Urology Journal[JOURNAL]
Sun
200 papers
National Lifetime Prevalence and Demographic Factors of Urolithiasis in Iran.
Basiri A, Kashi AH, Salehi Omran H … +5 more , Borumandnia N, Golshan S, Narouie B, Hajebrahimi S, Mombeini H
Urol J · 2023 Feb · PMID 36744405 · Publisher ↗
To estimate the current lifetime prevalence of urolithiasis at the national level in Iran and investigate the potential influential demographic factors in different geographical areas. Materials and methods: An epidemi...
To estimate the current lifetime prevalence of urolithiasis at the national level in Iran and investigate the potential influential demographic factors in different geographical areas. Materials and methods: An epidemiological study was conducted between October 2020 and November 2022 in 31 provinces of Iran at the national level. Data was obtained through telephone interviews with households. Items in the interview included questions about the current and past episodes of urolithiasis, family history of urolithiasis, and demographic and environmental variables of potential interest in urolithiasis. Results: A total of 44186 participants were investigated from 31 provinces of Iran. The overall percentage of those with lifetime prevalence of urolithiasis was 6.6%, including 7.9% for males and 5.3% for females (P<.001). In addition, with regard to the residential location, men were 53% (7.9% vs. 5.2%) more susceptible than women to urinary stones in urban areas and 36% (7.8% vs. 5.7%) more susceptible in rural areas. Out of 31 provinces, the Sistan-baluchistan province had the highest lifetime prevalence (15.6%) and the Golestan province had the lowest (2.1%). The lifetime prevalence of urolithiasis in the rural areas was 6.8% versus 6.5% in the urban areas (P=.29). Regarding age differentiation, the lifetime urolithiasis prevalence has increased up to the age of 70 years. In addition, the most prominent increase in the lifetime prevalence was observed in the age range of 20 to 60 years (from 0.9% to 11.8%). The ethnicity with the highest lifetime prevalence rate of urolithiasis was the Baluch ethnicity (18%). Conclusion: generally, 6.6% of Iranian population suffers from urinary stones during their lifetime. Urolithiasis prevalence has increased 0.06% annually compared to the latest national study that took place 15 years ago. This increasing trend seems to be less prominent than other countries. According to our findings, urinary stones are more prevalent in men than in women and in the third to sixth decade of life regardless of gender. Baluch ethnicity is associated with the highest lifetime prevalence rate of urolithiasis and there is no significant difference between rural and urban areas. However, the ratio of male to female risk of urolithiasis is higher in urban areas compared to rural areas.
Does the Prone Position During the Shockwave Lithotripsy of Kidney Stones Improve the Stone-Free Rate? Results from a Randomized Clinical Trial.
Mohammadi A, Oliveira Reis L, Khajavi A … +2 more , Zareian Baghdadabad L, Aghamir SMK
Urol J · 2023 May · PMID 36695211 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the impact of the skin-to-stone distance in the supine and prone positions on the outcome of shockwave lithotripsy of kidney stones. METHODS: In a prospective randomized clinical t...
OBJECTIVE: This study aimed to evaluate the impact of the skin-to-stone distance in the supine and prone positions on the outcome of shockwave lithotripsy of kidney stones. METHODS: In a prospective randomized clinical trial study, 81 patients that candidates for shockwave lithotripsy (SWL) of kidney stones were randomly divided into two groups to perform SWL in the prone position (40 patients) or conventional supine position (41 patients). Demographic data, stone characteristics, skin-to-stone distances (SSD) in CT, SSD during SWL with an ultrasound probe in prone and supine positions, total shock wave rate, total energy (kilovolt), visual analog scale (VAS), complications (Clavien-Dindo scale system), and SWL success rate evaluated in two intervention and control groups. All statistical analysis was performed by independent T-test, Chi-Square test, Fisher exact test, paired T-test, and SPSS 22.0 software for windows. RESULTS: There were no significant differences between demographic characteristics, SWL sessions, the median number of SWLs, the median SWL time, median total energy, VAS, and complications in the two groups. The SFR was numerically higher in the prone SWL group than in the supine SWL group (80% vs. 73.2%) but was not significantly different (P = 0.468). Also, the inline ultrasound (US) measuring of the SSD in the prone position was significantly different from US SSD measures in the supine position in the two groups (Ps = 0.001 and 0.024). The mean SSD was lower in the US measurement during the SWL process that measured in supine and prone position than the CT measurement (73.5 vs. 101.1), which means the routine SSD measured by CT scan is higher than SSD in the US probe measurement during SWL. CONCLUSION: The prone position SWL modification could be effective in obese patients with a BMI of more than 30 and increase the stone-free rate (P=0.039) with a similar safety profile and comparable VAS score. It seems the SSD measured by the ultrasound is a more accurate dynamic measurement during the SWL and needs to define the SSD according to the SSD calculation by the US probe of the therapy head. SFR was numerically higher in the prone compared with the supine treatment groups.
