International Urology and Nephrology最新文献

{"title":"Machine learning approaches for predicting and diagnosing chronic kidney disease: current trends, challenges, solutions, and future directions.","authors":"Prokash Gogoi, J Arul Valan","doi":"10.1007/s11255-024-04281-5","DOIUrl":"10.1007/s11255-024-04281-5","url":null,"abstract":"<p><p>Chronic Kidney Disease (CKD) represents a significant global health challenge, contributing to increased morbidity and mortality rates. This review paper explores the current landscape of machine learning (ML) techniques employed in CKD prediction and diagnosis, highlighting recent trends, inherent challenges, innovative solutions, and future directions. Through an extensive literature survey, we identified key limitations and challenges, including the use of small datasets, the absence of stage-specific predictions, insufficient focus on model interpretability, and a lack of discussions on safeguarding patient privacy in managing sensitive CKD data. We considered these limitations and challenges as research gaps, and this review paper aims to address them. We emphasize the potential of Generative AI to augment dataset sizes, thereby enhancing model performance and reliability. To address the lack of stage-specific predictions, we highlight the need for effective multi-class models to accurately predict CKD stages, enabling tailored treatments and improved patient outcomes. Furthermore, we discuss the critical importance of model interpretability, utilizing methods such as SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations) to ensure transparency and trust among healthcare professionals. Privacy concerns surrounding sensitive patient data are also addressed. We present innovative privacy-preserving solutions using technologies, such as homomorphic encryption, federated learning, and blockchain. These solutions facilitate collaboration across institutions while maintaining patient confidentiality and addressing challenges related to limited generalizability and reproducibility in CKD prediction. This review informs healthcare professionals and researchers about advancements in ML for CKD prediction, to improve patient outcomes and address research gaps.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum intact parathyroid hormone and survival in dialysis patients.","authors":"Chunlei Luo, Xueyan Bian, Chunyang Ji, Hanlu Wang, Jianwei Ma, Chenyu Zhong, Qiang Yu","doi":"10.1007/s11255-024-04288-y","DOIUrl":"10.1007/s11255-024-04288-y","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between serum intact parathyroid hormone (iPTH) levels and survival in maintenance dialysis patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients who began and continued dialysis from January 2013 to December 2022. Patients were categorized based on their baseline and time-averaged (TA) iPTH levels into three groups: low (iPTH < 150 pg/ml), medium (150 ≤ iPTH < 300 pg/ml), and high (iPTH ≥ 300 pg/ml). We utilized the Kaplan-Meier method to assess survival differences, the Cox proportional hazards regression model to identify risk factors impacting adverse outcomes and the restricted cubic spline model to evaluate the association between iPTH levels and the all-cause mortality.</p><p><strong>Results: </strong>We included a total of 1023 participants, comprising 524 hemodialysis and 499 peritoneal dialysis. Kaplan-Meier analysis showed that high baseline group had higher survival and low baseline group had poorer survival, compared with medium baseline group, respectively (χ² = 44.974, P < 0.001). The three TA groups showed similar results (χ² = 67.316, P < 0.001). Multivariate COX regression analysis showed that low TA iPTH was an independent risk factor for all-cause death (hazard ratio [HR] = 1.655, 95% CI 1.159-2.365, P = 0.006). The restricted cubic spline model revealed an L-shaped connection between TA iPTH level and the all-cause mortality with an inflection point of 193 pg/ml.