Frontiers in urology最新文献

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Bladder irrigation with tap water to reduce antibiotic treatment for catheter-associated urinary tract infections: an evaluation of clinical practice 自来水膀胱冲洗减少抗生素治疗导管相关性尿路感染的临床评价
Frontiers in urology Pub Date : 2023-02-01 DOI: 10.3389/fruro.2023.1172271
F. V. van Veen, Stefan Den Hoedt, R. Coolen, Jessica Boekhorst, J. Scheepe, B. Blok
{"title":"Bladder irrigation with tap water to reduce antibiotic treatment for catheter-associated urinary tract infections: an evaluation of clinical practice","authors":"F. V. van Veen, Stefan Den Hoedt, R. Coolen, Jessica Boekhorst, J. Scheepe, B. Blok","doi":"10.3389/fruro.2023.1172271","DOIUrl":"https://doi.org/10.3389/fruro.2023.1172271","url":null,"abstract":"Introduction Catheter-associated urinary tract infection (CAUTI) is a common complication among patients with urinary catheters and is often treated with antibiotics. With increasing rates of antibiotic resistance, it is necessary to explore alternative treatment options for CAUTIs. The aims of this study were 1) to assess the efficacy and treatment satisfaction of bladder irrigation (BI) with tap water to prevent and treat CAUTIs, 2) and to evaluate the current use of BI for CAUTIs among Dutch clinicians. Methods The first part of this study consisted of a cross-sectional study among patients with intermittent or indwelling catheters who performed BI with tap water between March 2020 and May 2021. Efficacy, treatment satisfaction, and Patient Global Impression of Improvement (PGI-I) were assessed using questionnaires. Outcomes were compared between neurogenic lower urinary tract dysfunction (NLUTD) and non-NLUTD patients. Factors associated with overall treatment satisfaction were determined using logistic regression analysis. Second, a nationwide survey of Dutch clinicians was conducted to evaluate the current use of BI for CAUTIs. Results A total of 99 patients who were performing BI for at least three months were included. The median age was 61.9 years, 41.4% had NLUTD, and 72.2% performed BI >1 year. The majority of both NLUTD (65.9%) and non-NLUTD patients (68.4%) were (very) satisfied with BI. Women had higher odds of reporting higher satisfaction and each additional CAUTI decreased the odds. Most NLUTD (85.4%) and non-NLUTD (65.5%) patients reported an improvement on the PGI-I with a difference in favour of NLUTD patients (p=0.002). In addition, 40.4% of the patients had no CAUTI, and 59.6% reported 1.39 (SD 2.06) CAUTIs. Only half of these self-reported CAUTIs were treated with antibiotics. In addition, 33 (58.9%) clinicians used BI for CAUTIs, of which ten used tap water as irrigation agent. Discussion This study provides first evidence supporting the efficacy of BI with tap water in the treatment of CAUTIs and reducing the use of antibiotics. Patients are overall satisfied and experience improvement in their condition with BI. In addition, the majority of the surveyed Dutch clinicians use BI for CAUTIs. However, irrigation with tap water is still not widely used.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"47 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41267418","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}
引用次数: 0
Robot-assisted laparoscopic orchiopexy: A comparative analysis with laparoscopic orchiopexy 机器人辅助的腹腔镜睾丸切除术:与腹腔镜睾丸切除术的比较分析
Frontiers in urology Pub Date : 2023-01-30 DOI: 10.3389/fruro.2023.1103915
A. Rensing, Abdul Qadar, Clark Higganbotham*, D. Frimberger, B. Meenakshi‐Sundaram
{"title":"Robot-assisted laparoscopic orchiopexy: A comparative analysis with laparoscopic orchiopexy","authors":"A. Rensing, Abdul Qadar, Clark Higganbotham*, D. Frimberger, B. Meenakshi‐Sundaram","doi":"10.3389/fruro.2023.1103915","DOIUrl":"https://doi.org/10.3389/fruro.2023.1103915","url":null,"abstract":"Background While undescended testes are relatively common, the nonpalpable testis remains a challenging problem. The gold standard treatment remains the laparoscopic orchiopexy. However, today robot-assisted surgery has challenged traditional laparoscopy in many areas of urology. Yet the value of this new approach remains controversial, given concerns with operative time and cost. We reviewed our contemporary results of both robot-assisted orchiopexy (RALO) and traditional laparoscopic orchiopexy (TLO). Our primary aims were to