Author Archive

Schistomiasis

ByProfessor Mohamed Shalaby
Professor and Former Chairman of the Urology Department 
Assiout University

Schistosomiasis, presently know as bilharziasis to credit Theodor Bilharz the discoverer of the parasite, dates back to antiquity. Its evolutionary origin most likely stems from the Great Lakes region of East Africa, the hypothesized cradle of man’s ancestors . The host and the parasite had over the years become well adapted to each other under environmental conditions ideally suited for the transmission of the parasite. However under natural conditions of the past, severe widespread infections were unusual considering the nomadic nature of man’s life at that time. The ancient Egyptians, through settling and cultivating the Nile Valley, were among the first to contract the disease in an endemic manner. They recognized the disease four to five thousand years ago and mentioned it in medical papyri as well as depicted it in engravings on the walls of temples . Recently, it was confirmed by direct demonstration of the eggs of the parasite in the tissues of mummies through paleopathologic studies.

Plagiarism in Medical Research.. The “Plague” of the New Millennium

ByIsmail O. Abdelhafeez* and Amr E. Riad°
Urology Department Ain Shams University* and Urology Department Theodore Bilharz Institute°

Plagiarism is defined in dictionaries as the “wrongful appropriation”, “close imitation” or “purloining and publication” of another author's “language, thoughts, ideas, or expressions” and the representation of them as one's own original work, but the notion remains problematic with nebulous boundaries. There is no rigorous and precise distinction between imitation, stylistic plagiarism, copy, replica and forgery. The modern concept of plagiarism as immoral and originality as an ideal emerged in Europe only in the 18th century, particularly with the Romantic movement, while in the previous centuries authors and artists were encouraged to “copy the masters as closely as possible” and avoid “unnecessary invention”.

The 18th century, new morals have been institutionalized and enforced prominently in the sectors of academia and journalism, where plagiarism is now considered academic dishonesty and a breach of journalistic ethics, subject to sanctions like expulsion and other severe career damage. Not so in the arts, which not only have resisted in their long-established tradition of copying as a fundamental practice of the creative process, but with the boom of the modernist and postmodern movements in the 20th century, this practice has been heightened as the central and representative artistic device Plagiarism remains tolerated by 21st century artists.

A Brief History of Urology in EGYPT

By Hussein A. Amin, M.D., FACS.
Former Chairman of Urology Department Benha University

When Nitze invented the cystoscope in 1907, he opened the way to the gradual separation of Urology as a Specialty from General Surgery throughout the civilized world, including Egypt.
Between 1930 and 1940 The Specialty of Urology in Egypt developed separately in two main centers, first Alexandria and then Cairo.

In 1934 an immigrant Russian surgeon, Jacob Bitchai settled in Alexandria and started cystoscopic procedures in the Moassat Charity Hospital. In 1945 he got the lucky chance of treating the Prime Minister of Egypt for urine retention. The case proved to be a prostatic abscess which got drained once the instrument was passed in. The relief was dramatic for the patient, as well as for the surgeon, who was appointed as Visiting Professor of Urology in the newly inaugurated King Farouk (Alexandria) University.

EFFECTIVENESS OF ANTIMICROBIAL PROPHYLAXIS IN RECURRENT URINARY TRACT INFECTION (UTI) IN CHILDREN

ALSAYED S. ABDELAZEZ*, MAHMOUD M. ALI**, ABDELAZEZ A EMAI**  AND ABDELRAZAK MANSOUR M ALI***
* Department of urology, Al-Azhar University, Damietta, Egypt.
**Department of urology, Al-Azhar University, Cairo, Egypt.
***Department of Pediatrics, Al-Azhar University, Cairo, Egypt.

 

Objective: To evaluate the effectiveness of trimethoprim–sulfamethoxazole (TMP-SMX) as antimicrobial prophylaxis for recurrent UTI in children.

Materials and Methods: From June 1st 2010 to June 1st 2011, 360 children <12 years with proven UTI were treated and divided into two groups: Study group (n=180) who received daily low doses of TMP-SMX suspension (2 mg of trimethoprim + 10 mg of sulfamethoxazole /kg) as a prophylaxis and Control group (n=180) who received placebo and followed-up for 12 months.

Results: The median age at entry was 44± 7.23 months. UTI developed in 8.1% in study group (n=14/172) and 9.8% in placebo group (n=14/172) and the difference was statistically insignificant (P >0.05). The most serious adverse effect was the development of antibiotic resistance organism to TMP-SMX in antibiotic group in comparison to placebo group [71.4% (n=10/14) Vs 17.7% (n=3/17) respectively] (P <0.05).

Conclusion: Low-dose TMP-SMX was not associated with decreased recurrent UTI in predisposed risk children, whereas the risk for antimicrobial resistance was significantly increased.

Keywords: Children, recurrent UTI, antibiotic prophylaxis.

 

BIPEDICLED SCROTAL MYOCUTANEOUS FLAP: A NEW TECHNIQUE FOR AUGMENTATION PHALLOPLASTY

A. YOUSSEF, M. ESMAT AND M. WAEL
Department of Urology, Ain Shams University, Cairo, Egypt

Purpose: To assess efficiency and safety of our new technique of "bipedicled scrotal myocutaneous flap" in penile girth enhancement in cases of small penis syndrome.

