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Verteporfin: A Novel Antiproliferative Agent for Urinary Tract Fibrosis? 维替泊芬:一种新型尿路纤维化抗增生性药物?
Pub Date : 2022-01-14 DOI: 10.48083/gztk5882
J. Singh
No abbstract.
没有abbstract。
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引用次数: 0
One-Year Outcomes of the ROBUST II Study Evaluating the Use of a Drug-Coated Balloon for Treatment of Urethral Stricture 鲁棒II研究评估使用药物包被球囊治疗尿道狭窄的一年结果
Pub Date : 2022-01-14 DOI: 10.48083/mlxk5817
J. DeLong, M. Ehlert, B. Erickson, K. Robertson, R. Virasoro, S. Elliott
Objective To report 1-year results of the ROBUST II study investigating the safety and efficacy of a paclitaxel-coated balloon for the treatment of recurrent urethral strictures. Methods Subjects were adult men with a single anterior urethral stricture ≤ 3 cm in length and at least 2 prior stricture treatments. After treatment with the Optilume urethral drug-coated balloon (DCB), subjects were followed through 1 year. The primary safety endpoint was the rate of treatment-related serious complications at 90 days post-procedure. Efficacy outcomes included symptomatic assessments, erectile function measured using the International Index of Erectile Function (IIEF), Qmax, and anatomic success. Results Sixteen men with an average of 4.1 prior dilations were treated with the DCB. Anatomic success was achieved at 6 months in 73%. Average IPSS improved from 18.4 to 6.0 at 1 year (P < 0.001). Qmax improved from 6.9 mL/sec to 20.8 mL/sec (P < 0.001). There was no change in IIEF. Four subjects received additional treatment within 1 year. There were no treatment-related serious complications. Conclusions Short-term follow-up of men with urethral stricture treated with the Optilume DCB showed durable anatomic results at 6 months and sustained symptomatic improvement through 1 year. Treatment with the device was safe.
目的报告一项为期1年的ROBUST II研究的结果,该研究调查了紫杉醇包被球囊治疗复发性尿道狭窄的安全性和有效性。方法研究对象为单个前尿道狭窄长度≤3cm且既往至少2次前尿道狭窄治疗的成年男性。经Optilume尿道药物包覆球囊(DCB)治疗后,随访1年。主要安全终点是手术后90天治疗相关严重并发症的发生率。疗效结果包括症状评估、使用国际勃起功能指数(IIEF)测量勃起功能、Qmax和解剖成功。结果16例患者接受DCB治疗,平均术前扩张4.1次。6个月解剖成功率为73%。平均IPSS在1年后从18.4提高到6.0 (P < 0.001)。Qmax由6.9 mL/sec提高到20.8 mL/sec (P < 0.001)。IIEF没有变化。4名受试者在1年内接受了额外治疗。无治疗相关的严重并发症。结论尿道狭窄患者经Optilume DCB治疗后,6个月解剖效果持久,1年症状持续改善。使用该装置治疗是安全的。
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引用次数: 1
A Rare Case of Hypersensitivity Reaction Associated With Sacral Neuromodulation Hardware 一例罕见的与骶神经调节硬体相关的超敏反应
Pub Date : 2022-01-14 DOI: 10.48083/nade9605
Kendall A. Vignaroli, S. Popat, K. Kobashi
No abstract.
没有抽象的。
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引用次数: 0
Comparing Micro-Ultrasound to mpMRI in Detecting Clinically Significant Prostate Cancer 微超声与mpMRI检测临床意义前列腺癌的比较
Pub Date : 2022-01-14 DOI: 10.48083/dhnc9428
G. Tan, B. Wodlinger, C. Pavlovich, L. Klotz
Objectives To compare the performance of micro-ultrasound (mUS) with multi-parametric magnetic resonance imaging (mpMRI) in detecting clinically significant prostate cancer. Materials and Methods Retrospective data from consecutive patients with any indication for prostate biopsy in 2 academic institutions were included. The operator, blinded to mpMRI, would first scan the prostate and annotate any mUS lesions. All mUS lesions were biopsied. Any mpMRI lesions that did not correspond to mUS lesion upon unblinding were additionally biopsied. Grade group (GG) ≥ 2 was considered clinically significant cancer. The Jeffreys interval method was used to compare performance of mUS with mpMRI with the non-inferiority limit set at −5%. Results Imaging and biopsy were performed in 82 patients with 153 lesions. mUS had similar sensitivity to mpMRI (per-lesion analysis: 78.4% versus 72.5%), but lower specificity, positive predictive value, negative predictive value, and area under the curve. Micro-ultrasound found GG ≥ 2 in 13% of cases missed by mpMRI, while mpMRI found GG ≥ 2 in 11% of cases missed by mUS. The difference 0.020 (95% CI −0.070 to 0.110) was not statistically significant (P = 0.33). Conclusion The sensitivity of mUS in detecting GG ≥ 2 disease was similar to that of mpMRI, but the specificity was lower. Further evaluation with a larger sample size and experienced operators is warranted.
