Urologia Journal最新文献

{"title":"Evaluation of the effect of acupuncture combined with cross-moxibustion in the treatment of patients with severe overactive bladder.","authors":"Xiaogang Guo, Xiaojun Guo, Pingping Hu, Tao Han, Wentao Gai, Yuanyuan Yu, Xuechao Lu","doi":"10.1177/03915603251327833","DOIUrl":"https://doi.org/10.1177/03915603251327833","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the therapeutic effect of acupuncture combined with cross-moxibustion in patients with severe overactive bladder (OAB).</p><p><strong>Methods: </strong>OAB patients from August 2018 to July 2023 were collected, and 101 severe OAB patients were selected based on the Overactive Bladder Symptom Scale (OABSS) score. The patients were divided into three groups according to their treatment methods, including 33 cases of behavioral therapy group, 32 cases were in the acupoint acupuncture group, and 36 cases were in the acupuncture combined with cross-moxibustion group. The treatment outcomes of the three groups were evaluated through the OABSS score, and the quality of life (QOL) was assessed.</p><p><strong>Results: </strong>Among the 101 patients with severe OAB, no statistical differences in age and gender were observed among the three groups of treatments. The treatment effects were evaluated using the OABSS score and it was found that behavioral treatment was basically ineffective. In contrast, both acupuncture and acupuncture combined with cross-moxibustion had significant differences via comparing at pre-post treatment periods, which the OABSS score decreased by 3.25 ± 1.83 and 7.83 ± 1.34 respectively, suggesting that acupuncture combined with cross-moxibustion is more effective than acupuncture group alone. The patient's quality of life was further evaluated through QOL scores, and the results showed that while the acupuncture group was effective, acupuncture combined with cross-moxibustion improved more significantly.</p><p><strong>Conclusion: </strong>The combination of acupuncture and moxibustion is the most effective treatment for patients with severe overactive bladder.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251327833"},"PeriodicalIF":0.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664787","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":"Endovideosurgical methods for treatment of local prostate cancer: Comparative functional and oncological results.","authors":"Chernov Yaroslav, Chinenov Denis, Kurbanov Asadulla, Kovalevskii Anatoliy, Yurkanova Darina, Votyakov Artem, Rapoport Leonid, Korolev Dmitry, Shpot Evgeniy","doi":"10.1177/03915603251318868","DOIUrl":"https://doi.org/10.1177/03915603251318868","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, robot-assisted radical prostatectomy (RARP), extraperitoneal radical prostatectomy (ERPE), and laparoscopic radical prostatectomy (LRP) are frequently used for the treatment of localized prostate cancer.</p><p><strong>Materials and methods: </strong>The study included 2,290 patients with localized prostate cancer. All patients underwent radical prostatectomy (RPE) performed by a single surgeon using different surgical approaches: robot-assisted (RARP, <i>n</i> = 888), laparoscopic (LRP, <i>n</i> = 965), and extraperitoneal (ERPE, <i>n</i> = 437). Oncological outcomes were assessed based on postoperative PSA levels. Functional status was assessed using the following questionnaires: IIEF-5, ICIQ-SF, DRIP-test, and 24-h pad test.</p><p><strong>Results: </strong>In the NS group (LRP and RARP access), the operative time was (200.0 [180.0; 225.0] vs 180.0 [135.0; 230.0] min; <i>p</i> < 0.0001), and the volume of blood loss was (300.0 [200.0; 350.0] vs. 200.0 [150.0; 250.0]). According to the ICIQ-SF test, the presence of patients with symptoms of severe to moderate urinary incontinence (ICIQ-SF scale) in the early postoperative period (mean 9.0 [4.0; 14.0] for RARP vs 11.0 [5.0; 16.0] for LRP and 12.0 [11.0; 14.0] for ERPE, <i>p</i> < 0.0001) contrasted with the results 12 months after surgery, where only patients with mild to moderate urinary incontinence remained (mean 1.0 [0.0; 5.0] for RARP, 4.0 [2.0; 7.0] for LRP, and 5.0 [3.0; 8.0] for ERPE, <i>p</i> < 0.0001).Postoperative erectile function results were evaluated at 12, 24, and 36 months. In all three groups without the NS technique, all patients had significant erectile dysfunction (<i>p</i> < 0.0001). In contrast, at a median follow-up of 12 months, the postoperative questionnaire results for RARP using the NS technique averaged 14.0 [10.0; 18.0], and for LRP 9.0 [6.0; 11.0] (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Robot-assisted radical prostatectomy is the preferred method as it provides better functional outcomes. The use of the nerve-sparing technique significantly improved outcomes in terms of urinary continence and also resulted in fewer patients requiring urological pads.