Advances in Urology最新文献

{"title":"Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett's Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study.","authors":"Mohamed Shahin,&nbsp;Mohamed Abdalrazek,&nbsp;Mohamed Abdelmaboud,&nbsp;Ibrahim Mahmoud Elsayaad,&nbsp;Muhammad Abdelhafez Mahmoud,&nbsp;Mahmoud Abdelhady Mousa,&nbsp;Ahmed Elshamy,&nbsp;Omar Alsamahy,&nbsp;Mohamed Rehan,&nbsp;Sayed Elhady,&nbsp;Ibrahim Gamaan","doi":"10.1155/2022/6996933","DOIUrl":"https://doi.org/10.1155/2022/6996933","url":null,"abstract":"<p><strong>Background: </strong>Proximal hypospadias, with significant curvature, is one of the most challenging anomalies. Great diversity and a large number of procedures described over the last 4 decades confirmed the fact that no single procedure has been universally accepted or successful. So, the aim of this study is to evaluate double-faced tubularized preputial flap (DFPF) versus transverse tubularized inner preputial flap (Duckett's procedure) as regards surgical outcomes, complications rate, and cosmetic results for repair of penoscrotal hypospadias with chordee. <i>Patients and Methods</i>. This was a prospective comparative study on 144 children with primary penoscrotal hypospadias with moderate or severe chordee, conducted at New Damietta and Assuit hospitals, Al-Azhar University, from March 2016 to March 2022. The patients were randomly divided into two equal groups; group A (<i>n</i> = 72) underwent DFPF, and group B (<i>n</i> = 72) underwent Duckett's procedure.</p><p><strong>Results: </strong>No significant difference was identified as regards demographic data. The follow-up period ranged from 20 to 66 months (mean of 28 months after DFPF and 31 months after Duckett's repair), and the complication rate was 20.1% (29 of 144 children). There were statistically significant differences between the two groups as regards the urethral stricture, penile rotation, and total complication rate. HOSE score was adopted for assessment of surgical outcomes, urine stream, and cosmetic results.</p><p><strong>Conclusions: </strong>The DFPF technique is feasible and reliable for one-stage repair of penoscrotal hypospadias with chordee and can be considered as a good option as it ensures better surgical and cosmetic outcomes with lower incidence of complications.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":"6996933"},"PeriodicalIF":1.4,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9519334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391823","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":"Outcomes of Top-Down Holmium Laser Enucleation of Prostate for Recurrent/Residual Benign Prostatic Hyperplasia: One-Year Follow-Up.","authors":"Ahmed S Zakaria,&nbsp;Amr Hodhod,&nbsp;Loay Abbas,&nbsp;Moustafa Fathy,&nbsp;Ruba Abdul Hadi,&nbsp;Waleed Shabana,&nbsp;Anastasia Alexandra MacDonald,&nbsp;Ahmed Gamaleldin,&nbsp;Mohamed Abdallah,&nbsp;Mohamed Elgharbawy,&nbsp;Abdulrahman Ahmad,&nbsp;Adam Roos,&nbsp;Ahmed Kotb,&nbsp;Walid Shahrour,&nbsp;Hazem Elmansy","doi":"10.1155/2022/5185114","DOIUrl":"https://doi.org/10.1155/2022/5185114","url":null,"abstract":"<p><strong>Materials and methods: </strong>We carried out a retrospective analysis of patients who underwent top-down HoLEP for the management of recurrent BPH at our institution. Patients who had previously undergone TURP were assigned to group I, while those with no history of prostate surgery were allocated to group II. Preoperative clinical characteristics, enucleation time, resected tissue weight, morcellation time, energy used, and intraoperative and postoperative complications were recorded and statistically analyzed. Patients were followed up postoperatively at 1, 3, 6, and 12 months. The evaluation included the International Prostate Symptom Score (IPSS), quality of life assessment (QoL), maximum urinary flow rate (<i>Q</i> _max), postvoid residual urine test (PVR), and continence status.