Ahmed Elabbady | Alexandria University (original) (raw)

Papers by Ahmed Elabbady

Ecancermedicalscience, Dec 8, 2016

Introduction: Urethral stricture is a common urological condition, resulting from trauma or vener... more Introduction: Urethral stricture is a common urological condition, resulting from trauma or venereal infections. The aim of our study was to report a rare case of squamous cell carcinoma of the penis and pseudoepitheliomatous hyperplasia (PEH) of scrotal skin, on top of repeatedly managed urethral stricture which was of unknown aetiology. Methods: A Medline search of publications studying the association of urethral stricture with penile cancer was done. Results: Two case reports were identified that described two occurrences, which were separated by a few months. Conclusion: Repeated management of urethral stricture with visual urethrotomy or urethral dilation may result in a chronic inflammatory status, predisposing to PEH and squamous cell carcinoma of the genital organs.

The Journal of Urology, Sep 1, 1998

Journal of Urology, 1994

Neural stimulation of the sacral nerve roots could become an acceptable and prom1smg modality in ... more Neural stimulation of the sacral nerve roots could become an acceptable and prom1smg modality in controlling variable forms of difficult voiding dysfunctions. A total of 50 patients who presented with various forms of voiding dysfunction underwent initial screening by percutaneous nerve evaluation of the 83 nerve root guided by movements of the levator ani and toes. Only 17 patients demonstrated a satisfactory response to percutaneous nerve evaluation and subsequent subchronic wire testing for 4 to 5 days, and they were eligible to enter the study. The studied patients (13 women and 4 men) were classified into 2 groups according to presentation. Group 1 included 8 patients who presented mainly with nonobstructive chronic urinary retention. All 8 patients were on intermittent self-catheterization except 1 with a suprapubic tube. The 9 patients in group 2 mainly presented with other forms of voiding dysfunctions, including pain (suprapubic and perineal), frequency and/or urgency. All patients were neurologically free, and had failed pharmacological and surgical attempts to correct the problems. In both groups radiological and ultrasound evaluations of the urinary tract as well as cystourethroscopy were within normal limits. Urodynamic studies were performed preoperatively and postoperatively. Unilateral 83 foramen implantation was performed on the selected side in all patients. Followup ranged from 3 to 52 months. All patients were followed preoperatively and postoperatively by voiding and itemized symptom score diary as well as a quality oflife questionnaire. Each symptom and question were given certain grades that reflect the severity or importance to the patient. The symptom scores and the quality of life questionnaires were analyzed preoperatively and postoperatively. In group 1 voided volume (expressed as a percentage of total bladder capacity) was significantly increased at 6 months (23 ± 7.5% preoperatively versus 81.9 ± 7.7% postoperatively, p <0.05) and, accordingly, residual volume (also expressed as a percentage of total bladder capacity) was significantly decreased. The maximum flow rate increased to 18.0 ± 2.6 ml. per second postoperatively compared to 7.8 ± 3.1 ml. per second preoperatively. The number of intermittent self-catheterizations per day decreased to 1.3 ± 0.8 compared to 4.2 ± 0.6 preoperatively (p <0.05). Uninhibited bladder contractions with vesicosphincteric dyssynergia disappeared in 1 patient, while they persisted in 1 for up to 6 months. In group 2 the average improvement in pain and difficulty to start voiding was 85%, frequency improved by 37%, urgency by 42%, and leaking episodes and number of diapers per day decreased by 50%. Uninhibited bladder contractions disappeared in 1 patient within 6 months. No significant difference was observed in any of the other urodynamic parameters. The impact of voiding problem on patient activities and quality of life was considerably improved. The appliance was well tolerated with no serious complication. The prosthesis was removed in 1 patient due to local pain at the site of the pulse generator. We believe that neural stimulation is a valid option in treating select cases of voiding dysfunction.

Archive of Clinical Cases

Renal cell carcinoma (RCC) frequently spreads to distant organs like the lung, lymph nodes, bone,... more Renal cell carcinoma (RCC) frequently spreads to distant organs like the lung, lymph nodes, bone, and liver. However, there have been some reports of RCC bladder metastasis. We present a case of a 61-year-old man presented with total painless gross hematuria. The patient had a history of right radical nephrectomy for papillary (type 2) RCC, high-grade, pT3a with negative surgical margins. There was no evidence of metastases on 6-month surveillance CT. After one-year post-operation, at this current admission, the cystoscopy discovered a solid bladder mass away from the trigone in the right lateral bladder wall. The resected bladder mass was metastatic papillary RCC with PAX-8 positive but GATA-3 negative on immunostaining. A positron emission tomography scan confirmed multiple lung, liver, and osseous metastases. This case report can highlight the importance of having bladder metastasis in RCC mind, although rare, and may necessitate the surveillance measures like urine analysis at m...