</p><p><strong>Conclusion: </strong>The survival for maintenance dialysis patients varies significantly based on their baseline and time-averaged iPTH levels, with time-averaged iPTH emerges as an independent risk factor for all-cause death in these patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion on the treatment of diabetic kidney disease based on the \"gut-fat-kidney\" axis.","authors":"Yaping He, Dengke Jia, Wenying Chen, Juan Liu, Congrong Liu, Xiaowei Shi","doi":"10.1007/s11255-024-04283-3","DOIUrl":"https://doi.org/10.1007/s11255-024-04283-3","url":null,"abstract":"<p><p>Diabetic kidney disease is the main cause of end-stage renal disease, and its prevention and treatment are still a major clinical problem. The human intestine has a complex flora of hundreds of millions of microorganisms, and intestinal microorganisms, and their derivatives are closely related to renal inflammatory response, immune response, and material metabolism. Brown adipose tissue is the main part of adaptive thermogenesis. Recent studies have shown that activating brown fat by regulating intestinal flora has good curative effects in diabetic kidney disease-related diseases. As an emerging medical concept, the \"gut-fat-kidney\" axis has received increasing attention in diabetic kidney disease and related diseases. However, the specific mechanism involved needs further study. A new theoretical basis for the prevention and treatment of diabetic kidney disease is presented in this article, based on the \"gut-fat-kidney\" axis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive effects of nitric oxide donors in contrast-induced nephropathy in patients undergoing coronary artery angiography: an updated systematic review and meta-analysis of 13 randomized controlled trials.","authors":"Ahmed A Ibrahim, Shehroze Tabassum, Mohamed Abuelazm, Ahmed Mazen Amin, Mohamed Saad Rakab, Mohamed Rifai, AlMothana Manasrah, Abdelrahman Mahmoud, Ahmed Gaber Emara, Basel Abdelazeem, Muner M B Mohamed, Arvind Kunadi, Irfan Zeb","doi":"10.1007/s11255-024-04261-9","DOIUrl":"https://doi.org/10.1007/s11255-024-04261-9","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the preventive effects of nitric oxide (NO) donors in CIN patients undergoing CAG/PCI.</p><p><strong>Methods: </strong>We conducted a comprehensive systematic review and meta-analysis of RCTs from PubMed, Web of Science, Scopus, Embase, and Cochrane searches until May 5th, 2024. Dichotomous data were pooled using risk ratio (RR), and continuous data were pooled using mean difference (MD), both with a 95% confidence interval (CI), using (R version 4.3).</p><p><strong>Results: </strong>Our analysis included 13 RCTs encompassing 3,550 patients. NO donors were significantly associated with a decreased incidence of CIN compared to placebo either as an oral administration (RR: 0.33 with 95% CI [0.26, 0.42], P < 0.01) or IV infusions (RR: 0.56 with 95% CI [0.40, 0.78], P < 0.01). Moreover, NO donors were significantly associated with decreased serum creatinine levels compared to placebo either as an oral administration (MD: - 0.07 with 95% CI [- 0.10, - 0.04], P < 0.01) or IV infusions (MD: - 0.07 with 95% CI [- 0.09, - 0.04], P < 0.01). In terms of safety, NO donors were significantly associated with a decreased incidence of major adverse cardiac events (MACE) compared to placebo as an oral administration (RR: 0.64 with 95% CI [0.45, 0.89], P < 0.01). However, there was no significant difference between NO donors as IV infusions and placebo in MACE (RR: 0.68 with 95% CI [0.38, 1.21], P = 0.18). Finally, NO donors were significantly associated with a decreased incidence of all-cause mortality compared to placebo as an oral administration (RR: 0.58 with 95% CI [0.36, 0.94], P = 0.03). Nevertheless, there was no statistically significant difference in all-cause mortality between IV infusions of NO donors and placebo (RR: 1.84 with 95% CI [0.40, 8.52], P = 0.44).</p><p><strong>Conclusion: </strong>NO donors as adjunct therapy are associated with reduced incidence of CIN and decreased serum creatinine levels, either as an oral or IV administration. They were also associated with reduced incidence of MACE, all-cause mortality, and recurrent myocardial infarction as an oral administration, which makes this simple, low-cost intervention an important therapeutic option in patients undergoing CAG/PCI.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of serum calcium concentration with chronic kidney disease and mortality in type 2 diabetes mellitus patients: evidence from the NHANES 1999-2018.","authors":"Minzi Qiu, Yanxia Chen, Ben Ke, Xiangdong Fang, Chengyun Xu, Jinghai Hua","doi":"10.1007/s11255-024-04272-6","DOIUrl":"https://doi.org/10.1007/s11255-024-04272-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the relationship of serum calcium (Ca) concentration with diabetic kidney disease (DKD) and all-cause mortality among type 2 diabetes mellitus (T2DM) patients using National Health and Nutrition Examination Surveys (NHANES).