Prospective Investigation on the Paternity Intention and Affecting Factors in 84 Post-treatment Testicular Cancer Patients.
Yenigurbuz S, Ediz C, Kizilkan YE … +6 more , Akan S, Pehlivanoglu M, Temel MC, Tavukcu HH, Erturk T, Yilmaz O
Urol J · 2023 May · PMID 36694915 · Publisher ↗
PURPOSE: to investigate the factors affecting post-treatment paternity intention in patients followed up after the diagnosis of testicular cancer and to make recommendations for the early postoperative period based on th...
PURPOSE: to investigate the factors affecting post-treatment paternity intention in patients followed up after the diagnosis of testicular cancer and to make recommendations for the early postoperative period based on the identified factors. MATERIALS AND METHODS: This prospective descriptive study included total 185 patients who presented to our outpatient clinic between February 2000 and July 2020 who had radical orchiectomy due to suspected testicular cancer based on physical examination and other assessments. Contact information was found for 88 of 185 patients, and accordingly, the patients were reached by one-to-one phone calls. Upon literature review, a questionnaire consisting of 10 previously validated items was developed by the researchers. The patients were compared by separating them into two groups composed of patients with (Group 1) and without (Group 2) paternity intention. RESULTS: A total of 84 patients participated in the study, and the participation rate was 95.5%. It was found that 19 of 32 (38%) patients with paternity intention already had children. Only 21 (40%) of 52 patients without paternity intention were married. The mean age was 26.65 (18-39) years in Group 1, while it was 28.73 (19-45) years in Group 2. Tumor volume and serum tumor markers were higher in Group 2 than in Group 1. Parameters such as testicular side in which the tumor was located, smoking status, undescended testis history, and postsurgical chemotherapy history were not statistically significant difference between the two groups. CONCLUSION: The major findings included that the young aged, unmarried, and serious testicular cancer (Tumor volume and serum tumor markers were higher) can be affecting factors for testicular cancer patients' paternity intention. Early psychological counseling about paternity may be useful for testicular cancer patients.
Predictor Factors of Female Sexual Distress in a Population-Based Sample of Iranian Women: a Path Analysis.
Bayat F, Ozgoli G, Mahmoodi Z … +1 more , Nasiri M
Urol J · 2023 May · PMID 36683531 · Publisher ↗
PURPOSE: To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis. MATERIALS AND METHODS: Thi...
PURPOSE: To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis. MATERIALS AND METHODS: This study was conducted in two stages. Initially we obtained the FSD predictor factor's conceptual model through a literature review and expert panel. In the Second stage, a population-based cross-sectional study on 207 non-pregnant and married women (without any age restriction) in Zanjan, Iran was conducted. FSDs-R, FSFI-6, DASS-21, and GEMREL Standard questionnaires and the demographic researcher-made questionnaire were used in this study. The data undergone path analysis based on the initial conceptual model. RESULTS: Sexual function (SF) had the strongest relationship with FSD from the direct path (β = -.49) and overall effect (β = -.58). The highest indirect effect belonged to depression-anxiety-stress level (β = .284) mediated by SF (β = -.42) and relationships satisfaction with spouse (β = -.20). Age difference (β = -.13) and relationships satisfaction with spouse (β = -.19) had only a direct effect on FSD. Marriage Duration had only indirect effect on FSD through mediating role on SF (β = -.26) and depression-anxiety-stress level (β = -.15). CONCLUSION: Among the predictor factors investigated in this study, sexual dysfunction is the most important predictor of FSD. In addition; men older than their spouses, longer marriage duration, relationship dissatisfaction with the spouse and higher rate of depression-anxiety-stress have positive correlation with SD. Therefore, we should offer a combination of the mentioned factors in providing care for women with SD.
Study of Temperature Changes around Fibres in Super Pulse Thulium Fibre Laser in Vitro Lithotripsy.
Tianfu D, Bo X, Xue Z … +3 more , Lei L, Chaoyue J, Jianxing L
Urol J · 2023 Feb · PMID 36609817 · Publisher ↗
PURPOSE: To investigate temperature changes around the fibres of the super pulse thulium fibre laser (SP-TFL) during in vitro lithotripsy. MATERIALS AND METHODS: Stones were placed in the in vitro model. The laser was co...
