Pub Date : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0129
F. Gökalp, Ömer Koraş, S. Polat, M. Şahan, A. Eker, D. Baba, I. Bozkurt
Urine culture was recommended before any type of stone surgeries. The urine culture generally collected from bladder and infectious complications could occurs even the bladder urine culture was negative. The studies suggested that bladder urine culture do not correlate with pelvic urine culture and pelvic urine culture were better predictors for infectious complications and sepsis. However, the pelvic urine culture could not collect routinely. Our study demonstrated that preoperative bladder urine culture may not shows pelvic urine culture colonization and in patients with preoperative hydronephrosis and low tomographic pelvic urine density prone to positive pelvic urine culture. Our study suggest that preoperative patients who pelvic density. Abstract Objective: There is no correlation between the preoperative bladder urine culture (PBUC) sensitivity test and the results of the renal pelvic urine culture (RPUC) test. Materials and Methods: A total of 129 patients who underwent f-URS included the study. Preoperatively, PBUC was collected in all cases, and RPUC was taken when starting the surgery. Results: In PBUC, there was growth in 25 (19.4%) patients and in RPUC, there were only in 35 (27.1%) cases. Preoperative tomographic urine density at the renal pelvis [odds ratio (OR): 0.848, p<0.001], grade ≥2 hydronephrosis (OR: 18.970, p=0.001), and lower calyceal stone location (OR: 0.033, p=0.017) were determined as independent predictive factors for RPUC growth. The ability of tomographic urine density to foresee positive RPUC positivity was determined to be 0.858 (0.780-0.936). The tomographic urine density threshold for RPUC positivity prediction was 4.5, with 80% sensitivity and 77.7% specificity. Conclusion: PBUCs do not necessarily mean accurate colonization. urine for managing postoperative infectious complications. Patients that have preoperative hydronephrosis and nominal tomographic urine density could develop RPUC even if the preoperative bladder urine samples are negative.
{"title":"Comparison of Preoperative Urine Culture and Intraoperative Renal Pelvis Culture in Patients Who Underwent Flexible Ureterorenoscopy","authors":"F. Gökalp, Ömer Koraş, S. Polat, M. Şahan, A. Eker, D. Baba, I. Bozkurt","doi":"10.4274/jus.galenos.2022.2021.0129","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0129","url":null,"abstract":"Urine culture was recommended before any type of stone surgeries. The urine culture generally collected from bladder and infectious complications could occurs even the bladder urine culture was negative. The studies suggested that bladder urine culture do not correlate with pelvic urine culture and pelvic urine culture were better predictors for infectious complications and sepsis. However, the pelvic urine culture could not collect routinely. Our study demonstrated that preoperative bladder urine culture may not shows pelvic urine culture colonization and in patients with preoperative hydronephrosis and low tomographic pelvic urine density prone to positive pelvic urine culture. Our study suggest that preoperative patients who pelvic density. Abstract Objective: There is no correlation between the preoperative bladder urine culture (PBUC) sensitivity test and the results of the renal pelvic urine culture (RPUC) test. Materials and Methods: A total of 129 patients who underwent f-URS included the study. Preoperatively, PBUC was collected in all cases, and RPUC was taken when starting the surgery. Results: In PBUC, there was growth in 25 (19.4%) patients and in RPUC, there were only in 35 (27.1%) cases. Preoperative tomographic urine density at the renal pelvis [odds ratio (OR): 