Urology and Andrology – Open Journal最新文献

{"title":"Laparoscopic Management of Adrenal and Extra-Adrenal Pheochromocytoma","authors":"Shrenik J. Shah, S. Nurbhai, Rusha Surti, Parixit Malaviya, Pratik Chaudhary","doi":"10.17140/uaoj-7-146","DOIUrl":"https://doi.org/10.17140/uaoj-7-146","url":null,"abstract":"Background and Purpose Laparoscopic management of extra-adrenal pheochromocytoma requires meticulous surgical procedures because of the variable anatomic position and/or proximity to major blood vessels and the potential catecholamine surge during operation. We present our experiences with laparoscopic management of extra-adrenal pheochromocytoma and compare the intraoperative hemodynamics with those during laparoscopic resection of adrenal pheochromocytoma. Patients and Methods We retrospectively reviewed the medical records of 3 patients who underwent laparoscopic management of extra-adrenal pheochromocytoma (retrocaval, n=1; interaortocaval, n=1; periadrenal, n=1) and 24 patients who underwent laparoscopic management of adrenal pheochromocytoma between June 2005 and June 2023. We also evaluated fluctuations in blood pressure (BP) reported during both surgeries. Results The tumors were successfully resected under laparoscopic guidance in both groups, and one patient had converted to open surgery. Intraoperative hypertension (BP>200 mm Hg) was observed in 1 extra-adrenal pheochromocytoma and 13 adrenal pheochromocytoma patients, whereas intraoperative hypotension (BP <80 mm Hg) was observed in 1 extra-adrenal pheochromocytoma and 12 adrenal pheochromocytoma patients. Conclusion Laparoscopy is the method of choice for extra-adrenal resection because it is feasible and reproducible with appropriate preoperative planning, similar to adrenal resection.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"30 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250004","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":"Urolithiasis in Primary Gout, Incidence of Clinically Presented and Asymptomatic Kidney Stones: Identification of Significant Risk Factors","authors":"N. Radosavljevic, Dejan Nikolic, Zoran Radosavljevic","doi":"10.17140/uaoj-7-143","DOIUrl":"https://doi.org/10.17140/uaoj-7-143","url":null,"abstract":"Background The aim of this study is to explore the prevalence of urolithiasis in patients with primary gout as well as its correlation with other associated risk factors. Methods The study was conducted on 102 patients with primary gout, they underwent ultrasonography examination and their general, clinical, and urinalysis data were recorded for further assessment and statistical analysis. Results There were 102 patients with primary gout included in our study, 69 (67.6%) males, mean age of patients was 64.3±9.7. The overall prevalence of urolithiasis in our patients with primary gout is 37.3% and 15.7% have “silent” urolithiasis. Patients with urolithiasis (Group 1) are significantly older, 68.9±7.4-years, had a long history of gout 10.3±4.5-years, presence of tophi in 9 (23.6%) patients and more than 3 gouty arthritis attacks per year in 17(44.7%) patients. Also, patients in Group 1 have a significantly lower urine pH of 5.2±0.4 compared to patients without urolithiasis (Group 2) who have a urine pH of 6.6±0.2. Results showed that obesity, diabetes, and hyperlipidemia are significantly more common in patients with urolithiasis (Group 1) while the presence of hypertension is not significantly different between groups. Correlation between urolithiasis and parameters related to disease (duration, tophi, and more than three attacks per year) and parameters related to urinalysis (pH and crystalluria) was tested and found statistically significant. Logistic regression analyses (univariate and multivariate) of tested parameters confirmed that obesity, diabetes mellitus, and hyperlipidemia are predictive factors for the presence of urolithiasis in patients with primary gout. Conclusion There is a high prevalence of urolithiasis in patients with primary gout including asymptomatic urolithiasis, associated with the age of patients, duration, and severity of gout, obesity, diabetes, and hyperlipidemia. Therefore, ultrasonographic screening as harmless and available should be recommended in order to prevent complications.