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Article
Inconclusive Urinary Bladder Biopsy; Facts and Lessons

Author: Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 4 Pages: 303-306
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:To review the pathologic analysis of urinary bladder biopsies and study the frequency and causes of inconclusive biopsies among Iraqi patients.METHODS:This is a retrospective study in which 933 patients underwent 1047 urinary bladder biopsy procedures during endoscopic evaluation, or transurethral resection of a known bladder cancer in Surgical Specialties Hospital, Baghdad, Iraq between June 2000 and June 2007. Pathologic records of patients were reviewed.RESULTS:In 933 patients aged 2-100 years with a mean age of 56.87±14.3 years who underwent 1047 urinary bladder biopsy procedures, pathologic review showed bladder cancer in 655 (62.56%) biopsies, no overt malignancy in 340 (32.47%) biopsies, no pathological diagnosis could be made in 43 (4.11%) biopsies, and normal biopsy in 9 (0.86%) biopsies. In 238 bladder cancer biopsies, pathologic analysis of muscle invasion was not carried out due to their lack of muscular tissue.CONCLUSION:Urinary bladder biopsy is one of the most common biopsies in urology practice. Every effort is made to prevent technical defects of taking and processing such biopsies, to optimize pathologic analysis and surgical management.

Keywords

Bladder biopsy --- Cystoscopy


Article
Schistosoma – Associated Bladder Cancer in Iraq Single Center Pathologic Review

Author: Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 2 Pages: 174-177
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:OBJECTIVE:To study the frequency of schistosomiasis in pathologic urinary bladder specimens and the contribution of transitional cell and squamous cell types to the schistosoma – associated and non schistosoma – associated bladder cancer among Iraqi patients.METHODS:This is a retrospective study in which 1092 pathologic records of 933 patients, who underwent urinary bladder biopsies from bladder tumors or suspicious lesions discovered incidentally during endoscopic evaluation and those who ultimately had radical cystectomy and urinary diversion for invasive bladder cancer, were reviewed in Surgical Specialties Hospital, Baghdad, Iraq between June 2000 and June 2007.RESULTS:In this study 933 patients aged 2-100 years with a mean age of 56.87±14.3 years. Pathologic review showed schistosomiasis in 81 (8.68%) patients of whom schistosoma associated bladder cancer was reported in 49 (60.5%) patients and schistosomiasis with no pathologic evidence of malignancy in 32 (39.5%) patients. The cell type of schistosoma associated bladder cancer was transitional cell carcinoma (TCC) in 26 (53%), squamous cell carcinoma (SCC) in 19 (38.7%), adenocarcinoma in 1 (2%), and undifferentiated in 3 (6.12%) patients. Out of 852 patients with no pathologic evidence of schistosomiasis, 563 were reported to have non schistosoma associated bladder cancer. The cancer cell type was TCC in 491 (87.21%), SCC in 45 (7.99%), adenocarcinoma in 15 (2.66%), undifferentiated in 11 (1.95%) and sarcoma in 1 (0.18%) patients.CONCLUSION:Schistosoma associated bladder cancer is still a problem in Iraq as well as other endemic countries. Although the major histological cell type of such cancer in Iraq was SCC, there is a trend for increasing frequency of TCC among patients infected with schistosomiasis.


Article
Ureteral Stent Forgotten for 10 Years; A Challenge When Choices are Limited

Author: Ausama Saadi Abdul muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 95-99
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract


Article
Genetic Treatment of Urological Diseases; are We Ready? (Review Article)

Author: Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 128-136
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: There is an increasing interest in the role of genetics in many urological diseases and malfunctions. The door was opened for early diagnosis, application of genetically based armamentarium to prevent, treat or modify the clinical course as well as prediction of the prognosis of such abnormalities. Many urologists share the idea that the use of a genetic tool to diagnose or treat their patients still has a long time before coming into a real clinical and surgical practice. The purpose of this article is to briefly and simply review gene therapy, epigenetic therapy and stem cell therapy principles and prospects in the management of various urological disorders and to encourage standard urology centers' authorities in the Middle East countries to develop, share and improve their national experience which can serve genetic counseling and possible therapeutic management of their own patients to cope with the international revolution in this field


Article
Lower Ureteral Obstruction and Leakage in the FirstMonth Following Renal Transplantation

