Urologia Journal最新文献

Objective: To compare trends and incidence of surgical intervention among adults with urolithiasis in Ontario, Canada, and Israel.

Patients and methods: A retrospective analysis was conducted using administrative databases from Clalit Health Service in Israel and IC/ES in Canada. The study included adults who underwent their initial surgical treatment for urolithiasis. Descriptive statistics summarized baseline patient demographics, while comparisons were analyzed with a t-test.

Results: Between 2003 and 2018, 31,034 and 105,013 patients who underwent surgical intervention for upper urinary tract stones for the first time in their clinical history, excluding those with prior surgical treatments for the same condition, in Israel and Ontario, respectively. The number of insured at Clalit Health Services increased by 21.3%, while the population in Ontario grew by 18.5%. The total number of treated cases rose by 82% and 64.4% in Israel and Ontario, respectively. The procedures per 100,000 people increased by 51% in Israel and 34.6% in Ontario. In Israel, the proportion of females undergoing surgery decreased from 33.5% to 32%, while in Ontario, it increased from 36.3% to 49.8%. Ureteroscopy (URS) was more commonly used in Ontario, while shock wave lithotripsy (SWL) was more common in Israel. URS utilization surged by 281% in Israel and 145.5% in Ontario. Percutaneous nephrolithotripsy (PCNL) increased by 52% in Israel and 8.6% in Ontario, while SWL procedures declined by 57% in Israel and 32.5% in Ontario.

Conclusions: A significant rise in the number of patients undergoing their first stone-related procedure in both regions, particularly in Israel. There was a difference in the proportion of female patients requiring surgical intervention, with an increase in Ontario and a decrease in Israel.

Many studies reveal the presence of an effect of age, abstinence and seasons on semen parameters, but the number of patients enrolled is small and the presence of therapies unknown. We aimed to evaluate the correlation between abstinence days, age, season, and semen parameters (volume, concentration, progressive motility, total number of sperms, morphology) among men referred to our laboratory. We proceeded with a cross-sectional, observational, exploratory study in an Andrology laboratory. A population of 348 male partners of infertile couples who did not receive any treatment in the 3 months preceding semen analysis was selected. Sperm volume, concentration, total number, progressive motility and morphology of sperms were conducted strictly following the guidelines indicated in the last edition of WHO manual for semen analysis. Pearson's correlation analysis and Kendall's correlation analysis were applied. Sperm concentration, semen volume and sperm total number moderately increased as well as the abstinence, while progressive motility and morphology moderately decreased. Regarding the age, in the 20-35 age group there was a weak inverse association with concentration, total number, motility and morphology and a weak positive association with volume; in the 42-63 age group there was a moderate positive association between age and concentration, motility and morphology, but an inverse association with volume. No correlation emerged between seasonal variations and semen parameters. These results suggested the importance of correct information to patients for proper semen analysis for diagnostic and therapeutic purposes.

Introduction: Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common and challenging condition with no consensus on the best treatment. Also, based on a search in reputable scientific databases, it was found that so far, no study has been conducted to evaluate the response to treatment with concomitant use of tamsulosin, levofloxacin, and celecoxib in chronic pelvic pain syndrome in men.

Methods: Ninety six male patients under 40 years of age with chronic pelvic pain syndrome who met the inclusion criteria and exclusion criteria were included in the study. Patients (there was only one group of patients in this study) were treated simultaneously with 3 drugs tamsulosin (0.4 mg), levofloxacin (500 mg), and celecoxib (200 mg) for 1 month and after 1 month of treatment response to treatment (pain relief) according to age factors. Weight, underlying disease, smoking, BMI, prostatitis family history, and education were recorded by the researcher in preprepared data collection forms. The results and information obtained were entered into statistical software and analyzed.

Results: About 42.7% of patients experienced pain relief after treatment. Age, smoking, and family history of prostatitis showed significant relationships with pain reduction. Weight gain decreased the chances of pain reduction (OR = 0.303), while increased BMI (OR = 0.476) and smoking (OR = 0.801) also negatively influenced pain relief.

Conclusions: The results of this study showed that the concomitant use of tamsulosin, levofloxacin and celecoxib in patients with chronic pelvic pain syndrome had acceptable results in reducing the symptoms of patients.