目的比较微超声(mUS)与多参数磁共振成像(mpMRI)在诊断具有临床意义的前列腺癌中的应用价值。材料和方法回顾性分析2个学术机构连续有前列腺活检指征患者的资料。操作人员对mpMRI不知情,首先扫描前列腺并注释任何mUS病变。所有mUS病变均行活检。在解盲时,任何mpMRI病变不对应于mUS病变的都进行了额外的活检。分级组(GG)≥2级为临床显著癌。采用Jeffreys区间法,在非劣效限制设置为- 5%的情况下,比较mUS与mpMRI的表现。结果82例患者153个病灶行影像学检查和活检。mUS与mpMRI具有相似的敏感性(每病灶分析:78.4%对72.5%),但特异性、阳性预测值、阴性预测值和曲线下面积较低。微超发现GG≥2者占mpMRI漏诊病例的13%,mpMRI发现GG≥2者占mUS漏诊病例的11%。差异0.020 (95% CI - 0.070 ~ 0.110)无统计学意义(P = 0.33)。结论mUS检测GG≥2病变的敏感性与mpMRI相似,但特异性较低。进一步的评估与更大的样本量和经验丰富的操作员是必要的。
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引用次数: 0
The Efficacy and Safety of a Conservative Management Approach to Radiation-Induced Male Urethral Strictures in Elderly Patients With Comorbidities 有合并症的老年放射性男性尿道狭窄保守治疗的有效性和安全性
Pub Date : 2022-01-14 DOI: 10.48083/xfyl6260
Alexander T. Rozanski, M. Moynihan, Lawrence T. Zhang, A. Muise, D. Holst, Steven A Copacino, L. Zinman, J. Buckley, A. Vanni
Objectives To assess the outcomes of a conservative management approach to radiation-induced urethral stricture disease (R-USD) in an elderly population with comorbidities. Methods Patients with R-USD managed with endoscopic procedures and/or clean intermittent catheterization (CIC) between 2007 and 2019 were included. Patients were excluded if they had an obliterative stricture, prior urethral reconstruction/urinary diversion surgery, or < 3 months follow-up. Primary outcome measures were urinary tract infection (UTI), acute urinary retention (AUR), serum creatinine, uroflowmetry/post-void residual, and urinary incontinence (UI). Failure was defined as progression to reconstructive surgery or permanent indwelling catheterization. Results Ninety-one men were analyzed with a median follow-up of 15.0 months (IQR 8.9 to 37.9). Median age was 75.4 years (IQR 70.0 to 80.0), body mass index was 26.5 kg/m2 (IQR 24.8 to 30.3), and Charlson comorbidity index was 6 (IQR 5 to 8). Median stricture length was 2.0 cm (IQR 2.0 to 3.0). Stricture location was bulbar (12%), bulbomembranous (75%), and prostatic (13%). A total of 90% underwent dilation, and 44% underwent direct visual internal urethrotomy (DVIU). For those that underwent these procedures, median number of dilations and DVIUs per patient was 2 (IQR 1 to 5) and 1 (IQR 1 to 3), respectively. Forty percent used CIC. Thirty-four percent developed a UTI, and 15% had an AUR episode requiring urgent treatment. Creatinine values, uroflowmetry measurements, and UI rates remained stable. Eighty percent avoided reconstructive surgery or indwelling catheterization. Conclusion Most elderly patients with comorbidities with R-USD appear to be effectively managed in the short-term with conservative strategies. Close observation is warranted because of the risk of UTIs and AUR. The potential long-term consequences of repetitive conservative interventions must be considered.