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251318868"},"PeriodicalIF":0.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664786","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":"A comparative analysis of surgical trends in upper urinary tract stone management in Ontario, Canada, and Israel.","authors":"Dor Golomb, Orit Raz, Amir Cooper, J Andrew McClure, Blayne Welk, Sumit Dave, Fernanda Gabrigna Berto, Jennifer Bjazevic, Hassan Razvi","doi":"10.1177/03915603251325096","DOIUrl":"https://doi.org/10.1177/03915603251325096","url":null,"abstract":"<p><strong>Objective: </strong>To compare trends and incidence of surgical intervention among adults with urolithiasis in Ontario, Canada, and Israel.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted using administrative databases from Clalit Health Service in Israel and IC/ES in Canada. The study included adults who underwent their initial surgical treatment for urolithiasis. Descriptive statistics summarized baseline patient demographics, while comparisons were analyzed with a <i>t</i>-test.</p><p><strong>Results: </strong>Between 2003 and 2018, 31,034 and 105,013 patients who underwent surgical intervention for upper urinary tract stones for the first time in their clinical history, excluding those with prior surgical treatments for the same condition, in Israel and Ontario, respectively. The number of insured at Clalit Health Services increased by 21.3%, while the population in Ontario grew by 18.5%. The total number of treated cases rose by 82% and 64.4% in Israel and Ontario, respectively. The procedures per 100,000 people increased by 51% in Israel and 34.6% in Ontario. In Israel, the proportion of females undergoing surgery decreased from 33.5% to 32%, while in Ontario, it increased from 36.3% to 49.8%. Ureteroscopy (URS) was more commonly used in Ontario, while shock wave lithotripsy (SWL) was more common in Israel. URS utilization surged by 281% in Israel and 145.5% in Ontario. Percutaneous nephrolithotripsy (PCNL) increased by 52% in Israel and 8.6% in Ontario, while SWL procedures declined by 57% in Israel and 32.5% in Ontario.</p><p><strong>Conclusions: </strong>A significant rise in the number of patients undergoing their first stone-related procedure in both regions, particularly in Israel. There was a difference in the proportion of female patients requiring surgical intervention, with an increase in Ontario and a decrease in Israel.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251325096"},"PeriodicalIF":0.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606490","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":"Does salvage endoscopically guided tract dilatation increase complications during sonography-guided percutaneous nephrolithotomy?","authors":"Hamid Pakmanesh, MohammadAli Kohansal, Aida Barfzadeh","doi":"10.1177/03915603251325422","DOIUrl":"https://doi.org/10.1177/03915603251325422","url":null,"abstract":"<p><strong>Background: </strong>In percutaneous nephrolithotomy, when tract dilatation fails due to short advancement, endoscopic tract dilatation can be used as a salvage technique for renal access. We aimed to report complications of this technique and compare it with uneventful dilatation cases.</p><p><strong>Methods and materials: </strong>The study enrolled patients who underwent sonography-guided PCNL for six consecutive months in 2023. After renal puncture under the sonography guide, an Amplatz dilator was used for one-shot tract dilation. In the case of short-advancement, a bi-prong forceps was used under direct endoscopic vision for tract dilatation. The study compared the operation time, postoperative complications, and stone-free rate between successful one-shot Amplatz dilatation (SA) and those with salvage endoscopic tract dilatation (SE).