Hellenic Urology最新文献

{"title":"Nephrometry scores in renal cancer","authors":"N. Kostakopoulos, Titos Markopoulos, A. Skolarikos","doi":"10.4103/HUAJ.HUAJ_21_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_21_20","url":null,"abstract":"Several independent tools and measurements can be used to assess the same endpoint. This is the case for renal tumors, for which different nephrometry scores (NSs) based on preoperative imaging are currently available. These systems provide objective information with regard to surgical complexity, risk of blood loss, ischemia time, and perioperative complications that can assist physicians in the decision-making process and in planning the most appropriate surgical approach. In this review article, the most widely used preoperative NSs are being mentioned; their parameters are analyzed and their usefulness and reliability in everyday clinical and surgical practice are being compared.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132864987","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}

{"title":"Acupuncture in the treatment of chronic prostatitis/chronic pelvic pain syndrome: A brief review","authors":"K. Stamatiou, E. Samara, Konstantinos Kefalas, G. Perletti","doi":"10.4103/HUAJ.HUAJ_17_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_17_20","url":null,"abstract":"Introduction/Aim: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects many adult men worldwide. It has been almost a decade since the introduction of acupuncture on CP/CPPS treatment. Since then, a number of studies have been performed. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS. Materials and Methods: A systematic search was performed in electronic libraries for clinical trials, experimental studies, and systematic reviews on the topic using the terms: “chronic prostatitis,” “chronic pelvic pain syndrome,” “acupuncture” combined with the keywords: “treatment,” “efficacy,” and “safety,” in various combinations. In order to provide accurate conclusions, we evaluated only randomized studies focused on the effects and safety data of acupuncture in the treatment of CP/CPPS-related symptoms. Only trials performed in patients with confirmed CP/CPPS randomized with adequate methods and providing clear outcome reports were finally evaluated. Only full-text available papers written in the English language were considered. There was no restriction on publication date. Results: According to our research, 40 papers examining the role of the acupuncture in the treatment of CP/CPPS exist. Only 8 out of 40 fulfilled the above-mentioned criteria. Overall, evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Regarding long-term responses without additional treatment, the examined studies provide inconsistent information. Moreover, evidence regarding urination problems is limited. Conclusion: Available data suggest that acupuncture treatment is able to decrease CP/CPPS related pain. Since it was associated with rare and slightly adverse events, it could be considered as a safe complementary therapeutic option for men with CP/CPPS.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114621476","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}

{"title":"Acupuncture as a treatment choice for persistent chronic bacterial prostatitis-related symptoms: A pilot study","authors":"K. Stamatiou, E. Samara, N. Pierris, V. Karanasiou, G. Christopoulos, Konstantinos Kefalas, Konstantinos Zioutos","doi":"10.4103/HUAJ.HUAJ_18_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_18_20","url":null,"abstract":"Background and Aim: In several chronic bacterial prostatitis (CBP) cases, symptoms persist despite bacterial eradication. Since acupuncture has been shown to ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome, it may be an effective treatment option for clinically untreated CBP cases. In order to investigate the above hypothesis, we performed a pilot study. Methods: Patients with persistent CBP-related symptoms and confirmed bacterial eradication were randomly allocated to acupuncture or conventional medical treatment. Symptom burden was assessed at baseline, weeks 4 and 12. Eight patients received 30-min sessions of acupuncture twice weekly for 1 month (Group 1), ten patients received lornoxicam 8 mg orally once daily for 1 month (Group 2), eight patients received Serenoa repens (SR) 320 mg twice daily for 1 month (Group 3), and nine patients received pregabalin 25 mg twice daily for 1 month (Group 4). The primary outcome is the proportion of responders at week 4 with significant change from baseline in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score and International Prostate Symptom Score (IPSS) at week 4. Secondary outcomes included ratings of clinical pain (visual analog scale) and quality of life at week 12. Results: At week 4, no statistically significant differences in the mean decrease of NIH-CPSI and IPSS total scores from baseline among groups were noted. After 12 weeks, none of the participants experienced complete resolution of pain. Differences in the mean pain and quality of life levels were statistically insignificant. Conclusion: Acupuncture is an effective treatment option for persistent CBP-related pain however is inferior to conventional medical treatment in reducing CBP-related lower urinary tract symptoms. For this reason, it may be offered in combination with medical therapy in patients with combined symptoms.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131693171","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}