目的评价有合并症的老年人群放射性尿道狭窄病(R-USD)的保守治疗效果。方法纳入2007年至2019年期间接受内镜手术和/或清洁间歇导管(CIC)治疗的R-USD患者。如果患者有闭塞性狭窄,既往有尿道重建/尿改道手术,或随访< 3个月,则排除。主要结局指标为尿路感染(UTI)、急性尿潴留(AUR)、血清肌酐、尿流测定/尿后残留和尿失禁(UI)。失败被定义为进展到重建手术或永久留置导管。结果91例患者中位随访15.0个月(IQR 8.9 ~ 37.9)。中位年龄75.4岁(IQR 70.0 ~ 80.0),体重指数26.5 kg/m2 (IQR 24.8 ~ 30.3), Charlson合并症指数6 (IQR 5 ~ 8),中位狭窄长度2.0 cm (IQR 2.0 ~ 3.0)。狭窄部位依次为球部(12%)、球膜部(75%)和前列腺部(13%)。共有90%的患者接受了扩张,44%的患者接受了直接目视内尿道切开术(DVIU)。对于接受这些手术的患者,每位患者的扩张和dviu的中位数分别为2 (IQR 1至5)和1 (IQR 1至3)。40%的人使用了CIC。34%的人出现了尿路感染,15%的人出现了需要紧急治疗的AUR发作。肌酐值、尿流测量值和尿失禁率保持稳定。80%的患者避免了重建手术或留置导尿管。结论大多数老年R-USD合并症患者在短期内采用保守治疗是有效的。由于尿路感染和AUR的风险,需要密切观察。必须考虑重复性保守干预的潜在长期后果。
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引用次数: 1
Gadolinium Contrast in the Bladder: A Malignant Mimic 膀胱钆造影剂:恶性模拟
Pub Date : 2022-01-14 DOI: 10.48083/ofwx4645
J. Kovacic, J. Kam, E. Latif
No abstract.
没有抽象的。
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引用次数: 0
Our Billion-Dollar Donation to the Publishing Industry 我们向出版业捐赠的十亿美元
Pub Date : 2022-01-14 DOI: 10.48083/roge9523
Peter C. Black
No abstract.
没有抽象的。
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引用次数: 0
Urology Residency Training During the Pandemic: A Review of the Current Literature 大流行期间泌尿外科住院医师培训:当前文献综述
Pub Date : 2022-01-14 DOI: 10.48083/hmpr9995
I. Glykas, P. Stamatakos, C. Fragkoulis, M. Moussa, A. Papatsoris, G. Ntoumas, A. Dellis
Background Since COVID–19 was declared a pandemic on March 11, 2020, health care systems worldwide have been under significant strain. Although urology is not on the frontline of care for patients with COVID-19, every practicing urologist has been affected by the global outbreak. The objective of this review is to evaluate the impact of COVID–19 pandemic on urology residency training programs. Methods We reviewed the current evidence on urology residency training during the COVID-19 pandemic. Relevant databases (MEDLINE, Scopus, Cochrane Library) were searched for articles published to June 2021 that included residents’ or directors’ opinions on their residency training programs during the COVID-19 crisis. Results The literature search identified 72 articles. Fifteen studies including more than 2500 residents were eligible for inclusion in the analysis. During the pandemic, learning activities carried out by urology residents have been extensively affected. Worldwide, operation volume has decreased, especially for procedures in which residents were directly involved. Similarly, there has been a decline in most academic activities, and many studies have reported the negative impact on residents’ mental well-being and lifestyle. On the other hand, the lockdown provided an opportunity to review the current training system and to increase the implementation of tools such as telemedicine and smart-learning surgical skill training programs. Conclusion The COVID-19 pandemic has resulted in significant changes in urology residency programs worldwide, which have had a negative impact on surgical training and academic activities. Residents’ well-being and mental health have also been put at risk. However, this unprecedented situation has also generated new online learning modalities and technological innovations in the field of training in urology.