</p><p><strong>Results: </strong>The study included 108 patients with a mean age of 47.9 ± 11.6 (50.9% male). Short-advancement occurred in 63 patients (58.3%). The salvage technique was successful in 95.2% of occasions of short advancement. Pre-operative demographic and clinical data were not different in this group compared to the (SA) group. The operative time was 21.1 ± 14.5 min in the (SE) group, which was not longer than the (SA) group with 22.7 ± 12.6 min (<i>p</i> = 0.2). The stone-free rate was 81.0% in the (SE) group, which was not inferior to 73% in the (SA) group (<i>p</i> = 0.3). The transfusion rate and complications were not different as well.</p><p><strong>Conclusion: </strong>Salvage bi-prong forceps tract dilation in the event of short advancement after one-shot Amplatz tract dilation during percutaneous nephrolithotomy is not linked to a higher complication rate or inferior clinical outcomes compared to successful one-shot dilation.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251325422"},"PeriodicalIF":0.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606491","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":"Safety and efficacy of percutaneous nephrolithotripsy versus retrograde intrarenal surgery for obese patients with pelvic 1.5:3 cm renal stones.","authors":"Mohamed Soliman, Tarek Abd El-Mageed Salem, Bassem Adel Husein Metwally, Mohamed Mahmoud Abdelfatah Zaza","doi":"10.1177/03915603251317647","DOIUrl":"https://doi.org/10.1177/03915603251317647","url":null,"abstract":"<p><strong>Background: </strong>Retrograde intrarenal surgery (RIRS) has recently made significant breakthroughs, drawing some attention to it as a secondary or alternative method of treating kidney stones.</p><p><strong>Objectives: </strong>To compare the safety and efficacy of the percutaneous nephrolithotripsy (PCNL) in the prone position vs retrograde intrarenal surgery (RIRS) in surgical treatment of unilateral pelvic renal stones from 1.5 to 3 cm is size in adult obese patients with body mass index ⩾30.</p><p><strong>Methods: </strong>This prospective randomized comparative study was done at Helwan University Hospital. It was conducted on 120 patients with unilateral pelvic renal stones from 1.5 to 3 cm in largest diameter who was admitted through duration to compare the two procedures' differences in terms of complications, analgesic use, hospital stay, operational time, and stone-free rates.</p><p><strong>Results: </strong>There was no significant difference between the two groups as regard stone free rate and complications. Stone free rate was 91.1% in PCNL group while it was 84.5% in RIRS group (<i>p</i>-value = 0.314). The mean operative time for PCNL & RIRS groups was 96 ± 28.23 min and 119 ± 14.4 min, respectively (<i>p</i>-value = 0.026). Mean hospital stay was 3.16 ± 0.77 days in PCNL group while it was 1.19 ± 0.69 days in RIRS group (<i>p</i>-value < 0.001).</p><p><strong>Conclusion: </strong>RIRS can be used as the first option in obese individuals with 1.5 to 3 cm renal stones is based on the satisfactory results attained in the RIRS groups.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251317647"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493896","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":"Effect of FLRT3 on epithelial-mesenchymal transition in clear cell renal cell carcinoma.","authors":"Jiongming Wang, Zhouzhou Xie, Shansen Peng, Yueting Huang, Baitong Chen, Nanhui Chen","doi":"10.1177/03915603251319944","DOIUrl":"https://doi.org/10.1177/03915603251319944","url":null,"abstract":"<p><strong>Objective: </strong>FLRT3 is a member of the fibronectin leucine-rich transmembrane protein family, which regulates cell-cell adhesion and epithelial-mesenchymal transition (EMT). However, the role of FLRT3 in clear cell renal cell carcinoma (ccRCC) remains unknown; therefore, we explored the potential role of FLRT3 in ccRCC.</p><p><strong>Methods: </strong>We analyzed FLRT3 expression levels in ccRCC tissues across multiple databases. We examined the relationship between FLRT3 expression and EMT through single-cell data and transcriptional regulatory network analyses. Additionally, we investigated the association between FLRT3 expression levels and various clinicopathological indicators, compared the impact of FLRT3 expression on patient prognosis, and constructed a nomogram prognostic model. Furthermore, we performed enrichment analyses on differentially expressed genes to reveal potential biological functions and mechanisms.