Urology Annals最新文献

{"title":"Bladder perivascular epithelioid cell neoplasm: Review on clinical features of this rare tumor.","authors":"Zeno Adriaenssens, Robby Peter Anna Lamoury, Sam Tilborghs, Stefan De Wachter, Tim Brits","doi":"10.4103/ua.ua_40_23","DOIUrl":"10.4103/ua.ua_40_23","url":null,"abstract":"<p><p>Perivascular epithelioid cell neoplasm (PEComa) is a rare mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They can arise in various localizations such as the bladder. A total of 36 case reports regarding bladder PEComa have been described in the literature. Eleven reviews regarding this tumor have been published in literature so far primarily focusing on anatomic pathology. Through these reviews, it is known that in bladder PEComa, the melanocytic marker Human Melanoma Black-45 is expressed in 100% of cases whereas variable expression can be seen in multiple other melanocytic and myoid markers such as smooth muscle actin, <i>Melan-A, CD117, S100, CD31</i>, and CD34. Since current reviews mainly emphasize anatomic pathology, we perform a review focusing on the clinical aspects of PEComa at the level of the clinician. A manual electronic search of the PubMed/Medline and Web of Science Core Collection databases was conducted. Search was done on (perivascular epithelioid cell neoplasms [MeSH terms]) AND (Bladder). All case reports and reviews were encompassed until March 15, 2023, to identify studies that assessed bladder PEComa. The age of presentation is relatively low with a median age of 37 years. There is a female predominance with a female/male ratio of 1.5. The tumor shows no preference in anatomical localization within the bladder. Even involvement of the bladder neck, proximal urethra, and distal ureter has been described. The clinical presentation consists in the majority of patients of symptoms related to the urinary tract such as hematuria, dysuria, passage of urine sediment, frequency, and urgency. Other symptoms include abdominal discomfort and dysmenorrhea. In clinical examination, an abdominal mass can be found based on the size and location of the tumor. Further examination usually encompasses cystoscopy due to the hematuria and radiological investigations such as ultrasound (US), computed tomography, and magnetic resonance imaging. These radiological investigations reveal a heterogeneous solid mass with clear borders. In our center, we performed a transvaginal US additionally in a patient with bladder PEComa, which was the only investigation in our patient that concluded the mass was located in the Retzius space. For treatment, transurethral resection of the bladder tumor and partial cystectomy were both described in equal numbers. The choice of treatment depends on the localization and size of the tumor. Follow-up consists of imaging, but clear guidelines on this matter are lacking. Bladder PEComa is a rare condition and usually presents itself with nonspecific symptoms. Radiological investigations will reveal the tumor, but the final diagnosis is based on cytological and immunohistochemical features. Since bladder PEComa is an entity with uncertain malignant potential, it is important to include this entity in the differential diagnosis when a patient present","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983925","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":"Grossing to reporting of Wilms tumor with emphasis on proper sampling in treatment-naive and postchemotherapy specimens and their clinicopathological correlation with outcome.","authors":"Mohan Krishna Pasam, B Vishal Rao, Sai Kiran Chaganty, Rakesh Manilal Sharma, Veerendra Patil, Suseela Kodandapani, Sundaram Challa, Subramanyeshwar Rao Thammineedi","doi":"10.4103/ua.ua_60_23","DOIUrl":"10.4103/ua.ua_60_23","url":null,"abstract":"<p><strong>Context: </strong>Emphasis on grossing to reporting for the assessment of histopathological parameters predicting outcomes in Wilms tumor.</p><p><strong>Aims: </strong>To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens.</p><p><strong>Settings and design: </strong>This was a retrospective observational study.</p><p><strong>Subjects and methods: </strong>All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children's Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed.</p><p><strong>Statistical analysis used: </strong>Chi-square and Fisher's exact tests were used for statistical analysis.</p><p><strong>Results: </strong>A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (<i>n</i> = 10) we mixed histological type followed by blastemal type constituting (32%, <i>n</i> = 8). Regressive and epithelial histological types constituted 16% (<i>n</i> = 4) and 12% (<i>n</i> = 3), respectively. In the SIOP group 72% (<i>n</i> = 19) had no anaplasia and 28% (<i>n</i> = 7) had anaplasia. Fifty seven percent (<i>n</i> = 15) cases were Stage I, followed by 26.9% <i>n</i> = 7) and 11.5% (<i>n</i> = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission.</p><p><strong>Conclusions: </strong>Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983928","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 of nephrolithiasis in the Middle East over a recent decade: A systematic review.","authors":"Ehab Mahmoud Ahmed","doi":"10.4103/ua.ua_111_23","DOIUrl":"10.4103/ua.ua_111_23","url":null,"abstract":"<p><p>Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983848","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":"Thermoexpandable Memokath stent: Usage and efficacy in ureteral and urethral strictures in Saudi Arabia.","authors":"Omar Buksh, Anfar Jar, Ahmad Khogeer, Hani Alzahrani, Rabea Akram, Mohammad Taher, Mahmoud Al Akra'a, Adel Alammari, Islam Junaid","doi":"10.4103/ua.ua_160_22","DOIUrl":"10.4103/ua.ua_160_22","url":null,"abstract":"<p><strong>Objectives: </strong>Double J (DJ) stent is widely used in cases of ureteric strictures as a temporary solution; however, it has certain limitations, such as the need for frequent exchange. Alternatively, a long-lasting thermoexpandable stent (Memokath™ 051) has been used to relieve ureteral obstructions in comorbid patients with multiple reported advantages, such as longer durability which avoids the need of frequent exchanges. In addition, it can be used in certain cases of urethral strictures. Our study is the first in the region to report the experience and outcome of Memokath stent with ureteral and urethral strictures.</p><p><strong>Materials and methods: </strong>After local IRB approval, we retrospectively reviewed records of 21 patients who underwent insertion of Memokath 051 stent in the ureter and Memokath 045 in the urethra between 2013 and 2021. Indications of insertion, indwelling duration, and causes of removal were collected and analyzed by SPSS.</p><p><strong>Results: </strong>Twenty-one patients received 21 Memokath stents for 11 ureteral strictures and 10 urethral strictures. Fifty-five percent of ureteral strictures were malignant, and 27.3% of the benign ureteric strictures were transplant ureters. Ureteric memokath stents remained functioning for a mean of 16.1 months. Mean indwelling time for transplant ureteric memokath stents was 24.3 months. Total 4 ureteric stents had migrated, 4 stents blocked, and 2 stents were removed as planned and 1 stent removed due to febrile urinary tract infection (UTI). Ten urethral stents remained in place for mean of 14 months. Three stents were removed as planned with resolution of stricture, two were removed due to blockage, three stents had UTI, one was removed due to pain, and one stent remained functioning until the patient expired.</p><p><strong>Conclusion: </strong>Our outcome is comparable to other published studies, suggesting that ureteric Memokath stent is a better option with adequate indwelling time, especially in transplant ureters, in comparison with DJ stents. In addition, Memokath stents can be used in selected recurrent urethral strictures where surgical reconstruction is not feasible.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983852","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":"Varicocelectomy outcomes among patients with azoospermia and severe oligasthenoteratozoospermia","authors":"A. Alkhayal, Sahar Aljumaiah, Ali Alyami, S. Abumelha, K. Alrabeeah","doi":"10.4103/ua.ua_24_23","DOIUrl":"https://doi.org/10.4103/ua.ua_24_23","url":null,"abstract":"Varicocele is a reversible cause of male infertility. However, there are conflicting data available concerning the benefit of varicocele repair for patients with nonobstructive azoospermia (NOA) and severe oligoasthenoteratozoospermia (OAT). To address the benefit of varicocelectomy in patients with severe OAT and NOA with regard to their semen parameters and surgical sperm retrieval rate in those who underwent testicular sperm extraction (TESE) or testicular sperm aspiration (TESA). This retrospective cohort study was conducted on a sample of 13 patients diagnosed with NOA and severe OAT who underwent varicocelectomy for infertility treatment with no prespecified exclusion criteria. Thirteen patients were enrolled. Five patients were diagnosed with NOA; eight were diagnosed with severe OAT. For improvements in the semen parameters postoperatively, the semen concentration of all patients was significantly increased compared to the preoperative concentration (3.59 ± 10.0.8 vs. 0.25 ± 0.31, P = 0.02) and the remaining parameters were unchanged. Regarding sperm retrieval, three patients underwent TESE and two patients underwent TESA, in which all had positive results. Varicocele repair was found to improve the semen parameters in patients with NOA and severe OAT and produced a successful surgical sperm retrieval rate in all patients who underwent TESA or TESE.