Annals of urology & nephrology最新文献

{"title":"Intravesical Bacille Calmette-Guerin (BCG) Eradicates Bacteriuria in Antibiotic-Naïve Bladder Tumor Patients","authors":"Harry W Herr MD","doi":"10.33552/aun.2021.02.000548","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000548","url":null,"abstract":"Intravesical Mycobacterium bovis bacille Calmette-Guerin (BCG) is standard therapy for high grade noninvasive bladder cancer. BCG induces a robust immune response in the bladder, characterized by cytokine production, inflammation, and recruitment of immune cells [1]. Neoplastic cells slough in the urine as they are destroyed, leaving denuded mucosa in responding patients. Invading uropathogens trigger similar cellular responses that cause rapid shedding of infected bladder epithelial cells into the urine, known as exfoliation [2]. Bacteria can evade exfoliation by invading deeper epithelial cells and establish a reservoir for urinary tract infection [3]. Although contraindicated in acute cystitis, we have shown that BCG is safe and effective in patients with asymptomatic bacteriuria [4]. We hypothesized that the immune response to BCG may augment innate immune defenses to eradicate bacteriuria.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46525737","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":"Evaluation of Laser Therapy for Urgency Urinary Incontinence in Females","authors":"Ali Abid","doi":"10.33552/aun.2021.02.000546","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000546","url":null,"abstract":"Urgency urinary incontinence is a major health problem associated with detriments to the social, mental and economical spheres of an affected individual’s life. It is a symptom that is implicated in many syndromes such as overactive bladder, genitourinary syndrome of menopause and mixed urinary incontinence. The exact cause of urgency urinary incontinence has not been elucidated however some theories point to detrusor overactivity, poor bladder compliance and urothelial hypersensitivity as the culprits. The management of urgency urinary incontinence includes a stepwise approach beginning with behavioural and lifestyle modifications and physical therapy followed by pharmacological agents and then, for severe cases, surgical management. Laser therapy is a novel, non-hormonal, minimally invasive treatment approach that is rising in prominence in the literature. In this review an evaluation of the literature is conducted, appraising any relevant studies to determine if laser therapy is a viable management approach. Our finding is that at this current juncture there is not enough evidence to support the implementation of laser therapy for urgency urinary incontinence.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45017278","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":"Challenges of Management of Duplex System Ureterocele in an 18-Year-Old Woman: A Case Report","authors":"A. Muhammad","doi":"10.33552/aun.2021.02.000547","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000547","url":null,"abstract":"Background: Ureterocele is a cystic dilatation of the intravesical part of the ureter. Duplex system ureterocele is rare and occur more in females. Patients usually present with recurrent abdominal pain and urinary tract infection. The diagnosis and the treatment of duplex system ureterocele in women may pose diagnostic and therapeutic dilemma. We report a case of duplex system ureterocele in a woman highlighting diagnostic and therapeutic challenges. Case report: This is 18-year-old woman who presented with recurrent right flank pain, intermittent fever of 7months duration and lower urinary tract symptoms. There was right renal angle tenderness on abdominal examination. Abdominopelvic ultrasound and computerized tomographic scan urogram (CTU) revealed right hydronephrosis and a ureterocele. Accurate diagnosis was missed by all the imaging studies done. She had excision of the ureterocele and common sheath reimplantation of the two ureters on account of duplex system ureterocele. She had uneventful recovery. The urethral catheter, stents, drain and the stitches were remove 15 and 16 days postoperatively. She was discharged 20 days post operatively. Conclusion: Duplex system ureterocele may present with recurrent pyelonephritis. Computerized tomographic scan urogram is necessary for accurate diagnosis. There may be diagnostic and or therapeutic challenges. Common sheath ureteral reimplantation is associated with good outcome.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44827738","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":"Exstrophy Epispadias Complex: Outcome Analysis of Repair Performed at A Single Centre","authors":"M. Arya","doi":"10.33552/aun.2021.02.000545","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000545","url":null,"abstract":"Objective: The exstrophy-epispadias complex (EEC) is a rare developmental defect which affects multiple systems including the genitourinary system. We share our outcome analysis of 34 surgeries performed on 27 EEC cases at our institution. Material and Methods: This is a retrospective analysis of the outcome and follow up of patients operated for EEC. A total of 27 cases including 15 bladder exstrophy (11 Males, 4 Females) and 19 epispadias (14 Males, 5 Females) were treated from September 2014 to November 2019. Total 34 surgeries were performed on 27 patients which included 7 male cases of closed exstrophy who underwent subsequent epidpadias repair. These included two interesting exstrophy cases also. One of them was a female bladder exstrophy reared as male up to 19 years and another a 31 years male with skin covered