Urology - Science topic

Hi all

I am looking for 5 peer reviewers for an article on a penile abscess drained surgically. I do realise it need not be a surgical reviewer. But would appreciate anyone with a urological, general surgical background to help out.

Any help is greatly appreciated

Thanks

Akshay

Urology Registrar

NHS UK

Casodex (or bicalutamide) is available only as a racemic mixture (S and R enatiomers): 1) the pharmacologically active R (-)-enantiomer, and 2) S-Casodex, the inactive (+) enantiomer. The S-enantiomer is thus the non-working compound but is also metabolized at a much lower rate. In other word, much higher plasma levels are the result. Does anybody know if casodex can increase emotional instability/anxiety? And which enantiomer is causing this?

If I have an experience but no certificate in Machine Learning, and have both experience and certifcate in Medicine (Urology) ... and want to publish a peper that include an interaction between these 2 feilds, in either Urology or CS journals. Should i add a coauthor who is certified in Data science or CS? ... if not, Would it be necessary to prove my competency in ML by any means?

Why does combination therapy seem to be more effective for kidney cancer? Wouldn't you have more side effects due to consuming two drugs at the same time?

BPH is a innocent bystander in later stages of male life in humans. Normally Benign Prostatic hyperplasia is curable by using the various avaliable treatments and medications like 5alpha reductase inhibitors and antiandrogenic therapies. TURP, TUIP and prostatectomy are also advised very often. But what is the indication of the progression of the problem which is not curable from the avaliable measures. Is it a cancerous situation then? Is herbal therapy the probable answer of the problem in complicated cases?

What would you expect from a molecular test in cUTI in terms of antibiotic stewardship and health economics?

favorite publication/guidelines:

Wagenlehner, F.M.E., and Naber, K.G. (2006). Current challenges in the treatment of complicated urinary tract infections and prostatitis. Clin. Microbiol. Infect. 12 - PMID: 16669930

Grabe, M.B.T., Botto, H., Cek, M., Naber, K.G., Pickard, R.S., Tenke, P., Wagenlehner, F., and Wullt, B. (2015). EAU guidelines on urological infections. Uroweb 2015.

Caliendo, A.M., et al. (2013). Better tests, better care: improved diagnostics for infectious diseases. Clin. Infect. Dis. 57 - PMID: 24200831

Many believe that minilaparoscopy is attractive option that may replace conventional laparoscopy and might be an alternative to technically challenging LESS

I asked a similar question a few days ago, but I didnt quite get the complete answer I was looking for and no further answers have been given.

Since , for some time now, calcium ingestion has been recommended in order to bind with oxalate in the stomach and intestine and therefore, make it less available to be absorberd. On the other hand, I have seen citrate medication also being recommended since it binds with calcium to make it less available to bind with oxalate, in order not to form crystals, but also binds with calcium in the intestine to reduce its excretion. My question is if citrate wouldnt also make calcium less available to bind with oxalate in the stomach and intestine, and therefore, make it more likely to be absorbed.

What should be the approach in a 6 year old female (Presentation UTI) with left Duplex kidneys and double ureter with HDUN and dilated ureter of upper moiety till lower end ending in an Ureterocele? The Ureterocele is the sphincetric type with the mouth stenotic and opening just at the bladder neck. No reflux into either of the 3 ureteric openings. No back pressure changes in the bladder. DMSA shows L VS R 49/51% and Upper vs Lower moiety 33/67%.

Ich richte diese Frage an die Kollegen in Deutsch.

Der Grund meiner Anfrage: Ein Oberarzt der Urologischen Klinik in Warschau richtet diese Frage an das Deutsche Tuberkulose-Archiv in Heidelberg und weiter an mich.

Leider existieren exakte Daten erst seit 2000.

Die Zeit zwischen 1957-2000, die uns hier interessiert, ist schlecht abgebildet und nur mit Mühe wohl aus dem "Urologen" o.ä. herauszusuchen.

Der für solche Fragen in der Urologie zuständige Fachmann, Prof. Severin Lenz aus Berlin, tut sich mit seiner Antwort schwer. Der Münsteraner Epidemiologe hüllt sich in Schweigen.

Fällt einem aus der Community etwas hilfreiches ein?

