IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.024

引用次数: 0

Utilizing the Ex-Vivo Bovine Model in Retrograde Intrarenal Surgery Training 在逆行肾内手术培训中利用活体牛模型。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.053

{"title":"Utilizing the Ex-Vivo Bovine Model in Retrograde Intrarenal Surgery Training","authors":"","doi":"10.1016/j.urology.2024.06.053","DOIUrl":"10.1016/j.urology.2024.06.053","url":null,"abstract":"<div><h3>Objective</h3><p>To present an ex-vivo bovine model for retrograde intrarenal surgery (RIRS) training.</p></div><div><h3>Materials and Methods</h3><p>The model was specifically developed for a pre-congress course organized as part of the National Pediatric Urology Congress. The course involved a 2-day online theoretical segment followed by hands-on training. Bovine kidneys were chosen for their anatomical resemblance to human kidneys. The kidneys were sourced from a local slaughterhouse, ensuring the intactness of the pelvis, ureters, and perirenal fat. A Modified Larssen solution was used for tissue preservation. The tissue was positioned within a cardboard box, with specific preparation techniques to ensure realism. During the hands-on training, participants utilized a flexible ureterorenoscope for practice. After the course, participants completed an 18-question survey assessing the model and training experience.</p></div><div><h3>Results</h3><p>Twenty-four participants completed the training and survey. Four out of 8 procured kidneys were suitable. The model's cost was 18 euros. Around 87.5% of participants reported increased RIRS confidence. Those with prior course experience rated the model's anatomical resemblance higher (<em>P</em> = .016). No significant difference was observed in feedback on the model's durability or tactile feedback based on prior experience (<em>P</em> >.05).</p></div><div><h3>Conclusion</h3><p>The ex-vivo bovine model provides a promising alternative for RIRS training. While further studies are needed to validate its widespread application, initial feedback suggests it offers a balance between cost-effectiveness and realistic training experience.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0090429524005041/pdfft?md5=5c46da919098aca120d9e689251010df&pid=1-s2.0-S0090429524005041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Household Toilet and Sanitation Insecurity is Associated With Urinary Symptoms, Psychosocial Burden, and Compensatory Bladder Behaviors 家庭厕所和卫生设施不安全与泌尿系统症状、社会心理负担和膀胱补偿行为有关。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.071

{"title":"Household Toilet and Sanitation Insecurity is Associated With Urinary Symptoms, Psychosocial Burden, and Compensatory Bladder Behaviors","authors":"","doi":"10.1016/j.urology.2024.06.071","DOIUrl":"10.1016/j.urology.2024.06.071","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate whether being “at-risk” for toilet and sanitation insecurity in the United States is associated with urinary<span> symptoms, voiding<span> behaviors, and psychosocial burden. Based on census data, nearly 2 million people in the United States do not have access to adequate plumbing. More may have inconsistent access related to cost, inadequate facilities for the number of people in a home, or declining regional infrastructure. The effects of inadequate access in the United States are poorly characterized.</span></span></p></div><div><h3>Methods</h3><p><span>This is a secondary analysis of a community-based sample of adults electronically recruited to complete questionnaires on clinical and sociodemographic information, living situations, home toilets and plumbing, urinary<span><span> symptoms, compensatory bladder behaviors, and psychosocial burden. Multivariable </span>logistic regression was used to assess for associations between being at-risk for toilet and sanitation insecurity and urinary and psychosocial symptoms. </span></span>Linear regression<span> was used to assess for association with adopting compensatory bladder behaviors.</span></p></div><div><h3>Results</h3><p>This sample included 4218 participants, of whom 17% were identified as being at-risk for toilet and sanitation insecurity. Being at-risk for toilet and sanitation insecurity was associated with worse overall urinary symptoms and greater bother from these symptoms, in addition to worse self-assessed mental and physical health, anxiety, stress, depression, and fewer social supports. Finally, those at-risk for toilet and sanitation insecurity were more likely to adopt burdensome and unhealthy compensatory bladder behaviors.</p></div><div><h3>Conclusion</h3><p>As with other social determinants of health, toilet and sanitation insecurity may be an under-appreciated contributor to urinary symptoms, unhealthy toileting behaviors, and psychosocial distress.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stomal Stenosis After Continent Urinary Diversion in Bladder Exstrophy: Risk Factors and Management 膀胱萎缩症患者持续性尿路转流术后的间质狭窄：风险因素与管理。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.07.003

