Abdulaziz Alwehaibi, Fahad Alyami, Faisal Altwijri, M. Trbay
Office-based procedures under local anesthesia are not a popular and well-accepted concept in pediatric urology except for newborn circumcision. There is limited literature on the utilization of office-based procedures under local anesthesia in pediatric urology. In this study, we present our experience of office-based procedures under local anesthesia from a tertiary center. This is a retrospective study of the patients who underwent meatotomy and penile adhesion release in the clinic under local anesthesia between January 2017 and August 2022 by a single surgeon in a tertiary center. A total of 92 patients were included in this study. There were 65 patients diagnosed with meatal stenosis and 27 patients diagnosed with penile adhesion. The overall incidence of recurrence was noted in four patients. Only one patient had minimal complications. The overall average follow-up was 5.39 months (1–10 months). Selective office-based procedure (meatotomy and penile adhesion release) under topical local anesthesia is a simple, safe, and effective method to treat such conditions with a high success rate, especially with financial and time constraints on health care nowadays.
{"title":"Office-based pediatric urology procedures","authors":"Abdulaziz Alwehaibi, Fahad Alyami, Faisal Altwijri, M. Trbay","doi":"10.4103/ua.ua_89_23","DOIUrl":"https://doi.org/10.4103/ua.ua_89_23","url":null,"abstract":"\u0000 \u0000 Office-based procedures under local anesthesia are not a popular and well-accepted concept in pediatric urology except for newborn circumcision. There is limited literature on the utilization of office-based procedures under local anesthesia in pediatric urology. In this study, we present our experience of office-based procedures under local anesthesia from a tertiary center.\u0000 \u0000 \u0000 \u0000 This is a retrospective study of the patients who underwent meatotomy and penile adhesion release in the clinic under local anesthesia between January 2017 and August 2022 by a single surgeon in a tertiary center. A total of 92 patients were included in this study.\u0000 \u0000 \u0000 \u0000 There were 65 patients diagnosed with meatal stenosis and 27 patients diagnosed with penile adhesion. The overall incidence of recurrence was noted in four patients. Only one patient had minimal complications. The overall average follow-up was 5.39 months (1–10 months).\u0000 \u0000 \u0000 \u0000 Selective office-based procedure (meatotomy and penile adhesion release) under topical local anesthesia is a simple, safe, and effective method to treat such conditions with a high success rate, especially with financial and time constraints on health care nowadays.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690873","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}
Dora Jakus, Marijan Šitum, P. Čepin, Ivana Vrhovac, J. A. Borovac
To examine the relationship between clinical patient characteristics and the severity of the disease course in patients hospitalized due to urinary bladder tamponade. The severity was assessed based on hemoglobin (Hgb) levels upon admission, the requirement for red blood cell transfusion (RBCT), and length of hospital stay. A retrospective analysis was conducted at a single center, involving 75 patients who were hospitalized due to urinary bladder tamponade. Bladder cancer (33.3%) and postoperative bleeding (28%) were the most common causes of bladder tamponade. Patient age exhibited a negative correlation with Hgb levels upon admission (r = −0.539, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.425, P < 0.001) and the length of hospitalization (r = 0.541, P < 0.001). The number of comorbidities exhibited a negative correlation with Hgb levels upon admission (r = −0.555, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.522, P < 0.001) and the length of hospitalization (r = 0.543, P < 0.001). Patients taking antithrombotic therapy (AT) had lower mean Hgb levels on admission (87.8 ± 13.5 g/L vs. 107.6 ± 18.7 g/L, P < 0.001), a higher mean number of administered RBCT units (2.8 ± 2.1 vs. 1.1 ± 1.3, P < 0.001) and longer hospitalizations (4.6 ± 1.6 days vs. 3.1 ± 1.1 days, P < 0.001) compared to those not taking AT. Older patients with multiple comorbidities, particularly those taking AT, should be expected to have a more severe clinical course of bladder tamponade. Therefore, special clinical attention is necessary for this vulnerable patient group.
