Turkish journal of urology最新文献

{"title":"Mirabegron as a Medical Expulsive Therapy for 5-10 mm Distal Ureteral Stones: A Prospective, Randomized, Comparative Study.","authors":"Mohamed Abdel-Basir Sayed,&nbsp;Ahmed Mohamed Moeen,&nbsp;Hesham Saada,&nbsp;Anmar Nassir,&nbsp;Abdulmalik Tayib,&nbsp;Rabea Ahmed Gadelkareem","doi":"10.5152/tud.2022.22014","DOIUrl":"https://doi.org/10.5152/tud.2022.22014","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the efficacy and safety of mirabegron as a medical expulsive therapy in patients with distal ureteral stones of 5-10 mm size.</p><p><strong>Material and methods: </strong>A prospective, comparative study included 96 patients with radiopaque distal ure- teral stones of 5-10 mm who were randomly allocated and treated by medical expulsive therapy in 2 groups from January 2019 to December 2020. Patients in group A received only ketorolac 30 mg/day for 5 days, then on demand. Patients in group B received mirabegron 50 mg/day for 4 weeks plus ketorolac 30 mg/day like in group A. The stone expulsion rate was the primary outcome.</p><p><strong>Results: </strong>There were no significant differences regarding age, gender, body mass index, laterality, degree of hydronephrosis, and stone size. After 4 weeks, stone expulsion rate was 52.1% for group A versus 89.6% for group B (P < .001). The median (range) of time to stone expulsion was 14 (13-23) and 7 (3-16) days for groups A and B, respectively (P = .004). The medians (range; interquartile range) of episodes of renal pain (1 (0-2; 1) vs. (0-2; 2); P < .001) and extra analgesic ampoules (1 (0-7; 4) vs. 0 (0-2; 0) vials; P < .001) were significantly higher in group A than those in group B, respectively. In multivariate analysis, only medical expulsive therapy (P <.001) and stone size (P < .001) were independent predictors of stone expulsion rate.</p><p><strong>Conclusion: </strong>Mirabegron is an effective and safe medical expulsive therapy agent in patients with 5-10 mm distal ureteral stones.</p>","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 3","pages":"209-214"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9730259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Approach for Traumatic Complex Degloving Perineal Injuries: A Retrospective Review of 6 Cases","authors":"Chin Yiun Lee, Syahril Anuar Salauddin, H. Ghazali","doi":"10.5152/tud.2022.21320","DOIUrl":"https://doi.org/10.5152/tud.2022.21320","url":null,"abstract":"Objective Degloving perineal injury is defined as avulsion of the perineal skin and subcutaneous tissue from its surrounding fascia, bone, and organs. This injury is most commonly caused by road vehicle accidents or alleged falls from heights. This devastating injury is associated with high morbidity and mortality if mismanaged. We retrospectively evaluated our management protocol for degloving perineal injury and the clinical outcomes of our case series. Material and Methods Six cases of open perineal degloving injuries were managed and retrospectively reviewed at our center from 2018 to 2020, comprising 2 cases of isolated degloving wounds of the scrotum and 4 cases of complex perineal injuries associated with pelvic fracture, anorectal injuries, or complete transacted urethral injuries. Two of the 6 patients had open-book pelvic fractures that required pelvic stabilization. Results Complex degloving perineal injuries can be managed through (1) resuscitation and pelvic packing; (2) urgent life-threatening treatments; (3) pelvic exploration with debridement; and (4) primary repair of anorectal or transacted urethral injuries with external pelvic fixation. All patients promptly underwent surgical repair after immediate diagnosis and resuscitation. Additionally, patients were operated by specialized teams according to the proposed management approach as shown in Figure 1. All patients recovered well and had good functional outcomes. Conclusion A multidisciplinary team comprising general surgeons, urologists, orthopedic surgeons, and plastic surgeons was involved in this review. Prompt diagnosis and immediate surgical intervention remain the standard requirements for complex degloving perineal injuries. We proposed a management protocol that is safe for managing complex perineal injuries.