in treatment and increase antitumor effects on prostate cancer cells via inhibiting Akt/mTOR signaling pathways. So, ATO, combined with inhibiting glutathione synthesis, can effectively treat bladder cancer epithelial cells.<br /> Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190812Laparoscopic Injection of Methylene Blue to Discriminate Cyst from Calyceal Diverticulum81110622110.22034/au.2020.221836.1008ENSeyed Mohammad Kazem AghamirUrology research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1611-0362Fatemeh KhatamiUrology research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-6311-1336Hamidreza ZiaUrology research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-2335-4843Journal Article20190615<strong>Introduction</strong><br /><strong> </strong><br />Renal cysts are sacs of fluid with a thin wall, usually with no symptoms, and have no connection to the renal calyx. Another renal lesion that can be misdiagnosed with cysts is the calyceal diverticulum linked to the renal calyx. The new approach of laparoscopic injection of methylene blue can help the surgeon distinguish renal cysts from a calyceal diverticulum in a patient with no double J (Dj/JJ).<br /><strong>Case presentation</strong><br />A 52-years patient with a 15 cm lesion underwent laparoscopic surgery of a renal cyst. Surgery was done in the flank position, and the peritoneoscopy was performed after the cyst reveal. Several small cysts were observed at the bottoms of the cyst, so we injected methylene blue to make it clear this lesion was exactly cysts, not calyceal diverticulum. It was proven that there is no leaking of blue color to the renal calyx through the catheter. The cyst was revealed and was removed and sent for pathology.<br /><strong>Conclusions</strong><br />In our study, the laparoscopic injection of methylene blue indicated no connection with the renal calyx, so the lesion is a renal cyst. So it can be a new approach for distinguishing cysts from a calyceal diverticulum.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190815Impact of Bone Mineral Density on the Recurrent Urolithiasis121610632410.22034/au.2020.227228.1014ENAbdolrasoul MehrsaiUrology Research Center,Tehran University of Medical Sciences, Tehran, IranElham Hashemian NaeiniDepartment of Gynecological Oncology, Mirza Koochak Khan Hospital, Tehran, IranFatemeh Dadkhah TehraniDepartment of Biomadical Engineering, Amirkabir University of Technology, Tehran, IranKeramatollah Noori JalayaniDepartment of Medicine, Tehran University of Medical Sciences, Tehran, IranJournal Article20190616<strong>Introduction</strong><br />Patients with urinary stones have calcium metabolism deficiencies, leading to excessive calcium absorption from their bones. This phenomenon may expose these individuals to osteoporosis. This study evaluated bone mineral density (BMD) in patients with urinary stones in Iran.<br /><strong>Methods</strong><br />This is an analytical case-control study performed in Sina hospital from March 2016 to January 2018. Twenty-four male patients between 30 and 50 with recurrent urinary tract stones were enrolled in the study. The control group was selected from the same period and sex group with no history of urinary stone formation. The diet was similar in the two groups. The sampling method was non-random. Age and BMI were considered confounding variables. After completing, the questionnaire measured the BMD of the lumbar spine (L4 L2) and the femoral neck. The data were analyzed using linear regression and t-test.<br /><strong>Results</strong><br />In both regions, BMD was significantly lower in patients compared to the control group (p-value<0.01). Besides, there was a significant correlation between the duration of urinary stones and BMD in each of the mentioned areas (p-value<0.001, r=-0.73 in the lumbar spine, p-value<br /><strong>Conclusions</strong><br />Reduction of bone density in patients with recurrent urinary stones may indicate a primary impairment in the bone metabolism of these individuals. Considering that 30% of patients have osteopenia and, generally, patients with urinary stones are not allowed to use calcium, it is necessary to eliminate calcium from their diets only after complete analysis.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190817Equivalency of First-Void Urine Culture with Prostatic Secretion Fluids172210661010.22034/au.2020.221850.1010ENKiumars GhazisaidiInfectious Disease Research Center, Golestan University of Medical Sciences, Gorgan, IranYasaman AzimiDepartment of Medicine, Tehran University of Medical Sciences, Tehran, IranAli SamadiDepartment of Genetics and Molecular Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran0000-0001-9171-6896Seyed Mohammad Kazem AghamirUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1611-0362Maryam AghaiiUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-0770-0654Gholamreza PourmandUrology Research Center, Tehran University of Medical Sciences, Tehran, IranJournal Article20190525<strong>Introduction</strong><br />The purpose of the current study was to investigate the separation of the bacterial factors of men’s urinary tract infections using the prostate massage technique and compare them with the initial-stream, midstream, and end-stream urine in Tehran’s Health Centers. <br /><strong>Methods</strong><br />This study collected samples from 50 men with genital-urinary tract defects who were referred to medical centers. Patients were asked for demographic information, medical history, and drugs taken during sampling. Prostate secretions and first-void urine (VB1) were collected from the first 25 patients; prostate secretions and VB1, midstream urine (VB2), and end-stream urine (VB3) were collected from the second 25 patients.