PURPOSE: To investigate temperature changes around the fibres of the super pulse thulium fibre laser (SP-TFL) during in vitro lithotripsy. MATERIALS AND METHODS: Stones were placed in the in vitro model. The laser was continuously excited for 180 s; the probe was positioned 5 mm around the fibre; the laser power was set at 10, 15, 20, 25, and 30 W; and the irrigation rate was set at 0, 15, 25, 35 ml/min, using a domestic SP-TFL. The temperature variations around the fibre under different power settings and different irrigation rates were compared. RESULTS: Without irrigation, the temperature around the fibre rapidly reached the safety threshold of 43℃ at 24 s. At irrigation rate 15 ml/min and laser power <15 W, the temperature around the fibre was <43℃. Once the laser power increased to ≥20 W, the temperature around the fibre increased to >43℃ at its lowest plateau. At irrigation rate 25 ml/min and laser power ≤25 W, the temperature around the fibre was <43℃. At irrigation rate 35 ml/min and laser power <30 W, the fibre temperature was <43℃. When laser power was ≥30 W, the fibre temperature was >43℃. CONCLUSION: In extracorporeal ureteroscope SP-TFL lithotripsy, when the laser power is ≤15 W, ≤25 W, and ≤30 W, the irrigation rate should be maintained at ≥15 ml/min, ≥25 ml/min, and ≥35 ml/min, respectively.
Cribriform Pattern of The Prostate Adenocarcinoma: Sensitivity of Multiparametric MRI.
Tuna MB, Arslan A, Kök YB … +8 more , Doganca T, Argun OB, Tufek I, Pirdal BZ, Saglican Y, Obek C, Karaarslan E, Kural AR
Urol J · 2022 Dec · PMID 36528799 · Publisher ↗
BACKGROUND: The aim of this study was to investigate the diagnostic performance of mpMRI for detecting cribriform pattern prostate cancer. MATERIALS AND METHODS: This study retrospectively enrolled 33 patients who were r...
BACKGROUND: The aim of this study was to investigate the diagnostic performance of mpMRI for detecting cribriform pattern prostate cancer. MATERIALS AND METHODS: This study retrospectively enrolled 33 patients who were reported cribriform pattern prostate cancer at final pathology. The localization, grade and volumetric properties of the dominant tumors and areas with cribriform pattern at the final pathological specimens were recorded and the diagnostic value of mpMRI was evaluated on the basis of the cribriform morphology detection rate. It was analyzed using Wilcoxon test, the Chi-square test and Fisher's Exact test. The significance level (P-value) was set at .05 in all statistical analyses. RESULTS: A total of 58 prostate cancer foci were (38 cribriform, 20 non-cribriform foci) identified on the final pathology. mpMRI identified 36 of the 38 cribriform morphology harboring tumor foci with a sensitivity of 94.7% (95% confidence interval 82.7-98.5%). In 17 of the 33 patients mpMRI detected single lesion and for these lesions; mpMRI identified cribriform morphology positive areas precisely in 15 patients with significantly low ADCmean and ADCmin values compared to the non-cribriform cancer areas within the primary index lesion (P < .001). For the remaining 16 patients with multiple lesions; all of the tumor foci that harboring cribriform morphology were identified by mpMRI but in none of them any ADCmean and ADCmin value divergence were detected between the cribriform and non-cribriform pattern tumor foci within the primary index lesion. CONCLUSION: Cribiform pattern should be considered in single lesions with an area of lower ADC value on mpMRI.
The Effect of Autologous Temporal Fascia Graft on Erectile Function and Psychometric Properties in Peyronie's Disease Patients.
Ulubay M, Akdeniz E
Urol J · 2022 Dec · PMID 36528798 · Publisher ↗
PURPOSE: The aim of this study is to evaluate the results of the surgical technique used by the authors on Peyronie's disease (PD) patients who underwent surgical treatment with a temporalis fascia autograft. MATERIALS A...
PURPOSE: The aim of this study is to evaluate the results of the surgical technique used by the authors on Peyronie's disease (PD) patients who underwent surgical treatment with a temporalis fascia autograft. MATERIALS AND METHODS: Patients with normal erectile functions and > 60° penile curvature who underwent surgical treatment with temporalis fascia autografts were included in this retrospective study. The patients were recruited between January 2017 and May 2021. Preoperative assessment included the International Index of Erectile Function erectile function (IIEF-EF) score, penile duplex and penile curvature angle measurement. Postoperative self-reports, penile deformity, IIEF-EF scores and the Patient Global Impression of Improvement (PGI-I) questionnaire were assessed every three months. RESULTS: Twenty-two patients with a mean age of 52.09 ± 6.61 years were included in the study, and no major complications developed in any case. Postoperative assessment revealed curvature relapse in seven patients (31.8%), although no intervention was performed on five patients with < 20° curvature. Six patients experienced a postoperative decrease in penile length and erectile function was completely preserved in 68.18%. The mean level of satisfaction with surgery measured using the visual analogue scale was 79.13 ± 21.23. CONCLUSION: The temporalis fascia graft, thin and durable graft, is a highly successful therapeutic option in the surgical treatment of PD patients and a good alternative in terms of its cosmetic and functional results.