British Journal of Urology, 1995

Objective To determine the effect of diabetes mellitus (DM) on erectile function and evaluate the... more Objective To determine the effect of diabetes mellitus (DM) on erectile function and evaluate the levels of nitric oxide synthetase (NOS) activity in streptozotocininduced diabetic rats. Materials and methods Rats were studied at 9 weeks and 1 4 weeks after the induction of DM by streptozotocin and compared with untreated control rats. Erectile potency was assessed physiologically by testing and recording mating behaviour. NOS activity was assayed in penile tissues and major pelvic ganglia (MPG) by conversion of [3H] L-arginine to [3H] citrulline. Histological, ultrastructural and immunohistochemical studies of penile tissues were performed in similar groups of rats. Results Diabetes mellitus adversely and significantly degraded all parameters of mating behaviour, thus indicating defective erectile potency. However, NOS activities in penile tissues from both groups of diabetic rats were significantly higher than those in controls (P<0.01). In MPG, NOS activities were not significantly different between diabetic and control rats (P> 0.05). Histological, ultrastructural and immunohistochemical studies of penile tissues revealed no significant differences between control and diabetic rats, indicating an intact effector organ (smooth muscles) in rats with up, to 14 weeks of DM. Conclusion The impotence frequently observed in diabetic subjects would suggest that despite the increase in NOS activity in the penis, the pharmacological action of nitric oxide is impaired.

Urology, 1995

Objectives. Diabetes mellitus (DM) is an important cause of organic impotence. It is estimated th... more Objectives. Diabetes mellitus (DM) is an important cause of organic impotence. It is estimated that 35% to 75% of diabetic patients are impotent. In the present study we investigated the effect of experimentally induced diabetes (streptozocin 60 mg/kg, intraperitoneally, for 9 weeks) on sexual behavior and compared it to the apomorphine (APO) bioassay test. Methods. Libido, genital reflex excitability, and penile competence as measured by different parameters of mating behavior were reduced with DM (P c 0.05 versus control for each parameter). Results. Of 17 diabetic rats, 53% (9 rats) experienced positive mating behavior (either intromission or ejaculation) compared with 82.4% (14 rats) positive response to the APO bioassay test. Moreover, combined apomorphine injection and mating sexual testing in diabetic rats that achieved intromission but not ejaculation or those that did not achieve intromission in the initial mating, considerably improved the performance of these rats. Conclusions. We suggest that the APO test alone or, even better, combined APO injection and sexual testing are superior in eliciting maximum erectile capabilities of the diabetic rats than mating testing alone.

The Journal of Urology, 2011

The Journal of Urology, 1998

Purpose: A new modification for urinary diversion following cystectomy is presented. Materials an... more Purpose: A new modification for urinary diversion following cystectomy is presented. Materials and Methods: A total of 20 patients with bladder cancer who were treated with radical cystectomy underwent urinary diversion using a new technique. The sigmoid colon is dismembered approximately 30 cm. proximal t o the peritoneal reflection and detubularized by anterior incision in its proximal two-thirds. Ureters are reimplanted by nipple or submucosal tunnel technique. The rectosigmoid sheet is folded on itself and closed to form a rectosigmoid pouch. The terminal colon is reanastomosed end to side to the anterior surface of the rectum just proximal to the peritoneal reflection. Results: During 4 to 36 months of followup all patients had complete daytime continence and only 2 had minimal nighttime fecal incontinence. The average daytime and nighttime evacuation frequency was 6 and 2 times, respectively. All patients were able to withhold voiding for an average of 30 minutes after maximum desire to void. Eight patients voided clear urine separated from stools in most instances while 12 voided mixtures of urine and stools. Postoperative excretory urogram revealed improvement of previously dilated systems in 8 renal units, deterioration in 4 and stable renal morphology in 28. An ascending pouchogram demonstrated good filling capacity in all cases. Urodynamic studies revealed low basic pressure within the pouch (mean 9.7 ? 1.8 cm. water) with high compliance (mean 32.3 5 10). Conclusions: This type of diversion provides a low pressure urine reservoir with satisfactory early results of preservation of the upper urinary tract and evacuation pattern.

