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PURPOSE: Urological complications are common and serious in kidney transplant patients. Correct diagnosis of urological complications and rapid intervention are very important to maintain the transplanted organ. Using endoscopic methods and rapid access to ureteral orifice can be effective in treatment and management of urological complications in transplant patients. MATERIALS AND METHODS: In this retrospective cohort study, 934 medical records of kidney transplant patients who underwent surgery through Posterolateral Extravesical Ureteroneocystostomy (PLEVUNC) and anterior extravesical ureteroneocystostomy (AEVUNC) techniques from 2011 to 2018 were evaluated. The outcomes of PLEVUNC and AEVUNC techniques were evaluated in 461 and 473 transplant patients, respectively. The patients were followed up for 60 months. Immediate and delayed complications, urological complications requiring endoscopic intervention, duration of access to ureteral orifice, as well as ureteroscopic and endoscopic outcomes were evaluated. RESULTS: The mean and ± SD (standard deviation) age of patients in PLEVUNC and AEVUNC groups were 46.2 7± 2.7 years and 47.3 ± 3.6 years, respectively. Urinary leakage and UTI were the most common immediate (7% and 6.2%) and delayed (5.5% and 5.5%) complications in both groups, respectively. The time to find ureteral orifice in patients requiring endoscopic intervention was significantly shorter in PLEVUNC group 3.5±1.2 compared with the AEVUNC group 10 ± 4.5 (P <.001). In 100% of PLEVUNC group and 62.6% of AEVUNC group, ureteral orifice of transplanted kidney was observed (P <.001). Ureteroscopy was reported successful in 94.5% and 37.4% of patients in PLEVUNC and AEVUNC groups, respectively. CONCLUSION: Easy and safe access to the ureteral orifice and to the upper urinary tract in transplant recipients can be achieved with the PLEVUNC technique. In case of urological complications this method facilitates endoscopy.

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BACKGROUND: Dopamine Receptor (DR) gene family play an essential role in the regulation of Interleukin- 6 (IL-6) production. Our prior analysis of human prostate biopsy samples demonstrated the increased expression of IL-6 and a downregulating trend for dopamine receptor gene family. OBJECTIVE: The objective was to investigate the expression of dopamine receptors, their catabolizing enzyme and IL-6 in prostate cancer cell lines and assess pharmacological effect of dopamine receptor modulators as a novel class of drugs repurposed for the treatment of prostate cancer. METHODS: The therapeutic effect of dopamine, DR agonists, and DR antagonist were examined using LNCaP and PC3 cell lines. Cell viability and proliferation were assessed by MTT assay and proliferating cell nuclear antigen expression analysis, respectively. Furthermore, bax/bcl2 ratio, immunofluorescence assay and flow cytometric assay were performed for apoptosis analysis. RT- qPCR analysis was used to characterize the relative expression of dopamine-related genes, catabolic enzyme Catechol-o-Methyl-Transferase (COMT) and IL-6 before and after treatment to assess the therapeutic effects of drugs. RESULTS: LNCaP cells express DRD1, DRD2, DRD5 and COMT genes and PC3 cells only express IL-6 gene. In-vitro, dopamine receptor agonists reduced cell viability of LNCaP and PC3 cells. In contrast, dopamine and dopamine receptor antagonist significantly increased tumor growth in PC3 cells. CONCLUSION: Our results offer novel suggestion for a pathogenic role of dopamine receptor signaling in prostate cancer adenocarcinoma and indicates that modulators of DR- IL-6 pathway, including FDA-approved drug bromocriptine, might be utilized as novel drug repurposing strategy.

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BACKGROUND: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most prevalent diseases in male population, implicated with fundamental differences between benign and malignant growth of prostate cells. An imbalance through a network of nervous, endocrine, and immune systems initiate a signal of altered growth from the brain to the prostate gland, leading to adverse effects such as inflammation. OBJECTIVE: The aim of this study was to evaluate the gene expression of dopamine receptor family, COMT, and IL6 to identify novel correlations in BPH and PCa in both blood and tumor of the patients. METHODS: Peripheral blood mononuclear cells from BPH (n= 30) and PCa (n= 30) patients, and prostate tumor tissues (n= 14) along with pathologically normal adjacent tissues (n= 14) were isolated, mRNA was extracted, and cDNA was synthesized, respectively. Quantitative real- time PCR was applied for DRD1- DRD5, COMT, and IL6 genes in all samples. RESULTS: We found, for the first time, that the expression of COMT and IL6 genes were inversely correlated with the expression of DRD1 and DRD2 genes through the extent of differentiation of PCa from BPH condition. In addition, the PSA levels were correlated with the expression of DRD1 in BPH cases and DRD1, DRD4, DRD5, and IL6 in PCa cases. CONCLUSION: Results implicate a potential cross- talk between the signaling pathways derived by IL6 cytokine and dopamine receptors in PCa. Thus, it seems promising to reassemble the consequent signaling pathways by adequate agonists and antagonists to help increase therapeutic efficacy.