{"title":"Optimizing anticancer therapy in newly diagnosed metastatic castration sensitive prostate cancer","authors":"A. Thanos","doi":"10.4103/HUAJ.HUAJ_19_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_19_20","url":null,"abstract":"Historically, androgen deprivation therapy has been the standard of care in the management of metastatic castration sensitive prostate cancer (mCSPC). However, during the past 5 years, numerous different treatment options have become available and have been set under investigation. The addition of docetaxel or abiraterone acetate has improved outcomes for patients with mCSPC and has become a new standard of care. New drugs targeting androgen receptor axis, local therapy including surgery, radiotherapy, and brachytherapy as well as metastatic-directed treatments have also demonstrated promising outcomes. In this work, the available data on all treatment modalities employed in mCSPC are being reviewed.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128579392","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}

{"title":"Partial orchiectomy: Experience of four cases in a secondary hospital of greece","authors":"J. Kyriazis, D. Dimitriou, M. Karavitakis, A. Thanos","doi":"10.4103/HUAJ.HUAJ_16_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_16_20","url":null,"abstract":"Aim of the Study: The aim of this study is to review our collective experience with partial orchectomy due to testicular tumors in a secondary hospital of Greece. Materials and Methods: In total four young patients with relative indications for a partial orchectomy (single testis and/or tumors <2 cm in diameter, patient consent for a close follow-up, negative tumor markers) underwent partial orchiectomy in our institution. All operations were performed under clamping of the spermatic cord, and postoperative period was uneventful. Results: Pathology examination revealed one case of Sertoli cell only tumor, one patient with testicular cancer of mixed pathology (embryonal and teratoma), one case of organized hematoma, and one case with focal atypical inflammation. Patients underwent a close follow-up protocol. The patient with the mixed tumor was subjected to adjuvant chemotherapy with BEP (bleomycin, etoposide, cisplatin). The patient with atypical inflammation had a single testis due to a history of contralateral seminoma. During follow-up, he developed local tumor recurrence and underwent orchiectomy that revealed the presence of seminoma. The patient was set under testosterone replacement therapy. Conclusions: Partial orchiectomy represents a safe treatment option in the management of small testicular tumors. A benign pathology in up to 50% of cases should be expected. In case of both malignant and benign pathologies, a close follow-up is deemed necessary for the timely recognition of local recurrences in case of insufficient cancer eradication.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130418755","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}

{"title":"Extracorporeal shock wave lithotripsy for bladder stones: Does it have any role in the modern endourology era?","authors":"T. Karagiotis, A. Papatsoris, A. Skolarikos, C. Deliveliotis","doi":"10.4103/HUAJ.HUAJ_20_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_20_20","url":null,"abstract":"Bladder lithiasis accounts for around 5% of all urinary tract stones diseases with typical symptoms dysuria, hematuria, urgency and intermittent urination. therapy, percutaneous procedures, and open surgical treatments have been replaced by transurethral lithotripsy. The aim of this study is to investigate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of vesical lithiasis. A total of 47 patients underwent ESWL for bladder calculi, using the electromagnetic Dornier Lithotripter S. Stone and prostate size as well as postvoid urine residual was determined with sonography. The success of the procedure was determined in the absence of stone fragments after 4 weeks. The mean age of patients was 69.1 years (34–93 ± 11.43) with a median prostate size at 50.1 cm3 (0–85 ± 15.81) and an average postvoid residual at 131 ml (50–190 ± 32.82). The mean size of lithiasis was found 1.97 cm (1–4.5 ± 0.79) and the median number of impact waves 2704.34 (1800–3000 ± 293.37) with the average duration of session 20.63 min (15–25 ± 2.63). Only two patients received analgesic treatment and the mean pain visual analog scale score was 1.73 (0–4 ± 0.98). The stone-free rate was found at 76.5% (36/47) and no severe complications (Clavien–Dindo >2) were observed. ESWL is a safe and efficient alternative for the management of vesical lithiasis, especially for high-risk patients that are not candidates for a more invasive treatment.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116873658","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}

