Pub Date : 2022-10-01DOI: 10.4103/UROS.UROS_123_21
A. Madani, Fatemeh Chafjiri, S. Esmaeili, Z. Madani, E. Leili
Purpose: There are different approaches to the treatment of urinary incontinence (UI), including pharmacological, nonpharmacological, and surgical methods. Pulsed electromagnetic field (PEMF) stimulation is a nontraditional and noninvasive type of treatment, which is gaining increasing popularity in healthcare departments for UI treatment. Materials and Methods: In this quasi-experimental study, women (age ≥21 years) with lower urinary tract symptoms (LUTS) were assigned to three groups regarding the UI type (urgency, stress, and mixed UI). The Bristol Female LUTS (BFLUTS) questionnaire was used to evaluate the UI severity. The patients were treated with PEMF stimulation twice per week up to 6 weeks. The results were evaluated at three and 6 months posttreatment. Results: Ninety women completed 6 months of follow-up in this study. The mean age of the participants was 58.5 ± 13.9 years. Of 90 patients, 61 (67.8%) had mixed UI, 22 (24.4%) had urge UI, and 7 (7.8%) had stress UI. There were significant differences between the groups regarding the frequency of leakage from baseline to 3 and 6 months after treatment; the reduction of leakage severity was only nonsignificant in the stress UI group (P = 0.368). Based on the results, the number of used pads reduced from 4.18 ± 3.00 to 1.08 ± 2.03 (P < 0.001); this reduction was also significant in each of the groups. The mean BFLUTS score reduced from 7.42 ± 2.53 at baseline to 5.56 ± 2.37 and 3.00 ± 2.33 at 3 and 6 months after treatment, respectively (P < 0.001). No significant complications were detected in the groups. Conclusion: The PEMF stimulation is a safe and effective approach for reducing the symptoms of patients with UI. The best response to treatment was reported at 6 months posttreatment. Therefore, it is recommended to use PMEF stimulation as a noninvasive treatment along with routine therapies.
{"title":"Efficacy and safety of Pulsed Electromagnetic Field (PEMF) stimulation in the treatment of urinary symptoms in women with urinary incontinence","authors":"A. Madani, Fatemeh Chafjiri, S. Esmaeili, Z. Madani, E. Leili","doi":"10.4103/UROS.UROS_123_21","DOIUrl":"https://doi.org/10.4103/UROS.UROS_123_21","url":null,"abstract":"Purpose: There are different approaches to the treatment of urinary incontinence (UI), including pharmacological, nonpharmacological, and surgical methods. Pulsed electromagnetic field (PEMF) stimulation is a nontraditional and noninvasive type of treatment, which is gaining increasing popularity in healthcare departments for UI treatment. Materials and Methods: In this quasi-experimental study, women (age ≥21 years) with lower urinary tract symptoms (LUTS) were assigned to three groups regarding the UI type (urgency, stress, and mixed UI). The Bristol Female LUTS (BFLUTS) questionnaire was used to evaluate the UI severity. The patients were treated with PEMF stimulation twice per week up to 6 weeks. The results were evaluated at three and 6 months posttreatment. Results: Ninety women completed 6 months of follow-up in this study. The mean age of the participants was 58.5 ± 13.9 years. Of 90 patients, 61 (67.8%) had mixed UI, 22 (24.4%) had urge UI, and 7 (7.8%) had stress UI. There were significant differences between the groups regarding the frequency of leakage from baseline to 3 and 6 months after treatment; the reduction of leakage severity was only nonsignificant in the stress UI group (P = 0.368). Based on the results, the number of used pads reduced from 4.18 ± 3.00 to 1.08 ± 2.03 (P < 0.001); this reduction was also significant in each of the groups. The mean BFLUTS score reduced from 7.42 ± 2.53 at baseline to 5.56 ± 2.37 and 3.00 ± 2.33 at 3 and 6 months after treatment, respectively (P < 0.001). No significant complications were detected in the groups. Conclusion: The PEMF stimulation is a safe and effective approach for reducing the symptoms of patients with UI. The best response to treatment was reported at 6 months posttreatment. Therefore, it is recommended to use PMEF stimulation as a noninvasive treatment along with routine therapies.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"170 - 175"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41489652","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}
Pub Date : 2022-10-01DOI: 10.4103/UROS.UROS_119_21
Chang-Ho Chiang, Wei-Jen Chen, I. Huang, E. Huang, Hsiao‐Jen Chung, William J. Huang