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BACKGROUND: Assessing the net-results of microsurgical varicocelectomy in infertile men with non-obstructive azoospermic (NOA) and clinical varicocele in five years at Royan Institute. MATERIALS AND METHODS: This is a descriptive retrospective cohort study. A backward-looking review of patients treated for NOA and varicocele from march 2011 to march 2016 was performed. In addition, MDTESE results of 57 patients with NOA and clinical varicocele, with 537 NOA patients without varicocele were compared. RESULTS: Of 57 patients who underwent varicocelectomy, eight patients (14%) had sperm on sperm analysis post-operatively. One of the eight patients was single, and one of them had spontaneous pregnancy (1/7) 14%, and one had a child by microinjection (1/7) 14%. Out of these 8 patients, 6 had hypospermatogenesis pathology. Of 38 patients who underwent MDTESE, 14 patients (36%) had sperm on their testis tissues, but one of them had no egg fertilization. Therefore, the fertilization rate was (92%). Of the remaining 13 patients, 3 had live child birth (3/13) 23%. Sperm retrieval rate (SRR) in NOA men without clinical varicocele was lower from those who had varicocele and NOA (22 vs. 36%). Also live birth rate in NOA men with varicocelectomy was higher than NOA men without varicocele (23 vs. 11%). CONCLUSION: Microsurgical varicocelectomy in NOA men may have positive effects on post-operative sperm in ejaculate and natural or assisted pregnancies, but it seems that the effect is more significant on MDTESE results and following successful microinjection. Meanwhile, SRR and live birth rate was higher in our patients compare to NOA men without clinical varicocele.

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BACKGROUND: The main purpose of this study is to evaluate the effects of varicocelectomy on serum testosterone levels and semen quality in infertile men who suffer from varicocele. MATERIALS AND METHODS: This prospective study enrolled 115 subjects with clinical varicocele grades II and III and 240 fertile men as the control group. Total volume of testosterone serum level (ng/dl) and semen quality were compared before and after microscopic varicocelectomy. We normalized testosterone serum levels for age, grade, and testis size basis. SPSS 20 software was used to analyze the data. All results of continuous variables were reported as mean ± SD. Statistical significance was set at a P<0.05. RESULTS: The mean ages of individuals who participated in the treatment (32.2 ± 5.23) and control (32.8 ± 5.27) groups were similar. There were similar mean values for adjusted testosterone levels between the varicocele (567 ± 222 ng/ml) and control (583 ± 263 ng/ml) groups. In the varicocele group, the adjusted testosterone levels insignificantly increased to 594 ± 243 ng/ml. Among semen parameters, only mean sperm concentration significantly increased after varicocelectomy. CONCLUSION: Despite increases in sperm concentration, adjusted testosterone levels did not significantly improve after varicocelectomy.

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BACKGROUND: Chlamydia trachomatis (CT) with damaging effects on sperm quality parameters can often cause infertility in men. OBJECTIVE: The main objective of this study was to determine the diagnostic value of polymerase chain reaction (PCR) and enzyme linked immuno sorbent assay (ELISA) for screening and detecting CT in semen samples of infertile men. MATERIALS AND METHODS: In this cross-sectional study, 465 men referring to the clinical laboratory of Royan Institute were chosen for primary screening and detection of the presence of CT. 93 samples were normozoospermia with normal sperm parameters i.e. sperm number, motility and morphology (Asymptomatic) and 372 had abnormal sperm parameters (Symptomatic) in semen analysis. ELISA test was performed as the screening test. Samples with optical density (OD) >0.200 were selected as the case and asymptomatic samples with OD <0.200 were selected as the control group for the confirmatory test. PCR assay was used to confirm the serological results. RESULTS: In the case groups (n=62), 4 out of 32 symptomatic samples (12.5%), and 1 out of 30 asymptomatic samples (3.3%) revealed positive results in PCR. No PCR positive sample was observed in the control group (n=34). The final results revealed that considering OD >0.400 as the ELISA positive, the diagnostic value of CT-ELISA positive in symptomatic and asymptomatic infertile patients were 0.019 (7 of 372) and 0.021 (2 of 93), respectively. There was no relationship between the presence of CT infection and different sperm abnormalities. CONCLUSION: The anti-CT IgA ELISA test may be introduced as an appropriate tool for screening purpose in the seminal plasma to select suspicious samples for PCR confirmatory tests.

