Hammouda Sherif

Bio: Hammouda Sherif is an academic researcher from Banha University. The author has contributed to research in topics: Urinary incontinence & Overactive bladder. The author has an hindex of 7, co-authored 21 publications receiving 219 citations. Previous affiliations of Hammouda Sherif include University of Tübingen.

Holmium laser enucleation versus transurethral resection of the prostate.

Abstract: Introduction This was a prospective, randomized clinical trial to compare the safety, efficacy, and medium-term durability of holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation versus standard transurethral resection of the prostate (TURP) for the surgical treatment of patients with bladder outlet obstruction due to benign prostatic hyperplasia (BPH). The patients had prostates that were greater than 30 g and less than 100 g and were followed for 1 year. Patients and methods From April 2008 to December 2009, 80 consecutive patients with lower urinary tract obstruction (LUTS) due to BPH were randomized to either surgical treatment with HoLEP (group 1, n = 40) or standard TURP (group 2, n = 40). Preoperative assessments included American Urological Association (AUA) symptom score, serum prostate-specific antigen (PSA), post-voiding residual (PVR) urine volume, transrectal ultrasound (TRUS), and urodynamic studies. Perioperative parameters included total operating time, resected tissue weight, hemoglobin loss, presence or absence of blood transfusion, time of catheter removal, and duration of hospital stay. Postoperative evaluations were conducted at 1, 6, and 12 months. Results Patients in the HoLEP group had shorter catheterization times and hospital stays than patients in the TURP group. There was no significant difference in operating times between the two groups. Mean hemoglobin loss was lower in the HoLEP group (1.8 ± 1.3 g/dL versus 2.9 ± 1.5 g/dL). There was a significantly greater improvement from baseline AUA symptom scores and PVR urine volumes in the HoLEP group versus the TURP group, at all postoperative assessments. Postoperatively, 25% of patients in group 1 (HoLEP) and 20% of patients in group 2 (TURP) had irritative voiding symptoms. Urethral stricture occurred in three cases (one case in the HoLEP group and two cases in the TURP group). Conclusion HoLEP proved to be a safe and highly effective technique for surgical treatment of bladder outlet obstruction due to BPH.

Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long term oncological, functional and quality of life results

Abstract: Purpose: Analyze current knowledge and practice regarding tumor-related cystectomy with subsequent orthotopic neoblad-der both in male and female patients. Design, setting, and participants: Evaluate literature predominantly from the last decade dealing with long-term experi-ence in large numbers of patients with an orthotopic neobladder following cystectomy. Oncological outcome specific to an orthotopic neobladder, functional aspects such as urinary continence, renal function, sexual activity and other quality of life issues are elucidated. Results: Local pelvic recurrences after urothelial bladder cancer occur in 7-12%. Urethral second primary tumors in male and female patients in contemporary series with bladder substitution are 4-6% and 1.4 o 4%, respectively. Upper tract recurrences vary between 2.4-17%. Complications regarding the upper urinary tract have dramatically diminished due to simplified forms of upper tract protection as well as a more refined technique of ureterointestinal anastomosis. Depending on the technique ureteroileal stenosis was lately reported to lie between 2.7 to 3.8%. Renal function remained stable in 96% after a mean follow-up of up to 5 years.

Posterior tibial nerve stimulation as treatment for the overactive bladder.

Abstract: Objective To evaluate the efficacy of posterior tibial nerve stimulation (PTNS) as a treatment for the overactive bladder (OAB) resistant to medical treatment. Patients and methods The study included 60 patients, comprising 55 women (92%) and five men (8%) with a mean (SD) age of 41.4 (10.8) years, who presented to the Urology Department of Benha University Hospital from June 2010 to October 2012. All patients were assessed initially by taking a history, a physical examination, urine analysis, routine laboratory investigations, and a urodynamic evaluation in the form of flowmetry, cystometry, and a pressure-flow study in some cases. A voiding diary (daytime and night-time frequency, voiding volume, and leakage episodes) was completed by all patients, and all underwent 12 sessions of PTNS using a personal computer-based system, and were reassessed after the sixth session, at the end of the course, and at 3 and 6 months after the last session, using the same methods as in the baseline visit. Results There was a statistically significant improvement in all the variables assessed. No infection or failure of the PTNS mechanism was detected while using the technique, but there were rare instances of minor bleeding and a temporary painful feeling at the insertion site. Conclusion PTNS is safe, and gives statistically significant improvements in the patient’s assessment of OAB symptoms.