{"title":"The impact of age, sex, comorbidities, and use of antithrombotics on the clinical course severity among patients surgically treated for urinary bladder tamponade","authors":"Dora Jakus, Marijan Šitum, P. Čepin, Ivana Vrhovac, J. A. Borovac","doi":"10.4103/ua.ua_70_23","DOIUrl":"https://doi.org/10.4103/ua.ua_70_23","url":null,"abstract":"\u0000 \u0000 To examine the relationship between clinical patient characteristics and the severity of the disease course in patients hospitalized due to urinary bladder tamponade. The severity was assessed based on hemoglobin (Hgb) levels upon admission, the requirement for red blood cell transfusion (RBCT), and length of hospital stay.\u0000 \u0000 \u0000 \u0000 A retrospective analysis was conducted at a single center, involving 75 patients who were hospitalized due to urinary bladder tamponade.\u0000 \u0000 \u0000 \u0000 Bladder cancer (33.3%) and postoperative bleeding (28%) were the most common causes of bladder tamponade. Patient age exhibited a negative correlation with Hgb levels upon admission (r = −0.539, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.425, P < 0.001) and the length of hospitalization (r = 0.541, P < 0.001). The number of comorbidities exhibited a negative correlation with Hgb levels upon admission (r = −0.555, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.522, P < 0.001) and the length of hospitalization (r = 0.543, P < 0.001). Patients taking antithrombotic therapy (AT) had lower mean Hgb levels on admission (87.8 ± 13.5 g/L vs. 107.6 ± 18.7 g/L, P < 0.001), a higher mean number of administered RBCT units (2.8 ± 2.1 vs. 1.1 ± 1.3, P < 0.001) and longer hospitalizations (4.6 ± 1.6 days vs. 3.1 ± 1.1 days, P < 0.001) compared to those not taking AT.\u0000 \u0000 \u0000 \u0000 Older patients with multiple comorbidities, particularly those taking AT, should be expected to have a more severe clinical course of bladder tamponade. Therefore, special clinical attention is necessary for this vulnerable patient group.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689780","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}
Naif Alqarni, Fahad Alyami, Mohammed A. Alshayie, AlhasanMohamed Abduldaem, Mohammed Sultan, S. Almaiman, H. Alsufyani, I. Abunohaiah
Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. The incidence is around 1: 750–1500 live births. The standard treatment for (UPJO) is open pyeloplasty (OP) with a high success rate of 90%–95%. In the last 20 years, minimal invasive pyeloplasty (MIP) became an excellent alternative technique to OP which was historically the standard of care. The study participants were male and female patients aged 14 years old or less who had undergone open/minimally invasive pyeloplasty during 2015–2020 and who had at least 1-year follow-up after surgery. The data were collected retrospectively from patients’ charts. The patients were categorized into two cohort groups: OP and on the other arm minimally invasive pyeloplasty (robotic/laparoscopic) comparing the outcomes as a 1ry endpoint. 2ry endpoints were hospital stay, duration of surgery, and anteroposterior diameter of renal ultrasound. A total of 133 patients were included in the study. Eighty-four underwent MIP while 49 patients underwent OP. 1ry endpoint was the success rate in both groups. The success rate was 94% (n: 79) and 98% (n: 48) in patients who underwent MIP and OP, respectively. P <0.05 is considered significant. Open and minimally invasive pyeloplasty are comparable in terms of success rate. However, OP was associated with shorter hospital stays and shorter operative times.
