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Ahmed NHA, Sabr NS, Bapir R, Hiwa DS, Hasan AH, Salih RQ, Tahir SH, Abdalla BA, Othman S, Kakamad FH. Hysteroscopic management of complete septate uterus with septate cervix, and longitudinal vaginal septum: a case report. J Surg Case Rep 2024; 2024:rjae238. [PMID: 38638926 PMCID: PMC11026055 DOI: 10.1093/jscr/rjae238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/23/2024] [Indexed: 04/20/2024] Open
Abstract
Mullerian anomalies occur as a result of errors during embryogenesis. The estimated incidence of these anomalies is around 1% in the general population and 3% in women complaining of suboptimal reproductive outcomes and infertility. A 21-year-old female patient was referred to our hospital due to primary infertility for 18 months. After a proper history, physical examination and further diagnostic steps, including ultrasound and magnetic resonance imaging, a diagnosis of complete septate uterus with septate cervix and longitudinal vaginal septum was made. Following hysteroscopic resection of all the septa and two cycles of ovulation induction, the patient was able to conceive. However, she needed cervical cerclage later due to cervical insufficiency. The baby was delivered at term and was healthy. A uterine, cervical and longitudinal vaginal septum is a unique entity of Mullerian anomalies. Resection of all septa through a hysteroscopic approach resulted in a good outcome for our patient.
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Affiliation(s)
- Nahida Hama Ameen Ahmed
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Sulaymaniyah Maternity Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Nasren Sharef Sabr
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Rawa Bapir
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Dilan S Hiwa
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Ali H Hasan
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Sulaymaniyah Directorate of Health, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Rawezh Q Salih
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Soran H Tahir
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Berun A Abdalla
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Snur Othman
- Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Kurdistan 46001, Iraq
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Bhatti KH, Bapir R, Sohail N, Gomha FS, Shaat AHA, Channa AA, Abdelrahman KM, Muhammed BO, Hama NH, Kakamad FH, Abdalla BA, Hama JI, Abdullah HO. Occupational hazard in urolithiasis patients in Qatar: A single-center cross-sectional study. Arch Ital Urol Androl 2024; 96:12022. [PMID: 38502028 DOI: 10.4081/aiua.2024.12022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Urolithiasis is one of the most prevalent urological diseases and is associated with a substantial economic burden. Its prevalence varies according to geographical location. Qatar is a Middle Eastern country located in the Afro-Asian Stone Belt. It has a dry and hot climate, which may predispose individuals working in these environments to form kidney stones (KSs). METHODS A population sample of 4204 patients was categorized into five occupational classes. The frequencies and correlations of these occupations with KS formation were calculated. RESULTS Among the total cases, 2000 presented with KSs, with the majority being of Asian descent (49%), followed by individuals of Middle Eastern descent (35.1%). Technicians accounted for 35.15% of KS cases followed by clerks (29.2%) and executives (14.6%). Among KS cases, 44% had a single stone, 30% had multiple stones, and 26% had two stones. In comparing both KS and non-KS groups, age, gender, occupation, and race were significantly associated with KS formation (p<0.05), while BMI did not show any significant correlation (p>0.05). Asian males aged 31-40, working as technicians, were significantly more prone to urolithiasis. In comparing age, BMI, and gender with stone characteristics, only age was found significantly associated with stone size (p<0.05). Occupation showed an impact on all studied stone characteristics. Clerks and technicians presented more frequently with stones within the 11-15 mm range, while executives more frequently presented with smaller stones (p<0.001). Stone density was more frequently <500 HU in workers, technicians and housewives and >500 HU in executives and clerks (p<0.001). CONCLUSIONS Our findings revealed an elevated risk of urolithiasis among certain occupational groups, particularly technicians, who frequently work outdoors in high-temperature environments. Alternatively, the sedentary nature of clerical and executive positions can also contribute to the risk of urolithiasis.
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Affiliation(s)
| | - Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization for Scientific Research (Middle East Office), Hamid Str, Azadi Mall, Sulaimani, Kurdistan; Department of Urology, Surgical Teaching Hospital, Sulaimani, Kurdistan.
| | - Nadeem Sohail
- Urology Department, Hamad Medical Corporation, Alkhor.
| | | | | | | | | | | | - Nali H Hama
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan.
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization for Scientific Research (Middle East Office), Hamid Str, Azadi Mall, Sulaimani, Kurdistan; College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan.
| | - Berun A Abdalla
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization for Scientific Research (Middle East Office), Hamid Str, Azadi Mall, Sulaimani, Kurdistan.
| | | | - Hiwa O Abdullah
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization for Scientific Research (Middle East Office), Hamid Str, Azadi Mall, Sulaimani, Kurdistan.
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Bapir R, Qader D, Gharib D, Tahir S, Abdullah A, Asaad H, Ahmed S, Ali H, Abdullah H, Ahmed S, Hussein Kakamad F, Aghaways I. Delayed Presenting Gastric Duplication Cyst Mimicking a Left Adrenal Cyst in a Young Female: A Case Report with a Literature Review. Case Rep Gastroenterol 2024; 18:153-160. [PMID: 38524872 PMCID: PMC10959546 DOI: 10.1159/000537972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Gastric duplication cyst (GDC) is a rare congenital anomaly of the gastrointestinal tract. Though GDC is often misdiagnosed, misidentification as an adrenal cyst has rarely been reported. Herein, we report a case of GDC in a young female mimicking an adrenal cyst. Case Presentation A 17-year-old female presented with chronic epigastric pain, nausea, and intermittent vomiting. Physical examinations revealed mild tenderness in the epigastric region. Esophagogastroduodenoscopy showed no abnormality. Ultrasound, contrast-enhanced computed tomography scan, and MRI of the abdomen and pelvis showed an oval-shaped left adrenal cystic lesion measuring 33 × 26 mm. Preoperative blood investigations and hormonal assessments were normal. Laparoscopy showed that the cyst originated from the greater curvature of the stomach. The left adrenal gland was normal. After an intraoperative consultation with a gastrointestinal surgeon, a wedge resection of the cyst was performed. Histopathology confirmed the gastric duplication cyst. Conclusion GDCs are rare congenital malformations that may become symptomatic during adulthood. They can mimic adrenal cysts and lead to misdiagnosis.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaimani, Iraq
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Deedar Qader
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Dana Gharib
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | - Soran Tahir
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Ari Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Sulaimani Teaching Hospital, Sulaimani, Iraq
| | - Hoshmand Asaad
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | | | - Hemn Ali
- Smart Health Tower, Sulaimani, Iraq
| | - Hiwa Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Sasan Ahmed
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Fahmi Hussein Kakamad
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
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Bapir R, Abdalqadir AM, Aghaways E, Bayz HH, Abdullah HO, Ahmed SF, Abdalla BA, Hama JI, Muhammed BO, Hamahussein KF, Faraj FM, Kakamad FH. Brucella epididymo-orchitis: A single-center experience with a review of the literature. Arch Ital Urol Androl 2023; 95:11978. [PMID: 38193225 DOI: 10.4081/aiua.2023.11978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 01/10/2024] Open
Abstract
Brucella epididymo-orchitis (BEO) is a rare complication of brucellosis. Despite the high incidence of brucellosis in developing countries, few case series on BEO are available. This study focuses on the clinical presentations, diagnosis, and treatment of BEO with a review of the literature. This study included consecutive BEO patients diagnosed and treated at Smart Health Tower between 2021 and 2023. The required data were retrospectively collected from patients' profiles. The BEO diagnosis was established through scrotal Doppler ultrasound in cases with a positive Rose Bengal test and positive IgG and IgM results for brucellosis, in addition to scrotal pain and swelling. This study included 11 cases whose ages ranged from 22 to 55 years. Most of the cases presented with testicular pain (72.7%), followed by fever (63.6%) and arthralgia (63.6%). The right side (54.5%) was slightly more affected than the left side (45.5%). The major abnormal laboratory finding was an elevated C-reactive protein (82%). The treatment was conservative, in which a combination of gentamicin, doxycycline, and rifampicin was administered to the patients for about 6-8 weeks. One case underwent an orchiectomy due to the abscess formation. All the patients responded well to the treatment, with no recurrence. In the Middle East, brucellosis remains a concerning infectious disease. Early diagnosis, aimed at preventing abscess formation and other complications, takes first priority to avoid invasive interventions.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani; Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan.
| | | | - Esmaeel Aghaways
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan.
| | | | - Hiwa O Abdullah
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan.
| | - Shaho F Ahmed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan.
| | - Berun A Abdalla
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan.
| | | | | | - Karokh Fadhil Hamahussein
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan.
| | | | - Fahmi Hussein Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan; Kscien Organization, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan; College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan.
