A. Martínez-Salas, Iñigo Navarro-Ruesga, Erick A. Rodenas-Gil, Jesús Sebastián Muruato-Araiza, Aldo Jiménez-García, I. Reyna-Blanco, J. Morales-Montor, C. Pacheco-Gahbler
Introduction: The COVID-19 pandemic has delayed screening, diagnostic workup, and treatment in prostate cancer (PCa) patients. Our purpose was to review PCa screening, diagnostic workup, active surveillance (AS), radical prostatectomy (RP), radiotherapy (RT), androgen deprivation therapy (ADT) and systemic therapy during the COVID-19 pandemic. Materials and Methods: We performed a systematic literature search of MEDLINE, EMBASE, Scopus, LILACS, and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) statement for relevant material published from December 2019 to February 2021. Results: Prostate biopsy can be delayed, except when high-risk PCa is suspected or the patient is symptomatic. Active surveillance is appropriate for patients with very low risk, low risk (LR) and favorable intermediate risk (FIR). RP and RT for high risk and very high risk can be safely postponed up to 3 months. Hypofractionated external beam RT (EBRT) is recommended when RT is employed. ADT should be used according to standard PCa-based indications. Chemotherapy should be postponed until the pandemic is contained. Conclusions: The international urological community was not prepared for such an acute and severe pandemic. PCa patients can be adequately managed according to risk stratification. During the COVID-19 pandemic, LR and FIR patients can be followed with active surveillance. Delaying RP and RT in high risk and locally advanced disease is justified.
2019冠状病毒病(COVID-19)大流行延迟了前列腺癌(PCa)患者的筛查、诊断和治疗。我们的目的是回顾在2019冠状病毒病大流行期间的前列腺癌筛查、诊断检查、主动监测(AS)、根治性前列腺切除术(RP)、放疗(RT)、雄激素剥夺治疗(ADT)和全身治疗。材料和方法:我们根据2019年12月至2021年2月发表的相关材料的PRISMA-P声明，对MEDLINE、EMBASE、Scopus、LILACS和Web of Science进行了系统的文献检索。结果:前列腺活检可以延迟，除非怀疑有高危前列腺癌或患者有症状。主动监测适用于极低风险、低风险(LR)和有利的中间风险(FIR)患者。高风险和极高风险的RP和RT可以安全地推迟3个月。当采用放射治疗时，建议采用分形外束放射治疗(EBRT)。ADT应根据标准的基于pca的适应症使用。化疗应推迟到疫情得到控制为止。结论:国际泌尿界对如此急性和严重的大流行没有做好准备。前列腺癌患者可以根据风险分层进行适当的管理。在COVID-19大流行期间，可以对LR和FIR患者进行主动监测。在高风险和局部晚期疾病中延迟RP和RT是合理的。
{"title":"Management Recommendations for Prostate Cancer during the COVID-19 pandemic: A Systematic Review","authors":"A. Martínez-Salas, Iñigo Navarro-Ruesga, Erick A. Rodenas-Gil, Jesús Sebastián Muruato-Araiza, Aldo Jiménez-García, I. Reyna-Blanco, J. Morales-Montor, C. Pacheco-Gahbler","doi":"10.48083/MBSB4196","DOIUrl":"https://doi.org/10.48083/MBSB4196","url":null,"abstract":"Introduction: The COVID-19 pandemic has delayed screening, diagnostic workup, and treatment in prostate cancer (PCa) patients. Our purpose was to review PCa screening, diagnostic workup, active surveillance (AS), radical prostatectomy (RP), radiotherapy (RT), androgen deprivation therapy (ADT) and systemic therapy during the\u0000COVID-19 pandemic.\u0000Materials and Methods: We performed a systematic literature search of MEDLINE, EMBASE, Scopus, LILACS, and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) statement for relevant material published from December 2019 to February 2021.\u0000Results: Prostate biopsy can be delayed, except when high-risk PCa is suspected or the patient is symptomatic. Active surveillance is appropriate for patients with very low risk, low risk (LR) and favorable intermediate risk (FIR). RP and RT for high risk and very high risk can be safely postponed up to 3 months. Hypofractionated external beam\u0000RT (EBRT) is recommended when RT is employed. ADT should be used according to standard PCa-based indications. Chemotherapy should be postponed until the pandemic is contained.\u0000Conclusions: The international urological community was not prepared for such an acute and severe pandemic. PCa patients can be adequately managed according to risk stratification. During the COVID-19 pandemic, LR and FIR patients can be followed with active surveillance. Delaying RP and RT in high risk and locally advanced disease\u0000is justified.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85142923","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}
M. Elbaset, M. Edwan, Rasha T. Abouelkhei, Rawdy Ashour, M. Ramez, Abdalla Abdelhamid, Y. Osman
Objective: To define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. Methods: We undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. Results: The study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). Conclusion: Initial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.