{"title":"Minimally invasive versus open pyeloplasty in pediatric population: Comparative retrospective study in tertiary centre","authors":"Naif Alqarni, Fahad Alyami, Mohammed A. Alshayie, AlhasanMohamed Abduldaem, Mohammed Sultan, S. Almaiman, H. Alsufyani, I. Abunohaiah","doi":"10.4103/ua.ua_101_23","DOIUrl":"https://doi.org/10.4103/ua.ua_101_23","url":null,"abstract":"\u0000 \u0000 Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. The incidence is around 1: 750–1500 live births. The standard treatment for (UPJO) is open pyeloplasty (OP) with a high success rate of 90%–95%. In the last 20 years, minimal invasive pyeloplasty (MIP) became an excellent alternative technique to OP which was historically the standard of care.\u0000 \u0000 \u0000 \u0000 The study participants were male and female patients aged 14 years old or less who had undergone open/minimally invasive pyeloplasty during 2015–2020 and who had at least 1-year follow-up after surgery. The data were collected retrospectively from patients’ charts. The patients were categorized into two cohort groups: OP and on the other arm minimally invasive pyeloplasty (robotic/laparoscopic) comparing the outcomes as a 1ry endpoint. 2ry endpoints were hospital stay, duration of surgery, and anteroposterior diameter of renal ultrasound.\u0000 \u0000 \u0000 \u0000 A total of 133 patients were included in the study. Eighty-four underwent MIP while 49 patients underwent OP. 1ry endpoint was the success rate in both groups. The success rate was 94% (n: 79) and 98% (n: 48) in patients who underwent MIP and OP, respectively. P <0.05 is considered significant.\u0000 \u0000 \u0000 \u0000 Open and minimally invasive pyeloplasty are comparable in terms of success rate. However, OP was associated with shorter hospital stays and shorter operative times.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712573","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. Alathel, Omar Alfraidi, Abdulrahman Saad A. Alsayyari, Bader A Aljaafri, Faris Alsalamah, Hesham Almeneif, Abdurhman S Alsaif
Urolithiasis is a common and recurrent condition with a rising global incidence. Stones typically develop in the upper urinary tract, primarily the kidneys. Various factors such as age, gender, diet, fluid intake, climate, occupation, genetics, and metabolic diseases influence stone formation. Stones can vary in size and location, causing obstruction, urine stasis, and complications such as infection. The prevalence of urolithiasis in Saudi Arabia has significantly increased in recent decades, and the study aims to determine the current prevalence and composition trends of urolithiasis, guide treatment and prevention strategies, as well as understand predictors of occurrence and recurrence. It is a retrospective cohort study where the data was collected in the time frame of 2015–2021. The study was conducted in the Department of Surgery and the Division of Urology at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia. The study reveals significant trends in the sociodemographic profile and clinical aspects of urolithiasis patients. With a higher incidence among males (68.5%). Stone compositions predominantly consist of calcium oxalate (67.8%) and uric acid (19.7%), while site distribution shows the left kidney as the most common location (36.5%). Notably, hypertensive patients exhibit a significant association with stone site (P = 0.014). Encouragingly, the majority of patients do not experience reoccurrence (91.6%), and the study demonstrates an increasing recurrence rate with subsequent visits. The relatively shorter hospital stays (55.9% with 1-day stays) indicate efficient management, and this knowledge can aid in optimizing patient care. This study sheds light on the multifaceted nature of urolithiasis by examining various facets. Low recurrence rate of kidney stones offers positive prospects for effective initial management. The shorter hospital stays, suggest advancements in medical practices, enhancing patient convenience and healthcare resource optimization. Investigating the underlying causes behind the observed stone compositions yield insights into potential preventive strategies. Furthermore, extended studies examining the impact of lifestyle modifications and medical interventions on stone recurrence could contribute to refined treatment protocols. These findings can guide healthcare professionals in optimizing patient care, preventive strategies, and future research endeavors.
{"title":"Exploring the incidence and characteristics of urolithiasis in the central region of Saudi Arabia: Insights from a prominent medical center","authors":"A. Alathel, Omar Alfraidi, Abdulrahman Saad A. Alsayyari, Bader A Aljaafri, Faris Alsalamah, Hesham Almeneif, Abdurhman S Alsaif","doi":"10.4103/ua.ua_1_24","DOIUrl":"https://doi.org/10.4103/ua.ua_1_24","url":null,"abstract":"\u0000 \u0000 Urolithiasis is a common and recurrent condition with a rising global incidence. Stones typically develop in the upper urinary tract, primarily the kidneys. Various factors such as age, gender, diet, fluid intake, climate, occupation, genetics, and metabolic diseases influence stone formation. Stones can vary in size and location, causing obstruction, urine stasis, and complications such as infection. The prevalence of urolithiasis in Saudi Arabia has significantly increased in recent decades, and the study aims to determine the current prevalence and composition trends of urolithiasis, guide treatment and prevention strategies, as well as understand predictors of occurrence and recurrence.