retrospectively compare success rates, and operative time. Our secondary aims were to compare costs and complications related to each method. Methods In this study, all patients treated with laparoscopic and robot-assisted laparoscopic orchiopexy from April 2017 to January 2022 were reviewed using CPT code 54692. Exclusion criteria included bilateral concomitant orchiopexy or concomitant “major surgery,” or follow up less than 6 months. Also excluded were 1st stage orchiopexies. For the purposes of comparison, 1-stage and 2nd stage orchiopexies were included in the analysis. Patient demographics, surgical operative notes and documentation were all reviewed. Results After exclusion criteria was applied, 16 and 17 remained in the laparoscopic and robot-assisted cohorts, respectively. Upon follow up, all patients in both the laparoscopic and robot-assisted cohorts were noted to have a healthy testicle palpable in the dependent portion of the scrotum. The median operative time in the TLO group was 71 minutes, compared to 101 minutes in the RALO group (p>0.0001). When comparing median hospital charges, the TLO group was lower at $38,813, compared to $46,455 in the RALO group (p = 0.0069). There was one postoperative complication in the TLO group (localized wound infection), compared to zero in the RALO group. Conclusions The robot-assisted orchiopexy is safe and effective. However, at this time it remains more costly in terms of time and resources.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44202471","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}
引用次数: 0
Current state of female pediatric urologists at Societies for Pediatric Urology fellowship accredited programs 女性儿科泌尿科医师在儿科泌尿科协会认证项目的现状
Frontiers in urology Pub Date : 2023-01-27 DOI: 10.3389/fruro.2023.1104597
Natalie Armon, Nora Thompson, D. DaJusta, M. Fuchs, C. Ching
{"title":"Current state of female pediatric urologists at Societies for Pediatric Urology fellowship accredited programs","authors":"Natalie Armon, Nora Thompson, D. DaJusta, M. Fuchs, C. Ching","doi":"10.3389/fruro.2023.1104597","DOIUrl":"https://doi.org/10.3389/fruro.2023.1104597","url":null,"abstract":"Purpose Gender inequities in medicine exist. Urology is a male dominated surgical specialty, with recent census data showing females represent only 10.9% of the workforce. We aimed to characterize the composition of female pediatric urologists across the Societies for Pediatric Urology (SPU) pediatric urology fellowship accredited programs, with particular attention to academic promotion and leadership positions. Methods In January 2023, we reviewed the official websites of the 27 pediatric urology programs listed on the SPU website as fellowship accredited programs. We identified pediatric urology surgery attendings, their gender, academic title, and if they were named a director of an internal program or had a hospital leadership position. We identified the program chief and fellow/resident program director. This data was associated with years in practice. Results Females represented 27.4% of pediatric urology surgical attendings. Four programs (14.8%) had no female attendings. Female staff were in practice a median shorter time than that of males (6 vs. 16 years, p<0.0001). A significantly higher proportion of females were assistant professors (62.2 vs. 35.2%; p=0.0041) while a significantly higher proportion of men were professors (37.0 vs. 18.9%; p=0.0421). Only one program (3.7%) had a female department/division chief. There was no difference between genders regarding being named a director of a program and/or having an identified hospital position of leadership. Female professors had been in practice a significantly shorter time than male professors (p=0.0003); women with an internal or hospital leadership position had also been in practice a significantly shorter time than males (p<0.001). Conclusions Females are represented more in SPU pediatric urology fellowship accredited programs than the overall urology workforce. Fewer female attendings are professors compared to male attendings; however, differences in promotion could be impacted by female attendings being earlier in their career. Hopefully with time, we will see more equal representation amongst genders in pediatric urology programs overall, but especially where we are training the next generation.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47989487","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}