0.848, p<0.001], grade ≥2 hydronephrosis (OR: 18.970, p=0.001), and lower calyceal stone location (OR: 0.033, p=0.017) were determined as independent predictive factors for RPUC growth. The ability of tomographic urine density to foresee positive RPUC positivity was determined to be 0.858 (0.780-0.936). The tomographic urine density threshold for RPUC positivity prediction was 4.5, with 80% sensitivity and 77.7% specificity. Conclusion: PBUCs do not necessarily mean accurate colonization. urine for managing postoperative infectious complications. Patients that have preoperative hydronephrosis and nominal tomographic urine density could develop RPUC even if the preoperative bladder urine samples are negative.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46026517","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0116
L. Anzai, D. Daar, J. Frey, L. Zhao, J. Levine
Cite this article as: Anzai LM, Daar DA, Frey JD, Zhao LC, Levine JP. Free Ileal Flap: An Alternative Approach to Urethral Reconstruction. J Urol Surg, 2022;9(3):212-214. Correspondence: Jamie P. Levine MD, Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, USA E-mail: jamie.levine@nyulangone.org ORCID-ID: orcid.org/0000-0002-6048-8242 Received: 21.11.2021 Accepted: 27.02.2022 Introduction
{"title":"Free Ileal Flap: An Alternative Approach to Urethral Reconstruction","authors":"L. Anzai, D. Daar, J. Frey, L. Zhao, J. Levine","doi":"10.4274/jus.galenos.2022.2021.0116","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0116","url":null,"abstract":"Cite this article as: Anzai LM, Daar DA, Frey JD, Zhao LC, Levine JP. Free Ileal Flap: An Alternative Approach to Urethral Reconstruction. J Urol Surg, 2022;9(3):212-214. Correspondence: Jamie P. Levine MD, Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, USA E-mail: jamie.levine@nyulangone.org ORCID-ID: orcid.org/0000-0002-6048-8242 Received: 21.11.2021 Accepted: 27.02.2022 Introduction","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49284001","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0137
Amy Kuprasertkul, Alexander T. Rozanski, A. Christie, P. Zimmern
Objective: To report the outcomes of the anterior vaginal wall suspension (AVWS) procedure for stress urinary incontinence (SUI). Materials and Methods: Following institutional review board approval, a long-term pelvic organ prolapse database of non-neurogenic patients who underwent AVWS for bothersome SUI and ≤ stage 2 anterior vaginal compartment laxity was reviewed. Any patient with prior SUI surgery or < a 6-month follow-up were excluded. Preoperative evaluation included detailed history, validated questionnaires [Urogenital Distress Inventory-Short form, visual analog quality of life score (QoL)], physical examination, and standing lateral voiding cystourethrogram (VCUG). Follow-up included VCUG at 6-12 months postoperatively, yearly examinations, and questionnaires. Failure was measured by a Kaplan-Meier curve using time to reoperation for SUI. Results: Between 1996 and 2016, 171 patients met the study criteria. The median follow-up was 4.2 years, with 26 (15%) patients having over a 10-year follow-up. Median (interquartile range): age 64 (53-70), body mass index 26 (22-30), and parity 2 (2-3). Ninety-one (53%) patients underwent AVWS with a concomitant procedure, hysterectomy being the most common. Aa and Ba points, questionnaire results, and QoL improved post-operatively and remained improved over time. VCUG findings also improved for urethral support and bladder base reduction. SUI reoperation occurred in 9 (5%) patients, including: fascial sling placement (3) or injectable agents (6). Conclusion: The AVWS procedure can correct SUI secondary to urethral hypermobility by restoration of the vaginal anatomic support to the bladder neck and bladder base.
