Cytotoxic Effect of Saffron Stigma Aqueous Extract on Human Prostate Cancer and Mouse Fibroblast Cell Lines.

PURPOSE: Several lines of experimental evidence have shown that saffron has anticarcinogenic effects. This study aimed at evaluating the possible anticancer effect of saffron stigma aqueous extract on human prostate cancer (PC3) and mouse fibroblast cells (L929) as non-cancerous control cells. MATERIALS AND METHODS: Saffron stigma aqueous extract at concentrations of 100, 200, 400, 600, 800, 1600 and 3200 µg/mL were prepared. PC3 and L929 cells were incubated with different concentrations of saffron extracts in different time intervals (24, 48, 72, 96 and 144 hours). MTT assay was used for each cell line to investigate the cytotoxic effect of saffron. Morphological alterations were also observed under light inverted microscope. RESULTS: In fibroblast cell line after 24 hours, Saffron extract did not affect significantly the normal cells and they were intact in morphologic view. After 96 hours in the cells with highest concentration (1600 µg/mL), cell death and cellular form changes as well as severe granulation was observed. In prostate cell line after 24 hours, the only changes were observed in cells with the concentration of 1600 µg/mL. The cells were granulated and the form of the cells were spherule. After 72 hours, in group with the concentration of 1600 µg/mL, severe granulation was observed and the cell count decreased and some cells were dead. CONCLUSION: Saffron aqueous extract has an in vitro inhibitory effect on the proliferation of human prostate cell and mouse L929 cells which is dose-dependent.

Angioemboliziation of Internal Pudendal Artery for Treatment of Long Lasting Gross Hematuria After Transurethral Resection of the Prostate.

To present a case of recurrent gross hematuria after transurethral resection of the prostate that was refractory to endoscopic and open hemostatic interventions at the bladder neck and prostatic fossa. After performing angiographic evaluation of the pelvic vessels and finding the pseudoaneurysm, percutaneous embolization of arterial supply of the pseudoaneurysm was done. The location and type of lesion were successfully determined by angiography and controlled by angio-embolization of the internal pudendal artery. It seems that angiography can be helpful in the diagnosis and management of refractory bleeding after prostatectomy.

Effect of Unilateral Iatrogenic Testicular Torsion on the Contralateral Testis in Rats: Prepubertal and Postpubertal.

PURPOSE: The present study was conducted to investigate the influence of hemicastration and age at hemicastration on the contralateral testis weight and function/testosterone production. MATERIALS AND METHODS: 64 Wistar-derived male rats were divided randomly into 4 groups. Group 1 was named immature intervention, group 2 immaturecontrol, group 3 mature intervention, and group 4mature control. In group 1, rats were hemicastrated at 30 days of age (prepubertal). In group 2, sham surgery (midscrotal incision) was per-formed atthe same age. In group 3, rats were hemicastrated at 70 days of age (postpubertal) and in group 4,sham surgery was done at the same age. Twenty days after the first surgery, contralateral orchiectomy wasperformed in intervention groups and controls underwent random orchiectomy (left or right). Blood sampling for evaluation of serum testosterone was performed just before second surgery. RESULTS: The mean testis weight (1692 ± 26.7 in group 1 versus 1375 ± 39.7 in group 2; P < .001 and 1760 ± 26.6 in group 3 versus 1425 ± 44.9 in Group 4; P < .001) and the mean testicular weight (mg) per 100 g of body weight (735.8 ± 82.3 in group 1 versus 634.8 ± 84.8 in group 2; P = .005 and 652.4 ± 61.4 in group 3 versus 572.6 ± 97.7 in group 4; P = .03) were significantly greater in hemicastrated rats as to their controls. Also, these parameters was greater in prepubertal group than postpubertalhemicastrated rats. There was no appreciable difference in serum testosterone levels across the 4 groups (P = .77). CONCLUSION: Our research demonstrated that hemicastration results in compensatory hypertrophy of the remaining testis and it decreases as the animals age. Hemicastration does not lead to reduction in serum testosterone levels and the remaining testis can retrieve a normal serum testosterone level.

The Therapeutic Effects of Intracavernosal Plaque Excision in Peyronie's Disease: A None Grafting or Tunical Excising Procedure.

BACKGROUND: Current surgical treatments in Peyronie's disease are accompanied by complications such as penile shortening, loss of sensation, erectile dysfunction and recurrence of disease. The aim of this study was the evaluation of clinical results of intracavernosal plaque excision in Peyronie's disease. METHODS: The operation was performed on 35 men. It was consisted of incising the tunica albuginea parallel to the plaque and through this incision, and the plaque was removed from the inside surface without excision or replacing the underlying tunica albuginea by grafts. All patients were evaluated before and periodically within 12 months after the surgery with measurement of penile length, curvature angle in the rigidity phase, and sexual satisfaction. RESULTS: The mean age of patients was 51.4±5.3 years (range 42-59 years). The angle of penile curvature was 25-45° (mean=35°). Thirty patients (86%) obtained a nearly complete straightening of penis. All patients restored their previous penile length without any disorder of sensation within the glans penis and expressed improvement of sexual activity. CONCLUSION: Intracavernosal plaque excision is a simple, easy and minimal invasive method that does not result in penile shortening, loss of sensation or erectile dysfunction. In properly selected patients, this technique can lead to acceptable elimination of penile curvature and sexual satisfaction.

