Current Urology最新文献

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Visual guidelines and tutoring in pediatric urological surgery. 儿童泌尿外科视觉指导与辅导
IF 1.6 4区 医学
Current Urology Pub Date : 2024-03-01 Epub Date: 2022-08-02 DOI: 10.1097/CU9.0000000000000066
Stanislav Kotcherov, Shahar Rotem, Jawdat Jaber, Galit Avraham, Gennady Lev, Michal Darmon, Yudith Gabay, Boris Chertin
{"title":"Visual guidelines and tutoring in pediatric urological surgery.","authors":"Stanislav Kotcherov, Shahar Rotem, Jawdat Jaber, Galit Avraham, Gennady Lev, Michal Darmon, Yudith Gabay, Boris Chertin","doi":"10.1097/CU9.0000000000000066","DOIUrl":"10.1097/CU9.0000000000000066","url":null,"abstract":"<p><strong>Background: </strong>The aim of this prospective randomized study was to evaluate the impact of visual guidelines (picture book) and parents tutoring on pediatric urological surgery on parent's stress and anxiety, the number of postoperative contacts, and complications.</p><p><strong>Materials and methods: </strong>Following institutional ethical committee approval, a special picture book reflecting different stages of the convalescent period following multiple types of pediatric urological surgery was developed. Parents were randomly divided into 2 groups in which 33 parents in Group 1 received the picture book in addition to routine instructions prior to the surgery and 31 in Group 2 received only routine postoperative instructions. The parents were asked to answer a questionnaire (Amsterdam Preoperative Anxiety and Information Scale) regarding the level of anxiety before surgery and immediately after surgery in the recovery room. The number of postoperative parent's calls, nonplaned emergency room visits, and complications were recorded.</p><p><strong>Results: </strong>No statistically significant difference in perioperative parental anxiety was found <i>(p</i> = 0.88). The visual tutoring group had a significantly lower rate of emergency room admissions (6.6% vs. 18.6%, <i>p</i> = 0.0433), however parents from this group made a higher number of postoperative calls (9.9% vs. 3.1%, <i>p</i> = 0.38). Two (6.6%) from the tutoring group expressed their desire to omit visual counseling in future surgical preparation and 4 (13.2%) did not have an opinion. Overall satisfaction with regards to the preoperative counseling and information and the number of postoperative complications was similar in both groups.</p><p><strong>Conclusions: </strong>Visual tutoring does not add any value to parental anxiety but seems helpful in reducing postoperative emergency room visits. Some parents preferred to exclude visual information from future preoperative counseling.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"1 1","pages":"18-22"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42533932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Hypoxia activates the hypoxia-inducible factor-1α/vascular endothelial growth factor pathway in a prostatic stromal cell line: A mechanism for the pathogenesis of benign prostatic hyperplasia 低氧激活前列腺基质细胞系中的低氧诱导因子-1α/血管内皮生长因子通路:良性前列腺增生的发病机制
IF 1.6 4区 医学
Current Urology Pub Date : 2023-12-14 DOI: 10.1097/cu9.0000000000000233
Tao Zhang, Changlin Mao, Yao Chang, Jia Lyu, Delong Zhao, Sentai Ding
{"title":"Hypoxia activates the hypoxia-inducible factor-1α/vascular endothelial growth factor pathway in a prostatic stromal cell line: A mechanism for the pathogenesis of benign prostatic hyperplasia","authors":"Tao Zhang, Changlin Mao, Yao Chang, Jia Lyu, Delong Zhao, Sentai Ding","doi":"10.1097/cu9.0000000000000233","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000233","url":null,"abstract":"\u0000 \u0000 \u0000 The development of benign prostatic hyperplasia (BPH) is closely related to hypoxia in the prostatic stroma, and the hypoxia-inducible factor-1α/vascular endothelial growth factor (HIF-1α/VEGF) pathway has been shown to significantly activate in response to hypoxia. The underlying mechanism for activation of this pathway in the pathogenesis of BPH remains unclear.\u0000 \u0000 \u0000 \u0000 We constructed HIF-1α overexpression and knockdown BPH stromal (WPMY-1) and epithelial (BPH-1) cell lines, which were cultured under different oxygen conditions (hypoxia, normoxia, and hypoxia + HIF-1α inhibitor). Quantitative real-time polymerase chain reaction (qPCR) and Western blotting were applied to detect the expression of the HIF-1α/VEGF pathway. Cell proliferation and apoptosis were analyzed by Cell Counting Kit-8 and flow cytometry. We used the miRWalk 2.0 database and Western blotting to predict the potential miRNA that selectively targets the HIF-1α/VEGF pathway, and verified the prediction by qPCR and dual-luciferase assays.