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Bhatti KH, Bapir R, Bhatti WS, Muhammad HM, Abdullah HO, Abdalla BA, Channa AA, Rahim HM, Cheema NA, Sohail N, Gomha FS, Fattah FH, Ahmed NHA, Aghaways I, Kakamad FH. Efficacy of sexual intercosurse in the spontaneous passage of distal or intramural ureteral stones: a randomsized controlled trial. Ann Med Surg (Lond) 2023; 85:5972-5976. [PMID: 38098570 PMCID: PMC10718389 DOI: 10.1097/ms9.0000000000001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023] Open
Abstract
Background The role of sexual intercourse as an alternative treatment approach for ureteral stones (UTSs) is a recent area of investigation with only small sample-sized studies. This study aims to evaluate the role of sexual intercourse in the spontaneous passage of distal or intramural UTSs via a larger sample size. Materials and methods The study population included cases that had either a distal ureteric or an intramural radiopaque stone. The patients were divided into two groups; group A was instructed to engage in sexual intercourse two to three times per week while also receiving symptomatic treatment for 4 weeks. Group B received symptomatic treatment alone and was instructed to abstain from sexual intercourse or masturbation for the same period. Results A total of 160 male patients were enrolled in this study. The ages of the patients ranged from 21 to 58 years. The rate of stone expulsion after 2 weeks was 68.18% in group A and 53% in group B (P=0.053). The expulsion rate after 4 weeks was 80% in group A and 68.4% in group B (P=0.072). The mean expulsion time was 13.9±5.4 days for the experimental group and 15.2±6.7 days for the control group (P=0.179). The experimental group required fewer analgesic injections in comparison to the control group (P<0.05). Conclusion While the role of sexual intercourse in facilitating the passage of distal or intramural UTSs cannot be fully established, it may aid to some extent. However, it should not be relied upon as a standalone treatment modality.
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Affiliation(s)
| | - Rawa Bapir
- Department of Urology, Surgical Teaching Hospital
- Smart Health Tower, Madam Mitterand Street
- Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaimani, Kurdistan
| | - Waseem Sarwar Bhatti
- Department of the Urology and Renal Transplantation, Government Institute of Medical Science (GIMS), Gambat, Pakistan
| | - Huda Muhaddien Muhammad
- College of Medicine, University of Sulaimani, Madam Mitterrand Street
- Smart Health Tower, Madam Mitterand Street
| | - Hiwa O. Abdullah
- Smart Health Tower, Madam Mitterand Street
- Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaimani, Kurdistan
| | - Berun Anwar Abdalla
- Smart Health Tower, Madam Mitterand Street
- Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaimani, Kurdistan
| | | | - Hawbash M. Rahim
- Smart Health Tower, Madam Mitterand Street
- Department of Medical Laboratory Science, College of Health Sciences, University of Human Development
- Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaimani, Kurdistan
| | | | | | - Faaz S. Gomha
- Al Ramadi Teaching Hospital, Al Anbar/Ramadi City, Iraq
| | - Fattah H. Fattah
- College of Medicine, University of Sulaimani, Madam Mitterrand Street
- Smart Health Tower, Madam Mitterand Street
| | | | - Ismael Aghaways
- Department of Urology, Surgical Teaching Hospital
- College of Medicine, University of Sulaimani, Madam Mitterrand Street
| | - Fahmi H. Kakamad
- College of Medicine, University of Sulaimani, Madam Mitterrand Street
- Smart Health Tower, Madam Mitterand Street
- Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaimani, Kurdistan
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Tolani MA, Tzelves L, Trinchieri A, Buchholz N. Treatment of urge incontinence in postmenopausal women: A systematic review. Arch Ital Urol Androl 2023; 95:11718. [PMID: 37791545 DOI: 10.4081/aiua.2023.11718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the genitourinary syndrome of menopause which is characterized by physical changes of the vulva, vagina and lower urinary tract. The treatment strategies for postmenopausal urinary incontinence are various and may include estrogens, anticholinergics, and pelvic floor muscle training. A comparison of these treatments is difficult due to the heterogeneity of adopted protocols. We systematically reviewed the evidence from randomized controlled trials (RCTs) focusing on treatment of postmenopausal women with urge incontinence. METHODS We conducted a systematic review and meta-analysis by searching PubMed and EMBASE databases for randomized controlled trials (RCTs) reporting results of treatments for postmenopausal urinary urge incontinence. Odds ratios for improvement of urinary incontinence were calculated using random effect Mantel-Haenszel statistics. RESULTS Out of 248 records retrieved, 35 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared with placebo, systemic estrogens were associated with decreased odds of improving urinary incontinence in postmenopausal women (OR = 0.74, 95% CI: 0.61-0.91, 7 series, 17132 participants, Z = 2.89, P = 0.004, I2 = 72%). In most studies, no significant improvement in urinary symptoms was observed in patients treated with local estrogens, although they showed to be helpful in improving vaginal symptoms. Vitamin D, phytoestrogens and estrogen modulators were not effective in improving symptoms of incontinence and other symptoms of genitourinary menopause syndrome or yielded contradictory results. A randomized controlled trial demonstrated that oxybutynin was significantly better than placebo at improving postmenopausal urgency and urge incontinence. The combination of anticholinergics with local estrogens has not been shown to be more effective than anticholinergics alone in improving urinary incontinence symptoms in postmenopausal women. Physical therapy showed an overall positive outcome on postmenopausal urinary incontinence symptoms, although such evidence should be further validated in the frame of quality RCTs. CONCLUSIONS The evidence for effective treatment of postmenopausal urinary incontinence is still lacking. Welldesigned large studies having subjective and objective improvement primary endpoints in postmenopausal urinary incontinence are needed. At present, a combination of different treatments tailored to the characteristics of the individual patient can be suggested.
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Affiliation(s)
- Rawa Bapir
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Department, HMC, Hamad Medical Corporation.
| | - Ahmed Eliwa
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | - Nazim Gherabi
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Faculty of Medicine Algiers 1, Algiers.
| | - Derek Hennessey
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mercy University Hospital, Cork.
| | - Vittorio Magri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Unit, ASST Fatebenefratelli Sacco, Milan.
| | - Panagiotis Mourmouris
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | - Konstantinos Stamatiou
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Tzaneio General Hospital, Piraeus.
| | - Musliu Adetola Tolani
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Department of Surgery,Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State.
| | - Lazaros Tzelves
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Alberto Trinchieri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology School, University of Milan.
| | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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Ali RM, Muhealdeen DN, Fakhralddin SS, Bapir R, Tahir SH, Rashid RJ, Omer CS, Abdullah HO, Abdalla BA, Mohammed SH, Kakamad FH, Abdullah F, Karim M, Rahim HM. Prognostic factors in renal cell carcinoma: A single‑center study. Mol Clin Oncol 2023; 19:66. [PMID: 37614366 PMCID: PMC10442722 DOI: 10.3892/mco.2023.2662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/30/2023] [Indexed: 08/25/2023] Open
Abstract
Renal cell carcinoma (RCC) is a heterogeneous and complex disease with numerous pathophysiologic variants. ~40% of patients succumb due to the progression of the disease, making RCC the most fatal of the common urologic malignancies. Prognostic factors are indicators of the progression of the disease, and the precise determination of these factors is important for evaluating and managing RCC. In the present study, it was aimed to determine and find associations among the histopathological features of RCCs and their impact on survival and metastasis. This is a cross-sectional study of RCC cases who have undergone partial or radical nephrectomy from March 2008 to October 2021 and have been pathologically reviewed at Shorsh General Teaching Hospital in Sulaimani, Iraq. The data in the pathology studies were supplemented by follow-up of the patients to obtain information about survival, recurrence and metastasis. In total, 228 cases of RCC were identified, among whom 60.5% were men and 39.5% were women, with a median age of 51 years. The main tumor types were clear cell RCC (71.1%), papillary RCC (13.6%), and chromophobe RCC (11%). Various measures of aggressiveness, including tumor necrosis, sarcomatoid change, microvascular invasion, and parameters of invasiveness (invasion of the renal sinus and other structures), were significantly correlated with each other, and they were also associated with reduced overall survival and an increased risk of metastasis on univariate analysis. However, on multivariate analysis, only tumor size and grade, and microvascular invasion retained statistical significance and were associated with a lower survival rate. In conclusion, pathological parameters have an impact on prognosis in RCC. The most consistent prognostic factors can be tumor size and grade, and microvascular invasion.