{"title":"Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy","authors":"M. Elbaset, M. Edwan, Rasha T. Abouelkhei, Rawdy Ashour, M. Ramez, Abdalla Abdelhamid, Y. Osman","doi":"10.48083/OZUL6913","DOIUrl":"https://doi.org/10.48083/OZUL6913","url":null,"abstract":"Objective: To define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy.\u0000Methods: We undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone\u0000diameter were assessed using non-contrast computed tomography at the time of admission.\u0000Results: The study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively).\u0000Conclusion: Initial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"456 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73075248","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}
Xanthogranulomatous pyelonephritis (XGP) is a rare but severe form of inflammatory renal disease associated with renal stones and results in granulomatous tissue invading and destroying normal parenchyma. A serious complication of XGP is fistulization to surrounding structures. We present a case of XGP with pyeloduodenal fistula (PDF) in a 48-year-old female with a history of hypertension and recurrent urinary infections but no previous stones.
{"title":"Pyeloduodenal Fistula in Xanthogranulomatous Pyelonephritis","authors":"Ryan Yan, Mark T. Dawidek, Drew Phillips, B. Chew","doi":"10.48083/NSLU7720","DOIUrl":"https://doi.org/10.48083/NSLU7720","url":null,"abstract":"Xanthogranulomatous pyelonephritis (XGP) is a rare but severe form of inflammatory renal disease associated with renal stones and results in granulomatous tissue invading and destroying normal parenchyma. A serious complication of XGP is fistulization to surrounding structures. We present a case of XGP with pyeloduodenal fistula (PDF) in a 48-year-old female with a history of hypertension and recurrent urinary infections but no previous stones.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91350942","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}
B. Ouédraogo, B. Kirakoya, M. Kaboré, Adama Millogo, A. Ouattara, F. A. Kaboré
Objective: To report etiological and therapeutic features of vesicouterine fistulas (VUF) in Burkina Faso. Patients and Methods: We performed a retrospective, descriptive, and multicentric study based on the medical records of women treated for VUF from January 2010 to December 2016. Results: VUF accounted for 7.2% (36/497) of urogenital fistulas managed during the study period. The median age of the 36 patients was 35 years (interquartile range = 27 to 37.5 years) with values ranging from 16 years to 64 years old. Among VUF, obstetric fistula accounted for 26 cases (26/36) versus 10 cases (10/36) of iatrogenic fistula. Obstetric VUF were consecutive to emergency Caesarean section (n = 16) and vaginal delivery (n = 10) after prolonged obstructed labor. The 10 cases of iatrogenic VUF were subsequent to prelabour Caesarean section. The main circumstance of VUF occurrence was Caesarean section (26/36). In 10 cases (10/36), VUF was associated with a vesicovaginal fistula. Thirty days after the removal of the catheter, the success rate fell from 89% to 80.6%. Conclusion: VUF is rare but its frequency is not negligible in our context. The main circumstance of occurrence remains Caesarean section. The best treatment remains prevention.