\u0000 \u0000 \u0000 \u0000 It is a retrospective cohort study where the data was collected in the time frame of 2015–2021. The study was conducted in the Department of Surgery and the Division of Urology at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia.\u0000 \u0000 \u0000 \u0000 The study reveals significant trends in the sociodemographic profile and clinical aspects of urolithiasis patients. With a higher incidence among males (68.5%). Stone compositions predominantly consist of calcium oxalate (67.8%) and uric acid (19.7%), while site distribution shows the left kidney as the most common location (36.5%). Notably, hypertensive patients exhibit a significant association with stone site (P = 0.014). Encouragingly, the majority of patients do not experience reoccurrence (91.6%), and the study demonstrates an increasing recurrence rate with subsequent visits. The relatively shorter hospital stays (55.9% with 1-day stays) indicate efficient management, and this knowledge can aid in optimizing patient care.\u0000 \u0000 \u0000 \u0000 This study sheds light on the multifaceted nature of urolithiasis by examining various facets. Low recurrence rate of kidney stones offers positive prospects for effective initial management. The shorter hospital stays, suggest advancements in medical practices, enhancing patient convenience and healthcare resource optimization. Investigating the underlying causes behind the observed stone compositions yield insights into potential preventive strategies. Furthermore, extended studies examining the impact of lifestyle modifications and medical interventions on stone recurrence could contribute to refined treatment protocols. These findings can guide healthcare professionals in optimizing patient care, preventive strategies, and future research endeavors.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715035","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}
Pushpendra Kumar Shukla, A. Singh, Sameer Trivedi, U. Dwivedi, Yashpal Ramole, Faiz Ahmed Khan, Manish Pandey
Peyronie’s disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity. This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years. The mean operative time was 126.31 ± 21.45 min. Additional Nesbit’s plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances. LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results.
{"title":"Role of lingual mucosa as a graft material in the surgical treatment of Peyronie’s disease","authors":"Pushpendra Kumar Shukla, A. Singh, Sameer Trivedi, U. Dwivedi, Yashpal Ramole, Faiz Ahmed Khan, Manish Pandey","doi":"10.4103/ua.ua_3_24","DOIUrl":"https://doi.org/10.4103/ua.ua_3_24","url":null,"abstract":"\u0000 \u0000 Peyronie’s disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity.\u0000 \u0000 \u0000 \u0000 This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years.\u0000 \u0000 \u0000 \u0000 The mean operative time was 126.31 ± 21.45 min. Additional Nesbit’s plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances.\u0000 \u0000 \u0000 \u0000 LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700725","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}
Khalid Alrabeeah, A. Alkhayal, Sahar Aljumaiah, Mohammad Alghafees, Almohannad K Alqarni, Basel O Hakami
Klinefelter syndrome (KF) is a group of chromosomal disorders with at least one extra X chromosome in male individuals that leads to infertility and diminished hair growth in affected males. In this study, we present a case series of 16 nonmosaic KF and an extensive literature review. This is a retrospective study including 16 nonmosaic Klinefelter Syndrome patients that underwent micro-testicular sperm extraction (m-TESE) at our center between January 2016 and December 2022. Frequencies and percentages were used to present categorical variables, whereas continuous variables were presented as the median and interquartile range (IQR). The sperm retrieval rate (SRR) was assessed using a one-sample proportions test with continuity correction. Fisher’s exact test was to assess the differences between patients with negative and positive retrieval in terms of the categorical variables. A Wilcoxon rank-sum test was applied to explore the between-group differences in the numerical variables. A literature search was performed for additional publications of discussing m-TESE among KF patients. The median (IQR) age of patients was 40.0 years (34.5–47.0). All of the patients had nonobstructive azoospermia, and the majority of them (93.8%) had primary infertility. The most common histopathological findings were atrophic tubules (57.1%), followed by Sertoli cell-only (28.6%). Sperm retrieval was positive for two patients with a rate of 12.5% (95% confidence interval 2.2 to 39.6). Patients with positive sperm retrieval were significantly younger than their peers with negative retrieval (median = 28.0, IQR = 27.5 to 28.5 vs. median = 41.5, IQR = 35.8 to 47.0, P = 0.031). The successful conception rate was 100% (n = 2) using intracytoplasmic sperm injection with a birth rate of 100% (n = 2). Our observed SRR among nonmosaic KF patients was marginally lower than the reported literature. Younger-age patients were significantly more likely to benefit from the procedure.