{"title":"Nephrometry scoring system selects candidates for radical nephrectomy versus nephron-sparing surgery for treatment of renal masses and predicts surgical and oncological outcome","authors":"Ahmed Saafan, H. Mohamed, M. Mansour, Mohamed Kotb Ahmed Tolba","doi":"10.4103/HUAJ.HUAJ_6_20","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_6_20","url":null,"abstract":"Purpose: The study was designed to ensure the sensitivity of preoperative planning by applying radius, endophytic/exophytic, nearness to collecting system, anterior/posterior, and location to poles (RENAL) nephrometry scoring system on computed tomography films of patients having organ-confined solid and cystic renal tumors and to assess its correlation with the surgical technique by applying RENAL on the specimen intraoperative. Materials and Methods: Eighty-five patients with organ-confined solid and cystic renal masses underwent RENAL nephrometry system which was correlated with the surgical technique either radical or nephron-sparing surgery or the surgical and oncological outcome. Results: RENAL nephrometry scoring system shows high sensitivity with the type and outcome of surgery of resection of the renal tumors. Conclusion: RENAL nephrometry score system is an objective method to help in the decision of surgical approach to resect organ-confined solid and cystic renal tumors.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115275276","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}

{"title":"Potassium Para-aminobenzoate (Potaba) induced DRESS syndrome. A case report","authors":"C. Georgiadis, C. Gkekas, V. Kalyvas, E. N. Symeonidis, D. Papadopoulos, A. Malioris, M. Papathanasiou","doi":"10.19264/HJ.V31I2.269","DOIUrl":"https://doi.org/10.19264/HJ.V31I2.269","url":null,"abstract":"Potassium Para-aminobenzoate (Potaba) is an antifibrotic agent indicated for use in the treatment of early stage Peyronie’s disease. It exerts a protective effect by stabilizing the curvature, reducing the plaque size and improving pain perception. It is considered relatively safe with no significant side effects reported other than gastrointestinal irritation. In this paper, we report a case of DRESS syndrome associated with Potaba administration. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug related allergic reaction with systemic manifestations and a significant mortality rate of up to 10%. It is a delayed type IVb hypersensitivity reaction characterised by fever, skin rash, lymphadenopathy, haematological abnormalities and multiple internal organ involvement such as the heart, kidneys, liver, pancreas and lungs. To the best of our knowledge, this is the second case of Potaba induced DRESS syndrome. The patient was managed conservatively and had fully recovered within 9 weeks after the discontinuation of the causative drug. Timely diagnosis of the condition is of paramount importance to avoid multiple organ damage since there is no disease specific treatment so far and supportive therapy with discontinuation of the triggering agent is the indicated response.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117158269","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}