</p><p><strong>Methods: </strong>Data of T2DM patients aged ≥ 40 years were screened from the NHANES database from 1999 to 2018. The outcomes were the risk of DKD diagnosed by urine albumin-to-creatinine ratio (UACR) ≥ 30 mg/g or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and the risk of all-cause mortality ascertained by linkage to National Death Index (NDI) records through 31 December 2019. The weighted univariate and multivariate logistic regression model and cox proportional hazard model were utilized to explore the relationships of serum Ca concentration with DKD and all-cause mortality, respectively, with odds ratios (ORs), hazard ratios (HRs) and 95% confidence interval. The relationships were further explored stratified by age, gender, body mass index (BMI), the duration of T2DM, and the history of cardiovascular disease (CVD), cancer and DKD.</p><p><strong>Results: </strong>Totally, 6595 T2DM patients were included. Of these patients, 2441 (37.01%) had DKD and 1868 (28.32%) deaths occurred over a mean follow-up of 104.50 (± 1.61) months. In fully adjusted model, we observed high serum Ca concentration was associated with high risk of DKD (OR = 1.45, 95% CI 1.18-1.77) and high all-cause mortality risk (HR = 1.33, 95% CI 1.16-1.52). These relationships remained significant after performing subgroup analyses. The Restricted cubic spline curves shown that linear correlations were observed between serum Ca concentration and DKD as well as all-cause mortality (P < 0.05).</p><p><strong>Conclusions: </strong>Elevated serum Ca concentration may predict the high risk of DKD and poor prognosis in T2DM patients, and future large-scale and well-designed prospective cohort study is needed to explore the association of serum Ca concentration and DKD and prognosis in T2DM patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the use of loop diuretics and prognosis in critically ill patients with acute kidney injury: a retrospective propensity score-matched cohort study.","authors":"Hua Xiao, Kai Liu, Hong-Hao Meng, Yun-Peng Peng, Guo-Bao Hong, Xin-Zhou Zhang","doi":"10.1007/s11255-024-04271-7","DOIUrl":"https://doi.org/10.1007/s11255-024-04271-7","url":null,"abstract":"<p><strong>Background: </strong>The role of loop diuretics in patients with acute kidney injury (AKI) is controversial. This study examined the association between the use of loop diuretics and prognosis in critically ill patients with AKI.</p><p><strong>Methods: </strong>This study used data from the medical information mart for the intensive care IV database. Adult critically ill patients with AKI were included in the analysis. Patients were partitioned into two groups based on their use of loop diuretics in the ICU, and potentially confounding variables between the two groups were balanced using propensity score matching (PSM). We used time-dependent Cox proportional hazards regression, logistic regression, and Hodges-Lehman estimator to assess the impact of loop diuretics on all-cause mortality, renal replacement therapy (RRT) use, and the length of hospital stay, respectively.</p><p><strong>Results: </strong>This study included a cohort of 19,671 patients. After PSM, both groups consisted of 6200 patients. The use of loop diuretics was associated with a lower risk of in-hospital mortality (HR, 0.672; 95% CI 0.597-0.757; P < 0.001), lower in-ICU mortality (HR, 0.375; 95% CI 0.315-0.446; P < 0.001), and lower odds of in-hospital RRT (OR, 0.472; 95% CI 0.400-0.555; P < 0.001). A sensitivity analysis using the original cohort (HR, 0.624; 95% CI 0.561-0.693; P < 0.001) and weighted cohort (HR, 0.654; 95% CI 0.582-0.736; P < 0.001) also demonstrated lower in-hospital all-cause mortality.</p><p><strong>Conclusions: </strong>The use of loop diuretics is associated with a substantial reduction in mortality among critically ill patients with AKI.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of urination process on heart rate variability.","authors":"Faruk Dişli, Sedat Yıldız","doi":"10.1007/s11255-024-04282-4","DOIUrl":"10.1007/s11255-024-04282-4","url":null,"abstract":"<p><strong>Purpose: </strong>Heart rate variability (HRV) is used for the assessment of activity of the autonomic nervous system (ANS). As urination is also under the control of the ANS, this study aimed to investigate the usefulness of HRV in the assessment of ANS during the peri-urination period. The psychological effects of sitting on a chair or on the toilet during pre- and post-urination periods were also assessed.