ABSTRACT

Aim: To compare the clinical efficacy and tolerability of naftopidil versus tamsulosin in patients with LUTS due to BPH. Tamsulosin acts via α1A-receptor and naftopidil acts via α1D-receptor blocker. The latter is believed to be more efficacious with fewer side effects.

Settings and Design: A prospective, randomized, non-placebo clinical study.

Methods and Materials: 110 patients fulfilling our inclusion criteria were randomized (double-blinded) to receive naftopidil (50 mg) or tamsulosin (0.4 mg) once daily for 3 months after obtaining institutional ethical clearance and administering informed consent. The patients were followed for changes in International Prostate Symptom Score (IPSS), Sexual Function Inventory Score (SFIS), peak flow rate (PFR), average flow rate (AFR), post-void residue (PVR), episodes of acute urinary retention (AUR), and side effects, which were recorded and analyzed using appropriate statistical tools.

Statistical Analysis: Recorded data was analyzed using appropriate statistical tools including the unpaired Student t test, Tukey test, and the repeated measure ANOVA test.

Results: Naftopidil and tamsulosin both improved patient symptoms, uroflowmetry, and other parameters. Naftopidil appeared to have an earlier onset of action shown by significant change in values of IPSS (P = 0.003), PVR (0.041), storage subscore (SIPSS) (P = 0.011), and Qol (P = 0.017) at 2 weeks. A higher incidence of postural hypotension, headache, and drug failure were observed with tamsulosin (not statistically significant). SFIS was significantly lower in the tamsulosin group.

Conclusions: The management of symptomatic BPH, with either naftopidil or tamsulosin, appeared to be equally effective, safe, and well tolerated. Naftopidil appeared to have a faster onset of action with fewer side effects versus tamsulosin. All patients appeared to be equally compliant, and there was no treatment withdrawal due to observed side effects with either drug.

Iqbal Singh, Ankit Gupta, Vivek Agrawal, Mohit Joshi

Submitted January 2, 2013 - Accepted for Publication February 14, 2013

KEYWORDS: Tamsulosin, naftopidil, voiding dysfunction, LUTS

CORRESPONDENCE: Iqbal Singh, MCh (Urology), DNB (Genitourinary Surgery), MS, University College of Medical Sciences, the University of Delhi, New Delhi, India ()

CITATION: UroToday Int J. 2013 April;6(2):art 17. http://dx.doi.org/10.3834/uij.1944-5784.2013.04.04

ABSTRACT

Capsular leiomyoma of the kidney is a rare benign tumor. Usually they are very small tumors and do not produce symptoms. We report a case of a huge renal capsular leiomyoma in a pregnant woman, which led to premature delivery of the baby.

Tanveer Iqbal Dar, Abdul Rouf Khawaja, Mohd Sajid Bazaz, Farzana Bashir, Ajay Kumar Sharma

Submitted January 15, 2013 - Accepted for Publication February 4, 2013

KEYWORDS: Leiomyoma, kidney, pregnancy

CORRESPONDENCE: Dr. Tanveer Iqbal Dar, Senior Resident, Sir Ganga Ram Hospital, New Delhi, Delhi, India 1900 60 ()

CITATION: UroToday Int J. 2013 April;6(2):art 16. http://dx.doi.org/10.3834/uij.1944-5784.2013.04.03

ABSTRACT

Introduction: The primary aim of this study was to evaluate the incidence of von Hippel-Lindau (VHL) gene mutations among a group of Kashmiri patients diagnosed with renal cell tumors. Correlation of these mutations was explored with clinical pathological status of the illness.

Methods: PCR-SCCP and DNA sequencing evaluated the DNA samples of both the tumor and adjacent normal tissue for the occurrence of VHL gene mutations. In addition, blood samples were used from all the cases to rule out any germ-line mutation.

Results: Mutations of the VHL gene identified in renal-cell cancer (RCC) patients were 52.5% (21 of 40), including 9 missense, 10 frame shift, and 2 non-sense mutations. Of the mutations, 52.38% were detected in exon 1, 38.1% in exon 2, and 9.52% in exon 3. Nineteen out of 23 (82.6%) cases of the clear-cell type and 2 out of 2 (100%) of angiomyolipomas of RCC were positive for VHL gene mutation. No correlation was found between tumor grade and/or stage and the presence of VHL mutation.