Alternative Medical Interventions Versus Conventional Treatment of Renal Colic: An Updated Systematic Review and Network Meta-Analysis.
Seghatoleslami G, Sanie Jahromi MS, Farzaneh R … +11 more , Rahsepar S, Malekshoar M, Vatankhah M, Akhavan R, Abbasi B, Akhavan H, Abiri S, Taheri L, Kalani N, Foroughian M, Hakemi A
Urol J · 2022 Dec · PMID 36475393 · Publisher ↗
PURPOSE: To systematically review the recent alternative medical interventions on renal colic pain and compare their efficiency with conventional treatments. MATERIALS AND METHODS: This was a systematic review and networ...
PURPOSE: To systematically review the recent alternative medical interventions on renal colic pain and compare their efficiency with conventional treatments. MATERIALS AND METHODS: This was a systematic review and network meta-analysis (NMA) study, based on the PRISMA guidelines on online databases of PubMed, Scopus, and web of science. We quarried these databases with relevant keywords for clinical trial studies that aimed at reducing renal colic pain in patients refereeing to the ED from after January 2011 to February 2022. Randomized clinical trials that used the Visual Analogue Scale (VAS) for assessment of renal colic pain before and after medical interventions in adult patients were included in this study. NMA was conducted based on the continuous values of the mean difference of the pain after 30 and 60 minutes of the medication administration. RESULTS: Twenty-four studies that were meeting the inclusion criteria were included in our review with 2724 adult participants who were mostly male. Study arms included conventional medications (NSAID, Opioid, paracetamol), ketamine, MgSo4, desmopressin, and lidocaine. Based on the qualitative synthesis, ten studies (41.7%) did not find significant differences between conventional and alternative treatments. Also, there is no agreement on some more recent medications like using ketamine or desmopressin while MgSO4 and lidocaine use are supported by most studies. NMA revealed that desmopressin is significantly having worse pain reduction properties. NMA did not show any difference between ketamine, lidocaine, and MgSo4, versus the conventional treatment. CONCLUSION: To conclude, lidocaine and MgSo4 might be good alternative treatments for renal colic when conventional treatments are contraindicated or pain is not responding to those. Ketamine might be indicated in patient-based circumstances. Desmopressin may be agreeably avoided in further research or clinics.
Comparison of the Effectiveness of Pre-urodynamic Single-dose Levofloxacin with Post-urodynamic Levofloxacin for Three Days Related to the Incidence of Urinary Tract Infection: A Randomized Control Trial.
Rahardjo HE, Widia F, Manurung MA … +6 more , Wicaksono I, Soedarman S, Purwanto HPA, Rizaly AA, Leonardo K, Afriansyah A
Urol J · 2023 May · PMID 36461695 · Publisher ↗
PURPOSE: The current study aims to compare the effectiveness of pre-urodynamic single-dose levofloxacin and post-urodynamic levofloxacin for three days related to the incidence of urinary tract infections post-urodynamic...
PURPOSE: The current study aims to compare the effectiveness of pre-urodynamic single-dose levofloxacin and post-urodynamic levofloxacin for three days related to the incidence of urinary tract infections post-urodynamic examination. MATERIALS AND METHODS: This is a single-blind randomized clinical trial conducted in three outpatient urology centers in Jakarta: Cipto Mangunkusumo General Hospital, Siloam Asri Hospital, and Persahabatan General Hospital using a consecutive sampling method between July 2019 - February 2022. The outcome of the study is the incidence of urinary tract infections in both treatment groups. Urinary tract infection was defined as a patient with one or more clinical symptoms of lower urinary tract infection and one or more urinalysis parameters positive for urinary tract infections. Chi-square was used to evaluate the association where p < 0.05 was used to determine statistical significance. RESULTS: A total of 126 patients (63 patients in each arm) were included in the evaluation and analysis. Overall, urinary tract infections were detected in 25 cases (19.8%), 12 patients from the pre-urodynamic antibiotic group (9.5%) and 13 patients from the post-urodynamic antibiotic group (10.3%) (P = .823). E.coli was the most common bacteria found in the urine culture. CONCLUSION: There is no significant difference between a single dose of 500 mg of Levofloxacin administered one hour before the urodynamic study and a once-daily dose of 500 mg of Levofloxacin for three days following the urodynamic study related to urinary tract infections prevention post-urodynamic examination.