Purpose: The Taiwan Central Epidemic Command Center raised the coronavirus disease 2019 (COVID-19) pandemic alert to level 3 throughout the nation since May 19, 2021, and asked hospitals to reduce patient intake. Surgical departments were the worst affected. The aim of this study is to share experiences of urological practice adjustment in a tertiary medical center during the pandemic and to evaluate the impact of the COVID-19 pandemic on the urological service in Taiwan under a level 3 epidemic alert. Materials and Methods: This observational study was conducted from June 1, 2021, to June 31, 2021, when a level 3 pandemic alert was declared. Data of patients visiting the urology department at the Taipei Veterans General Hospital were recorded and compared with data 1 year before the COVID-19 outbreak in Taiwan (June 1, 2020, to June 31, 2020). Data included outpatient visits, elective surgeries, emergent surgeries, functional urological examinations, and diagnostic procedures in outpatient settings. Results: There was no significant decrease in all types of uro-oncological surgeries, except bladder urothelial carcinoma (UCB)-related procedures. The total number of UCB-related procedures showed 66.67% reduction. Stone-related surgeries were reduced by 45.7%. Only 12% of all transurethral prostate resections were performed in the pandemic. There was a significant decrease in all types of functional urology and andrology procedures. More than 30% reduction was noted in the number of patients visiting the urology department in June 2021 compared to that in June 2020. Conclusion: Our data provide a reference of how the urological service was affected during the level 3 pandemic alert in Taiwan. We postponed most elective surgeries and outpatient visits or diagnostic outpatient examinations procedures according to prioritization guidelines. Uro-oncology-related service was less affected because oncology patients have a stronger motivation for treatment. Benign urological condition-related procedures were significantly influenced. After the epidemic slowdown, the backlog should be gradually managed based on priority.
{"title":"Impact of COVID-19 pandemic on urological service: Experience at a Taiwanese tertiary center","authors":"Chang-Ho Chiang, Wei-Jen Chen, I. Huang, E. Huang, Hsiao‐Jen Chung, William J. Huang","doi":"10.4103/UROS.UROS_119_21","DOIUrl":"https://doi.org/10.4103/UROS.UROS_119_21","url":null,"abstract":"Purpose: The Taiwan Central Epidemic Command Center raised the coronavirus disease 2019 (COVID-19) pandemic alert to level 3 throughout the nation since May 19, 2021, and asked hospitals to reduce patient intake. Surgical departments were the worst affected. The aim of this study is to share experiences of urological practice adjustment in a tertiary medical center during the pandemic and to evaluate the impact of the COVID-19 pandemic on the urological service in Taiwan under a level 3 epidemic alert. Materials and Methods: This observational study was conducted from June 1, 2021, to June 31, 2021, when a level 3 pandemic alert was declared. Data of patients visiting the urology department at the Taipei Veterans General Hospital were recorded and compared with data 1 year before the COVID-19 outbreak in Taiwan (June 1, 2020, to June 31, 2020). Data included outpatient visits, elective surgeries, emergent surgeries, functional urological examinations, and diagnostic procedures in outpatient settings. Results: There was no significant decrease in all types of uro-oncological surgeries, except bladder urothelial carcinoma (UCB)-related procedures. The total number of UCB-related procedures showed 66.67% reduction. Stone-related surgeries were reduced by 45.7%. Only 12% of all transurethral prostate resections were performed in the pandemic. There was a significant decrease in all types of functional urology and andrology procedures. More than 30% reduction was noted in the number of patients visiting the urology department in June 2021 compared to that in June 2020. Conclusion: Our data provide a reference of how the urological service was affected during the level 3 pandemic alert in Taiwan. We postponed most elective surgeries and outpatient visits or diagnostic outpatient examinations procedures according to prioritization guidelines. Uro-oncology-related service was less affected because oncology patients have a stronger motivation for treatment. Benign urological condition-related procedures were significantly influenced. After the epidemic slowdown, the backlog should be gradually managed based on priority.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"182 - 186"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42915977","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}
S. Swain, S. Rulaniya, V. Neniwal, Pamelle Yadav, P. Agarwal, Shweta Bhalothia, K. Tonge, Zaid Khan
