ABSTRACT
The diagnostic tool in prostate cancer is prostate biopsy but recently classic biopsy has low efficacy. In recent years, trans-rectal ultrasound guided prostate biopsy is a standard method in prostate cancer diagnosis. In the present study, we report our experience about ultrasound guided 10-14 core prostate biopsies at a hospital in Mashhad. The study included 196 men with PSA values of >/= 10 ng/ml or 10 ng/ml >/= PSA level >/= 4 ng/ml and Free PSA/ Total PSA ratio was less than 20%. These patients underwent transrectal ultrasound [TRUS]-guided 10-14 core prostate biopsy. Of the 196 patients, cancer in 73 patients [37.2%], intraepithelial neoplasia in 14 patients [7.1%] and benign prostatic hyperplasia in 108 patients [55.1%] were diagnosed. Transrectal ultrasound guided 10-14 core prostate biopsy diagnosed prostatic cancer in 25% of 14 patients who had no prostatic cancer with traditional biopsy. There were non significant associations between age and total and free PSA. There was a non significant correlation between the free PSA and Gleason score, but there was a significant correlation between the Gleason score and total PSA. This study shows that the TRUS-guided 10-14 core biopsies yield a better prostate cancer detection rate than the classic biopsy
ABSTRACT
Fluoroscopy-guided intervention during percutaneous nephrolithotomy [PCNL] has become the order of the day. During this procedure, both the patient and the physician are exposed to some radiation. Measurement of radiation doses in patients and The aim of this study was to evaluate percutaneous nephrolithotomy [PCNL] in the patients with solitary kidneys. Between 1995 and 2005, we had 11 patients with a solitary kidney and kidney calculi who underwent PCNL at our center. Tubeless and standard PCNLs were performed in 3 and 7 patients. In 1 patient, we could not achieve access to the system due to the stricture of the infundibulum. The calculi were extracted or fragmented successfully in 10 patients. In 2 patients with residual calculi, a double-J catheter was inserted and extracorporeal shock wave lithotripsy [SWL] was performed. Retroperitoneal hematoma was detected in 3 cases by ultrasonography 1 week after the procedure, which was treated conservatively. Also, fever occurred in 3 patients after the procedure which was treated successfully. The patients were discharged on the 3rd and 4th postoperative days. Although PCNL is accompanied by the risk of complications such as severe bleeding that may result in kidney loss in patients with a solitary kidney, the rate of success and complications seem to be similar to the other patients if careful operation and correct selection of candidates are done. Therefore, we recommend cautious performance of PCNL in patients with solitary kidneys