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"142 - 149"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46588736","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":"Three-Dimensional Reconstruction of Pelvicalyceal System of the Kidney Based on Native CT Images Are 1-Step Away from the Use of Contrast Agents","authors":"B. Guliev, A. Talyshinskii, I. Akbarov, V. Chukanov, P. Vasilyev","doi":"10.5152/tud.2022.21329","DOIUrl":"https://doi.org/10.5152/tud.2022.21329","url":null,"abstract":"Objective To describe special algorithm for the semi-autonomous 3-dimensional reconstruction of the pelvicalyceal system based on native computed tomography images of patients with upper urinary tract obstruction. Materials and Methods Fifty patients with renal colic fitting to inclusion criteria were enrolled. All patients underwent computed tomography urography to perform 3-dimensional reconstruction of the pelvicalyceal system on the affected size based on excretory phase representing “gold standard” and on native phase, which was performed via Medical Imaging Interaction Toolkit program updated with the described algorithm. Five urologists estimated their similarities and the potential use of non-contrast models for interventional planning. Contralateral non-distended pelvicalyceal system was reconstructed to evaluate the viability of the proposed technology in such cases. Surface areas of contrast and non-contrast models were compared. Distended pelvicalyceal system of 1 patient was used to reconstruct virtual endoscopic view. Obtained 3-dimensional non-contrast pelvicalyceal system models were analyzed by an engineer for suitability for 3-dimensional printing. Results The average surface area of contrast and non-contrast models was 3513 and 3371 mm2, respectively (P = .0818). Non-contrast 3-dimensional reconstruction was possible with all distended pelvicalyceal systems and with 9 non-distended cases. Properties of non-contrast models were estimated as 4.3 out of 5. Obtained models were suitable for their intraluminal reconstruction and potential 3-dimensional printing. Conclusion Described semi-autonomous approach allows for 3-dimensional reconstruction of dilated pelvicalyceal system based on non-contrast computed tomography images.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"130 - 135"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43767376","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":"MRI/US Fusion Transperineal Versus Transrectral Biopsy of Prostate Cancer: Outcomes and Complication Rates, a Tertiary Medical Center Experience in the Middle East","authors":"A. El-Achkar, Nassib F. Abou Heidar, Muheiddine Labban, Mouhamad Al-Moussawy, Hisham Moukaddem, R. Nasr, R. Khauli, A. El-Hajj, M. Bulbul","doi":"10.5152/tud.2022.21248","DOIUrl":"https://doi.org/10.5152/tud.2022.21248","url":null,"abstract":"Objective : To report on the outcomes of transperineal versus transrectal magnetic resonance imaging/ultrasound fusion biopsy of the prostate including detection of clinically significant cancer and complications. This is the first and largest series in the Middle East. Material and methods Between May 2019 and June 2020, 145 patients with suspicious lesions on magnetic resonance imaging underwent magnetic resonance imaging/ultrasound fusion prostate biopsy at our center. Transperineal biopsy was performed under light sedation, while transrectal biopsy patients had a periprostatic block for anesthesia. Clinically significant cancer was defined as Gleason ≥3 + 4 Results In all, 98 transperineal biopsies and 47 transrectal magnetic resonance imaging/ultrasound fusion prostate biopsies were done. Patients had similar prebiopsy parameters (transperineal vs. transrectal): median age (64.5 vs. 66 years; P = .68), median prostate-specific antigen value (7.5 vs. 7.5; P = .42), and median prostate volume (51 vs. 52.5; P = .83). Those that underwent transperineal biopsy had fewer average total number of cores compared to transrectal ultrasound-guided biopsy (11 vs. 13; P = .025) fewer average number of random cores (3 vs. 6; P < .0001), and the detection rate of clinically significant cancer was similar between the groups (44% vs. 48.9%; P = .57). No difference in hematuria, retention, and sepsis rate requiring admission (1 vs. 2; P = .2) was observed. However, more patients had urinary tract infection in the transrectal ultrasound-guided biopsy group compared to transperineal biopsy group (5 vs. 1; P = .006) that were treated with antibiotics on outside basis. Conclusion : Magnetic resonance imaging/ultrasound transperineal fusion biopsy has similar detection rate of clinically significant cancer compared to transrectal ultrasound-guided biopsy with less urinary tract infection post biopsy.