</p><p><strong>Results: </strong>Two hundred and sixty-nine patients were included in this study. Group I consisted of 68 patients with recurrent BPH, while group II included 201 patients. There were no statistically significant differences in preoperative characteristics between both groups. The median enucleation time for group I (67.5 min (25-200)) was not significantly longer than that for group II (60 min (19-165) (<i>p</i>=0.25)). Operative outcomes, including morcellation time, resected weight, catheter duration, and hospital stay, were comparable between both groups. At 1, 3, 6, and 12 months, all urinary functional outcomes showed significant improvement, and there were no significant differences between the two groups. At 3 months' follow-up, two patients in group I and three patients in group II experienced stress urinary incontinence (SUI). At the last follow-up visit, one patient from group I presented with persistent SUI.</p><p><strong>Conclusions: </strong>For managing recurrent and nonrecurrent cases of BPH, top-down HoLEP is safe with comparable urinary functional outcomes. Patients with a history of previous prostate surgery can be counselled that their prior transurethral procedure does not reduce the benefits of HoLEP.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"5185114"},"PeriodicalIF":1.4,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516419","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":"The Effects of Pelvic Floor Muscle Exercise Combined with Core Stability Exercise on Women with Stress Urinary Incontinence following the Treatment of Nonspecific Chronic Low Back Pain.","authors":"Shamima Islam Nipa,&nbsp;Thanyaluck Sriboonreung,&nbsp;Aatit Paungmali,&nbsp;Chailert Phongnarisorn","doi":"10.1155/2022/2051374","DOIUrl":"https://doi.org/10.1155/2022/2051374","url":null,"abstract":"<p><strong>Aim: </strong>To compare the combined effects of core stability exercise and pelvic floor muscle exercise (PFME) with the effects of PFME alone on women with stress urinary incontinence (SUI) who experience nonspecific chronic low back pain (NSCLBP).</p><p><strong>Methods: </strong>A stratified randomized controlled trial study (RCT) was conducted with 50 women with SUI who experienced LBP, aged 18-60 years and with pad weight ≥2 grams for the one-hour pad test. The respondents were divided into two groups: the intervention group (PFME + core stability exercise) and the control group (PFME). The primary outcomes were the amount and frequency of urine leakage, which were measured using the one-hour pad test and the Bengali-ISI subjective questionnaire. A secondary outcome was quality of life (QoL), which was measured using King's Health Questionnaire (KHQ). An ITT analysis was conducted using repeated measures ANOVA (2 × 2) with Bonferroni's post-hoc analysis. <i>Results/Preliminary Findings</i>. The findings illustrated that 72% (<i>n</i> = 18) of the intervention and 28% (<i>n</i> = 7) of the control group participants showed improvement in UI after 12 weeks of intervention. In addition, the amount and frequency of urine leakage significantly decreased in the intervention group compared to the control group (<i>p</i> ≤ 0.001).</p><p><strong>Conclusion: </strong>The RCT-illustrated improvement of SUI in women with nonspecific chronic low back pain, reduction of frequency, and improvement of the QoL were more evident from PFME with core stability exercise than from PFME alone.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":"2051374"},"PeriodicalIF":1.4,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359358","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":"Diagnosing Oncocytoma by Core Needle Biopsy: A Single-Center Experience.","authors":"Chen Mayer,&nbsp;Yasmin Abu-Ghanem,&nbsp;Zohar A Dotan,&nbsp;Iris Barshack,&nbsp;Eddie Fridman","doi":"10.1155/2022/1589040","DOIUrl":"https://doi.org/10.1155/2022/1589040","url":null,"abstract":"<p><strong>Background: </strong>Oncocytoma is one of the most common benign kidney tumors, accounting for 3-7% of all solid renal masses. Diagnosing oncocytomas using renal biopsy remains a controversy in the uro-pathologic community. With the increasing use of biopsies for assessment of renal lesions, reaching this pathologically benign diagnosis may prevent further surgical measures and have significant clinical benefit.</p><p><strong>Objective: </strong>To demonstrate our center's results using renal biopsy to diagnose oncocytomas and to suggest that this diagnosis can be made with high success rates.