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COMPARATIVE STUDY BETWEEN ORCHIDECTOMY ALONE AND ORCHIDECTOMY WITH HORMONAL THERAPY (COMBINED ANDROGEN BLOCKADE) FOR PATIENTS WITH ADVANCED CARCINOMA OF THE PROSTATE

Author: Firas Shakir Attar
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 95-101
Publisher: Basrah University جامعة البصرة

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Abstract

Worldwide, prostate cancer incidence and mortality vary significantly between countries andregions and are highest in African American men. In the USA, prostate cancer is the mostcommon visceral malignant neoplasm in men and the second leading cause of cancer-relateddeaths. Bilateral orchidectomy with or without hormonal therapy are the main treatment optionsfor patients with advanced prostate carcinoma.The objective of this study is to compare the efficacy of orchidectomy alone and orchidectomyplus flutamide in treating patients with advanced carcinoma of prostate.The study was conducted from June 2006 to March 2010. Thirty six patients were included inthe study. The inclusion criteria were histologically documented carcinoma prostate along withdistant metastasis (stage D2). Following orchidectomy, the patients were stratified into twogroups. Group I had patients treated with orchidectomy alone (17 patients) and Group II thosetreated with orchidectomy plus flutamide therapy (19 patients). Follow up of patients was donefor the next two years following initiation of therapy.The maximum percentage change in PSA was found in the first three months afterorchidectomy. The mean percentage change at two years, in the two groups was 65% and 62%respectively. Based on the evaluation of response, there was no significant difference inresponse rate between the two treatment groups.In conclusion, addition of antiandrogen like flutamide to orchidectomy has not given anysignificant benefit to effect the PSA changes as well the survival in advanced carcinoma ofprostate. Hence, routine use of additional antiandrogen to orchidectomy is not advisable.

Keywords

ORCHIDECTOMY


Article
How to Reduce Time Delays in Presentation and Treatment of Testicular Torsion; the Role of Public and Practitioners Education

Author: Saad Dakhil Farhan Daraji
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 499-503
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Testicular torsion (TT) requires prompt diagnosis and treatment to avoid testicular Loss. Most studies have focused on the ideal work up to rule TT out in cases of acute scrotum. A long response time to the scrotal pain was related to high orchidectomy rate during surgery for acute torsion.OBJECTIVE:We attempted here to highlight the causes behind high orchidectomy rate during the surgery for testicular torsion and the advices to decrease this problem.PATIENTS AND METHODS: Surgical exploration which was done for suspected testicular torsion in 50 consecutive males with their age (range 1-20 years. All patients were evaluated with detailed history, physical examination and Basic Laparotory investigations, some patients underwent scrotal ultrasound scan with color-Doppler preoperatively when possible. Patient age, site of pain, duration of symptoms, ultrasound finding, approximate time from admission to surgery, operative findings, and type of the operation and causes of delay for orchidectomy group were recorded.RESULTS: Intra operative Testicular torsion was documented in 36 patients, orchidectomy and orchidopexy was performed equally, Delays to reach the hospital for more than 4 hours after the onset of pain significantly associated with increase the risk of orchidectomy .The risk of orchidectomy significantly increased with increased patient age. Parents neglect appear the most important cause for small age group while self ignorance, social fear and false medical advices for older ages.CONCLUSION: A long response time to the scrotal pain and a high orchidectomy rate were exposed by this study. This was thought to be due to ignorance, which could be eliminated through public education.


Article
Effect Of Castration Methods On Gene Expression Of Androgen Receptor Gene In Skeletal Muscles Of Awassi Sheep
تأثير طريقة الاخصاء على التعبير الجيني لجين مستقبلات الاندروجين في العضلات الهيكلية لأغنام العواسي

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Abstract

The effect of castration on skeletal muscle development in awassi sheep were studied at the gene expressed for androgen receptor. The result showed that live weigh for epididymectomy rams was heavier than control and orchidectomy rams, respectively. There was significant difference (p < .05). By using the (2^ΔCT) with reference gene method, the findings documented that there was higher up-regulated in mRNA expression for androgen receptor in splenius muscles cells for epididymectomy rams compare with interact rams. In contrast, there was down-regulated for mRNA expression for androgen receptor cells for orchidectomy rams. In conclusion the continuous producing of testes hormones lead to growth of skeletal muscles of wether's significant increase the growth of skeletal muscles of wethers by epididymectomy companied with other rams.

تم دراسة تأثير نوع الأخصاء على تطور العضلات الهيكلية في اغنام العواسي من خلال تعيين التعبير الجيني لجين مستقبلات الاندروجين, حيث أظهرت النتائج بان الوزن الحي للاكباش المخصية بطريقة ازالة جزء من البربخ كان وزنها اعلى من الاكباش في مجموعة السيطرة والاكباش المخصية بطريقة ازالة الخصية حيث انه كات هناك فرق معنوي (p < .05)كما واثبتت الدراسة بان هناك مستوى عالي للتعبير الجيني للحامض النووي الرايبوزي الناقل لمستقبلات الاندروجين في خلايا العضلة العنقية للاكباش المخصية بطريقة ازالة جزء من البربخ مقارنة مع الاكباش السليمة على العكس من ذلك فأن النتائج اظهرت أن التعبير الجيني لجين مستقبلات الاندروجين كان واطئ لنفس الخلايا في الاكباش المخصية بطريقة ازالة الخصية, من هنا نستنتج بأن استمرارية الخصية بانتاج الهرمونات يؤدي الى زيادة معنوية في نمو العضلات الهيكلية للاكباش المخصية بطريقة ازالة جزء من البربخ مقارنة مع بقية الاكباش الاخرى.

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