Purpose: The purpose of this study is to describe a simple extravesical laparoscopic approach for supratrigonal vesicovaginal fistula (VVF) repair without cystotomy and closer of the vaginal vault. Materials and Methods: This retrospective observational study reviewed data of 36 patients from January 2015 to January 2020. In our technique, the fistula tract was identified without cystotomy with the help of preplaced ureteric catheter in VVF tract. After meticulous extravesical dissection of the fistula tract, the bladder wall was closed in a single layer using polyglactin 2.0 sutures. The omental flap was approximated over the vaginal vault without primary closer of the vault. Results: In most of the patients the fistula opening were located 2 cm away from ureteric orifice while in 4 patients it located within 2 cm of orifice. The mean operative time was 86 min (65–125) and estimated blood loss was 94 ml (40–130). The mean size of fistula was 7.1 mm (5–15 mm). Omental flap was approximate over vaginal opening in most of the patients. The average hospital stay of patients was 5 days. In all patients, Foley catheter was removed on day 14 after cystogram. The mean follow-up of patients was 4.2 months (3–7). All patients remained continent and symptom free during the follow-up periods. Conclusion: Our technique without suturing of the vaginal vault in laparoscopic VVF repair is safe in a simple supratrigonal fistula with good results and avoiding added suturing.
{"title":"Post hysterectomy vesicovaginal fistula repair without vaginal vault closure - A simple laparoscopic extravesical repair approach","authors":"S. Swain, S. Rulaniya, V. Neniwal, Pamelle Yadav, P. Agarwal, Shweta Bhalothia, K. Tonge, Zaid Khan","doi":"10.4103/uros.uros_17_22","DOIUrl":"https://doi.org/10.4103/uros.uros_17_22","url":null,"abstract":"Purpose: The purpose of this study is to describe a simple extravesical laparoscopic approach for supratrigonal vesicovaginal fistula (VVF) repair without cystotomy and closer of the vaginal vault. Materials and Methods: This retrospective observational study reviewed data of 36 patients from January 2015 to January 2020. In our technique, the fistula tract was identified without cystotomy with the help of preplaced ureteric catheter in VVF tract. After meticulous extravesical dissection of the fistula tract, the bladder wall was closed in a single layer using polyglactin 2.0 sutures. The omental flap was approximated over the vaginal vault without primary closer of the vault. Results: In most of the patients the fistula opening were located 2 cm away from ureteric orifice while in 4 patients it located within 2 cm of orifice. The mean operative time was 86 min (65–125) and estimated blood loss was 94 ml (40–130). The mean size of fistula was 7.1 mm (5–15 mm). Omental flap was approximate over vaginal opening in most of the patients. The average hospital stay of patients was 5 days. In all patients, Foley catheter was removed on day 14 after cystogram. The mean follow-up of patients was 4.2 months (3–7). All patients remained continent and symptom free during the follow-up periods. Conclusion: Our technique without suturing of the vaginal vault in laparoscopic VVF repair is safe in a simple supratrigonal fistula with good results and avoiding added suturing.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"187 - 191"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44770899","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}
Pub Date : 2022-10-01DOI: 10.4103/uros.uros_158_21
R. Girgin, Emine Can, Gökhan Çeker, E. Kaymaz, Ö. Çınar, N. Mungan
Purpose: Urethral stricture may cause irreversible results, as it prevents normal voiding. Although various endoscopic and open surgical options are available, the results are not always satisfactory so the main purpose is to prevent the formation of urethral scar. Our purpose was to examine the effects of intraurethrally administered Anatolian propolis on healing after an experimental urethral injury. Materials and Methods: A total of 40 Wistar male rats were used. Rats were divided into five equal groups: healthy control (Group 1), urethral damage/pathology (Group 2), solvent control (Group 3), 1-week propolis treatment (Group 4) and 3-week propolis treatment (Group 5). Urethral damage was performed with a 29G needle. Intraurethral, 50% ethanol, was administered in the solvent control group and 30% propolis was administered intraurethrally to the rats in Groups 3 and 4. Penile tissues were taken under deep anesthesia and examined under a light microscope. Results: Irregularities and luminal narrowing in the urethral epithelium and connective tissue were found in Group 2, except for one rat. Similarly, hyperemia-bleeding was observed in all rats except for one rat. Irregularities and hyperemia in the urethral epithelium and connective tissue were found in Group 3, except for two rats. Total improvement was observed in one rat, and more than 50% of fibrosis was observed in four rats in Groups 2 and 3. In Group 4, irregularity was observed in the urethral epithelium in four rats, while no inflammation was found in five rats. All of the rats had <50% fibrosis. In Group 5, six rats had complete recovery and <30% fibrosis. Conclusion: Anatolian propolis applied into the urethra seems to accelerate recovery after urethral trauma and reduces the formation of fibrosis.
