Predictive factors of bleeding and fever after percutaneous nephrolithotomy.

AIM: Percutaneous nephrolithotomy (PCNL) remains the standard procedure for large (≥2 cm) renal calculi; however, up to one quarter of PCNL patients experience some perioperative complications. The aim of the present study was to investigate the factors that may influence bleeding and fever following percutaneous nephrolithotomy. METHODS: In total, 170 patients, who underwent percutaneous nephrolithotomy between January 2012 and January 2016 in our Urology department, were retrospectively evaluated for postoperative bleeding and fever. Preoperative, operative and postoperative factors were assessed using univariate followed by multivariate regression. RESULTS: The mean patient age was 49.41 ± 15.07 years (14-83). The overall stone-free rate was 83.5%. We recorded 48 postoperative complications (28.2%): 34 cases of fever and 14 cases of bleeding. Univariate analyses showed an association between diabetes and postoperative bleeding (p=0.002). Staghorn calculus (p=0.0001), prone position (p=0.009), operative time (p=0.0001) and presence of residual stones ≥  7 mm were associated to postoperative fever (p=0.01). Multivariate stepwise regression analyses showed that diabetes was the only independent predictive factor of postoperative bleeding (OR=7.6). Staghorn lithiasis (OR=5.9), prone position (OR=3.7) and operative time > 95 minutes (OR=6.2) were the predictive factors of postoperative fever. CONCLUSIONS: To our knowledge, this study is the first to report that prone position was significantly associated with fever after percutaneous nephrolithotomy. Further studies are necessary to confirm our results in a greater number of patients.

CYP17 gene polymorphism and prostate cancer susceptibility in a Tunisian population.

Prostate cancer (PCa) formation has been reported to be associated with androgen. Two key steps in the sex steroid synthesis are mediated by the enzyme cytochrome P450c 17α which is encoded in the CYP17 gene. The A2 allele of the CYP17 gene has been thought to be associated with increased functional activity of this steroidogenic enzyme. Consequently, the A2 allele has been examined as a biomarker of individual susceptibility to hormone-related diseases among men. We prospectively assessed the association between the A2 allele of CYP17 and PCa risk among 125 cases and 125 controls in a case-control study. Our aim was to investigate whether a polymorphism of CYP17 gene could be used as a genetic marker for associating PCa. The result revealed a significant association between the CYP17 polymorphic genotypes and PCa. Therefore, CYP17 gene polymorphism is likely contributed to the pathogenesis of PCa but not to disease severity.