{"title":"The Anterior Vaginal Wall Suspension Procedure: Mid-Term Follow-Up of a Native Tissue Vaginal Repair for Stress Urinary Incontinence","authors":"Amy Kuprasertkul, Alexander T. Rozanski, A. Christie, P. Zimmern","doi":"10.4274/jus.galenos.2022.2021.0137","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0137","url":null,"abstract":"Objective: To report the outcomes of the anterior vaginal wall suspension (AVWS) procedure for stress urinary incontinence (SUI). Materials and Methods: Following institutional review board approval, a long-term pelvic organ prolapse database of non-neurogenic patients who underwent AVWS for bothersome SUI and ≤ stage 2 anterior vaginal compartment laxity was reviewed. Any patient with prior SUI surgery or < a 6-month follow-up were excluded. Preoperative evaluation included detailed history, validated questionnaires [Urogenital Distress Inventory-Short form, visual analog quality of life score (QoL)], physical examination, and standing lateral voiding cystourethrogram (VCUG). Follow-up included VCUG at 6-12 months postoperatively, yearly examinations, and questionnaires. Failure was measured by a Kaplan-Meier curve using time to reoperation for SUI. Results: Between 1996 and 2016, 171 patients met the study criteria. The median follow-up was 4.2 years, with 26 (15%) patients having over a 10-year follow-up. Median (interquartile range): age 64 (53-70), body mass index 26 (22-30), and parity 2 (2-3). Ninety-one (53%) patients underwent AVWS with a concomitant procedure, hysterectomy being the most common. Aa and Ba points, questionnaire results, and QoL improved post-operatively and remained improved over time. VCUG findings also improved for urethral support and bladder base reduction. SUI reoperation occurred in 9 (5%) patients, including: fascial sling placement (3) or injectable agents (6). Conclusion: The AVWS procedure can correct SUI secondary to urethral hypermobility by restoration of the vaginal anatomic support to the bladder neck and bladder base.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41660355","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 : 2022-09-14DOI: 10.4274/jus.galenos.2021.2021.0104
R. Mondschein, Caitlin Ying Ming Louey, A. Ng, P. McCahy
There is some laboratory-based evidence that high-powered laser systems destroy stones more effectively than low-power laser systems. However, whether this translates clinically is unknown, as direct clinical comparisons are absent from the literature. This study provides a direct comparison of the two laser systems. Abstract Objective: Holmium lasers are an effective endoscopic treatment for renal stones. Although laboratory studies have demonstrated reduced destruction times for high-power lasers, clinical evidence is lacking. Operative times for ureterorenoscopy (URS) were investigated by comparing high- and low power lasers in a general hospital setting. Materials and Methods: An audited review was conducted of 354 patients who underwent URS over a two-year period at two hospital sites using high- or low power laser. Operative time, stone characteristics, disposable equipment, s use of dusting, complications and stone-free rates were recorded. Linear regression was used to model the relationship between laser type and theater time. Univariate analysis was performed to determine other factors associated with increased operative time. Results: Mean operative time was 61.9 minutes. No significant difference between sites [0.40, p=0.88, confidence interval (CI) -4.9-5.8] was found, including following the exclusion of large stones (>20 mm). Stone size categories analyzed separately showed reduced operative times for larger stones when using high-power laser. Basket use (8.4, p=0.002, CI 3.06-13.65) and increasing stone size (6.9, p<0.005, CI 3.4-10.4) were associated with increased operative time. Complications and stone-free rates did not vary between sites. Conclusion: High-power laser was not associated with reduced total operative time in this cohort, although there was a trend toward this for larger renal calculi. Further delineation by surgeon expertise would be useful to determine whether high power laser is generally advantageous in the clinical setting. In training hospitals, any differences may be obscured by other factors.