{"title":"Sperm extraction in nonmosaic Klinefelter syndrome patients: A case series and literature review of sperm extraction in Klinefelter syndrome patients","authors":"Khalid Alrabeeah, A. Alkhayal, Sahar Aljumaiah, Mohammad Alghafees, Almohannad K Alqarni, Basel O Hakami","doi":"10.4103/ua.ua_55_23","DOIUrl":"https://doi.org/10.4103/ua.ua_55_23","url":null,"abstract":"\u0000 \u0000 Klinefelter syndrome (KF) is a group of chromosomal disorders with at least one extra X chromosome in male individuals that leads to infertility and diminished hair growth in affected males. In this study, we present a case series of 16 nonmosaic KF and an extensive literature review.\u0000 \u0000 \u0000 \u0000 This is a retrospective study including 16 nonmosaic Klinefelter Syndrome patients that underwent micro-testicular sperm extraction (m-TESE) at our center between January 2016 and December 2022. Frequencies and percentages were used to present categorical variables, whereas continuous variables were presented as the median and interquartile range (IQR). The sperm retrieval rate (SRR) was assessed using a one-sample proportions test with continuity correction. Fisher’s exact test was to assess the differences between patients with negative and positive retrieval in terms of the categorical variables. A Wilcoxon rank-sum test was applied to explore the between-group differences in the numerical variables. A literature search was performed for additional publications of discussing m-TESE among KF patients.\u0000 \u0000 \u0000 \u0000 The median (IQR) age of patients was 40.0 years (34.5–47.0). All of the patients had nonobstructive azoospermia, and the majority of them (93.8%) had primary infertility. The most common histopathological findings were atrophic tubules (57.1%), followed by Sertoli cell-only (28.6%). Sperm retrieval was positive for two patients with a rate of 12.5% (95% confidence interval 2.2 to 39.6). Patients with positive sperm retrieval were significantly younger than their peers with negative retrieval (median = 28.0, IQR = 27.5 to 28.5 vs. median = 41.5, IQR = 35.8 to 47.0, P = 0.031). The successful conception rate was 100% (n = 2) using intracytoplasmic sperm injection with a birth rate of 100% (n = 2).\u0000 \u0000 \u0000 \u0000 Our observed SRR among nonmosaic KF patients was marginally lower than the reported literature. Younger-age patients were significantly more likely to benefit from the procedure.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697170","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}
Salah Bakry, Anmar Nassir, S. Bakry, Bassam Saati, Mohammed Bandar Alotaibi, Mohanned Alomairi
Overactive bladder (OAB) syndromes are a vital global issue linked to sleep disturbances and insomnia. This survey explores the relationship between these health burden issues and their risk factors. A survey-based study was conducted among Makkah city citizens’ in April 2023. A standardized tool of OAB symptom score and Insomnia Severity Index was used to screen participants. The collected data were statistically analyzed using SPSS. Overall, 529 participants were enrolled in this survey with mean = 37.3 and standard deviation = 13.7. Most participants had mild OAB 74.67%, while insomnia represents no clinically significant subtype among the majority 55.39%. About 25.33% of participants had clinical OAB (moderate and severe), while approximately 44.61% had insomnia. Similarly, participants with the mild subtype of OAB show a significant correlation with no clinically significant subtype of insomnia (P ˃ 0.001). Furthermore, participants with moderate OAB were statistically associated with subthreshold insomnia (P ˃ 0.001). Medical attention and public awareness are mandatory for the early detection of OAB and insomnia.