{"title":"The effect of intraurethrally applied anatolian propolis extract on urethral healing in a rat model","authors":"R. Girgin, Emine Can, Gökhan Çeker, E. Kaymaz, Ö. Çınar, N. Mungan","doi":"10.4103/uros.uros_158_21","DOIUrl":"https://doi.org/10.4103/uros.uros_158_21","url":null,"abstract":"Purpose: Urethral stricture may cause irreversible results, as it prevents normal voiding. Although various endoscopic and open surgical options are available, the results are not always satisfactory so the main purpose is to prevent the formation of urethral scar. Our purpose was to examine the effects of intraurethrally administered Anatolian propolis on healing after an experimental urethral injury. Materials and Methods: A total of 40 Wistar male rats were used. Rats were divided into five equal groups: healthy control (Group 1), urethral damage/pathology (Group 2), solvent control (Group 3), 1-week propolis treatment (Group 4) and 3-week propolis treatment (Group 5). Urethral damage was performed with a 29G needle. Intraurethral, 50% ethanol, was administered in the solvent control group and 30% propolis was administered intraurethrally to the rats in Groups 3 and 4. Penile tissues were taken under deep anesthesia and examined under a light microscope. Results: Irregularities and luminal narrowing in the urethral epithelium and connective tissue were found in Group 2, except for one rat. Similarly, hyperemia-bleeding was observed in all rats except for one rat. Irregularities and hyperemia in the urethral epithelium and connective tissue were found in Group 3, except for two rats. Total improvement was observed in one rat, and more than 50% of fibrosis was observed in four rats in Groups 2 and 3. In Group 4, irregularity was observed in the urethral epithelium in four rats, while no inflammation was found in five rats. All of the rats had <50% fibrosis. In Group 5, six rats had complete recovery and <30% fibrosis. Conclusion: Anatolian propolis applied into the urethra seems to accelerate recovery after urethral trauma and reduces the formation of fibrosis.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"205 - 212"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46789620","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}
Pub Date : 2022-10-01DOI: 10.4103/UROS.UROS_128_21
YingRui Huang, Wei-Chia Lee, Y. Chuang, Cheng-Nan Tsai, Chun-Chieh Yu, H. Wang, C. Su
Purpose: Ketamine abusers may develop severe ulcerative cystitis along with irritative bladder symptoms. A reliable animal model may benefit the understanding of pathophysiologies and the development of therapeutic strategies for ketamine-induced cystitis (KIC). We used a popular rat model of KIC to validate the micturition behavior, functional brain images, and possible molecular mechanisms of this model. Materials and Methods: Female Sprague–Dawley rats were distributed to control (saline) and ketamine-treated rats (25 mg/kg/day for 28 days). Functional magnetic resonance imaging (fMRI), metabolic cage study, and cystometry were evaluated. Potential bladder transcripts involved in KIC were screened by using next-generation sequencing. Results: In contrast to the control, the ketamine-treated rats developed bladder overactivity accompanied by enhanced fMRI signals in periaqueduct and caudal putamen areas. Alterations in bladder transcripts, including eleven genes involving in regulating NF-κB signaling of bladder inflammation, and Crhr2 gene overexpression associating with vascular endothelial growth factor signaling of bladder ischemia were found in ketamine-treated rats. Both categories could be attributed to neurogenic inflammation induced by the direct toxicity of urinary ketamine and its metabolites. Conclusion: Our study results suggest this animal model could mimic irritative bladder symptoms associated with central sensitization in KIC. Through the bladder transcripts analysis, we highlight the neurogenic inflammation underlying the pathophysiologies of KIC in rats.