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Affiliation(s)
- Rawa M. Ali
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Pathology Department, Shorsh General Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Dana N. Muhealdeen
- Department of Oncology, Hiwa Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Saman S. Fakhralddin
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Rawa Bapir
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Urology Department, Sulaymaniyah General Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Soran H. Tahir
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Rezheen J. Rashid
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Oncology, Hiwa Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Choman Sabah Omer
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Hiwa O. Abdullah
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Berun A. Abdalla
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Shvan H. Mohammed
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Fakher Abdullah
- Kscien Organization for Scientific Research, 3082 JJ Rotterdam, The Netherlands
| | - Muhammad Karim
- Kscien Organization for Scientific Research, Tampa, FL 33637, USA
| | - Hawbash M. Rahim
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46001, Iraq
- Medical Laboratory Science Department, University of Human Development, Sulaymaniyah, Kurdistan 46001, Iraq
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Hussein ZN, Bapir R, Fakhralddin SS, Abdullah AM, Salih KM, kakamad FH. Penile calciphylaxis with penoscrotal necrosis: A case report with literature review. Urol Case Rep 2023; 50:102462. [PMID: 37416754 PMCID: PMC10320403 DOI: 10.1016/j.eucr.2023.102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/07/2023] [Indexed: 07/08/2023] Open
Abstract
Penile calciphylaxis, also known as calcific uremic arteriolopathy is an uncommon condition of the penile vessels due to its extensive vascular network. The aim of this report is to report a very rare case of penile calciphylaxis with penoscrotal necrosis. A 54-year-old male patient presented with progressive penoscrotal necrosis within a duration of one month. He had a history of diabetes mellitus and stage 5 chronic kidney disease. Under spinal anesthesia, partial penectomy and excision of the necrotic scrotum were performed. Histopathological examination was consistent with calciphylaxis. Despite it is a rare occurrence, penile calciphylaxis should be included in the different diagnosis of any diabetic and end stage kidney disease patients who presented with penile pain.
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Affiliation(s)
- Zhino Noori Hussein
- Department of Urology, Sulaimaniyah Surgical Teaching Hospital, Kirdistan Region, Iraq
| | - Rawa Bapir
- Department of Urology, Sulaimaniyah Surgical Teaching Hospital, Kirdistan Region, Iraq
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Kscien Organization, Hamdi Str., Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Saman Salih Fakhralddin
- Department of Urology, Sulaimaniyah Surgical Teaching Hospital, Kirdistan Region, Iraq
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Ari M. Abdullah
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Sulaimani Teaching Hospital, Sulaimani, Kurdistan, Iraq
| | - Karzan M. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Kscien Organization, Hamdi Str., Azadi Mall, Sulaimani, Kurdistan, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
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9
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Bapir R, Aghaways I, Ali RM, Fakhralddin SS, Ali RM, Rashid RJ, Abdullah AM, Ali MBA, Mohammed KK, Abdullah HO, Kakamad FH. Spermatocytic tumor of the testis: A case report and mini‑review of the literature. Med Int (Lond) 2023; 3:51. [PMID: 37810904 PMCID: PMC10557091 DOI: 10.3892/mi.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
Spermatocytic tumors are a rare type of testicular cancer, comprising <1% of all testicular malignancies. This type of cancer typically affects males in their 60s and 70s and rarely metastasizes; however, it poses a threat to the health of affected individuals if left untreated. The present study describes the case of a 68-year-old male patient with this type of tumor, including a presentation of his initial symptoms, treatment and subsequent monitoring. A male patient, aged 68 years, visited the authors' clinic with an asymptomatic mass in the right testicle. The mass had been progressively increasing in size for a duration of 5 years following a history of blunt injury. During the examination, a noticeable, painless enlargement was detected in the right testis, whereas the left testis appeared to be in a normal state. Tumor markers were within normal limits. Imaging revealed a complex mass (11x8x7 cm) almost replacing the right testis, with no detectable lymph nodes. A right radical orchidectomy was performed under spinal anesthesia. A histopathological examination revealed a spermatocytic tumor. The post-operative period was uneventful, with no metastasis detected in the CT scans. The patient was discharged with instructions for regular follow-up appointments. The case presented herein highlights a rare spermatocytic tumor in a 68-year-old male. The early detection and treatment of testicular tumors, regardless of age, are crucial for a good prognosis.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rawa M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Saman S. Fakhralddin
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rebaz M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Oncology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Rezheen J. Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Radiology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Ari M. Abdullah
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | | | - Karukh K. Mohammed
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower (Raparin branch), Sulaimani, Kurdistan 46001, Iraq
| | - Hiwa O. Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
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10
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Tolani MA, Tzelves L, Anker SD, Trinchieri A, Buchholz N. Risk of urogenital infections in non-diabetic patients treated with sodium glucose transporter 2 (SGLT2) inhibitors. Systematic review and meta-analysis. Arch Ital Urol Androl 2023; 95:11509. [PMID: 37314421 DOI: 10.4081/aiua.2023.11509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
Although SGLT2 inhibitors have been initially employed in the treatment of type 2 diabetes, their clinical use was later extended to the treatment of other conditions such as heart failure, chronic kidney disease and obesity. In patients with type 2 diabetes, the administration of SGLT2 inhibitors has been associated with an increased incidence of urogenital infections, which may be linked to high glucose levels in the urine. The rate of urogenital side effects may be different in non-diabetic patients. The aim of this study was to review the risk of urogenital infections in non-diabetic patients taking SGLT2 inhibitors. MATERIALS AND METHODS We conducted a systematic review and meta-analysis by searching PubMed and EMBASE for randomized controlled trials (RCTs) reporting urogenital adverse effects in non-diabetic patients treated with SGLT2 inhibitors. Odds ratios for urogenital infections were calculated using random effect Mantel-Haenszel statistics. RESULTS Out of 387 citations retrieved, 12 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared to placebo, SGLT2 inhibitors were associated with increased odds of genital infections (OR 3.01, 95% CI: 1.93- 4.68, 9 series, 7326 participants, Z = 5.74, p < 0.0001, I2 = 0%) as well as urinary tract infections (OR 1.33, 95% CI: 1.13-1.57, 9 series, 7326 participants, Z = 4.05, p < 0.0001, I2 = 0%). When four trials investigating the effects of SGLT2 inhibitors in populations including both diabetic and non-diabetic patients were considered, administration of SGLT2 inhibitors in diabetic patients was associated with significantly higher odds of genital infections but not urinary tract infections compared to patients without type 2 diabetes. In patients taking placebo, the odds for urinary tract infections were significantly increased in diabetic patients compared to non-diabetic patients. CONCLUSIONS The risk of genital infections is increased also in non-diabetic patients taking SGLT2 inhibitors although at a lesser extent that in diabetics. A careful assessment of the local anatomical conditions and of the history of previous urogenital infections is desirable to select those patients who need more intense follow-up, possibly combined with prophylactic measures of infections during treatment with SGLT2 inhibitors.
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Affiliation(s)
- Rawa Bapir
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Department, HMC, Hamad Medical Corporation.
| | - Ahmed Eliwa
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | - Nazim Gherabi
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Faculty of Medicine Algiers 1, Algiers.
| | - Derek Hennessey
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mercy University Hospital, Cork.
| | - Vittorio Magri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology Unit, ASST Fatebenefratelli Sacco, Milan.
| | - Panagiotis Mourmouris
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | - Konstantinos Stamatiou
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Department of Urology, Tzaneio General Hospital, 18536 Piraeus.
| | - Musliu Adetola Tolani
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Division of Urology, Department of Surgery, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State.
| | - Lazaros Tzelves
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Stefan D Anker
- Department of Cardiology and BCRT (Campus CVK), Charité Universitätsmedizin Berlin.
| | - Alberto Trinchieri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Urology School, University of Milan, Milan.
| | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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11
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Babarasul MH, Bapir R, Rahman DHK, Fakhralddin SS, Kakamad FH, Tahir SH, Ali RM, Abdalla BA, Mohammed SH, Hussein DM. Synchronous ipsilateral papillary renal cell carcinoma and urothelial carcinoma: A case report. Oncol Lett 2023; 25:221. [PMID: 37153050 PMCID: PMC10157353 DOI: 10.3892/ol.2023.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/14/2023] [Indexed: 05/09/2023] Open
Abstract
Concurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) in the same kidney is a rare phenomenon. It is critical to define this unusual disease to avoid a delay in diagnosis and improve the prognosis. The present study describes a case of a 71-year-old patient with synchronous ipsilateral RCC and UC of the renal pelvis and ureter. The patient presented with intermittent attacks of left loin pain with frank hematuria for 3 months and a weight loss of 5 kg over the same period of time. The patient had been a chronic heavy smoker for >45 years. Physical examination revealed stable vital signs; however, a mobile, non-tender mass was palpated in the left upper abdomen. A left nephroureterectomy with the removal of a bladder cuff was performed. Histopathological examination revealed a papillary RCC with a pathological stage of pT1N0Mx and a high-grade UC of the renal pelvis and ureter with a pathological stage of pT3-pN1-pMx. The postoperative recovery was good, and the patient was referred to an oncology center for further management. Previous reports have failed to identify definitive risk factors for the concurrence of RCC and UC. However, 24% of the patients in the various case reports in the literature were smokers. The most common presenting complaints included weight loss and painless hematuria. The concurrence of RCC and UC in the same kidney is a rare entity, and it frequently leads to a worse prognosis than the occurrence of RCC alone. Radical nephroureterectomy is the main line of treatment for patients with upper tract UC.
