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We reported radical cystectomy (RC), bilateral lymphadenectomy and orthotopic ileal neobladder reconstruction in a patient with history of kidney transplant. A 71-year-old man was referred to us with bladder tumor, elevated serum creatinine (1.9 mg/dl), hydroureteronephrosis in transplanted kidney and a 5–6-cm sessile mass in the right bladder wall with involvement of transplanted ureter orifice. The patient was candidate for RC. The native ureters were ligated permanently. Extended lymphadenectomy in left side and limited lymphadenectomy in right side were performed. The patient underwent ileal orthotopic neobladder reconstruction, and the graft ureter was reimplanted to ascending loop of the pouch with end-to-end anastomosis. In conclusion, bilateral lymphadenectomy is feasible in patients with a history of kidney transplantation during RC. Permanent ligation of native ureters is better to perform to reduce the time of surgery and prevent late probable morbidities due to uretero-intestinal reimplantation complications.

Pyogenic granuloma (PG) is an uncommon lesion of unknown etiology. It may be formed following a minor injury. They result from a reactive or inflammatory process consisting of proliferating vascular channels, immature fibroblastic connective tissue, and scattered inflammatory cells rather than neoplastic process. Bleeding is the most common symptom of the lesion. They may be seen in all age groups, and there is no clear predominance of a gender. Vulvar PGs can be confused with other polypoid or sessile lesions of the genital site. There are only a few cases of female genital PGs reported in the literature. Herein, we describe the first case of vulvar (clitoral) PG in an Iranian patient and a brief review of the literature in this regard.

Acute scrotum is a common clinical problem in children and torsion event superimposed on complete dissociation of the testicle and epididymis can be difficult to diagnose and often requires scrotal exploration. To the best of our knowledge, four cases of isolated torsion of the epididymis have been reported in the literature. We report a 17-year-old male patient with epididymal torsion who presented with testicular pain and hemi-scrotum swelling. Due to painful symptoms, emergency scrotal surgery exploration of the patient revealed a complete epididymis infarction due to isolated epididymal torsion with dissociation of the testis and epididymis.

Retrorenal colon is a risk factor for colonic injury during percutaneous nephrolithotomy (PCNL). Our aim in this study is to report the feasibility and outcomes of ultrasound-guided percutaneous nephrolithotomy in patients with preoperatively known retrorenal colon by cross-sectional imaging.In this prospective study, all patients with large renal stones and retrorenal colon in preoperative cross-sectional imaging from September 2020 to January 2022 who were candidates for PCNL were enrolled. Percutaneous access was established by ultrasonography guidance by the freehand method with dilation of the tract by a combination of fluoroscopy and ultrasonography.Of the 1123 patients (Male = 760 and Female = 363) who underwent PCNL, 13 patients (Male = 6 and Female = 7) had retrorenal colon in the preoperative computed tomography. The series included two patients with malrotated kidneys. Complete stone clearance was achieved in 11 patients. Patients were followed up for at least 3 months. No serious postoperative complications were observed during follow-up.In selected patients and experienced hands, ultrasound-guided PCNL can be an alternative option for the treatment of patients with large renal stones who have retrorenal colon in cross-sectional imaging.

Objective: The neurogenic bladder is one of the most serious and painful disorders seen in pediatric urology clinics. The upper urinary tract can be impaired by increased bladder pressure. Botulinum toxin-A (BTX-A) is one of the new therapeutic interventions for this disease. Thus, this research was designed to determine the clinical as well as radiological outcomes intravesical BTX-A injections in patients with overactive neurogenic bladder with Detrusor over activity. Patients and methods: From March 2012 to March 2019, this cohort study was conducted at Shahid Labbafinejad hospital in Tehran, Iran. Thirty-five pediatric patients with a neurogenic bladder and Detrusor overactivity who fulfilled the eligibility criteria received BTX-A injections. Demographic data, including spinal cord lesions or congenital malformations, upper and lower urinary tract nuclear scans, evidence of vesicoureteral reflux (VUR) and its severity, and hydronephrosis and 72 h voiding diary before and after intervention were all recorded. Results: The mean ± standard deviation age of participants was 9.47 ± 4.61 years. After injection, nocturia and urination frequency as general symptoms of the overactive neurogenic bladder improved ( p Conclusion: In the evaluation of voiding cystourethrography (VCUG) before and after the injection, downgrading of VUR was seen in 53% of the cases. In the 99mTc-DMSA nuclear scan before and after the injection, the appearance of a new parenchymal scar and uptake reduction was not observed, which indicates the cessation of scar formation in all patients. Although Enuresis, Urgency, Frequency, Nocturia, and UUI significantly improved after injection.

In this paper, we raise the hypothesis that Methylene Blue may be a treatment option for Corona Virus Disease of 2019 specially when combined with Non Steroid Anti-Inflammatory Drugs. In previous publications including ours, the role of kininogen system has been postulated. A correlation between clinical findings of the disease and this mechanism has been drawn to denote a pivotal role of kininogen-kallikrein system in pathophysiology of the disease. Therein the possible role of Icatibant, Ecallantide and Aprotinin in the treatment of this disease has been raised. Here we want to emphasize on an important post-receptor mechanism of bradykinin that is Nitric Oxide. We came to this aim because we found out how access to these novel treatment nominees may be expensive and unaffordable. For this reason we are focusing on possible role of an old albeit "mysterious" drug namely Methylene Blue. This medication may abort effects of Bradykinin by inhibition of Nitric Oxide synthase inhibitor and promote oxygen saturation while it is inexpensive and ubiquitously accessible. Clinical studies cannot be over emphasized.

Sexual Dysfunction [SD] is a common health problem among women that causes anxiety, interpersonal problems and a low quality of life. On the other hand, lower urinary tract symptoms [LUTS] are common among women, in particular in women suffering from FSD [female sexual dysfunction] although the relation between the two conditions is still unclear. Available data on the effect of LUTS on FSD are limited. The aim of this study is to evaluate the frequency of FSD in women with LUTS who referred to university hospitals [Razi and AL Zahra] and a private urology clinic in Rasht, Iran. In a cross-sectional study, 123 eligible patients suffering from LUTS entered the study. Validated Persian versions of the FSFI [Female sexual function index] and the Bristol questionnaires [BFLUTS] used to assess the participants and the data were analyzed using SPSS version 21. The mean age of women participating in this study was 40.64±6.18 years. FSD was diagnosed in 54.5% of the patients; 78.9% of these patients with FSD reported dysfunction in sexual desire, 78% reported sexual arousal disorder, 54.5% had lubrication disorders, 46.3% complained of orgasmic deficiency, 44.7% had sexual pain disorder and 37.4% had satisfaction voiding disorder. Based on the results, sexual dysfunction was common among women suffering from LUTS and sexual desire was the most frequently affected among FSD domains. In addition, our findings indicated that, contrary to common belief, issues such as the level of education have no significant effect on the frequency of FSD in women, but compared to women with normal sexual function, subjects with FSD were significantly older [P=0.0001].