Türk Üroloji Dergisi/Turkish Journal of Urology, 2021

Objective: This pilot study aimed to objectively assess the osteoporotic effect caused by androge... more Objective: This pilot study aimed to objectively assess the osteoporotic effect caused by androgen deprivation therapy (ADT) in patients with prostate cancer and compare this effect in surgical versus medical castration, specifically with luteinizing hormone-releasing hormone (LHRH) antagonists. Material and methods: The study included 60 patients with metastatic prostate adenocarcinoma treated with either bilateral orchidectomy (group I) or LHRH antagonist (Degarelix) injection (group II). The patients had a baseline bone mineral density (BMD) assessment before the start of ADT using dual energy X-ray absorptiometry (DEXA) scan and then follow-up assessment after 6 months. BMD was measured at the spine (lumbar vertebrae L2-L4), femur (total), and forearm (one-third radius). Results: Group I included 33 patients and group II 27 patients. Both the groups showed significant reduction in BMD at the spine and femur after 6 months, whereas the forearm did not show a significant reduction. Spine BMD showed 5.9%±2.6% and 4.7%±2.6% reduction whereas the femur BMD showed 6%±7.4% and 6%±4.7% reduction in the orchiectomy and the Degarelix groups, respectively. There was no statistically significant difference between the groups at the 3 measured sites. Conclusion: Both surgical castration and LHRH antagonists were associated with significant accelerated osteoporotic effect at the spine and femur after 6 months without difference between both the methods. Assessment of osteoporotic risk together with preventive or management measures should be started early during ADT.

Poster: "ECR 2015 / C-0590 / Multi-parameteric MRI and PI-RADS Scoring system: Our new incep... more Poster: "ECR 2015 / C-0590 / Multi-parameteric MRI and PI-RADS Scoring system: Our new inception in clinical practice with evaluation of the diagnostic performance of different Score combinations" by: "M. H. K. Khalifa, A. Hafez, K. El Noueam, A. Elabbady, A. Ramadan; Alexandria/EG"

International Journal of Health Sciences, 2016

Objective: There is a noticeable increase in the presentation of different types of urological ma... more Objective: There is a noticeable increase in the presentation of different types of urological malignancies at a younger age of presentation, in our institution. The objective of our study was to investigate cases presented with renal cell carcinoma, managed in the past 10 years for any possible epidemiological and cancer characteristics changes. Methodology: Retrospective data collection for cases managed by our institution in the time period (2002-2012) was done. We included patients with complete data and pathologically proven renal cell carcinoma at final diagnosis. Results: Complete data could be retrieved for 334 patients. The mean age of cases was 43.5 years, with 279 (83%), 200 (60%) and 128 (38%) of patients younger than 60, 50 and 40 years respectively. Males and females involvement were 191 (57%) and 143 (43%) respectively. By histopathology, 200 (60%) of patients had clear cell (CC) RCC and 134 (40%) patients had non-clear cell type (papillary or chromophobe). The mean tumor size was 10.9 cm and partial nephrectomy was applied for 16% of all the cases, including 65% for cases with tumor size less than 4 cm. Conclusion: There is a marked increase in the prevalence of renal cell carcinoma in the past 10 years, among younger age group, with higher rate for involvement of female gender. RCC is tending to present with large tumor size and more prevalence of non-clear cell histopathology. The use of partial nephrectomy is accepted for patients presented with renal mass and can safely challenge larger sized tumors.

Clinical Genitourinary Cancer, 2019

outcomes of open retrograde extra-peritoneal versus intra-corporeal robot assisted radical cysto-... more outcomes of open retrograde extra-peritoneal versus intra-corporeal robot assisted radical cysto-prostatectomy in males: A dual center comparative study,