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Affiliation(s)
- Muhamed Hussen Babarasul
- Department of Urology, Shaheed Shawkat Haji Musheer Hospital, Said Sadiq 46008, Republic of Iraq
| | - Rawa Bapir
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
- Department of Urology, Sulaymaniyah General Teaching Hospital, Sulaimani 46000, Republic of Iraq
| | | | - Saman Salih Fakhralddin
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Department of Urology, Sulaymaniyah General Teaching Hospital, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
- Correspondence to: Dr Fahmi H. Kakamad, College of Medicine, University of Sulaimani, Doctor City, Building 11, Apartment 50, Sulaimani 46000, Republic of Iraq, E-mail:
| | - Soran H. Tahir
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
| | - Rawa M. Ali
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
| | - Berun A. Abdalla
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
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12
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Bapir R, Hama Hussein KF, Baba HO, Muhialdeen AS, Tahir SH, Abdalla BA, Mohammed SH, Salih AM, kakamad FH, Aghaways I. Coexistence of acute pancreatitis and an obstructing upper ureteral calculus: does a calculus cause pancreatitis? a case report. Ann Med Surg (Lond) 2023; 85:3158-3162. [PMID: 37363548 PMCID: PMC10289531 DOI: 10.1097/ms9.0000000000000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/14/2023] [Indexed: 06/28/2023] Open
Abstract
Acute pancreatitis is an inflammatory disease that can affect both the peripancreatic tissues and distant organs. There are few reports of acute pancreatitis caused by endourological procedures. However, an obstructing ureteral calculus causing acute pancreatitis is very rare. Case presentation A 36-year-old male patient presented with epigastric, and right loin pain with decreased urine output for 3 days. On physical examination, he had central abdominal and right flank tenderness. An abdominal ultrasound showed mild to moderate ascites, a hyperechoic pancreas, a small (26×77 mm) left kidney with increased echogenicity, right renal hypertrophy with moderate hydronephrosis, and a dilated upper ureter due to a 10 mm obstructing stone with a perirenal fluid collection. The diagnosis of acute pancreatitis with an obstructing right upper ureteric stone was established. Under spinal anesthesia, an emergency ureteroscopy with laser fragmentation of the stone was performed, and a JJ stent was inserted. He developed postobstructive diuresis and his renal function was improved with a rapid decline of pancreatic enzymes as well. Clinical discussion Two theories explain the presentation of acute pancreatitis by ureteral obstruction. First, the obstructed severe hydronephrotic kidney compresses the duodenum and head of the pancreas, obstructing the distal part of the common bile duct and triggering the elevation of pancreatic duct pressure, bile reflux, trypsin activation, and pancreatic autodigestion. The second theory states that acute pancreatitis develops when urine is extravasated from an obstructed kidney into the adjacent tissues, irritating the uncinate process of the pancreas. Conclusion Although mentioning ureteral obstruction as a cause of pancreatitis is scarce, the clinician should be aware that in each case of ureteral obstruction, the emergence of acute pancreatitis is a possible complication.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street
- Department of Urology, Surgical Teaching Hospital
| | - Karokh F. Hama Hussein
- Smart Health Tower, Madam Mitterrand Street
- Kurdistan Center for Gastroenterology and Hepatology
| | - Hiwa O. Baba
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | - Aso S. Muhialdeen
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | - Soran H. Tahir
- Smart Health Tower, Madam Mitterrand Street
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Berun A. Abdalla
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | | | - Abdulwahid M. Salih
- Smart Health Tower, Madam Mitterrand Street
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. kakamad
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
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13
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Mohammed SA, Karim DO, Fakhralddin SS, Bapir R, Hadi TS, Hussein DM, Hiwa DS, Hamasalih HM, Hasan SJ, Kakamad FH. Secondary renal amyloidosis due to primary Sjogren's syndrome: a case report. Ann Med Surg (Lond) 2023; 85:3035-3038. [PMID: 37363481 PMCID: PMC10289626 DOI: 10.1097/ms9.0000000000000721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/15/2023] [Indexed: 06/28/2023] Open
Abstract
Amyloidosis is a rare disorder characterized by the deposition of abnormal proteins in extracellular tissues, resulting in the dysfunction of vital organs and, eventually, death. The occurrence of amyloidosis due to primary Sjogren's syndrome (pSS) is a rare finding. This study describes a rare case of pSS complicated by amyloid-associated amyloidosis. Case presentation A 35-year-old male was diagnosed with nephrotic syndrome and secondary amyloidosis caused by pSS. He had microscopic hematuria, a creatinine level of 6.59 mg/dl, and an elevated erythrocyte sedimentation rate of 107 mm/hrs. Furthermore, investigations of antinuclear antibodies, antimitochondrial antibodies, SSA, SSA native, and Ro-52 recombinant as well as rheumatoid factor showed positive results. After establishing the diagnosis of pSS through clinical, physical, and laboratory assessments, a renal biopsy was performed, which revealed the occurrence of secondary amyloidosis. Clinical discussion The risk of developing secondary amyloidosis depends on the extent of elevated serum amyloid levels as well as persistent subclinical inflammation. The definitive diagnosis of amyloidosis requires histological confirmation of amyloid fibril deposition in tissue. Conclusion Secondary renal amyloidosis is an unusual condition in patients with pSS. Still, it should be regarded in the differential diagnosis of patients with proteinuria and/or renal failure, and a renal biopsy should be performed.
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Affiliation(s)
| | - Dana O. Karim
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Department of Clinical Hematology, Hiwa Hospital, Sulaimani, Kurdistan, Iraq
| | - Saman S. Fakhralddin
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Kurdistan, Iraq
| | - Tahani Shakr Hadi
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Dlsoz M. Hussein
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Dilan S. Hiwa
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | | | - Sabah J. Hasan
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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14
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Bapir R, Kakamad FH, Aghaways I, Abdullah AM, Hassan MN, Abid AAM, Hasan SJ, Salih KM, Hamasalih HM. Para‑testicular arteriovenous malformation: A case report and mini‑review of the literature. Med Int (Lond) 2023; 3:28. [PMID: 37323126 PMCID: PMC10265326 DOI: 10.3892/mi.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Arteriovenous malformations from para-testicular structures are very rare, with only a limited number of cases reported in the literature. The present study reports a rare case of para-testicular arteriovenous malformation. A 6-year-old boy presented with painless swelling in the scrotum for 6 months. Upon examination, a non-tender and non-pulsatile cystic swelling was observed in the right hemi-scrotum below the testis. A scrotal ultrasound revealed a separate cystic lesion with a normal texture and the vascularity of both testes. Under general anesthesia, via a small scrotal incision, a cystic, blood-filled mass was excised. The results of a histopathological examination were suggestive of vascular malformation. The case described in the present study aims to shed light on vascular malformations. A number of vascular malformations are incorrectly referred to as hemangiomas, and numerous patients undergo inappropriate therapy due to this misclassification. Although para-testicular arteriovenous malformation is a very rare condition, it should be included in the differential diagnosis of para-testicular lesions.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ari M. Abdullah
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Department of Pathology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Marwan N. Hassan
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ayoob Asaad Mohammed Abid
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Sabah Jalal Hasan
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Karzan M. Salih
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Hussein M. Hamasalih
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
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15
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Bapir R, Shabur B, Aghaways I, Tahir S, Abdullah H, Ahmed R, Rashid R, Ali R, Abdalla B, Kakamad F. Synchronous Kaposi sarcoma and renal cell carcinoma in an elderly male patient (a very uncommon reported entity): A case report. Med Int 2023; 3:16. [PMID: 37021299 PMCID: PMC10068030 DOI: 10.3892/mi.2023.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Based on the literature, there are only three reports available to date on synchronous Kaposi sarcoma (KS) and renal cell carcinoma (RCC), at least to the best of our knowledge. The present study reports a rare case of synchronous classic KS and clear cell RCC. A 69-year-old male presented with painful, purplish nodular lesions on the dorsal aspect of his hands and feet. He had no chronic medical illnesses or prior surgical interventions. An excisional biopsy of one of the lesions revealed a nodular dermal lesion with numerous vascular channels and interlacing spindle cells. A 2.5 cm-enhancing mass was found in a contrast-enhanced computed tomography scan of the abdomen, suggesting RCC or metastasis. A partial nephrectomy was performed, and the histopathological findings were consistent with clear cell RCC. The patient responded well to paclitaxel and topical imiquimod (5%), and the skin lesions disappeared. Both KS and RCC are vascular tumors, and their pathogenesis is commonly affected by an angiogenic factor known as vascular endothelial growth factor (VEGF). A complete response of KS was observed after sorafenib, an inhibitor of VEGF receptors, was administered for the treatment of metastatic renal cancer. This reinforces the fact that there is a common therapeutic and pathogenetic pathway between these two neoplasms. Synchronous KS and clear cell RCC are rare findings. Their simultaneous appearance may be triggered by the common enhancing angiogenic factor, VEGF.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Bana Shabur
- Department of Oncology, Hiwa Oncology Hospital, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Soran Tahir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Hiwa Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Ronak Ahmed
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Rezheen Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Razhan Ali
- Department of Cardiothoracic Surgery, Shar Hospital, Sulaimani, Kurdistan 46000, Iraq
| | - Berun Abdalla
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Fahmi Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
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Bapir R, Ahmed SF, Tahir SH, Salih AM, Kakamad FH, Ahmed GS, Ali RK, Ahmed SM, Sidiq SH. Brucella orchitis presenting as a testicular mass mimicking a testicular tumor: a rare case report. Afr J Urol 2023. [DOI: 10.1186/s12301-023-00334-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Introduction
Brucella epididymo-orchitis is a complication that occurs in 5.7% of patients with brucellosis and can rarely mimic a testicular tumor. We here report a case of a 25-year-old man with a testicular brucellosis that presented as a testicular mass that responded to conservative treatment using antibiotic therapy.