{"title":"Vesicouterine Fistula in Burkina Faso: Report of 36 Cases in a Multicentric Study","authors":"B. Ouédraogo, B. Kirakoya, M. Kaboré, Adama Millogo, A. Ouattara, F. A. Kaboré","doi":"10.48083/NFMO2987","DOIUrl":"https://doi.org/10.48083/NFMO2987","url":null,"abstract":"Objective: To report etiological and therapeutic features of vesicouterine fistulas (VUF) in Burkina Faso.\u0000Patients and Methods: We performed a retrospective, descriptive, and multicentric study based on the medical records of women treated for VUF from January 2010 to December 2016.\u0000Results: VUF accounted for 7.2% (36/497) of urogenital fistulas managed during the study period. The median age of the 36 patients was 35 years (interquartile range = 27 to 37.5 years) with values ranging from 16 years to 64 years old. Among VUF, obstetric fistula accounted for 26 cases (26/36) versus 10 cases (10/36) of iatrogenic fistula.\u0000Obstetric VUF were consecutive to emergency Caesarean section (n = 16) and vaginal delivery (n = 10) after prolonged obstructed labor. The 10 cases of iatrogenic VUF were subsequent to prelabour Caesarean section. The main circumstance of VUF occurrence was Caesarean section (26/36). In 10 cases (10/36), VUF was associated with a\u0000vesicovaginal fistula. Thirty days after the removal of the catheter, the success rate fell from 89% to 80.6%.\u0000Conclusion: VUF is rare but its frequency is not negligible in our context. The main circumstance of occurrence remains Caesarean section. The best treatment remains prevention.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76667255","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}
The two faces of open access remain a point of contention in the global world of scientific publishing, and this carries over into the microcosm of urologic publishing. Many of us are part of the research community and all of us are consumers of new research findings. On both sides of the research enterprise—as providers and consumers—our interests are best met by broad dissemination and universal access to all published research. These are the underlying objectives of open access publishing.
{"title":"The Two Faces of Open Access","authors":"Peter Black","doi":"10.48083/EROK5654","DOIUrl":"https://doi.org/10.48083/EROK5654","url":null,"abstract":"The two faces of open access remain a point of contention in the global world of scientific publishing, and this carries over into the microcosm of urologic publishing. Many of us are part of the research community and all of us are consumers of new research findings. On both sides of the research enterprise—as providers and consumers—our interests are best met by broad dissemination and universal access to all published research. These are the underlying objectives of open access publishing.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87342387","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}
M. Labban, Nassib F. Abou Heidar, V. Misrai, Jad A. Najdi, A. El-Hajj
Objective: To compare the perioperative morbidity of robotic-assisted simple prostatectomy (RASP), anatomical endoscopic enucleation of the prostate (AEEP) and open simple prostatectomy (OSP) for the treatment of benign prostatic obstruction (BPO). Methods: The national surgical quality improvement program database was queried for AEEP, RASP, and OSPprocedures. Clavien-Dindo-graded complications, length of hospital stay (LOS), and operative time were compared among the procedures. To control for the potentially confounding variables, we first conducted a multivariate backward conditional logistic regression, and then resorted to propensity score matching. Results: We identified 2867 AEEP, 234 RASP, and 1492 OSP procedures. After matching, the risk of pulmonary, renal, infectious, and thromboembolic adverse events was lower after AEEP but not RASP in comparison with OSP (P < 0.05). In comparison with RASP, AEEP had lower cardiac and thromboembolic events (P < 0.05). When compared with OSP, AEEP had reduced odds of Clavien-Dindo grade I (OR = 0.12; 95% CI 0.10 to 0.16) and II (OR = 0.38; 95% CI 0.24 to 9.58) complications. Also, AEEP had lower odds for grade I and II as well as grade IV complications (OR = 0.30; 95% CI 0.19 to 0.48, and OR = 0.05; 95% CI 0.01 to 0.24, respectively) compared with RASP. Conclusion: AEEP and RASP were associated with fewer perioperative adverse events, a shorter LOS and a reduced risk of transfusion compared with OSP. AEEP was associated with overall lower complication rates than RASP and OSP.