</p><p><strong>Results: </strong>FLRT3 expression levels were significantly lower in ccRCC tissues compared to normal kidney tissues and progressively decreased with advancing pathological stages and grades. FLRT3 mediated the promotion of EMT by transcription factor ATF4; survival analysis indicated that patients with high FLRT3 expression had significantly better overall survival compared to those with low FLRT3 expression. Enrichment analysis revealed that FLRT3 was associated with epithelial cell differentiation, retinol metabolic processes, and collagen-containing extracellular matrix.</p><p><strong>Conclusion: </strong>FLRT3 expression is downregulated in ccRCC and may promote EMT through transcription factor ATF4. Downregulation of FLRT3 is associated with poor prognosis.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251319944"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493894","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":"Associated factors for benign prostatic hyperplasia in patients with bladder calculi.","authors":"Junjie Lu, Wanting Gao, Chunyang Fei, Wenqiang Liao, Gaoming Hou, Yuxue Lin, Wenwang Rao, Qingtao Yang, Xuxia Sui","doi":"10.1177/03915603251318869","DOIUrl":"https://doi.org/10.1177/03915603251318869","url":null,"abstract":"<p><strong>Purpose: </strong>A retrospective study was performed to identify potential metabolic abnormalities and inflammatory abnormalities associated with benign prostatic hyperplasia (BPH) secondary to bladder calculi.</p><p><strong>Materials and methods: </strong>This study enrolled 646 patients with bladder calculi between 2008 and 2022, including 314 patients with benign prostatic hyperplasia (BPH) and 332 without BPH. Demographic characteristics, serum biochemical parameters, prostate volume, maximum bladder calculus diameter, and randomized urinary metabolic profiles were compared between the two groups.</p><p><strong>Results: </strong>BPH was associated with increased aspartate aminotransferase/alanine aminotransferase (mean 1.2 vs 1.1, <i>P</i> < 0.05), lower cholinesterase (mean 7240.5 vs 7778.4, <i>P</i> < 0.01), increased systolic pressure (mean 137.2 vs 133.4, <i>P</i> < 0.01). Patients with BPH were significantly older and had higher systolic blood pressure compared to non-BPH patients. BPH group exhibited significantly lower levels of albumin/globulin ratio, cholinesterase, phosphorus, triglycerides, platelet count, neutrophil count, and white blood cell count, while demonstrating higher aspartate aminotransferase/alanine aminotransferase ratio, mean corpuscular volume, monocyte ratio, and urinary red blood cell count. Prostate volume was proportional to body weight and crystal count. Lower phosphorus (OR = 0.207; 95%CI = 0.068, 0.635; <i>P</i> < 0.01) and higher age (OR = 1.065; 95%CI = 1.041, 1.090; <i>P</i> < 0.001) were associated with BPH.</p><p><strong>Conclusions: </strong>Advanced age was identified as a significant risk factor for prostate hyperplasia in patients with bladder calculi, whereas elevated phosphorus levels emerged as a protective factor. The pathogenesis of BPH secondary to bladder calculi appears to be multifactorial, primarily influenced by metabolic abnormalities and inflammatory processes. These findings provide valuable insights for the clinical assessment and management of BPH secondary to bladder calculi.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251318869"},"PeriodicalIF":0.