</p><p><strong>Methods: </strong>Electrocardiogram was used to measure HRV in male participants (n = 40, aged 18-30). They were allowed to drink water to ease urination. At the stage close to voiding, six measurements (each for 90 s) were taken sequentially in sitting position (pre-urination chair, pre-urination toilet, urination, post-urination toilet, post-urination chair, and basal post-urination chair). HRV indices included standard deviation of R-R intervals (SDNN), root mean square of successive differences in R-R intervals (RMSSD), percentage of successive R-R intervals differing more than 50 ms (pNN50), total power (TP), very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) bands together with the ratio of LF/HF.</p><p><strong>Results: </strong>HR, SDNN, TP, LF, and LF/HF increased during urination process (P < 0.05), whereas RMSSD, pNN50, and HF increased before urination on toilet (P < 0.05) compared to sitting on a chair before and after urination.</p><p><strong>Conclusion: </strong>HRV indices dynamically reflected the physiological stages of urination. Parasympathetic activity (revealed by pNN50, RMSSD, and HF) increased before urination, whereas sympathovagal balance (revealed by LF/HF) increased during urination. Thus, HRV appears to be a suitable technique for studying physiological and pathological aspects of urination.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antegrade stenting for chronic malignant ureteral obstruction with the Resonance^® metallic stent: a case series.","authors":"Dillon Christopher Yong Jie Teo, Jian Ning Jan Hoe, Wei Zheng So, Collin Elijah Rui Hung Ho, Shao Jin Ong, Ho Yee Tiong","doi":"10.1007/s11255-024-04286-0","DOIUrl":"https://doi.org/10.1007/s11255-024-04286-0","url":null,"abstract":"<p><strong>Purpose: </strong>Polymeric and metallic stents are commonly used to manage patients with chronic malignant ureteric obstruction (CMUO). This paper compares the outcomes of ureteral stenting via the Resonance^® metallic stent against its polymeric counterpart in published literature, as well as between antegrade and retrograde approaches.</p><p><strong>Methods: </strong>A retrospective case series was conducted whereby patients who had undergone Resonance^® stent insertions via an antegrade route from June 2022 to May 2023 were reviewed through our electronic medical record system. Descriptive statistics were used to summarise patient demographics and clinical outcomes.</p><p><strong>Results: </strong>11 patients who presented with CMUO underwent 12 separate procedures of either unilateral or bilateral ureteral stenting. Total number of stents inserted was 16. Median age of patients was 65 (Range = 32) and 72.73% were males. 66.67% of the procedures yielded an improvement in the estimated glomerular filtration rate (eGFR) in patients as compared to before stenting. Stent failure, defined by stent removal before recommended removal date, occurred in 4 out of 16 (25%) stents. The median duration of Resonance^® stent in situ at the time of data collection (4th December 2023) was 245 days.</p><p><strong>Conclusion: </strong>We conclude that the Resonance^® stent is more effective at providing long term urinary drainage for CMUO, compared to its polymeric counterpart. However, antegrade insertion of the Resonance^® stent does not significantly decrease indwelling stent duration compared to retrograde insertion.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of urinary diversion on kidney function in posterior urethral valves and ureterovesical obstruction.","authors":"Hamid Arshadi, Iman Menbari Oskouie, Mahsa Ghozatloo, Masoumeh Majidi Zolbin, Hossein Amirzargar, Seyed Mohammad Ghahestani, Abdol-Mohammad Kajbafzadeh, Pooya Hekmati","doi":"10.1007/s11255-024-04287-z","DOIUrl":"10.1007/s11255-024-04287-z","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior urethral valves (PUV) and ureterovesical junction obstruction (UVJO) are common etiologies of lower urinary tract obstruction. The primary objective of therapy is to alleviate the obstruction in the urinary system. Temporary urinary diversion may be necessary in certain situations, such as Urinary tract infection (UTI), sepsis, and unchanging hydronephrosis. This study, aims to assess kidney parameters after urinary diversion (either pyelostomy or ureterostomy) in patients with PUV and UVJO.