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"98 - 105"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44614947","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":"The Epidemiology and Population-Based Studies of Women with Lower Urinary Tract Symptoms: A Systematic Review","authors":"A. Tahra, Omer Bayrak, R. Dmochowski","doi":"10.5152/tud.2022.21325","DOIUrl":"https://doi.org/10.5152/tud.2022.21325","url":null,"abstract":"In this systematic review, we focused on epidemiology and population-based studies to identify recent real-world data of women with lower urinary tract symptoms. The PubMed, Scopus, and Cochrane databases were used for the literature search using the following keywords: epidemiology, population-based studies, women, female, lower urinary tract symptoms, and urinary incontinence. A total of 20 articles in the English language were found to be eligible for this review. The prevalence of LUTS in women was 11.8%-88.5%. The prevalence of storage symptoms was 23.6%-79%, voiding symptoms was 1.8%-51%, and post-micturition symptoms was 0.3%-46%. The prevalence of voiding and storage symptoms was 8.3%-26.6% and the prevalence of combined voiding, storage, and post-micturition symptoms was 6.6%-19.2%. Any incontinence was observed in 5.8%-45.8% of women. The majority of patients suffered from stress urinary incontinence with 1.9%-31.8%. The prevalence of urgency urinary incontinence and mixed-type urinary incontinence was 0.7%-24.4% and 2.1%-12%, respectively. Increased age, marital and work status, comorbidities, alcohol consumption, higher parity, vaginal delivery, instrumental delivery, prolonged labor, laceration, and post-menopausal status were found to be risk factors for lower urinary tract symptoms. The prevalence of lower urinary tract symptoms in women is increasing, especially with age. Since the worldwide prevalence of lower urinary tract symptoms remains unknown, multi-continental studies, especially in the developing world, with less heterogeneity and more standardized definitions, are needed to better evaluate real-world data in women with lower urinary tract symptoms.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"155 - 165"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43285899","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":"Dorsal Dartos Flap Prepared Before Urethroplasty, Less Bleeding of Operation: A New Perspective on Hypospadias","authors":"Y. Issi, C. Bilir","doi":"10.5152/tud.2022.22031","DOIUrl":"https://doi.org/10.5152/tud.2022.22031","url":null,"abstract":"Objective The benefits of preparing the dorsal dartos flap before urethroplasty were investigated. Materials and methods Patients with coronal, subcoronal, and distal penile hypopadias without severe cordee who underwent surgical repair between October 2016 and September 2020 were included in the study. Tubularized incised plate urethroplasty technique was applied to all patients. The patients were divided into two groups: In Group 1, the dorsal dartos flap was prepared after urethroplasty, which is the commonly used technique today, and sutured on the neourethra. In Group 2, the dorsal dartos flap was prepared before the post-degloving urethroplasty. The amount of bleeding, the duration of the surgery, and the complications between the two groups were recorded and compared. Results Twenty-two patients who could be followed up for at least 3 months were examined. There were 10 patients in Group 1 and 12 patients in Group 2. A statistically significant difference was found between the amount of bleeding of the operation in the two groups. Duration of operation, hematoma, infection, skin necrosis, or glanular dehiscence were not observed in any patient. Conclusion Preparing the dorsal dartos flap, before urethroplasty significantly reduces the amount of bleeding. This may be a new modification alternative in hypospadias surgery.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"150 - 154"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46805051","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":"The Role of Preoperative Urinalysis in Predicting Postoperative Infection After Retrograde Intrarenal Surgery in Patients with Sterile Urine Culture","authors":"O. Kazan, Mehmet Caglar Cakici, F. Keser, M. Çulpan, O. Efiloglu, A. Yıldırım, G. Atis","doi":"10.5152/tud.2022.21331","DOIUrl":"https://doi.org/10.5152/tud.2022.21331","url":null,"abstract":"Objective Postoperative urinary tract infection is the most common complication of retrograde intrarenal surgery, and no consensus has been obtained that would reveal exact reasons yet. It was aimed to determine the possible factors, especially preoperative urinalysis, of postoperative urinary tract infection after retrograde intrarenal surgery. Material and Methods Patients who underwent retrograde intrarenal surgery in our clinic between 2013 and 2019 were retrospectively screened. Stone size <1 cm and >2 cm and pediatric patients were excluded from the study. The patients were divided into 2 groups as those with and without urinary infections in the early postoperative period. Urine analysis parameters and sterile urine cultures that were taken before the procedure