Journal of Clinical Urology最新文献_第4页

The three-glass test yields excellent results for diagnosis of chronic bacterial prostatitis: Study from a Pakistani tertiary care hospital 三玻璃试验在诊断慢性细菌性前列腺炎方面取得了良好的结果：来自巴基斯坦一家三级护理医院的研究

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Journal of Clinical Urology Pub Date : 2023-02-17 DOI: 10.1177/20514158231155046

Farooq Hameed, Adeel Anwaar

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Malignant upper urinary tract obstruction: A prospective evaluation of patients presenting as an emergency to urology and their long-term real-life outcomes 恶性上尿路梗阻：泌尿外科急诊患者及其长期现实生活结果的前瞻性评估

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Journal of Clinical Urology Pub Date : 2023-02-12 DOI: 10.1177/20514158231153251

Joel Corkill, R. Hawthorne, J. Westera, N. Collin, J. Aning

{"title":"Malignant upper urinary tract obstruction: A prospective evaluation of patients presenting as an emergency to urology and their long-term real-life outcomes","authors":"Joel Corkill, R. Hawthorne, J. Westera, N. Collin, J. Aning","doi":"10.1177/20514158231153251","DOIUrl":"https://doi.org/10.1177/20514158231153251","url":null,"abstract":"The objective of this study was to evaluate the management and survival outcomes of patients referred to urology as an emergency with malignant upper urinary tract obstruction (MUUTO). Between 2019 and 2020, the outcomes of all emergency referrals with MUUTO to the Urology team at a single institution were prospectively analysed. In total, 119 patients, median age 77 years, were referred to the urology team with MUUTO. Of these, 59% (70/119) had bilateral and 41% (49/119) unilateral obstruction. The three commonest primary underlying malignancies were gladder (41% (49/119)), prostate (19% (23/119)), and colorectal (8% (10/119)) cancer. The commonest indication for referral was acute kidney injury (86% (103/119)), the remainder had sepsis (13% (15/119)), and pain (1% (1/119)). Median in-patient stay for the admission was 7 days. Median estimated glomerular filtration rate (eGFR/1.73 m2) measured on discharge improved irrespective of whether intervention for MUUTO was received. Overall survival of the cohort was 13% (16/119). Patients referred with MUUTO as an emergency have a poor prognosis. Renal function does not significantly deteriorate in the short term in this patient group with no intervention, and overall survival is not significantly improved after intervention unless further treatment is received. Multidisciplinary team discussion, including patients and oncologists, should be best practice before intervention in this challenging situation. 2b","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46864383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Quality improvement in urological care: Core methodological principles 泌尿科护理质量改进:核心方法学原则

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Journal of Clinical Urology Pub Date : 2023-01-17 DOI: 10.1177/20514158221144344

A. Olaitan, T. Tien, S. Russ, Josephine Tapper, E. Herrington, J. Green, S. Chaudhri

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Prostate cancer among South Asian men in the United Kingdom: A systematic review 英国南亚男性前列腺癌:系统回顾

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Journal of Clinical Urology Pub Date : 2023-01-12 DOI: 10.1177/20514158221145775

Z. Panayi, S. Srirangam

{"title":"Prostate cancer among South Asian men in the United Kingdom: A systematic review","authors":"Z. Panayi, S. Srirangam","doi":"10.1177/20514158221145775","DOIUrl":"https://doi.org/10.1177/20514158221145775","url":null,"abstract":"Rates of prostate cancer (PC) vary considerably between ethnic groups worldwide, and migratory studies have demonstrated the importance of both inherent and environmental influences. Healthcare systems also differ significantly worldwide, and comparisons of PC data between the United Kingdom and America have previously shown contradictory conclusions among ethnic groups. The South Asian population (SA) is the most predominant UK ethnic minority group. To systematically explore and critically analyse the available UK-based evidence regarding PC among SA men. Specifically, to review research that assesses the following factors: PC incidence, disease characteristics, treatment and survival outcomes. The existing evidence suggests that UK SA men have a lower PC incidence and younger age at diagnosis, in comparison with White men in the United Kingdom. Contrasting evidence is presented in studies that separately analyse men originating from India, Pakistan and Bangladesh. There is insufficient and contradictory evidence regarding whether SA men show altered PC disease characteristics or have differential survival rates. The evidence is limited regarding PC treatment; however, this indicates that SA men are less frequently treated surgically compared to White men Further high-quality research is required focusing on accurate ethnicity allocation, analysis of separate SA origin countries, socio-economic adjustment, subgroup analysis of treatment in low-risk PC and identifying the support needs of SA minorities with PC. This will help to ensure that ethnic minorities with PC are appropriately diagnosed, counselled and treated 3","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65475624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resilience and mental health in UK urology trainees 英国泌尿外科受训人员的复原力和心理健康

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Journal of Clinical Urology Pub Date : 2022-12-27 DOI: 10.1177/20514158221142683

T. R. Terry

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A 15-year longitudinal analysis of the trends in the surgical management of renal and ureteric stones in Australia 澳大利亚肾和输尿管结石手术治疗趋势的15年纵向分析