</p><p><strong>Method: </strong>We conducted a retrospective analysis of all patients diagnosed with PUV or UVJO and treated with urinary diversion following urinary undiversion at our facility between 2015 and 2020. The following variables were collected: demographic details, surgical interventions (type of diversion), serum creatinine throughout follow-up, anterior-posterior diameter of the pelvis (APP), anterior-posterior diameter of the ureter (APU), and sonographic findings of renal parenchymal thickness (PT) as documented by a pediatric radiologist. Additionally, before and after urinary diversion, a Dimercapto succinic acid (DMSA) nuclear renal scan was conducted to assess renal function.</p><p><strong>Result: </strong>We analyzed 67 patients, with a mean follow-up of 38.3 months, undergoing either ureterostomy (42 patients) or pyelostomy (25 patients). This included 38 patients with PUV and 29 with UVJO. In PUV patients, significant improvements were observed in APP (MD = 5.56 ± 11.6, p = 0.0194), APU (MD = 5.57 ± 7.28, p < 0.001), and PT (MD = 3.66 ± 2.75, p < 0.001). Similarly, UVJO patients experienced significant improvements in APP (MD = 12.18 ± 18.63, p = 0.005), APU (MD = 7.82 ± 8.98, p = 0.001), and PT (MD = 2.79 ± 3.33, p = 0.001). DMSA scores did not significantly change in either group (p > 0.05). Notably, APP improved more in UVJO patients compared to PUV patients (p = 0.047).</p><p><strong>Conclusion: </strong>Our study suggests that urinary diversion could improve APP, APU, and renal parenchymal thickness in PUV and UVJO patients. The improvement of APP in UVJO patients was greater than in the PUV group. We propose further multi-center studies with longer durations of follow-up and more detailed additional data to support and confirm our results.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual outcomes following the surgical treatment of traumatic rupture of the corpora cavernosa.","authors":"Kays Chaker, Nader Gharbia, Yassine Ouanes, Boutheina Mosbahi, Moez Rahoui, Mokhtar Bibi, Wassim Ben Chedly, Yassine Nouira","doi":"10.1007/s11255-024-04285-1","DOIUrl":"https://doi.org/10.1007/s11255-024-04285-1","url":null,"abstract":"<p><strong>Introduction: </strong>Penile fracture is a post-traumatic condition affecting the tunica albuginea of the corpora cavernosa when erect. Clinical diagnosis and urgent surgical intervention are crucial to avoid severe functional complications, particularly erectile dysfunction. We aimed to evaluate male sexual function after surgical treatment in patients with penile fracture and to identify predictive factors of postoperative erectile dysfunction.</p><p><strong>Methods: </strong>We underwent a hospital-based retrospective study on patients who underwent surgical repair for fractures of the corpora cavernosa between 2012 and 2023. Included in this study were all patients who have a postoperative follow-up of at least 12 months. Patients were clinically evaluated for the presence of erectile dysfunction and the presence of postoperative penile curvature. The patients were asked to answer the structured questionnaire of the International Index of Erectile Function (IIEF-15).</p><p><strong>Results: </strong>We included 87 patients. The mean age was 38 ± 12 years. Fourteen patients (16%) developed a fibrous plaque, with a median onset time of 30 days postoperatively. Erectile dysfunction was noted in forty-four patients (51%). Active smoking (p < 0.002), the surgical approach (p = 0.02), a consultation time > 7.5 h (p = 0.01), a length of the discontinuity of the corpora cavernosa > 2.5 cm (p = 0.01) and the use of an erection inhibitor postoperatively (p = 0.021) were independent predictive factors of erectile dysfunction at 1 year postoperatively.</p><p><strong>Conclusion: </strong>Considering the results of our study, we propose rapid and urgent surgical management for penile fractures, and an elective surgical approach may be considered. We emphasize the fundamental role of sexual education, especially for young people, in preventing this sexual accident that could negatively impact their sexual life.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}