自2020年3月11日COVID-19被宣布为大流行以来,全球卫生保健系统一直面临巨大压力。尽管泌尿科不是COVID-19患者的一线护理,但每一位执业泌尿科医生都受到了全球疫情的影响。本综述的目的是评估COVID-19大流行对泌尿外科住院医师培训计划的影响。方法回顾COVID-19大流行期间泌尿外科住院医师培训的现有证据。检索相关数据库(MEDLINE、Scopus、Cochrane Library),检索截至2021年6月发表的包含住院医师或院长对2019冠状病毒病危机期间住院医师培训项目意见的文章。结果检索到72篇文献。包括2500多名居民在内的15项研究符合纳入分析的条件。大流行期间,泌尿科住院医师的学习活动受到广泛影响。在世界范围内,手术量已经减少,特别是那些住院医生直接参与的手术。同样,大多数学术活动也有所减少,许多研究报告了对居民心理健康和生活方式的负面影响。另一方面,封锁为审查当前的培训系统提供了机会,并增加了远程医疗和智能学习外科技能培训计划等工具的实施。结论新冠肺炎大流行导致全球泌尿外科住院医师计划发生重大变化,这对外科培训和学术活动产生了负面影响。居民的健康和心理健康也受到威胁。然而,这种前所未有的情况也在泌尿外科培训领域产生了新的在线学习模式和技术创新。
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引用次数: 0
Urological Involvement in the Multidisciplinary Management of Placenta Accreta Spectrum in a Centralised, High-Volume Centre: A Retrospective Analysis 在一个集中的、高容量的中心,泌尿科参与胎盘增生谱的多学科管理:回顾性分析
Pub Date : 2022-01-14 DOI: 10.48083/olra4694
B. Kelly, R. Moorhead, D. Wetherell, Tracey Gilchrist, M. Furrer, M. Perera, B. Norris, David H. Wrede, M. Umstad, J. Kearsley, Faris Al-Shammaa
Objectives Placenta accreta spectrum (PAS) significantly increases the complexity of childbirth and frequently involves urologic organs. Multidisciplinary team (MDT) care is paramount to ensure optimal outcomes. We aimed to evaluate urologic interventions in patients with PAS at a centralised, tertiary referral centre. Methods An analysis of a prospectively collected data set, consisting of all women presenting with PAS at our institution between November 2013 and June 2019. Patients who required urological intervention were identified, and perioperative details were retrieved. Results Forty-two cases of PAS were identified. The mean maternal age was 35 years, and mean gestational age at delivery was 34 weeks. Thirty-seven cases were managed electively, with 5 cases managed conservatively (no hysterectomy) and 5 requiring emergency management. Fifteen patients (36%) had suspected bladder invasion on MRI. A total of 36 patients (86%) had ureteric catheters inserted, 14 (33%) required bladder repair, and 2 had ureteric injuries (5%). Conclusions PAS frequently requires urological intervention to prevent and repair injury to the urinary bladder and ureter. PAS is a rare condition that is best managed in an MDT setting in a centralised, tertiary, high-volume centre with access to a variety of medical and surgical sub-specialities.
目的胎盘增生谱(PAS)显著增加了分娩的复杂性,并经常累及泌尿系统器官。多学科团队(MDT)护理对于确保最佳结果至关重要。我们的目的是在一个集中的三级转诊中心评估PAS患者的泌尿系统干预措施。方法对前瞻性收集的数据集进行分析,该数据集包括2013年11月至2019年6月期间在我院就诊的所有患有PAS的女性。确定需要泌尿外科干预的患者,并检索围手术期细节。结果共确诊PAS 42例。产妇的平均年龄为35岁,分娩时的平均胎龄为34周。37例选择治疗,5例保守治疗(不切除子宫),5例需要急诊治疗。15例患者(36%)MRI表现怀疑膀胱侵犯。输尿管置管36例(86%),膀胱修复14例(33%),输尿管损伤2例(5%)。结论PAS经常需要泌尿外科干预以预防和修复膀胱和输尿管损伤。PAS是一种罕见的疾病,最好在集中的三级高容量中心的MDT环境中进行管理,并可获得各种医学和外科专科。
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引用次数: 1
The Rising Tide of Women in Urology 女性在泌尿外科的兴起
Pub Date : 2021-11-04 DOI: 10.48083/JHEK4332
P. Laguna
No abstract.
没有抽象的。
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引用次数: 1
期刊
Société Internationale d’Urologie Journal
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