\u0000 \u0000 \u0000 \u0000 In a BPH stromal cell line (WPMY-1), the expression of VEGF was in accordance with HIF-1α levels, elevated in the overexpression cells and decreased in the knockdown cells. Hypoxia-induced HIF-1α overexpression, which could be reversed by a HIF-1α inhibitor. Moreover, the HIF-1α inhibitor significantly depressed cellular proliferation and promoted apoptosis in hypoxic conditions, assessed by Cell Counting Kit-8 and flow cytometry. However, in the BPH epithelial cell line (BPH-1), the expression level of HIF-1α did not influence the expression of VEGF. Finally, a potential miRNA, miR-17-5p, regulating the HIF-1α/VEGF pathway was predicted from the miRWalk 2.0 database and Western blotting, and verified by qPCR and dual-luciferase assay.\u0000 \u0000 \u0000 \u0000 In hypoxia, activation of the HIF-1α/VEGF pathway plays a crucial role in regulating cell proliferation in a BPH stromal cell line. Regulation by miR-17-5p may be the potential mechanism for the activation of this pathway. Regulation of this pathway may be involved in the pathogenesis of BPH.\u0000","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"32 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Comparison of midurethral tape with autologous rectus fascial sling surgery for stress urinary incontinence: A systematic review and meta-analysis 尿道中带与自体直肌筋膜吊带手术治疗压力性尿失禁的比较:系统回顾和荟萃分析
4区 医学
Current Urology Pub Date : 2023-11-06 DOI: 10.1097/cu9.0000000000000225
Yavuz Güler
{"title":"Comparison of midurethral tape with autologous rectus fascial sling surgery for stress urinary incontinence: A systematic review and meta-analysis","authors":"Yavuz Güler","doi":"10.1097/cu9.0000000000000225","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000225","url":null,"abstract":"Abstract Objectives To compare the success rates of autologous fascial mesh (sling and transobturator tape [TOT]) with midurethral synthetic meshes (tension-free vaginal tape sling [TVT] and TOT) for stress urinary incontinence. Materials and methods A literature search for studies published in English was conducted from May 10, 2022, to June 1, 2022. The search included MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Google Scholar, and ProQuest, using the terms{“Autologous fascial slings”}OR {“AFS”} AND{“TOT”} OR {“Transobturator tape”} OR{“TVT”} OR{“Transvaginal tape”}. A total of 20 studies, including 10 randomized controlled trials, were selected for the review. RevMan software (version 5.3) was used to calculate the pooled effect estimates for operative and postoperative variables. Results In the systemic review, 20 studies, including 10 randomized controlled trials, were assessed. In the TVT versus autologous pubovaginal sling (A-PVS) groups, the effect estimates for the surgical duration, catheter duration, success, and complication rates were more advantageous for TVT. However, in comparison to autologous transobturator tape groups, TOT provided better operative time and a shorter hospital stay. Moreover, in comparison to the A-PVS group, the TOT group was superior in terms of operating time, urethral catheterization, hospital stay, amount of residual urine, and wound complications. The A-PVS group had significantly more groin and thigh pain. Conclusions During medium- and long-term follow-ups, the use of autologous rectus fascia grafts using a A-PVS or TOT provided similar complication rates and urinary continence results as using midurethral synthetic meshes (TVT and TOT).","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Partial versus radical nephrectomy for T1b renal cell carcinoma: A comparison of efficacy and prognostic factors based on the Surveillance, Epidemiology, and End Results database T1b肾细胞癌部分与根治性肾切除术:基于监测、流行病学和最终结果数据库的疗效和预后因素的比较
4区 医学
Current Urology Pub Date : 2023-11-06 DOI: 10.1097/cu9.0000000000000229
Kong Ren, Fei Wu, Haihu Wu, Hao Ning, Jiaju Lyu