{"title":"Stomal Stenosis After Continent Urinary Diversion in Bladder Exstrophy: Risk Factors and Management","authors":"","doi":"10.1016/j.urology.2024.07.003","DOIUrl":"10.1016/j.urology.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><p><span>To identify risk factors for stenosis and compare management strategies for stenosis etiology and to examine the efficacy of each approach. Patients with classic bladder exstrophy (CBE), a rare </span>genitourinary malformation<span>, may require construction of a continent urinary stoma (CUS) if incontinence persists. Stomal stenosis is a challenging complication as it is common, progressive, and recurrent.</span></p></div><div><h3>Methods</h3><p><span>CBE patients who underwent CUS were retrospectively reviewed for risk factors for stenosis including stoma type, prior midline laparotomy number, and umbilicoplasty </span>suture material. Stenosis etiology and management strategies were further reviewed.</p></div><div><h3>Results</h3><p><span><span>A total of 260 CBE patients underwent CUS creation. Stenosis developed in 65 patients (25.0%) at a median interval of 1.9 years. Etiology included scar contracture (n = 41), keloid (n = 17), and </span>hypertrophic scar (n = 7). Multifilament suture was the only variable associated with an increased risk of stenosis compared to monofilament suture (</span><em>P</em><span> = .009). Almost all patients required surgical intervention. Most scar contractures underwent stomal incision with success in 100%. Hypertrophic scars and keloids responded best to excision with local tissue rearrangement (66.7%). At last follow-up, all patients achieved success.</span></p></div><div><h3>Conclusion</h3><p>Stomal stenosis is common and challenging for the reconstructive surgeon. Strategies to prevent and effectively manage this are greatly desired. Use of multifilament suture for the umbilicoplasty increased stenosis perhaps from a greater inflammatory response and scarring, while monofilament suture may reduce its incidence. Stomal incision for treating scar contractures, and excision with local tissue rearrangement for hypertrophic scars and keloids may improve successful primary surgical intervention.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Teaching Hospitals and Textbook Outcomes After Major Urologic Cancer Surgery 教学医院与泌尿系统癌症大手术后的教科书成果。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.007

{"title":"Teaching Hospitals and Textbook Outcomes After Major Urologic Cancer Surgery","authors":"","doi":"10.1016/j.urology.2024.06.007","DOIUrl":"10.1016/j.urology.2024.06.007","url":null,"abstract":"<div><h3>Objective</h3><p>To assess textbook outcomes by hospital teaching status following major surgery for urologic cancers.</p></div><div><h3>Methods</h3><p><span><span>We used 100% national Medicare Provider Analysis and Review files from 2017-2020 to assess rates of textbook outcomes in patients undergoing bladder<span> (ie, radical cystectomy), kidney (ie, radical or partial nephrectomy), and prostate (ie, radical prostatectomy) surgery for genitourinary malignancies. The extent of integration of learners into each hospital’s workforce—defined as major, minor, and non teaching hospitals—was the primary exposure. A textbook outcome, measured at the patient level, was defined as the </span></span>absence of in-hospital mortality and mortality within 30</span>  <span>days following discharge, no postoperative complication, and no prolonged length of stay.</span></p></div><div><h3>Results</h3><p><span><span>Textbook outcomes were achieved in 51% (8564/16,786) of patients after bladder cancer<span> surgery, 70% (39,938/57,300) of patients after kidney cancer surgery, and 82% (50,408/61,385) of patients after </span></span>prostate cancer surgery. After adjusting for patient- and hospital-level characteristics, teaching hospitals had higher rates of textbook outcomes in those undergoing bladder (50.7% vs 44.0%; </span><em>P</em> = .001), kidney (72.0% vs 69.7%; <em>P</em> = .02), and prostate (85.3% vs 81.0%; <em>P</em> <.001) surgery. This effect was attenuated, but not eliminated, by surgical volume in additional sensitivity analyses for bladder (OR: 1.20, 95% CI: 1.00-1.42; <em>P</em> = .04) and prostate (OR: 1.15, 95% CI: 1.00-1.32; <em>P</em> = .04) surgery. There were no significant differences in kidney cancer surgery outcomes after adjusting for hospital volume (OR: 1.03, 95% CI: 0.93-1.14; <em>P</em> = .6).</p></div><div><h3>Conclusion</h3><p>Undergoing major cancer surgery at a teaching hospital was associated with an increased likelihood of achieving a textbook outcome. This effect was attenuated by volume but persisted for bladder and prostate surgery.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to Editorial Comment on “Transsphincteric Repair of Rectourethral Fistulas in Combination With Dartos Muscle Flap Interposition Following Radical Prostatectomy” 对 "根治性前列腺切除术后经括约肌修补直肠尿道瘘并结合达托斯肌皮瓣插植术 "的编辑评论的回复。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.07.007