Patients and methods: This study was conducted on 23 patients complaining of small penile size who did not respond to psychiatric treatment. Patients with ambiguous genitalia, hypospadias and epispadias were excluded from this study. All patients were subjected to penile augmentation using the new technique of bipedicled scrotal myocuanenous flap to increase penile circumference and division of suspensory ligament for penile lengthening. The change in penile dimensions was assessed by preoperative and postoperative measurement of stretched penile length (SPL) and mid penile girth. Follow up of the patients was done at 3 months and 9 months postoperatively.

Results: No intra-operative complications occurred. At 3 months postoperatively, the mean increase in penile dimensions was 2.3±0.2 (1.9-2.7) cm and 2.0±0.3 (1.6-3.1) cm in penile girth and penile length respectively. The patients' satisfaction rate was 65.2%. Only 3 cases experienced delayed scrotal wound healing that was managed conservatively without late sequelea. On follow up the penile girth enhancement was symmetrical and durable. No other postoperative complications reported. No affection of penile erection, significant scarring nor long term affection of penile sensation occurred.

Conclusion: The technique of bipedicled scrotal myocutanous flap is an easy and effective technique that provides a reasonable long term symmetrical increase in penile girth by using a well vascularised nearby flap. Moreover, it is a safe technique with no associated postoperative harmful sequelea.

 

DIAGNOSTIC AND THERAPEUTIC EFFICACY OF LAPAROSCOPY IN THE MANAGEMENT OF THE UNDESCENDED TESTIS

K. MURSI, I. SAAD, A. SALEM, M. EL-GHONIEMY AND A. ABDEL-HAKIM
Urology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Purpose: Twenty percent of undescended testes (UDT) are non-palpable. Imaging has shown suboptimal accuracy in locating non-palpable testis (NPT) with laparoscopy proving to be superior. We aim to evaluate the safety and efficacy of laparoscopy in diagnosis and management of NPT.

Materials and Methods: Included patients were >1-year old with NPT. No imaging was done, and laparoscopy was performed all patients. Patients were classified according to diagnostic laparoscopy into 6 types, Type-I: no testes, vas or spermatic vessels, Type-II: a blind- ended vas, Type-III: vas and vessels entering the inguinal canal, Type-IV: testis at internal inguinal ring (IIR), Type-V: testis <1 one inch from IIR, and Type-VI: testis >1 inch from IIR. Stretching maneuver (SM) was added for Type-V. Follow-up included examination and Doppler US 2-months from surgery.

Results: Twenty-five NPT (15 unilateral and 5 bilateral patients) were included. Mean age 1.8 years. Four testes were Type-IV, 14 Type-V, and 7 Type-VI. Three testes were removed due to atrophy. In 8 (32%) testes, Laparoscopic Orchiopexy (LO) was performed (3 Type-IV and 5 Type-V with positive SM). In 14 (56%) testes, Fowler Stephens laparoscopic orchiopexy (FSLO) was done (6 testes Type-V with negative SM and 8 Type-VI). On follow-up, no significant difference in size, site and vascularity was found between FSLO and LO.

Conclusion: Laparoscopy has 100% accuracy in locating NPT. LO and FSLO can be considered treatments of choice for Type-IV and Type-VI NPT, respectively. SM evaluates mobility to contralateral IIR and detects appropriate surgery for Type-V NPT.

Keywords: Laparoscopy; management; undescended; testis.

IMPACT OF TAMSULOSIN ON CLEARANCE OF RENAL CALCULI AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

MOHAMED ABO EL-ENEN, MOHAMED GABER, * MOHAMED SAMY
 Urology and *Radiology Departments, Tanta University, Tanta, Egypt.

CONVENTIONAL AND VIRTUAL CYSTOSCOPIES FOR DIAGNOSIS OF URINARY BLADDER GROWTH LESIONS: A SUPPLEMENTARY RATHER THAN COMPETITIVE RULES

HOSSAM IBRAHIM, ABDUL NASER GHAREEB, MOKHTAR RAGAB  AND EMADELDEEN ALI SALAH*
Radiology and urology* Departments, Al-Azhar University Hospitals, Cairo and Assiut*.

Introduction and aim of the work: Recent CT scan technology allowed three dimensional image reconstructions to precisely and accurately show fine anatomical details. The goal of this study was to evaluate the usefulness of virtual cystoscopy (VC) in diagnosis of urinary bladder neoplasm in comparison with the gold standard conventional cystoscopy (CC).

Patients and Methods: Eighty three consecutive patients (mean age 54 years) clinically presenting for gross haematuria and positive urine cytology for malignancy, were prospectively evaluated with VC after bladder air insufflation or intravenous injection of contrast medium using multi-detector helical CT (1-mm section thickness). Afterwards, all patients had been subjected to CC and examination under anaesthesia.

Results: The findings of VCs were quite comparable with the findings from the CCs except in three patients were not detected by VC (two patients with tumor sizes < 3 mm and one with carcinoma in situ). The bladders of seven patients appeared normal on both CC and VC. The sensitivity and specificity of identification of bladder mass lesions using VC were 96% and 100% respectively, while, it’s positive and negative predictive values were 100%, and 70% respectively.

Conclusion: CT virtual cystoscopy is a minimally invasive technique that could be successfully used for detection of bladder tumors ≥3 mm especially for follow up after transurethral resection of bladder tumors (TURT) cases during daily routine abdominopelvic CT work. It is not a substitute but rather supplementary to CC.


Login



Signup Here
Lost Password

The EUA This Month

 

This site is
intended for health care professionals


Copyright 2010 © URO-Egypt.com. All rights reserved