{"title":"Using a rat model to translate and explore the pathogenesis of ketamine-induced cystitis","authors":"YingRui Huang, Wei-Chia Lee, Y. Chuang, Cheng-Nan Tsai, Chun-Chieh Yu, H. Wang, C. Su","doi":"10.4103/UROS.UROS_128_21","DOIUrl":"https://doi.org/10.4103/UROS.UROS_128_21","url":null,"abstract":"Purpose: Ketamine abusers may develop severe ulcerative cystitis along with irritative bladder symptoms. A reliable animal model may benefit the understanding of pathophysiologies and the development of therapeutic strategies for ketamine-induced cystitis (KIC). We used a popular rat model of KIC to validate the micturition behavior, functional brain images, and possible molecular mechanisms of this model. Materials and Methods: Female Sprague–Dawley rats were distributed to control (saline) and ketamine-treated rats (25 mg/kg/day for 28 days). Functional magnetic resonance imaging (fMRI), metabolic cage study, and cystometry were evaluated. Potential bladder transcripts involved in KIC were screened by using next-generation sequencing. Results: In contrast to the control, the ketamine-treated rats developed bladder overactivity accompanied by enhanced fMRI signals in periaqueduct and caudal putamen areas. Alterations in bladder transcripts, including eleven genes involving in regulating NF-κB signaling of bladder inflammation, and Crhr2 gene overexpression associating with vascular endothelial growth factor signaling of bladder ischemia were found in ketamine-treated rats. Both categories could be attributed to neurogenic inflammation induced by the direct toxicity of urinary ketamine and its metabolites. Conclusion: Our study results suggest this animal model could mimic irritative bladder symptoms associated with central sensitization in KIC. Through the bladder transcripts analysis, we highlight the neurogenic inflammation underlying the pathophysiologies of KIC in rats.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"176 - 181"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42892544","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}
Pub Date : 2022-10-01DOI: 10.4103/uros.uros_173_20
C. Lu, Y. Ou, Y. Lin, Li-Hua Huang, W. Weng, Chao-Yu Hsu, M. Tung
Purpose: Sharing experiences of complications with robotic-assisted laparoscopic radical prostatectomy (RALP) in 2000 patients treated by a single surgeon. Materials and Methods: We retrospectively reviewed 2,000 prostate cancer patients who underwent RALP (Group I, cases 1–1,000; Group II, cases 1001–2000) from December 2005 to September 2020 to compare the complications of the first 1000 patients with those of the latter 1000. All procedures were performed by the same experienced surgeon. Perioperative surgical complications were classified using the Clavien–Dindo classification. Complications were classified as minor (Clavien–Dindo Grades I–II) and major (Clavien–Dindo Grades III–IV), respectively. There was no Grade V complication. Results: Seventy-two cases developed complications in Group I: 26 with Clavien–Dindo Grade I, 29 with Grade II, 12 with Grade III, and 4 with Grade IV. The cases that developed complications in Group II, however, were lower at 48 cases: 15 with Clavien–Dindo Grade I, 17 with Grade II, 15 with Grade III, and 1 with Grade IV. Cases with minor Clavien–Dindo Grade (I–II) complications decreased significantly from Group I to Group II, at 55–32 patients (P = 0.0416). The transfusion rate was 1.1% in Group I, which was significantly higher than that in Group II at 0.1% (P = 0.0151). Conclusion: The assessment of the two groups indicated that the surgeon's learning curve for RALP improved with significantly fewer minor Clavien–Dindo Grade (I–II) group complications after 1000 surgeries.