引用次数: 0
Nocturia is associated with stiffer central artery and more likely development of major adverse cardiovascular events in men 夜尿症与男性中心动脉硬化和更容易发生主要不良心血管事件有关
Frontiers in urology Pub Date : 2023-01-26 DOI: 10.3389/fruro.2023.1113054
C. Chan, C. Ng, S. Yuen, B. Lau, C. Yee, J. Teoh, P. Chiu, S. Kwok
{"title":"Nocturia is associated with stiffer central artery and more likely development of major adverse cardiovascular events in men","authors":"C. Chan, C. Ng, S. Yuen, B. Lau, C. Yee, J. Teoh, P. Chiu, S. Kwok","doi":"10.3389/fruro.2023.1113054","DOIUrl":"https://doi.org/10.3389/fruro.2023.1113054","url":null,"abstract":"Objectives To study the association between nocturia and brachial-ankle pulse wave velocity (baPWV) [surrogate of central arterial stiffness (CAS)] in men and to explore this association on predicting major adverse cardiovascular events (MACE). Methods 246 consecutive men (mean age:68.1 ± 8.4, range 36-88) newly referred to urology clinic for male-lower urinary tract symptoms(mLUTS)/nocturia were recruited. Their bilateral baPWV were measured by automatic pulse waveform analyzer. The associations between baseline characteristics, mLUTS/nocturia and baPWV(>1800cm/sec) [significant CAS] were analyzed by multivariate logistic regression. We followed the cohort for a median period of 27.5 months. Cox proportional hazard regression analysis and Kaplan-Meier method were used to study factors predicting MACE. Results The mean ( ± SE) baPWV of our cohort was 1820 ± 16cm/sec. For comparison, the reported value of the general population of similar age structure was~1650cm/sec. IPSS (total) was not associated with baPWV, whereas IPSS-Question.7(nocturia) was significantly increased with baPWV in men<70yo [nocturia=1.6 ± 1.14, 2.1 ± 1.08, 2.67 ± 1.33) for baPWV(cm/sec) <1400, 1400-1800, >1800 respectively] (P-trend=0.002). Age≥70yo (OR:2.70, 95%CI:1.52-4.76), diabetes mellitus (OR:2.26, 95%CI:1.06-4.83), hypertension (OR:1.95, 95%CI:1.10-3.45) and nocturia≥3x/night (OR:1.75, 95%CI:1.02-3.12) independently determined baPWV>1800cm/sec. The cumulative incidence rate of MACE was 46.8/1000 man-years(95%CI:30.96-68.16/1000). The addition of nocturia≥3x/night and baPWV>1800 cm/sec to the basic model improved the prediction of the development of MACE (difference in -2 log likelihood value: 11.219, p<0.001). Past history of ischemic heart (HR:5.67, 95%CI:2.02-15.88), nocturia≥3x/night (HR:2.87, 95%CI: 0.94-8.76) and baPWV>1800cm/sec (HR:5.16, 95%CI:1.79-14.90) independently predicted MACE in men. Conclusion Men attending the urology clinic for male-LUTS/nocturia had higher baPWV. This association was more pronounced in men<70yo. Men presented with both nocturia≥3x/night and baPWV>1800cm/sec showed significant predilection for developing MACE.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42410328","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}
引用次数: 0
Traumatic testicular injuries in appalachia: A ten-year review from a level 1 trauma center and comparison to the national trauma data bank® 阿巴拉契亚地区外伤性睾丸损伤:来自一级创伤中心的十年回顾,并与国家创伤数据库®进行比较
Frontiers in urology Pub Date : 2023-01-24 DOI: 10.3389/fruro.2023.1105513
Katharina Mitchell, Chad Morley, J. Barnard
{"title":"Traumatic testicular injuries in appalachia: A ten-year review from a level 1 trauma center and comparison to the national trauma data bank®","authors":"Katharina Mitchell, Chad Morley, J. Barnard","doi":"10.3389/fruro.2023.1105513","DOIUrl":"https://doi.org/10.3389/fruro.2023.1105513","url":null,"abstract":"While only 20% of the nation’s population lives in rural areas, 40% of the Appalachian population resides in rural areas. Due to the rural nature of this region we hypothesized this may have implications regarding the outcomes of traumatic testicular injuries (TTI), such as increased rate of organ loss. Here in, we report the findings of our 10-year retrospective study analyzing patients presenting with TTI to our rural tertiary care facility in comparison to an 8-year review of 8,030 TTI from the National Trauma Data Bank (NTDB®). Of the 34,000 trauma patients reviewed, 23 (0.07%) had TTI which concurs with the NTDB® value of 0.2%. Blunt trauma accounted for 91.3% of TTI contrasting with NTDB® data suggesting 50.5% attributable to penetrating mechanisms. Firearm related injuries comprised 4.3% of TTI, but 38.3% of NTDB®’s. Motor vehicle collision/motor cycle crash (MVC/MCC) accounted for 26.0%, similarly NTDB® data showed 26.6%. Median length of stay (LOS) was 1 day, and 3 for NTDB®. Scrotal exploration occurred in 90.4% of cases with 52.4% requiring orchiectomy, whereas NTDB® data suggested 48.3% and 23.4% respectively. In conclusion, compared to the NTDB® TTI data, Appalachia has a higher incidence of blunt mechanism, scrotal exploration rate, and testicular loss.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46341277","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}