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PURPOSE: Partial nephrectomy is the gold standard treatment for small kidney masses. Data on the comparison oflaparoscopic (LPN) versus open partial nephrectomy (OPN) are based on retrospective studies. Thus, we plannedto compare these two techniques in a prospective trial. MATERIALS AND METHODS: The study population consisted of patients over 18 years old with single renal mass of≤ 4 cm. Patients were divided into two groups considering their preference. Study arms were matched accordingto age, gender, tumor size and location and renal nephrometry score. Mean operation time, warm ischemia time,hospital stay, peri-operative complications and changes in glomerular filtration rate (GFR) after 1 month were recordedand compared in two groups. Patients' satisfaction score, visual analogue scale and narcotics use to controlpost-operative pain were also studied. RESULTS: 34 and 31 patients underwent LPN and OPN, respectively. There was no significant difference betweenOPN and LPN regarding hospital stay (4.1 versus 4.6 days; P = .37), mean hemoglobin drop (2.17 and 1.96 g/dL;P = .62), changes in GFR and positive margin (1 versus 3 p=.40). LPN was accompanied with longer mean surgerytime (180 min versus 127 minutes; P < .001) and higher rate of urologic complications (P = .04); nevertheless,patient satisfaction rate was higher (P = .02) and dose of narcotics necessary for controlling post-operative painwas lower (P = .04) in LPN. CONCLUSION: This clinical trial shows that LPN has some benefits over OPN, including decreased post-operativepain and higher patient satisfaction. However, extra caution should be considered in the issue of tumor margin andurinary leakage in LPN.

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BACKGROUND: Although the effectiveness of ginger as an antioxidant agent has been exploited, little human research has been conducted on its activity on male reproductive functions. OBJECTIVE: This study was designed to investigate the effects of ginger (Zingiber officinale) on sperm DNA fragmentation (SDF) in infertile men. MATERIALS AND METHODS: This randomized double-blind, placebo-controlled trial with a 1:1 allocation was performed on 100 infertility treatment candidates who were admitted to Royan Institute for Reproductive Biomedicine, Tehran, Iran. Patients were randomly assigned to receive one of two treatments: ginger and placebo. Patients were given a 3-month oral treatment (members received capsules containing 250 mg of ginger powder twice a day in ginger and a placebo in other group). Before and after treatment, standardized semen samples were obtained to determine sperm concentration, motility, and SDF according to World Health Organization. RESULTS: There was no significant difference between two groups regarding SDF at baseline (53.48. 95%CI: 37.95-69.02) in cases and (56.75, 95%CI: 40.01-73.5) in controls. The average positive percentage of SDF in patients receiving ginger (17.77, 95%CI: 6.16-29.39) was lower compared with placebo (40.54, 95%CI: 23.94-57.13) after three month of treatment (p=0.02). In multivariate analysis, SDF was significantly lower in patients receiving ginger compared with placebo (mean difference: 3.21, 95%CI: 0.78-5.63, p=0.009). There were no significant differences between two groups regarding to semen parameters. CONCLUSION: The present study has demonstrated that ginger in a controlled study of efficacy was effective in decreasing SDF in infertile men.

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BACKGROUND: The most important surgical complications of renal transplantation are stenosis and obstruction of the ureterovesical anastomosis. Routine use of ureteral stents can prevent this complication, but the optimal time for ureteral stent use is still controversial. OBJECTIVES: The purpose of this study is to compare the benefits and complications of early and delayed stent removal after surgery. Early ureteral stent removal can decrease some complications, such as urinary tract infections (UTIs), bladder irritation symptoms, persistent hematuria, and the risk of stent crusting; its benefits include easier stent removal and shorter hospitalization time. PATIENTS AND METHODS: All patients who underwent kidney transplantation from May 2011 until March 2012 in Modarres Hospital were included in this study. We classified the patients into three groups, based on time of stent removal (10, 20, and 30 days after transplantation). RESULTS: Ninety-one patients were studied; urologic complications (hydroureteronephrosis and urinoma) in these three groups were analyzed and showed no statistical significant difference. CONCLUSIONS: We can remove the ureteral stent earlier after kidney transplantation with no increase in the prevalence of surgical complications.