{"title":"Screening of overactive bladder syndrome and its relation with insomnia: A public health experience","authors":"Salah Bakry, Anmar Nassir, S. Bakry, Bassam Saati, Mohammed Bandar Alotaibi, Mohanned Alomairi","doi":"10.4103/ua.ua_71_23","DOIUrl":"https://doi.org/10.4103/ua.ua_71_23","url":null,"abstract":"\u0000 \u0000 Overactive bladder (OAB) syndromes are a vital global issue linked to sleep disturbances and insomnia. This survey explores the relationship between these health burden issues and their risk factors.\u0000 \u0000 \u0000 \u0000 A survey-based study was conducted among Makkah city citizens’ in April 2023. A standardized tool of OAB symptom score and Insomnia Severity Index was used to screen participants. The collected data were statistically analyzed using SPSS.\u0000 \u0000 \u0000 \u0000 Overall, 529 participants were enrolled in this survey with mean = 37.3 and standard deviation = 13.7. Most participants had mild OAB 74.67%, while insomnia represents no clinically significant subtype among the majority 55.39%. About 25.33% of participants had clinical OAB (moderate and severe), while approximately 44.61% had insomnia. Similarly, participants with the mild subtype of OAB show a significant correlation with no clinically significant subtype of insomnia (P ˃ 0.001). Furthermore, participants with moderate OAB were statistically associated with subthreshold insomnia (P ˃ 0.001).\u0000 \u0000 \u0000 \u0000 Medical attention and public awareness are mandatory for the early detection of OAB and insomnia.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702274","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}
Hunter Hasley, T. Iarajuli, Jennifer Nguyen, Daniel Thiemann, Martin Malik, Jacquelyn Roth, Michael Raver, Michael Stifelman, R. Munver, Mutahar Ahmed, Nitin Yerram
In estimated glomerular filtration rate equations (eGFR), the race multiplier (RM) yields greater eGFR values and may assign less severe chronic kidney disease (CKD) stages to black individuals. When deciding on appropriateness for partial nephrectomy (PN), patients with CKD are often considered a relative or absolute indication. We hypothesize that the eGFR RM may have ramifications for patients being counseled for radical nephrectomy (RN) versus PN to manage their renal tumor. We utilized prospective and retrospective, IRB-approved single-center databases to select patients who underwent PN or RN between 2016 and 2022. Demographics, preoperative risk factors, preoperative eGFR, and surgical management were collected. Descriptive statistics and two-tailed difference of proportion tests compared the percentage of patients with CKD who underwent nephrectomy. This cohort included 1137 patients who underwent RN or PN, including 74 (6.5%) Black patients and 93.5% (n = 1063) non-Black patients. There was no statistically significant difference between the eGFR of Black and non-Black individuals using the Modification of Diet in Renal Disease equation (P = 0.24) or Chronic Kidney Disease Epidemiology Collaboration 2009 (CKD-EPI 2009) (P = 0.45); however, there was statistically significant difference in eGFR between sample populations when using CKD-EPI 2021 (P = 0.0055). Of the Black patient cohort, 16.2% of patients reclassified to a worse CKD class using CKD-EPI 2021, including 9.5% of Black patients reclassified to CKD3a or worse, and 14.6% of all patients (Black and non-Black) reclassified to a different CKD class under the CKD-EPI 2021 equation. There are quantitative differences in the evaluation of eGFR when utilizing different equations that may impact clinical considerations and health equity outcomes for nephrectomy across racial groups.
{"title":"Race-modified estimated glomerular filtration rate underestimates chronic kidney disease prevalence in Black patients undergoing partial and radical nephrectomy: Implications for surgical planning","authors":"Hunter Hasley, T. Iarajuli, Jennifer Nguyen, Daniel Thiemann, Martin Malik, Jacquelyn Roth, Michael Raver, Michael Stifelman, R. Munver, Mutahar Ahmed, Nitin Yerram","doi":"10.4103/ua.ua_7_24","DOIUrl":"https://doi.org/10.4103/ua.ua_7_24","url":null,"abstract":"\u0000 \u0000 In estimated glomerular filtration rate equations (eGFR), the race multiplier (RM) yields greater eGFR values and may assign less severe chronic kidney disease (CKD) stages to black individuals. When deciding on appropriateness for partial nephrectomy (PN), patients with CKD are often considered a relative or absolute indication. We hypothesize that the eGFR RM may have ramifications for patients being counseled for radical nephrectomy (RN) versus PN to manage their renal tumor.\u0000 \u0000 \u0000 \u0000 We utilized prospective and retrospective, IRB-approved single-center databases to select patients who underwent PN or RN between 2016 and 2022. Demographics, preoperative risk factors, preoperative eGFR, and surgical management were collected. Descriptive statistics and two-tailed difference of proportion tests compared the percentage of patients with CKD who underwent nephrectomy.\u0000 \u0000 \u0000 \u0000 This cohort included 1137 patients who underwent RN or PN, including 74 (6.5%) Black patients and 93.5% (n = 1063) non-Black patients. There was no statistically significant difference between the eGFR of Black and non-Black individuals using the Modification of Diet in Renal Disease equation (P = 0.24) or Chronic Kidney Disease Epidemiology Collaboration 2009 (CKD-EPI 2009) (P = 0.45); however, there was statistically significant difference in eGFR between sample populations when using CKD-EPI 2021 (P = 0.0055). Of the Black patient cohort, 16.2% of patients reclassified to a worse CKD class using CKD-EPI 2021, including 9.5% of Black patients reclassified to CKD3a or worse, and 14.6% of all patients (Black and non-Black) reclassified to a different CKD class under the CKD-EPI 2021 equation.