Pub Date : 2022-04-01DOI: 10.4103/uros.uros_113_21
Gh R Mokhtari, A. Madani, E. Leyli, A. Jafari
Purpose: Sildenafil is a phosphodiesterase Type 5 inhibitor, which is a powerful and effective therapy for male erectile dysfunction (ED) and enables to restore temporary ED. The aim of this study was to evaluate the effects of sildenafil on seminal parameters in male participants with idiopathic infertility. Materials and Methods: This randomized, double-blind, controlled cross-over clinical trial study was conducted on 79 participants who had been referred to urology clinics in Rasht. Participants were assigned to two Groups A (n = 40), and B (n = 39). In Phase I, participants in Group A received a pill of sildenafil (50 mg) and then received a pill of placebo after the washout period, and participants in Group B received a pill of placebo and then received a pill of sildenafil after the washout period. In Phase II, participants in Group A received a pill of placebo and then received a pill of sildenafil after the washout period; and participants in group B received sildenafil and then received a placebo after the washout period. Results: The mean age of patients was 34 ± 5 years. There was no significant difference in the mean sperm count before receiving the drug in all groups. Sperm count, motility, morphology, pH, viscosity, and liquefaction time of semen did not significantly change after receiving sildenafil in comparison to their corresponding placebo group (P > 0.05). Conclusion: Sildenafil did not change sperm parameters in treating infertile patients; sildenafil also had no positive effect on semen parameters.
{"title":"Sildenafil citrate effects on seminal parameters in male participants with idiopathic infertility; A randomized, double-blind, controlled cross-over clinical trial study","authors":"Gh R Mokhtari, A. Madani, E. Leyli, A. Jafari","doi":"10.4103/uros.uros_113_21","DOIUrl":"https://doi.org/10.4103/uros.uros_113_21","url":null,"abstract":"Purpose: Sildenafil is a phosphodiesterase Type 5 inhibitor, which is a powerful and effective therapy for male erectile dysfunction (ED) and enables to restore temporary ED. The aim of this study was to evaluate the effects of sildenafil on seminal parameters in male participants with idiopathic infertility. Materials and Methods: This randomized, double-blind, controlled cross-over clinical trial study was conducted on 79 participants who had been referred to urology clinics in Rasht. Participants were assigned to two Groups A (n = 40), and B (n = 39). In Phase I, participants in Group A received a pill of sildenafil (50 mg) and then received a pill of placebo after the washout period, and participants in Group B received a pill of placebo and then received a pill of sildenafil after the washout period. In Phase II, participants in Group A received a pill of placebo and then received a pill of sildenafil after the washout period; and participants in group B received sildenafil and then received a placebo after the washout period. Results: The mean age of patients was 34 ± 5 years. There was no significant difference in the mean sperm count before receiving the drug in all groups. Sperm count, motility, morphology, pH, viscosity, and liquefaction time of semen did not significantly change after receiving sildenafil in comparison to their corresponding placebo group (P > 0.05). Conclusion: Sildenafil did not change sperm parameters in treating infertile patients; sildenafil also had no positive effect on semen parameters.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"93 - 98"},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44246777","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 : 2022-04-01DOI: 10.4103/uros.uros_127_21
S. Abbosov, N. Sorokin, A. Shomarufov, A. Kadrev, Khusniddin Ugli Nuriddinov, S. Mukhtarov, F. Akilov, A. Kamalov
Bladder neck contracture (BNC) is one of the most common complications of surgical treatment of prostate diseases. The rate of postoperative BNC varies depending on the type of surgical treatment used. The options for treatment techniques for BNC can vary from endoscopic interventions to complex (abdominal) surgical interventions. This review evaluates various alternative surgical methods of BNC treatment. The search and analysis of publications in the databases PubMed (MEDLINE), Scopus, Cochrane Library, according to the keywords, “bladder neck sclerosis,” “benign prostatic hyperplasia,” “BNC,” “bladder neck stenosis,” “balloon dilation,” “treatment.” As a result, 71 publications were selected and included in this review. In addition to the standard treatment methods in the form of transurethral resection and incision of the bladder neck using electricity and laser energy, the urologist also has alternative methods of treatment, such as balloon dilation, placement of urethral stents, instillation of the bladder or intraoperative injection of cytostatic drugs, hormones, hyaluronic acid derivatives, and biomedical cell products into the bladder neck area. Although transurethral resection is currently the main treatment option for BNC, the recurrence rate after this procedure can reach up to 38%. According to the literature, balloon dilation can be a promising and minimally invasive method of treatment for recurrent BNC. This method can be used as the first stage in the treatment of recurrent contracture deformity. Furthermore, intravesical instillation of various anti-inflammatory drugs and cytostatics can be promising directions in the treatment and prevention of BNC.