Defining the Learning Curve of Flexible Ureterorenoscopy and Laser Lithotripsy.
Kezer C, Ozgor F
Urol J · 2022 Dec · PMID 36444766 · Publisher ↗
PURPOSE: To investigate the impact of learning curve (LC) on flexible ureterorenoscopy (f-URS). MATERIALS AND METHODS: Patients who underwent kidney stone surgery in a urology clinic from a tertiary health care instituti...
PURPOSE: To investigate the impact of learning curve (LC) on flexible ureterorenoscopy (f-URS). MATERIALS AND METHODS: Patients who underwent kidney stone surgery in a urology clinic from a tertiary health care institution with f-URS were enrolled in the study. Patient characteristics, the properties of kidney and kidney stones were recorded. Also, f-URS-related parameters, hospitalization time, the success of the procedure, and complications were noted. Patients were categorized equally into 4 groups, the first 20 f-URS cases in Group 1, and the last 20 f-URS cases in Group 4. Groups were compared according to patient preoperative parameters, intraoperative outcomes, success rate and complication rate. RESULTS: Time from the induction of anaesthesia to insertion of flexible ureterorenoscope was 18.6 min in group 1 and 17.2 min in group 2; then it significantly decreased to 15.0 min for cases 40 through 60 and 12.4 min for cases 60 through 80 (p = 0.001). Operation time in group 3 and group 4 was significantly shorter than in group 1 and group 2 (p = 0.001). Also, fluoroscopy time was significantly longer in group 1 (82.9 seconds) and reached a plateau in group 3 (50.3 seconds) and group 4 (41.7 seconds) (p = 0.001). Additionally, after the 20th case, we achieved a significantly higher success rate in comparison to the first 20 cases (65% in group 1, 85% in group 2, 85% in group 3, and 90% in group 4, p = 0.001). CONCLUSION: Flexible ureterorenoscopy is a surgery that requires high technique and experience. The present study found that success of f-URS reached satisfactory levels after 20th cases. In addition, 40 cases may be enough for surgical proficiency regarding decreases in preparation time, operation time, and fluoroscopy time.
Comparison of Incision Types Used for Kidney Extraction in Laparoscopic Donor Nephrectomy: A Retrospective Study.
Şahin S, Özdemir O, Ekşi M … +4 more , Evren İ, Karadağ S, Özlü DN, Taşçı Aİ
Urol J · 2022 Dec · PMID 36403091 · Publisher ↗
PURPOSE: Laparoscopic donor nephrectomy (LDN) is the most commonly used method for kidney removal in kidney transplantation and, various incisions are used for kidney extraction. In this study, we aimed to compare the re...
PURPOSE: Laparoscopic donor nephrectomy (LDN) is the most commonly used method for kidney removal in kidney transplantation and, various incisions are used for kidney extraction. In this study, we aimed to compare the results of LDN operations using iliac fossa incision and Pfannenstiel incision. MATERIAL AND METHOD: LDN cases performed in our institute between June 2016 and February 2020 were retrospectively analyzed. Patients with previous abdominal surgery, bleeding coagulation disorders, ectopic kidneys, and patients who were converted to perioperative open surgery were excluded. Demographic data of the patients, operation times, warm ischemia times, complications were recorded and the patients were divided into two groups according to incision types. RESULTS: After the inclusion and exclusion criteria, 203 patients were included in the study. Iliac fossa incision was used in 65% of the patients and the Pfannenstiel incision was used in 35% of the patients to remove the donor's kidney. There were no difference in age, body mass index, gender, and Charlson Comorbidity Index (CCI) scores between the two groups. Operation time and warm ischemia time were significantly longer in the Pfannenstiel group (p = 0.001 and p = 0.016 respectively). There was no significant difference between the two groups in terms of bleeding amount, length of hospital stay, need for narcotic analgesic, visual analog scale scores, and postoperative complications. CONCLUSION: Both types of incisions can be used successfully and safely for the extraction of the kidney in LDN. Although WIT and operation time has been observed to be longer when a Pfannenstiel incision is made, complications and analgesic use are not different between Pfannenstiel incisions and iliac fossa incisions.
Risk Factors and Oncologic Outcomes for Clinical T1 Renal Cell Carcinoma Upstaging to Pathological T3a and The Construction of Predictive Model: A Retrospective Study.
Wang H, Wang K, Liu C … +3 more , Wang G, Liu Y, Li G
Urol J · 2023 May · PMID 36382432 · Publisher ↗
PURPOSE: The study is intended to identify the independent predictors of clinical T1 (cT1) renal cell carcinoma upstaging to pathological T3a (pT3a) and construct the predictive nomogram model. METHODS: The data of cT1 r...