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469262","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 prevalence and susceptibility patterns of uropathogens in a private teaching hospital: A six years retrospective study at GAMBY teaching hospital, Bahir Dar, Ethiopia.","authors":"Adugna Tasew Tebabal, Ashagrachew Tewabe Yayehrad, Ebrahim Abdela Siraj, Dagninet Derebe Abie, Haylemariam Adera Bayleyegn, Abyot Terefe Teshome, Beselam Gizachew Astatekie, Sefiw Abere Zeleke, Samrawit Temesgen Setargew, Solomon Kassahun Tessega, Litgebew Yitayih Gelaw","doi":"10.1177/03915603251316700","DOIUrl":"https://doi.org/10.1177/03915603251316700","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Urinary tract infection (UTI) is humans' second most common bacterial infection. Indiscriminate use of antibiotics is a common practice in underdeveloped and many developing countries that often leads to the emergence of resistant microorganisms to one or several of these agents with gradual narrowing of scope for effective molecules to combat bacterial infections including UTIs. As a common practice, empirical antimicrobial treatment is initiated before the laboratory results of urine culture are available which may lead to the emergence and spread of antimicrobial-resistant strains. Therefore, this study was conducted to identify the common bacterial uropathogens associated with urinary tract infection and their susceptibility to antibiotics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aims to analyze the prevalence of culture-positive isolates and determine the susceptibility patterns of bacterial uropathogens to antibiotics at GAMBY Teaching General Hospital, Bahir Dar, Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An institution-based retrospective study was conducted at GAMBY Teaching General Hospital (GTGH) for patients who had UTIs, from November 1, 2015, to December 30, 2021 G.C. Antimicrobial sensitivity tests were done using the disc diffusion technique as per the standard of the Kirby-Bauer method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,714 urine samples were processed. Of the total urine samples collected, 974 (56.8%) were from women and 456 (26.6%) revealed a positive culture. Among the positive isolates, the gram-negative was 340 (74.6 %), which makes it the most prevalent type. E. coli, 276 (60.5%) and S. saprophyticus, 78 (17.1%) were the two most prevalent uropathogens isolated. The highest percentage of susceptibility to antimicrobial agents was seen with nitrofurantoin 338 (91.4%), Clindamycin 72 (83.7%), Norfloxacin 244 (79.2%), and Cefoxitin 22 (78.6%). Ampicillin 48 (100%), Piperacillin 6(100%), Cefixime 6 (100%), Clarithromycin 6 (100%), Amoxicillin 96 (96%), Amoxicillin/clavulanic acid 242 (89.6%), and Penicillin 12 (85.7%) had the highest percentage of resistance among all isolates to the antimicrobial agents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and recommendations: &lt;/strong&gt;Urinary tract infections are mostly caused by Gram-negative bacteria predominantly in females and Escherichia coli is the most common isolated bacteria. Nitrofurantoin, Norfloxacin, cefoxitin, and clindamycin are considered appropriate antimicrobials for the empirical treatment of urinary tract infections. The majority of uropathogens were resistant to antibiotics commonly used in clinical practice. The resistance pattern to all of the microorganisms incriminated showed there was a progressive increment of resistance to the common antibiotics over the study period. Empirical treatment of UTIs should be guided on the newer culture and sensitivity pattern and more importantly, prescriptions should be revised following the cult","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251316700"},"PeriodicalIF":0.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469330","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":"Harnessing radiomics and nutritional metrics to predict long-term survival in Fournier's gangrene patients.","authors":"Kamil Malshy, Stephen Schmit, Borivoj Golijanin, Benjamin Ahn, John Morgan, Amir Farah, Kennon Miller, Dragan Golijanin, Madeline Cancian","doi":"10.1177/03915603251318502","DOIUrl":"https://doi.org/10.1177/03915603251318502","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association of traditional and novel nutritional measurements with survival in Fournier's gangrene (FG) patients.</p><p><strong>Methods: </strong>We reviewed records of FG patients from our tertiary center (Jan 2013-Jan 2022). Radiomic sarcopenia parameters (Psoas Muscle Area [PMA], Roundness, Solidity, and calculated PMA-Index) were measured from admission CT scans at the L3 level using ImageJ software. We assessed sarcopenia's impact on survival through three analyses: Model 1 used a PMI below the sex-adjusted median; Models 2 and 3 used published cutoffs. Kaplan-Meier curves were used to compare survival between sarcopenic and non-sarcopenic patients. Multivariable Cox and logistic regression analyses adjusted for age and the Charlson Comorbidity Index (CCI) to assess mortality risk.