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Urinary stones are a common problem in Oman and their composition is unknown. The aim of this study is to analyze the components of urinary stones of Omani patients and use the obtained data for future studies of etiology, treatment, and prevention. Urinary stones of 255 consecutive patients were collected at the Sultan Qaboos University Hospital. Stones were analyzed by Fourier transform infrared spectrophotometer. The biochemical, metabolic, and radiological data relating to the patients and stones were collected. The mean age was 41 years, with M:F ratio of 3.7:1. The common comorbidities associated with stone formation were hypertension; diabetes, benign prostate hyperplasia; urinary tract infection; obesity; and atrophic kidney. The common presentation was renal colic and flank pain (96%). Stones were surgically retrieved in 70% of patients. Mean stone size was 9 ± 0.5 mm (range 1.3-80). Stone formers had a BMI ≥ 25 in 56% (P = 0.006) and positive family history of stones in 3.8%. The most common stones in Oman were as follows: Calcium Oxalates 45% (114/255); Mixed calcium phosphates & calcium oxalates 22% (55/255); Uric Acid 16% (40/255); and Cystine 4% (10/255). The most common urinary stones in Oman are Calcium Oxalates. Overweight is an important risk factor associated with stone formation. The hereditary Cystine stones are three times more common in Oman than what is reported in the literature that needs further genetic studies.
Asunto(s)
Cistinuria/epidemiología , Cálculos Urinarios/química , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Omán/epidemiología , Cálculos Urinarios/genética , Cálculos Urinarios/metabolismo , Adulto JovenRESUMEN
OBJECTIVES: To determine whether Helicobacter pylori (H. pylori) is detectable in both benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Epidemiological studies have shown significant associations between infective chronic prostatitis and prostatic carcinoma. Many bacteria have been found in the prostate of patients with chronic prostatitis, BPH, and PCa. METHODS: One hundred consecutive patients with prostate diseases were enrolled in the study. Detection of H. pylori DNA in prostate tissue from patients with BPH and PCa was performed using both immunohistochemistry and PCR, and the results were confirmed by DNA sequencing. Odds ratios and the Fisher Exact test were used for the analysis of the associations between the variables. RESULTS: Among the patients, 78% had BPH and 19% had PCa. While immunohistochemistry showed no positive sample for H. pylori, PCR combined with sequencing detected H. pylori DNA in prostate tissue samples from 5 patients. However, statistical analysis of the data showed that BPH and PCa are not significantly associated with the presence of H. pylori DNA in prostate tissue (odds ratio = 0.94, 95% confidence interval = 0.09-23.34, one-tailed Chi-square value = 0.660, p > 0.05). The limitation of this study was the small number of PCa patients. CONCLUSIONS: This study provides, for the first time, molecular evidence of the presence of H. pylori DNA in prostatic tissue of patients with BPH and PCa. It paves the way for further comprehensive studies to examine the association of H. pylori infection with BPH and PCa.
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OBJECTIVE: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones. METHODS: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. RESULTS: Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85%) had renal stones and 33 (15%) had ureteric stones. The mean±SD stone size was 11.3±4.5 mm, while the mean age of the patients was 39.9±12.8 years with 68.5% males. The mean renal stone size was 11.6±4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9±3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones) was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5%) with renal stones and 13 patients (39.4%) with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones). Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004) and the number of shockwaves (p=0.021). CONCLUSION: Siemens Modularis Vario lithotripter is a safe and effective tool for treating renal and ureteric stones.
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OBJECTIVES: The objectives of this study were to compare the demographics, semen parameters and hormone profiles in men with primary and secondary infertility. METHODS: The study was designed as a retrospective analysis of data collected from men attending a combined infertility clinic (seen together by urologist and gynaecologist) from January 2005 to December 2008 at Sultan Qaboos University Hospital, a tertiary care hospital in Oman. Ninety-eight consecutive male patients with one or more abnormalities in semen analysis were referred to the combined infertility clinic. A complete physical examination was carried out by a urologist followed by hormone evaluation of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and prolactin (PRL). RESULTS: The semen parameters and the sex hormone evaluation were not significantly different between the men with primary and secondary infertility. The men with primary infertility were younger than the men with secondary infertility. A total of 24% of the men in the primary group and 16% in the secondary group were azoospermic with normal gonadotropin values in 9 men and 1 man in the primary and secondary group respectively. CONCLUSION: Azoospermia was more common in the primary infertile group and, based on gonadotropin levels, obstructive causes seemed more prevalent in the primary group compared to secondary group.
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OBJECTIVES: Percutaneous access surgery of the kidneys was introduced in Sultan Qaboos University Hospital (SQUH) in 1998. We are presenting our early experience in the first 31 patients operated on over an eight year period using the percutaneous approach. METHODS: A retrospective review of 25 patients, who underwent percutaneous nephrolithotomy (PCNL) for the treatment of large renal stones and 6 patients who underwent endopyelotomy for the treatment of pelviureteric junction (PUJ) obstruction. RESULTS: In the PCNL group complete stone clearance was achieved in 68% (17/25) patients and the complication rate was 28% (7/25). In the endopyelotomy group the success rate of relief of obstruction of PUJ measured by renogram and relief of symptoms was 83% (5/6 patients). CONCLUSION: Our early results of PCNL are promising and comparable to international results.
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Widespread use of ultrasonography and computerized tomography of the abdomen result in the detection of a large number of renal mass lesions. Most of these are simple renal cysts, which do not need any further evaluation or follow up unless symptomatic. Simple renal cysts can be diagnosed with certainty if the treating physician or surgeon is aware of these features and can avoid unnecessary urology referral, patient anxiety, inconvenience and expense. Symptomatic cysts and complex renal cysts need further evaluation and intervention. We present the case of large symptomatic renal cysts persisting after aspiration sclerotherapy, which were managed by deroofing the cyst laparoscopically. Laparoscopic deroofing is rapidly becoming accepted as the surgical intervention of choice for symptomatic renal cysts persisting after aspiration sclerotherapy.
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A 45-year-old diabetic man presented with an episodic history of painless gross hematuria. He had had no previous urinary symptoms or any other medical problems. His physical examination, urine cytology, and computed tomography scan findings were normal. Cystoscopy demonstrated two nodular masses in the urinary bladder with a hemorrhagic mucosal surface. Biopsies revealed amyloidosis, and immunohistochemical staining of the specimens defined the process as amyloid AA (mostly seen in secondary amyloidosis). The workup for systemic conditions associated with amyloid AA was negative. This represents an unusual case of primary localized AA-type amyloidosis of the bladder.