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"62 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249353","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":"Long-Term Follow-Up After Laparoscopic Radical Prostatectomy for Localized and Locally Advanced Prostate Cancer","authors":"Shrenik J. Shah, Abhishek Jha, Chirag Davara, Rushi Mistry, Kapil Kachhadiya","doi":"10.17140/uaoj-7-147","DOIUrl":"https://doi.org/10.17140/uaoj-7-147","url":null,"abstract":"Objective To explore the impact of laparoscopic radical prostatectomy (LRP) on lower urinary tract symptoms and erectile function. Materials and Methods A retrospective study was conducted on patients who underwent LRP at the Civil Hospital Ahmedabad’s Urology Department from June 2008 to June 2023. Results Major complications following LRP are generally rare, including bladder neck stenosis, erectile dysfunction, and urinary incontinence. The incidence of erectile dysfunction varies widely, ranging from 11-87%, and urinary incontinence ranges from 0-87%, depending on the definitions used. Functional decline typically peaks shortly after surgery, with the most rapid recovery occurring within the first year post-LRP. Some patients continue to improve gradually over time. However, for some men, these adverse effects can be long-lasting. Other, less common side effects should also be considered. Despite significant technological advancements in the past 20 years, no single surgical technique has emerged as superior in terms of long-term outcomes, as surgical volume, surgeon experience, and patient characteristics remain key determinants. Conclusion When discussing treatment options for prostate cancer, it is crucial to consider potential complications like erectile dysfunction and urinary incontinence following LRP, as well as the expected recovery period. Counseling is provided to patients, taking into account their age and overall health profile. Surgical advice is given to eligible patients after evaluating the risk-benefit ratio. Patients who are older or do not meet the criteria are given appropriate guidance. All patients are informed about the possible complications after surgery and are presented with the option of palliative care or surgical treatment.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"60 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249747","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":"Penile Cancer in the Region of Thies: Epidemiological, Diagnostic and Therapeutic Aspects","authors":"S. Kouka, T. L. Bentefouet, N. M. Thiam, Modou Faye, Mbayang Diop, Mouhamed Cisse, Mohamed Jalloh, A. A. Diamé, Y. Diallo, S. Cheikhna","doi":"10.17140/uaoj-7-145","DOIUrl":"https://doi.org/10.17140/uaoj-7-145","url":null,"abstract":"Aim This study aimed to determine the epidemiological, clinical, histopathological, and therapeutic characteristics of patients with penile cancer in hospitals in the Thiès region. Patients and Methods We conducted a retrospective descriptive study collecting all cases of penile cancer in the different urology departments in the Thies region from January 1st, 2015, to December 31st, 2020. Results We recorded 14 cases of penile cancer during the study period. The average age of the patients was 42.93-years (range: 26 to 82-years). The average consultation time was 18-months. All patients were circumcised during childhood. The circumstances of discovery were penile pain (64.3%), ulceration of the penis (26.6%), and hematuria (14.3%). Squamous cell carcinoma was found in 100% of patients. The cancer was locally advanced or metastatic in 64.3% of cases. Partial amputation of the penis was carried out in 50% of patients, and total amputation of the penis was carried out in 42.85% of patients. One patient refused a total penile amputation. After a 6-month follow-up, 35.7% of patients had died. Conclusion The presentation of penile cancers is often late in the Thiès region. Improving the technical platform will make it possible to better manage these cancers.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"31 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140248244","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":"Percutaneous Nephrolithotomy 500 Cases in High-Risk and Altered Renal Function Test: Our Experience at Tertiary Care Centre","authors":"Shrenik J. Shah, Chirag Davara, Abhishek Jha, Kapil Kachhadiya, Rushi Mistry","doi":"10.17140/uaoj-7-144","DOIUrl":"https://doi.org/10.17140/uaoj-7-144","url":null,"abstract":"Introduction The study aims to evaluate the results of percutaneous nephrolithotomy (PCNL) in high-risk patients and patients with altered renal function tests (RFT) and complications in the management of renal stones in our hospital. Methods We retrospectively analyzed the outcomes of 500 patients who underwent PCNL between September 2020 and September 2023. We have analyzed data regarding patient details, investigations, PCNL puncture site, operative duration, number of punctures, stone-free rates (SFRs), duration of hospital stay, and