Indian Journal of Urology最新文献

{"title":"Peri-operative antibiotic usage during endourological surgery: A multi-institutional, national-level, cross-sectional audit of prevalent practice pattern in India.","authors":"Rishi Nayyar,&nbsp;Shritosh Kumar","doi":"10.4103/iju.iju_35_23","DOIUrl":"10.4103/iju.iju_35_23","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic use during endourological procedures is often discordant from the reported guidelines, despite the potential risks of antibiotic resistance, adverse effects, and health-care costs. A nationwide audit was conducted, with the support of the Urological Society of India, to ascertain the current antibiotic prescription practices for the endourological procedures and the reasons associated with them.</p><p><strong>Methods: </strong>A multi-institutional, national-level, cross-sectional audit analyzing elective endourological procedures was performed. The data regarding the disease profile; risk factors for infectious complications; urine culture; pre-, per-, and post-operative antibiotic use; additional antibiotic use; and patient demographics were collected in a standardized pro forma. Reasons for prescribing antibiotics divergent from the guideline recommendations were also noted. Any infectious complication that necessitated the antibiotic use was also noted prospectively up to 1 month. All the data were entered into a single centralized and customized online portal on a real-time basis.</p><p><strong>Results: </strong>One thousand five hundred and thirty-eight cases were recruited from 20 hospitals. A single-dose prophylaxis was prescribed in only 319 (20.7%) of the cases, and the majority received a multi-day prophylaxis. A combination of two or more antibiotics was prescribed as the prophylaxis in 51% of the cases. One thousand three hundred and fifty-six (88.2%) cases were continued on a long-duration prophylaxis after the discharge, with 1191 (77.4%) receiving it for > 3 days. One thousand one hundred and sixty (75.4%) cases received a guideline-discordant prophylaxis solely on the basis of the surgeon's or institution's protocol, rather than any specific case based need. Ninety eight (6.4%) cases developed postoperative urinary tract infection.</p><p><strong>Conclusions: </strong>Multi-dose, combination and post-discharge antibiotic prophylaxis for endourological surgeries is highly prevalent in India. This audit highlights the huge potential to reduce such guideline-discordant overuse of antibiotics during the endourological procedures.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"133-141"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/cb/IJU-39-133.PMC10249522.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975938","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":"Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India.","authors":"Atul Madhukar Budukh,&nbsp;Jarnail S Thakur,&nbsp;Tapas Kumar Dora,&nbsp;Prithviraj R Kadam,&nbsp;Sonali S Bagal,&nbsp;Kamalesh Kumar Patel,&nbsp;Alok K Goel,&nbsp;Sankalp M Sancheti,&nbsp;Ashish R Gulia,&nbsp;Pankaj P Chaturvedi,&nbsp;Rajesh P Dikshit,&nbsp;Rajendra A Badwe","doi":"10.4103/iju.iju_38_23","DOIUrl":"10.4103/iju.iju_38_23","url":null,"abstract":"<p><strong>Introduction: </strong>There is a scarcity of population-based prostate cancer survival data in India. We assessed the population-based, overall survival of patients with prostate cancer from the Sangrur and Mansa cancer registries of the Punjab state, India.</p><p><strong>Methods: </strong>In the year 2013-2016, a total of 171 prostate cancer cases were registered in these two registries. Based on these registries, survival analysis was performed using the date of diagnosis as the starting date and the last follow-up date being December 31, 2021 or the date of death. Survival was calculated using STATA software. Relative survival was calculated using the Pohar Perme method.</p><p><strong>Results: </strong>Follow up was available for all the registered cases. Of the 171 cases, 41 (24%) were alive and 130 (76.0%) were dead. Of the prescribed treatments, 106 (62.7%) cases completed the treatment and 63 (37.3%) cases did not complete the treatment. Overall, 5-year age-standardized prostate cancer relative survival was 30.3%. Patients who completed the treatment had a 7.8 times higher 5-year relative survival (45.5%) compared to those who did not (5.8%). The difference between the two groups is statistically significant (hazard ratio 0.16, 95% confidence interval [0.10-0.27]).</p><p><strong>Conclusion: </strong>To improve survival, we need to raise awareness in the community and among primary physicians so that prostate cancer cases can reach the hospital early and should be treated effectively. The cancer center should develop the systems in their hospital so that there will be no hurdles to the patients in treatment completion. We found a low overall relative survival among patients of prostate cancer in these two registries. Patients who received treatment had a significantly higher survival.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"148-155"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/8f/IJU-39-148.PMC10249534.