Endoscopic handling of post surgical female ureteral injuries

This study included 13 female patients with post-gynecologic [7] or post-obstetric ureteral [6] injuries. The diagnosis of ureteral injury was confirmed by clinical and radiological evaluation. Endoscopic correction was tried either by retrograde or antegrade approach. Ureteral injury was bilateral in four patients and unilateral in nine patients. Five patients presented in the same day of surgery, two of them were reoperated in the same day. Bilateral ureteral injury was corrected surgically in both of them. In the remaining three patients the general condition did not allow for reexploration. Retrograde pyelogram revealed hyper-angulation of the ureter in two and stenting was feasible in both of them. Complete ureteral obstruction was encountered in the third patient and PCN tube was placed. Eight patients presented few days after surgery. Retrograde pyelogram revealed complete obstruction in four patients, for whom PCN tube was placed as a temporary measure to save the renal units. Later on, antegrade studies were performed and surgical correction was done accordingly. In two patients the ureter was incompletely enclosed in sutures, those were handled ureteroscopically using the holmium YAG laser the sutures were fulgurated and the suture material was retrieved by three pronged grasper and stents were placed. In another patient with relative narrowing of the ureteral lumen balloon dilation and stent placement was done. In the last patient angulation was encountered and stent was successfully placed

Comparative study between different pharmaco-therapeutic agents used for the treatment of patients with benign prostatic hyperplasia

A total of 126 patients were included in this study. The mean age of patients was 59.7 +/- 9.6 years [range 48-89 years]. All patients had symptoms suggestive of benign prostatic hyperplasia [BPH]. All patients were treated medically for six months with different pharmacological agents: Doxazosin [41], finasteride [33], combined doxazosin with finastride [22] and Seronea repens extract [30]. A control group, given placebo, included 20 patients who were age- matched and had obstructive lower urinary tract symptoms proved to be caused by BPH. All patients in both study and control groups were followed up for a period at least six months. Symptomatic evaluation, sonography and uroflowmetry were done to measure the efficacy of these agents. From the results obtained, it was concluded that, doxazosin is the most rapid single agent to improve the symptoms of BPH. Finasteride relieves both symptoms and prostate size after six months. Combined therapy is more effective and rapid than treatment with either doxazosin or finasteride alone. Seronea repens extract has a clinical efficacy similar to that of finasteride on both symptoms of BPH and reduction in the prostate size

Up-regulation of the tumor suppressor gene P53 and WAF1 gene by IP6 in CP-3 human prostatic carcinoma cell line

This study investigated the effects of IP6 on the expression of p53 and WAF1/p21 in PC-3 human prostate carcinoma by immunocytochemistry. The immunocytochemical studies with anti p53 antibodies [wide type- PAb246 and Pab1620] and anti p21 WAF1 [EA10] antibodies demonstrated an increased level of p53 and p21 WAF1 after 3 and 6 days of treatment with 3.3 and 5 mM IP6. This increase was dose-dependent; however, a definite time-dependent increase was not observed. These data demonstrated that IP6 up-regulates the expression of the tumor suppressor gene p53 and p21 WAF1 gene and their modulation may be one of the mechanisms of the anti-neoplastic action of IP6 since loss of p53 function enhances cancer cells resistance to chemotherapeutic agents, the stimulating function of IP6 on p53 makes it an attractive adjuvant chemotherapeutic agent as well

Ureteroscopic manipulation in the re-implanted bilharzial ureter

Our purpose in this study is to evaluate the efficacy and safety of ureteroscopy in-patients with a re-implanted bilharzial ureter. The study included twenty-one patients with prior ureterovesical reimplantation because of bilharzial ureteral strictures. Seventeen patients had distal ureteral stones [2 multiple]. Four patients had retained foreign body in a re-implanted ureter; proximally migrated double-J stents in 3 and postoperative retained plastic catheter in one patient. Ureteroscopic manipulation was done for all patients using a small diameter ureteroscope 7.5 F. Preliminary cystoscopy revealed different locations for neo-ureteral orifices. Posteromedial in 13 patients, posterolateral in 2 patients and anterolateral in 6 patients. Stones were extracted in 15 patients [13 with single distal ureteral stones and 2 with multiple stones]. Stones were retrieved more easily in cases with posteromedially located orifices. Failure to negotiate the guide wire up the ureters was encountered in the 2 cases with posterolateral location of the orifices with termination of the procedure. Extraction of the proximally migrated stents and foreign body was successful in all the patients using a 3 pronged grasper. The location of the ureteral orifice influenced the success of the procedure. Reimplantation in the posteromedial location was the easiest to manipulate. Ureteroscopy has its role in patients with re-implanted bilharzial ureter. It can save the patient from a recurrent surgery with minimal or no complications. The site of the neo-ureteral orifices influence the success of the procedure