Ansonsten kämpfe ich mich durch etwa 40 Jahresbände (????) oder ich vertröste den Kollegen auf den St. Nimmerleinstag.

Mit herzlichem Gruß und Dank.

U. Aumann

60 years old man had right nephrectomy 7 years ago presented with Left renal hilar mass of 5cm, in contact to renal vessels, with other 5cm mass in the left suprarenal?

what to do?

Hi I am a urology researcher and we are comparing two methods for visualizing kidneys and evaluating them based on the number of calyces ( cavities within kidney) detected for each test.

Initially I thought to use sensitivity and specificity but there are several instances where one method missed several calyces. So, essentially I am wondering if there is a test that predicts how accurately one method is at detecting the total number of calyces within a region of the kidney.

For example: the reference method (true number) detected 8 calyces and the experimental method detected 5, so there are technically three false positives within that single patient sample. And my total sample is 54 patients. Is there a test I can use?

During laparoscopic operations in urology, there is a potential danger of transmitting the virus to personnel. The European Association of Urology recommends precautions for such surgery (EAU website). Is it advisable to use open surgery in such patients and in what cases?

I would like to ask the pediatric surgeons and urologists concerning circumcision in Caucasian children. What are the medical indications for performing circumcision in the neonatal period? What urological indications exist for this intervention in early childhood? What are the advantages and disadvantages of this manipulation, in case there are no other indications for it?

So, if I am correct, for some time now, calcium ingestion has been recommended in order to bind with oxalate in the gut and therefore, make it less available to be absorberd. On the other hand, I have seen citrate medication also being recommended since it binds with calcium to make it less available to bind with oxalate, in order not to form crystals. My question is if citrate wouldnt also make calcium less available to bind with oxalate in the gut, and therefore, make it more likely to be absorbed.

Which dose of vitamin C is the risk of forming oxalic stones? above 3 gm?

Because these cases are challenging.

Check the images (One of the images aren't so clear, so I marked the gases)

The urologist ordered K.U.B to get more info. about renal stone and the examination was done twice, and in both, there were gases that masked some info. my Q is, how can we improve the results next time, will taking castor oil instead of bisacodyl and glycerin improve the results or there is a problem with the preparation that she should avoid? Because first time, she took glycerin instead of castor oil, and bisacodyl in the next time she underwent the examination because of fearing strong adverse reactions associated with castor oil (Cytotoxicity and neurotoxicity as shown by animal studies)

She followed all the procedures except the castor oil step (Replacing it with other laxatives)

This is the preparation ordered by a radiology center :

1- Light dinner (Example: Jam, plain biscuit, boiled vegetables, fruits, honey) 10:30 PM that doesn't contain dairy products, fats, soft drinks and legumes

2- Ingesting 60 ml castor oil

3- Drinking anise tea without sugar 12:30 am

4- Drinking anise tea without sugar 1 am

5- Take disflayl (simethicone) 2 chewable tablets (without water) every half an hour 3 hours before the examination

The US abdomen and pelvis of 65 Years old male report says: Both kidneys are normal in size, shape and position. They show normal echogenicity with preserved interfaces and parenchymal thickness. No masses or cysts could be detected, apart from left lower pole simple cyst measuring 10 mm in diameter.

Will this need a follow-up by a CT scan, or there is no need?

Images of US attached

Carcinoma Prostate has been risk stratified and management based on the same is well established.

However, clinically T3a disease still remains a "grey zone" in the management strategies, in order to achieve the "Prostatic trifecta"".

With emerging radiological evidence that long capsular contact as well as capsular bulge (on MRI) should be considered as clinically T3a disease, the T2 disease paradigm also has had a dramatic shift.

What should be the ideal treatment strategy- Radical Prostatectomy or Radical Radiotherapy?

65 Y male who underwent Prostatectomy (weighing about 85 gm - 70 CC) got a urinary tract infection (As shown in the images attached) following the operation.Bothersome Symptoms following the operation (Hematuria that lasted more than a month but stopped) and another symptom that appeared 10-14 days after removal of the catheter (The catheter was removed two days after surgery) Burning urination (Still exists). Which antibiotic would you choose? And would you combine more than one antibiotic or monotherapy is just sufficient?