exstrophy, diphallia and total urinary incontinence since birth. Epispadias group also included two adult males. Result: Thirteen pediatric patients underwent primary bladder and abdominal closure. Bladder reclosure rate was 14.2%. One adult male underwent Mitrofanoff diversion. The other adult- 19 year female had bladder closure, followed by bladder augmentation and rectus flap interposition. Male epispadias repair was performed in 14 patients (7 post closed exstrophy and 7 epispadias). Fistula rate after male epispadias repair was 15.3%. Five females underwent repair for epispadias. Bladder neck reconstruction (BNR) was carried out in 6 patients. Continence rates post BNR was 83% (including social continence). This congenital anomaly requires accomplishment of meticulous repair in staged manner. These cases need follow up from birth to adulthood. Presentation at adult age is extremely rare and related to social stigma, illiteracy and poor access to health care system. and advancement meatal; CBE: Classical bladder exstrophy; CPRE: Complete primary repair of exstrophy; MSRE: Modern staged repair of exstrophy; VUR: Vesicoureteric reflux; SPCL: Suprapubic Cystoloithotomy; CIC: Clean intermittent catheterisation; IVU: Intravenous Urography; BSRI: Bem sex role inventory; SP: Suprapubic; GIDYQ-AA: Gender Identity/ Gender dysphoria questionnaire for adolescent and adults","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49151183","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":"Does Intralesional Injection of Clostridium Histolyticum affect the Treatment Practice of Peyronie’s Disease?","authors":"I. Gruenwald","doi":"10.33552/aun.2021.02.000544","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000544","url":null,"abstract":"Introduction: Penile curvature and pain during erection present a significant bothersome issue for men with Peyronie’s disease and their partners. Clostridium histolyticum was approved for intralesional-injection in patients with Peyronie’s disease and penile curvature. Aim: We aimed primarily to determine whether the introduction of intralesional-injection of clostridium histolyticum affects the treatment pattern of Peyronie’s disease at a single academic medical center. Material and methods: Medical records of patients evaluated for penile curvature related to Peyronie’s disease were retrospectively reviewed. Patients were allocated into two groups: those who received consultation prior to intralesional-injection availability, and those who received consultation after intralesional-injection availability. Treatment choices were summarized as percentages of each group. Comparison between the groups regarding the proportion of patients who chose to undergo specific treatment was performed using a Chi-square test. Results: Two hundred and twenty-seven patients were evaluated. Fifty-nine were evaluated before the introduction of intralesional-injection of clostridium histolyticum (group A) while 168 patients were evaluated post-introduction of intralesional-injection of clostridium histolyticum (group B). After the first discussion on management, 32 (54.2%) group A and 105 (62.5%) group B patients decided not to pursue treatment nor follow-up. No statistically significant difference in percentage of patients undergoing any treatment was observed between the groups (p>0.05). Of the remaining 27 patients in group A, 10 patients (37.0%) underwent surgery. Of the 63 remaining patients in group B, 14 (22.2%) underwent surgery. No statistically significant difference in percentage of patients undergoing surgery was observed between the 2 groups. Of the remaining patients in group B, only 12 (19.0%) were treated with intralesional-injection of clostridium histolyticum, and the rest, thirty-seven (59%) patients, elected to continue follow-up without treatment. Conclusion: The addition of intralesional-injection of clostridium histolyticum to Peyronie’s disease treatment arsenal did not significantly alter the percentage of patients choosing to undergo surgery.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45014055","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":"Congenital Pelvi-ureteric Junction Obstruction Associated with Crossing Lower Pole Vessels","authors":"A. Muhammad","doi":"10.33552/aun.2021.02.000543","DOIUrl":"https://doi.org/10.33552/aun.2021.02.000543","url":null,"abstract":"Background: Congenital pelvi-ureteric junction obstruction [PUJO] occurs when there is impairment of flow of urine from the renal pelvis to the proximal ureter due to inherited abnormalities of pelvi-ureteric junction [PUJ]. The presentation is usually at the 4 th or 5 th decade of life. It may rarely be associated with crossing lower pole vessel [CLPV]. Treatment is by Anderson- Hynes [dismembered] pyeloplasty which remove the abnormal PUJ and transposes the PUJ anterior to the offending vessels. I report a case of 45-year-old man with congenital PUJO associated with crossing lower pole vessel vessels who had dismembered Anderson -Hynes pyeloplasty. Case report: This is a 45-year-old man who presented with 4 years history of recurrent colicky left flank pain which was relieved by passing large volume of urine. The general examination was non remarkable. The left kidney was ballotable. The abdominopelvic computerized urogram revealed severe left hydronephrosis and hyperdense structure in the region of the left kidney. He had exploration via left Gibson incision with finding of multiple crossing lower pole vessels and aperistaltic segment at PUJ. He had excision of the abnormal PUJ, transposition of the crossing vessels posteriorly and dismembered Anderson-Hynes pyeloplasty. He had uneventful recovery and was discharged home 5 days postoperatively. Conclusion: Congenital PUJO associated with lower pole vessel is rare and may present in the 5 th decade of life. Anderson- Hynes dismembered pyeloplasty is the procedure of choice and associated with good outcome.