Recurrent primary malignant melanoma of the urinary bladder; a case report.

Primary malignant melanoma (PMM) of the urinary bladder is a rare disease. Symptoms include gross hematuria and irritative LUTS. The diagnosis is made with cystoscopy and TURBT. Treatment options include TURBT and adjuvant therapies. We present a 61-year-old female who was referred with persistent irritative LUTS without gross or microscopic hematuria. After undergoing cystoscopy, TURBT, and extensive workup, she was diagnosed with PMM of the urinary bladder. Due to her past medical history, recurrent PMM of the urinary bladder was the final diagnosis. She refused to receive further treatment or refer for follow-up.

A case of condyloma acuminate after about 30 years of urinary obstructive symptoms.

Condyloma acuminate (CA) is a warty lesion caused by human papilloma virus (HPV) mostly involve the external genitalia. A 65-year-old woman with a compliant of acute urinary retention came to our hospital emergency ward and the retention was resolved by placing a 6 Fr Foley catheter. On physical examination warty lesions on patient's urethral meatus was seen and biopsy was taken. The pathology confirmed the diagnosis of CA. 5-FU was prescribed for a month and the outcome was fully satisfactory. To sum up, CA in female with AUR should be kept in mind.

Comparison of sexual function changes in recipients of kidney transplant in females receiving kidney from the living donor and deceased donor.

BACKGROUND AND AIM: Chronic renal failure can result in different sexual and reproductive problems for women. Due to lack of information about sexual dysfunction of women with transplanted kidney and superiority of either living or deceased donor, we designed this retrospective cohort study to compare sexual function changes in recipients of kidney transplant in two groups receiving kidney from the living donor and deceased donor using Female Sexual Function Index score. METHODS AND MATERIALS: We included 55 female patients who underwent kidney transplant from 22 May 2015 to 22 May 2016 in Sina Hospital (Tehran, Iran). Laboratory factors, including creatinine, blood urea nitrogen, hemoglobin, fasting blood glucose, triglyceride, cholesterol, low-density lipoprotein, and high-density lipoprotein, were evaluated before and after the transplantation. Female Sexual Function Index questionnaire was used to evaluate sexual function of the patients before the transplant, 3 months after the transplant, and 9 months after the transplant. RESULTS: Our results revealed that there is significant improvement in the Female Sexual Function Index score of the patients after the transplant (p-value < .001). However, we found no significant difference between the scores of the patients with living donor and deceased donor (p-value > .05). Patients' age, creatinine level, low-density lipoprotein, and diastolic blood pressure are negative predictors of Female Sexual Function Index scores.

A Randomized Control Trial Comparing Combined Glandular Lidocaine Injection and Intraurethral Lidocaine Gel with Intraurethral Lidocaine Gel Alone in Cystoscopy and Urethral Dilatation.

PURPOSE: Cystoscopy is one of the most common urologic procedures. The aim of this study is to investigate the combined effect of intraurethral lidocaine gel and intraglandular injection of lidocaine 2% on pain during and after cystoscopy. Materials & Methods: In this double-blind, parallel group randomized clinical trial, 156 patients referred for double J removal, urethral dilatation, or cystoscopy were enrolled. The patients were divided into two groups, A and B. All patients received 20 cc of intraurethral lidocaine gel 2%. In group A (N = 75), lidocaine 2% was also injected into the glans penis. The patients in group B (N = 81) only received the intraurethral lidocaine gel. Cystoscopy was performed 10 minutes later. The primary outcome of interest was measured in terms of pain score (visual analogue scale) during and 5 minutes after cystoscopy. RESULTS: Immediate pain score after the procedure was 3.4 ± 3 and 4.6 ± 3 in groups A and B, respectively (P = .011). CONCLUSION: Based on the findings of the present study, lidocaine injection into the glans penis significantly reducedpain perception.

Mandibular Mass as an Only Presentation of Metatatic Renal Cell Carcinoma For Four Years: A Case Report.

Renal cell carcinoma is one of the most common tumors of the urinary tract. This tumor may appear as Para neoplasticsyndromes or distant metastasis. Metastases in uncommon areas are one of the characteristics of renal tumors.One of the uncommon metastatic renal masses areas is the mandible. In different studies, patient survival aftermetastasis diagnosis is usually one year or less. In this study we introduce a patient with mass of the right mandiblewhich existed four years before his referral, and in examinations it was diagnosed as metastasis with renal origin.

Screw as a Bladder Foreign Body.

Foreign bodies in the bladder are among the strangest differential diagnoses in the lower urinary tract symptoms (LUTS) and may be missed in initial medical evaluations. We present a 63-year-old man who was visited in the emergency department because of obstructive and irritative lower urinary tract symptoms. Two months earlier, he had a pelvic fracture due to motor vehicle accident and underwent an open reduction and internal fixation of the pubic rami and right acetabulum by an anterior ilioinguinal approach. After initial evaluation, an abdominopelvic X-ray revealed a 3 cm screw in the suprapubic area. He underwent urethrocystoscopy and a 3 cm screw was extracted by forceps.

Trainee-Associated Factors and Proficiency at Percutaneous Nephrolithotomy.

Percutaneous nephrolithotomy (PNL) is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees' ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period. Trainees in PNL fellowship programs were included. At the end of the program, the trainees' performance in PNL was assessed regarding five competencies and scored 1-5. If the overall score was 4 or above, the trainee was considered as proficient. The trainees' age at the beginning of the program and the years passed from their residency graduation were asked and recorded. Also, the number of PNL cases operated by each trainee was obtained via their logbooks. The age, years passed from graduation, and number of operated cases were compared between two groups of proficient and non-proficient trainees. Univariate and multivariate binary logistic regression analysis was applied to estimate the effect of aforementioned variables on the occurrence of the proficiency. Forty-two trainees were included in the study. The mean and standard deviation for the overall score were 3.40 (out of 5) and 0.67, respectively. Eleven trainees (26.2%) recognized as proficient in performing PNL. Univariate regression analysis indicated that each of three variables (age, years passed from graduation and number of operated cases) had statistically significant effect on proficiency. However, the multivariate regression analysis revealed that just the number of cases had significant effect on achieving proficiency. Although it might be assumed that trainees' age negatively correlates with their scores, in fact, it is their amount of practice that makes a difference. A certain number of cases is required to be operated by a trainee in order to reach the desired competency in PNL.