{"title":"Bladder neck contracture as a complication of prostate surgery: Alternative treatment methods and prospects (literature review)","authors":"S. Abbosov, N. Sorokin, A. Shomarufov, A. Kadrev, Khusniddin Ugli Nuriddinov, S. Mukhtarov, F. Akilov, A. Kamalov","doi":"10.4103/uros.uros_127_21","DOIUrl":"https://doi.org/10.4103/uros.uros_127_21","url":null,"abstract":"Bladder neck contracture (BNC) is one of the most common complications of surgical treatment of prostate diseases. The rate of postoperative BNC varies depending on the type of surgical treatment used. The options for treatment techniques for BNC can vary from endoscopic interventions to complex (abdominal) surgical interventions. This review evaluates various alternative surgical methods of BNC treatment. The search and analysis of publications in the databases PubMed (MEDLINE), Scopus, Cochrane Library, according to the keywords, “bladder neck sclerosis,” “benign prostatic hyperplasia,” “BNC,” “bladder neck stenosis,” “balloon dilation,” “treatment.” As a result, 71 publications were selected and included in this review. In addition to the standard treatment methods in the form of transurethral resection and incision of the bladder neck using electricity and laser energy, the urologist also has alternative methods of treatment, such as balloon dilation, placement of urethral stents, instillation of the bladder or intraoperative injection of cytostatic drugs, hormones, hyaluronic acid derivatives, and biomedical cell products into the bladder neck area. Although transurethral resection is currently the main treatment option for BNC, the recurrence rate after this procedure can reach up to 38%. According to the literature, balloon dilation can be a promising and minimally invasive method of treatment for recurrent BNC. This method can be used as the first stage in the treatment of recurrent contracture deformity. Furthermore, intravesical instillation of various anti-inflammatory drugs and cytostatics can be promising directions in the treatment and prevention of BNC.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"49 - 55"},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43358315","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}
Yi-Hsuan Wu, H. Ke, H. Tu, Ching-Chia Li, Wen-Jeng Wu, Wei‐Ming Li
Purpose: Socioeconomic inequality may contribute to different risk factors for cancers. This study aims to analyze the socioeconomic patterns of urological cancer incidence and mortality in Taiwan. Materials and Methods: Using data from the National Health Insurance, we designed a retrospective longitudinal cohort study of 3686 subjects who were newly diagnosed with bladder cancer (BC), kidney cancer (KC), and upper urinary tract cancer (UTUC) between 2000 and 2010. We analyzed patients' characteristics and mortality among the three cancers. Results: The average age of KC diagnosis was the youngest among the cancers. Moreover, KC tends to occur in patients with higher-income occupations who reside in urban areas. Both BC and UTUC were much more prevalent in patients with less socioeconomic means and those living in rural areas. Varied comorbidities showed different distributions among urological cancers. Although the extent was most prominent in KC, both overall mortality and cancer-specific mortality of the three cancers increased every year during the follow-up period. Conclusion: Our results demonstrate different patient characteristics and mortality among BC, KC, and UTUC in Taiwan.