Arab Journal of Urology, 2019

Objective: To compare bilateral orchidectomy, as the classical 'gold standard' androgendeprivatio... more Objective: To compare bilateral orchidectomy, as the classical 'gold standard' androgendeprivation therapy (ADT), and ADT using a luteinising hormone-releasing hormone (LHRH) antagonist (degarelix) for the treatment of metastatic prostate cancer regarding their shortterm biochemical efficacy, testosterone castrate level, tolerability, and effect on health-related quality of life (HRQoL). Patients and methods: A total of 60 patients with newly diagnosed metastatic prostate cancer were managed by either bilateral orchidectomy or degarelix injection as ADT. Both groups were compared according to their prostate-specific antigen (PSA) nadir and testosterone level at the 6-month follow-up. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) after 12 months. Results: Bilateral orchidectomy and degarelix showed comparable results for PSA reduction, but there was a statistically significantly lower castrate level of testosterone in the bilateral orchidectomy group. Using the EROTC QLQC-30, bilateral orchidectomy was associated with better HRQoL, better global health status, and better functional status. Conclusion: Bilateral orchidectomy resulted in lower castrate levels of testosterone, which may be associated with better disease control, together with better HRQoL and general health status compared to LHRH antagonist (degarelix). These results indicate that we should consider revisiting bilateral orchidectomy as a valuable and effective treatment option for ADT.

SN Comprehensive Clinical Medicine, 2019

The aim of our work was to show our new simple and reproducible technique of reconstructing the v... more The aim of our work was to show our new simple and reproducible technique of reconstructing the valve mechanism of continent urinary reservoir, as a possible safe alternative or additive to other techniques. Single 50 cm of ileum is isolate and folded into 3 segments; the afferent limb of which will be the one used for the valve mechanism and used for patients' catheterization. Double-walled intussusception was used to create the valve mechanism. Our technique was easy and reproducible with no immediate postoperative complications. The pouch could be easily catheterizable by the patients with no daytime leak and minimal or no night time leak. Double-walled intussuscepted ileum is a safe and reproducible technique to create the valve mechanism of continent urinary reservoir.

Arab Journal of Urology, 2017

were not taken. The remaining 37 patients had T1, grade 2-3 disease and none of them had evident ... more were not taken. The remaining 37 patients had T1, grade 2-3 disease and none of them had evident residual disease at the site of tumour resection. Conclusion: Re-staging TURBT could be safely omitted for select groups of patients. An experienced surgeon and teamwork, together with an extended TURBT can accurately achieve complete tumour resection, with accurate tumour staging, on initial resection.

Prostate International, 2016

Background: To examine the effects of type 2 diabetes mellitus (DM) on the variables associated w... more Background: To examine the effects of type 2 diabetes mellitus (DM) on the variables associated with prostatic growth including serum prostate-specific antigen (PSA), serum testosterone, and prostate volume, and to correlate these variables with the duration of diabetes treatment. Methods: Our study was conducted over 3 months recruiting 501 men aged ! 55 years; of whom 207 had type 2 DM. Exclusion criteria were active urinary tract infection, suspicious rectal examination, urologic cancer, end-organ damage, and recent urological manipulations. Serum PSA and serum testosterone were measured. Prostate volume was determined by abdominal ultrasonography using an ellipsoid formula. Results: The mean patient age was 60.21 ± 5.95 years. The mean PSA, testosterone, and prostate volume for diabetic men were 2.3 ng/mL, 3 ng/mL, and 56 g, respectively. The corresponding values for nondiabetic men were 3.5 ng/mL, 4 ng/mL, and 51 g, respectively (P ¼ 0.001, P ¼ 0.001, P ¼ 0.03, respectively). The mean PSA density was 0.049 ± 0.043 ng/mL/cm 3 in diabetics versus 0.080 ± 0.056 ng/mL/cm 3 in nondiabetics (P < 0.001). Conclusion: Type 2 DM is significantly associated with lower serum PSA and testosterone, and larger prostate volume.

European Urology Supplements, 2005

Central European Journal of Urology, 2014

Introduction Prostate cancer is a common health problem that in the majority of cases starts to d... more Introduction Prostate cancer is a common health problem that in the majority of cases starts to develop at the age of 50 years, reaching its peak at 60-70 years of age. A variation in its incidence and prevalence exists between western, Asian and Arabic populations. The aim of our work was to report the pattern of prostate cancer presentation in Alexandria University that as a tertiary referral center provides care for uro-oncology cases. Material and methods Data collection for all patients diagnosed with prostate cancer at Alexandria University in Egypt through the year 2012 was done. Results The mean age of the patients was 67. Mean serum total PSA, prostate volume and PSAd were 149 ng/ml, 63 grams and 3.1 ng/ml/gm respectively. 25% of patients were asymptomatic diagnosed accidentally during screening for prostate cancer. The remaining group was presenting with LUTS, including 23 patients who presented initially with back pain. Conclusions Egyptian men with prostate cancer have a markedly high PSA density and Gleason grade at diagnosis.