Case report
A 25-year-old patient presented with left testicular pain, abdominal pain, easy fatiguability, and feeling unwell. Physical examinations were normal. A testicular tumor was suggested by a scrotal color Doppler US scan and testicular MRI. However, tumor markers were all within the normal range. A serum Brucella agglutination test (Rose Bengal test) was done, and it was positive. The patient received anti-brucella antibiotics. An ultrasound scan 3 months later revealed complete recovery after completing antibiotic treatments.
Discussion
Brucella orchitis can be determined based on the triad of serology, ultrasonography, and the presence of the common symptoms like fever, testicular pain, redness, and enlargement. The early diagnosis of this phenomenon is crucial due to the morbidity and complications that may be encountered. Moreover, it has several differential diagnoses, such as testicular tumor, epididymitis, trauma, torsion of the testis, and hematocele. Failure to obtain an adequate diagnosis, particularly if a testicular tumor is suspected, may result in unnecessary intervention like orchiectomy.
Conclusion
Brucella orchitis is a complication of brucella infection that may mimic a testicular tumor. Several techniques of diagnosis are required for an accurate assessment.
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Fateh SM, Arkawazi LA, Tahir SH, Rashid RJ, Rahman DH, Aghaways I, Kakamad FH, Salih AM, Bapir R, Fakhralddin SS, Fattah FH, Abdalla BA, Mohammed SH. Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography. Mol Clin Oncol 2023; 18:11. [PMID: 36761384 PMCID: PMC9892965 DOI: 10.3892/mco.2023.2607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Renal cell carcinoma (RCC) accounts for 1-2% of all malignancies and is the most common renal tumor in adults. Imaging studies are used for diagnosis and staging. Tumor-Node-Metastasis staging strongly affects prognosis and management, while contrast-enhanced computed tomography (CECT) is regarded as a standard imaging technique for local and distant staging. The present study aimed to evaluate the accuracy of CECT for the preoperative staging of RCC by using surgical and pathological staging as the reference methods. This single-center prospective study was conducted between October 2019 and November 2021. The preoperative abdominal CT scans of patients suspected of having RCC were reviewed. Imaging data were collected, including tumor side and size, and perinephric fat invasion. Intraoperative notes were recorded, including the operation type, perinephric fat invasion, renal vein (RV) or inferior vena cava (IVC) tumor extension, and surrounding organ invasion. pathological data were collected on tumor size, RCC type, presence of clear margins, presence of renal capsule or perinephric fat invasion, renal sinus or pelvicalyceal system (PCS) invasion, segmental or main RV extension, and the involvement of Gerota's fascia and nearby organs. Preoperative CECT revealed that 42 out of 59 tumors had a greater maximum diameter than the pathological specimen, with an overall disparity of 0.25 cm. The specificity of CT for the detection of tumor invasion of the perinephric and renal sinus fat and PCS was 95%, and the sensitivity ranged from 80 to 88%. CT had an 83% sensitivity and a 95 specificity in detecting T4 stage cancer, with a 100% specificity for adrenal invasion. The concordance between radiographic and histological results for RV and IVC involvement was high, with specificities of 94 and 98%, and sensitivities of 80 and 100%, respectively. Overall accuracy for correct T staging was 80%. In conclusion, CECT is accurate in the local T staging of RCC, with high sensitivity and specificity for estimating tumor size and detecting extension to nearby structures and venous invasion.
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Affiliation(s)
- Salah M. Fateh
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Lusan A. Arkawazi
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Soran H. Tahir
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Radiology Center, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Rezheen J. Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Republic of Iraq,Radiology Center, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Dalshad H. Rahman
- Department of Surgery, Shar Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Fahmi H. Kakamad
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq,Correspondence to: Dr Fahmi H. Kakamad, College of Medicine, University of Sulaimani, Doctor City Building 11, Apartment 50, Madam Mitterrand Street, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Abdulwahid M. Salih
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Urology, Surgical Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Saman S. Fakhralddin
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Fattah H. Fattah
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Berun A. Abdalla
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq
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18
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Trinchieri A, Buchholz N. Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Arch Ital Urol Androl 2022; 94:492-506. [PMID: 36576454 DOI: 10.4081/aiua.2022.4.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Overactive bladder (OAB) symptoms of frequency, urgency and urge incontinence are frequently associated with known neurological diseases like multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's disease (PD), stroke. OBJECTIVE The aim of our study was to review the efficacy of pharmacological and non-pharmacological treatments for neurogenic overactive bladder. MATERIALS AND METHODS We searched two electronic databases (PubMed and EMBASE) for randomized controlled trials focusing on pharmacological and non-pharmacological medical treatments for overactive bladder symptoms associated with neurological diseases published up to 30 April 2022. RESULTS A total of 157 articles were retrieved; 94 were selected by title and abstract screening; after removal of 17 duplicates, 77 records were evaluated by full-text examination. Sixty-two studies were finally selected. The articles selected for review focused on the following interventions: anticholinergics (n = 9), mirabegron (n = 5), comparison of different drugs (n = 3), cannabinoids (n = 2), intravesical instillations (n = 3), botulinum toxin (n = 16), transcutaneous tibial nerve stimulation (TTNS) (n = 6), acupuncture (n = 2), transcutaneous electrical nerve stimulation TENS (n = 4), pelvic floor muscle training (PFMT) (n = 10), others (n = 2). Anticholinergics were more effective than placebo in decreasing the number of daily voids in patients with PD (mean difference [MD]- 1.16, 95 % CI - 1.80 to - 0.52, 2 trials, 86 patients, p < 0.004), but no significant difference from baseline was found for incontinence episodes and nocturia. Mirabegron was more effective than placebo in increasing the cystometric capacity in patients with MS (mean difference [MD] 89.89 mL, 95 % CI 29.76 to 150.01, 2 trials, 98 patients, p < 0.003) but no significant difference was observed for symptom scores and bladder diary parameters. TTNS was more effective than its sham-control in decreasing the number of nocturia episodes (MD -1.40, 95 % CI -2.39 to -0.42, 2 trials, 53 patients, p < 0.005) but no significant changes of OAB symptom scores were reported. PFMT was more effective than conservative advice in decreasing the ICIQ symptom score (MD, -1.12, 95 % CI -2.13 to -0.11, 2 trials, 91 patients, p = 0.03), although the number of incontinence episodes was not significantly different between groups. CONCLUSIONS The results of the meta-analysis demonstrate a moderate efficacy of all considered treatments without proving the superiority of one therapy over the others. Combination treatment using different pharmacological and non-pharmacological therapies could achieve the best clinical efficacy due to the favorable combination of the different mechanisms of action. This could be associated with fewer side effects due to drug dosage reduction. These data are only provisional and should be considered with caution, due to the few studies included in metaanalysis and to the small number of patients.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | | | - Ahmed Eliwa
- Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | | | | | | | - Panagiotis Mourmouris
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | | | | | - Noor Buchholz
- Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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19
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Adetola Tolani M, Tzelves L, Trinchieri A, Buchholz N. Risk of urinary stone formation associated to proton pump inhibitors: A systematic review and metanalysis. Arch Ital Urol Androl 2022; 94:507-514. [PMID: 36576453 DOI: 10.4081/aiua.2022.4.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Proton pump inhibitors are widely used as treatment of acid-related disorders. They are considered safe although their long-term use has been associated with some adverse effects including an increased propensity for urinary calculi formation. The aim of this study was to systematically review available data from studies evaluating the association of PPIs and nephrolithiasis. MATERIALS AND METHODS We searched two electronic databases (PubMed and EMBASE) for cohort studies or case-control studies evaluating the relationship between treatment with proton pump inhibitors and the risk of stone formation published up to 31 October 2022. The overall association of PPIs and urinary calculi was analyzed using a random effects model (RevMan5). The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. RESULTS A total of 550 studies were retrieved; 7 were selected by title and abstract screening; after removal of duplicates, 4 records were evaluated by full-text examination. An additional study was retrieved by handsearching the references included in screened studies. In the unadjusted analysis, the odds of urinary calculi were greater in subjects taking PPIs compared to controls (unadjusted OR = 2.10, 95% CI 1.74-2.52, p < 0.00001). The pooled odds ratio of two case-control studies confirmed that use of PPIs increased the odds of urinary calculi compared with non-use (OR 2.44, 95% CI 2.29 to 2.61). Pooled analysis of three cohort studies evaluating incident nephrolithiasis showed an overall hazard ratio estimate of 1.34 (95% CI = 1.28-1.40). One study found lower urinary citrate and urinary magnesium levels in subjects exposed to PPIs. The Newcastle-Ottawa Quality Assessment Scale scores ranged between 6 and 8. CONCLUSIONS PPIs showed an association with urinary calculi in patients included in the studies included in this review. If these data will be confirmed in adequately powered randomized trials, clinicians may consider limiting the long-term use of PPIs, to avoid unnecessary prolongation of treatment. Urinary magnesium and citrate should be evaluated in renal stone forming patients taking PPIs to supplement their intake when requested.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | | | - Ahmed Eliwa
- Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | | | | | | | - Panagiotis Mourmouris
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | | | - Musliu Adetola Tolani
- Division of Urology, Department of Surgery, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State.