Authors: Usama N Rifat --- Usama S Alnasiri --- Ausama Saadi Abdul muhsin
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 47-52
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Transplantation has revolutionized treatment of end- stage renal disease (ESRD) by proving more cost effective than hemodialysis, with a lower morbidity and improved quality of life.
Objective: To evaluate the development of these complications in the first month postoperatively and correlate their development to the type of donation whether related or unrelated.
Methods: Fifty (50) patients aged (15-62) years, with a mean age (34.46 ± 12.4 SD) years with (ESRD), who underwent renal transplantation from September 2000 to October 2002, were followed-up for one month postoperatively clinically and by assessment of renal function tests, sonographic and Doppler examinations. Ureteral obstruction was considered in those patients who had allograft dysfunction, ultrasonic evidence of peritransplant collection, moderate-severe dilatation of upper urinary tract of transplanted kidney and postoperative ipsilateral or bilateral leg edema. Ureteral leakage was considered in those patients who had persistent drainage of urine with or without allograft dysfunction. Two patients were excluded from the follow-up due to death in the first 24-hour postoperatively.
Results: Six (6) patients (12.5% of cases) developed ureteral obstruction due to peri-ureteral fluid collection. In five patients the collection decreased and upper urinary tract dilatation improved gradually, as shown by ultrasound, on watchful waiting. One patient had surgical evacuation of a large hematoma. Four (4) patients (8.3% of cases) developed ureteral leakage. The leakage stopped in one patient after keeping the urethral catheter for a longer period. Three patients had surgical exploration due to persistent urinary leakage. Redo implantation of allograft ureter was done in two cases.
Development of ureteral complications was compared with the type of donation (related or unrelated). The comparison was not statistically significant.
Conclusions: The development of ureteral complications in not related to the type of donation. Extravesical ureteral anastamosis with the use of a stent is less likely to be associated with postoperative ureteral complications.
Key words: Renal transplantation, Extravesical ureteroneocystostomy


Article
Postoperative Urological Complications of Renal Transplantation; Al Karama Hospital Experience

Authors: Yousuf M. Alhallaq --- Shawqi Ghazala --- Mohammad Batal --- Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 4 Pages: 384-486
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Studying early post kidney transplant urological complication will provide a feed back evaluation for the surgical technique used and the way of complication management.OBJECTIVES:To study the postoperative urological complications and their management in the first 6 months following renal transplantation.METHODS:This is a retrospective study in which 123 patients with end stage renal disease (ESRD) underwent renal transplantation from January 2001 to October 2004 in Al Karama teaching hospital, Baghdad – Iraq. All the transplanted kidneys were from living donors. Direct matching between the serum of recipient and lymphocytes of the donor was negative. Extravesical ureteroneosystostomy was carried out using a stent across the anastomotic site. Postoperatively recipients were followed for 6 months by clinical and regular laboratory tests. Ultrasound and color Doppler examinations were performed when there was any evidence of decreased urinary output, allograft dysfunction, or clinical suspicion of rejection.RESULTS:In 123 patients aged 5 – 59 years with a mean age of 34 years, renal transplantation was carried out. Postoperative urological complications within the first 6 months were reported in 12 (9.75%) patients including urinary leakage in 6 (4.8%), ureteral obstruction in 3 (2.4%), and lymphocele in 3 (2.4%) patients.CONCLUSION:Major urological complications after renal transplantation contribute to patient morbidity and compromise graft function. Early diagnosis and treatment will avoid loss of the graft.


Article
Surgical Pathology Archive of Urology in Iraq; where Do we Stand?

Authors: Thűroff JW --- Stefan Biesterfeld --- Zitella Andrea --- Gontero Paolo --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 2 Pages: 191-195
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The international surgical centres recognised the progressive importance of archiving the written pathological data as well as the pathological materials such as paraffin blocks and slides using updated techniques to facilitate possible future retrieval of patients' pathological data and research plans.OBJECTIVE:To highlight the difficulties and pitfalls of the current pathological archive of urology in Iraq and demonstrate the characteristics of urology archives in advanced urology centres represented by Torino University (Italy) and Johannes Gutenberg University – Mainz (Germany). Recommendations are suggested to optimise our surgical pathology archive in general and urology archive in particular in the third millennium.CONCLUSION:Surgical pathology archive is an essential component of the daily surgical practice and research procedure. In Iraq clear legislation is needed to protect and regulate the surgical pathology archive including that of urology, as well as adequate economic funding to implement new international standards and techniques in this field.

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