Canadian Journal of Urology最新文献

Hypogonadism, frailty, and postoperative outcomes among men undergoing partial nephrectomy. 接受部分肾切除术的男性性腺功能减退、虚弱和术后结果。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Alon Lazarovich, Daniel R Greenberg, Stephen P Rhodes, Hriday P Bhambhvani, Luis C Gago, Hiten D Patel, Robert E Brannigan, Jonathan E Shoag, Joshua A Halpern

{"title":"Hypogonadism, frailty, and postoperative outcomes among men undergoing partial nephrectomy.","authors":"Alon Lazarovich, Daniel R Greenberg, Stephen P Rhodes, Hriday P Bhambhvani, Luis C Gago, Hiten D Patel, Robert E Brannigan, Jonathan E Shoag, Joshua A Halpern","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: To determine the prevalence of hypogonadism in men undergoing partial nephrectomy (PN) and whether hypogonadism and frailty are associated with adverse postoperative outcomes.Materials and methods: We identified men undergoing PN between 2012-2021 using the Merative Marketscan database. Patients were considered to have hypogonadism if diagnosed within 5 years prior to PN. Frailty was determined using the Hospital Frailty Risk Score (HFRS). Length of stay (LOS), complications, ED visits, and inpatient readmissions were compared. Sub-group analysis of men with hypogonadism was performed to determine if testosterone replacement therapy (TRT) improved clinical outcomes.Results: Among 9,105 men who underwent PN, 809 (8.9%) were hypogonadal prior to PN. Hypogonadal men were significantly more frail compared to eugonadal men (HFRS score: median 6.7, IQR 4.1-10.1 vs. median 5.6, IQR 3.3-8.8, p < 0.001). However, there was no significant difference in LOS following PN nor in 90-day postoperative complications, ED visits, or inpatient readmission between men with and without hypogonadism. However, intermediate- and high-risk frailty were associated with increased risk of 90-day ED visits and 90-day inpatient readmission compared to low-risk patients. Among high-risk men with hypogonadism, TRT was associated with decreased risk of 90-day ED visits (p = 0.04).Conclusions: Frailty was associated with postoperative outcomes following PN. Hypogonadism was associated with frailty, and treatment of hypogonadal men with TRT was associated with reduction in post-operative risk. These findings suggest a role for frailty assessment, and possibly testosterone screening, in men undergoing PN.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 6","pages":"12045-12052"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830968","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

Measuring the efficacy of Serenoa repens (USPlus) extract with mobile uroflowmetry. 用移动尿流仪测定白藜芦醇提取物（USPlus）的疗效。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Joshua Winograd, John Lama, Alia Codelia-Anjum, Naeem Bhojani, Dean S Elterman, Kevin C Zorn, Eric Margolis, Jamin Brahmbhatt, Ricardo Gonzalez, Bilal Chughtai

{"title":"Measuring the efficacy of Serenoa repens (USPlus) extract with mobile uroflowmetry.","authors":"Joshua Winograd, John Lama, Alia Codelia-Anjum, Naeem Bhojani, Dean S Elterman, Kevin C Zorn, Eric Margolis, Jamin Brahmbhatt, Ricardo Gonzalez, Bilal Chughtai","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Benign prostatic hyperplasia (BPH) is a prevalent condition affecting a significant portion of the male population, leading to secondary lower urinary tract symptoms (LUTS). Alternative therapies such as phytotherapy using Lipidosterolic extract of Serenoa repens (LSESR USPlus) are commonly used. However, the efficacy of LSESr remains controversial due to conflicting data. We sought to determine the effect of a standardized USP-verified Saw Palmetto extract on male LUTS secondary to BPH.Materials and methods: In this prospective single-arm trial, we investigated the efficacy of a standardized USP-verified Saw Palmetto extract in treating male LUTS secondary to BPH. We utilized the ProudP mobile application for home uroflowmetry and symptom assessment.Results: Results from 46 patients using 320 mg daily of USP-verified Saw Palmetto extract revealed significant improvements in IPSS and QoL scores at 12 weeks compared to baseline, particularly in patients with moderate symptoms. Uroflowmetry parameters also improved with increased flow rates, primarily in patients with mild symptoms.Conclusion: Our findings support the efficacy of USP-verified Saw Palmetto extract in alleviating LUTS in men with BPH. Further studies are warranted in larger, diverse cohorts over longer follow up periods.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 6","pages":"12053-12059"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830991","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