目的:比较机器人辅助单纯性前列腺切除术(RASP)、解剖内镜下前列腺摘除(AEEP)和开放式单纯性前列腺切除术(OSP)治疗良性前列腺梗阻(BPO)的围手术期发病率。方法:查询国家外科质量改进程序数据库中AEEP、RASP和ospp程序。比较两种手术方式的clavien - dindo分级并发症、住院时间(LOS)和手术时间。为了控制潜在的混淆变量，我们首先进行了多变量反向条件逻辑回归，然后采用倾向得分匹配。结果:AEEP 2867例，RASP 234例，OSP 1492例。配对后，与OSP相比，AEEP组肺部、肾脏、感染性和血栓栓塞性不良事件的风险较低，RASP组的风险较低(P < 0.05)。与RASP相比，AEEP有较低的心脏和血栓栓塞事件(P < 0.05)。与OSP相比，AEEP降低了Clavien-Dindo I级的几率(OR = 0.12;95% CI 0.10 ~ 0.16)和II (OR = 0.38;95% CI 0.24 ~ 9.58)并发症。此外，AEEP发生I级、II级和IV级并发症的几率较低(OR = 0.30;95% CI 0.19 ~ 0.48, OR = 0.05;95% CI分别为0.01 ~ 0.24)。结论:与OSP相比，AEEP和RASP围手术期不良事件更少，LOS更短，输血风险更低。与RASP和OSP相比，AEEP的总体并发症发生率较低。
{"title":"Perioperative Outcomes of Anatomic Endoscopic Enucleation of the Prostate, Robotic and Open Simple Prostatectomy From a Multi-Institutional Database","authors":"M. Labban, Nassib F. Abou Heidar, V. Misrai, Jad A. Najdi, A. El-Hajj","doi":"10.48083/LKVV8843","DOIUrl":"https://doi.org/10.48083/LKVV8843","url":null,"abstract":"Objective: To compare the perioperative morbidity of robotic-assisted simple prostatectomy (RASP), anatomical endoscopic enucleation of the prostate (AEEP) and open simple prostatectomy (OSP) for the treatment of benign prostatic obstruction (BPO).\u0000Methods: The national surgical quality improvement program database was queried for AEEP, RASP, and OSPprocedures. Clavien-Dindo-graded complications, length of hospital stay (LOS), and operative time were compared among the procedures. To control for the potentially confounding variables, we first conducted a multivariate\u0000backward conditional logistic regression, and then resorted to propensity score matching.\u0000Results: We identified 2867 AEEP, 234 RASP, and 1492 OSP procedures. After matching, the risk of pulmonary, renal, infectious, and thromboembolic adverse events was lower after AEEP but not RASP in comparison with OSP (P < 0.05). In comparison with RASP, AEEP had lower cardiac and thromboembolic events (P < 0.05). When compared\u0000with OSP, AEEP had reduced odds of Clavien-Dindo grade I (OR = 0.12; 95% CI 0.10 to 0.16) and II (OR = 0.38; 95% CI 0.24 to 9.58) complications. Also, AEEP had lower odds for grade I and II as well as grade IV complications (OR = 0.30; 95% CI 0.19 to 0.48, and OR = 0.05; 95% CI 0.01 to 0.24, respectively) compared with RASP.\u0000Conclusion: AEEP and RASP were associated with fewer perioperative adverse events, a shorter LOS and a reduced risk of transfusion compared with OSP. AEEP was associated with overall lower complication rates than RASP and OSP.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87625132","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}
A. Aydh, S. Shariat, R. Motlagh, E. Laukhtina, F. Quhal, K. Mori, H. Mostafaei, A. Necchi, B. Pradère
Introduction: Medical organizations have provided evidence-based guidelines for penile cancer treatment. This current review aims to compare and appraise guidelines on penile cancer treatment to provide a useful summary for clinicians. make an evidence-based approach in the clinical practice. Materials and Methods: We searched in PubMed and Medline for guidelines published between January 1, 2010, and February 1, 2020. The search query terms were “penile cancer,” “penile tumor,” “guidelines,” and “penile malignancy.” In the final analysis, we include the most recent versions of relevant guidelines published in English. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to appraise the quality of each guideline. Results: In the final analysis, we included guidelines from the National Comprehensive Cancer Network (updated in 2020), The European Association of Urology (updated in 2018), and The European Society for Medical Oncology (published in 2013). The overall agreement among reviewers was excellent. The range of scores for each domain was as follows: scope and purpose (46% to 61%); stakeholder involvement (33% to 60%); rigor of development (34% to 69%); clarity and presentation (61% to 81%); applicability (33% to 59%) and editorial independence (52% to 78%). The European Association of Urology and National Comprehensive Cancer Network clinical practice guidelines received better scores according to the AGREE II evaluation. Conclusion: Despite the effort made by the guidelines groups to make a practical guideline regarding penile cancer treatment, the actual available evidence is weak. However, we believe our recommendations offer clear guidance.