{"title":"Complications of robotic-assisted laparoscopic radical prostatectomy: Experience Sharing from 2000 cases involving a single surgeon","authors":"C. Lu, Y. Ou, Y. Lin, Li-Hua Huang, W. Weng, Chao-Yu Hsu, M. Tung","doi":"10.4103/uros.uros_173_20","DOIUrl":"https://doi.org/10.4103/uros.uros_173_20","url":null,"abstract":"Purpose: Sharing experiences of complications with robotic-assisted laparoscopic radical prostatectomy (RALP) in 2000 patients treated by a single surgeon. Materials and Methods: We retrospectively reviewed 2,000 prostate cancer patients who underwent RALP (Group I, cases 1–1,000; Group II, cases 1001–2000) from December 2005 to September 2020 to compare the complications of the first 1000 patients with those of the latter 1000. All procedures were performed by the same experienced surgeon. Perioperative surgical complications were classified using the Clavien–Dindo classification. Complications were classified as minor (Clavien–Dindo Grades I–II) and major (Clavien–Dindo Grades III–IV), respectively. There was no Grade V complication. Results: Seventy-two cases developed complications in Group I: 26 with Clavien–Dindo Grade I, 29 with Grade II, 12 with Grade III, and 4 with Grade IV. The cases that developed complications in Group II, however, were lower at 48 cases: 15 with Clavien–Dindo Grade I, 17 with Grade II, 15 with Grade III, and 1 with Grade IV. Cases with minor Clavien–Dindo Grade (I–II) complications decreased significantly from Group I to Group II, at 55–32 patients (P = 0.0416). The transfusion rate was 1.1% in Group I, which was significantly higher than that in Group II at 0.1% (P = 0.0151). Conclusion: The assessment of the two groups indicated that the surgeon's learning curve for RALP improved with significantly fewer minor Clavien–Dindo Grade (I–II) group complications after 1000 surgeries.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"192 - 198"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46155046","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}
Pub Date : 2022-07-01DOI: 10.4103/uros.uros_135_21
Yu-Cheng Lu, Y. Tsai, Po-Ming Chow, Wen-Ching Weng, W. Huang, S. Chueh, Kao-Lang Liu, Kuo-How Huang
Purpose: The purpose was to investigate the risk of subsequent malignancies in patients with renal cell carcinoma (RCC) using hospital-based cancer registry database and a nationwide health insurance database. Materials and Methods: We used the following three databases: Cancer Registry Database of National Taiwan University Hospital (NTUH), National Health Insurance Research Database (NHIRD), and registry for catastrophic illness patients, a subset from NHIRD. We identified patients with RCC and analyzed the risk of subsequent malignancies in these patients. Results: Of the 1188 patients with RCC treated at NTUH, 141 (11.9%) had subsequent malignancies. Cancers in the colon, liver, prostate, lung and stomach were the five most common other primary malignancies. The nationwide analysis showed that 4.68% of the RCC patients had subsequent malignancies. The percentage was significantly higher than that in the general population in Taiwan. The five most common subsequent malignancies in patients with RCC were bladder, liver, colon, lung, and prostate cancer. The risk of developing these subsequent cancers in RCC patients was also significantly higher than that in the general population. Conclusion: Subsequent malignancies were noted in a high proportion of patients with RCC in Taiwan. It is a multifactorial process and the mechanism is still uncertain. This important issue warrants further studies to elucidate the mechanism.