complications. Results Out of 500 patients, 384 (76.87%) were males and 116 (23.13%) were females, with a male-to-female ratio of 3.32:1. The average age was 40.8±10.4 (mean±SD) (range: 24 to 74-years). The average operative time was 127±37 min (mean±standard deviation (SD)). The radiation exposure was from 1 min 30 sec to 3 min, with a mean (±SD) of 30 sec. The mean duration of the hospital stay was 2.7±1.6 days. Complete stone clearance was 87%, whereas SFRs defined by no identifiable stone on a plain radiograph or ultrasound or residual fragments <5 mm were 90.93%. The complication rate was 2.2%. Conclusion The usual course of treatment for renal stones larger than 2 cm is PCNL. Significant factors influencing the stone-free rate include stone burden, stone type, PCNL puncture, number of punctures, and operative time. With the development of several lithotripsy procedures and the miniaturization of instruments, PCNL continues to be an excellent therapeutic option for patients with large renal stones, comorbidities, and changed RFT, with tolerable rates of complications.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250731","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":"Single Dose Diclofenac and Tamsulosin Effectiveness in Patients Undergoing Double J-Stent Removal Under Local Anaesthesia","authors":"Sugam Godse, Anuj Kumar, Harmandeep Singh, M. K. Chhabra","doi":"10.17140/uaoj-6-141","DOIUrl":"https://doi.org/10.17140/uaoj-6-141","url":null,"abstract":"Purpose The purpose of this study was to see effectiveness of diclofenac sodium and tamsulosin combination on patients’ pain perception after ureteral stent removal. Materials and Methods Study was carried out from October 2019 to March 2021. All patients with unilateral stent placement after renal or ureteric stone endoscopic surgery were randomized in 3 groups. Group-A include 20 patients who were given placebo drug 2-hours prior to double J (DJ) removal. Group-B included 20 patients who were given oral diclofenac 2-hours prior to DJ removal. Group-C included 20 patients who were given oral diclofenac and tamsulosin 2-hours prior to DJ removal. All patients received 10 cc 2% viscous lidocaine intraurethral before cystoscopy. No sedatives or analgesics were administered during the procedure. All patients provided consent before the procedure and they were asked to record their pain experience on a visual analog pain scale as soon as the procedure was finished. The pulse rate and systolic and diastolic blood pressure (BP) were also recorded 5-minutes before the procedure and during the procedure Results General characteristic of age, gender and indication for DJ-stenting were comparable in all groups. The mean pain score on the visual analogue scale (VAS) in Group-C was significantly lower than that in Group-A and B (p<0.001) A statistically significant difference was found between the two groups in terms of anxiety scores after cystoscopy, intraoperative systolic BP and pulse rate. Patients who were given oral diclofenac and tamsulosin two hours prior to DJ removal experienced less pain and anxiety. Conclusion Oral diclofenac plus tamsulosin combination prior to DJ removal improves patient’s comfort.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115276826","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":"Spontaneous Bladder Rupture: A Rare Case of an Acute Abdomen","authors":"Abilash Menon, L. Vermeulen, F. Ordones","doi":"10.17140/uaoj-6-142","DOIUrl":"https://doi.org/10.17140/uaoj-6-142","url":null,"abstract":"Spontaneous idiopathic rupture of the bladder (SIBR) is still a rare occurrence. Although a few cases of bladder wall rupture associated with bladder wall disease have been documented in the literature, there are limited cases reported worldwide. We describe a patient who presented to the Emergency Department of Tauranga Hospital in New Zealand with diffuse abdominal pain due to a bladder rupture confirmed by a CT-scan. Despite no obvious explanation a relationship with an alcohol binge was posited. He underwent surgery and recovered completely","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132762470","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":"Primary Malignant Melanoma of the Bladder: A Rare Case Report","authors":"Shrenik J. Shah, Abhishek K. Singh, S. Hazarika, Saket Narnoli, K. Patel, Prince Lathiya, Aznoor Hussain","doi":"10.17140/uaoj-6-140","DOIUrl":"https://doi.org/10.17140/uaoj-6-140","url":null,"abstract":"Background Primary malignant melanoma (PMM) of the bladder is a rare ailment and has a poor prognosis; only 40 cases of PMM reported in literature till date. In this case report