{"title":"Evaluation of the Guidelines for Penile Cancer Treatment: Overview and Assessment","authors":"A. Aydh, S. Shariat, R. Motlagh, E. Laukhtina, F. Quhal, K. Mori, H. Mostafaei, A. Necchi, B. Pradère","doi":"10.48083/TKFP8406","DOIUrl":"https://doi.org/10.48083/TKFP8406","url":null,"abstract":"Introduction: Medical organizations have provided evidence-based guidelines for penile cancer treatment. This current review aims to compare and appraise guidelines on penile cancer treatment to provide a useful summary for clinicians. make an evidence-based approach in the clinical practice.\u0000Materials and Methods: We searched in PubMed and Medline for guidelines published between January 1, 2010, and February 1, 2020. The search query terms were “penile cancer,” “penile tumor,” “guidelines,” and “penile malignancy.” In the final analysis, we include the most recent versions of relevant guidelines published in English. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to appraise the quality of each guideline.\u0000Results: In the final analysis, we included guidelines from the National Comprehensive Cancer Network (updated in 2020), The European Association of Urology (updated in 2018), and The European Society for Medical Oncology (published in 2013). The overall agreement among reviewers was excellent. The range of scores for each domain was as follows: scope and purpose (46% to 61%); stakeholder involvement (33% to 60%); rigor of development (34% to 69%); clarity and presentation (61% to 81%); applicability (33% to 59%) and editorial independence (52% to 78%). The European Association of Urology and National Comprehensive Cancer Network clinical practice guidelines received better scores according to the AGREE II evaluation.\u0000Conclusion: Despite the effort made by the guidelines groups to make a practical guideline regarding penile cancer treatment, the actual available evidence is weak. However, we believe our recommendations offer clear guidance.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89544209","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}
Kirtishri Mishra, R. A. Campos, L. Bukavina, R. Gomez
Objective: To evaluate the outcomes of surgical management of men with spina cord injury (SCI) with subsequent catheter damage to the urethra that prevents clean intermittent catheterization (CIC). Methods: We performed a retrospective analysis of male SCI individuals on CIC with catheter-induced urethral injuries who had undergone an operative intervention in the last 30 years at our institution. The offered surgical managements were direct vision internal urethrotomy (DVIU) or urethroplasty (UP). Continent diversion (CDIV) was indicated when reconstruction was not possible. Results: A total of 43 male SCI patients were identified. Median age was 50 years (IQR 41 to 57), and follow-up was 69 months (IQR 34 to 125). Inability to perform CIC was due to urethral stricture (25), false passages (11), fistula (4), diverticulum (2), and urethral erosion (1) . Primary intervention techniques were DVIU, UP, and CDIV. Overall primary success, defined by the ability to return to continent CIC, was 25/43 (58%); secondary surgery (10 CDIV, 3 UP, 1 DVIU) rescued 14/18 failures for a final 91% success rate. Conclusion: Urethral injuries in men with SCI are complex, but individualized continued surgical management can be successful in up to 90% of patients. Therefore, reconstruction should be considered in this population to restore continent intermittent catheterization.