| | - Lazaros Tzelves
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | | | - Noor Buchholz
- Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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Bapir R, Salih RQ, Salih KM, Shabur B, Salih AM, Kakamad FH, Abdullah HO, Fattah FH, Mohammed SH. Simultaneous Sertoli Cell-Only Syndrome and Leydig Cell Tumor in a Patient with Azoospermia: A Rare Case Report. Case Rep Oncol 2022; 15:1095-1100. [PMID: 36605229 PMCID: PMC9808302 DOI: 10.1159/000526668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/04/2022] [Indexed: 12/14/2022] Open
Abstract
Testicular cancers comprise 1-1.5% of entire cancers in men, and sex cord-stromal tumors include 5% of testicular cancers. This study aims to report a simultaneous Sertoli cell-only syndrome and Leydig cell tumor in the same patient. A 32-year-old man presented with a history of primary infertility for 3 years. Physical examination revealed normal secondary sexual characteristics. Two successive seminal fluid analyses revealed azoospermia. A scrotal ultrasound scan showed a 28 × 27 mm hypoechoic and hypervascular right testicular mass. Right radical orchiectomy and simultaneous left testicular biopsy were conducted. The histopathological examination revealed Sertoli cell-only syndrome and Leydig cell tumor with focal Leydig cell hyperplasia. Reversing fertility following the management of Leydig cell tumor is rarely mentioned in the literature. A study revealed that fertility recovered following 4 months of management in a primary infertile male. However, infertile men with nonobstructive azoospermia due to SCOS can only have a child by testicular sperm extraction technique. Despite the rare occurrence of Leydig cell tumor, it could be seen in association with Sertoli cell-only syndrome in infertile men with azoospermia. Clinical examination and imaging studies are important in these patients as the possibility of having a testicular mass is high among them.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaimani, Iraq,Department of Urology, Surgical Teaching Hospital, Sulaimani, Iraq,Kscien Organization, Sulaimani, Iraq
| | - Rawezh Q. Salih
- Smart Health Tower, Sulaimani, Iraq,Kscien Organization, Sulaimani, Iraq
| | - Karzan M. Salih
- Smart Health Tower, Sulaimani, Iraq,Iraqi Board for Medical Specialities, Sulaimani Center, Sulaymaniyah, Iraq
| | | | - Abdulwahid M. Salih
- Smart Health Tower, Sulaimani, Iraq,College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Sulaimani, Iraq,Kscien Organization, Sulaimani, Iraq,College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Hiwa O. Abdullah
- Smart Health Tower, Sulaimani, Iraq,Kscien Organization, Sulaimani, Iraq
| | - Fattah H. Fattah
- Smart Health Tower, Sulaimani, Iraq,College of Medicine, University of Sulaimani, Sulaimani, Iraq
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21
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Bapir R, Ahmed SF, Salih AM, Kakamad FH, Hussein KFH, Salih KM, Ali RM, Hussein DM, Mustafa MQ, Abdalla BA, Salih RQ. Aerococcus viridans pyelonephritis in a young age female patient with type 1 diabetes mellitus: a rare case report. Afr J Urol 2022. [DOI: 10.1186/s12301-022-00327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Aerococcus species are Gram-positive cocci, with negative catalase and oxidase activities and growth characteristics similar to viridans streptococci. They rarely cause infection in humans. However, there are reports of bacteremia, meningitis, septic arthritis, and endocarditis due to this pathogen in the literature. Herein we report a rare case of pyelonephritis due to A. viridans.
Case presentation
A 31-year-old-female patient with type 1 diabetes mellitus was presented with left loin pain, fever, nausea, and anorexia for 3 days. She had a history of obstructive nephropathy due to sloughed necrotic papillae 3 months earlier, mandating bilateral JJ stent insertion. She was treated with a 2 weeks course of doxycycline (100 mg, twice daily) based on the antibiotic susceptibility profile of her urine culture and responded well.
Conclusion
This case highlights the possibility of complicated urinary tracts infection due to a rare human pathogen.
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22
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Bapir R, Hawrami T, Aghaways I, Ali R, Hiwa D, Hussein D, Kakamad F, Salih A. A huge retroperitoneal ganglioneuroma in a middle‑aged patient: Report of a diagnostically challenging case with review of the literature. Oncol Lett 2022; 24:449. [DOI: 10.3892/ol.2022.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/03/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Rawa Bapir
- Department of Urology, Surgical Teaching Hospital, Pathology Lab, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Tahir Hawrami
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Rawa Ali
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Dilan Hiwa
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Dlsoz Hussein
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Fahmi Kakamad
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Abdulwahid Salih
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
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23
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Mahmood SN, Ahmed CJ, Tawfeeq H, Bapir R, Fakhralddin SS, Abdulla BA, Pedro RN, Buchholz N. Evaluation of mini-PCNL and RIRS for renal stones 1–2 cm in an economically challenged setting: A prospective cohort study. Ann Med Surg (Lond) 2022; 81:104235. [PMID: 36147078 PMCID: PMC9486407 DOI: 10.1016/j.amsu.2022.104235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 10/27/2022] Open
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Aghaways I, Ibrahim R, Bapir R, Salih RQ, Salih KM, Abdulla BA. The role of inflammatory serum markers and ureteral wall thickness on spontaneous passage of ureteral stone < 10 mm: A prospective cohort study. Ann Med Surg (Lond) 2022; 80:104198. [PMID: 36045783 PMCID: PMC9422225 DOI: 10.1016/j.amsu.2022.104198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. There is a widespread discussion on the preferred initial treatment method, whether medical or surgical, and each has its pros and cons. In this study, we aimed to assess the role of both ureteral wall thickness around the stone and inflammatory markers in guiding the decision-making process. Methods In this prospective study, 161 patients who presented with ureteric colic and were diagnosed with ureteral stone with NCCT were included. UWT around the stone was measured, and the NLR and PLR were calculated. The patients were given a single daily dose of tamsulosin 0.4 mg for 4 weeks with weekly follow-up to determine SSP or failure. Results Of the 161 patients with a mean age 40.12 ± 12.36 SD, 55.9% had a spontaneous stone passage. Receiver operating characteristics showed a cut off value of 2.45 mm UWT of non SSP patients with an 83% sensitivity and 86% specificity. Moreover, there was a significant correlation between higher NLR, PLR and increased UWT (Pearson correlation of 0.314 and 0.426 respectively). The combined higher NLR, PLR and increased UWT were associated with failure of SSP (p-value <0.001). Conclusion Many factors play a role in decision making for management of ureteral stones. Our study concludes that patients with high NLR, PLR, and UWT around the stone have lesser chance of SSP using MET. Their rise can be used as predictors to decide early intervention. Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. Impacted ureteral stones occupy the majority of emergency department visits due to urolithiasis. The role of inflammatory serum markers and UWT around the stone on spontaneous passage are controversial.