My Morning Commute and the Impact of Urology. 我的晨运和泌尿外科的影响。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Leonard G Gomella

引用次数: 0

Clinical implications of tumor laterality in renal cell carcinoma. 肾细胞癌肿瘤偏侧性的临床意义。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Jacob Grassauer, Wesley H Chou, Anna Geduldig, Jackson Schmidt, Nicholas H Chakiryan

{"title":"Clinical implications of tumor laterality in renal cell carcinoma.","authors":"Jacob Grassauer, Wesley H Chou, Anna Geduldig, Jackson Schmidt, Nicholas H Chakiryan","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: It is unclear whether laterality has prognostic implications for patients with renal cell carcinoma (RCC). Some suggest that left sided tumors may have worse survival outcomes. The purpose of this study is to associate tumor characteristics and clinical outcomes with laterality in patients with RCC.Materials and methods: Patients with RCC were identified in the National Cancer Database between 2004-2020. Patients were categorized as having either localized, regional or metastatic disease. Time-series charts were generated to demonstrate laterality differences and variance over time. Multivariable Cox proportional hazards regression was utilized to associate laterality with overall survival, stratified by clinical stage. Kaplan-Meier estimates were utilized to visualize survival functions.Results: A total of 306,196 patients were included, 156,450 (51.1%) had right sided tumors and 283,282 (92.5%) had localized RCC. Localized tumors were more likely to be right sided (0.51 [95% CI 0.50-0.52], p < 0.001). Metastatic and regional tumors (cN+M0) were more likely to be left sided (0.48 [0.47-0.49], p < 0.001; and 0.43 [0.41-0.45], p < 0.001; respectively). For localized disease, smaller tumors were more likely to be right sided (< 2 cm: 0.52 [0.51-0.52], p < 0.001), while tumors > 7cm showed no significant site association (0.49 [0.49-0.50], p = 0.07). When stratified by staging, there were no significant associations between laterality and OS (localized RCC: HR 1.01 [0.99-1.02], p = 0.50; metastatic RCC: 1.03 [1.00-1.07], p = 0.7; cN+M0 RCC: 0.96 [0.86-1.07], p = 0.50).Conclusions: Left-sided RCC tumors are associated with larger tumor size and a higher propensity for regional nodal involvement and distant metastases. However, they do not demonstrate more aggressive behavior leading to meaningful survival differences.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 6","pages":"12060-12071"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830962","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

Legends in Urology v31I06. 泌尿学传说v31I06。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Francesco Montorsi

引用次数: 0

Illuminating the use of photodynamic therapy in urologic oncology. 阐明光动力疗法在泌尿系统肿瘤学中的应用。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Gabrielle R Yankelevich, Kale Moreland, Makayla M Swancutt, Robert L Grubb

引用次数: 0

Single-port robotic laparoscopic ureterocalicostomy: surgical technique and clinical outcomes. 单孔机器人腹腔镜输尿管造口术：手术技术和临床效果。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Alex J Xu, Jeffery S Lin, Po Yen Chen, Samuel Carbunaru, Yeonsoo S Lee, Lee C Zhao