引用次数: 1
Epididymitis, orchitis, and epididymo-orchitis associated with SARS-CoV-2 infection in pediatric patients: A systematic review 儿童患者中与严重急性呼吸系统综合征冠状病毒2型感染相关的附睾炎、睾丸炎和附睾睾丸炎:一项系统综述
Frontiers in urology Pub Date : 2023-01-19 DOI: 10.3389/fruro.2022.1092192
Daniel Inouye, Zoe Baker, Adam Peña, Evalynn Vasquez
{"title":"Epididymitis, orchitis, and epididymo-orchitis associated with SARS-CoV-2 infection in pediatric patients: A systematic review","authors":"Daniel Inouye, Zoe Baker, Adam Peña, Evalynn Vasquez","doi":"10.3389/fruro.2022.1092192","DOIUrl":"https://doi.org/10.3389/fruro.2022.1092192","url":null,"abstract":"Introduction Epididymitis, orchitis, and epididymo-orchitis (EO) are common disorders in pediatric patients which may be caused by infection, trauma, or inflammation. SARS-CoV-2 associated EO has been previously described, particularly in adults. However, no systematic reviews of these manifestations in pediatric patients yet exist. We present a systematic literature review of epididymitis, orchitis, and EO associated with SARS-CoV-2 in pediatric patients to shed light on these relatively rare, yet potentially severe, conditions to understand presentation, course of illness, management options, and outcomes. Materials and Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed using specified key terms to search PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Embase. Articles were independently screened by two reviewers. Manuscripts with detailed descriptions of SARS-CoV-2 associated epididymitis, orchitis, or EO in pediatric patients were included. Exclusion criteria included: no clear diagnosis of the target diseases and no detailed clinical course described. Quality and bias were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports. Results 60 records were initially identified, with 6 case reports included in the systematic review. All 6 patients included presented with fever and genitourinary symptoms. Four patients were also diagnosed with multisystem inflammatory syndrome in children (MIS-C). One patient underwent surgical exploration for presumed testicular torsion, though intraoperatively there was no evidence of torsion. All patients recovered without documented long-term sequelae. Discussion While observational studies are prone to bias, this systematic review suggests that epididymitis, orchitis, and EO are significant manifestations of SARS-CoV-2 that may mimic urologic emergencies (i.e., testicular torsion). Providers should suspect these conditions in pediatric COVID-19 patients with scrotal symptoms, particularly with associated MIS-C. The long-term genitourinary sequelae of SARS-CoV-2 should be investigated, including the effects on pediatric patients undergoing reproductive development.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43501706","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}
引用次数: 0
Intravesical compartments in the bladder can affect microbiological culturing outcome: An experimental study in pigs 膀胱内腔室可影响微生物培养结果:猪的实验研究
Frontiers in urology Pub Date : 2023-01-09 DOI: 10.3389/fruro.2022.1028778
Kristian Stærk, L. Langhorn, L. Nielsen, Thomas Andersen
