Papers by Ahmed Abdel-bary
European Urology Supplements, 2016
Egyptian Journal of Medical Research
The goal of our study is to assess if the use of Storz professional image enhancement system (SPI... more The goal of our study is to assess if the use of Storz professional image enhancement system (SPIES) improve carcinoma in situ (CIS) detection. We conducted a prospective study on 35 patients of both sexes who have fulfilled the inclusion criteria from December 2019 to May 2020. Preoperatively, we collected urine samples from all patients amenable for cystoscopy for urine analysis and urine cytology. Contrast enhanced abdomen and pelvic computerized tomography (CT) was done for all patients. Under spinal anaesthesia white light cystoscopy (WLC) was done first, then SPIES camera was used by the same operator to detect any other suspicious lesions. TURBT was done for all lesions and specimens were sent for histopathology assessment. Our results showed that there was statistically significant difference between the SPIES and WLC regarding the number of lesions detected, as the total number of lesions detected by the SPIES was 37 lesions, three of these lesions were CIS, but the WLC detected only 27 lesions, no CIS was detected by WLC (p value 0.001). Pathological recurrence was confirmed in 6/35 (17.1%) patients at 3 months follow up.
International Journal of Urology, Aug 26, 2020
To compare percutaneous nephrostomy tube versus JJ stent as an initial urinary drainage procedure... more To compare percutaneous nephrostomy tube versus JJ stent as an initial urinary drainage procedure in kidney stone patients presenting with acute kidney injury. Methods: Between January 2017 and January 2019, 143 patients with acute kidney injury secondary to obstructive kidney stone were prospectively randomized into the percutaneous nephrostomy tube group (71 patients) and JJ stent group (72 patients
Egyptian Journal of Radiology and Nuclear Medicine, 2020
Background Carcinoma of the urinary bladder is a common malignant tumor of the urinary tract in b... more Background Carcinoma of the urinary bladder is a common malignant tumor of the urinary tract in both men and women. Proper management of the urinary bladder cancer depends on the stage of the lesions. The aim of this prospective study was to determine the accuracy of diffusion-weighted images in early detection of muscle invasion, local tumor staging of urinary bladder carcinoma, and to measure the correlation between apparent diffusion coefficient (ADC) and histologic grade. Sixty patients with urinary bladder mass lesions underwent transurethral cystoscopy and biopsy after MR imaging. Radical cystectomy was done for lesions infiltrating muscularis propria. Different MR image sets (T2WIs, DWIs images) were interpreted; ADC values of tumors were calculated. Results Kappa agreement was better in DWI than T2WI (Kappa was 0.756 and 0.484) and the overall agreement was (83.6% and 63.6%) among both respectively. Accuracy of DWI in diagnosis of tumor stages were 80%, 43%, 96%, and 100% wh...
Urology, 2015
To evaluate the efficacy of combined vaginal pelvic floor electrical stimulation (PFS) and local ... more To evaluate the efficacy of combined vaginal pelvic floor electrical stimulation (PFS) and local vaginal estrogen in treatment of female overactive bladder (OAB). This is a randomized controlled trial carried out on 315 perimenopausal females with OAB who were randomly allocated into 3 equal groups. Group A underwent PFS using vaginal probes twice weekly for 12 sessions. Group B received local vaginal estrogen, whereas group C received both PFS and local estrogen. All patients were evaluated by a voiding diary, quality-of-life questionnaire, vaginal examination, urine analysis, blood sugar, ultrasonography, and urodynamic study before and after therapy. Patients were followed up 1 week, 3, and 6 months post-therapy. The analyzed variables included day and night time frequency, incontinence episodes, urgency, quality of life, detrusor overactivity), and functional bladder capacity). Outcome measure was urge incontinence. Within each group, there was a statistically significant improvement in all variables after treatment. Improvement of urgency was better in group C than in groups A and B (P = .000, .009). Improvement of incontinence was better in groups A and C than in group B (P = .005, .004). Follow-up showed worsening of symptoms within 6 months in all groups except incontinence in group C. Vaginal PFS and estrogen found to be effective in treating OAB symptoms in perimenopausal females. Estrogen seems to augment the effect of PFS especially in the treatment of urgency incontinence and can delay its recurrence.
International Journal of Urology, 2020
To evaluate the efficacy and safety of ultraslow full‐power shock wave lithotripsy protocol in th... more To evaluate the efficacy and safety of ultraslow full‐power shock wave lithotripsy protocol in the management of high attenuation value upper ureteric stones compared with slow‐rate, power‐ramping shock wave lithotripsy.