Conclusions: In conclusion, sporadic RCC shows mutations in the VHL gene, which mainly appear in the clear-cell subtype in our patients. Thus alteration in the VHL gene has been implicated in the pathogenesis of renal-cell sporadic cancer of the patients in our population.

Aashaq Hussain Bhat, Arshad Ahmad Pandith, Zafar Amin Shah, Saleem Wani

Submitted January 23, 2013 - Accepted for Publication February 5, 2013

KEYWORDS: Renal cell carcinoma, PCR, sporadic, angiomyolipoma

CORRESPONDENCE: Dr. Mohammad Saleem Wani, Department of Urology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir ()

CITATION: UroToday Int J. 2013 April;6(2):art 15. http://dx.doi.org/10.3834/uij.1944-5784.2013.04.02

ABSTRACT

Background: Balanitis xerotica obliterans (BXO) is a well-known chronic disease affecting male genitalia. There are several treatment options available for this. This study was performed to establish the efficacy of tacrolimus ointment as a mode of nonsurgical management of early BXO changes.

Introduction: BXO is a chronic, lymphocyte-mediated skin disease causing glandular urethral stricture of unknown origin. Exact incidence of the disease is obscure; there are several surgical and nonsurgical treatment options available. Among the nonsurgical management, the use of tacrolimus (immunomodulator) ointment is being considered.

Methodology: This study was performed at our institution among the patients attending the outpatient department with typical clinical features of BXO during the year 2011. Thirty cases were studied.

Results and Discussion: The majority (63.33%) of cases presented during the third to sixth decade of life. Symptomatic relief occurred in 16 cases (53.33%) treated with tacrolimus ointment. There are several modes of nonsurgical management, including steroid ointment usage, carbon dioxide laser therapy, topical tacrolimus application, etc. Among these therapies, the use of topical tacrolimus has promising results with better symptomatic relief and fewer side effects, as seen in our study.

Anowar Ali Mallick, Tapas Kumar Majhi, Supriya Basu, Dilip Kumar Pal

Submitted November 24, 2012 - Accepted for Publication February 4, 2013

KEYWORDS: Balanitis xerotica obliterans (BXO), topical, tacrolimus, treatment

CORRESPONDENCE: Dilip Kumar Pal, MS, MCh, Vinayak Garden, Flat No. A/3D 41B, Simla Road, Kolkata, India 700006 ()

CITATION: UroToday Int J. 2013 April;6(2):art 14. http://dx.doi.org/10.3834/uij.1944-5784.2013.04.01

Dear Colleagues,

February is always an exciting time at the Berkeley offices of UroToday International Journal. As the year begins, new projects and ideas are birthed, paving the way for progress to follow. We at UIJ are always looking for new ways to inform our community, and the first issue of 2013 greets new and longstanding readers alike. No matter your specific niche, we’re sure to have articles of interest that will inform, enlighten, and inspire.

In this issue, Chamberlain et al. evaluate their institutional experience with pediatric recipients of adult donor nephrectomies. They determine that although renal transplants in pediatric patients are associated with postoperative morbidity, graft survival is comparable to adult laparoscopic donor nephrectomy recipients.

Kolte and team discuss supine percutaneous nephrolithotomy as a less practiced modality for the treatment of upper-tract calculi. Their single center experience in 100 patients treated by supine PCNL over a period of 18 months proves the procedure is simple and feasible.

A study by Labib et al. compares short-term outcomes of treatment of urethral stricture disease between human immunodeficiency virus seropositive and HIV seronegative patients. Through their investigation, they discover that stricture recurrence following treatment is not affected by HIV status, nor is time to recurrence and cumulative survival of urethral stricture disease following treatment.

Singh et al. revisit urethral stricture etiology and they discover that the etiology of urethral strictures is not uniform across the world. The iatrogenic and idiopathic strictures are surprisingly common, and avoiding unnecessary urethral catheterization and repeated urethral instrumentation can reduce iatrogenic strictures

We also present a series of case studies on several topics, including congenital bladder diverticulum, female hypospadias and urethral stricture disease in a circumcised female, and a renal abscess in the isthmus of a horseshoe kidney, among others.

We appreciate your continued support, and we hope you find topics of interest with every issue released in 2013. We look forward to the new findings our authors present with every article submitted, and the surprises that await us at every turn. 

Warm regards, 

Karl-Erik Andersson