Advances in Urology最新文献

{"title":"Corrigendum to “HDR Brachytherapy in the Management of High-Risk Prostate Cancer”","authors":"S. Masson, R. Persad, A. Bahl","doi":"10.1155/2016/6345816","DOIUrl":"https://doi.org/10.1155/2016/6345816","url":null,"abstract":"[This corrects the article DOI: 10.1155/2012/980841.].","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/6345816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64472375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Single Wire Ureteral Access Sheath, Both Safe and Economical","authors":"J. Delto, G. Wayne, Ajaydeep S Sidhu, Rafael Yanes, A. Bhandari, A. Nieder","doi":"10.1155/2016/6267953","DOIUrl":"https://doi.org/10.1155/2016/6267953","url":null,"abstract":"Introduction. Novel disposable products for ureteroscopy are often inherently more expensive than conventional ones. For example, the Cook Flexor© Parallel™ (Flexor) access sheath is designed for ease and efficiency of gaining upper tract access with a solitary wire. We analyze the cost combinations, efficiency, and safety of disposable products utilized for upper tract access, including the Flexor and standard ureteral access sheath. Methods. We performed a retrospective review from January 2014 to October 2014 of patients undergoing URS for nephrolithiasis, who were prestented for various reasons (e.g., infection). Common combinations most utilized at our institution include “Classic,” “Flexor,” and “Standard.” Total costs per technique were calculated. Patient characteristics, operative parameters, and outcomes were compared among the groups. Results. The most commonly used technique involved a standard ureteral sheath and was the most expensive ($294). The second most utilized and least expensive combination involved the Flexor, saving up to $80 per case (27%). All access sheaths were placed successfully and without complications. There were no significant differences in operative time, blood loss, or complications. Conclusions. In prestented patients within this study, the Flexor combination was the most economical. Although the savings appear modest, long-term impact on costs can be substantial.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/6267953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64468371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Relaxation of the Ureter When Using Ureteral Access Sheaths during Ureterorenoscopy: A Randomized Feasibility Study in a Porcine Model","authors":"S. K. Lildal, K. Andreassen, Frederikke Eichner Christiansen, H. Jung, M. Pedersen, P. Osther","doi":"10.1155/2016/8064648","DOIUrl":"https://doi.org/10.1155/2016/8064648","url":null,"abstract":"Objective. High intraluminal pressure during ureterorenoscopy (URS) increases risk of infectious and haemorrhagic complications. Intrarenal pressure may be reduced by the use of ureteral access sheaths (UASs), which on the other hand may cause ureteral damage. We have previously shown that the β-agonist isoproterenol (ISO), when administered topically in the irrigation fluid, is able to inhibit ureteral muscle tone and lower intrarenal pressure during URS. The aim of this study was to examine the effect of ISO on the success rate of UAS insertion in a porcine model. Materials and Methods. 22 pigs in which a UAS could not initially be placed were randomized to endoluminal irrigation with either ISO (0.1 μg/mL) or saline before a new insertion trial. Subsequently, it was registered whether the UAS could be passed without resistance. During extraction of the sheath, any ureteral lesions were characterized ureteroscopically using the PULS classification system. Surgeons were blinded to randomization. Results. In the ISO group, the observed effect of irrigation was 63% successful UAS insertions, compared to 27% in the saline group. No serious lesions (<PULS grade 2) were observed in the ISO group. Conclusions. Endoluminal irrigation with ISO may facilitate UAS insertion and potentially decrease UAS related ureteral lesions.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/8064648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64547592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Presentation of Duplex Kidneys: Ureteropelvic Junction Obstruction","authors":"Cemile Başdaş, S. Çelebi, S. Özaydın, Birgül Karaaslan, Elmas Reyhan Alim, Ü. Güvenç, S. Sander","doi":"10.1155/2016/7960794","DOIUrl":"https://doi.org/10.1155/2016/7960794","url":null,"abstract":"Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy in six moieties, dismembered pyeloplasty in eight moieties, heminephrectomy in four cases, and simultaneous upper heminephrectomy and lower pole ureteropyelostomy in one patient. Conclusion. There is no standard approach for these patients and treatment should be individualized according to physical presentation, detailed anatomy, and severity of obstruction.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"81 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7960794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64542328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Bioceramic Urethral Bulking Agents Elicit Improved Host Tissue Responses in a Rat Model","authors":"T. Mann-Gow, B. King, A. el-Ghannam, C. Knabe-Ducheyne, M. Kida, O. Dall, J. Krhut, P. Zvára","doi":"10.1155/2016/1282531","DOIUrl":"https://doi.org/10.1155/2016/1282531","url":null,"abstract":"Objectives. To test the physical properties and host response to the bioceramic particles, silica-calcium phosphate (SCPC10) and Cristobalite, in a rat animal model and compare their biocompatibility to the current clinically utilized urethral bulking materials. Material and Methods. The novel bulking materials, SCPC10 and Cristobalite, were suspended in hyaluronic acid sodium salt and injected into the mid