Penile fracture and its treatment: is retrograde urethrograghy necessary for management of penile fracture?

OBJECTIVE: Penile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography. METHODS: From February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months. RESULTS: Patients' mean age was (32.78 ± 10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88 ± 0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen. CONCLUSION: There is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.

Treatment of Kidney Stones Using Extracorporeal Shock Wave Lithotripsy (ESWL) and Double-J Stent in Infants.

Background. Extracorporeal shock wave lithotripsy (ESWL) has progressively acquired popularity as being the gold standard treatment for upper urinary tract lithiasis in infants since 1980. Our aim was to evaluate the outcome of ESWL for kidney stones and the use of double-J stent in infants. Material and Methods. A prospective clinical trial study performed on 50 infants with renal calculi at pelvic admitted in the Urology ward of Shafa Hospital, Sari, Iran, between 2001 and 2010. Main outcome measure of our study was clearing stones after one or more consecutive sessions of ESWL. Results. The study included 50 patients with renal calculi at pelvic. Among them, there were 35 (70%) boys and 15 (30%) girls with the age ranging from 1 to 13 months (mean of 7 month ± 3 days). All of them were treated by standard ESWL using Simons Lithostor plus machine. The stone sizes ranged from 6 mm to 22 mm. Double-J stents were placed in 11 infants (22%) with stones larger than 13 mm. Most of the patients required only one ESWL session. Conclusion. Since there were no complications following ESWL treatment, we can conclude that, in short term, ESWL is an effective and safe treatment modality for renal lithiasis in infants. In addition, we recommend double-J stent in infants with stones larger than 13 mm.

Percutaneous treatment of bladder calculi in children: 5 years experience.

INTRODUCTION: We sought to evaluate the safety and efficacy of percutaneous cystolithotripsy in children. MATERIALS AND METHODS: Thirty children (27 boys and 3 girls; mean age, 6.06 +/- 2.64 years; range, 1.5 to 12 years) with bladder calculi underwent percutaneous stone removal. The mean size of the largest diameters of the calculi was 24.8 +/- 8.47 mm (range, 13 mm to 50 mm). Under general anesthesia, a 1-cm incision was made 1 to 2 cm above the pubic symphysis. A 26-F nephroscope was introduced into the bladder following tract dilation, and the calculi were removed. If the calculi were larger than 1 cm, fragmentation was performed. The procedure was done without fluoroscopy. Finally, a urethral catheter was placed for 48 hours. RESULTS: All patients became stone free. The mean operative time was 23.13 +/- 8.38 minutes (range, 12 to 40 minutes). All patients were discharged 24 hours after operation, except 1, who was hospitalized 2 more days for suprapubic pain and severe irritating symptoms. No significant intraoperative or postoperative complications were seen. CONCLUSION: Percutaneous suprapubic cystolithotripsy is an efficient and safe technique for treating bladder calculi in children. We recommend this technique for treating large bladder calculi (larger than 1 cm) in children.

Treatment of renal colic using intracutaneous injection of sterile water.

INTRODUCTION: To evaluate the intracutaneous injection of sterile water in the treatment of renal colic. MATERIALS AND METHODS: One hundred patients with renal colic were randomly divided into two groups of 50 patients and underwent the treatment. In the first (study) group 0.5 ml of sterile water and in the control group, 0.5 ml of normal saline was intradermally injected. The severity of pain was assessed by visual analogue scale (VAS) system before and 30 and 90 minutes after the injection. Patients in whom the presence of stone was not proved were excluded from the study. RESULTS: Before the treatment mean pain severity in the study group was 9.860.4 and in the control group was 9.960.19, so that the difference was not statistically significant (p=0.12). Thirty and 90 minutes after the injection, the means were 0.762.3 and 1.022.63 in study group and 5.944 and 6.74.19 in control group, respectively. The results in 30 and 90 minutes between the two groups were statistically significant (p=0.000 and p=0.000, respectively). Pain in all patients in the study group was relieved; however, only %34 of the patients in the control group reported a decrease in pain. There was no complication among the patients of both groups and only a severe and transient pain during injection was reported by the patients. CONCLUSION: This study along with many other existing studies indicates the efficacy of intradermal injection of sterile water for the treatment of severe pain syndromes such as renal colic. The advantages of this method are its efficacy, availability, cost benefits, and easy application. We recommend the use of this approach for the treatment of renal colic.