were also analyzed separately. Results A total of 289 patients meeting the defined criteria were included in the study. There was no statistical difference between the 2 groups in terms of demographics. The number of patients with previous urinary tract infection history (55% vs. 20.5%) and operation time (62.5 ± 16.6 minutes vs. 60 ± 19.4 minutes) were significantly higher in those who had postoperative early urinary tract infection. Among urinalysis, the presence of pyuria, leukocyte count, leukocyte esterase positivity, and nitrite positivity were significantly higher in those who had postoperative early urinary tract infection. In multivariate analysis, urinary tract infection history, operation time, and nitrite positivity were found as independent factors in predicting postoperative early urinary tract infection. Conclusion Previous urinary tract infection history, prolonged operation time, and nitrite positivity in urinalysis were determined as independent risk factors for postoperative urinary tract infection in kidney stones between 1 and 2 cm.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"136 - 141"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41347935","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":"The Study of 3D Printing-Assisted Electrospinning Technology in Producing Tissue Regeneration Polymer-Fibroin Scaffold for Ureter Repair","authors":"Hanzi Hu, Chia-Lun Wu, Cheng-Shuo Huang, Meng‐Yi Bai, Dah-Shyong Yu","doi":"10.5152/tud.2022.21217","DOIUrl":"https://doi.org/10.5152/tud.2022.21217","url":null,"abstract":"Objective Long segment ureteral lesion with obstruction is a clinically difficult issue for recovering and maintaining organ or tissue function. Regeneration medicine using various biomaterials as a scaffold in supporting tissue regrowth is emerging. We developed this customized scaffold using electrospinning and 3-dimensional assistance and expected that it may provide an alternative biomaterial for ureter defect repair. Material and Methods Our study synthesized polycaprolactone and silk fibroin combination as biomaterial scaffolds. The differences in physicochemical properties and biocompatibility of polycaprolactone–silk fibroin bio-scaffolds prepared by electrospinning alone and 3-dimensional printing combined with electrospinning in proper ratios were compared and characterized. SV-HUC-1 uroepithelial cells cultured in polycaprolactone–silk fibroin (4 : 6) scaffolds were observed under a scanning electron microscope and using calcein-acetomethoxy and propidium iodide stain. The ex vivo resected healthy human ureteral segment tissue was anastomosed with the polycaprolactone–silk fibroin scaffolds and cultured in an ex vivo bath for 2 weeks. The cellular growth on the polycaprolactone–silk fibroin scaffold was observed microscopically. In the New Zealand white rabbit model, we performed a 1/5 ratio (2 cm out of 10 cm) defect replacement of the unilateral ureter. After 7 weeks, the rabbits were sacrificed and the implanted ureter scaffolds were resected for tissue sectioning and the cellular growth was observed by hematoxylin and eosin and Masson staining. Results When the proportion of silk fibroin was increased and the 3-dimensional electrospinning method was used, both the size and diameter of nanofiber holes were increased in the polycaprolactone–silk fibroin scaffold. Scanning electron microscope and fluorescent stain revealed that cultured 3T3 and SV-HUC-1 uroepithelial cells could electively penetrate inside the polycaprolactone–silk fibroin (4 : 6) nanofibrous scaffolds in 3 days. The polycaprolactone–silk fibroin scaffold anastomosis in an ex vivo bath showed cellular growth stably along the scaffold for 2 weeks, and most of the cells grow along with the outboard of the scaffold in layers. In an animal model, different layered cells can be observed to grow along with the outboard of the scaffold with mucosa, submucosa, muscular layer, and the serosa layer order after 7 weeks. Mucosa and muscular layer growth along the scaffold inner wall were seen simultaneously. Conclusion 3-dimensional electrospinning synthesized 4 : 6 polycaprolactone–silk fibroin nanofiber scaffolds that are feasible for tissue growth and achieve the purpose of ureteral reconstruction in animal experiments. This new form of 3-dimensional electrospinning constructed polycaprolactone–silk fibroin nanofiber scaffold may be considered as a clinical urinary tract tissue reconstruction alternative in the future.