{"title":"Partial versus radical nephrectomy for T1b renal cell carcinoma: A comparison of efficacy and prognostic factors based on the Surveillance, Epidemiology, and End Results database","authors":"Kong Ren, Fei Wu, Haihu Wu, Hao Ning, Jiaju Lyu","doi":"10.1097/cu9.0000000000000229","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000229","url":null,"abstract":"Abstract Objectives This study compared the long-term efficacy and prognostic factors of partial nephrectomy (PN) and radical nephrectomy (RN) for T1bN0M0 renal cell carcinoma (RCC) using data from the Surveillance, Epidemiology, and End Results (SEER) database. Materials and methods We retrospectively analyzed the clinical data of 12,471 patients diagnosed with T1bN0M0 RCC from the SEER database between 2010 and 2019. Patients were divided into the PN and RN groups, and propensity score matching was conducted to balance the differences between the groups. We compared overall survival (OS), RCC cancer–specific mortality (CSM), and noncancer-specific mortality (NCSM) between the two groups. The risk factors for all-cause and RCC-related mortality were analyzed. Results After propensity score matching, there were 3817 patients in each group. After matching, OS and NCSM were significantly longer in the PN group ( p < 0.001); however, there was no significant between-group difference in the RCC-CSM. The hazard ratio (HR) for all-cause mortality was significantly lower in the PN group (HR, 0.671; 95% confidence interval [CI], 0.579–0.778, p < 0.001), but PN was not associated with lower RCC-related mortality. Subgroup analysis showed that PN reduced the HR of all-cause mortality by 35% (HR, 0.647; 95% CI, 0.536–0.781; p < 0.001) in patients with 4.0- to 5.5-cm tumors compared with RN and by 29% (HR, 0.709; 95% CI, 0.559–0.899; p = 0.004) in those with larger tumors (5.6–7.0 cm). Multifactorial analysis showed that PN was an independent predictor of OS (HR, 0.671; 95% CI, 0.579–0.778; p < 0.001). In addition, multivariate analysis validated that age at diagnosis, sex, pathological grade, and tumor size were associated with outcomes. Conclusions In patients with T1b RCC, PN resulted in better OS and NCSM outcomes than RN. The benefit of PN in all-cause mortality was pronounced in patients with 4.0–5.5 cm tumor loads. Therefore, individualized treatment schemes should prioritize PN, when technically feasible.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135635021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The role of botulinum toxin in the management of nonneurogenic overactive bladder in children: Highlights for clinical practice. A systematic review 肉毒毒素在儿童非神经源性膀胱过动症治疗中的作用:临床实践的重点。系统回顾
4区 医学
Current Urology Pub Date : 2023-10-30 DOI: 10.1097/cu9.0000000000000124
José A. Câncio Martins Bissaia Barreto, Maria I. Táboas Simões, Gonçalo Gomes Engenheiro, Joana I. Ferreira Matos, Joana A. Rodrigues Leal
{"title":"The role of botulinum toxin in the management of nonneurogenic overactive bladder in children: Highlights for clinical practice. A systematic review","authors":"José A. Câncio Martins Bissaia Barreto, Maria I. Táboas Simões, Gonçalo Gomes Engenheiro, Joana I. Ferreira Matos, Joana A. Rodrigues Leal","doi":"10.1097/cu9.0000000000000124","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000124","url":null,"abstract":"Abstract Overactive bladder (OAB) is the most common voiding dysfunction in children; however, nonneurogenic or idiopathic OAB remains poorly studied. First-line treatment includes conservative measures; however, as many patients are refractory, have adverse effects, or are contraindicated for anticholinergics, new options must be explored. This review covers the use of intravesical botulinum toxin (BoNT) for idiopathic OAB treatment in children, emphasizing its efficacy, safety, differences between toxins, doses, and injection techniques. Clinical results were promising, with all 8 studies reporting good results. All authors used BoNT type A, either onabotulinum or abobotulinum toxin A. Response rates were variable, with full-response percentages of 32%–60%. As proven by the full-response rates of 50%, repeated injections are as safe and effective as first injections. Only a few cases of urinary tract infection, transient urinary retention, and hematuria have been reported, with no major local or systemic adverse effects. Despite these limitations, evidence encourages and supports BoNT type A use as a safe and effective treatment modality for refractory idiopathic OAB in pediatric settings, regardless of dosage and target toxin. To the best of our knowledge, this is the first systematic review of the use of intravesical botulinum toxin type A for idiopathic OAB treatment in children.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136022944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Prognostic value of Controlling Nutritional Status score for postoperative complications and biochemical recurrence in prostate cancer patients undergoing laparoscopic radical prostatectomy 控制营养状态评分对腹腔镜前列腺根治术前列腺癌患者术后并发症及生化复发的预后价值