PURPOSE: The study is intended to identify the independent predictors of clinical T1 (cT1) renal cell carcinoma upstaging to pathological T3a (pT3a) and construct the predictive nomogram model. METHODS: The data of cT1 renal cell carcinoma was collected from patients who were treated in the Second Hospital of Tianjin Medical University from January 2010 to December 2016. Mann-Whitney U and chi-square tests were performed to analyze continuous and categorical variables respectively. Univariate and multivariate logistic regression were used to identify the predictors of upstaging. Kaplan-Meier method, log-rank test and Cox regression were performed to analyze survival materials. RESULTS: Among 1,376 cT1 renal cell carcinoma patients, 75 patients were observed upstaging to pT3a, accounting for 5.5%. There were 6 potential predictors of upstaging, i.e age, clinical symptom, tumor size, Fuhrman grade, tumor necrosis and tumor edge regularity. The 5-year recurrence free survival probabilities of upstaging and non-upstaging patients were 73.3% and 91.1%, respectively and upstaging was an independent predictor of recurrence free survival. Two predictive nomograms were constructed and the C-index of them were 0.842 and 0.806, and the calibration curve and decision curve analysis showed highly clinical accuracy of the nomograms. CONCLUSION: Two nomogram models were built to predict the probability of cT1 renal cell carcinoma upstaging to pT3a with highly accuracy and specificity. Upstaging was an independent risk factor of recurrence free survival for cT1 renal cell carcinoma patients.
Effect of Rectal Midazolam on Pain, Stress, and Cooperation of Patient during Urodynamic Test in Women: A Randomized Clinical Trial.
Saberi N, Hayrabedian A, Mazdak H … +4 more , Hassannejad R, Zargham M, Mohammadi Sichani M, Mirzaei M
Urol J · 2023 Feb · PMID 36382431 · Publisher ↗
PURPOSE: The urodynamic study is an invasive test, and causes pain and stress in the patient. We have investigated the effect of rectal midazolam sedation on the pain, stress, and cooperation of women performing urodyna...
PURPOSE: The urodynamic study is an invasive test, and causes pain and stress in the patient. We have investigated the effect of rectal midazolam sedation on the pain, stress, and cooperation of women performing urodynamic study. Materials and Methods: At the present randomized clinical trial (RCT) from January to July of 2021 a total of 84 women were prospectively randomized to undergo urodynamic study with or without sedation. The primary outcome of interest was experienced pain during urodynamic study. In the intervention group, after monitoring baseline vital signs (heart rate, blood pressure, O2 saturation), sedation was done with rectal midazolam at a dose of 0.3 mg/kg (maximum 15 mg). Completing the procedure, after recovery from sedation patients were asked to fill a self-assessed visual analog pain scale (VAS, 0-10), 5-point visual stress scale (1-5) and, patient collaboration level during urodynamic study was evaluated by nurse with a researcher-made tool (0-3). In the control group test was performed in routine practice with no sedation. Baseline vital signs measured pre and intra-procedural time, as well as their experienced pain, stress, and cooperation levels were recorded. Results: 84 female cases were evaluated. In terms of comparison of changes in pre and intra-test physiologic parameters, results showed that there were no significant differences between the two groups for all physiologic parameters: SBP, DBP, PR, SpO2. Analysis of the pain score showed that it was lower in the intervention group, and there was a significant difference in pain score between the two groups (P =.024). While the stress and corporation scores were not reported statistically significant (P=.388 and P=.955, respectively). CONCLUSION: Sedation with rectal midazolam in adult women before UDS is safe and effective in reducing pain but is not effective in reducing stress and increasing cooperation. The amount of pain based on the visual analog pain scale is mild and although this method is safe, its use routinely is not recommended.
Postoperative Pulmonary Complications after Percutaneous Nephrolithotomy Under Spinal Anesthesia.
Açıkgöz A, Kara B, Önem K … +1 more , Çetinkaya M
Urol J · 2022 Dec · PMID 36382430 · Publisher ↗
PURPOSE: To evaluate risk factors and outcomes of Pulmonary Complications (PCs) in Percutaneous Nephrolithotomy (PCNL) under Spinal anesthesia (SA). MATERIAL AND METHOD: 286 patients who underwent PCNL under SA between 2...
