The role of mpMRI and PSA density in patients with an initial negative prostatic biopsy.

Introduction: While an elevated PSA significantly increases the risk of men harboring prostate cancer, many men with a persistently elevated PSA have negative prostate biopsies. More recently, multiparametric MRI (mpMRI) has had promising implications for the diagnosis of prostate cancer. We aim to investigate the diagnostic role of mpMRI in predicting the future diagnosis of prostate cancer in patients with an initial negative biopsy.

Lymph node density in muscle-invasive transitional cell carcinoma of the urinary bladder; versus progressive disease.

Objective: The prognosis of bladder cancer patients with positive lymph node (LN) disease is affected by both the extent of lymphadenectomy and LN density retrieved during radical cystectomy. This study aimed at assessing the differences in LN metastasis between patients who presented primarily with muscle-invasive transitional cell carcinoma of the bladder " disease" versus "progressive disease." The latter is defined as patients who progressed to muscle-invasive bladder cancer (MIBC) following prior conservative management of a non-muscle-invasive disease.

The value of extended good quality transurethral resection of bladder tumour in the treatment of the newly diagnosed bladder cancer.

Objective: To report our experience for the initial management of patients with newly diagnosed bladder tumours using our team approach for each case and using an aggressive extended transurethral resection of bladder tumour (TURBT) in order to investigate the real need for a routine 'second-look' cystoscopy in the current era.

Patients And Methods: The study included 50 consecutive patients admitted to the urology department, of our tertiary care centre, for management of newly diagnosed bladder cancer. Exclusion criteria included past history of bladder tumour, palpable mass on bimanual examination under anaesthesia, presence of residual tumour at the end of resection, and patients with tumours of the bladder dome as thorough resection is difficult to achieve in this area without an attendant risk.

Renal cell carcinoma: Are we attacking a different tumor over the past 10 years?

Objective: There is a noticeable increase in the presentation of different types of urological malignancies at a younger age of presentation, in our institution. The objective of our study was to investigate cases presented with renal cell carcinoma, managed in the past 10 years for any possible epidemiological and cancer characteristics changes.

Methodology: Retrospective data collection for cases managed by our institution in the time period (2002-2012) was done.

Sexual activity and the risk of prostate cancer: Review article.

Introduction: Sexual activity can affect prostate cancer pathogenesis in a variety of ways; including the proposed high androgen status, risk of sexually transmitted infections and the potential effect of retained carcinogens within the prostatic cells.

Methods: PubMed review of all publications concerning sexual activity and the risk of prostate cancer was done by two researchers.

Results: Few publications could be detected and data were classified as a prostate cancer risk in association with either heterosexual or homosexual activities.

Open adrenalectomy for medium sized adrenocortical tumour: How I do it?

Introduction: The aim of our work was to report our experience in managing cases with medium-sized adrenocortical carcinoma by the high retroperitoneal extra pleural approach.

Methods: During the past 2 years, 10 patients with suspected adrenocortical carcinoma were managed by our technique: the high supra 10th rib, retroperitoneal extra pleural approach. We included cases with 5 to 10 cm adrenal masses, suspected as adrenocortical carcinoma.

Pattern of prostate cancer presentation among the Egyptian population: A study in a single tertiary care center.

Introduction: Prostate cancer is a common health problem that in the majority of cases starts to develop at the age of 50 years, reaching its peak at 60-70 years of age. A variation in its incidence and prevalence exists between western, Asian and Arabic populations. The aim of our work was to report the pattern of prostate cancer presentation in Alexandria University that as a tertiary referral center provides care for uro-oncology cases.

High-grade microscopic hematuria in adult men can predict urothelial malignancy.

Introduction: Microscopic hematuria in men younger than 40 is a confusing issue to urologists, especially when these men have normal radiological findings. We report our experience in looking for urologic malignancy in this group of patients.

Methods: We conducted a prospective study for men with vague urological symptoms.

Pyelonephritis can be a source of a life-threatening necrotizing myofasciitis.

Necrotizing fasciitis is a progressive, rapidly spreading, inflammatory infection located in deep fascia. It may cause necrosis of skin and subcutaneous tissue and can even results in involvement of adjacent soft tissues such as muscles resulting in necrotizing myositis. We report the case of an adult male presenting with necrotizing myofasciitis secondary to left pyelonephritis.

Chronic prostatitis/chronic pelvic pain syndrome: the role of an antifungal regimen.

Introduction: The role of fungal infection as a causative factor for prostatitis is currently underestimated. The aim of our work was to evaluate the response to an antifungal regimen in the setting of patients presenting with symptoms of chronic pelvic pain syndrome that have been refractory to treatment with antibiotics and alpha-blockers.

Material And Methods: We included 1,000 consecutive patients.

Percutaneous silicon catheter insertion into the inferior vena cava, following percutaneous nephrostomy exchange.

Percutaneous nephrostomy (PCN) has been widely used to drain an infected, obstructed kidney. Few major complications have been associated with it. Few publications have reported the misplacement of nephrostomy tube into the inferior vena cava (IVC), following percutaneous nephrolithotomy.

Squamous cell carcinoma on top of urethral stricture: case report and review of the literature.

Introduction: Urethral stricture is a common urological condition, resulting from trauma or venereal infections. The aim of our study was to report a rare case of squamous cell carcinoma of the penis and pseudoepitheliomatous hyperplasia (PEH) of scrotal skin, on top of repeatedly managed urethral stricture which was of unknown aetiology.

Methods: A Medline search of publications studying the association of urethral stricture with penile cancer was done.

Ileal conduit post radical cystectomy: modifications of the technique.

Introduction: Ileal conduit, post radical cystectomy, is currently the most practiced type of urinary diversion. The aim of our study was to modify the ileal conduit technique in order to retain acceptable outcomes while decreasing the rate of postoperative urine leak and ureteroileal stricture.

Methods: Forty consecutive patients were included in our study, from January to June 2011.

Unusual presentations of prostate cancer: A review and case reports.

Objective: To report our institutional experience with some rare presentations of prostate cancer, as prostate cancer is a common problem and affects a large group of men during their lifetime, but a few studies report unusual presentations of metastatic prostate cancer.

Methods: All possible clinical and pathological data were collected for six relevant patients with prostate cancer and unusual metastases who were identified at our institution. PubMed was searched for unusual presentations of prostate cancer in the last 20 years (1982-2012) and all relevant publications were assessed.