The urologist (Who did the surgery) recommended Cefepime 1 gm IM twice daily monotherapy. Is this the best choice? Or what would you choose/recommend based on this sensitivity test and history?

Also: The surgeon prescribed levofloxacin 750 mg after the surgery for 21 days. The surgery took place 7-8-2019

Past medical history:

Acetylsalicylic acid (Aspirin): 100 mg once daily

Rosuvastatin calcium: 10 mg once daily

Candesartan cilexetil: 4 mg once daily

Do you advocate bowel preparation and dietary restriction (Fasting overnight) prior to k.u.b?

I would like to collect the cancer cells in urine from patients who suffer from urological cancer, as a new form of liquid biopsy. However, the urine contains epithelial cells as well as cancer cells. Moreover, it is expected that the amount of cancer cells is much less than bladder or kidney cells. I was wondering if there is a way to pick up those rare cancer cells from a background of normal cells?

Does this report indicate any malignancy and what are your recommendations based on these reports?

Transrectal Ultrasonography of the pelvis report:

The prostate is enlarged weighing about 85 gm with apparently intact capsule. The median lobe is hypertrophied indenting the bladder base and mildly projecting within its lumen. Heterogenous parenchymal echogenicity is noted however no definite evidences of focal lesions...BPH...For correlation with PSA level.

Both seminal vesicles are bulky showing tiny cystic changes.

Past Abdomen and Pelvis US report:

Mild circumferential wall thickening of the urinary bladder, with prominent trabeculations and with echofree lumen and no mural lesions..features of chronic obstruction uropathy...for clinical and lab correlation.

Full volume= 315 cc3

Post-voiding volume= 20 cc3

The prostate is enlarged in size (70 cc) seen identing the bladder base with prominent median lobe with intact capsule

Normal size and echogenicity of both seminal vesicles

Hi,

Is there any alternative method to HPLC to measure cystine concentration in mouse urine? I have found HPLC is mostly used to measure cystine in human urine.

In case of mice there are limited studies regarding cystine measurement.

Thank you.

In your opinion observe or treat this stone?

Stone info.Non obstructing renal pelvic stone measuring 9 mm with mean density of 1300 HU, Radiopaque (K.U.B)- most likely calcium oxalate stone (Physician opinion after taking history).

Relevant history:

53 Y Female, underwent vaginal hysterectomy (one month ago) accompanied by ureteral stent for prolapsed uterus that was followed by hydronephrosis ( Right sided mild to moderate hydro-uretero-nephrosis is seen, the ureter is diffusely dilated along its length till the vesical attachment with few kinks at its upper third in absence of any stones or obstructing lesions.

Left sided mild to moderate hydro-uretero-nephrosis is seen, the ureter is diffusely dilated along its length till the vesical attachment in absence of any ureteric stones or obstructing lesions)

She also has non-alcoholic fatty liver disease.

So in your opinion given the above info.should she observe and wait or undergo SWL?

53 Y F has 3rd degree uterine prolapse associated with bladder prolapse (Will under hysterectomy) but there are some urological problems that arose on examination. Initially Right grade 2 Hydronephrosis on US scan (Abdomen and Pelvic), thus she did CT scan to know the cause as directed by the Urologist and the findings are presented as follow (Image attached - CT image). So my Q is how would you manage the renal stones, Kinks, angiomyolipoma, Hydronephrosis? Will you just observe/wait and see the results after hysterectomy or you will try the ureter stent?

Medical History:

Atrial Fibrillation (Bisoprolol 2.5 mg once daily)

Chronic venous insufficiency (Daflon 500 mg one tablet daily)

Allergic Rhinitis (Cetirizine 10 mg once daily)

Non-Alcoholic Fatty liver disease

Should the patient fast for 12 hours and if so, does he have to drink to fill the bladder before the scan?

History: Hydronephrosis Grade 2 (US examination)

patient presented with sever loin pain, and anemia..

In my clinical practice, I frequently see patients complaining sexual disturbances becoming apparent after unwise administration of alpha-blockers for BPH. Frequent misuse by the urologists is the mot common mistake. How can we change this?