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BACKGROUND: The most important surgical complications of renal transplantation are stenosis and obstruction of anastomosis of the ureter to the bladder. Although the routine use of the ureteral stents to prevent such complications seems rational, the optimal time to keep the ureteral stent is still controversial. OBJECTIVES: This study presents the benefits and complications of removing the ureteral stent based on the elapsed time after the surgery. PATIENTS AND METHODS: All patients who underwent kidney transplantation between May 2011 and August 2014 in Modarres hospital, Tehran, Iran, were enrolled in the study. The patients were classified into three groups. The ureteral stent was removed 10, 20, and 30 days after the transplantation in these groups. RESULTS: A total of 529 patients underwent kidney transplant surgery in our center. Urologic complications among the three groups consisting of hydronephrosis, urinoma and collection did not have statistically significant differences. CONCLUSIONS: Ureteral stent can be picked up with no increased risk of urologic complications at shorter intervals after the kidney transplantation surgery.

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PURPOSE: Prostate cancer (PCa) poses a significant health problem in developed countries. Prostate specific antigen (PSA) based screening for PCa is controversial and large trials have failed to show a significant reduction in prostate-specific mortality and all-cause mortality. Considering the contradictory data on PCa screening, current guidelines emphasize shared decision making. Physicians are the ones in charge of helping patients with informed decision making, so we conducted this study to find out what urologists would do for themselves as patients. MATERIALS AND METHODS: Urologists attending the 15th congress of Iranian Urological Association were invited to participate in a questionnaire-based survey on PCa screening. A total of 184 physicians completed the questionnaire. RESULTS: Of participants 76.8% declared that they would like to be screened. 69.3% of those in favor of screening did not consider digital rectal examination (DRE) as part of their screening program. 62.8% of the urologists willing to be screened chose serial PSA as their follow up method in case their PSA level came above normal ranges, and 35.8% preferred to be biopsied. CONCLUSION: Urologists tend to prefer PSA screening despite the current controversy about its usefulness. Most of the urologists practicing in Iran do not choose DRE as part of their screening program. Large high quality studies conducted in other countries are needed to look into urologist's attitudes towards PCa screening, and to investigate their preferences in order to understand the rationale behind their decisions.

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BACKGROUND: To evaluate predictive factors of successful microdissection-testicular sperm extraction (MD-TESE) in patients with presumed Sertoli cell-only syndrome (SCOS). MATERIALS AND METHODS: In this retrospective analysis, 874 men with non-obstructive azoospermia (NOA), among whom 148 individuals with diagnosis of SCOS in prior biopsy, underwent MD-TESE at Department of Andrology, Royan Institute, Tehran, Iran. The predictive values of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) levels, testicular volume, as well as male age for retrieving testicular sperm by MD-TESE were analyzed by multiple logistic regression analysis. RESULTS: Testicular sperm were successfully retrieved in 23.6% men with presumed SCOS. Using receiver operating characteristic (ROC) curve analysis, it was shown that sperm retrieval rate in the group of men with FSH values >15.25% was 28.9%. This was higher than the group of men with FSH ≤15.25 (11.8%). CONCLUSION: Sperm retrieval rate (SRR) was 23.6% in men with presumed SCOS and FSH level can be a fair predictor for SPR at MD-TESE. MD-TESE appears to be recommendable in such cases (SCOS with high FSH concentration) with reasonable results.