PURPOSE: To evaluate risk factors and outcomes of Pulmonary Complications (PCs) in Percutaneous Nephrolithotomy (PCNL) under Spinal anesthesia (SA). MATERIAL AND METHOD: 286 patients who underwent PCNL under SA between 2017 and 2021 were identified retrospectively and divided into group 1 (clinically significant PCs) and group 2 (no clinically significant PCs). Demographic, preoperative, and intraoperative variables and postoperative outcomes were compared between both groups. Independent risk factors for PCs were evaluated by univariable and multivariable logistic regression analyses. RESULTS: PCs were noted in 90 patients (31.5%). Advanced age (P = .011), high body mass index (BMI) (P < .001), and the presence of chronic obstructive pulmonary disease (COPD) (P < .001) were risk factors for PCs. CONCLUSION: SA is an effective method of anesthesia for all PCNL patients and carries a lower rate of PCNL-associated PCs. Risk factors for PCs after PCNL were advanced age, obesity, and preoperative COPD.
Letter to the Editor re: Evaluation of the Clinical Effects of Abobotolinum Toxin A (Dysport) Injection in the Treatment of Neurogenic Lower Urinary Tract Dysfunction.
Gadelrab M, Chamsin A, Khadr R … +2 more , Omar AM, Floyd MS
Urol J · 2022 Oct · PMID 36281742 · Publisher ↗
N/A As submitted as a letter to the editor.
N/A As submitted as a letter to the editor.
The Long-term Effects of Transurethral Bladder Neck Incision in the Treatment of Female Bladder Neck Obstruction.
Qin Y, Wu L, Wang F … +3 more , Zhang C, Zhang P, Hu X
Urol J · 2022 Dec · PMID 36242528 · Publisher ↗
PURPOSE: To investigate the long-term effects of transurethral bladder neck incision (TUBNI) for female primary bladder neck obstruction (PBNO). MATERIALS AND METHODS: We retrospectively reviewed seventy women diagnosed...
PURPOSE: To investigate the long-term effects of transurethral bladder neck incision (TUBNI) for female primary bladder neck obstruction (PBNO). MATERIALS AND METHODS: We retrospectively reviewed seventy women diagnosed with bladder neck obstruction by video-urodynamic study (VUDS). TUBNI was performed for each patient, with incisions made at 2 different sites on the bladder neck. Postoperatively, patients were assessed by international prostate symptom score (IPSS), quality of life (QOL) and uroflowmetry. RESULTS: Follow-up data were available for 4-108 months (median 42 months) postoperatively. During follow-up, the IPSS, QOL, time to maximum uroflow rate, postvoid residual urine volume decreased significantly after TUBNI compared with preoperative [13.0 (10.0, 15.0) versus 3.0 (3.0, 8.0), P ＜ .001], [5.0 (5.0, 5.0) versus 2.0 (1.0, 3.0), P ＜ .001], [9.0 (5.0, 37.0) versus 6.1 (4.2, 8.7), P ＜ .001], [77.5 (23.5, 165.8) versus 0.0 (0.0, 30.0), P ＜ .001]. The maximum uroflow rate, average uroflow rate and the voided volume increased significantly compared with preoperative [7.0 (4.0, 10.3) versus 19.8 (12.8, 25.2), P ＜ .001], [3.0 (2.0, 5.0) versus 8.0 (4.9, 10.7), P ＜ .001] and [156.5 (85.0, 211.3) versus 261.3 (166.2, 345.6), P ＜ .001]. Several complications were identified after surgery, including bladder neck reobstruction, urethral stricture, and stress urinary incontinence, the corresponding number was 5 (7.1%), 7(10%) and 7(10%). Successful operation was achieved in 60/70 (85.7 %) patients. CONCLUSION: PBNO is a very rare yet easily treatable condition. VUDS is the primary diagnostic tool for the diagnosis of bladder neck obstruction in women, while TUBNI can effectively relieve obstruction symptoms and improve the quality of life for patients.
IGF-1-induced Muscle-Derived Stem Cells as a Potential Treatment of Stress Urinary Incontinence in Female Rats.
Chen C, Xu Y, Song Y
Urol J · 2022 Dec · PMID 36242527 · Publisher ↗
PURPOSE: Stress urinary incontinence (SUI) is prevalent among elderly women. This study aimed to discuss the potential of muscle-derived stem cells (MDSCs)-based therapy in treating SUI by exploring the effect of Insulin...
PURPOSE: Stress urinary incontinence (SUI) is prevalent among elderly women. This study aimed to discuss the potential of muscle-derived stem cells (MDSCs)-based therapy in treating SUI by exploring the effect of Insulin-like growth factor-1 (IGF-1) on transplanted MDSC and urethral sphincter function. MATERIALS AND METHODS: Bilaterally pudendal nerve-transected (PNT) female rats were divided into four groups: sham, PNT+ phosphate buffered solution (PBS) injection, PNT+IGF-1/MDSCs and PNT+ green fluorescent protein (GFP)/MDSCs. IGF-1 was expressed in MDSCs by lentiviral vector. Viable MDSCs were detected by laser scanning confocal microscopy (LSCM). The expression of Myosin heavy chain (MyHC), vascular endothelial growth factor (VEGF), VEGF receptor 2 (VEGFR-2), microvessel density (MID) and urethral resistance function were assessed. RESULTS: IGF-1 promoted the survival and differentiation of MDSCs. IGF-1-expressing MDSCs facilitated local angiogenesis and muscle fiber regeneration, and alleviated symptoms of SUI. CONCLUSIONS: IGF-1-expressing MDSCs may be used as a novel treatment for patients with SUI.