56year old male presented to his local physician for dry cough,clinical exam was nil significant.CBC is N except ESR 40,blsugar ,urea,creatinine, LFT were N,X Ray chest N,U/S mass in the R lobe of liver.when he was ref to our hospital.viral markers are N so as AFP and PT INRAny other investigation.A high resolution cect was reported as HCC in segments 6 and7.Rest of the study was N.Anyother investigation will be of any help before proceeding for surgery or straight away go ahead with surgery.I have once again repeating AFP and

viral studies and PFT.

A case of 72 year old woman with chief complaint of foreign body sensation in throat from about 1 month.

Rhinofibrolaringoscopy showed a red and swollen epiglottis covered in small portion with “slight thickening white tissue” (Acanthosis?’)  (only epiglottis, rest were normal) neck palpation and classical blood tests normal.

after antibiotic treatment and anti-reflux therapy without results,  for suspicion of mycosis I gave one week / 10 days of antifungal, without results too.

After 2 months this the view, the “ white tissue” is more widespread, always only epiglottis.

Biopsy has been performed, with results “fragments of granulation tissue with lymphocytes and neutrophils (LCA +, CKAE1 / AE3 -)”.

3 months after the first visit this is the situation, same epiglottis, but now I noted a hypertrophy of the base of the tongue.

I would like to know what is your hypothesis or what could be done to reach diagnosis.

can the supeesaturated urine produce a stone in vitro?

How often you use fluoroscope during routine ureteroscopy? and did you feel that fluroless URS is safe?

This question has arisen from contributor Pete Batcheller, who added a response to my question "Is Botox an effective treatment for Episodic Migraines?".  Mr Batcheller is a very dedicated believer that high dose Vit D3 is effective in preventing Cluster Headaches (CH). 

High dose Vit D3 has been researched for its anti-inflammatory functions and it is possible it may help reduce the incidence and severity of CH when used in doses of 10,000 IU a day. Bearing in mind the morbidity of CH and the low price of VitD3 supplements, it suggests it is worth trying provided the potential harmful effects of Hypervitaminosis D are avoided.

He quotes a paper "Burton et al. titled A Phase I/II Safety Trial of High Dose Oral Vitamin D3 with Calcium Supplementation in Patients with Multiple Sclerosis" where doses up to 40,000IU a day were given over 48 weeks and the serum 25(OH)D (along with Serum + Urinary Calcium and other markers were measured)

While it is very clear to me that this is not a sufficiently long period to be certain that the long term dangers of heart attacks and kidney damage due to increased serum 25(OH) are not worsened, the interesting observation from Burton's work was that though there was a significant delayed rise in Serum 25(OH)D to a maximum of 410nmol this fell again to approx 200nmol during the period when 10,000IU was taken, and by extrapolation would probably fall further if the time the 10,000IU was take had been extended

It is now generally accepted that 5,000 IU given long term is safe

So, bearing in mind the intense morbidity of CH and CH may be associated with low serum levels of 30nmol or less of 25(OH)D:-

1. Does anybody have experience of high dose (10,000IU/day) VitD3 for CH

2. What serum level of 25(OH)D would be safe to run at for extended periods? Is 200nmol safe? What papers are there to back up safe levels when adminise

I have a trial to use the anterior peritoneal reflection of vesico- uterine pouch as an iterposition layer, in surgical treatment of VVF.

We all come across various conditions in different fields in medical science, where imaging plays a vital role in the management of any clinical condition. Radiologists are specifically trained to read and report on their findings on various images viz. CT scans, USG, MRI etc.

My question is: how adept should a non-radiologist be in reading the images? and at what stage of his career ?

I am always confronted with the dilemma of inserting a urinary catheter or not in patients with acute kidney injury for the sake of strict output monitoring. I would like to know what's the best evidence based practice for this issue. Thank you

I read about urethral stricture because there is often relapse after surgery, the stricture comes back.

Ovarian reserve testing for fertility prediction is a common practice in gynecological routine. Even in scientific events, some may have listened to the postulate that tests should be part of a periodic female evaluation, as a counseling tool for reproductive planning. I do not know any reference of the value of ovarian reserve testing for women who have not tried to conceive. As a matter of fact, in my point of view, the value of ovarian reserve testing (if there is any) is exclusive for infertile women. What is your opinion?