The safety and efficacy of early second session shock wave lithotripsy (SWL) compared with laser ... more The safety and efficacy of early second session shock wave lithotripsy (SWL) compared with laser ureteroscopy (URS) for the treatment of upper ureteric stones were evaluated. From January to October 2019, 108 patients with upper ureteric stones (< 1.5 cm and ≤ 1000 Hounsfield unit (HU)) were randomized into SWL and laser URS groups. The second SWL session was performed within 48–72 h of the first session. Using plain abdominal X-ray and ultrasonography, patients were evaluated 48–72 h after the first SWL session and one week after the second and third SWL sessions or one week after URS. The procedure was considered a success when no additional procedures were needed to clear the stone. To determine the stone-free rate (SFR), noncontrast computed tomography of the urinary tract was performed three months postoperatively. In the SWL group, the success rates were 92.6% and 94.4% after the second and third sessions. The SFR was 96.2% in the laser URS group. The success rates were not...
International Journal of Urology, 2020
International Journal of Urology, 2019
To compare the efficacy and safety of ultraslow full‐power versus slow rate, power‐ramping shock ... more To compare the efficacy and safety of ultraslow full‐power versus slow rate, power‐ramping shock wave lithotripsy in the management of stones with a high attenuation value.
The Prostate, 2019
Our aim was to determine the factors predicting the outcome of intraprostatic injection of Botuli... more Our aim was to determine the factors predicting the outcome of intraprostatic injection of Botulinum Toxin‐A (BTX‐A) in the treatment of benign prostatic hyperplasia (BPH)‐induced lower urinary tract symptoms (LUTS) and to evaluate its efficacy and safety.
Introduction: To evaluate the effect of tamsulosin in improving urinary symptoms in patients with... more Introduction: To evaluate the effect of tamsulosin in improving urinary symptoms in patients with JJ ureteral stent in a prospective randomized placebo controlled crossover study. Material and methods: 100 patients were enrolled, divided into two groups each [50 patients]. Group A: received Tamsulosin 0.4 mg capsule once daily for two weeks. Group B: received placebo once daily for the same period of time. Then they came for the first visit for evaluation and switch to the other drug for another two weeks. Result: Comparing the two visits of each group, it was evident that incidence of LUTS were significantly lower with tamsulosin prescription.While comparing the first visit of first group [on tamsulosin] with the second visit of second group [on tamsulosin], there were no significant difference in the symptoms. Conclusions: Tamsulosin has a significant effect in improving JJ related symptoms disregarding its time of prescription.
Hypothesis / aims of study Feminizing genitoplasty entails vaginoplasty, clitoroplasty, introitop... more Hypothesis / aims of study Feminizing genitoplasty entails vaginoplasty, clitoroplasty, introitoplasty and labioplasty. Most of the literature focused on the cosmetic outcome of feminizing genitoplasty and its functional outcome in terms of clitoral sensation, adequacy of the vagina for sexual intercourse and orgasmic functions, with little reports on continence condition for patients who did vaginoplasty. Most vaginoplasties include surgical dissection in the pelvis and perineum close to pudendal nerves, external urinary sphincter or pelvic nerve fibers between bladder and vagina and/or disruption of bladder supportive pelvic fascia; which all can cause urinary incontinence. We evaluated the functional outcome of vaginoplasty in terms of continence condition with correlation to the age of the patient at surgery, severity of clinical condition and surgical procedure used.
African Journal of Urology
Background To evaluate and compare the recurrence rate of overactive bladder (OAB) symptoms after... more Background To evaluate and compare the recurrence rate of overactive bladder (OAB) symptoms after solifenacin treatment in patients who stop the drug suddenly versus those who gradually wean the drug after improvement of their condition. Methods Our study included 60 patients with idiopathic OAB and treated with solifenacin 5 mg twice daily for one month. After improvement of their condition, we divided the responders into two groups, group I stopped the drug suddenly, while group II underwent gradual weaning of the drug. Results The recurrence rate of symptoms of OAB was 33.3% and 60% after 1 and 3 months in patients who stopped the solifenacin suddenly after improvement of their symptoms, while it was 6.7% and 23.3% after 1 and 3 months in patients who gradually weaned solifenacin. Conclusion After the improvement of OAB symptoms, gradual weaning of solifenacin can help in decreasing the recurrence rate of symptoms.
African Journal of Urology
Objective: To study the beneficial effect of repeated sequential ejaculation in infertile men who... more Objective: To study the beneficial effect of repeated sequential ejaculation in infertile men who are candidates for assisted reproduction. Materials and methods: The study included a total of 237 infertile males attending our infertility and IVF center from January 2016 till December 2017. All patients were asked to provide two semen samples (1-3 h apart) after an abstinence period of 3-7 days. The two consecutive semen samples were analyzed according to the 2010 WHO criteria for semen analysis and their parameters were compared. Results: The mean age for our study group was 35.7 years (20-56 year). Of the 237 subjects, 157 showed oligoasthenozoospermia on their initial semen sample while the remaining 80 were azoospermic. A statistically significant difference was detected between the 2 sequential semen samples regarding all semen parameters except grade A motility. Despite the significant decrease in seminal volume by sequential sampling, there was a statistically significant increase in sperm concentration in the second ejaculate compared to the first (6.2 ± 0.61 versus 3.4 ± 0.52 million/mL, respectively, p = 0.016). The mean normal sperm morphology also demonstrated a significant increase (2.1 ± 1.8-5.1 ± 2.6%, p < 0.002). Mean progressive sperm motility increased from 1.13 ± 0.31 to 1.7 ± 0.31% (p = 0.010) on repeated sampling. Also, we were able to retrieve viable sperm in 15% of the azoospermic patients whom were known to be azoospermic on previous occasions.