4区 医学
Current Urology Pub Date : 2023-10-25 DOI: 10.1097/cu9.0000000000000231
Tianyu Xiong, Xiaobo Ye, Guangyi Zhu, Fang Cao, Yun Cui, Liming Song, Mingshuai Wang, Wahafu Wasilijiang, Nianzeng Xing, Yinong Niu
{"title":"Prognostic value of Controlling Nutritional Status score for postoperative complications and biochemical recurrence in prostate cancer patients undergoing laparoscopic radical prostatectomy","authors":"Tianyu Xiong, Xiaobo Ye, Guangyi Zhu, Fang Cao, Yun Cui, Liming Song, Mingshuai Wang, Wahafu Wasilijiang, Nianzeng Xing, Yinong Niu","doi":"10.1097/cu9.0000000000000231","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000231","url":null,"abstract":"Abstract Background The correlation between the Controlling Nutritional Status (CONUT) score and the prognosis of patients with prostate cancer (PCa) has yet to be elucidated. Herein, we analyzed the prognostic value of CONUT scores in patients with PCa who underwent laparoscopic radical prostatectomy. Materials and methods Data of 244 patients were retrospectively evaluated. Perioperative variables and follow-up data were analyzed. The patients were categorized into 2 groups according to their preoperative CONUT scores. Postoperative complication and incontinence rates were also compared. The Kaplan-Meier method was used to estimate the median biochemical recurrence-free survival (BCRFS) between the 2 groups. Univariate and multivariate Cox regression analyses were performed to identify the potential prognostic factors for BCRFS. Results Patients were categorized into the low-CONUT group (CONUT score <3, n = 207) and high-CONUT group (CONUT score ≥3, n = 37). The high-CONUT group had a higher overall complication rate (40.5% vs.19.3%, p = 0.004), a higher major complication rate (10.8% vs. 3.9%, p = 0.013), and longer postoperative length of stay (8 days vs. 7 days, p = 0.017). More fever, urinary infection, abdominal infection, scrotal edema, rash, and hemorrhagic events (all p values < 0.05) were observed in the high-CONUT group. A higher rate of urinary incontinence was observed in the high-CONUT group at 1 (34.4% vs. 13.2%, p = 0.030) and 3 months (24.1% vs. 8.2%, p = 0.023) postoperatively. The high-CONUT group had shorter medium BCRFS (23.8 months vs. 54.6 months, p = 0.029), and a CONUT score ≥3 was an independent risk factor for a shorter BCRFS (hazards ratio, 1.842; p = 0.026). Conclusions The CONUT score is a useful predictive tool for higher postoperative complication rates and shorter BCRFS in patients with PCa who undergo laparoscopic radical prostatectomy.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"30 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Our experience with management of congenital urological pathologies in adulthood: What pediatric urologists should know and adult urologists adopt in pediatric practice experience 成人先天性泌尿系统疾病的处理经验:儿科泌尿科医生应该知道的和成人泌尿科医生在儿科实践中采用的经验
4区 医学
Current Urology Pub Date : 2023-10-25 DOI: 10.1097/cu9.0000000000000228
Leon Chertin, Binyamin B. Neeman, Jawdat Jaber, Guy Verhovsky, Amnon Zisman, Ariel Mamber, Ilan Kafka, Ala Eddin Natsheh, Dmitry Koulikov, Ofer Z. Shenfeld, Boris Chertin, Stanislav Koucherov, Amos Neheman
{"title":"Our experience with management of congenital urological pathologies in adulthood: What pediatric urologists should know and adult urologists adopt in pediatric practice experience","authors":"Leon Chertin, Binyamin B. Neeman, Jawdat Jaber, Guy Verhovsky, Amnon Zisman, Ariel Mamber, Ilan Kafka, Ala Eddin Natsheh, Dmitry Koulikov, Ofer Z. Shenfeld, Boris Chertin, Stanislav Koucherov, Amos Neheman","doi":"10.1097/cu9.0000000000000228","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000228","url":null,"abstract":"Abstract Purpose To summarize our experience in the management of congenital anomalies in the kidney and urinary tract (CAKUT) in adults. Materials and methods We conducted a retrospective chart review of all adult patients who underwent primary surgical intervention for CAKUT