Many urologists advice patients with urethral stricture disease to carry out clean intermittent self-catheterisation when the patient is unable or unwilling to have surgical treatment. If this is your practice, how often do you advise patients to self-catheterise?

I ask about both tools of follow up and the schedule.

Purple urine in the bag is a known entity.

Blood and urine examinations normal

68 yr-old man

Rheumatic athritis. No renal lithiasis.

TURP in 2010 (adenoma, 55 grams)

And relapse of dysuria because of giant stone in prostatic bed...

Lithotripsy, urinalysis (once he had corynebacterium glucuronolyticum in 2013)

TURP again and again under antibiotics...

In 2016 Holep (complete), ,no bacteriuria, carboapatite and brushite stones...

Recurrence in 2017...

Any idea ?

Thank you.

CT and MRI of the pelvis with contrast, confirmed no evidence of bowel/vaginal fistula.

Hysteroscopy biopsy showed no malignancy

The patient had tubal sterilisation 30 years ago

which kind of preoperative testosterone, how long before surgery, have you any compications after surgery?

I am planning a study using an anesthetized pig model to better understand bladder filling and motion. From the literature, it seems that urethane would be the best anesthetic for the study, because it does not change the bladder motion or bladder capacity as much as other anesthetics. In the literature, I've seen many different administration methods used, so would you recommend a slow, IV drip or a large bolus at the start of the study? If we do the large bolus (~1.2 g/kg seems common), who long does it last in a pig?

Dear all,

excuse me for bothers. I am currently working on calculation of the cost-efficiency and costs-benefits analysis of novel diagnostic tool, potentially applicable into clinical practice of urologists and general practitionners.

Therefore, I need your help in clarification of some questions.

Saying generally, how much does it cost, to diagnose acute cystitis at the

doctor's office in Great Britain and Hungary (if we will imagine that there is no

health insurance)?

Could you please send me the mean prices for the investigation and diagnosis of the uncomplicated cystitis i.e.:

1) Consultation and taking history by the physician (necessary)

2) Symptom directed physical examination (necessary)

3) Urinalysis (necessary)

4) Urine culture (additional)

5) Mean time at doctor's office, necessary for the diagnosis of the cystitis could be made.

And I would even more appreciate your help, if someone could share an information about approximate number of cases of symptomatic cystitis per year in these countries?

Thank you in advance!

Sensory and motoneurons in the spinal cord can control micturition throughout the hypogastric, pelvic and pudendal nerves, but how important is the consciousness for an efficient voiding? Furthermore, how to evaluate cognitive micturition in an animal model?  

Suggestions and toughs would be very welcome.

Thanks!

AM 

Hello! 

I've read article "High Resolution Diffusion Tensor Imaging of Human Nerves in Forearm"

I am interesting for DTI on dorsal penile nerves.

What do you think about it? Is it possible or not?

Lower urinary symptom, especially the last 8 weeks. Needs a cathether to void urine.

It seem to origin from the urethra. Or?

I was planning a retrograde urethragraphy and urethra/cystoscopy

There is an emerge of usage of Prostate Cancer Vaccine in the U.S (ie.Sipuleucel-T). Is there an existence of Prostate Cancer Vaccine usage in Middle East and Turkey? If so, is there anyone in Turkey specifically working on the subject.

Thank You

My VCaP cell has been cultured in DMEM medium (in petri dish) for over 20 days, the cell still grows very slowly. So the medium is exchanged every 2 days. The passage of the VCaP cells has not been administered. But I checked the previous paper, the doubling time of VCaP cell line is 5-6 days. The suggestive passage condition for VCaP cells is when the confluence reaches 80-100%.  Thus, I am still waiting. 

I plan a mouse trial to describe the role of macrophages in hollow viscus organ remodeling. I am looking for options to collaborate/share animals.

Thank you!!

M

I was trying to freeze some cells. my cells were like 80% confluent in the flask and I trypsinized them, tried as much as I can to avoid clumpes by drawing cells up and down several times and then took 10 microml of the solution on each side of hemocytometer. However I got very few cells when I counted ( average was 50x10^4). what went wrong in the process for me to get this few number of cells ?