{"title":"Intravesical compartments in the bladder can affect microbiological culturing outcome: An experimental study in pigs","authors":"Kristian Stærk, L. Langhorn, L. Nielsen, Thomas Andersen","doi":"10.3389/fruro.2022.1028778","DOIUrl":"https://doi.org/10.3389/fruro.2022.1028778","url":null,"abstract":"Urinary tract infections (UTIs) are one of the most common bacterial infections worldwide. The diagnosis is mainly dependent on the quantitative identification of uropathogens in urine from suspected patients and therefore, it is essential that bacterial count in urine specimens accurately reflects the bacterial population inside the bladder. In this study, we collected the first- and last urine specimens during a single full voiding from pigs with experimentally induced UTI and compared the urine density and bacterial counts of the collected specimens. We found that specimens from the same voiding varied in density and in bacterial counts by up to a thousand-fold with significant impact on diagnostic sensitivity. In conclusion, the porcine bladder can simultaneously contain intravesical compartments of varying density and bacterial counts that greatly influences microbiological analysis. The distribution of bacteria in intravesical compartments is critical to consider when using pigs as biomedical models of UTI. Furthermore, the similarities of porcine and human anatomy and physiology, suggest that the results are likely to be translatable to human, in which case potential UTIs could be overlooked by today’s diagnostic procedures.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48372803","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}
引用次数: 0
Reduction in maternal anxiety following prenatal pediatric urology consultation 减少产前儿科泌尿科会诊后产妇焦虑
Frontiers in urology Pub Date : 2023-01-06 DOI: 10.3389/fruro.2022.1089135
J. Yang, Zoe Baker, Hannah Dillon, Arthi Hannallah, Irene Klecha, Michelle M. Soohoo, J. Ko, R. D. De Filippo, Evalynn Vasquez
{"title":"Reduction in maternal anxiety following prenatal pediatric urology consultation","authors":"J. Yang, Zoe Baker, Hannah Dillon, Arthi Hannallah, Irene Klecha, Michelle M. Soohoo, J. Ko, R. D. De Filippo, Evalynn Vasquez","doi":"10.3389/fruro.2022.1089135","DOIUrl":"https://doi.org/10.3389/fruro.2022.1089135","url":null,"abstract":"Introduction Fetal anomalies detected on prenatal ultrasound can elicit maternal psychological distress and may be associated with increased risk of adverse fetal outcomes. Prenatal consultation with pediatric specialists may allay parental worries by improving clarity surrounding a fetal diagnosis, establishing a postnatal management plan, and providing expert advice. We sought to determine whether maternal anxiety and worry decreased following prenatal pediatric urology consultations among a cohort of pregnant women whose fetuses were diagnosed with urologic anomalies. Methods Pregnant women referred to pediatric urologists for prenatal consultation through our Fetal Maternal Center following detection of a urologic anomaly were recruited from February 2021 to March 2022 inclusive. Participants completed questionnaires before and after prenatal pediatric urology consultation assessing maternal current state anxiety (S-Anxiety) on the State-Trait Anxiety Inventory (STAI) and self-reported worry surrounding the fetal diagnosis. Differences in anxiety and worry before versus after prenatal consultation were analyzed using paired t-tests and McNemar’s tests. Results 26 pregnant women completed pre- and post-visit questionnaires. Most participants (92.3%) received prenatal pediatric urology consultation for anomalies of the fetal kidney(s), including hydronephrosis and suspected multicystic dysplastic kidney. The proportion of participants reporting extreme or moderate levels of worry surrounding the fetal diagnosis significantly decreased from 69.2% prior to prenatal pediatric urology consultation, to 30.8% after consultation (p=0.02). Reductions in worry after prenatal consultation were reported among 80.8% of participants. Average state anxiety on the STAI similarly significantly decreased from 35.2 ( ± 9.4) before prenatal consultation to 31.4 ( ± 11.1) after consultation. Differences in reductions in anxiety and worry did not significantly differ among participants attending prenatal consultations in-person or via telehealth. Conclusions Among a cohort of pregnant women diagnosed with fetal anomalies of the urinary tract, anxiety and worry surrounding the fetal diagnosis significantly decreased after prenatal in-person or telehealth consultations with pediatric urologists.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44185956","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}
引用次数: 0
The disparities in clinical trials addressing urologic conditions among lower-income countries 低收入国家泌尿系统疾病临床试验的差异
Frontiers in urology Pub Date : 2023-01-05 DOI: 10.3389/fruro.2022.1069265
A. Choksi, Christopher S. Hayden, S. Rahman, S. Lokeshwar, I. Kim