Rapid Detection of Extended Spectrum Β-lactamase (ESBL) Producing Strain of Escherichia coli in Urinary Tract Infections Patients in Benha University Hospital, Egypt

Abstract: Background: An increase in extended spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) has been observed. Aims: Of this study was done to detect the prevelance of ESBL, AmpC producing and ESBL and AmpC co-producing strains of Escherichia coli (E. coli) in urinary tract infections patients in Benha University Hospital and to evaluate the performance of CHROMagarTM ESBL media for rapid screening of ESBL producing E. coli. Place and Duration of Study: This is a Six-months Cross sectional study conducted in Urology and Microbiology & Immunology departments, Benha University, Egypt. Methodology: All patients under study were subjected to: Full history taking and clinical examination. Bacteriological study included; urine sample collection from each patient and subjected to urine analysis, urine culture on cysteine lactose electrolyte deficient agar (CLED) agar, CHROMagarTM ESBL media and MacConkey agar supplemented with 2 mg/liter ceftazidime (MCKC). ESBL detection in E. coli isolated on CLED agar by phenotypic screening by clinical and laboratory standards institute (CLSI) method then Original Research Article British Microbiology Research Journal, 4(4): 443-453, 2014 444 phenotypic confirmation by E. test. The presence AmpC beta-lactamase ESBL was detected by AmpC disc test and detection of AmpC beta-lactamase and ESBL coproducers by cefepime and Cefepime + Clavulanate E test. Results: In this study out of 45 E. coli strains 24 (53.3%) ESBL producers were detected by E. test (golden method for confirmation of ESBL according to CLSI) and 21(46.7%) strains were non ESBL producers. There was no significant difference between ESBL isolation from community acquired and health care associated UTI patients; out of the 24 isolated ESBL producing E.coli strains 9 (37.5%) were detected in community acquired UTI patients while 15 (62.5%) were detected in health care associated UTI patients. The sensitivity of both MCKC and CHROMagarTM ESBL media were 100% (95%CL: 85.6% to 100%).While specificity were 87.5% (95%CL:67.6% to 97.2%) and 80.8% (95%CL: 60.6% to 93.4%) respectively. In our study out of 45 isolated E. coli strains 14 (31.1%) were AmpC producers by AmpC test, 4 (8.9%) were AmpC and ESBL co-producers by cefepime/ cefepime clavulanic E.test. Conclusion: It is important to know the prevalence of ESBL, AmpC producing and ESBL&AmpC co-producing organisms so that judicious use of antibiotics could be done and increase awareness about the need for routine detection of AmpC and ESBL in clinical isolates. CHROMagarTM ESBL media detect ESBL producers from clinical specimen and give rapid presumptive identification by means of colony colour after 24h with good sensitivity and specificity.

Efficacy of botulinum toxin type A 100 units versus 200 units for treatment of refractory idiopathic overactive bladder

Abstract: Objective: To evaluate the efficacy and safety of a single intra detrusor injection of BoNTA comparing two different doses (100 U or 200 U) in patients with idiopathic overactive bladder. Materials and Methods: A randomized prospective study evaluated the efficacy of BoNTA in management of refractory idiopathic overactive bladder and included 80 patients. All patients were assessed initially by taking a history, a physical examination, overactive bladder symptom score, urine analysis, routine laboratory investigations, KUB and pelviabdominal. OABSS was adjusted on all patients postoperative at 1,3,6,9 months also Urodynamic was done for all patients preoperative and postoperative at 3, 6, 9 months. Results: The mean age was 30.22±8.37 and 31.35±7.61 in group I and II respectively. There was no statistically difference between both groups in all parameters all over the study except at 9 months after treatment. Hematuria was observed 6 and 9 patients in group I and II respectively. Dysuria was observed in 6 and 15 patients in group I and II respectively. UTI was detected in 3 and 7 patients in group I and II respectively. Conclusion: A single-injection procedure of 100 U or 200 U BoNTA is an effective and safe treatment for patients with IOAB who failed anticholinergic regimens. OABSS and QoL were improved for 6 months; 100 U injections seemed to have comparable results with 200 U. There was a significant difference at month 9 towards 200 U with more incidences of adverse events.