</p><p><strong>Design: </strong>, <i>Setting</i>, <i>and Participants</i>. From our center's database, we retrospectively identified and retrieved all cases of oncocytoma diagnosed between the years 2011 and 2020 by renal biopsy. Medical records of those patients were then reviewed to view follow-up meetings and imaging of the lesions biopsied. <i>Outcome Measurements and Statistical Analysis</i>. In 21 biopsies performed on 19 patients, diagnosis was supported by subsequent follow-up averaging at 3.44 years per patient. <i>Results and Limitations</i>. The lesions exhibited benign behavior during follow-up after biopsy, consistent with the diagnosis of oncocytoma.</p><p><strong>Conclusions: </strong>Our study demonstrates that with good patient selection and proficient cooperation between urologists, radiologists and dedicated uro-pathologists, correctly diagnosing oncocytomas using RCB is a viable task. <i>Patient Summary</i>. Oncocytomas are benign lesions of the kidney. In our study, we reviewed all cases of oncocytomas pathologically diagnosed using renal biopsy from our center's database. We found that in subsequent follow-up later to biopsy, the lesions displayed benign behavior consistent with oncocytoma. The use of percutaneous biopsies to reach this diagnosis could save patients more extensive surgeries.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"1589040"},"PeriodicalIF":1.4,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448055","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":"Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases.","authors":"Alberto Artiles Medina,&nbsp;Victoria Gómez Dos Santos,&nbsp;Víctor Díez Nicolás,&nbsp;Vital Hevia Palacios,&nbsp;Mercedes Ruiz Hernández,&nbsp;Inés Laso García,&nbsp;Marina Mata Alcaraz,&nbsp;Cristina Galeano Álvarez,&nbsp;Miguel Ángel Jiménez Cidre,&nbsp;Fernando Arias Fúnez,&nbsp;Milagros Fernández Lucas,&nbsp;Francisco Javier Burgos Revilla","doi":"10.1155/2022/9299397","DOIUrl":"https://doi.org/10.1155/2022/9299397","url":null,"abstract":"<p><strong>Introduction: </strong>Transplantation surgery teams often have to face complex cases. In certain circumstances, such as occlusion of the iliac vessels or prior pelvic surgery, heterotopic kidney transplantation may not be feasible and orthotopic kidney transplantation (OKT) could be a good alternative. Kidney autotransplantation (KAT) has been described as a potential treatment for complex renovascular, ureteral, or neoplastic conditions. There are scarce data regarding the complications and outcomes of these procedures; therefore, we present our experience.</p><p><strong>Materials and methods: </strong>We retrospectively analysed the medical records of both 21 patients who had received OKT and 19 patients who underwent KAT between 1993 and 2020. We collected demographic features and data regarding surgical technique, complications, and graft outcomes. Kidney graft survival was calculated using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Regarding OKT, in 15 (71.43%) cases, it was the first kidney transplantation. The most common indication was the unsuitable iliac region due to vascular abnormalities (57.14%). The early postoperative complication rate was high (66.67%), with 23.81% of Clavien grade 3b complications. During the follow-up period (mean 5.76 -SD 6.15- years), we detected 9 (42.85%) graft losses. At 1 year, the survival rate was 84.9%. Concerning KAT, the most frequent indication was ureteral pathology (52.63%), followed by vascular lesions (42.11%). The overall early complication rate was 42.11%. During the follow-up period (mean of 4.47 years), 4 (15.79%) graft losses were reported.</p><p><strong>Conclusions: </strong>Although OKT and KAT have high complication rates, these techniques can be considered as two valuable approaches for complex cases, in the absence of other therapeutic options.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":"9299397"},"PeriodicalIF":1.4,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40615194","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":"The Safety and Efficacy of Endoscopic Combined Intrarenal Surgery (ECIRS) versus Percutaneous Nephrolithotomy (PCNL): A Systematic Review and Meta-Analysis.","authors":"Victor A Abdullatif,&nbsp;Roger L Sur,&nbsp;Ziad A Abdullatif,&nbsp;Sharon R Szabo,&nbsp;Joel E Abbott","doi":"10.1155/2022/1716554","DOIUrl":"https://doi.org/10.1155/2022/1716554","url":null,"abstract":"<p><strong>Purpose: </strong>Our aim is to evaluate the safety and efficacy of endoscopic combined intrarenal surgery compared to percutaneous nephrolithotomy to guide practitioners and inform guidelines.