有一些基于实验室的证据表明，高功率激光系统比低功率激光系统更有效地破坏石头。然而，由于文献中没有直接的临床比较，这是否在临床上转化是未知的。本研究提供了两种激光系统的直接比较。摘要目的:钬激光是一种有效的内镜治疗肾结石的方法。虽然实验室研究已经证明高功率激光可以缩短破坏时间，但缺乏临床证据。通过比较在一般医院设置的高功率和低功率激光输尿管镜(URS)的手术时间。材料和方法:对354例在两家医院使用高功率或低功率激光接受URS治疗的患者进行了为期两年的审计审查。记录手术时间、结石特征、一次性器械的使用、并发症及结石清除率。采用线性回归方法对激光类型与作战时间之间的关系进行建模。进行单因素分析以确定与手术时间增加相关的其他因素。结果:平均手术时间61.9分钟。包括排除大结石(> ~ 20mm)后，各部位间无显著差异[0.40,p=0.88，置信区间(CI) -4.9 ~ 5.8]。单独分析的石头大小类别表明，使用高功率激光时，较大的石头减少了手术时间。使用手术篮(8.4,p=0.002, CI 3.06-13.65)和增大结石大小(6.9,p<0.005, CI 3.4-10.4)与延长手术时间相关。不同部位的并发症和无结石率没有差异。结论:在这个队列中，高功率激光与总手术时间的减少无关，尽管对于较大的肾结石有这种趋势。外科医生专业知识的进一步描述将有助于确定高功率激光在临床环境中是否普遍有利。在培训医院，任何差异都可能被其他因素所掩盖。
{"title":"Do High-Power Lasers Reduce Operative Time for Ureterorenoscopy? A Comparison of Holmium Lasers in An Australian Tertiary Centre","authors":"R. Mondschein, Caitlin Ying Ming Louey, A. Ng, P. McCahy","doi":"10.4274/jus.galenos.2021.2021.0104","DOIUrl":"https://doi.org/10.4274/jus.galenos.2021.2021.0104","url":null,"abstract":"There is some laboratory-based evidence that high-powered laser systems destroy stones more effectively than low-power laser systems. However, whether this translates clinically is unknown, as direct clinical comparisons are absent from the literature. This study provides a direct comparison of the two laser systems. Abstract Objective: Holmium lasers are an effective endoscopic treatment for renal stones. Although laboratory studies have demonstrated reduced destruction times for high-power lasers, clinical evidence is lacking. Operative times for ureterorenoscopy (URS) were investigated by comparing high- and low power lasers in a general hospital setting. Materials and Methods: An audited review was conducted of 354 patients who underwent URS over a two-year period at two hospital sites using high- or low power laser. Operative time, stone characteristics, disposable equipment, s use of dusting, complications and stone-free rates were recorded. Linear regression was used to model the relationship between laser type and theater time. Univariate analysis was performed to determine other factors associated with increased operative time. Results: Mean operative time was 61.9 minutes. No significant difference between sites [0.40, p=0.88, confidence interval (CI) -4.9-5.8] was found, including following the exclusion of large stones (>20 mm). Stone size categories analyzed separately showed reduced operative times for larger stones when using high-power laser. Basket use (8.4, p=0.002, CI 3.06-13.65) and increasing stone size (6.9, p<0.005, CI 3.4-10.4) were associated with increased operative time. Complications and stone-free rates did not vary between sites. Conclusion: High-power laser was not associated with reduced total operative time in this cohort, although there was a trend toward this for larger renal calculi. Further delineation by surgeon expertise would be useful to determine whether high power laser is generally advantageous in the clinical setting. In training hospitals, any differences may be obscured by other factors.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43214746","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0135
M. Değer, N. Akdoğan, M. Demirkol, Sümeyye Seday, Sevinç Püren Yüce, V. Izol, I. Aridogan
Objective: To investigate the effect of coronavirus disease-2019 (COVID-19) phobia in patients with ureteral stones. Materials and Methods: Between August 2020 and March 2021, patients over the age of 18 who were diagnosed with ureteral stones were included in this study. The COVID-19 Phobia scale (C19P-S) was used to measure the COVID-19 phobia levels of the patients. Demographic and patients' characteristics were recorded. The time between the onset of the patient's complaint and the time of admission to the hospital was recorded and grouped as group 1 (≤7 days), group 2 (7-21 days), group 3 (>21 days). Results: A total of 77 patients with a mean age of 45.8±14.8 years were eligible for analysis. Among these, 55 (71.4%) were male. According to the time between the onset of the patient's complaint and the time of admission to the hospital, there were 39 (50.6%) patients in group 1 (≤7 days), 17 (22.1%) patients in group 2 (7-21 days) and 21 (27.3%) patients group 3 (>21 days). The median C19P-S scores in these groups were 32.0 (15.0- 46.0), 37.0 (26.0-62.0) and 56.0 (37.0-80.0), respectively. There were significant differences in terms of C19P-S between groups of the time between the onset of the patient's complaint and the time of admission to the hospital (p≤0.001). Conclusion: COVID-19 phobia caused a delay in the hospital admission of patients with ureter stones. When patients have complaints, it is necessary to raise the awareness of society about applying to the hospital and to increase awareness of this issue.