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975939","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":"A rare case of air cysto-uretero-pyelogram due to emphysematous cystitis.","authors":"Shakti Swarup Sarangi,&nbsp;Deepak Prakash Bhirud,&nbsp;Shiv Charan Navriya,&nbsp;Arjun Singh Sandhu","doi":"10.4103/iju.iju_48_23","DOIUrl":"10.4103/iju.iju_48_23","url":null,"abstract":"<p><p>Emphysematous infection of the urinary tract is a hazardous condition and is life-threatening if not managed quickly. We report an 82-year-old woman with uncontrolled diabetes mellitus and urethral stricture who presented with emphysematous cystitis with the gas reaching up to the pelvicalyceal system on the left side (emphysematous pyelonephritis) and appearing in X-ray as air pyelogram. The patient was managed with drainage and intravenous antibiotics and she recovered.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"169-170"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/42/IJU-39-169.PMC10249520.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674223","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":"A rare diagnosis of renal replacement lipomatosis.","authors":"Rajnandini Dasgupta,&nbsp;Chandan J Das,&nbsp;Amit Gupta","doi":"10.4103/iju.iju_24_23","DOIUrl":"10.4103/iju.iju_24_23","url":null,"abstract":"<p><p>Renal replacement lipomatosis (RRL) is a rare, benign entity characterized by marked fat proliferation within the renal sinus and perinephric space. We present images of a patient with RRL.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"165-166"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/cf/IJU-39-165.PMC10249532.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992996","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":"Early and late complications of suprapubic cystostomy - Report of two cases.","authors":"Anandan Murugesan,&nbsp;Devdas Madhavan","doi":"10.4103/iju.iju_64_23","DOIUrl":"10.4103/iju.iju_64_23","url":null,"abstract":"<p><p>Suprapubic cystostomy (SPC), although a common procedure, may be associated with complications. We present two cases of transperitoneal tract of SPC. The early complication was ileal perforation, resulting in perforation peritonitis and late complication was incisional hernia around the SPC tract. Avoiding peritoneal violation helps in preventing such complications.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"167-168"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/07/IJU-39-167.PMC10249517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992999","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":"Primary retroperitoneal fibrosis presenting as a renal mass.","authors":"Nikita Shrivastava,&nbsp;Divya Aggarwal,&nbsp;Rahul Jena","doi":"10.4103/iju.iju_391_22","DOIUrl":"10.4103/iju.iju_391_22","url":null,"abstract":"<p><p>A 67-year-old male was incidentally found to have a large left perinephric mass with a poorly functioning left kidney. A differential diagnosis of renal cell carcinoma, lymphoma, retroperitoneal fibrosis (RPF), and IgG4 renal disease was suggested on imaging studies and biopsy of the mass. A left radical nephrectomy was performed as malignancy could not be ruled out. The final diagnosis was RPF without periaortitis and the patient is doing well at 9 months of follow-up. RPF, although characterized as a manifestation of periaortitis and large vessel vasculitis, might also present as an isolated perinephric mass without aortic involvement. Surgical management is an alternative, especially when malignancy is suspected.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"157-159"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/b3/IJU-39-157.PMC10249537.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993000","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":"Re: Ramadhani MZ, Kloping YP, Rahman IA, Yogiswara N, Soebadi MA, Renaldo J. Silodosin as a medical expulsive therapy for distal ureteral stones: A systematic review and meta-analysis. Indian J Urol 2023;39:21-6.","authors":"Gopal Sharma","doi":"10.4103/iju.iju_439_22","DOIUrl":"10.4103/iju.iju_439_22","url":null,"abstract":"I read with great interest an article published by Ramadhani et al.[1] in the latest edition of the Journal. In this study, the authors have performed a systematic review and meta-analysis of the studies examining the role of silodosin as a medical expulsive therapy for distal ureteric stones. I would like to congratulate the authors on their publication. Multiple randomized control trials have established the efficacy of alpha‐blockers as a part of medical expulsive therapy for distal ureteric stones. Most of the studies conducted in this field have been small, single‐center, poor‐quality randomized studies. Therefore, there is still a scope for a well-conducted multicentric randomized control trial to close this debate. This is where systematic reviews and meta-analyses have proved handy by performing a pooled analysis of these small randomized studies. However, this pooling of data may not be without limitations as there would be heterogeneity in the patient population and outcomes studied. In the present meta-analysis, the authors have tried to handle this delicate issue; however, there are still limitations that need to be addressed.","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"177-178"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/e9/IJU-39-177.PMC10249525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993002","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":"PROMPTS Trial: Screening spinal magnetic resonance imaging in castration-resistant prostate cancer.","authors":"Soumya Shivasis Pattnaik","doi":"10.4103/iju.iju_21_23","DOIUrl":"10.4103/iju.iju_21_23","url":null,"abstract":"SUMMARY