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47526431","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":"Knowledge about Benefits of Kidney Transplantation: A Survey of Dialysis Patients.","authors":"Valerie Nwanji,&nbsp;Aria Ghahramani,&nbsp;Mujahed Dauleh,&nbsp;Nasrollah Ghahramani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Knowledge about benefits of kidney transplantation (KT) is an important determinant of the patients' decision to pursue KT. We investigated factors associated with End Stage Renal Disease (ESRD) patients' knowledge about KT benefits.</p><p><strong>Methods: </strong>We randomly invited 1,400 dialysis patients to complete a survey about benefits of KT. Using multivariate analysis, we calculated odds ratios for the probability of choosing the correct responses.</p><p><strong>Results: </strong>Of 673 participants, 17.6% agreed with benefit of KT for older patients, 36.5% agreed with benefit of KT for diabetic patients, and 31.5% agreed with benefit of pre-emptive KT. Non-white (OR: 0.68) and older (OR: 0.65) participants were less likely to agree with the survival benefit of KT. Older participants were less likely to agree with benefit of KT for older (OR: 0.64), and diabetic patients (OR: 0.54). Participants with less than high school education were less likely to agree with benefit of pre-emptive KT (OR: 0.58). Participants with a previous KT were more likely to agree with benefit of KT for older (OR: 2.32), and diabetic patients (OR: 2.50), and with the benefit of pre-emptive KT (OR: 2.34). Participants who had received 3 or more modes of education about KT were more likely to agree with benefit of KT for diabetic patients (OR: 2.04), and with benefit of pre-emptive KT (OR:1.67).</p><p><strong>Conclusions: </strong>Dialysis patients have limited knowledge about benefits of KT. Previous KT, exposure to 3 or more modes of KT education, and education attainment are significant contributors to knowledge about KT benefits.</p>","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341390/pdf/nihms-1704722.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39293019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Peritoneal Loose Body (Mice) in Left Sided Inguinal Hernial Sac","authors":"D. Patel","doi":"10.33552/aun.2020.02.000542","DOIUrl":"https://doi.org/10.33552/aun.2020.02.000542","url":null,"abstract":"This work is licensed under Creative Commons Attribution 4.0 License AUN.MS.ID.000542. Abstract Background: Peritoneal loose bodies or peritoneal mice are calcified pieces of necrotic tissue found in the peritoneal cavity. They are usually asymptomatic and small, ranging from 0.5 to 1 cm in size, but rarely may be up to 5 to 10 cm in size [1]. Peritoneal loose bodies develop from Appendices epiploicae that has undergone axial rotation followed by necrosis of its pedicle and detachment. Peritoneal loose bodies are incidental finding at laparotomy [2] but they are rarely described in hernial sac in the literature. By this article I have attempted to describe the rare case report of this subject to add to the scarce literature on this subject Case report: One such loose body of 2*2 cm size was found intraoperatively in a 45-year-old male patient presented to civil hospital Ahmedabad with left sided inguinal hernia & operated at Civil Hospital, Ahmedabad in the indirect inguinal hernial sac. Left inguinal hernioplasty was done and excised sac with containing loose body was sent for histopathology which confirmed it to be a peritoneal loose body.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47274301","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":"Iatrogenic Ureteral Transection During Suprapubic Cystolithotomy: A Rare Case Report","authors":"M. Arya","doi":"10.33552/aun.2020.02.000541","DOIUrl":"https://doi.org/10.33552/aun.2020.02.000541","url":null,"abstract":"Primary vesical calculi are not uncommon in children in India. Percutaneous cystolithotomy (PCCL) or suprapubic cystolithotomy (SPCL) is the modality of treatment for large calculi owing to the small caliber of the urethra in children. Ureteral injury during SPCL is exceptional and unheard of. Herein, we report such a case with plausible reasons.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43636037","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":"Central Migration of Tunneled Dialysis Catheter into Right Ventricle causing Positional Superior Vena Cava Obstruction: A Case Report","authors":"M. Sharif","doi":"10.33552/aun.2020.02.000540","DOIUrl":"https://doi.org/10.33552/aun.2020.02.000540","url":null,"abstract":"Tunneled dialysis catheters placement under real-time ultrasound guidance using the internal jugular route is considered to be a relatively simple and straightforward procedure, though its insertion and maintenance are not entirely risk-free. A literature search is full of reports describing various complications dialysis catheters placement; however, a central displacement of the catheter months after insertion is not described in the past. This case report highlights a case of the central migration of tunneled dialysis catheters and emphasizes the importance of close monitoring of the position of these catheters.","PeriodicalId":93263,"journal":{"name":"Annals of urology & nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41988724","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}