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Affiliation(s)
- Ismaeel Aghaways
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
| | - Rebaz Ibrahim
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
| | - Rawa Bapir
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- U-merge Ltd. (Urology in Emerging Countries), London, UK
- Corresponding author. Doctor city, building 4, apartment 23, Sulaymaniyah, Iraq.
| | - Rawezh Q. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
| | - Karzan M. Salih
- Iraqi Board for Medical Specialties, Department of Surgery, Sulaymaniyah Center, Sulaymaniyah, Iraq
| | - Berwn A. Abdulla
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
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25
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Trinchieri A, Buchholz N. Effect of alpha-adrenoceptor antagonists on sexual function. A systematic review and meta-analysis. Arch Ital Urol Androl 2022; 94:252-263. [PMID: 35775356 DOI: 10.4081/aiua.2022.2.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Alpha-adrenoreceptor antagonists or alpha-blockers are used in the treatment of hypertension, in the therapy of benign prostatic hyperplasia and in medical expulsive treatment of ureteral stones. These agents may affect the sexual function, with differences between drugs within the same class, depending on their selectivity for receptor subtypes. The aim of this review was to analyze the effects of alpha-blockers on sexual function. MATERIALS AND METHODS We conducted a systematic review and meta-analysis by searching PubMed, EMBASE and other databases for randomized controlled trials (RCTs) reporting sexual adverse effects in patients treated with alpha-blockers. Odds ratios for sexual dysfunction were calculated using random effects Mantel-Haenszel statistics. RESULTS Out of 608 records retrieved, 75 eligible RCTs were included in the meta-analysis. Compared with placebo, alphablockers were associated with increased odds of ejaculatory disorders both in patients with lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH) (OR: 7.53, 95% CI: 3.77-15.02, Z = 5.73, p < 0.00001, I2 = 55%) and in patients with ureteral stones (OR: 2.88, 95% CI: 1.50-5.44, Z = 3.19, p < 0.001, I2 = 31%). Uroselective alpha-blockers showed higher odds of ejaculatory disorders. Conversely, nonselective alpha-blockers were not associated with higher odds of ejaculatory dysfunction. Silodosin was associated with increased odds of ejaculatory dysfunction compared with tamsulosin (OR: 3.52, 95% CI: 2.18-5.68, 15 series, 1512 participants, Z = 5.15, p < 0.00001, I2 = 0%). Naftopidil and alfuzosin showed lower odds of ejaculatory dysfunction compared to uroselective alpha-blockers.No statistically significant differences in the odds of erectile dysfunction were observed when alpha-blockers were compared to placebo.
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Affiliation(s)
- Rawa Bapir
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | - Kamran Hassan Bhatti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Urology Department, HMC, Hamad Medical Corporation.
| | - Ahmed Eliwa
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | - Nazim Gherabi
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Faculty of Medicine Algiers 1, Algiers.
| | - Derek Hennessey
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Mercy University Hospital, Cork.
| | - Vittorio Magri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and ASST Nord Milano, Milan.
| | - Panagiotis Mourmouris
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
| | - Joseph Philipraj
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
| | - Alberto Trinchieri
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Urology School, University of Milan.
| | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai; and Sobeh's Vascular and Medical Center, Dubai Health Care City, Dubai.
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Bapir R, Ahmed SF, Gharib SM, Qader D, Kakamad FH, Popov E, Buchholz N, Salih AM. Acute intestinal pseudo-obstruction by pheochromocytoma: A case report with review of literature. Int J Surg Case Rep 2022; 94:107008. [PMID: 35447562 PMCID: PMC9043669 DOI: 10.1016/j.ijscr.2022.107008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 10/26/2022] Open
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Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Trinchieri A, Buchholz N. Infectious complications of endourological treatment of kidney stones: A meta-analysis of randomized clinical trials. Arch Ital Urol Androl 2022; 94:97-106. [PMID: 35352534 DOI: 10.4081/aiua.2022.1.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Endourological treatment is associated with a risk of postoperative febrile urinary tract infections and sepsis. The aim of this study was to review the reported rate of infectious complications in relation to the type and modality of the endourologic procedure. METHODS This systematic review was conducted in accordance with the PRISMA guidelines. Two electronic databases (PubMed and EMBASE) were searched. Out of 243 articles retrieved we included 49 studies after full-text evaluation. RESULTS Random-effects meta-analysis demonstrated that retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) were associated with not significantly different odds of getting fever (OR = 1.54, 95% CI: 0.99 to 2.39; p = 0.06) or sepsis (OR = 1.52, 95% CI: 0.37 to 6.20, p = 0.56). The odds of getting fever were not significantly different for mini PCNL compared to standard PCNL (OR = 1.11, 95% CI: 0.85 to 1.44; p = 0.45) and for tubeless PCNL compared to standard PCNL (OR = 1.34 95% CI: 0.61 to 2.91, p = 0.47). However, the odds for fever after PCNL with suctioning sheath were lower than the corresponding odds for standard PCNL (OR = 0.37, 95% CI: 0.20 to 0.70, p = 0.002). The odds of getting fever after PCNL with perioperative prophylaxis were not different from the corresponding odds after PCNL with perioperative prophylaxis plus a short oral antibiotic course (before or after the procedure) (OR = 1.31, 95% CI: 0.71 to 2.39, p = 0.38). CONCLUSIONS The type of endourological procedure does not appear to be decisive in the onset of infectious complications, although the prevention of high intrarenal pressure during the procedure could be crucial in defining the risk of infectious complications. on behalf of U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaymaniyah, Kurdistan region.
| | | | - Ahmed Eliwa
- Department of Urology, Zagazig University, Zagazig, Sharkia.
| | | | | | | | - Panagiotis Mourmouris
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens.
| | - Adama Ouattara
- Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Gianpaolo Perletti
- Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese, Italy; Faculty of Medicine and Medical Sciences, Ghent University.
| | - Joseph Philipraj
- Department of Urology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry.
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Bapir R, Ali RM, Hussien DA, Omar DA, Kakamad FH, Salih AM, Mohammed SH. Xanthogranulomatous epididymo-orchitis: A case report with review of the literature. Int J Surg Case Rep 2022; 92:106832. [PMID: 35220165 PMCID: PMC8889127 DOI: 10.1016/j.ijscr.2022.106832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Xanthogranulomatous orchitis is an extremely rare condition of the test is marked by the necrosis and effacement of testicular parenchyma by an inflammatory process. The current study aims to report a case of xanthogranulomatous epididymo-orchitis. CASE REPORT A 35-year-old man presented with a history of recurrent attacks of dull pain and swelling of the right side of the scrotum for 3 weeks. He denied having any history of trauma or urinary symptoms. Physical examination revealed tenderness and warmth of the right side of the scrotum. Urine culture was negative. The patient managed operatively. DISCUSSION The underlying pathophysiology of xanthogranulomatous orchitis is yet unknown. The pathogenesis of this inflammatory process in the testis is frequently driven by obstruction of the epididymis or the urinary tract. Urinary tract infection has also been considered as an etiologic factor. CONCLUSION Xanthogranulomatous orchitis is an uncommon testicular inflammatory condition. Histopathologic examination is required for definitive diagnosis and for the exclusion of occult germ cell malignancy.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Department of Urology, Surgical Teaching Hospital, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Rawa M Ali
- Shorsh General Teaching Hospital, Pathology Lab, Sulaimani, Kurdistan, Iraq
| | - Dahat A Hussien
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Diyar A Omar
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq; Medical Laboratory Technician Department, Shaqlawa Technical college, Erbil Polytechnic University, Erbil, Kurdistan, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
| | - Abdulwahid M Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
| | - Shvan H Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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Rashid AO, Mahmood SN, Amin AK, Bapir R, Buchholz N. Multitract percutaneous nephrolithotomy in the management of staghorn stones. Afr J Urol 2020. [DOI: 10.1186/s12301-020-00086-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Staghorn stones are difficult to manage with a risk of significant renal impairment and urosepsis. Percutaneous nephrolithotomy is the first-line treatment for staghorn stones. Often, multiple access tracts are needed to render the patient stone-free. PCNL has been combined with SWL, flexible URS (ECIRS), and mini-PCNL to access residual fragments without the need of additional tracts. However, in a country with limited access to technology and a restraint on resources, multitract PCNL still is the preferred option. The aim of this study was to assess the safety and efficacy of multitract PCNL in such an environment.