\u0000 \u0000 \u0000 \u0000 There are quantitative differences in the evaluation of eGFR when utilizing different equations that may impact clinical considerations and health equity outcomes for nephrectomy across racial groups.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696649","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 objectives of this study were to detect whether the use of alpha-blockers in posterior urethral valve (PUV) pediatric patients after valve ablation will improve the persistent obstructive symptoms despite the absence of obstruction and if there are associated side effects of its use. Methods: A prospective, single-blinded randomized study was conducted at the urology department of two hospitals on 50 male children between September 2019 and June 2021 with PUV. All children were treated by endoscopic ablation of PUV using the cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent second-look cystoscopy 1 month after primary valve ablation to see residual valves as a routine procedure confirming no remnant of the valve and still complaining of obstructive symptoms. They were divided into two equal groups 25 patients each. Group A was given alpha-blockers and Group B placebo for 1 month. Marked improvement of obstructive symptoms in Group A reaching about 90% (21 patients), whereas no mentioned improvement in Group B was noticed with no side effects of both medication the alpha-blocker and the placebo during its use. The use of alpha-blockers improves the obstructive symptoms in pediatric patients with PUV after valve ablation and in the absence of any further urethral obstruction with no side effects noticed during the period of its use.
{"title":"The effect of use of alpha-blockers in posterior urethral valve pediatric patients postvalve ablation in the absence of further outlet obstruction","authors":"W. Aboulela, M. Eladawy, Ahmed Abdel Latif","doi":"10.4103/ua.ua_105_23","DOIUrl":"https://doi.org/10.4103/ua.ua_105_23","url":null,"abstract":"\u0000 \u0000 The objectives of this study were to detect whether the use of alpha-blockers in posterior urethral valve (PUV) pediatric patients after valve ablation will improve the persistent obstructive symptoms despite the absence of obstruction and if there are associated side effects of its use.\u0000 \u0000 \u0000 \u0000 \u0000 Methods: A prospective, single-blinded randomized study was conducted at the urology department of two hospitals on 50 male children between September 2019 and June 2021 with PUV. All children were treated by endoscopic ablation of PUV using the cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent second-look cystoscopy 1 month after primary valve ablation to see residual valves as a routine procedure confirming no remnant of the valve and still complaining of obstructive symptoms. They were divided into two equal groups 25 patients each. Group A was given alpha-blockers and Group B placebo for 1 month.\u0000 \u0000 \u0000 \u0000 Marked improvement of obstructive symptoms in Group A reaching about 90% (21 patients), whereas no mentioned improvement in Group B was noticed with no side effects of both medication the alpha-blocker and the placebo during its use.\u0000 \u0000 \u0000 \u0000 The use of alpha-blockers improves the obstructive symptoms in pediatric patients with PUV after valve ablation and in the absence of any further urethral obstruction with no side effects noticed during the period of its use.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711835","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}
Ashraf M Abd Elal, H. Shaher, Ehab El-Barky, Saad Ali, R. Omar
The objective is to compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and ultrasound-guided (US-guided) shock wave lithotripsy (SWL) for the treatment of radiolucent lower pole calculi of 1–2 cm. This prospective randomized study was performed at our tertiary care urology institute of Benha University Hospitals; cases were randomized either to undergo RIRS (Group A) or US-guided SWL with a triple focus system (Group B). The safety and effectiveness of both therapies were compared using new criteria for stone-free rate (SFR): Grade A (absolutely stone free), Grade B (≤2 mm fragments), and Grade C (>2 mm up to 4 mm fragments), fluoroscopy time, operative time, auxiliary procedures, retreatment, and complications. Out of 100 patients, 92 were eligible for this study. RIRS had a higher SFR of 88.9% compared to SWL, 72.3% (P = 0.045). Furthermore, stone-free classification significantly differed between the studied groups (P < 0.001), with Grade A being significantly higher in Group A. Conversely, Grades B and C were lower in Group A. On the other hand, operative and fluoroscopy times were significantly reduced with SWL (P = 0.004 and < 0.001, respectively). While complications did not significantly differ between the two groups (P = 0.340), a significant distinction was observed in terms of the Clavien–Dindo classification. RIRS is an effective and safe option for treating radiolucent lower calyceal stones of ≤2 cm, with a greater SFR and lower need for auxiliary operations. However, Sono SWL is a cost-effective alternative that can achieve a comparable success rate after retreatment sessions.