I am using UM UC6 bladder cancer cells.

anyone have 5 minutes urology book

Looking at the anatomy of the male urinary tract, there's the urinary bladder which gives off the prostatic urethra where urine passes through when the internal urethral sphincter relaxes. The prostate gland itself surrounds the prostatic urethra, and I would think the gland secretes into the urethra (hence how some urinary PSA gets into urine samples collected).

Do these prostatic secretions leak backwards through a contracted internal urinary sphincter and into the urine stored in the urinary bladder when a man is in a "resting state" (i.e. not urinating, which would relax the sphincter)?

Nocturia and Thin urine flow trouble many adult males above 60 .TURS surgery is the gold standard now especially with Holmium lasers we know.Corn Hairs silks to ''Galo and Gokroo- Satholi'' in Indian ayurveda to Saww palmetto are known in varied cultures as "Cure'' relief for nocturia and poor urine flow in adult males.Do you know any thing else helps if we put patient on Tab Tamsulosin 0.4 ugms hs too?

Dear colleagues,

I am Jakhongir F. Alidjanov, urologist from Uzbekistan, working on Research Project at the Justus-Liebig University of Giessen.

The main aim of the project is to investigate changes in metabolomic profile of the urine due to causative pathogens of urinary tract infections. Since being clinician, I am not so familiar with advanced microbiology. Therefore I would really appreciate if you could help me to clarify some advanced issues.

What pathogenic bacteria (E. coli, P. aeruginosa, E, faecalis, K. pneumoniae, S. saprophiticus etc.) do usually use as a nutrient source for living and multiplication in the urine? Below, I am posting some metabolites present in the urine which in my humble opinion could be appropriate to be investigated.

1. 1.3-propanediol (K. pneumoniae);

2. 4-Pyridoxic acid;

3. 6-hydroxylnicotinic acid (P. aeruginosa);

4. Acetate (highest in presence of Gram+);

5. Androsterone (may be reduced in stress urinary incontinence);

6. Citrate;

7. Creatinine;

8. Ethanol;

9. Formate (highest in presence of Gram-);

10. Glucose;

11. Glycerol (K. pneumoniae);

12. Glycolic acid;

13. Hippurate (highest in presence of Gram-);

14. Indoxyl sulphate (may be converted by uropathogens into indirubin and indigo – “purple bag syndrome”);

15. Lactate (highest in presence of Gram+);

16. L-alanine;

17. L-cysteine;

18. L-fucose (may have an influence to virulence of some E. coli strains producing verotoxin);

19. L-glutamine;

20. L-histidine;

21. L-lysine;

22. L-serine;

23. L-theronine;

24. L-tyrosine;

25. Mandelic acid (antibacterial properties);

26. Methanol;

27. N-acetylneuraminic acid (found in cell membranes, may make a sense in diagnosing intracellular E. coli?);

28. Nicotinic acid (P. aeruginosa);

29. Nitrite;

30. Succinate (highest in presence of Gram-);

31. Taurine;

32. Trimethylamine (E. coli);

33. Trimethylamine N-oxide (E. coli);

34. Urea (highest in presence of Gram-);

35. α-Aminoadipic acid;

Could you please look on them and give your suggestions regarding this issue? What else should we investigate?

Thank you all in advance for your responses.

Hi, everyone

When I try to make a histogram with error bar, I need the average and standard deviation(SD) calculated for one set of data first, and the error bar is represented by SD.

However, what is the error bar of Rate(e.g. morbidity)? For example, I decide to compare the incidence of a disease in two areas(A city and B city). In A city, out of 1000 individuals collected, 25(2.5%) are attacked by the disease. In B city, out of 1100 individuals collected, 10(1%) are attacked by the disease. Then, chi-squared test is used to compare the morbidities, and the P value is 0.00817. Here is the figure.

How to add error bar to the histogram of morbidity? I'm confused what the error  bar of Rate means.

Thank you in advance!

Determination of types of uro-stone in situ by radiology or any other investigations

Is there anyone who needs to block the kidneys (single sided or double sided) in case of urinoma, perforations, fistula, iatrogenic ureteric lesions or other lower urinary track problem that temporarily needs absence of urine?

Nephrostomies alone will not always do the job.