<br /><strong>Results</strong><br />Using prostate secretions culture, out of the first 25 samples, 7 samples (28%) were infected by <em>Mycoplasma hominis </em>and 9 samples (36%) were infected by <em>Ureaplasma urealyticum</em>. using VB1 culture, it was analyzed that 6 samples (24%) were infected by <em>Mycoplasma hominis </em>and 8 samples (32%) were infected by <em>Ureaplasma urealyticum</em>. In the second 25 samples, Bacterial contamination was seen in 23 samples (92%) by prostate secretions culture. VB1 culture showed bacterial contamination in 14 samples (56%). VB2 and VB3 cultures showed bacterial contamination in 3 (12%) and only 2 samples (8%).<br /><strong>Conclusions</strong><br />In conclusion, the results obtained from the prostate secretions culture were more accurate and precise than the VB1 culture, but they were close to each other. Therefore, instead of using prostate massage, which can be irritating for the patients or if the patient does not have prostate secretions, VB1 culture can be used.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190823An Unusual Extrarenal Renal Cell Carcinoma: Case Report232610662410.22034/au.2020.227372.1015ENFateme GuitynavardUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-7664-5329Seyed Habibollah MousavibaharUrology and Nephrology Research Center, Hamedan University of Medical Sciences, Hamedan, IranFatemeh Dadkhah TehraniDepartment of Biomedical Engineering, Amirkabir University of Technology, Tehran, IranArezoo Eftekhar JavadiDepartment of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, IranHamidreza ZiaUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-2335-4843Journal Article20190528<strong>Introduction</strong><br />Renal cell carcinoma (RCC) is the most common type of kidney tumor. The extra-renal type has been previously reported only by a few studies. In this type of RCC, cancerous tissue is present in regions other than the kidney. Here we present an isolated renal mass (RM), primarily diagnosed as an adrenal mass.<br /><strong>Case presentation</strong><br />A 52-year-old male presented with left flank pain without weight loss, visible hematuria, and hydronephrosis was the case of this study. Computed tomography (CT) scan revealed a mass that could be either an adrenal tumor, retroperitoneal diagnosis, or a renal upper bridge tumor. The kidney mass was seen above the junction of the middle and upper renal bridges. Its surrounding was liberated from the Gerota. The kidney mass was independent and encapsulated of the kidney but adhered to its surface. It was gradually released from the capsule and extracted. The capsule beneath the mass was intact, and the site had no bleeding. The mass was then placed in endobag and removed from port ten, and the entrance of port ten was sutured during a six-month follow-up there was no hydronephrosis and no evidence of urinoma around the kidney.<br /><strong>Conclusions</strong><br />Rare cases of extrarenal RCC, which attach to the kidney, Can be removed without any damage to the kidney.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190825Comparison on Diagnostic Accuracy of Prostate Cancer Detection Tools: A Systematic Review and Meta-Analysis273910662510.22034/au.2020.226654.1012ENSeyed Mohammad Kazem AghamirUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1611-0362Gita ShafieeChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1611-0362Mehdi EbrahimiDepartment of Internal Medicine, Faculty of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran Iran0000-0002-2783-1248Hossein YarmohammadiChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran0000-0001-8316-9511Rezvan RazmandeChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IranHassan AhmadiChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IranLeila Zareian BaghdadabadUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-5197-5276Ramin HeshmatChronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IranJournal Article20190602<strong>Introduction</strong><br />Some tests and markers have proved to improve the diagnosis of prostate cancer (PCa). This meta-analysis aimed to review the diagnostic accuracy of three commercial tests, prostate health index (PHI), prostate cancer antigen 3 (PCA3), and prostate imaging reporting & data system V2 (PI-RADS) for detecting of PCa. <br /><strong>Methods</strong><br />We did a comprehensive literature search of international databases, including Scopus, Web of Science, and PubMed, from January 2000 to Feb 2018. We included three groups of diagnostic accuracy studies that used PCA3, PHI, and PI-RADS to assess PCa. The l quality of the study was measured by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. <br /><strong>Results</strong><br />Twenty-six studies on PHI, 24 articles on PI-RADS, and 26 papers on PCA3 were included in the meta-analysis. For the diagnosis of PCa, the sensitivity and specificity were 0.76 and 0.84 for PI-RADS, 0.48 and 0.85 for PHI, and 0.49 and 0.79 for PCA3. Also, the derived area under curves (AUC) from the hierarchic summary ROCs (HSROCs) were 0.86 (95% CI, 0.83-0.89) for PI-RADS, 0.72 (0.68-0.76) for PCA3, and 0.70 (0.66-0.74) for PHI. Fagan’s nomograms showed that the post-test probability of cancer subjects with a positive test was 53%, 63%, and 45% for PHI, PI-RADS, and PCA3, respectively.<br /><strong>Conclusions</strong><br />Available evidence suggests that the PI-RADS is superior in diagnosing PCa with high sensitivity, specificity, and AUC compared to PHI and PCA3.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190827Efficacy of Additional Solifenacin Succinate Therapy in Females with Urinary Tract Infection404210662610.22034/au.2020.227867.1017ENBehzad NarouieDepartment of Urology, Zahedan University of Medical Sciences, Zahedan, Iran0000-0003-1574-0055Akram MirzaeiUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-2219-999XJournal Article20190608Urinary tract infection (UTI) is a collective word for diseases involving any portion of the urinary tract and it’s the most common infection in local primary care that has suffered from it by up to 60 percent of females and has at least one symptomatic UTI in a lifetime. UTI can have consequences like kidney infection, infections of the urinary tract, and, eventually, toxic septicemia. UTI is often confused with wide-spectrum antibiotics, so it is imperative to characterize resistance patterns to enhance in-vitro antibiotic strategies. According to previous studies, the use of anticholinergics to relieve UTI symptoms has never been investigated. This research is the first randomized trial of anticholinergic-like solifenacin succinate (with a strong affinity for smooth muscle receptors M3) to treat and improve UTI.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190817Ultrasound-Guided Paravertebral Block compare to the Intravenous Tramadol for Pain Control in Percutaneous Nephrolithotomy434510662710.22034/au.2020.228227.1016ENVahid ShokohidehDepartment of Medicine, Jiroft University of Medical Sciences, Tehran, IranRahil MashhadiUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1788-5282Journal Article20190609< p>Percutaneous nephrolithotomy (PCNL) is a standard treatment method for large choroidal stones with a shorter hospital stay than surgical procedures. After PCNL, a nephrostomy tube is placed for better discharge of urine, to prevent bleeding, and allow for further possible operations, which is can be the major cause of pain and discomfort for the patient. Paravertebral block (PVB) is a successful, non-complicating local anesthetic used in many surgical procedures to manage pain. It is suggested that using PVB to reduce pain after PCNL has had good results. In the previous study, the important problem of post-PCNL pain reduction has been properly managed by the PVB method, and its high efficacy, contrary to tramadol, has been demonstrated. Evaluation of the PVB method is a good choice in this regard, but the question arises as to why Tramadol is selected as a method compared to PVB.Urology Research Center, Tehran University of Medical SciencesTranslational Research in Urology2717-042X1120190821Novel Surgical Strategy for Treatment of Abnormal Cavernous (Balloon-Like Penile) Resulting in Sex Disability465010662810.22034/au.2020.228327.1018ENSeyed Amin MirsadeghiUrology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0001-9601-1588Mohammad AslzareDepartment of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20190612<strong>Introduction</strong><br />Cavernous malformations can result in erectile dysfunction and sex disability. Several treatment strategies are available, and we introduce a novel surgery method with vascular mesh.<br /><strong>Case presentation</strong><br />A 23-years old man had a normal erection, but he could not perform coitus, and his penis bent. He was operated on for ventral chordee with a misdiagnosis of chordee and then treated with an injection of papaverine because of the misdiagnosis of erectile dysfunction (ED), but the problem remained unsolved. We decide to have a novel surgery method using vascular mesh. Our surgery was completely successful, and our new method of surgery can take the place of penile implants for such cases.<br /><strong>Conclusions</strong><br />Our technique with vascular mesh can be considered the most efficient method to make the cavernous retain its normal function.