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Journal of Clinical Urology Pub Date : 2022-12-27 DOI: 10.1177/20514158221135683

Bharti Arora, E. Chung

{"title":"A 15-year longitudinal analysis of the trends in the surgical management of renal and ureteric stones in Australia","authors":"Bharti Arora, E. Chung","doi":"10.1177/20514158221135683","DOIUrl":"https://doi.org/10.1177/20514158221135683","url":null,"abstract":"This study evaluates the evolving surgical management of renal stones in Australia over the past 15 years. The National Australian Medicare and Australian Institute of Health and Welfare (AIWH) data were used to obtain the annual number of hospital presentations for urolithiasis and surgical procedures for upper urinary tract stones from 2005 to 2020. The four treatment modalities observed included nephrolithotomy, shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL) and endoscopic lithotripsy. The total number of renal colic presentations in Australian hospitals and urology procedures claimed by Medicare has increased during the past 15 years. A total of 218,999 urological procedures were claimed by Medicare for renal stones over 15 years. There has been a dramatic rise in endoscopic lithotripsy surgery for stones. In 2005–2006, endoscopic lithotripsy comprised 56.6% of total stonework claimed by Medicare, and this proportion jumped to 88.9% in 2019–2020. All other modalities saw a decline in absolute and relative numbers. Endoscopic management of upper renal tract stones predominates in the current management of renal stone disease in Australia. Epidemiology audits such as this study can provide insight into national disease trends and guide future healthcare policies and resource planning. 2b","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44789275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intravesical gentamicin treatment for recurrent urinary tract infections: A systematic review over the last two decades 膀胱内庆大霉素治疗复发性尿路感染:近二十年的系统综述

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Journal of Clinical Urology Pub Date : 2022-12-23 DOI: 10.1177/20514158221138845

G. Rutherford, Lieo Jiun Tan, O. Aboumarzouk, J. de Souza, R. Khan, B. Somani, T. Amer

{"title":"Intravesical gentamicin treatment for recurrent urinary tract infections: A systematic review over the last two decades","authors":"G. Rutherford, Lieo Jiun Tan, O. Aboumarzouk, J. de Souza, R. Khan, B. Somani, T. Amer","doi":"10.1177/20514158221138845","DOIUrl":"https://doi.org/10.1177/20514158221138845","url":null,"abstract":"Recurrent urinary tract infections (rUTIs) have a significant effect on a patient’s quality of life and frequent use of antibiotics increases multi-drug resistance. Previous research on intravesical antibiotics suggests that this has a local effect on bacteria with reduced systemic absorption and associated side effects. We conducted a systematic review to assess the effectiveness and adverse effects of intravesical gentamicin treatment. Systematic review of all English published articles from January 2001 to October 2021 according to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. A total of 139 studies were identified, 20 full-text articles were screened and 6 subsequently included totalling 166 patients. All studies reported a decrease in the mean number of urinary tract infections (UTIs) with a significant reduction ( p = 0.0025 and p < 0.004) in two studies. When the number of breakthrough UTIs on prophylactic gentamicin installations was assessed, 65% ( n = 86/133) remained UTI free. Throughout treatment, 99% of serum gentamicin levels were <0.3 ng/dL, and reported instances of increased creatinine were low (2%). A decrease in the growth of multi-drug-resistant bacteria was reported in two papers ( p = 0.065 and p = 0.04). Intravesical gentamicin seems to be an effective treatment in patients with symptomatic rUTIs. The evidence suggests it also reduces UTIs caused by multi-drug-resistant bacteria with no systemic absorption and minimal renal toxicity. 2a","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43241179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Urodynamic characteristics of adult men with mixed detrusor overactivity with detrusor underactivity: A database analysis 逼尿肌过度活动和逼尿肌活动不足混合型成年男性的尿动力学特征：数据库分析

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Journal of Clinical Urology Pub Date : 2022-12-22 DOI: 10.1177/20514158221143248

S. Sinha, Sirish Bharadwaj

{"title":"Urodynamic characteristics of adult men with mixed detrusor overactivity with detrusor underactivity: A database analysis","authors":"S. Sinha, Sirish Bharadwaj","doi":"10.1177/20514158221143248","DOIUrl":"https://doi.org/10.1177/20514158221143248","url":null,"abstract":"To examine the urodynamic characteristics of men with mixed detrusor overactivity with detrusor underactivity (DODU) across the entire adult-age spectrum. Data included all adult men who underwent urodynamics for refractory non-neurogenic lower tract symptoms between 2011 and 2019. DODU was defined as the concomitant presence of detrusor overactivity (DO) during storage with underactivity (bladder contractility index, BCI < 100) during voiding. Nonparametric tests with multiple hypothesis correction were used (SPSS 25.0). DODU was noted in 199/1596 men (12.5%; median, 62 years). Men with DODU were older than men with detrusor underactivity (DU) or DO alone (median, 62, 48 and 56 years, respectively). DODU was commoner in older men but was noted across all age groups. As compared to men with isolated DU, men with DODU were more likely to be obstructed (38.7% versus 23.6%) and had better contractility (median BCI 81 versus 75). Peak detrusor contraction pressure during overactivity was lower in men with DODU than men with isolated DO. DODU should not be regarded as an exclusively geriatric disease. Differences in urodynamic characteristics suggest that this condition might not just be the coincidental occurrence of DO and underactivity in the same individual. III","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47177419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of outpatient surveillance in post-intravesical BCG management of high-risk bladder cancer 门诊监测对高危膀胱癌症膀胱内BCG治疗的疗效