{"title":"The risk of subsequent malignancies in patients with renal cell carcinoma: A nationwide, population-based study","authors":"Yu-Cheng Lu, Y. Tsai, Po-Ming Chow, Wen-Ching Weng, W. Huang, S. Chueh, Kao-Lang Liu, Kuo-How Huang","doi":"10.4103/uros.uros_135_21","DOIUrl":"https://doi.org/10.4103/uros.uros_135_21","url":null,"abstract":"Purpose: The purpose was to investigate the risk of subsequent malignancies in patients with renal cell carcinoma (RCC) using hospital-based cancer registry database and a nationwide health insurance database. Materials and Methods: We used the following three databases: Cancer Registry Database of National Taiwan University Hospital (NTUH), National Health Insurance Research Database (NHIRD), and registry for catastrophic illness patients, a subset from NHIRD. We identified patients with RCC and analyzed the risk of subsequent malignancies in these patients. Results: Of the 1188 patients with RCC treated at NTUH, 141 (11.9%) had subsequent malignancies. Cancers in the colon, liver, prostate, lung and stomach were the five most common other primary malignancies. The nationwide analysis showed that 4.68% of the RCC patients had subsequent malignancies. The percentage was significantly higher than that in the general population in Taiwan. The five most common subsequent malignancies in patients with RCC were bladder, liver, colon, lung, and prostate cancer. The risk of developing these subsequent cancers in RCC patients was also significantly higher than that in the general population. Conclusion: Subsequent malignancies were noted in a high proportion of patients with RCC in Taiwan. It is a multifactorial process and the mechanism is still uncertain. This important issue warrants further studies to elucidate the mechanism.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"124 - 129"},"PeriodicalIF":0.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43851113","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}
Pub Date : 2022-07-01DOI: 10.4103/uros.uros_164_21
R. Danarto, AH Wisda Kusuma, AdryanKalya Ndraha Khairindra
Purpose: World Health Organization has declared coronavirus disease 2019 (COVID-19), a global pandemic in March 2020. Nations around the world enact prevention measures such as lockdowns, quarantines, massive testing, and tracing policies. Prevention measures against the pandemic may result in less opportunities for urology residents to learn. This study aims to investigate the difference in urology residency in Indonesia before and during the COVID-19 pandemic. Materials and Methods: This research is a cross-sectional study. Authors analyzed 147 urology residents across five urology education centers in Indonesia who fulfilled a self-administered online questionnaire. Participants were asked about their objective and subjective experience regarding urology residency, before and during the COVID-19 pandemic. Results: Change in urology education paradigm in Indonesia during the COVID-19 pandemic is agreed upon by 95.91% participants, 57.82% thinks it brings negative causes negative consequences. Anxiety toward competence level is felt by 70.06% of participants. Reduced opportunities to learn, especially surgical skills may lead to this result. Overall mental health condition of participants does not significantly change. Multiple factors may contribute to this result. Conclusion: As changes and adaptations are inevitable, more attention should be brought to residents' competence level while maintaining COVID-19 prevention protocol. This is the first nationwide survey showing the effects of the COVID-19 pandemic on urology education system in Indonesia. Authors suggest a larg-scale study, with more detailed questionnaire to further elaborate the causes and effects of each variable observed.
{"title":"Shifting paradigm of urology residency after the COVID-19 pandemic in Indonesia","authors":"R. Danarto, AH Wisda Kusuma, AdryanKalya Ndraha Khairindra","doi":"10.4103/uros.uros_164_21","DOIUrl":"https://doi.org/10.4103/uros.uros_164_21","url":null,"abstract":"Purpose: World Health Organization has declared coronavirus disease 2019 (COVID-19), a global pandemic in March 2020. Nations around the world enact prevention measures such as lockdowns, quarantines, massive testing, and tracing policies. Prevention measures against the pandemic may result in less opportunities for urology residents to learn. This study aims to investigate the difference in urology residency in Indonesia before and during the COVID-19 pandemic. Materials and Methods: This research is a cross-sectional study. Authors analyzed 147 urology residents across five urology education centers in Indonesia who fulfilled a self-administered online questionnaire. Participants were asked about their objective and subjective experience regarding urology residency, before and during the COVID-19 pandemic. Results: Change in urology education paradigm in Indonesia during the COVID-19 pandemic is agreed upon by 95.91% participants, 57.82% thinks it brings negative causes negative consequences. Anxiety toward competence level is felt by 70.06% of participants. Reduced opportunities to learn, especially surgical skills may lead to this result. Overall mental health condition of participants does not significantly change. Multiple factors may contribute to this result. Conclusion: As changes and adaptations are inevitable, more attention should be brought to residents' competence level while maintaining COVID-19 prevention protocol. This is the first nationwide survey showing the effects of the COVID-19 pandemic on urology education system in Indonesia. Authors suggest a larg-scale study, with more detailed questionnaire to further elaborate the causes and effects of each variable observed.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"119 - 123"},"PeriodicalIF":0.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42812705","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}