between 1998 and 2021. Results The study included 102 patients with a median age of 25 (interquartile range, 23–36.5). Of these, 85 (83.3%) patients reported normal prenatal ultrasound, and the remaining 17 (16.7%) patients were diagnosed with antenatal hydronephrosis. These patients were followed up conservatively postnatally and were discharged from follow-up because of the absence of indications for surgical intervention or because they decided to leave medical care. All studied adult patients presented with the following pathologies: 67 ureteropelvic junction obstructions, 14 ectopic ureters, 9 ureteroceles, and 6 primary obstructive megaureters, and the remaining 6 patients were diagnosed with vesicoureteral reflux. Forty-three percent of the patients had poorly functioning moieties associated with ectopic ureters or ureteroceles. Notably, 67% of patients underwent pyeloplasty, 9% underwent endoscopic puncture of ureterocele, 3% underwent ureteral reimplantation, 6% underwent endoscopic correction of reflux, 7% underwent partial nephrectomy of non-functioning moiety, and the remaining 9% underwent robotic-assisted laparoscopic ureteroureterostomy. The median follow-up period after surgery was 33 months (interquartile range, 12–54). Post-operative complications occurred in 5 patients (Clavien-Dindo 1–2). Conclusions Patients with CAKUT present clinical symptoms later in life. Parents of patients diagnosed during fetal screening and treated conservatively should be aware of this possibility, and children should be appropriately counseled when they enter adolescence. Similar surgical skills and operative techniques used in the pediatric population may be applied to adults.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135215990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Feasibility and safety of percutaneous nephrolithotomy in the management of renal stones with emphysematous pyelonephritis following control of infection 经皮肾镜取石术在控制感染后治疗肾结石合并肺气性肾盂肾炎的可行性和安全性
4区 医学
Current Urology Pub Date : 2023-10-20 DOI: 10.1097/cu9.0000000000000232
Anshuman Singh, Surag K.R., Anupam Choudhary, Suraj Jayadeva Reddy, Kasi Viswanath Gali, Abhijit Shah
{"title":"Feasibility and safety of percutaneous nephrolithotomy in the management of renal stones with emphysematous pyelonephritis following control of infection","authors":"Anshuman Singh, Surag K.R., Anupam Choudhary, Suraj Jayadeva Reddy, Kasi Viswanath Gali, Abhijit Shah","doi":"10.1097/cu9.0000000000000232","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000232","url":null,"abstract":"Management of renal calculi in the presence of emphysematous pyelonephritis (EPN) is challenging. The optimal management strategy for patients with EPN and renal calculi remains unclear. This study aimed to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the management of these patients and to provide insights into the postoperative outcomes and complications of PCNL according to the modified Clavien-Dindo classification. This retrospective study included patients with EPN and renal stones who underwent PCNL, after initial conservative management, between January 2012 and December 2021. Patient demographics, presenting symptoms, features of septicemia, preoperative drainage, postoperative complications, and outcomes were recorded. Postoperative complications were categorized according to the modified Clavien-Dindo classification. A total of 48 patients with EPN and renal calculi were included in this study. Percutaneous nephrolithotomy was performed 4–6 weeks later after obtaining a negative urine culture or under appropriate antibiotic coverage if the culture was unsterile. Of the total, 39 (81.25%) patients had postoperative complications, but only 9 (18.75%) patients had grade III or higher complications. Of these, 3 (6.25%) patients had grade IIIa complications, 3 (6.25%) had grade IIIb complications, 2 (4.1%) had grade IVa complications, and 1 (2.08%) had grade IVb complications and was admitted to the intensive care. No mortality was observed during the postoperative period. Initial conservative management of EPN followed by PCNL after initial infection control is an effective strategy for managing these patients. Patients with higher EPN grades have a higher risk of major postoperative complications after PCNL for renal stones. Specifically, patients with an EPN class 3 or 4 had a higher risk of complications than those with an EPN class 2 or lower. Patients with EPN class 1 have a relatively uncomplicated postoperative course after PCNL.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135616996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Laparoscopic continent cutaneous urinary diversion using a modified Yang–Monti technique in an adult: A case report including 5-year follow-up 使用改良的Yang-Monti技术在成人腹腔镜下大陆皮肤尿转移:1例包括5年随访的报告