</p><p><strong>Materials and methods: </strong>A detailed database search was performed in PubMed, OVID, Scopus, and Web of Science in October 2021 to identify articles pertaining to ECIRS published between 2001 and 2021.</p><p><strong>Results: </strong>Four nonrandomized comparative studies and one RCT were identified, yielding five studies with a total of 546 patients (ECIRS/mini-ECIRS, <i>n</i> = 277; PCNL/mini-PCNL, <i>n</i> = 269). Subjects in these five studies met the predefined inclusion criteria established by two reviewers (J.E.A. and R.L.S.) and were therefore eligible for analysis. The results demonstrated that ECIRS was associated with a higher SFR (OR: 4.20; 95% CI: 2.79, 6.33; <i>p</i> < 0.00001), fewer complications (OR: 0.63; 95% CI: 0.41, 0.97; <i>p</i>=0.04), and a shorter hospital stay (WMD: -1.27; 95% CI: -1.55, -0.98; <i>p</i> < 0.00001) when compared to PCNL. There were no statistically significant differences in blood transfusions (OR: 0.45; 95% CI: 0.12, 1.68; <i>p</i>=0.24), operative time (SMD: -1.05; 95% CI: -2.42, 0.31; <i>p</i>=0.13), or blood loss (SMD: -1.10; 95% CI: -2.46, 0.26; <i>p</i>=0.11) between ECIRS and PCNL.</p><p><strong>Conclusions: </strong>ECIRS may be a more suitable approach for the surgical management of large and complex kidney stones currently indicating PCNL due to its superior efficacy with comparable surgical time and complication rate, though it is thought that a lack of resources and properly trained personnel may preclude ECIRS from becoming the standard. It is our impression that ECIRS may become the preferred technique in the endourologic community corresponding to the evolutionary sequence of percutaneous stone surgery.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":"1716554"},"PeriodicalIF":1.4,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40568231","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 of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy.","authors":"Stefano Salciccia,&nbsp;Pietro Viscuso,&nbsp;Giulio Bevilacqua,&nbsp;Antonio Tufano,&nbsp;Paolo Casale,&nbsp;Ettore De Berardinis,&nbsp;Giovanni Battista Di Pierro,&nbsp;Susanna Cattarino,&nbsp;Alessandro Gentilucci,&nbsp;Francesca Lourdes Lia,&nbsp;Di Giulio Ivan,&nbsp;Davide Rosati,&nbsp;Francesco Del Giudice,&nbsp;Alessandro Sciarra,&nbsp;Gianna Mariotti","doi":"10.1155/2022/8736249","DOIUrl":"https://doi.org/10.1155/2022/8736249","url":null,"abstract":"<p><strong>Purpose: </strong>To compare different forms of invasive treatments for postradical prostatectomy (RP) urinary incontinence (UI) in terms of quantitative and qualitative parameters and continence recovery rate.</p><p><strong>Methods: </strong>We distinguished five categories of treatment: <i>A</i> = bulking agents, <i>B</i> = fixed slings, <i>C</i> = adjustable slings, <i>D</i> = circumferential compressor devices (artificial sphincter), and <i>E</i> = noncircumferential compressor devices (ProACT). A literature search was performed following the PRISMA guidelines. We performed a cumulative meta-analysis to explore the trend in the effect sizes across groups at postoperative follow-up. We compared the available treatment arms using standardized mean difference (SMD) and event rate (ER) for questionnaire results, number of pads/day, and percentage of pad-free patients. <i>Evidence synthesis</i>. 36 clinical trials were selected. At baseline, in the different populations, mean number of pad-day varied from 1.1 to 8.8, 24-hour pad weight varied extremely from 17.3 <i>g</i> to 747.0 <i>g</i>, and mean ICIQ-UI-SF questionnaire score varied from 4.8 to 18.6. Considering a random effect model among eligible studies, ER of continence recovery was 0.33 (95% CI -0.12-0.78), 0.63 (95% CI 0.55-0.71), 0.65 (95% CI 0.58-0.72), 0.50 (95% CI 0.34-0.66), and 0.53 (95%CI 0.36-0.70), respectively, in groups A, B, C, D, and E (<i>I</i> ² 85.87%; <i>Q</i> 249.82-<i>P</i> > 0.01) (test of group differences <i>P</i>=0.22).</p><p><strong>Conclusion: </strong>In our analysis, the use of adjustable and fixed slings is associated with the highest whereas the use of bulking agents is associated with the lowest recovery rate of continence after treatment. Results are conditioned by an elevated rate of heterogeneity in part explained with a high variability of consistence in urinary leakage at baseline among populations.