Pub Date : 2022-07-01Epub Date: 2022-08-25DOI: 10.4103/uros.uros_31_22
Naoki Wada, Sergei Karnup, Katsumi Kadekawa, Nobutaka Shimizu, Joonbeom Kwon, Takahiro Shimizu, Daisuke Gotoh, Hidehiro Kakizaki, William C de Groat, Naoki Yoshimura
This review article aims to summarize the recent advancement in basic research on lower urinary tract dysfunction (LUTD) following spinal cord injury (SCI) above the sacral level. We particularly focused on the neurophysiologic mechanisms controlling the lower urinary tract (LUT) function and the SCI-induced changes in micturition control in animal models of SCI. The LUT has two main functions, the storage and voiding of urine, that are regulated by a complex neural control system. This neural system coordinates the activity of two functional units in the LUT: the urinary bladder and an outlet including bladder neck, urethra, and striated muscles of the pelvic floor. During the storage phase, the outlet is closed and the bladder is quiescent to maintain a low intravesical pressure and continence, and during the voiding phase, the outlet relaxes and the bladder contracts to promote efficient release of urine. SCI impairs voluntary control of voiding as well as the normal reflex pathways that coordinate bladder and sphincter function. Following SCI, the bladder is initially areflexic but then becomes hyperreflexic due to the emergence of a spinal micturition reflex pathway. However, the bladder does not empty efficiently because coordination between the bladder and urethral sphincter is lost. In animal models of SCI, hyperexcitability of silent C-fiber bladder afferents is a major pathophysiological basis of neurogenic LUTD, especially detrusor overactivity. Reflex plasticity is associated with changes in the properties of neuropeptides, neurotrophic factors, or chemical receptors of afferent neurons. Not only C-fiber but also Aδ-fiber could be involved in the emergence of neurogenic LUTD such as detrusor sphincter dyssynergia following SCI. Animal research using disease models helps us to detect the different contributing factors for LUTD due to SCI and to find potential targets for new treatments.
{"title":"Current Knowledge and Novel Frontiers in Lower Urinary Tract Dysfunction after Spinal Cord Injury: Basic Research Perspectives.","authors":"Naoki Wada, Sergei Karnup, Katsumi Kadekawa, Nobutaka Shimizu, Joonbeom Kwon, Takahiro Shimizu, Daisuke Gotoh, Hidehiro Kakizaki, William C de Groat, Naoki Yoshimura","doi":"10.4103/uros.uros_31_22","DOIUrl":"https://doi.org/10.4103/uros.uros_31_22","url":null,"abstract":"<p><p>This review article aims to summarize the recent advancement in basic research on lower urinary tract dysfunction (LUTD) following spinal cord injury (SCI) above the sacral level. We particularly focused on the neurophysiologic mechanisms controlling the lower urinary tract (LUT) function and the SCI-induced changes in micturition control in animal models of SCI. The LUT has two main functions, the storage and voiding of urine, that are regulated by a complex neural control system. This neural system coordinates the activity of two functional units in the LUT: the urinary bladder and an outlet including bladder neck, urethra, and striated muscles of the pelvic floor. During the storage phase, the outlet is closed and the bladder is quiescent to maintain a low intravesical pressure and continence, and during the voiding phase, the outlet relaxes and the bladder contracts to promote efficient release of urine. SCI impairs voluntary control of voiding as well as the normal reflex pathways that coordinate bladder and sphincter function. Following SCI, the bladder is initially areflexic but then becomes hyperreflexic due to the emergence of a spinal micturition reflex pathway. However, the bladder does not empty efficiently because coordination between the bladder and urethral sphincter is lost. In animal models of SCI, hyperexcitability of silent C-fiber bladder afferents is a major pathophysiological basis of neurogenic LUTD, especially detrusor overactivity. Reflex plasticity is associated with changes in the properties of neuropeptides, neurotrophic factors, or chemical receptors of afferent neurons. Not only C-fiber but also Aδ-fiber could be involved in the emergence of neurogenic LUTD such as detrusor sphincter dyssynergia following SCI. Animal research using disease models helps us to detect the different contributing factors for LUTD due to SCI and to find potential targets for new treatments.</p>","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 3","pages":"101-113"},"PeriodicalIF":0.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9518811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385039","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}
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