urethra of a rat. Additional animals were injected with bulking materials currently in clinical use. Physiological response was assessed using voiding trials, and host tissue response was evaluated using hard tissue histology and immunohistochemical analysis. Distant organs were evaluated for the presence of particles or their components. Results. Histological analysis of the urethral tissue five months after injection showed that both SCPC10 and Cristobalite induced a more robust fibroblastic and histiocytic reaction, promoting integration and encapsulation of the particle aggregates, leading to a larger bulking effect. Concentrations of Ca, Na, Si, and P ions in the experimental groups were comparable to control animals. Conclusions. This side-by-side examination of urethral bulking agents using a rat animal model and hard tissue histology techniques compared two newly developed bioactive ceramic particles to three of the currently used bulking agents. The local host tissue response and bulking effects of bioceramic particles were superior while also possessing a comparable safety profile.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1282531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64212402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urethral Stricture Disease: Challenges and Ongoing Controversies","authors":"M. Djordjevic, F. Martins, V. Kojović, D. Kurbatov","doi":"10.1155/2016/1238369","DOIUrl":"https://doi.org/10.1155/2016/1238369","url":null,"abstract":"Management of urethral stricture disease presents constant challenge for all reconstructive urologists. Urethral stricture disease is generally defined as stenoses that are typically long, involving broad areas of varying spongiofibrosis, and result from inflammation and/or infection, rather than trauma. Although the management of urethral strictures may be complex and challenging, very often they are treated by health care personnel without the necessary and proper training and knowledge of the current, modern, validated techniques and procedures. Notable changes in surgical approach have been adopted worldwide, resulting in significant improvement of successful outcomes and simultaneously decreasing the complication rate. Nowadays, most urethral strictures can be reconstructed in a one-stage procedure, leaving some complex cases for a less convenient, but safer, two-stage repair strategy. The exciting and enjoyable “nature” of reconstructive surgery, in general, and urethral reconstruction, in particular, is the unexpected and unpredictable nature of the stricture and, consequently, the need for the creative combination of different techniques and strategies, often involving tissue transfer procedures, either as grafts or as flaps, for achieving a successful outcome. This special issue contains a number of articles with description of different aspects, presentations, and treatments of urethral stricture disease with the aim to make further improvement of understanding and managing this severe surgical condition. \u0000 \u0000Multi-institutional review article from Portugal, India, and USA presents modality of challenging treatment of long-segment and panurethral stricture disease. Francisco E. Martins and colleagues evaluated etiology, pathogenesis, and diagnostic work-up and, finally, presented different surgical options for treatment, together with outcomes and complications. They concluded that one-stage repair with buccal mucosa grafts presents an excellent option in the treatment of long urethral stricture. However, for obliterative disease, two-stage urethroplasty offers a viable alternative. \u0000 \u0000J. Gelman and E. S. Wisenbaugh presented a review article about management of patients who suffer pelvic fracture urethral injuries which usually develop into obliterative strictures with distraction defect. They comprehensively evaluated initial management, preoperative planning, and techniques for posterior urethral stricture disease. The authors emphasize the importance of adequate vascularization of urethra for successful repair. They believe that possible future modification of operative technique could be a bulbar artery sparing surgery during posterior urethral reconstruction. Results from referral centers confirm that when open repair fails, excision and primary anastomosis still remains the procedure of choice and offers a very high success rate. In another article entitled “The Use of Flaps and Grafts in the Treatment of Urethral Stricture Diseas","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1238369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64208957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Potential Live Kidney Donors and Computed Tomographic Renal Angiograms at Christchurch Hospital","authors":"T. Alsulaiman, S. Mark, Sarah Armstrong, D. Mcgregor","doi":"10.1155/2016/4924320","DOIUrl":"https://doi.org/10.1155/2016/4924320","url":null,"abstract":"Aims. To examine the outcome of potential live kidney donors (PLKD) assessment program at Christchurch Hospital and, also, to review findings of Computed Tomographic (CT) renal angiograms that led to exclusion in the surgical assessment. Methods. Clinical data was obtained from the database of kidney transplants, Proton. Radiological investigations were reviewed using the hospital database, Éclair. The transplant coordinator was interviewed to clarify information about PLKD who did not proceed to surgery, and a consultant radiologist was interviewed to explain unfavorable findings on CT renal angiograms. Results. 