{"title":"The impact of socioeconomic inequality on urological cancer: A nationwide population-based study in Taiwan","authors":"Yi-Hsuan Wu, H. Ke, H. Tu, Ching-Chia Li, Wen-Jeng Wu, Wei‐Ming Li","doi":"10.4103/uros.uros_60_21","DOIUrl":"https://doi.org/10.4103/uros.uros_60_21","url":null,"abstract":"Purpose: Socioeconomic inequality may contribute to different risk factors for cancers. This study aims to analyze the socioeconomic patterns of urological cancer incidence and mortality in Taiwan. Materials and Methods: Using data from the National Health Insurance, we designed a retrospective longitudinal cohort study of 3686 subjects who were newly diagnosed with bladder cancer (BC), kidney cancer (KC), and upper urinary tract cancer (UTUC) between 2000 and 2010. We analyzed patients' characteristics and mortality among the three cancers. Results: The average age of KC diagnosis was the youngest among the cancers. Moreover, KC tends to occur in patients with higher-income occupations who reside in urban areas. Both BC and UTUC were much more prevalent in patients with less socioeconomic means and those living in rural areas. Varied comorbidities showed different distributions among urological cancers. Although the extent was most prominent in KC, both overall mortality and cancer-specific mortality of the three cancers increased every year during the follow-up period. Conclusion: Our results demonstrate different patient characteristics and mortality among BC, KC, and UTUC in Taiwan.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"56 - 62"},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46066381","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 : 2022-04-01DOI: 10.4103/uros.uros_112_21
Kevin Glorius Tampubolon, S. Pramod, Ferry Safriadi, M. Fitriana, B. Hernowo
Purpose: Around 75% of all bladder cancers are classified into nonmuscle invasive bladder cancer (NMIBC). The NMIBC's high recurrence and progressivity rate are most commonly found in tumors invading the lamina propria (LP), classified as staged pT1 when it extended to the LP with a heterogeneous recurrence and progression. This study aimed to correlate the measurement of tumor depth and width to lymphovascular invasion (LVI) in NMIBC. Materials and Methods: A 5-year retrospective analytical study (2015–2019) was conducted in a tertiary hospital in Indonesia. We reassessed and analyzed the tumor depth and width of 64 patients with pT1 bladder cancer based on histopathological reports and analyzed the correlation of tumors and LVI. The depth was reassessed by measuring the transitional urothelium with the LP as an initial marking point, up to the tumor's edge in the LP, and tumor's width by measuring the largest width of one tumor focus in the LP, along with the presence of LVI by histopathological exams. Data were analyzed using the Mann − Whitney test. Results: The participants were 64 patients with pT1 bladder cancer. The mean tumor pT1 invasion depth was 2.03 ± 0.918 mm. The non-LVI group's mean tumor invasion depth was 1.72 ± 0.721 mm, whereas the LVI group was 2.21 ± 0.980 mm. The tumor invasion depth was a significant factor for LVI, whereas the tumor maximum diameter was not. Conclusion: The tumor invasion's depth was significantly associated with the LVI. The pT1 tumor invasion depth measurement might serve as a predictive variable of tumor recurrence and progressivity.
{"title":"Correlations of tumor depth and width with lymphovascular invasion in non-muscle invasive bladder cancer","authors":"Kevin Glorius Tampubolon, S. Pramod, Ferry Safriadi, M. Fitriana, B. Hernowo","doi":"10.4103/uros.uros_112_21","DOIUrl":"https://doi.org/10.4103/uros.uros_112_21","url":null,"abstract":"Purpose: Around 75% of all bladder cancers are classified into nonmuscle invasive bladder cancer (NMIBC). The NMIBC's high recurrence and progressivity rate are most commonly found in tumors invading the lamina propria (LP), classified as staged pT1 when it extended to the LP with a heterogeneous recurrence and progression. This study aimed to correlate the measurement of tumor depth and width to lymphovascular invasion (LVI) in NMIBC. Materials and Methods: A 5-year retrospective analytical study (2015–2019) was conducted in a tertiary hospital in Indonesia. We reassessed and analyzed the tumor depth and width of 64 patients with pT1 bladder cancer based on histopathological reports and analyzed the correlation of tumors and LVI. The depth was reassessed by measuring the transitional urothelium with the LP as an initial marking point, up to the tumor's edge in the LP, and tumor's width by measuring the largest width of one tumor focus in the LP, along with the presence of LVI by histopathological exams. Data were analyzed using the Mann − Whitney test. Results: The participants were 64 patients with pT1 bladder cancer. The mean tumor pT1 invasion depth was 2.03 ± 0.918 mm. The non-LVI group's mean tumor invasion depth was 1.72 ± 0.721 mm, whereas the LVI group was 2.21 ± 0.980 mm. The tumor invasion depth was a significant factor for LVI, whereas the tumor maximum diameter was not. Conclusion: The tumor invasion's depth was significantly associated with the LVI. The pT1 tumor invasion depth measurement might serve as a predictive variable of tumor recurrence and progressivity.