4区 医学
Current Urology Pub Date : 2023-10-19 DOI: 10.1097/cu9.0000000000000230
Silu Chen, Yuye Wu, Peng Zhang, Zhihua Li, Xinfei Li, Zhenyu Li, Kunlin Yang, Xuesong Li
{"title":"Laparoscopic continent cutaneous urinary diversion using a modified Yang–Monti technique in an adult: A case report including 5-year follow-up","authors":"Silu Chen, Yuye Wu, Peng Zhang, Zhihua Li, Xinfei Li, Zhenyu Li, Kunlin Yang, Xuesong Li","doi":"10.1097/cu9.0000000000000230","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000230","url":null,"abstract":"Abstract Continuous cutaneous urinary diversion is challenging when the appendix is physically unavailable. The Yang–Monti channel is an alternative to the tunneled appendix for urinary diversion. We present a case involving a 49-year-old man who underwent total urethrectomy and cystostomy 10 months previously. No tumor recurrence was observed; however, the patient experienced severe catheter-related bladder irritation after the procedure. The patient was readmitted to the authors’ hospital and underwent laparoscopic continent cutaneous urinary diversion using extracorporeal construction of a modified Yang–Monti channel. The operation lasted 232 minutes, with an estimated blood loss of 10 mL. The patient was discharged from hospital 6 days after surgery and removal of the cystostomy tube. After this, clean intermittent catheterization was performed every 3 hours for 4 weeks. Five years after the procedure, the modified Yang–Monti channel was still used for clean intermittent catheterization without any stomal stenosis being observed. The patient was satisfied with his postoperative quality of life.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135780526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Robot-assisted ileocystoplasty for the treatment of adult neurogenic bladder: A video demonstration and outcomes 机器人辅助回肠成形术治疗成人神经源性膀胱:视频演示和结果
4区 医学
Current Urology Pub Date : 2023-09-26 DOI: 10.1097/cu9.0000000000000221
Siying Yeow, Ahmed Goolam, Amanda Chung
{"title":"Robot-assisted ileocystoplasty for the treatment of adult neurogenic bladder: A video demonstration and outcomes","authors":"Siying Yeow, Ahmed Goolam, Amanda Chung","doi":"10.1097/cu9.0000000000000221","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000221","url":null,"abstract":"Abstract Ileocystoplasty is one of the treatment options in the armamentarium for the management of adults with neurogenic bladder dysfunction, after failure of less invasive treatment alternatives, such as intravesical onabotulinum toxin A injection therapy and sacral neuromodulation. It has traditionally been performed as open surgery and can be associated with significant morbidity, especially in the early postoperative period. [ 1] Complications associated with open ileocystoplasty include prolonged postoperative ileus, wound infections, and pain. Performing robot-assisted ileocystoplasty can reduce the morbidity associated with open surgery [ 2] and has been shown to be safe and feasible in experienced hands, [ 3] although it may be associated with increased operative duration because of its learning curve. Our technique of robot-assisted ileocystoplasty and early postoperative outcomes is demonstrated in this video (Supplemental Digital Content, http://links.lww.com/CURRUROL/A47). Robotic console time was 180 minutes, with minimal blood loss. Eight-hourly catheter aspiration and flushes were performed to manage the mucus in the urine. There were no metabolic acidosis or electrolyte derangements postoperatively. The patient was discharged on postoperative day 5. Postoperative cystogram at week 2 showed no leak and the patient is doing well at 1 year postoperatively. Robotic ileocystoplasty is safe and feasible and can reduce the morbidity associated with open surgery with good outcomes.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134960280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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