162 PLKD were identified during the period January 04–June 08. Of those, 65 (40%) proceeded to have nephrectomy, 15 were accepted and planned to proceed to surgery, 13 were awaiting further assessment, and 69 (42.5%) did not proceed to nephrectomy. Of the 162 PLKD, 142 (88%) were directed donors. The proportion of altruistic PLKD who opted out was significantly higher than that of directed PLKD (45% versus 7%, P = 0.00004). Conclusions. This audit demonstrated a positive experience of live kidney donation at Christchurch Hospital. CT renal angiogram can potentially detect incidental or controversial pathologies in the kidney and the surrounding structures. Altruistic donation remains controversial with higher rates of opting out.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/4924320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64403996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual (Dys)function after Urethroplasty","authors":"L. Xambre","doi":"10.1155/2016/9671297","DOIUrl":"https://doi.org/10.1155/2016/9671297","url":null,"abstract":"There is a paucity of published literature on the andrological consequences of urethral repair. Until recently authors have focused mainly on technical aspects and objective results. Reported outcomes of urethral reconstruction surgery have traditionally focused only on urodynamic parameters such as flow rates. Patient reported outcome measures have largely been neglected and there is a scarcity of well conducted systematic studies on the subject. For these reasons whether the different components of sexual life are more or less affected by different types of urethral reconstruction remains largely unknown. In an attempt to clarify the available scientific evidence, the authors make a critical review of available literature, systematizing it by sexual domain and study type. Brief pathophysiological correlations are discussed.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"99 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/9671297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64630580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Guidance for Renal Tract Access and Dilation Reduces Radiation Exposure during Percutaneous Nephrolithotomy","authors":"T. Chi, S. Masic, Jianxing Li, M. Usawachintachit","doi":"10.1155/2016/3840697","DOIUrl":"https://doi.org/10.1155/2016/3840697","url":null,"abstract":"Purposes. To present our series of 38 prone percutaneous nephrolithotomy procedures performed with renal access and tract dilation purely under ultrasound guidance and describe the benefits and challenges accompanying this approach. Methods. Thirty-eight consecutive patients presenting for percutaneous nephrolithotomy for renal stone removal were included in this prospective cohort study. Ultrasonographic imaging in the prone position was used to obtain percutaneous renal access and guide tract dilation. Fluoroscopic screening was used only for nephrostomy tube placement. Preoperative, intraoperative, and postoperative procedural and patient data were collected for analysis. Results. Mean age of patients was 52.7 ± 17.2 years. Forty-five percent of patients were male with mean BMI of 26.1 ± 7.3 and mean stone size of 27.2 ± 17.6 millimeters. Renal puncture was performed successfully with ultrasonographic guidance in all cases with mean puncture time of 135.4 ± 132.5 seconds. Mean dilation time was 11.5 ± 3.8 min and mean stone fragmentation time was 37.5 ± 29.0 min. Mean total operative time was 129.3 ± 41.1. No patients experienced any significant immediate postoperative complication. All patients were rendered stone-free and no additional secondary procedures were required. Conclusions. Ultrasound guidance for renal access and tract dilation in prone percutaneous nephrolithotomy is a feasible and effective technique. It can be performed safely with significantly reduced fluoroscopic radiation exposure to the patient, surgeon, and intraoperative personnel.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3840697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64352288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Urethral Stricture Disease Negatively Impacts the Quality of Life of Family Members","authors":"J. Weese, Valary T Raup, J. Eswara, Stephen D. Marshall, Andrew J Chang, J. Vetter, S. Brandes","doi":"10.1155/2016/3582862","DOIUrl":"https://doi.org/10.1155/2016/3582862","url":null,"abstract":"Purpose. To quantify the quality of life (QoL) distress experienced by immediate family members of patients with urethral stricture via a questionnaire given prior to definitive urethroplasty. The emotional, social, and physical effects of urethral stricture disease on the QoL of family members have not been previously described. Materials and Methods. A questionnaire was administered prospectively to an immediate family member of 51 patients undergoing anterior urethroplasty by a single surgeon (SBB). The survey was comprised of twelve questions that addressed the emotional, social, and physical consequences experienced as a result of their loved one. Results. Of the 51 surveyed family members, most were female (92.2%), lived in the same household (86.3%), and slept in the same room as the patient (70.6%). Respondents experienced sleep disturbances (56.9%) and diminished social lives (43.1%). 82.4% felt stressed by the patient's surgical treatment, and 83.9% (26/31) felt that their intimacy was negatively impacted. Conclusions. Urethral stricture disease has a significant impact on the family members of those affected. These effects may last decades and include sleep disturbance, decreased social interactions, emotional stress, and impaired sexual intimacy. Treatment of urethral stricture disease should attempt to mitigate the impact of the disease on family members as well as the patient.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3582862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64336270","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}