Purpose: A retrospective study was performed to identify potential metabolic abnormalities and inflammatory abnormalities associated with benign prostatic hyperplasia (BPH) secondary to bladder calculi.

Materials and methods: This study enrolled 646 patients with bladder calculi between 2008 and 2022, including 314 patients with benign prostatic hyperplasia (BPH) and 332 without BPH. Demographic characteristics, serum biochemical parameters, prostate volume, maximum bladder calculus diameter, and randomized urinary metabolic profiles were compared between the two groups.

Results: BPH was associated with increased aspartate aminotransferase/alanine aminotransferase (mean 1.2 vs 1.1, P < 0.05), lower cholinesterase (mean 7240.5 vs 7778.4, P < 0.01), increased systolic pressure (mean 137.2 vs 133.4, P < 0.01). Patients with BPH were significantly older and had higher systolic blood pressure compared to non-BPH patients. BPH group exhibited significantly lower levels of albumin/globulin ratio, cholinesterase, phosphorus, triglycerides, platelet count, neutrophil count, and white blood cell count, while demonstrating higher aspartate aminotransferase/alanine aminotransferase ratio, mean corpuscular volume, monocyte ratio, and urinary red blood cell count. Prostate volume was proportional to body weight and crystal count. Lower phosphorus (OR = 0.207; 95%CI = 0.068, 0.635; P < 0.01) and higher age (OR = 1.065; 95%CI = 1.041, 1.090; P < 0.001) were associated with BPH.

Conclusions: Advanced age was identified as a significant risk factor for prostate hyperplasia in patients with bladder calculi, whereas elevated phosphorus levels emerged as a protective factor. The pathogenesis of BPH secondary to bladder calculi appears to be multifactorial, primarily influenced by metabolic abnormalities and inflammatory processes. These findings provide valuable insights for the clinical assessment and management of BPH secondary to bladder calculi.

Background: In percutaneous nephrolithotomy, when tract dilatation fails due to short advancement, endoscopic tract dilatation can be used as a salvage technique for renal access. We aimed to report complications of this technique and compare it with uneventful dilatation cases.

Methods and materials: The study enrolled patients who underwent sonography-guided PCNL for six consecutive months in 2023. After renal puncture under the sonography guide, an Amplatz dilator was used for one-shot tract dilation. In the case of short-advancement, a bi-prong forceps was used under direct endoscopic vision for tract dilatation. The study compared the operation time, postoperative complications, and stone-free rate between successful one-shot Amplatz dilatation (SA) and those with salvage endoscopic tract dilatation (SE).

Results: The study included 108 patients with a mean age of 47.9 ± 11.6 (50.9% male). Short-advancement occurred in 63 patients (58.3%). The salvage technique was successful in 95.2% of occasions of short advancement. Pre-operative demographic and clinical data were not different in this group compared to the (SA) group. The operative time was 21.1 ± 14.5 min in the (SE) group, which was not longer than the (SA) group with 22.7 ± 12.6 min (p = 0.2). The stone-free rate was 81.0% in the (SE) group, which was not inferior to 73% in the (SA) group (p = 0.3). The transfusion rate and complications were not different as well.

Conclusion: Salvage bi-prong forceps tract dilation in the event of short advancement after one-shot Amplatz tract dilation during percutaneous nephrolithotomy is not linked to a higher complication rate or inferior clinical outcomes compared to successful one-shot dilation.

Objective: To evaluate the therapeutic effect of acupuncture combined with cross-moxibustion in patients with severe overactive bladder (OAB).

Methods: OAB patients from August 2018 to July 2023 were collected, and 101 severe OAB patients were selected based on the Overactive Bladder Symptom Scale (OABSS) score. The patients were divided into three groups according to their treatment methods, including 33 cases of behavioral therapy group, 32 cases were in the acupoint acupuncture group, and 36 cases were in the acupuncture combined with cross-moxibustion group. The treatment outcomes of the three groups were evaluated through the OABSS score, and the quality of life (QOL) was assessed.