目的是比较逆行肾内手术（RIRS）和超声引导下冲击波碎石术（SWL）治疗 1-2 厘米放射性下极结石的安全性和有效性。 这项前瞻性随机研究在本哈大学医院的三级泌尿科研究所进行；病例被随机分配为接受 RIRS（A 组）或使用三焦点系统的 US 导引震波碎石（SWL）（B 组）。采用新的无结石率（SFR）标准对两种疗法的安全性和有效性进行了比较：标准包括：A 级（完全无结石）、B 级（碎石≤2 毫米）和 C 级（碎石＞2 毫米至 4 毫米）、透视时间、手术时间、辅助手术、再治疗和并发症。 在 100 例患者中，有 92 例符合研究条件。RIRS 的 SFR 为 88.9%，高于 SWL 的 72.3%（P = 0.045）。此外，研究组之间的无结石分级有明显差异（P < 0.001），A 组的 A 级明显更高，相反，A 组的 B 级和 C 级较低。虽然两组患者的并发症没有明显差异（P = 0.340），但在 Clavien-Dindo 分级方面却有显著差异。 RIRS 是治疗≤2 厘米的放射性下腔肾盏结石的一种有效而安全的方法，具有更高的 SFR 和更低的辅助手术需求。不过，声纳下腔静脉置入术是一种具有成本效益的替代方法，可在再治疗后达到相当的成功率。
{"title":"Comparative study between retrograde intrarenal surgery and ultrasound- guided shock wave lithotripsy for treatment of 1 to 2 cm radiolucent lower calyceal stones","authors":"Ashraf M Abd Elal, H. Shaher, Ehab El-Barky, Saad Ali, R. Omar","doi":"10.4103/ua.ua_5_24","DOIUrl":"https://doi.org/10.4103/ua.ua_5_24","url":null,"abstract":"\u0000 \u0000 \u0000 The objective is to compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and ultrasound-guided (US-guided) shock wave lithotripsy (SWL) for the treatment of radiolucent lower pole calculi of 1–2 cm.\u0000 \u0000 \u0000 \u0000 This prospective randomized study was performed at our tertiary care urology institute of Benha University Hospitals; cases were randomized either to undergo RIRS (Group A) or US-guided SWL with a triple focus system (Group B). The safety and effectiveness of both therapies were compared using new criteria for stone-free rate (SFR): Grade A (absolutely stone free), Grade B (≤2 mm fragments), and Grade C (>2 mm up to 4 mm fragments), fluoroscopy time, operative time, auxiliary procedures, retreatment, and complications.\u0000 \u0000 \u0000 \u0000 Out of 100 patients, 92 were eligible for this study. RIRS had a higher SFR of 88.9% compared to SWL, 72.3% (P = 0.045). Furthermore, stone-free classification significantly differed between the studied groups (P < 0.001), with Grade A being significantly higher in Group A. Conversely, Grades B and C were lower in Group A. On the other hand, operative and fluoroscopy times were significantly reduced with SWL (P = 0.004 and < 0.001, respectively). While complications did not significantly differ between the two groups (P = 0.340), a significant distinction was observed in terms of the Clavien–Dindo classification.\u0000 \u0000 \u0000 \u0000 RIRS is an effective and safe option for treating radiolucent lower calyceal stones of ≤2 cm, with a greater SFR and lower need for auxiliary operations. However, Sono SWL is a cost-effective alternative that can achieve a comparable success rate after retreatment sessions.\u0000","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361429","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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