Your experience of optimum duration for ureteral stenting post augmentation cystoplasty, in the following cinarios, 1) augment without ureter reimplantation, 2) with reimplantation 3) redo augmentation ?

Typically, clear cell renal cell carcinoma (CCRCC) is characterized by epithelial cells with clear cytoplasm and a well-defined cell membrane. Are there any software or methods  we could use to quantify the transparency of the cytoplasm?

taking in consideration that pigs are not available in our locality  

Open Hepaticojejunostomy vs. Hepaticoduodenostomy for choledochal cyst in children,Which one is better?

With a high clinical suspicion of pyelonephritis (costa-vertebral pain, fever, chills, dysuria), a urinalysis and urine cultures are obtained, in addition to other diagnostic test. The urinalysis is positive for macro-hematuria, and protein, but negative nitrates. The urine culture showed absolutely no growth. What could the potential reasons for the non-growth be? Can a delay in transport, inadequate storage, or inadequate temperature cause this? Or is there some other explanation? 

Resently patient dose measurement in urology methods is considered as a favorite field for Medical Physicists and other specialists, since in these procedures the patients experince the high radiation doses, thus consider this condition can reduces the patient and specialists dose.

smooth muscle relaxants are necessary for the elimination of small stones from the kidney through the ureter, and when they arrive to bladder they need open way to pass through the urethra, but the smooth muscle relaxation of bladder "detrusor muscle" cause urine retention, so the first step of elimination of kidney stone is good "passing from kidney through ureter to the bladder" ...while the second step seems bad "passing from bladder to urethra" because the bladder is relaxed and tends to store  more urine, how it is possible to accelerate the second step of the elimination of kidney stone from the bladder?

The loss of the cremasteric reflex after hernia repair is usually considered as a sign of the ipsilateral testis non-functioning. Are there any data of the correlation of the former and the latter?

Eight decades ago, Al exander Randall identified calcium phosphate deposits at the tip of renal papillae as the origin of renal calculi. The awareness that these “Randall’s plaque” promote renal stone formation has been amplified during the past years by the development of endoscopic procedures allowing the in situ visualization of these plaques. Recent studies based upon kidney biopsies evidenced that apatite deposits at the origin of these plaque originate from the basement membranes of thin loops of Henle and then spread in the surrounding interstitium. In addition, scanning electron microscopy examination of calcium oxalate stones developed on Randall’s plaque evidenced that plaque may also be made of tubules obstructed by calcium phosphate plugs. Hypercalciuria has been associated to Randall’s plaque formation. However, several additional mechanisms may be involved resulting in increased tissular calcium phosphate supersaturation and the role of macromolecules in plaque formation remains elusive. At last, apatite crystals are the main mineral phase identified in plaques, but other calcium phosphates and various chemical species such as purines have been evidenced, revealing thereby that several mechanisms may be responsible for plaque formation.

Urolithiasis August 2014 Date: 07 Aug 2014

Randall’s plaque as the origin of calcium oxalate kidney stones

Michel Daudon, Dominique Bazin, Emmanuel Letavernier

I only know three indications: 1. Pregnant women, 2. patients undergoing prostate surgery or other invasive urologic surgery, and 3. kidney or kidney pancreas organ transplant patients within the first year of receiving the transplant. But I don´t have evidence in patients with single kidneyy.

January 12, 2015. doi:10.1001/jamainternmed.2014.7132

after scrotal urethroplasty hairs form in the urethra how to remove them ?

MicroRNA expression signatures are highly reproducible;therefore, the definition of a signature of malignancy (Jung et al,2009) or a molecular classification of tumours according to their miRNA expression is feasible (Lu et al, 2005).For prostate cancer  showed that a set of only three miRNAs was able to correctly discriminate between prostate cancer samples and the corresponding normal tissue from the same organ with an overall accuracy of 77% (Wach et al, 2012) ,it is true for RCC too.

Antenatally detected hydronephrosis

A taghorn urethral fistula is a fistula with only one opening at the urethral side and 2or more openings to the skin

i had faced one in my life

spot sample is interesting screening tool in pediatric stone patients

Stag horn calculus may require PCNL through superior calyceal access alone or with accessory tracts through middle or lower calyx. How safe is it ?