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OBJECTIVE: To evaluate microsurgical testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) treatment in patients with non-mosaic Klinefelter syndrome (KS). METHODS: We retrospectively evaluated the micro-TESE/ICSI performance in 134 patients with classic KS and 537 men with nonobstructive azoospermia (NOA) and normal karyotype referred to Royan Institute between 2009 and 2011. The patients were divided into 2 groups according to micro-TESE outcome. Several factors, including patients' age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, were compared between the 2 groups. RESULTS: Sperm retrieval rate by micro-TESE in the KS and control groups were 28.4% (38/134) and 22.2% (119/537), respectively. In the KS group, the mean age of patients with successful sperm retrieval of spermatozoa was significantly lower than those with negative results (30.0 ± 0.65 vs 33.68 ± 0.6 year, P = .001) and comparison of laboratory parameters between the 2 groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.4 ± 0.48 vs 2.33 ± 0.23 ng/mL, P <.001). The fertilization rate was significantly higher in the KS group than the control group (28% vs 21%, P = .038). Also, live birth rate per embryo transfer was higher in the KS group, but it was not significant (13% vs 3%, P = .05). CONCLUSION: This study of sperm recovery and ICSI outcome in men with and without KS shows that micro-TESE/ICSI is a successful intervention for the majority of men with KS.

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BACKGROUND: Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly. OBJECTIVES: We designed this study to evaluate the association between ureteral length and postoperative complications. PATIENTS AND METHODS: We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it. RESULT: A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off. CONCLUSIONS: The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon's skillfulness and development in use of immunosuppressant's postoperatively.

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PURPOSE: To determine the optimal number of biopsies in patients with non-obstructive azoospermia (NOA) who undergo testicular sperm extraction (TESE), and assess the impact of testicular histology on outcome. MATERIALS AND METHODS: Seven hundred and forty-one patients with NOA who underwent TESE in our institution were enrolled in the study. Testicular sperm extraction was performed applying an open surgical technique on the larger testis. The number of biopsies varied according to the presence or absence of spermatozoa. No further biopsies were obtained once spermatozoa were detected. If no spermatozoa were seen, the procedure was continued to a maximum number of 5 biopsies, including a single biopsy of the contralateral testis. RESULTS: Spermatozoa were obtained in 330 (44.5%) patients after a single biopsy. The success rate increased to 381 (51.4%), 416 (56.1%), 433 (58.4%), and 441 (59.5%) after the second, third, fourth, and contralateral sampling, respectively. Multiple sampling increased the success rate; however, success rate did not increase considerably after the third sampling. Performing contralateral testicular biopsy was advantageous in patients with uniform or mixed pattern hypospermatogenesis. CONCLUSION: We recommend performing at least 3 biopsies in patients with NOA who undergo TESE. Further biopsies may also be advantageous when the NOA is a consequence of either uniform or mixed pattern hypospermatogenesis.

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OBJECTIVE: To investigate the impact of immediate surgical repair and conservative treatment of penile fracture (PF) on penile vascular indices. METHODS: The study includes 146 surgically treated (group 1), and 56 conservatively treated patients (group 2). All of the participants underwent penile duplex Doppler ultrasonography (PDDU), and Doppler parameters including the peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were measured in both corpora at baseline and after intracavernosal injection of 20 µg prostaglandin E1. Univariable and multivariable Cox regression analysis addressed study variables. RESULTS: An increased number of men in group 2 (25.0%) compared with men in group 1 (19.2%) reported ED, but the difference did not reach statistical significance (P=0.06). In patients with ED the mean PSV did not differ significantly between the group 1 (30.1±4.02 cm/s) and group 2 (30.1±4.02 cm/s) (P=0.32). Also, in patients without ED, the mean PSV for group 1 (82.4±24.1 cm/s) subjects did not differ significantly from the means for the group 2 patients (79.4±27.2 cm/s) (P=0.21). Vascular hemodynamics in fractured corpus cavernosum did not differ significantly between two groups (P=0.08). CONCLUSIONS: Current method of surgical treatment does not provide better outcome in terms of erectile function and penile vascular hemodynamics.

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PURPOSE: To determine the role of glutathione S-transferases (GSTs; GSTM1, GSTT1, and GSTP1) gene polymorphisms in susceptibility to male factor infertility. MATERIALS AND METHODS: We report a pooled analysis of 11 studies on the association of GSTM1, GSTT1, and GSTP1 polymorphisms and male factor infertility, including 1323 cases and 1054 controls. RESULTS: An overall significant association was determined between the GSTM1 null genotype [odds ratio (OR), 2.74; 95% confidence interval (CI), 1.72 to 3.84; P = .003], GSTT1 null genotype (OR, 1.54; 95% CI, 1.43 to 3.47; P = .02), and male factor infertility. The GSTP1 Ile/Val genotype had overall protective effect against development of infertility (OR, 0.48; 95% CI, 0.27 to 0.77), while there was significant heterogeneity between studies. In sensitivity analysis, two studies were excluded; the association and direction between GSTM1 and GSTT1 null genotypes and GSTP1 Ile/Val genotype and male infertility remained unchanged. There was no significant interaction between smoking status and studied genotypes on male infertility risk (P = .26). CONCLUSION: These results demonstrated that amongst populations studied to date, GSTM1 and GSTT1 null genotypes are associated with strong and modest increase in the risk of male infertility, respectively. On the contrary, GSTP1 Ile/Val genotype has protective effect.