</p><p><strong>Results: </strong>Of 130 men and 31 women (82% white), 60 patients (37.3%) had died after a median follow-up of 2.2 years (IQR 0.9-4.4). Survival rates were 94% at 30 days, 92% at 90 days, 80% at 1 year, 77% at 2 years, and 56% at 5 years. Non-survivors were older (median age 63 vs 55.1 years, <i>p</i> < 0.001) and had higher median CCI (4.8 vs 3; <i>p</i> < 0.001).In Model 1, sarcopenic patients had a non-significant increased mortality risk with hazard ratio (HR 1.47, 95% CI 0.82-2.64, <i>p</i> = 0.196). Models 2 and 3 showed similar results (HR 1.41, 95% CI 0.70-2.84, <i>p</i> = 0.325; HR 1.35, 95% CI 0.70-2.61, <i>p</i> = 0.364). None of the models were significant when adjusting for CCI and age. Survivors had better traditional metabolic profiles, including higher albumin (3.1vs 2.7 g/dL), hemoglobin (12.4vs 11.4 g/dL), and lower creatinine (1.39 vs 2.1 mg/dL); however, none of these were significant when adjusting for age and CCI.</p><p><strong>Conclusions: </strong>Despite a mild trend, none of the sarcopenia models were able to predict long-term mortality in FG patients in our cohort. This well-known, cost-effective nutritional predictor still requires further research to optimize its utilization in the FG patient population.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251318502"},"PeriodicalIF":0.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433697","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":"Evaluation of the analgesic effect of a combination of oral acetaminophen and oxycodone after extracorporeal shock wave lithotripsy (SWL).","authors":"Leila Zareian Baghdadabad, Abdolreza Mohammadi, Iman Menbari Oskouie, Farshid Alaeddini, Hirad Farajidavar, Leonardo Oliveira Reis, Seyed Mohammad Kazem Aghamir","doi":"10.1177/03915603251317046","DOIUrl":"https://doi.org/10.1177/03915603251317046","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to compare the effects of suppository diclofenac (an example of NSAIDs) and oral administration of the combination of oxycodone (an example of an opioid) and acetaminophen in managing pain in patients with renal colic after SWL treatment.</p><p><strong>Method: </strong>The current study is a double-blind clinical trial involving individuals scheduled to receive elective SWL therapy for kidney and ureteral stones. Participants were randomly assigned to one of two groups using the block randomization technique: suppository Diclofenac (100 mg) or a combination of 325 mg Acetaminophen + 5 mg oxycodone administered orally for pain relief following SWL. Pain intensity was measured immediately after the SWL procedure, and analgesics were then given to the patients. After 30 min, pain severity was reassessed. The severity of pain in patients was documented before and after drug administration at 24, 48, and 72 h after the SWL intervention.</p><p><strong>Results: </strong>154 renal stone patients (63 females) underwent SWL with a mean age of 41.52 ± 10.52 years. The two groups were similar in terms of age (<i>p</i> = 0.572), sex (<i>p</i> = 0.212), location of the stone (<i>p</i> = 0.868), size of the stone (<i>p</i> = 0.762), and occurrence of complication (<i>p</i> = 0.302). There was no significant difference in the reduction of pain severity between the two groups after 30 min (<i>p</i> = 0.224), 2 days (<i>p</i> = 0.501), and 3 days (<i>p</i> = 0.229) following SWL intervention. However, after a 24-h follow-up, pain severity decreased more in the diclofenac group compared to the other group (<i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The combination of oxycodone and acetaminophen, including a multimodal analgesic approach, can be considered a preferred option in the clinical setting for pain management of patients undergoing SWL. It provides relief for patients as effectively as NSAIDs, with the same safety profile, leading to high patient satisfaction.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251317046"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415434","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}