World journal of urology, Jan 3, 2017
We aimed to compare the safety and efficacy of solifenacin versus trospium chloride and compare e... more We aimed to compare the safety and efficacy of solifenacin versus trospium chloride and compare each drug versus placebo regarding the relief of stent-related symptoms following uncomplicated ureteroscopic lithotripsy (URSL). In a prospective, randomized, double-blind study, 210 eligible patients who underwent URSL with double-J stent insertion were recruited and randomly assigned to either the first group, receiving solifenacin (10 mg), second group, receiving trospium chloride (60 mg), or the third group, receiving placebo (one tablet). All patients were kept on study medication once daily during the entire 2-week postoperative period. All subjects were asked to complete a brief-form questionnaire to assess the lower urinary symptoms, stent-related body pain and hematuria, preoperatively and 2 weeks postoperatively. There were no statistically significant differences among the study groups in terms of mean age, gender, anthropometric measurements, stone and stent criteria. The ove...
African Journal of Urology, 2012
Objective: To determine the efficacy, safety and urodynamic effects of the Martius flap and the a... more Objective: To determine the efficacy, safety and urodynamic effects of the Martius flap and the anterior vaginal wall sling in treating post-birth trauma in the form of urethra-vaginal fistula (UVF) associated with stress urinary incontinence (SUI). Patients and methods: Between July 2006 and August 2011, 19 patients underwent repair of UVF by interposition of a Martius flap and correction of associated SUI by a modified anterior vaginal wall sling. The procedure was carried out 3-17 (mean 7) months after post-birth trauma. Pre-operative evaluation consisted of history, voiding diary, physical examination, routine laboratory work-up, abdominopelvic ultrasonography, intravenous urography (IVU), and cystourethrography. The patients were followed up for a mean of 34 months. Follow-up included history, physical examination, urine analysis and pelvic ultrasonography for the assessment of residual urine. Urodynamic evaluation was performed at 3 months post-operatively. Results: None of the patients developed recurrence of UVF. SUI was corrected in 16 patients (84%). In the post-operative period, 3 patients (16%) complained of an overactive bladder (OAB) with urodynamic detrusor overactivity (DO) and an obstructed flow. These problems were managed successfully using anticholinergics and urethral dilation. Three patients (16%) complained of mild SUI, but refused further management. Within 3 years following the intervention, 3 patients complained of a recurrence of SUI which was managed successfully by a rectus sheath sling.
Arab Journal of Urology, 2014
To determine the utility of the urinary stone-attenuation value (SAV, in Hounsfield units, HU) fr... more To determine the utility of the urinary stone-attenuation value (SAV, in Hounsfield units, HU) from non-contrast computed tomography (NCCT) for predicting the success of extracorporeal shock-wave lithotripsy (ESWL). Patients and methods: The study included 305 patients with renal calculi of 630 mm and upper ureteric calculi of 620 mm. The SAV was measured using NCCT. Numerical variables were compared using a one-way analysis of variance with posthoc multiple two-group comparisons. Univariate and multivariate regression analysis models were used to test the preferential effect of the independent variable(s) on the success of ESWL. Results: Patients were grouped according to the SAV as group 1 (6500 HU, 81 patients), group 2 (501-1000 HU, 141 patients) and group 3 (>1000 HU, 83 patients). ESWL was successful in 253 patients (83%). The rate of stone clearance was 100% in group 1, 95.7% (135/141) in group 2 and 44.6% (37/83) in group 3 (P = 0.001). Conclusions: The SAV value is an independent predictor of the success of ESWL and a useful tool for planning stone treatment. Patients with a SAV P956 HU are not ideal candidates for ESWL. The inclusion criteria for ESWL of stones with a
Journal of endourology / Endourological Society, 2014
To compare the safety, efficacy, and complications of percutaneous nephrolithotomy (PCNL) in the ... more To compare the safety, efficacy, and complications of percutaneous nephrolithotomy (PCNL) in the oblique supine lithotomy position vs the prone position in a randomized comparative study. The study included 101 and 102 patients in the oblique supine lithotomy position and prone position, respectively. Inclusion criteria were renal and upper ureteral stones. Exclusion criteria were uncorrectable bleeding disorders, active urinary tract infection, and pregnancy. Both the groups were comparable regarding the male/female ratio, stone size, and site. No significant differences were found in terms of the stone-free rate, blood transfusion rate, and complication rates. Significant differences were reported in mean hemoglobin loss (-1.03 and -2.18 g/dL), mean operative time (86.16 and 111.7 minutes), and mean hospital stay (49.88 and 81.2 hours) in the supine and prone positions, respectively, and anesthesiological parameters (the mean blood pressure decreased by 2 and 14.06 mm Hg, the mean...
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Papers by Ahmed Abdel-bary