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PURPOSE: To assess whether bowel preparation prior to kidney-ureter-bladder (KUB) radiography and intravenous urography (IVU) are of value in improving visualization of the urinary system. MATERIALS AND METHODS: A total of 186 patients participated in this study. Thirty-nine patients with chronic constipation based on Rome III criteria and 147 patients with normal bowel habits were included. All the patients were randomly divided into two groups. Patients in group 1 received castor oil before imaging and had to eat or drink nothing after midnight. Patients in group 2 were allowed to eat and drink before the examination and received no bowel preparation. Kidney-ureter-bladder radiographies were obtained in all the patients and IVUs were indicated in 77 patients. To assess the image quality, radiographic images were divided into 5 anatomical regions and each region was scored from 0 to 3 based on obscurity of the images by the bowel gas or fecal residue. RESULTS: Mean total score for visualization of the urinary system on plain and contrast images did not differ significantly between the two groups (P = .253). However, patients with chronic constipation who received bowel preparation revealed a significantly better visualization score on plain images (P = .001). CONCLUSION: Bowel preparation prior to KUB and IVU does not improve the quality of the images in patients with normal bowel habits. However, a significantly better visualization of KUB was noted among patients with chronic constipation who had received bowel preparation.

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BACKGROUND: X-ray contrast arteriography has traditionally been used for pre-operative evaluation in living kidney donors. However, magnetic resonance angiography (MRA) offers a non-invasive alternative, which has been considered to be less accurate. This study was performed to determine whether MRA in the pre-operative investigation of living kidney donors provides sufficient information. METHODS: From December 2005 to December 2007, 173 potential live donors were evaluated in this study. Donors performed digital subtraction angiography (DSA) and those with one or more accessory arteries at least on one side recruited for further evaluation with three-dimensional gadolinium-enhanced MRA. RESULTS: A total of 30 donors constituted the study population. When compared with DSA as the reference method, MRA detected 20 of 36 renal accessory arteries which indicates a sensitivity of 55.6%. The difference between MRA and DSA in identifying accessory renal arteries was significant (p-value <0.001). Considering intraoperative findings as the standard of reference, MRA depicted correctly four of six (66.7%) accessory arteries on the transplanted kidneys. CONCLUSIONS: MRA has the advantage of avoiding exposure to ionizing radiation and is non-invasive. These are important considerations in pre-operative evaluation of a generally healthy donor population. However, MRA provides suboptimal accuracy in detecting small accessory arteries.

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OBJECTIVE: To compare the different aspects of the postoperative outcomes in diabetics and nondiabetics of transurethral prostatectomy in patients with benign prostatic hyperplasia. METHODS: From December 2000 to December 2003, a total of 138 men with BPH, who were candidates for transurethral resection of the prostate (TURP), were selected for this study, of these 20 were diabetics. The International Prostate Symptom Score (I-PSS) and the erectile function were assessed preoperatively and during an average follow-up period of 63 months postoperatively. Comorbid conditions and all surgical complications during the follow-up were recorded. RESULTS: No significant differences were detected between the baseline IPSS and the prostate volume in diabetic and nondiabetic patients. Both groups showed significant reductions in IPSS, and greater reductions were detected in nondiabetic patients 6 months after their operations that were not statistically significant (23.5 +/- 8.0 versus 20.9 +/- 7.6 respectively, p = 0.169). There were no significant differences in the perioperative complications. The incidence of a second TURP was higher in diabetics (25% vs. 7.8%, p = 0.033). Although not statistically significant, a higher incidence of postoperative erectile dysfunction (ED) in diabetic patients (37.5% vs. 11.5%, p = 0.073) was observed. CONCLUSION: TURP is a beneficial and safe procedure in diabetic patients with BPH and is not associated with a higher incidence of perioperative or postoperative complications except for the possible postoperative ED and the retreatment rate that seems to be higher.

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