{"title":"Extended pelvic lymph node dissection during extraperitoneal laparoscopic or robotic assisted radical prostatectomy","authors":"I. Kyriazis, E. Liatsikos, J. Stolzenburg","doi":"10.19264/HJ.V31I2.270","DOIUrl":"https://doi.org/10.19264/HJ.V31I2.270","url":null,"abstract":"Objective: Extraperitoneal access in endoscopic (laparoscopicic or robotic assisted) radical prostatectomy is a standard approach in the management of prostatic cancer with well-established advantages over transperitoneal access. Still, traditionally, extraperitoneal endoscopic radical prostatectomy (EERP) has been associated with an inability to offer an extended pelvic lymph node dissection (PLND). The former is due to the fact that in the extraperitoneal space, peritoneal folding covers the majority of common iliac vessels and as a result in extraperitoneal PLND, lymph nodes (LNs) located above the bifurcation of common iliac vessels cannot be dissected. We herein present a simple and easy technique to offer an extended PLND during EERP. Methods: After a conventional extraperitoneal PLND, a peritoneal fenestration cranially to extrernal iliac vessels is performed bilaterally exposing the common iliac vessels. Results: Upon peritoneal fenestration, PLND can be continued in a standard fashion as in transperitoneal approach until the uppermost limit of the extended PLND template which is the ureteral crossing over common iliac vessels. Following LN dissection, both peritoneal fenestrations are left open at both sides, as this approach has been found to decrease the incidence of postoperative lymphocele formation. Conclusions: Peritoneal fenestration over common iliac vessels during extraperitoneal PLND is an easy approach that allows surgeon to reach the uppermost limit of extended PLND template. The latter peritoneal dissection is not time consuming and is expected to decrease the morbidity of the operation reducing the incidence of postoperative lymphocele formation.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129697884","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}

{"title":"Implementation of quality management systems in public health: The experience of the Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School","authors":"C. Mamoulakis, Iordanis Skamagas, M. Petrodaskalaki, C. Mavridis, G. Georgiadis, C. Belantis, Ioannis-Erineos Zissis, G. Avgenakis, Eleftheria Giannitsi, Dimitra Pantartzi, Stavros Synodinos","doi":"10.19264/HJ.V31I2.264","DOIUrl":"https://doi.org/10.19264/HJ.V31I2.264","url":null,"abstract":"Introduction-Objective: Assessing the quality of health service provision at a Department level is difficult and needs to be documented. Documentation is achieved by certification. In spite of the increasing trend for more specialized quality standards, ISO 9001:2015 is the most widespread one. The Directorate of the Department of Urology of the University General Hospital of Heraklion, in cooperation with the Hospital Administration proceeded to study/ install the quality management system (QMS) according to ISO 9001:2015 for the provision by the Department of Urology and its Special Units (Non-Invasive Urology-Lithotripsy & Cystoscopy-Urodynamics) of diagnostic, therapeutic and nursing services as well as for the production of scientific work, research activity and provision of educational services. The procedure was implemented in July 2017 through the Special Account for Research of the University of Crete; using funds from a specific program set up for the development of the Department of Urology. To the best of our knowledge, this is the first case of certification of a Urological Department in a Public Hospital in Greece. The purpose of this study is to present the initial experience/results from the implementation of a QMS according to ISO 9001:2015 at our Department. Material and Methods: The procedure was initiated by providing medical-nursing and administrative staff with self-assessment questionnaires and special forms for problem-filling and improvement suggestions. All forms were filled in anonymously. All data gathered were processed by our quality management consultant. The results were presented to the parties involved in an open meeting at the Department and formed the basis for the QMS design. Through a 12-month strenuous workout with meetings about every 15 days, a QMS consisting of 14 procedures, two working instructions, 17 forms, and 13 administrative nursing protocols was set up. The system included 24 forms provided by the Ministry of Health and 29 clinical nursing protocols issued by the local Health Region. The staff was systematically trained in keeping them up and, with suggestions/ corrective actions the QMS was improved. Results: Through patient satisfaction questionnaires, the Department was rated with 9.1/10 (reception/stay), 9.8/10 (medical follow up), 9.3/10 (nursing care) and 9.2/10 (general service). With the implementation of the QMS, quality indicators related to medical-nursing care (drop-fall rates, fever rates, admission severity-related mortality, etc.) are monitored. Through staff meetings the progress of indicators is presented and actions are being taken aiming at improvements. The operation of the Department has been parameterized and co-perception has been conquered. By implementing a QMS, future goals have also been set: a) Higher staff participation rate problems/suggestions for improvement recording, b) Monitoring achievement of research objectives through standardized procedures, c) Higher satis","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130177966","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}