[Comparative study of therapeutic effects of two medicinal procedures of fluoxetine in premature ejaculation]

Comparative study of therapeutic effects of two medicinal procedures of fluoxetine 3 hours before coitus and each 12 hours, and declining symptoms of SSRI drugs in patients through decreasing dosage and therapeutic procedure in patients refer to 501 hospital and private clinic. The procedure of this study is based on non stochastic clinical test without quasi drug group and a comparison from therapeutic effect and symptoms of two medicinal procedures of fluoxetine 4 hours before coitus and each 12 hours in premature ejaculation treatment in 88 patients refer to 501 hospital and private clinic. Patient were divided into two groups in peradventure manner. In first group, it is prescribed 20mg of fluoxetine daily 4 hours before coitus in 39 patients and 2nd groups group, it is prescribed 20mg of fluoxetine each 12 hours before coitus in 49 patients. Finally it was analyzed data in SPSS software. The average of ejaculation duration in fluoxetine group 4 hours after coitus before treatment was 139.97 Sec. that after 4 weeks of hospitalization reached to 225.25 and p.v: 0.0000 and after 8 weeks to 261.153 Sec. and p.v.:0.0000 and in compare with ejaculation duration between 4th and 8th weeks it gained p.v: 0.003. The average of ejaculation duration in fluoxetine group 12 hours after coitus before treatment was 107.04 Sec. that after 4 weeks of hospitalization reached to 294.08 and p.v: 0.0000 and after 8 weeks to 324.08 Sec. and p.v:0.0000 and in compare with ejaculation duration between 4th and 8th weeks it gained p.v:0.029. In comparing ejaculation duration between 2 groups' fluoxetine 4 hours before coitus [t=225.25] and each 12 hours [t=294.08] in 4th week after treatment it gained p.v:0.03. In comparing ejaculation duration between 2 groups' fluoxetine 4 hours before coitus [t=261.153] and each 12 hours [1=324.08] in 8th week after treatment it gained p.v:0.000. Symptom measure in fluoxetine group 4 hours before coitus 12.8% and symptom measure in fluoxetine group 12 hours before coitus 44.9% and p.v:0.001. In this study, both drug method improved ejaculation duration but in 2nd group it was considerably higher than the 1st one. Also from symptom point of view, symptoms in fluoxetine group each 12 hours was considerably higher than group with 4 hours before coitus

Effect of cystoscopy on prostate-specific antigen, new words about old subject

Prostate Specific Antigen [PSA] is a protein currently used in conjunction with the digital rectal examination to detect and guide management of prostate cancer. There are several causes of increase in serum PSA including urological manipulations, medications, prostatic diseases, prostate cancer, prostate inflammation or infection, etc. some studies had reported cystoscopy to cause transient increases in PSA. The present study has been undertaken with an aim to find out the effect of rigid cystoscopy on serum PSA level. One hundred two men referring to clinic of urology of Imam Reza Hospital from 2008 to 2010 were included in this study. Their age ranged from 31-88 years with the mean of 65.85 years. Our inclusion criteria were having an indication for cystoscopy like BPH, erection disorder, signs related to prostate or bladder carcinoma. Patients with positive urine culture, any medication affecting PSA level, history of urinary retention, any urological manipulations a few days before and ejaculation 48-72 hours before PSA assessment were excluded from the study. Blood samples were taken before and 24 hours after cystoscopy for PSA measurement. PSA was measured by Sandwich ELISA test using PSA kit [pishtaz kit - made in Iran] containing monoclonal antibody. PSA level of the study cases varied from 0.1 to 21 ng/ml. Mean PSA values before and after cystoscopy were 3.004 +/- 3.34 and 2.92 +/- 2.98 respectively indicating that after cystoscopy not only PSA value did not raise but also decreased to some extent. Our findings indicate that, cystoscopy has no effect on PSA value and does not lead to its elevation. It can be concluded that serum PSA after rigid cystoscopy is an accurate and reliable finding to decide about patients condition related to prostate cancer

[Comparison of the efficacy of fluoxetine and citalopram in the treatment of premature ejaculation]

Background: prevalence of sexual disorder in American males is 30-50% and prevalence of premature ejaculation is 15-42%. Premature ejaculation [PE] is the most common sexual dysfunction compliant in about 35-40% of men younger than 40 years, therefor a study for survey and dignosis of this disorders very important. we compare the efficacy and side effects of fluoxetine and citalopram for patients complaining of premature ejaculation without evident organic causes

Materials and Methods: the study comprised 77 patients with a mean age of 33.8 years with premature ejaculation which presented to the urology clinic of 501 army hospital. The patient were randomized into treatment groups receving 2 capsule of 20mg fluoxetine daily [group 1] and 2 tabs of 20mg citalopram daily [group 2] for 4 weeks. The follow up included ejaculatory latency time measurement

Results: mean pretreatment ejaculatory latency times for groups 1 and 2 were 58.26 second [range 10 to 120] and 51.76 second [range 10 to 120] respectively. After 4 weeks treatment of fluoxetine and citalopram mean ejaculatory latency times was 7.77 minute and 6.73 minute respectively. Nausea, insomnia, headache and diarrhea were reported side effects but no significant difference was noted between fluoxetine and citalopram

Conclusion: with this study no difference treatment efficacy was reported between fluoxetine and citalopram

[Evaluation of the frequency of the varicucele and its effect on the espermogram]

Background: the aim of this study is to assess the frequency of varicucele at asymptomatic soldieres and effect of varicucele on the spermogram. Varicucele prevalence in population is 15%