we described a case of PMM of the bladder, treatment, and a review of the literature as the recommended treatment choices are not widely known. Case Presentation A 55-year-old Indian female came with a history of hematuria for two-months. Ultrasonography revealed a 18×16 mm size mass located in the antero-inferior wall of urinary bladder with involvement of bladder neck. She underwent transurethral resection of the bladder tumor outside and histologically reported to be malignant melanoma and confirmed on immunohistochemistry (IHC). No further primary sites of melanoma were found. Computed tomography (CT) showed an irregular enhancing mucosal thickening along internal urethral meatus and adjacent urinary bladder. The patient eventually underwent radical cystectomy with anterior pelvic exenteration with ileal conduit. Conclusion Primary bladder melanoma is very aggressive in nature. In most of the cases bladder malignant melanoma is secondary, so extensive search for any primary melanotic lesion is essential. It is often difficult to discriminate whether a bladder melanoma is primary or metastatic. Certain diagnostic features can be obtained through histopathological investigation, immuno-histochemistry, clinical history, and endoscopic evaluation. Despite a wide range of treatments, people with PMM still have a worst prognosis.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129814190","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":"Pulsed Electromagnetic Stimulation Therapy for Erectile Dysfunction","authors":"C. Bhandari, Trilok Mahajan","doi":"10.17140/uaoj-5-137","DOIUrl":"https://doi.org/10.17140/uaoj-5-137","url":null,"abstract":"Erectile dysfunction (ED) is a significant and common medical problem. Currently, there are several treatment available options for patients with ED, both non-invasive and invasive like phosphodiesterase 5 inhibitors, intra-cavernosal injections (BIMIX,TRIMIX), intraurethral prostaglandin E1 pellets, vacuum erection devices and insertion of a penile prosthesis. Most of these options are invasive, which can be troublesome for patients, and also have side-effect profiles. Pulsed-electro magnetic stimulation therapy (PLMST) has gained interest in the field of sexual medicine. In the given case author presented a successful effect of in a case of erectile dysfunction.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132086418","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":"Botulinum Toxin Type A in Neurogenic Overactive Bladder Dysfunction in Patients with Multiple Sclerosis","authors":"Villalba Bachur Roberto F, Kohan Diego F, Fernandez C. Gaston, Angeloni Guido, Koren Claudio A, Longo Emilio M","doi":"10.17140/uaoj-5-138","DOIUrl":"https://doi.org/10.17140/uaoj-5-138","url":null,"abstract":"Introduction Lower Urinary tract symptoms are common in patients with multiple sclerosis (MS) and have a negative influence on the quality of life (QoL). Detrusor overactivity is the most frequent symptom. Lifestyle modifications are the first therapeutic line followed by oral medication in patients with storage dysfunction. When these drugs are ineffective or intolerable, botulinum toxin bladder injection is an alternative treatment. The aim of this work is to evaluate the effectiveness and the impact on QoL of patients with MS and refractory or intolerant to oral therapy overactive bladder (OAB) after botulinum toxin type A bladder injection. Materials and Methods Retrospective study with six-months follow-up of patients with MS diagnosis and a refractory or intolerable to oral drugs OAB treated with botulinum toxin injections. All patients completed urological evaluation and a QoL questionnaire prior to the injection, 3 and 6-months after. Evaluation of the urodynamics tests prior and 3-months post injection was made. Outcomes Sixteen patients were treated. The QoL questionnaire showed progressive improvement 3 and 6-months after the injection. There was decrease in the number of daily voids urination and in the urinary incontinence episodes. There was an upgrade in the bladder capacity from 191 to 338 ml average (p 0.0004) and 75% evidenced disappearance of detrusor overactivity (p 0.0005). Thirteen (13) patients (81.25%) made spontaneous urination with post-voiding residue <100 ml after injection. Three (3) episodes of urinary tract infection were evidenced. Conclusion Botulinum toxin generates a positive impact on the QoL of patients with neurogenic OAB with MS.","PeriodicalId":388500,"journal":{"name":"Urology and Andrology – Open Journal","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125979133","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}