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":"8736249"},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40461732","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":"Role and Utility of Mixed Reality Technology in Laparoscopic Partial Nephrectomy: Outcomes of a Prospective RCT Using an Indigenously Developed Software","authors":"N. Gadzhiev, I. Semeniakin, A. Morshnev, A. Alcaraz, V. Gauhar, Z. Okhunov","doi":"10.1155/2022/8992051","DOIUrl":"https://doi.org/10.1155/2022/8992051","url":null,"abstract":"Objective To develop a software for mixed reality (MR) anatomical model creation and study its intraoperative clinical utility to facilitate laparoscopic partial nephrectomy. Materials and Methods After institutional review board approval, 47 patients were prospectively randomized for LPN into two groups: the control group (24 patients) underwent operation with an intraoperative ultrasound (US) control and the experimental group (23 patients) with smart glasses HoloLens 2 (Microsoft, Seattle, WA, USA). Our team has developed an open-source software package called “HLOIA,” utilization of which allowed to create and use during surgery the MR anatomical model of the kidney with its vascular pedicle and tumor. The study period extended from June 2020 to February 2021 where demographic, perioperative, and pathological data were collected for all qualifying patients. The objective was to assess the utility of a MR model during LPN and through a 5-point Likert scale questionnaire, completed by the surgeon, immediately after LPN. Patient characteristics were tested using the chi-square test for categorical variables and Student's t-test or Mann–Whitney test for continuous variables. Results Comparison of the variables between the groups revealed statistically significant differences only in the following parameters: the time for renal pedicle exposure and the time from the renal pedicle to the detection of tumor localization (p < 0.001), which were in favor of the experimental group. The surgeon's impression of the utility of the MR model by the proposed questionnaire demonstrated high scores in all statements. Conclusions Developed open-source software “HLOIA” allowed to create the mixed reality anatomical model by operating urologist which is when used with smart glasses has shown improvement in terms of time for renal pedicle exposure and time for renal tumor identification without compromising safety.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46787693","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":"Combined Training Intervention Targeting Medical and Nursing Staff Reduces Ciprofloxacin Use and Events of Urinary Tract Infection","authors":"J. Forster, Petra Schulze, Claudia Burger, M. Krone, U. Vogel, Güzin Surat","doi":"10.1155/2022/2474242","DOIUrl":"https://doi.org/10.1155/2022/2474242","url":null,"abstract":"Inappropriate diagnosis of urinary tract infections (UTI) contributes to antimicrobial overuse. A combined training intervention for medical and nursing staff mainly addressing the analytic process reduced UTI events (9.20 vs. 7.36 per 1000 PD, −20.0%, p = 0.003) and the utilization rate of ciprofloxacin (11.6 vs. 3.5, −69.6 p = 0.001) in a Bavarian University Hospital. Combined training intervention—as part of an antibiotic stewardship program—can be effective in avoiding unnecessary urinalysis and reducing antibiotic consumption.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43928765","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":"DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction","authors":"L. Vale, A. Charrua, H. Cavaleiro, R. Ribeiro-Oliveira, A. Avelino, T. Antunes-Lopes, A. Albino-Teixeira, F. Cruz","doi":"10.1155/2022/6292457","DOIUrl":"https://doi.org/10.1155/2022/6292457","url":null,"abstract":"Objectives To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn's multiple comparisons test, and Spearman's correlation test was used. Results DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions Low urothelial ATP parallels with a high incidence of DU early after pBOO.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45468775","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}