Comparison of the Efficacy of Oxybutynin, Phenazopyridine, Celecoxib, and Placebo in the Treatment of Urinary Tract Symptoms after BCG Therapy in Patients with Bladder Tumors.

PURPOSE: Intravesical BCG (Bacillus Calmette-Guérin) therapy is indicated as an effective treatment for patients with non-muscle-invasive bladder cancer, despite associate with the side effects. In this study, the incidence of BCG therapy adverse effects was compared among three groups of patients who received celecoxib, phenazopyridine, and oxybutynin with placebo. MATERIALS AND METHODS: The randomized controlled clinical trial was conducted on four groups using the parallel group method. A checklist is used for weekly assessment of urinary symptoms, systemic symptoms of BCG therapy, and adverse drug reactions. RESULTS: The study included 120 patients, 10 female and 110 male. The mean age 59.65 ± 6.2 years. The results of multivariate analysis show that there is a significant decrease in urinary frequency for patients who received phenazopyridine (95% CI: 0.09, 0.31, OR = 0.17, P <.001) and also celecoxib group (95% CI: 0.10, 0.43, OR = 0.21, P <.001) compared to those in placebo group. Patients in celecoxib group (95% CI: 0.02, 0.07 ,OR = 0.04, P <.001), phenazopyridine (95% CI : 0.07, 0.37,OR=0.16, P <.001) and oxybutynin (95% CI: 0.02, 0.12,OR = 0.05, P <.001) were less likely to have urgency than those in placebo. Moreover, significant decrease was found for dysuria in the three treatment groups in comparison with placebo group. CONCLUSION: According to the results, celecoxib, phenazopyridine and oxybutynin can effectively decrease the side effects of BCG immunotherapy compared to placebo. Among these three treatments, the most effective and safest treatment option is celecoxib.

Evaluation of the success rate and complications of conventional varicocelectomy: Do we need microscopic surgery really?

OBJECTIVE:: Varicocele is the most commonly curable cause of infertility in men. Varicocele is found in 15% of the total male population, 35% of men with primary infertility, and 75%-81% of men with secondary infertility. Generally, patients seek microscopic surgery via surfing the Internet, which is not an available option in all medical centers. The purpose of this study was to determine the success rate and complications of conventional varicocelectomy and to compare it with that of the microscopic method. METHODS:: In this descriptive cross-sectional study, 88 patients with varicocele who underwent non-microscopic varicocele surgery in the 15th Khordad Hospital during 2013-2015 were evaluated by the census method. RESULTS:: The mean age of patients with varicocele was 27.30 years; 52 patients underwent bilateral varicocelectomy and 36 left varicocelectomy. Surgical complications of non-microscopic varicocelectomy in the studied patients included bleeding and hydrocele formation both in 0.7% and recurrence in 2.8%. Testicular atrophy was not observed in any case. CONCLUSION:: The incidence of recurrence, hydrocele formation, atrophy, and bleeding in non-microscopic varicocelectomy, if done in accordance with its principles, is not more than the microscopic approach and therefore it could be recommended as a safe surgical treatment in centers where microscopic surgery is not available.

Impact of prostate needle biopsy on erectile function: A prospective study.

BACKGROUND: Needle biopsy of the prostate is a diagnostic method for prostate cancer which is a relatively safe method with low risk of serious complications. The evidences regarding the occurrence of erectile dysfunction following prostate biopsy are controversial. Herein, we aimed at determining the rate of erectile dysfunction in those undergoing transrectal ultrasound-guided prostate biopsy. METHOD: All candidates for prostate biopsy were enrolled. The International Index of Erectile Function-5 was completed 1 m before and 1, 3, and 6 months after ultrasound-guided prostate biopsy by each patient for erectile dysfunction. Patients with a previous history of erectile dysfunction which due to a positive pathology had received any type of treatment were excluded from the study. RESULTS: Eighty patients with the mean age of 64.8 years, the mean prostate-specific antigen level of 11.64 ng/dL, and the mean prostate volume of 62.43 cc were included. The prostate biopsy result was positive in 38.8% of the cases. No significant relationship was found between erectile dysfunction and prostate-specific antigen level, prostate volume, and the pathology result (P = 0.320, 0.509, and 0.131). The mean questionnaire score 1 month before and after the biopsy was 23 and 18, respectively; it demonstrated a significant difference (P < 0.001). The same score was 17 and 14.5 three and six months after biopsy. The mean score 1 m before and 3 m after biopsy also revealed a significant difference (P < 0.001). CONCLUSION: Transrectal ultrasound-guided needle biopsy of the prostate causes progressive erectile dysfunction in these patients. This relationship is not affected by the biopsy result, prostate volume, or the prostate-specific antigen level.