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"118 - 129"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49650566","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":"The Combined Effect of Downregulated RB1 and Overexpressed lncRNA SSTRS-AS1 on Prediction Time to Castration-Resistant Prostate Cancer: Indonesian Cohort Studies","authors":"I. Soerohardjo, Andy Zulfiqqar, I. Widodo, Didik Setyo Heriyanto, Sumadi Lukman Anwar","doi":"10.5152/tud.2022.21282","DOIUrl":"https://doi.org/10.5152/tud.2022.21282","url":null,"abstract":"Objective: Identifying the mechanism underlying the initiation and development of castration-resistant prostate cancer remains challenging. Time to castration-resistant prostate cancer is defined by prostate-specific antigen progression and may represent a risk factor for developing immune alterations with a negative prognostic role in the overall survival of patients with prostate cancer. This study aimed to evaluate the combined effect of downregulated RB1 and overexpressed SSTR5-AS1 as biomarkers for predicting time to castration-resistant prostate cancer. Material and Methods: The clinical and pathological data of patients with prostate cancer were collected retrospectively. Between 2015 and 2019, a total of 36 patients who received castration were included. Expressions of mRNA of RB1 and SSTR5-AS1 from primary tumors were quantified using quantitative real-time polymerase chain reaction. Patients were divided into 2 groups: the first group consisted of patients with Rb1 expression lower than the median and expression of SSTRS5-AS1 higher than the median, and the second group consisted of all the other patients. This study was conducted in compliance with the latest Helsinki Declaration and registered on Elsevier International Standard Randomized Controlled trial number registry. Results: In this study, patients with both downregulated RB1 and overexpressed Long non-coding RNAs (lncRNA) SSTR5-AS1 showed shorter time to castration-resistant prostate cancer (mean 23.6 ± 3.3 months) compared to other groups (mean 38.3 ± 4.9 months) (log-rank test, P = .028). Conclusion: The combination of downregulation of RB1 and overexpression of SSTR5-AS1 is a strong predictor of shorter time to castration-resistant prostate cancer in the Indonesian population. Additionally, patients with International Society of Urological Pathology (ISUP) score >4 did not demonstrate this predictive value on time to castration-resistant prostate cancer.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"112 - 117"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48783860","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":"Mini-Cog to Predict Postoperative Delirium in Patients Who Underwent Transurethral Resection of Bladder Tumor While Awake","authors":"S. Yajima, Y. Nakanishi, S. Matsumoto, Naoya Ookubo, K. Tanabe, M. Kataoka, H. Masuda","doi":"10.5152/tud.2022.21312","DOIUrl":"https://doi.org/10.5152/tud.2022.21312","url":null,"abstract":"Objective In the postoperative management of transurethral resection of bladder tumor, attention should be paid to the appearance of delirium. Recently, the mini-cognitive assessment instrument (Mini-Cog) has been validated as a screening tool for cognitive impairment. We assessed whether positive preoperative cognitive impairment screening by Mini-Cog is associated with the occurrence of postoperative delirium. Material and Methods In this study, consecutive patients who underwent transurethral resection of bladder tumor while awake and were cognitively screened preoperatively using the Mini-Cog test at our institution were retrospectively analyzed. The relationship between the Mini-Cog test and clinical variables was examined. Univariate and multivariate analyses were carried out to determine the risk factors for the occurrence of postoperative delirium. Results Of the 193 included patients, 37 (19%) patients had probable cognitive impairment (Mini-Cog scores < 3). There were significant differences in patients’ age (P < .001), Eastern Cooperative Oncology Group-physical status (P = .01), decline in instrumental activities of daily living from baseline (P = .03), preoperative diagnosis of dementia (P < .001), and use of benzodiazepine (P = .03) between the Mini-Cog score ≥ 3 group and the Mini-Cog score < 3 group. Multivariate analysis demonstrated that a Mini-Cog score < 3 (odds ratio = 6.8, P < .001) and instrumental activities of daily living decline (odds ratio = 3.0, P = .02) were independent risk factors for the occurrence of postoperative delirium. Conclusion Screening of patients for cognitive function using the Mini-Cog test before transurethral resection of bladder tumor may allow for better identification of patients at risk of postoperative delirium.","PeriodicalId":23366,"journal":{"name":"Turkish journal of urology","volume":"48 1","pages":"106 - 111"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43615476","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}