Indian Journal of Urology 

About: Indian Journal of Urology is an academic journal published by Medknow. The journal publishes majorly in the area(s): Medicine & Prostate cancer. It has an ISSN identifier of 0970-1591. It is also open access. Over the lifetime, 1774 publications have been published receiving 15979 citations. The journal is also known as: IJU.

Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction.

Abstract: Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors - including age, genetics and geography - play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.

Maximum androgen blockade in advanced prostate cancer : an overview of 22 randomised trials with 3283 deaths in 5710 patients

Abstract: The paucity of consistent, convincing and categorical evidence of an improved survival with Maximum Androgen Blockade (MAB), notwithstanding many randomised trials comparing castration alone versus some form of MAB over one, two (castration combined with anti-androgens, viz, flutamide, cyproterone acetate (CPA), or nilutamide) stimulated the authors to organise a systematic collaborative overview (meta-analysis), of the randomised evidence on MAB in advanced prostate cancer Overall, 25 properly randomised trials (that began before December, 1989) involving an unconfounded comparison of castration (medical/surgical) alone versus castration and additional treatment with an anti-androgen such as flutamide, cyproterone acetate or nilutamide, were identified Of these, two were 3-arm trials in which all 3 arms were relevant to the present analysis Logrank statistics was used which compared the number of deaths observed (O) in the MAB arm with the number of deaths that would have been expected (E) in that arm on the basis of the average pattern of survival in a combination of the 2 treatment arms The calculations of (E) were stratified for year of death The statistics (O-E) and its variance (V) were calculated on an intention-to-treat basis Logrank statistics for each were added together to obtain a total which was used to test the overall effect 87 percent of these patients had metastases when rando- mised Follow-up results were not available for 70 patients (12 percent) The median follow-up was 40 months, during which 57 percent of patients died The crude mortality rates were 50 percent for castration alone and 56 percent for MAB Life-table estimates of the 5-year survival rates were 228 percent and 262 percent respectively, revealing a non- significant improvement of 35 percent No significant heterogeneity was found between the trials (or between the effects of different types of MAB) and no evidence of any significant additional benefit was found in these MAB trial results (2p greater than 01) This study reveals that currently available evidence does not show a longer survival benefit with MAB (cf conventional castration)

Semen analysis and sperm function tests: How much to test?

Abstract: Semen analysis as an integral part of infertility investigations is taken as a surrogate measure for male fecundity in clinical andrology, male fertility, and pregnancy risk assessments. Clearly, laboratory seminology is still very much in its infancy. In as much as the creation of a conventional semen profile will always represent the foundations of male fertility evaluation, the 5th edition of the World Health Organization (WHO) manual is a definitive statement on how such assessments should be carried out and how the quality should be controlled. A major advance in this new edition of the WHO manual, resolving the most salient critique of previous editions, is the development of the first well-defined reference ranges for semen analysis based on the analysis of over 1900 recent fathers. The methodology used in the assessment of the usual variables in semen analysis is described, as are many of the less common, but very valuable, sperm function tests. Sperm function testing is used to determine if the sperm have the biologic capacity to perform the tasks necessary to reach and fertilize ova and ultimately result in live births. A variety of tests are available to evaluate different aspects of these functions. To accurately use these functional assays, the clinician must understand what the tests measure, what the indications are for the assays, and how to interpret the results to direct further testing or patient management.

Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review.

Abstract: We reviewed the incidence, predisposing factors, presentation and management of complications related to the use of synthetic mesh in the management of stress urinary incontinence and pelvic organ prolapse repair Immediate complications, such as bleeding, hematoma, injury to adjacent organs during placement of mesh and complication of voiding dysfunction are not discussed in this review, since they are primarily related to technique A PubMed search of related articles published in English was done from April 2008 to March 2011 Key words used were urinary incontinence, mesh, complications, midurethral sling, anterior prolapse, anterior vaginal repair, pelvic organ prolapse, transvaginal mesh, vault prolapse, midurethral slings, female stress urinary incontinence, mesh erosion, vaginal mesh complications, and posterior vaginal wall prolapse Since there were very few articles dealing with the management of mesh-related complications in the period covered in the search we extended the search from January 2005 onwards Articles were selected to fit the scope of the topic In addition, landmark publications and Manufacturer and User Facility Device Experience (MAUDE) data (FDA website) were included on the present topic A total of 170 articles were identified The use of synthetic mesh in sub-urethral sling procedures is now considered the standard for the surgical management of stress urinary incontinence Synthetic mesh is being increasingly used in the management of pelvic organ prolapse While the incidence of extrusion and erosion with mid-urethral sling is low, the extrusion rate in prolapse repair is somewhat higher and the use in posterior compartment remains controversial When used through the abdominal approach the extrusion and erosion rates are lower The management of mesh complication is an individualized approach The choice of the technique should be based on the type of mesh complication, location of the extrusion and/or erosion, its magnitude, severity and potential recurrence of pelvic floor defect

Hemorrhagic cystitis: A challenge to the urologist

Abstract: Severe hemorrhagic cystitis often arises from anticancer chemotherapy or radiotherapy for pelvic malignancies. Infectious etiologies are less common causes except in immunocompromised hosts. These cases can be challenging problems for the urologist and a source of substantial morbidity and sometimes mortality for the patients. A variety of modalities of treatment have been described for the management of hemorrhagic cystitis but there is none that is uniformly effective. Some progress has been made in the understanding and management of viral hemorrhagic cystitis. This article reviews the common causes of severe hemorrhagic cystitis and the currently available management options.