{"title":"The disparities in clinical trials addressing urologic conditions among lower-income countries","authors":"A. Choksi, Christopher S. Hayden, S. Rahman, S. Lokeshwar, I. Kim","doi":"10.3389/fruro.2022.1069265","DOIUrl":"https://doi.org/10.3389/fruro.2022.1069265","url":null,"abstract":"Introduction Genitourinary pathologies are increasingly common in low and lower-middle Q6 income countries (LMICs) however there is a disproportionate distribution of clinical trials in higher income countries as compared to LMICs. In order for evidence-based practice to be implemented in LMICs with regards to urologic conditions and malignancies, clinical trials need to be performed within LMICs such that the results can be analyzed based on the context of the local environment. Methods We queried ClinicalTrials.gov and the ICTRP for active clinical trials that were related to ‘prostatic neoplasms’, ‘urinary bladder neoplasms’, ‘kidney neoplasms’, ‘urolithiasis’, ‘urinary tract infections’ and ‘lower urinary tract symptoms’. The national incidence and DALYs was obtained from the Global Burden of Disease 2019 to analyze for a correlation between the numbers of clinical trials performed in a country with the burden of disease. Results A total of 4,169 clinical trials were identified based on the search query terms. Ninety percent of the clinical trials are being conducted in 32 countries. A majority of clinical trials are being performed in HICs. The proportion of non-oncologic urologic clinical trials performed in LMICs is greater than the proportion of urologic oncology clinical trials performed in LMICs (p <0.001). Linear regression models demonstrates a weak relationship between the global burden of disease and the number of clinical trials conducted in each country for the individual urologic conditions. Discussion A majority of urologic clinical trials are being conducted in high-income countries which does not coincide with the global burden of disease of urologic conditions.","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48440434","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}
引用次数: 1
The use of autologous skeletal muscle-derived cells as a sling in the treatment of stress-induced urinary incontinence: An experimental study in dogs 自体骨骼肌来源细胞作为吊带治疗压力性尿失禁的实验研究
Frontiers in urology Pub Date : 2023-01-05 DOI: 10.3389/fruro.2022.959583
B. Wadie, H. G. Aamer, S. Khater, M. Gabr
{"title":"The use of autologous skeletal muscle-derived cells as a sling in the treatment of stress-induced urinary incontinence: An experimental study in dogs","authors":"B. Wadie, H. G. Aamer, S. Khater, M. Gabr","doi":"10.3389/fruro.2022.959583","DOIUrl":"https://doi.org/10.3389/fruro.2022.959583","url":null,"abstract":"Purpose This is an experimental preclinical study testing the applicability of autologous skeletal muscle-derived cells as a treatment of SUI in a canine model. Methods Ten mongrel dogs were included in this study. Skeletal muscle was harvested for biopsy in 4 dogs. One month later, incontinence was induced in 8 dogs through urethrolysis. Biopsied muscle cells were incubated and expanded for 8 weeks. Muscle-derived cells were collected and covered with a polyglycolic acid (PGA) scaffold immersed in culture medium and coated with Matrigel to be used as a sling, which was placed suburethrally in 8 dogs; 4 had cell seeding, and 4 had scaffolds only. Urethral pressure (UP) measurements were performed at baseline and 2 & 6 weeks after sling insertion. The urethra was harvested 4 weeks after sling insertion for histopathology. Results One month, a statistically significant increase of mean urethral pressure values compared to baseline was observed in all dogs with a scaffold inserted. The increase ranged from 5 to 40 cmH2O. Histopathology showed significant periurethral proliferation of skeletal muscles in 4 dogs with cell-seeded scaffolds. These levels were the maximum levels in dogs # 1 & 2. This was not the case in the 4 dogs that had slings only. Conclusion Based on the outcome of this preliminary experience, the use of skeletal muscle-seeded PGA scaffolds seems to be an easy and reproducible procedure which preserves histological differentiation and integrity in a canine model","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47742775","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}
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