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Journal of Clinical Urology Pub Date : 2022-12-09 DOI: 10.1177/20514158221139897

J. K. Raja Thinagaran, P. James, S. Agrawal

{"title":"Efficacy of outpatient surveillance in post-intravesical BCG management of high-risk bladder cancer","authors":"J. K. Raja Thinagaran, P. James, S. Agrawal","doi":"10.1177/20514158221139897","DOIUrl":"https://doi.org/10.1177/20514158221139897","url":null,"abstract":"Intravesical Bacillus Calmette–Guérin (BCG) instillation is an established form of immunotherapy for intermediate and high-risk bladder cancers. Mandatory cystoscopic surveillance is commonly performed under general anaesthesia (GA) to facilitate biopsy or other procedures. However, it is resource-intensive with unclear clinical benefit. We performed a two-cycle audit, before and after changing post-BCG surveillance policy, from GA cystoscopy to local anaesthetic flexible cystoscopy (LAFC) on trans urethral laser ablation (TULA) lists, where patients may undergo a tumour biopsy or laser ablation. In the first cycle, we audited 53 patients undergoing 114 post-BCG rigid cystoscopies from January 2018 to December 2019. In the second cycle, there were 56 patients undergoing 99 post-BCG LAFCs on TULA lists in 2020. In the first audit cycle cohort, the mean patient age was 72.29 ± 8.98 years and 48 were men; malignant histology was identified only on five occasions (three grade progressions). Fourteen patients required overnight admission. In the second audit cycle cohort, the mean patient age was 70.44 ± 9.17 years and 47 were men. Four had a grade progression, while another a stage progression. Out of 99 LAFCs, 47 confirmed normal bladder appearance. A biopsy was taken during other 52 cystoscopies: 17 (33%) confirmed malignancy. Fifteen patients showed findings that were labelled as recurrence, but only two required a further GA procedure to deal with recurrence. One patient was admitted for post-procedure bleeding, which settled with irrigation. Local anaesthetic TULA procedure is a safe and effective alternative for a GA rigid cystoscopy to survey bladders of patients on intravesical BCG therapy. 3","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44179737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Pedicled dorsal penile skin tube as neourethra in total penectomy for primary male urethral carcinoma 带蒂阴茎背侧皮管作为新尿道在原发性男性尿道癌全切术中的应用

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Journal of Clinical Urology Pub Date : 2022-11-24 DOI: 10.1177/20514158221136340

C. Yepes, M. Bandini, P. Joshi, Ahmed A Alrefaey, S. Bhadranavar, S. Bafna, S. Kulkarni

{"title":"Pedicled dorsal penile skin tube as neourethra in total penectomy for primary male urethral carcinoma","authors":"C. Yepes, M. Bandini, P. Joshi, Ahmed A Alrefaey, S. Bhadranavar, S. Bafna, S. Kulkarni","doi":"10.1177/20514158221136340","DOIUrl":"https://doi.org/10.1177/20514158221136340","url":null,"abstract":"The aim of this article is to present our experience of pedicled dorsal penile skin tube as neourethra after radical penectomy due to invasive primary male carcinoma of anterior urethra. This is an observational descriptive study including seven men with primary urethral carcinoma who underwent radical penectomy between 2018 and 2021. Instead of urinary derivation with suprapubic catheter, perineal urethrostomy, or bladder orthotopic/heterotopic reconstruction, patients underwent reconstruction of the anterior urethra with a pedicled dorsal penile skin tube. In brief, before corpora amputation and radical urethrectomy, the dorsal penile skin is preserved to reconstruct the neourethra. The distal end of the skin is anastomosed with the proximal urethral stump (usually membranous urethra) to assure continuity of the urinary tract, without jeopardising urinary continence. Finally, the flap is tubularized with two layers of watertight running sutures. Median age was 50 (35–70) years. Histology revealed squamous cell carcinoma in all patients. Almost 100% of patients presented locally advanced (pT3–4, G3) disease and received perioperative chemotherapy (MVAC). The median follow-up was 10 (5–24) months. Median operative time was 230 min (190–315). There were not severe (Clavien–Dindo III–IV) perioperative complications. All patients were able to void in standing position through the reconstructed neourethra. No patients reported post-operative incontinence. Two patients died after 8 and 11 months from surgery. This new technique of using the dartos-based dorsal penile skin tube urethroplasty offers the possibility to void in standing position after radical penectomy with no need of urinary derivations. Not applicable.","PeriodicalId":15471,"journal":{"name":"Journal of Clinical Urology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49382023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0