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273382","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":"Techniques in minimally invasive transperitoneal pyeloplasty: A compilation","authors":"C. Mallikarjuna, S. Ghouse, Vijay Kumar Sarma Madduri, M. Bendigeri, B. Enganti, P. Reddy, Gopal Ramdas Tak","doi":"10.4103/ua.ua_38_23","DOIUrl":"https://doi.org/10.4103/ua.ua_38_23","url":null,"abstract":"Minimally invasive management (laparoscopic/robot assisted) is currently the standard of care for managing pelvi ureteric junction obstruction (PUJO). Open techniques of management of PUJO are well described in literature. However, there appears to be relative lack of description of minimally invasive techniques in the literature. This article is aimed at describing in detail, with images, the various techniques and modifications in laparoscopic or robot-assisted management of PUJO. A review of literature on PubMed was performed and all articles which detailed any technique of minimally invasive pyeloplasty were included. The various techniques of minimally invasive pyeloplasty as well as the authors’ techniques are compiled and described in detail with intraoperative images. Operative techniques of minimally invasive pyeloplasty are not well described in literature. We have attempted to present a comprehensive resource of different techniques of minimally invasive pyeloplasty and the clinical scenarios in which they may be appropriate. This should prove to be a useful reference to the practicing urologist. In this paper, we have compiled the various surgical techniques of treating obstruction at the PUJ of the kidney along with intraoperative photograph.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275026","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":"Hematuria: Is it useful in predicting renal or ureteral stones in patient presenting to emergency department with flank pain?","authors":"Mansour Alnazari, A. Bakhsh, H. Shaqroon, Emad S. Rajih, Nizar Abdulaziz Al-Nakshabandi, Danny M. Rabah","doi":"10.4103/ua.ua_66_23","DOIUrl":"https://doi.org/10.4103/ua.ua_66_23","url":null,"abstract":"The objective of the study was to evaluate hematuria as a diagnostic test for renal and ureteral stones compared with a noncontrast-enhanced computed tomography (CT) scan (gold standard test) in emergency room patients with acute flank pain. In total, 604 patients treated in our emergency department from 2006 to 2011, with a history of flank pain and suspected urolithiasis were included in a retrospective review. All patients were evaluated with a noncontrast-enhanced CT scan and urine analysis. Using the noncontrast CT scan as the gold standard for the evaluation of the presence, number, size, and site (renal or ureteral [upper, middle, and lower]) of the stones, we calculated the sensitivity, specificity, and positive and negative predictive values of hematuria for diagnosing both renal and ureteral stones. Urolithiasis was diagnosed in 388 patients (64%) and 216 patients (36%) had no stones on a noncontrast-enhanced CT scan. The sensitivity, specificity, positive predictive value, and negative predictive value for microhematuria were 77%, 33%, 67%, and 45%, respectively. Microhematuria was more common in patients with ureteral stones only (139 patients) and had a sensitivity of 85% compared to patients with renal stones only (32 patients), with a sensitivity of 55% (P < 0.001). There were no significant differences in the specificity or positive or negative predictive values. Although microhematuria is more sensitive to ureteral stones, the absence of microhematuria does not exclude the possibility of urolithiasis and a noncontrast-enhanced CT scan should be the gold standard diagnostic tool.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273162","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":"Use of artificial stones in training and laboratory studies, have we found the right material? Outcomes of a systematic review from the European School of Urology","authors":"P. Kallidonis, A. Peteinaris, Domenico Veneziano, Amelia Pietropaolo, K. Pagonis, C. Adamou, A. Vagionis, A. Al-Aown, E. Liatsikos, B. Somani","doi":"10.4103/ua.ua_112_22","DOIUrl":"https://doi.org/10.4103/ua.ua_112_22","url":null,"abstract":"In this review, we investigated the current literature to find out which artificial stones (AS) are available in endourology, and in which experimental and training schemes they are used. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Twenty-one out of 346 studies met our inclusion criteria and are presented in the current review. The inclusion criteria were the existence of AS and their use for laboratory and training studies. There is a wide variety of materials used for the creation of AS. BegoStone powder (BEGO USA, Lincoln, Rhode Island) and plaster of Paris™ were used in most of the studies. In addition, Ultracal-30 (U. S. Gypsum, Chicago, IL) was also used. Other materials that were used as phantoms were AS created from plaster (Limbs and Things, UK), standardized artificial polygonal stone material (Chaton 1028, PP13, Jet 280; Swarovski), model stones consisting of spheres of activated aluminum (BASF SE, Ludwigshafen am Rhein, Deutschland), Orthoprint (Zhermack, Badia Polesine, Italy), and a combination of plaster of Paris, Portland cement, and Velmix (calcium sulfate powder). Many experimental settings have been conducted with the use of AS. Our research demonstrated nine studies regarding testing and comparison of holmium: yttrium–aluminum–garnet laser devices, techniques, and settings. Six studies were about extracorporeal shock wave lithotripsy testing and settings. Three experiments looked into treatment with percutaneous nephrolithotomy. Additionally, one study each investigated imaging perioperatively for endourological interventions, stone bacterial burden, and obstructive uropathy. AS have been used in a plethora of laboratory experimental studies. Independent of their similarity to real urinary tract stones, they present a tremendous potential for testing and training for endourological interventions.