Materials and Methods: this study is cross sectional was performed on the 1275 soldiers after physical exam and paraclinical exam 165 cases had varicucele

Results: this was a cross-sectional study. 118 subjects had varicucele grade 1[71/5%], 33 subjects grade 2[20%] and 14 grade3 [8/5%]. The results of motility was: uper 60% was 86% and lower 60% was 13.9%. morphology was: lower 20% abmormality was 96.9% and upper 20% of abnormality was 3.1%. In this study prevalence of varicucele was 13.5% in the asymptomatic suldieres. Count: 81.1% of patiant have morethan 60 million/mil sperm at spermogram and lower 3.5% were Azoosperm. In this study the pick of age was between 19-21 years. 90% of patiants had varicucele in left testis and 3% had varicucele in right testis. The volum of sperm in 94% of patiant was upper 1.5 milliliter and only 60% of patiant had under 1.5

Conclusions: We understand that the results of study had been equalized with the other studies

[Study on the etiology of urinary tract infection and benign prostate hypertrophy in the patients referred to 501 hospital from 2005 to 2006]

Background: the urinary tract infection is common the etiologic of U.T.I is gram negative bacillary [especially E.coli] in general. Multiple risk factors as B.P.H, nephrolithiasis, diabete, previous U.T.I, folley catheter, genetic, cigarette and alcoholism is predispose to U.T.I

Material and methods: in this study urine culture of 100 male patients with U.T.I and B.P.H evaluated

Results: the most common etiologic causes U.T.I in B.P.H is E.coli [80%], other causes is proteus [10%] and klebsiella [5%]

Conclusions: thus, our data show causes of U.T.I in male with B.P.H like to other general population

[ survey of prevalence of sexual disorders and risk factors in patient who Reffered in Urology ward in 501 Hospital 2004-05]

Background: prevalence of sexual disorder in American males is 30-50% and prevalence of premature ejaculation is 15-42%, Therefor a study for survey and dignosis of this disorders very important

Materials and Methods: this is a descriptive study [Case - Series] in 150 Patients who Refferd to the Urology clinic at 501 medical center with any symptoms of sexual disorders. The data were collected and analysed in SPSS-11.5

Results: the Prevalence of different sexual disorders was as follow : premature ejacalation [39.3%], erection dysfunction [22/7%], desire disorder [4.7%], and erectal dysfunction and premature ejaculation [32%]

Counclosions: in this study, Premature ejaculation was the most common sexual disorder. Moreover psychiatric disorders were the most common influicing factor on rectal dysfunction

[ comparison of the efficacy of common pain management in acute renal colic]

Background: Renal colic is a common cause of acute severe pain. Opioids and non-opioids analgesics and NSAIDs and phosphodiesterase enzyme [PDE] inhibitors are four medical cathegories that recommended for treatment, but the relative efficacy of these drugs is uncertain

Materials and Methods: To examine the benefits and disadvantages of pethidine, piralgin, diclofenac and aminophyllin for the management of pain in acute renal colic, as a randomised clinical trial study, patients with four suspected renal colic[n=200] were randomised to receive these 4-drugs at emergency ward of -hospitals. Pain relief and side effects was assessed at one hour after the analgesics. Datas has been analised by statistical soft ware of SPSS-ver.11

Results: pain reliefed in the pethidine group after 30 minute and one hour was %60 [30 patients] and %94 [47 patients], for piralgin group was %54 [27 patients] and %92 [46 patients], diclofenac group was %28 [14 patients]and %68 [34 patients] and for aminophylline was %24 [12 patients] and %62 [31 patients]. [P< 0/05] The side-effects of 4-groups was included: pethidine: nausea [11 Patients], vomiting [7 Patients], respiratory depression [3 Patients] and headache [2 Patients]; piralgin [3 Patients]; aminophylline: orthostatic hypothension [7Patients], vertigue [9 Patients], headache [1 2 patients]; diclofenac had no side-effect

Conclusion: Tramadol response was as same as pethidine but less side-effects. diclofenac is a good choice for mild pain; but aminophyllin had a bad response with very much side-effects

[ comparison of the efficacy of common pain management in acute renal colic]

Background: Renal colic is a common cause of acute severe pain. Opioids and non-opioids analgesics and NSAIDs and phosphodiesterase enzyme [PDE] inhibitors are four medical cathegories that recommended for treatment, but the relative efficacy of these drugs is uncertain

Materials and Methods: To examine the benefits and disadvantages of pethidine, piralgin, diclofenac and aminophyllin for the management of pain in acute renal colic, as a randomised clinical trial study, patients with four suspected renal colic [n=200] were randomised to receive these 4-drugs at emergency ward of -hospitals. Pain relief and side effects was assessed at one hour after the analgesics. Datas has been analised by statistical soft ware of SPSS-ver.11

Results: pain reliefed in the pethidine group after 30 minute and one hour was %60 [30 patients] and %94 [47 patients], for piralgin group was %54 [27 patients] and %92 [46 patients], diclofenac group was %28 [14 patients] and %68 [34 patients] and for aminophylline was %24 [12 patients] and %62 [31 patients]. [P< 0/05] The side-effects of 4-groups was included: pethidine: nausea [11 Patients], vomiting [7 Patients], respiratory depression [3 Patients] and headache [2 Patients]; piralgin [3 Patients]; aminophylline: orthostatic hypothension [7 Patients], vertigue [9 Patients], headache [12 patients]; diclofenac had no side-effect

Conclusion: Tramadol response was as same as pethidine but less side-effects. diclofenac is a good choice for mild pain; but aminophyllin had a bad response with very much side-effects