The PROMPTS trial [1] is a recently concluded phase 3 trial which was conducted in 45 NHS hospitals in the United Kingdom. It evaluated the role of screening spinal magnetic resonance imaging (MRI) and subsequent treatment of radiological spinal cord compression in asymptomatic patients with metastatic castration-resistant prostate cancer (CRPC) and whether early treatment reduced the incidence of clinical spinal cord compression. This study included patients with an Eastern Cooperative Oncology Group performance status of 0–2, with asymptomatic spinal metastasis without any history of prior spinal cord compression, and no spinal MRI in the past 12 months. Patients were randomized 1:1 into two groups. In one group, screening spinal MRI was done followed by treatment for radiological spinal cord compression (if diagnosed). The other group did not undergo the screening spinal MRI. Patients who were included in the study and had screening detected radiological spinal cord compression were offered treatment in the form of radiotherapy or surgical decompression as recommended by the physician and 6-month spinal MRI was done. All patients were followed up every 3 months, and then at the 30 th and 36 th months. The study evaluated the incidence of confirmed clinical spinal cord compression and the time taken to develop cord compression. The trial enrolled 420 patients, 210 in each arm. Screening MRI detected radiological cord compression in 61 (31%) of 200 patients with assessable scans in the intervention group. At a median follow-up of 22 months (interquartile range: 13–31), time to clinical cord compression was not significantly improved with screening. One-year clinical cord compression rates were 6·7% for the control group and 4·3% for the screening and treatment group. Median time to clinical cord compression was not reached in either group. This study concluded that despite there being a significant incidence of radiological (asymptomatic","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"175-176"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/a3/IJU-39-175.PMC10249523.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674216","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":"Hourglass appearance in cystocele with an impacted vesical calculus.","authors":"Manickam Ramalingam,&nbsp;Senthil Kallappan,&nbsp;M N Janani","doi":"10.4103/iju.iju_20_23","DOIUrl":"10.4103/iju.iju_20_23","url":null,"abstract":"A 62-year-old hypertensive female presented with a mass protruding from the vagina for the past 20 years. She complained of dysuria and urinary incontinence for the past 3 months. There was no history of surgical intervention in the past. The examination revealed a tender irreducible total uterine prolapse (procidentia) and cystocele with a decubitus ulcer. Computed tomography urogram showed a total uterine prolapse along with the prolapse of a part of urinary bladder, with a vesical calculus of size 2.8 cm × 2.7 cm in the prolapsed part of the bladder, below the level of the pubic symphysis, with minimal wall thickening. After optimization, vesical lithotripsy and bilateral ureteric stenting were performed, followed by hysterectomy after 2 days.","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"163-164"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/95/IJU-39-163.PMC10249529.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674217","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":"Comparison between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of mortality on Fournier's gangrene cases.","authors":"Soetojo Wirjopranoto","doi":"10.4103/iju.iju_256_22","DOIUrl":"10.4103/iju.iju_256_22","url":null,"abstract":"<p><strong>Introduction: </strong>Fournier's gangrene (FG) is an infection of the subcutaneous tissue and fascia that progresses quickly and leads to necrosis. It is more prevalent in male patients and immunocompromised individuals, such as those suffering from uncontrolled diabetes. It has a high mortality rate, which makes its early identification and clinical suspicion critical. This study aimed to compare two laboratory parameters, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and to predict the mortality of FG in a tertiary care hospital.</p><p><strong>Methods: </strong>In a retrospective study, data was retrieved from medical records for the period from January 2014 to December 2020, of patients diagnosed with FG. Recorded data that is age, sex, comorbidities, mortality, and laboratory results (PLR and NLR) were used to assess determinants of survival.</p><p><strong>Results: </strong>There were 23 (17.04%) nonsurvivors among the 135 subjects studied. The mean age was 50.9 ± 14.9 years and men were 103 (83%) patients. Among the participants, diabetes mellitus was the most frequent comorbidity at 74 (54.81%) patients. NLR ≥8 was statistically significant (<i>P</i> = 0.013) for identifying mortality, while PLR >140 was not. In multivariate analysis, NLR ≥8 was found to be a reliable predictor of the FG mortality rate (adjusted odds ratio 12.062, confidence interval 95% 2.115-68.778, <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>NLR had prognosis predictive value for FG, whereas PLR did not.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"39 2","pages":"121-125"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/99/IJU-39-121.PMC10249533.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10356446","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}