Nuclear matrix protein [NMP 22] as a diagnostic tool in urinary bladder cancer

To evaluate the role of urinary nuclear matrix protein NMP22 in urinary bladder cancer diagnosis. From August 2003 to January 2007, 373 patients, were enrolled in this study in Al Noor Specialist Hospital K.S.A and Urology Department in Benha Faculty of Medicine, patients were complaining of hematuria, LUTS, and bladder mass suspected On U/S examination, after clinical evaluation including complete history, general and local examination especially D.R.E, 50 ml of midstream morning urine samples was taken from all patients and examined for complete urine analysis and for detection of urine level of NMP 22 assay, cystoscopy, and TUR resection was done for all the patients and comparative analysis was done for the results of the cystoscopy, histopathology and NMP22 assay results. The results of the present study revealed that there was decreased overall sensitivity [28.2%] and specificity was [75%] ofNMP 22 in diagnosing transitional cell carcinoma of the bladder in comparison with confirmed cystoscopic positive results [98.8%] but the specificity and sensitivity increases in large invasive tumors to be [56.7%], and specificity [75%]. NMP22 could be considered a diagnostic or screening tool only in high grade transitional cell carcinoma, invasive or large advancing tumor, but NMP22 could not replace cystoscopy as the gold standard for cancer bladder diagnosis

the current management of chronic prostatitis/chronic pelvic pain syndrome effective

To re-evaluate the efficacy of the current applied manage-merit of chronic prostatitis/CPPS. From September 2000 to December 2006, 1690 patients diagnosed as chronic prostatitis/chronic pelvic pain syndrome [CP/CPPS] were managed in this series, in Urology Department, Benha Faculty of Medicine and Al Noor Specialist Hospital KS.A. We have classified the patients into 3 groups according to presence of pus cells in expressed prostatic secretion or urine sample after massage [VB3] in Stamy's method, and according to NIH/CP classification, the three groups have been subdivided to A and B subgroup. The subgroup A received antibiotics and subgroup B received placebo, anti-inflammatories, plant extract or alpha-blockers. Evaluation of the result of management was done according to NIH-CPSI score. Data from the 3 groups were analyzed and compared. The improved patients were statistically analyzed according to the decrease by more than 25% NIH/CPSI score from the base line. The results of the present study have revealed that there was in significant difference between the improved percentages of patients in subgroup A1 [44.6%] received antibiotics in comparison to patients in subgroup Bl [43.2%] received placebo or other measures in the 1[st] group P>0.05. In the 2nd group there was significant improvement in subgroup B2 63.5% than group A[3] 24.5%, in the 3[rd] group there was significant increase in the percentage of the total improved patients but there was no significant difference between the improved patients of the two subgroups A[3], B[3]. We concluded from this study that the management of chronic prostatitis/chronic pelvic pain syndrome still a challenge for urolo-gists and there was no significant difference between the percentage of improved patients treated by antibiotics and other treated by placebo or other measures and further research is needed and more studies are required to confirm efficacy of therapies and trial of another measures

Is varicocelectomy in non-obstructive azoospermic patients has an effective role?

Objective: Evaluation of the role of varicocelectomy in azoospermic patients

Patients and Methods: From Oct. 1998 to April 2007 188 nonobstructive azoospermic patients have undergone varicocelectomy; all patients were examined clinically and generally especially for the presence of varicocele, clinical or subclinical and classified in grades, testicular volume was estimated and routine investigations, including complete hormonal assay were done semen analysis for at least 3 times and U/S scrotum with Doppler for all cases. All patients were with history of primary infertility except 6 cases of secondary infertility, prevaricocelectomy and 3 to 6ms post-varicocelectomy semen parameters were compared and analyzed

Results: Postoperative semen analysis revealed overall sperm detection in 36 patients 18.8% of cases and 19 patients 10.6% of cases have shown spermatid and many spermatogenic cells in subsequent semen analysis. It was shown that 14, 8 patients [40%, 31%] respectively of huge or large preoperative varicocele were improved in detection of sperms in the ejaculate,9 patients 13% of grade II or moderate varicocele have been improved but grade I and subclinical varicocele showed little improvement. Regarding the relation with testicular volume there was significant improvement in 8,10 patients [49%, 45.6%], in cases presented with accepted or within normal testicular volume

Conclusions: Our study revealed that varicocelectomy in azoospermic patient can play an effective role in the management of male infertility and can result in pregnancy in some patients with accepted testicular volume or in the presence of preoperative large or evident varicocele, also there was considerable improvements in spermatogenesis in the other patients which could improve the assisted reproductive techniques results

PSA screening in long-term post-open prostatectomy patients for estimation of the incidence of prostatic adenocarcinoma

Objectives: To evaluate the effect of long-term open prostatectomy on PSA and the incidence of prostatic adenocarcinoma in those patients in comparison with benign prostatic hyperplasia patients

Patients and Methods: From March 2002 to April 2007, 1883 patients were enrolled in this study in Urology Department, Benha Faculty of Medicine and Al Noor Specialist Hospital KSA, the age of the patients was started from 58 to 93 yrs with mean of 73. 1st group was 870 patients with long-term open prostatectomy of around 10 years duration and the second group was 1013 patients of BPH symptoms of the same age group receiving alpha-blocker, anti-inflammatory, or diagnosed for the first time, subdivision of the 2 groups into subdivision A from 60 to 70 and subdivision B above 70. Total PSA was estimated for all patients, clinical evaluation especially digital rectal examination [DRE] and transrectal U/S. In suspected cases prostatic biopsy was done. The data of the two groups were compared and analyzed

Results: The results of the present study have revealed that there was significant decrease in the mean PSA values of the 870 patients post-prostectomy group 1.89 ng/ml, P<0.05 in comparison with the benign prostatic hyperplasia group mean value 3.1 ng/ml but there was no significant decrease in the overall incidence of prostatic adeno-carcinoma, which was found to be 0.15% and 0.11% in the post-prostatectomy group and 0.19% in the benign prostatic hyperplasia group

Conclusion: It was shown that there was significant decrease in the mean PSA values of the post-prostatectomy group in comparison to the mean values in the BPH group but there is no significant decrease in the expected incidence of prostatic adenocarcinoma in the same age group