引用次数: 0

Reply to Editorial Comment on “Incidence and Management of Radiation Cystitis After Pelvic Radiotherapy for Prostate Cancer: Analysis From a National Database" 对 "前列腺癌盆腔放疗后放射性膀胱炎的发病率和管理：来自全国数据库的分析"。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.027

引用次数: 0

Reply to Editorial Comment on “Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During Monopolar Transurethral Resection of the Prostate: A Randomized Controlled Clinical Trial” 对 "前列腺内注射氨甲环酸可减少单极 TURP 术中的失血量：一项随机对照临床试验 "的编辑评论的回复。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.062

引用次数: 0

The Prevalence of Urinary Incontinence, Knowledge and Practice of Pelvic Floor Muscle Training Among Female Recruits in Basic Training 基础训练中女兵尿失禁的发生率、盆底肌肉训练的知识和实践。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.07.016

{"title":"The Prevalence of Urinary Incontinence, Knowledge and Practice of Pelvic Floor Muscle Training Among Female Recruits in Basic Training","authors":"","doi":"10.1016/j.urology.2024.07.016","DOIUrl":"10.1016/j.urology.2024.07.016","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the prevalence, and severity of urinary incontinence (UI) among female recruits during basic training and their knowledge and practice of pelvic floor muscle training (PFMT). Furthermore, to determine if there is a relationship between the severity of UI and PFMT knowledge and practice.</p></div><div><h3>Methods</h3><p>This correlational study utilized a demographic and health questionnaire, a UI questionnaire (International Consultation on Incontinence Questionnaire Short Form [ICIQ-SF]), and a PFMT questionnaire-Short version of the Patient-reported Outcome Measures [PFMT-P]).</p></div><div><h3>Results</h3><p>The study included 349 female recruits with a mean age of 18.17 ( ± 0.390). The prevalence of UI was 26.7%, with a low mean of 2.03 ( ± 3.893) on the ICIQ-SF. PFMT knowledge level was moderate, 1.46 ( ± 0.790), and the mean practice of PFMT was low, 2.51( ± 1.180). No significant correlation was found between the ICIQ-SF score and the level of knowledge, r<sub>s</sub> = −0.09, <em>P</em> = .092. There was a weak but significant correlation between the ICIQ-SF score and PFMT practice, r<sub>s</sub> = 0.170, <em>P<!--> </em>= .003.</p></div><div><h3>Conclusion</h3><p>A little more than a quarter of the female recruits reported UI with a low severity. A relationship was found between UI and PFMT practice.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0090429524005697/pdfft?md5=ed08792184700bb7ae394cbc66dd3829&pid=1-s2.0-S0090429524005697-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on “Eulogy for B&O Suppositories: A Resident’s Remembrance of Rectal Relief” 为 B&O 栓剂讴歌》的社论评论：一位居民对直肠舒缓的回忆"。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.017

引用次数: 0

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