Methods
We analyzed data on sixty-five patients with staghorn calculus who underwent multitract PCNL for a staghorn calculus. Data included demographics, stone parameters, intraoperative parameters, complications and clinical outcomes. Hb-drop and creatinine changes were assessed pre- and post-OP. Complications were graded according to the modified Clavien-Dindo classification.
Results
In a total of 65 patients [47 males (72%)], 154 percutaneous access tracts were used in 66 renal units. The number of tracts varied between 2 and 4 in a single renal unit. The stone-free rate was 85%. 20% of patients developed grade I, 14% grade II, and 3% grade III b complications. There were no grade IV and V complications.
Conclusion
Multitract PCNL is safe and efficient, with a good stone-free rate and an acceptable complication rate. When auxiliary combination treatments are not available, multitract standard PCNL remains an option.
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Fakhralddin SS, Bapir R, Babarasul MH, Ibrahim ZB, Aghaways I. Typical leiomyoma of the scrotum: A rare case report. Int J Surg Case Rep 2020; 67:142-145. [PMID: 32062120 PMCID: PMC7021516 DOI: 10.1016/j.ijscr.2020.01.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/20/2020] [Accepted: 01/25/2020] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Scrotal leiomyomas are benign tumors arising from the dartos layer of the scrotal wall. The exact cause of this tumor is not yet clear. Malignant transformation to leiomyosarcomas has been reported. CASE PRESENTATION A 52-year-old male who complained of a painless lump on the right side of the scrotum that lasted 12 years. Physical examination revealed a single, firm, and non-tender, mobile lump on the anterior aspect of the right scrotum. Both testes were normal and no inguinal lymph nodes could be palpated. Ultrasound scan of the scrotum showed a 40 mm × 20 mm hypoechoic, poorly vascular lesion in the scrotum. Under spinal anesthesia, the mass has been excised. Histopathological and immunohistochemical findings were consistent with the diagnosis of scrotal leiomyoma. DISCUSSION Leiomyomas may originate from any location in the genitourinary system where there is smooth muscle. Scrotal smooth muscle tumors can be categorized into Leiomyomas, atypical or symplastic leiomyomas, which are not hypercellular and lack mitotic activity, and leiomyosarcomas. Ultrasound is the first-line imaging investigation in patients with suspected scrotal masses. Typical leiomyomas and atypical ones behave similarly. Therefore, they are managed only with surgical excision, while leiomyosarcomas need a wide 3-5 cm margin resection. Both recurrence and malignancy have been described. Close follow-up is required to detect recurrence. CONCLUSION Scrotal leiomyoma is a rare benign mesenchymal tumor of the middle-aged men. The current report describes the clinical and histopathological characteristics to help reduce erroneous diagnoses of this rare tumor.
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Affiliation(s)
| | - Rawa Bapir
- Shaheed Shawkat Haji Musheer Hospital/Said Sadiq, Sulaymaniyah, Iraq; U-merge Ltd., (Urology in Emerging Countries), London, United Kingdom(1).
| | | | | | - Ismaeel Aghaways
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Iraq
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Aghaways I, Bapir R, Hawrami TA, Thahir NM, Al Kadum Hassan MA, Salih Hassan KM. Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report. Int J Surg Case Rep 2019; 59:31-34. [PMID: 31102837 PMCID: PMC6525288 DOI: 10.1016/j.ijscr.2019.04.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/04/2019] [Accepted: 04/22/2019] [Indexed: 11/30/2022] Open
Abstract
Bladder injury is an uncommon complication of cesarean delivery with an incidence ranging from 0.0016% to 0.94%. Delayed blabber rupture post CD may present with urinary ascites and elevated serum creatinine mimicking acute kidney injury. Cystography is the diagnostic imaging of choice with the reported accuracy of 85%–100%. Surgical repair is the treatment of choice for intraperitoneal bladder injury. Conservative management with intraperitoneal and urethral catheter may succeed in properly selected cases.
Introduction Bladder injury is an uncommon complication of cesarean delivery (CD) with an incidence ranging from 0.0016% to 0.94%. The risk factors are emergency CDs, subsequent CDs, trial of normal delivery after CD and whether adhesions are present or not. The presentation is either immediate intraoperative event or delayed bladder rupture and urinary ascites. Case presentation A 35-year-old female presented with considerable abdominal distension, shortness of breath, oliguria, straining to void and elevated levels of blood urea and serum creatinine 11 days after an uneventful Caesarean delivery. Abdominal ultrasound showed marked ascites. Immediate resuscitation was done, a urethral catheter and percutaneous intraperitoneal pigtail catheter were inserted confirming urinary ascites. Next day cystoscopy was performed and revealed a perforation at the posterior wall of the bladder. She was kept on conservative treatment with adequate urine diversion through both urethral and intraperitoneal catheter. Her condition improved and responded well. Discussion To the best of our knowledge this presentation of delayed intraperitoneal bladder rupture post CD is the second case reported in literature. Although surgical repair is regarded as the treatment of choice for intraperitoneal bladder injury, conservative treatment may succeed in properly selected cases. Non-operative managements include indwelling transurethral Foley catheter alone, percutaneous peritoneal drain alone or combined Foley catheter and percutaneous peritoneal drain for complete urinary drainage. Conclusion Delayed urinary bladder rupture is a very rare complication of cesarean delivery. Non-operative treatment can be a viable alternative to surgical repair in carefully selected patients.
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Affiliation(s)
- Ismaeel Aghaways
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Sulaymaniyah, Kurdistan Region, Iraq
| | - Rawa Bapir
- Sulaymaniyah Surgical Teaching Hospital, Urology Department, Sulaymaniyah, Kurdistan Region, Iraq; Shaheed Shawkat Haji Musheer Hospital, Urology Department, Said Sadiq/Sulaymaniyah,Kurdistan Region, Iraq.
| | - Tahir A Hawrami
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Sulaymaniyah, Kurdistan Region, Iraq
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Ahmed HK, Bapir R, Abdula GF, Hassan KMS, Ali RM, Salih MA. Solitary contralateral adrenal metastasis of renal cell carcinoma 15 years following radical nephrectomy: A case report and review of literature. Int J Surg Case Rep 2019; 58:33-36. [PMID: 30999151 PMCID: PMC6468145 DOI: 10.1016/j.ijscr.2019.03.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Renal cell carcinoma (RCC) is known to metastasize to almost every organ. A well-recognized phenomenon in RCC is late metastatic recurrence after nephrectomy which is arbitrarily defined as more than 10 years. The incidence of solitary ipsilateral and contralateral adrenal metastasis is 3% and 0.7% respectively in patients who have underwent radical nephrectomy. CASE REPORT A57-year-old female presented with an incidental ultrasonic finding of a right adrenal mass 15 years after radical nephrectomy for left side renal cell carcinoma. Further evaluation with abdominal contrast enhanced CT scan revealed a right adrenal mass suggestive of metastatic lesion. The results of laboratory examinations showed the mass to be nonfunctional. Open right adrenalectomy was performed. She was discharged home on 4th postoperative day. Pathological examination revealed morphological and immunohistochemical findings in line with metastatic renal cell carcinoma of the left kidney. During the last 2 years she has being on regular follow up, neither local recurrence nor distant metastasis anywhere have been detected by whole body Positron Emission Tomography(PET) scan. DISCUSSION Late metastatic contralateral adrenal recurrence from RCC is very rare and to the best of our knowledge, 5 similar cases have been reported 10 years after radical nephrectomy. Early diagnosis of adrenal metastasis is challenging because they are usually silent both anatomically and functionally. CONCLUSION Solitary contralateral adrenal metastatic recurrence of RCC is extremely rare event. Surgical removal is a wise option in these cases that may improve survival.
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Affiliation(s)
| | - Rawa Bapir
- Sulaymaniyah Surgical Teaching Hospital, Urology Department, Sulaymaniyah, Iraq; Shaheed Shawkat Haji Musheer Hospital, Urology Department, Said Sadiq/Sulaymaniyah, Iraq.
| | | | | | - Rawa Muhsin Ali
- Shorsh General Teaching Hospital, Pathology Department, Iraq
| | - Mahabad Abdalaziz Salih
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Radiology, Iraq
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