Does Renal Mass with Venous Thrombosis always Indicate Renal Cell Carcinoma? A Case Series.
Ghorbani H, Farzadnia M, Golshan A
Urol J · 2022 Dec · PMID 36207826 · Publisher ↗
Intravascular tumor extension in the major renal veins or their tributaries, as a rare but important clinical entity that can change the disease stage, prognosis, and approach to treatment. There is limited literature on...
Intravascular tumor extension in the major renal veins or their tributaries, as a rare but important clinical entity that can change the disease stage, prognosis, and approach to treatment. There is limited literature on the obstruction of renal vein and IVC by tumor thrombus in other types of renal tumors that are not of RCC type. We presented four different renal tumor cases with the presence of gross renal vein or IVC thrombosis. Although the incidence of renal vein and IVC tumor thrombus might be suggestive of (often diagnosed as) RCC, the possibility of other non-RCC renal tumors should be included in the differential diagnosis.
A case of Bladder and Rectal Injury due to Dislodgement of Leg Brace During Ureteroscopic Lithotripsy.
Shoubin L
Urol J · 2022 Oct · PMID 36207825 · Publisher ↗
we present a case of bladder and rectum perforation due to dislodgement of leg brace during holmium laser lithotripsy. A 66-year-old man admitted to the hospital due to "intermittent pain in the left lumbar region for...
we present a case of bladder and rectum perforation due to dislodgement of leg brace during holmium laser lithotripsy. A 66-year-old man admitted to the hospital due to "intermittent pain in the left lumbar region for more than 30 days" and was performed with Holmium laser lithotripsy after routine perioperative preparation.The right leg brace suddenly fell off during the operation, and caused perforations in the posterior wall of the bladder and the anterior wall of the rectum. we finally treated the rectal perforation with enteroscopic titanium clip closure and bladder perforation with indwelling catheter. The patient was discharged after the urinary catheter was removed two weeks after surgery.
Laparoscopic vs Open Extravesical Ureteral Reimplantation in Pediatric Population: A Single-Center Experience.
Fernández-Alcaráz D, Robles-Torres JI, García-Hernández C … +2 more , Guillén-Lozoya AH, Landa-Juárez S
Urol J · 2022 Dec · PMID 36127884 · Publisher ↗
PURPOSE: To evaluate the safety and efficacy of conventional laparoscopic vs open Lich-Gregoir ureteral reimplantation in pediatric vesicoureteral reflux. MATERIAL AND METHODS: A retrospective study was conducted in a te...
PURPOSE: To evaluate the safety and efficacy of conventional laparoscopic vs open Lich-Gregoir ureteral reimplantation in pediatric vesicoureteral reflux. MATERIAL AND METHODS: A retrospective study was conducted in a tertiary care hospital. Patients with vesicoureteral reflux who underwent open or laparoscopic Lich-Gregoir ureteral reimplantation from 2013-2020 were included. The primary outcome was resolution of reflux. Complications and perioperative characteristics were evaluated. The outcomes between open and laparoscopic surgery were analyzed. RESULTS: A total of 110 patients and 150 ureters were included. The mean age was 4.5 years ± 3.4 and 73.6% were females. A total of 125 ureters (83.3%) underwent laparoscopic and 25 (16.6%) open Lich-Gregoir vesicoureteral reimplantation (5:1 Ratio). Resolution was reported in 112 (89.6%) for laparoscopy and 21 (84%) for open surgery (P = .42). Mean surgical time for laparoscopy and open surgery were 142.4 min ± 64.4 and 153 min ± 40, respectively (P =.29). Mean bleeding (9.5 mL ± 11.2 vs 29.6 mL ± 22.8) and length of hospital stay (2.4 days ± 2.3 vs 5.05 ± 3.1) were significantly higher with open surgery (P < .001). No significant difference in complications was reported between open surgery (32%) and laparoscopic approach (22.4%) (P = .305). CONCLUSION: Conventional laparoscopic vesicoureteral reimplantation with the Lich-Gregoir technique has an acceptable success rate comparable with open surgery, with shorter hospital stay, less bleeding, and less need of transfusion.
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