Results: Among the 101 patients with severe OAB, no statistical differences in age and gender were observed among the three groups of treatments. The treatment effects were evaluated using the OABSS score and it was found that behavioral treatment was basically ineffective. In contrast, both acupuncture and acupuncture combined with cross-moxibustion had significant differences via comparing at pre-post treatment periods, which the OABSS score decreased by 3.25 ± 1.83 and 7.83 ± 1.34 respectively, suggesting that acupuncture combined with cross-moxibustion is more effective than acupuncture group alone. The patient's quality of life was further evaluated through QOL scores, and the results showed that while the acupuncture group was effective, acupuncture combined with cross-moxibustion improved more significantly.

Conclusion: The combination of acupuncture and moxibustion is the most effective treatment for patients with severe overactive bladder.

Background: Onabotulinum toxin A injection is recommended for overactive bladder (OAB) resistant to medical treatments. However, success is not universal, and factors influencing outcomes remain unclear. This study evaluates the factors affecting the success of onabotulinum toxin A injection in refractory idiopathic OAB.

Methods: Data from patients with resistant idiopathic OAB treated with 100 IU onabotulinum toxin A (BOTOX^®, Allergan, Dublin, Ireland) between January 2019 and August 2023 were analyzed. Demographic data and symptom duration were recorded. Patients were evaluated pre- and post-procedure using the overactive bladder symptom score (OABSS) and 3-day bladder diaries. A ⩾50% improvement in OABSS was considered treatment success. Botox was injected at 20 sites (5 IU per site) via 22 Fr rigid cystoscope under sedoanalgesia.

Results: A total of 210 patients (80.5% female, n = 169) with a mean age of 53.76 ± 14.90 years were included. Symptom duration averaged 39.82 ± 22.28 months. Wet OAB was diagnosed in 83.3% (n = 175), while 16.7% (n = 35) had dry OAB. Pre-procedure mean OABSS was 9.18 ± 1.31, daily micturition 8.67 ± 1.52, urge incontinence 2.57 ± 1.28, nocturia 1.87 ± 0.75, and pad use 2.44 ± 1.24/day. Treatment success was achieved in 82.4% (n = 173).

Conclusion: The degree of patient complaints, particularly daily micturition frequency, significantly affects treatment success. Patients with higher daily micturition may require advanced interventions beyond Botox.

Objective: To determine the association between thyroid disorders and the Risk of developing prostate cancer.

Methods: We conducted this review following the recommendations of the Cochrane Collaboration and the PRISMA Statement. From the moment to the present, we have conducted a search strategy using MEDLINE, WEB OF SCIENCE, and GOOGLE SCHOLAR. We included cohort and case-control studies that examined the relationship between thyroid disorders and the Risk of developing prostate cancer. We assessed the Risk of bias using the Newcastle Ottawa Quality Assessment scale. Meta-analysis was conducted in Review Manager 5.4.1 (Revman^®).

Results: We included nine studies in the analysis. The studies included were classified into two groups: those that studied hypothyroidism and those that studied hyperthyroidism. The results showed no association between thyroid abnormalities and prostate cancer risk, with an HR of 1.05 (95% CI: 0.90-1.22). Hyperthyroidism also showed no association with an HR 1.64 (95% CI: 1.00-2.69), characterized by increased serum T4 and decreased TSH. There was also no significant association with hypothyroidism, with an HR of 0.85 (95% CI: 0.67-1.10).

Conclusion: Thyroid disorders were not associated with the Risk of developing prostate cancer.

In the realm of medical procedures for urinary obstructions, a distinct division of roles is evident: the vast majority of percutaneous nephrostomies (PCNs) are the domain of Interventional Radiology (IR), while the placement of double J stents (JJ stents) falls squarely under Urology. This division, however, is not without its complexities. When confronted with a patient suffering from a urinary obstruction, the decision-making process can become intricate. The underlying cause often fuels the debate: should IR intervene with a PCN, or should Urology place a JJ stent? Such decisions have profound implications for the individual patient.In this comprehensive review, we aim to compare the utilization of PCN to that of JJS in a variety of clinical settings and evaluate their indications, relative efficacies, and potential complications to ascertain whether one procedure outperforms the other.