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"77 - 81"},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43900310","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}
Chien-Ming Lai, R. Wu, Chun-Hsien Wu, Chiang-Ting Wang, V. Lin
Purpose: Prostate biopsy induced prostate hemorrhage and periprostate tissue inflammation which raised the concerns of increasing difficulty even in the era of robot-assisted radical prostatectomy (RARP). To evaluate the correlation between postoperative outcomes and the interval after biopsy, we compared surgical outcomes in different time interval (≤4 weeks, 4–8 weeks, and ≥8 weeks). Materials and Methods: We collected patients with localized prostate cancer who underwent RARP by a single experienced surgeon at our institute between April 2016 and February 2019. The complicated statuses such as previously transurethral resection of prostate, grossly nodal positive disease, or locally advanced disease were excluded. A total of 83 patients were enrolled retrospectively according to the regulation of the institutional review board in the institute. The patients were divided into three groups according to the time interval between prostate biopsy and RARP (≤4 weeks, 4-8 weeks and ≥ 8 weeks). The demographic information and perioperative and postoperative outcomes were collected and analyzed. Results: Regarding preoperative characteristics, there were similarities in the three groups. Concerning intraoperative outcomes, statistical difference was observed in mean estimated blood loss (253.1 vs. 158.9 vs. 170.9 ml, P = 0.047). In addition, operative time was similar among three groups (221.9 vs. 248.5 vs. 226.7, P = 0.199). There was no difference in positive surgical margin rate among three groups. The time interval groups did not correlate to prolonged days either urinary catheter indwelling or hospitalization (P > 0.05). There was no difference in decreased erection hardness scores at 12 months between 3 groups (−0.75 vs. −0.77 vs. −0.57, P = 0.556). Conclusion: In our experience, RARP can be effectively and safely performed in different time intervals after prostate biopsy without increasing total operative time or adversely compromising postoperative functionally and oncologic outcomes. However, performing RARP < 4 weeks after prostate biopsy did probably have the risk of increase estimated blood loss.
{"title":"Does the timing of performing robot-assisted radical prostatectomy after prostate biopsy affect the outcome?","authors":"Chien-Ming Lai, R. Wu, Chun-Hsien Wu, Chiang-Ting Wang, V. Lin","doi":"10.4103/uros.uros_39_21","DOIUrl":"https://doi.org/10.4103/uros.uros_39_21","url":null,"abstract":"Purpose: Prostate biopsy induced prostate hemorrhage and periprostate tissue inflammation which raised the concerns of increasing difficulty even in the era of robot-assisted radical prostatectomy (RARP). To evaluate the correlation between postoperative outcomes and the interval after biopsy, we compared surgical outcomes in different time interval (≤4 weeks, 4–8 weeks, and ≥8 weeks). Materials and Methods: We collected patients with localized prostate cancer who underwent RARP by a single experienced surgeon at our institute between April 2016 and February 2019. The complicated statuses such as previously transurethral resection of prostate, grossly nodal positive disease, or locally advanced disease were excluded. A total of 83 patients were enrolled retrospectively according to the regulation of the institutional review board in the institute. The patients were divided into three groups according to the time interval between prostate biopsy and RARP (≤4 weeks, 4-8 weeks and ≥ 8 weeks). The demographic information and perioperative and postoperative outcomes were collected and analyzed. Results: Regarding preoperative characteristics, there were similarities in the three groups. Concerning intraoperative outcomes, statistical difference