{"title":"Single-port robotic laparoscopic ureterocalicostomy: surgical technique and clinical outcomes.","authors":"Alex J Xu, Jeffery S Lin, Po Yen Chen, Samuel Carbunaru, Yeonsoo S Lee, Lee C Zhao","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: We describe a method of robotic ureterocalicostomy (RALUC) with the Da Vinci Single Port (SP) platform and present clinical outcomes in our cohort of patients.Materials and methods: We retrospectively reviewed all patients undergoing RALUC with the SP platform in a single-institution, IRB-approved database between 2020-2023. Demographics, preoperative, intraoperative, and postoperative outcomes were collated. Surgical success was defined as freedom from hardware, avoidance of additional surgical reconstruction, and no obstruction on follow up imaging/ureteroscopy. An incision is made 1/3rd the distance from anterior superior iliac spine to the umbilicus. The retroperitoneal space is entered and SP Access Port is placed. The psoas is identified and concomitant ureteroscopy is used to identify the ureter. The ureter is dissected to the most proximal aspect and transected. The remaining proximal ureteral stump is suture ligated. The lower pole parenchyma is removed to access the calyx. Absorbable barbed suture is used to control parenchymal bleeding and evert the mucosal edge of the calyx. Barbed suture is then used for the ureterocaliceal anastomosis over a ureteral stent.Results: Six patients underwent RALUC. Retroperitoneal approach was used for 5/6 cases. Prior ureteral surgery had been performed in 4/6 patients. Fifty percent of cases included an additional procedure with a median operative time of 248 minutes. One patient required nephrostomy tube placement postoperatively. Median follow up was 10.35 months with surgical success rate of 67%.Conclusions: SP RALUC is a safe and feasible option for proximal ureteral reconstruction in patients with unfavorable upper urinary tract anatomy or in salvage cases.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 6","pages":"12072-12076"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830916","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

Robotic-assisted laparoscopic pyelolithotomy in a horseshoe kidney. 机器人辅助的马蹄肾腹腔镜肾盂取石术。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-12-01

Stephanie Aron, Anthony Galvez, Ryan Nasseri, Susana Berrios, Tyler Sheetz

引用次数: 0

Rapid onset severe hyperkalemia during robotic radical cystectomy: a case report. 机器人根治性膀胱切除术中快速出现的严重高钾血症：病例报告。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Matthew Buell, Brian Hu

引用次数: 0

Practical, cost-effective removal of Hem-o-lok Weck clip: a novel technique. 实用、经济地取出 Hem-o-lok Weck 夹：一种新技术。

IF 1.2 4区医学

Canadian Journal of Urology Pub Date : 2024-10-01

Braden Rolig, James A Brown

{"title":"Practical, cost-effective removal of Hem-o-lok Weck clip: a novel technique.","authors":"Braden Rolig, James A Brown","doi":"","DOIUrl":"","url":null,"abstract":"The Hem-o-lok Weck clip is part of a polymer locking ligation system often employed for hemostasis in surgical practices. Its use is routine in a wide array of surgical subspecialties. Surgeons have limited options in removing these clips when they are aberrantly positioned. Herein, we describe a novel, cost-effective approach for removing a Hem-o-lok clip using standard robotic instruments. This simple approach will allow surgeons to remove a Hem-o-lok clip precisely and quickly if it is not adequately placed. During a routine robotic-assisted laparoscopic prostatectomy a Hem-o-lok Weck clip was noted to be in juxtaposition to the rectal wall, and it was deemed appropriate to remove it. Ultimately, the indwelling Prograsp forceps was moved from the right fourth arm position to the left arm position. This allowed the Prograsp forceps to compress the scissors in the right hand port, which was insufficient in cutting the hinge of the clip. This provided sufficient force to cut through the clip at its hinge with ease. The Hem-o-lok Weck clip is used in various surgical specialties. It is occasionally placed suboptimally and requires removal. Given the challenge of finding and using the clip removal device, surgeons should be aware of this simple and cost-effective way of removing a Hem-o-lok clip if desired.","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"31 5","pages":"12019-12021"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513871","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