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270995","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":"Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis","authors":"N. Borkar, Charu Tiwari, Debajyoti Mohanty, Deepti Vepakomma, Nilesh Nagdeve","doi":"10.4103/ua.ua_11_23","DOIUrl":"https://doi.org/10.4103/ua.ua_11_23","url":null,"abstract":"Laparoscopic exploration is currently considered the gold standard for managing nonpalpable intraabdominal testes. The problem of short vascular pedicle is addressed in Fowler-Stephen (FS) technique by the division of testicular vessels and in Shehata technique (ST) by traction on testicular vessels. There is a lack of the consensus among pediatric surgeons on the choice of one technique over other. This analysis compares the reported outcomes of staged laparoscopic orchidopexy by ST with the time tested FS technique in managing high intraabdominal undescended testis. The present systematic review and meta-analysis was conducted as per the preferred reporting items for the systematic review and meta-analyses guidelines. Only randomized controlled trials and comparative studies were included. The primary outcomes compared were the incidence of testicular atrophy, testicular retraction/ascent rate, and operative time of Stage I and Stage II orchidopexy. The present analysis was based on three randomized studies with a total of 119 undescended testes in 117 patients satisfying the inclusion criteria. The operative time was less in Stage I FS technique; however, there was no statistically significant difference in operative time of both procedures during the Stage II laparoscopic orchidopexy. Pooled analysis of postintervention testicular atrophy, testicular retraction rate, and duration of postoperative hospitalization showed no difference between both procedures. Both FS and STs are comparable in terms of postintervention testicular atrophy, testicular retraction/ascent; however, the mean operative time is significantly less with FS technique in Stage I laparoscopic orchidopexy.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270914","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":"Day of surgery admission in urology: Patient criteria and the organization required for same-day admission in urology: A retrospective study.","authors":"Hamed Ambusaidi, Muaath Khaled Alshuaibi, Alexandre Colau, Inès Dominique, Martin Mouton, Philippe Sebe","doi":"10.4103/ua.ua_148_22","DOIUrl":"10.4103/ua.ua_148_22","url":null,"abstract":"<p><strong>Background: </strong>The day of surgery admission (DOSA) has been practiced in surgery for decades, with reports dating as far back as 1909. DOSA policy has potential benefits for the health system and the patient, especially when there is a shortage of health-care resources.</p><p><strong>Objective: </strong>This study aims to compare DOSA and standard prior admission (D-1) among patients who underwent major urological operations.</p><p><strong>Methods: </strong>This retrospective study enrolled a total of 206 patients who did not meet the criteria for day care surgery admission. The patients were divided into two groups: those admitted on the same day of surgery and those admitted the day before surgery. Among the participants, 111 (53.8%) were admitted on the same day, while 95 (46.2%) were admitted the day before surgery. We collected data from the electronic health records of these patients, documenting various variables, including patient demographics, type of surgery, admission type and date, intervention date, length of stay, complications, Clavien-Dindo score, and American Society of Anesthesiologists (ASA) score.</p><p><strong>Results: </strong>We included a total of 206 patients who were admitted for operations in the urology department. The mean age was 70.5 years, and the majority was males (83.5%). Endoscopic procedures were the most common interventions (68%). The most ASA score for the enrolled patients was 2 (56.2%). DOSA was done for 53.8% of the patients, whereas the remaining patients were admitted 1 day before elective surgery. DOSA patients were significantly younger (<i>P</i> = 0.025), had a higher proportion of ASA score 1 (12.7%) and ASA score 3 (26.4%), had significantly fewer postoperative complications (<i>P</i> = 0.002), and had statistically significantly a shorter length of stay (<i>P</i> < 0.001) compared to D-1 admission patients.</p><p><strong>Conclusion: </strong>In our study, DOSA patients were younger, had a lower prevalence of comorbidities, utilized anticoagulants less frequently, experienced fewer complications, and had significantly shorter hospital stays. Since the DOSA policy is safe and has a lower financial and economic burden on the health-care system, we recommend more urological and surgical centers to implement it.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41353797","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}