was observed in mean estimated blood loss (253.1 vs. 158.9 vs. 170.9 ml, P = 0.047). In addition, operative time was similar among three groups (221.9 vs. 248.5 vs. 226.7, P = 0.199). There was no difference in positive surgical margin rate among three groups. The time interval groups did not correlate to prolonged days either urinary catheter indwelling or hospitalization (P > 0.05). There was no difference in decreased erection hardness scores at 12 months between 3 groups (−0.75 vs. −0.77 vs. −0.57, P = 0.556). Conclusion: In our experience, RARP can be effectively and safely performed in different time intervals after prostate biopsy without increasing total operative time or adversely compromising postoperative functionally and oncologic outcomes. However, performing RARP < 4 weeks after prostate biopsy did probably have the risk of increase estimated blood loss.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"63 - 69"},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47239222","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 : 2022-01-01DOI: 10.4103/uros.uros_138_20
Kau-Han Lee, I. Tsai, Zhihai Chen, Chien-Liang Liu, Steven Y Huang, A. Chiu
Purpose: Percutaneous nephrolithotomy (PCNL) is the standard procedure used for large kidney stones, and multiple tracts of PCNL are applied to achieve better stone clearance. However, the creation of multiple tracts may have the potential risk of bleeding and higher complication rates compared with single-tract procedures. We reviewed our experience managing staghorn calculi with multiple tracts compared with a single tract. Materials and Methods: Records of 36 patients with staghorn calculi who underwent PCNL at our institution between January 2018 and April 2020 were reviewed retrospectively. Nineteen patients were managed by single-tract access (Group 1), and 17 patients underwent multiple-tract access (Group 2). Both groups were compared in terms of perioperative findings and postoperative outcomes. Results: The mean number of percutaneous accesses in the multiple-tract group was 2.88, with most patients requiring two tracts. The mean duration of fluoroscopy screening and operative time was longer in Group 2. Stone-free rates were 59% and 70.5% in Groups 1 and 2, respectively. The mean hospital stay was similar in both groups. Complications included blood transfusion, resulting from a hemoglobin drop of 2.15 ± 0.96 and 1.59 ± 0.69 g/dL in Groups 1 and 2, respectively. Mean pre- and post-operative creatinine concentrations were 1.212 and 1.211 mg/dL in Group 1 and 1.206 and 1.157 mg/dL in Group 2. Mean changes in creatinine values were not statistically significant between the groups. Clavien–Dindo Classification Grade II complications included urosepsis and blood transfusion, which occurred in five patients in Group 1 and three in Group 2. Pseudoaneurysm attributed to Grade III complications occurred in one patient in Group 1. Conclusion: Multiple-tract access during PCNL is a safe and efficient method to manipulate staghorn kidney stones. Mini PCNL with multiple-tract access is a successful alternative to deal with staghorn stones involving multiple calyces.
{"title":"Single versus multiple mini-tract percutaneous nephrolithotomy for staghorn renal stone: A single-center study","authors":"Kau-Han Lee, I. Tsai, Zhihai Chen, Chien-Liang Liu, Steven Y Huang, A. Chiu","doi":"10.4103/uros.uros_138_20","DOIUrl":"https://doi.org/10.4103/uros.uros_138_20","url":null,"abstract":"Purpose: Percutaneous nephrolithotomy (PCNL) is the standard procedure used for large kidney stones, and multiple tracts of PCNL are applied to achieve better stone clearance. However, the creation of multiple tracts may have the potential risk of bleeding and higher complication rates compared with single-tract procedures. We reviewed our experience managing staghorn calculi with multiple tracts compared with a single tract. Materials and Methods: Records of 36 patients with staghorn calculi who underwent PCNL at our institution between January 2018 and April 2020 were reviewed retrospectively. Nineteen patients were managed by single-tract access (Group 1), and 17 patients underwent multiple-tract access (Group 2). Both groups were compared in terms of perioperative findings and postoperative outcomes. Results: The mean number of percutaneous accesses in the multiple-tract group was 2.88, with most patients requiring two tracts. The mean duration of fluoroscopy screening and operative time was longer in Group 2. Stone-free rates were 59% and 70.5% in Groups 1 and 2, respectively. The mean hospital stay was similar in both