{"title":"Long-Term Outcomes Following Surgical Management of Urethral Catheter Injuries in Men With Spinal Cord Injury","authors":"Kirtishri Mishra, R. A. Campos, L. Bukavina, R. Gomez","doi":"10.48083/AGBN5610","DOIUrl":"https://doi.org/10.48083/AGBN5610","url":null,"abstract":"Objective: To evaluate the outcomes of surgical management of men with spina cord injury (SCI) with subsequent catheter damage to the urethra that prevents clean intermittent catheterization (CIC).\u0000Methods: We performed a retrospective analysis of male SCI individuals on CIC with catheter-induced urethral injuries who had undergone an operative intervention in the last 30 years at our institution. The offered surgical managements were direct vision internal urethrotomy (DVIU) or urethroplasty (UP). Continent diversion (CDIV) was indicated when reconstruction was not possible.\u0000Results: A total of 43 male SCI patients were identified. Median age was 50 years (IQR 41 to 57), and follow-up was 69 months (IQR 34 to 125). Inability to perform CIC was due to urethral stricture (25), false passages (11), fistula (4), diverticulum (2), and urethral erosion (1) . Primary intervention techniques were DVIU, UP, and CDIV. Overall primary success, defined by the ability to return to continent CIC, was 25/43 (58%); secondary surgery (10 CDIV, 3 UP, 1 DVIU) rescued 14/18 failures for a final 91% success rate. \u0000Conclusion: Urethral injuries in men with SCI are complex, but individualized continued surgical management can be successful in up to 90% of patients. Therefore, reconstruction should be considered in this population to restore continent intermittent catheterization.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81781943","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}
German Patiño, M. Ndoye, H. Thomas, Andrew J. Cohen, Nnenaya A. Mmonu, C. Chu, B. Breyer
Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of participants were males, aged 36 to 45, and practiced in a non-academic setting. Ninety-three percent of urologists used CPGs in their everyday clinical practice, and 43% believed CPGs were very important to medical decision-making. However, barriers such as the lack of adaptability or applicability of CPGs to local settings were mentioned by 29% and 24% of participants, respectively. Urologists believed scientific associations (81%), national urology boards (68%), and ministries of health (56%), were important stakeholders to consult to foster the development of local CPGs. Conclusions Globally, CPGs are widely used tools for clinical practice. However, there are concerns about the adaptability and applicability of CPGs to settings that may lack the resources to implement their recommendations. Efforts should be directed towards incorporating scientific and medical stakeholders into the review and adaptation of urology CPGs to suit the unique features of local health care systems.
{"title":"Use of Urology-Based Clinical Practice Guidelines in International Settings","authors":"German Patiño, M. Ndoye, H. Thomas, Andrew J. Cohen, Nnenaya A. Mmonu, C. Chu, B. Breyer","doi":"10.48083/QVXE4949","DOIUrl":"https://doi.org/10.48083/QVXE4949","url":null,"abstract":"Objective\u0000Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process.\u0000Methods\u0000This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software.\u0000Result\u0000A total of 249 practicing urologists from 28 countries completed the survey. The majority of participants were males, aged 36 to 45, and practiced in a non-academic setting. Ninety-three percent of urologists used CPGs in their everyday clinical practice, and 43% believed CPGs were very important to medical decision-making. However, barriers such as the lack of adaptability or applicability of CPGs to local settings were mentioned by 29% and 24% of participants, respectively. Urologists believed scientific associations (81%), national urology boards (68%), and ministries of health (56%), were important stakeholders to consult to foster the development of local CPGs.\u0000Conclusions\u0000Globally, CPGs are widely used tools for clinical practice. However, there are concerns about the adaptability and applicability of CPGs to settings that may lack the resources to implement their recommendations. Efforts should be directed towards incorporating scientific and medical stakeholders into the review and adaptation of urology CPGs to suit the unique features of local health care systems.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82609617","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}
Surgical training in the West Africa sub-regional countries produces specialist surgeons in most surgical disciplines, including urology, to ensure that people of the sub-region—and sometimes beyond—have access to surgical services. The training is conducted at tertiary health facilities accredited by the national and sub-regional postgraduate colleges.
{"title":"West Africa Sub-Regional Training and Skills Transfer: My Experience at the Urology Unit of the Korle-Bu Teaching Hospital, Accra, Ghana","authors":"","doi":"10.48083/uyeq3443","DOIUrl":"https://doi.org/10.48083/uyeq3443","url":null,"abstract":"Surgical training in the West Africa sub-regional countries produces specialist surgeons in most surgical disciplines, including urology, to ensure that people of the sub-region—and sometimes beyond—have access to surgical services. The training is conducted at tertiary health facilities accredited by the national and sub-regional postgraduate colleges.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91538903","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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