groups. Complications included blood transfusion, resulting from a hemoglobin drop of 2.15 ± 0.96 and 1.59 ± 0.69 g/dL in Groups 1 and 2, respectively. Mean pre- and post-operative creatinine concentrations were 1.212 and 1.211 mg/dL in Group 1 and 1.206 and 1.157 mg/dL in Group 2. Mean changes in creatinine values were not statistically significant between the groups. Clavien–Dindo Classification Grade II complications included urosepsis and blood transfusion, which occurred in five patients in Group 1 and three in Group 2. Pseudoaneurysm attributed to Grade III complications occurred in one patient in Group 1. Conclusion: Multiple-tract access during PCNL is a safe and efficient method to manipulate staghorn kidney stones. Mini PCNL with multiple-tract access is a successful alternative to deal with staghorn stones involving multiple calyces.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"35 - 41"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41764036","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}
Purpose: To assess the clinical outcomes following dorsal buccal mucosal graft urethroplasty (BMGU) in perimenopausal women (PMW) suffering from urethral stricture disease. Materials and Methods: PMW (40–65 years) presenting with urinary symptoms were evaluated with uroflowmetry, voiding cystourethrogram (VCUG), and urethral calibration. PMW with maximum flow rate (Qmax) less than 10 ml/s or postvoid residual (PVR) volume greater than 50 ml, VCUG showing evidence of urethral stricture, and failure to calibrate with 14 Fr Foley catheter were included in the study. Patients with underactive bladder, carcinoma cervix, pelvic trauma, and oral submucosal fibrosis were excluded from the study. Patients satisfying inclusion and exclusion criteria underwent dorsal BMGU. Outcomes of the surgery were assessed by uroflowmetry at 3-monthly intervals. Results: The number of patients satisfying the inclusion and exclusion criteria between March 2014 and March 2020 was eight. The mean age of the patients was 52.1 years. The mean stricture length was 1.9 cm. The mean preoperative Qmax and PVR were 4.2 ml/s and 110 ml, respectively. The mean postoperative Qmax and PVR at 6 months were 15.4 ml/s and 39.1 ml, respectively. One patient had a recurrent stricture and underwent dilatation. Donor site complications were minor. The overall success rate of the procedure was 87%. Conclusion: Dorsal BMGU in females for urethral stricture disease offers successful urethral reconstruction and the advantage of least disruption of continence mechanism and resilience to hormonal changes in PMW.
{"title":"Outcome analysis of dorsal buccal mucosal graft urethroplasty in perimenopausal women with urethral stricture disease","authors":"A. Iyyan, P. Murugan, Shree Rajagopal, S. Sali","doi":"10.4103/uros.uros_85_21","DOIUrl":"https://doi.org/10.4103/uros.uros_85_21","url":null,"abstract":"Purpose: To assess the clinical outcomes following dorsal buccal mucosal graft urethroplasty (BMGU) in perimenopausal women (PMW) suffering from urethral stricture disease. Materials and Methods: PMW (40–65 years) presenting with urinary symptoms were evaluated with uroflowmetry, voiding cystourethrogram (VCUG), and urethral calibration. PMW with maximum flow rate (Qmax) less than 10 ml/s or postvoid residual (PVR) volume greater than 50 ml, VCUG showing evidence of urethral stricture, and failure to calibrate with 14 Fr Foley catheter were included in the study. Patients with underactive bladder, carcinoma cervix, pelvic trauma, and oral submucosal fibrosis were excluded from the study. Patients satisfying inclusion and exclusion criteria underwent dorsal BMGU. Outcomes of the surgery were assessed by uroflowmetry at 3-monthly intervals. Results: The number of patients satisfying the inclusion and exclusion criteria between March 2014 and March 2020 was eight. The mean age of the patients was 52.1 years. The mean stricture length was 1.9 cm. The mean preoperative Qmax and PVR were 4.2 ml/s and 110 ml, respectively. The mean postoperative Qmax and PVR at 6 months were 15.4 ml/s and 39.1 ml, respectively. One patient had a recurrent stricture and underwent dilatation. Donor site complications were minor. The overall success rate of the procedure was 87%. Conclusion: Dorsal BMGU in females for urethral stricture disease offers successful urethral reconstruction and the advantage of least disruption of continence mechanism and resilience to hormonal changes in PMW.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"26 - 29"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42644532","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}
Mudassir M. Wani, Iqbal Sheikh, H. Marsh, M. Sheriff, Z. Bhat, John Mullighan
Purpose: The purpose of this study was to investigate the management of acute urolithiasis during index admission by primary ureteroscopy (P-URS) during coronavirus disease-2019 (COVID-19) pandemic. With the rise in prevalence of urolithiasis, the focus has shifted to manage patients presenting with acute ureteric colic during their first admission rather than using temporary measures such as emergency stenting (ES) or nephrostomies which are followed by deferred ureteroscopic procedures Deferred Ureteroscopy (D-URS). We compared the results of ES with P-URS procedures in terms of quality and cost benefits during COVID-19 pandemic. Materials and Methods: Data were collected prospectively from April 2020 to March 2021 for all emergency urolithiasis procedures performed including ES and P-URS. The quality assessment was based in relation to patient factors including the number of procedures per patient, number of days spent at hospital, number of days off work, and expertise of person operating. Cost analysis included theater expenses, hospital stay charges, and loss of working days. Results: This study revealed that the average stay of patients on index admission who had an ES was 1.35 days compared to 1.78 days in patients who underwent P-URS. Patients who had ES had to undergo D-URS and spent another average of 1.5 days in the hospital. Overall, additional expenditure in patients who did not undergo primary ureterorenoscopy was on an average in the range of £1800 (excluding loss of work for patients, who needed to return for multiple procedures). Conclusion: We conclude that the approach of P-URS and management of stones in index admission is very effective in both improving quality of patients (during the COVID-19 pandemic) and bringing down cost expenditure effectively.
{"title":"Primary ureteroscopy for diagnosing and treating acute urolithiasis during the COVID-19 pandemic: Quality and cost benefits","authors":"Mudassir M. Wani, Iqbal Sheikh, H. Marsh, M. Sheriff, Z. Bhat, John Mullighan","doi":"10.4103/uros.uros_91_21","DOIUrl":"https://doi.org/10.4103/uros.uros_91_21","url":null,"abstract":"Purpose: The purpose of this study was to investigate the management of acute urolithiasis during index admission by primary ureteroscopy (P-URS) during coronavirus disease-2019 (COVID-19) pandemic. With the rise in prevalence of urolithiasis, the focus has shifted to manage patients presenting with acute ureteric colic during their first admission rather than using temporary measures such as emergency stenting (ES) or nephrostomies which are followed by deferred ureteroscopic procedures Deferred Ureteroscopy (D-URS). We compared the results of ES with P-URS procedures in terms of quality and cost benefits during COVID-19 pandemic. Materials and Methods: Data were collected prospectively from April 2020 to March 2021 for all emergency urolithiasis procedures performed including ES and P-URS. The quality assessment was based in relation to patient factors including the number of procedures per patient, number of days spent at hospital, number of days off work, and expertise of person operating. Cost analysis included theater expenses, hospital stay charges, and loss of working days. Results: This study revealed that the average stay of patients on index admission who had an ES was 1.35 days compared to 1.78 days in patients who underwent P-URS. Patients who had ES had to undergo D-URS and spent another average of 1.5 days in the hospital. Overall, additional expenditure in patients who did not undergo primary ureterorenoscopy was on an average in the range of £1800 (excluding loss of work for patients, who needed to return for multiple procedures). Conclusion: We conclude that the approach of P-URS and management of stones in index admission is very effective in both improving quality of patients (during the COVID-19 pandemic) and bringing down cost expenditure effectively.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"30 - 34"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42824228","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":"Step into 2022 with best luck","authors":"Y. Chuang","doi":"10.4103/uros.uros_10_22","DOIUrl":"https://doi.org/10.4103/uros.uros_10_22","url":null,"abstract":"","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"1 - 2"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44210654","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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