{"title":"The Effect of COVID-19 Phobia on the Time of Admission to the Hospital in Patients with Ureteral Stones","authors":"M. Değer, N. Akdoğan, M. Demirkol, Sümeyye Seday, Sevinç Püren Yüce, V. Izol, I. Aridogan","doi":"10.4274/jus.galenos.2022.2021.0135","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0135","url":null,"abstract":"Objective: To investigate the effect of coronavirus disease-2019 (COVID-19) phobia in patients with ureteral stones. Materials and Methods: Between August 2020 and March 2021, patients over the age of 18 who were diagnosed with ureteral stones were included in this study. The COVID-19 Phobia scale (C19P-S) was used to measure the COVID-19 phobia levels of the patients. Demographic and patients' characteristics were recorded. The time between the onset of the patient's complaint and the time of admission to the hospital was recorded and grouped as group 1 (≤7 days), group 2 (7-21 days), group 3 (>21 days). Results: A total of 77 patients with a mean age of 45.8±14.8 years were eligible for analysis. Among these, 55 (71.4%) were male. According to the time between the onset of the patient's complaint and the time of admission to the hospital, there were 39 (50.6%) patients in group 1 (≤7 days), 17 (22.1%) patients in group 2 (7-21 days) and 21 (27.3%) patients group 3 (>21 days). The median C19P-S scores in these groups were 32.0 (15.0- 46.0), 37.0 (26.0-62.0) and 56.0 (37.0-80.0), respectively. There were significant differences in terms of C19P-S between groups of the time between the onset of the patient's complaint and the time of admission to the hospital (p≤0.001). Conclusion: COVID-19 phobia caused a delay in the hospital admission of patients with ureter stones. When patients have complaints, it is necessary to raise the awareness of society about applying to the hospital and to increase awareness of this issue.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42057529","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 : 2022-09-14DOI: 10.4274/jus.galenos.2021.2021.0085
J. Saad, R. Shanmugasundaram, Sean Heywood, C. Varol, M. Roberts
Testicular torsion (TT) is a urological emergency, which requires a time-sensitive approach to diagnosis and management. TT predominantly presents with severe, sudden onset, unilateral testicular pain in men under the age of 21. It is a clinical diagnosis with assistance from a scrotal ultrasound or confirmation via scrotal exploration. Here we present an interesting case of a 67-year-old man with TT. This case demonstrates that medical professionals should have a high degree of clinical suspicion for men of all ages with unilateral scrotal pain.
{"title":"Testicular Torsion: Not Just in Young Men","authors":"J. Saad, R. Shanmugasundaram, Sean Heywood, C. Varol, M. Roberts","doi":"10.4274/jus.galenos.2021.2021.0085","DOIUrl":"https://doi.org/10.4274/jus.galenos.2021.2021.0085","url":null,"abstract":"Testicular torsion (TT) is a urological emergency, which requires a time-sensitive approach to diagnosis and management. TT predominantly presents with severe, sudden onset, unilateral testicular pain in men under the age of 21. It is a clinical diagnosis with assistance from a scrotal ultrasound or confirmation via scrotal exploration. Here we present an interesting case of a 67-year-old man with TT. This case demonstrates that medical professionals should have a high degree of clinical suspicion for men of all ages with unilateral scrotal pain.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42005560","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0087
S. Tekgül, B. Çıtamak, H. Doğan, T. Ceylan
Objective: To define and discuss the new concept which using loop cutaneous ureterostomy (LCU) in patients with obstructing megaureter and solitary kidney. Materials and Methods: Two patients with solitary kidney with obstructive pattern were included. Both patients underwent LCU within the 1 st month to reduce the obstruction and to relieve the pelvicaliceal system. Thereafter, parents were taught to dilate the ureter and irrigate the bladder with sterile saline by a disposable 6F catheter via antegrade fashion through the distal ureter. Initially, 10 cc saline was used once a day, then it was increased to 20 cc once a day after 2 months. When the bladder capacity was sufficient (50 mL capacity at the 6 th month or by cystoscopic evaluation intraoperatively), we performed undiversion with ureteroneocystostomy and Double-J-stent placement. Results: Ureterorenal dilatations were followed-up by ultrasonography and renal function tests. No bladder dysfunction and renal insufficiency were observed during follow-up. At the postoperative controls, patients’ renal function tests were compatible with their ages and they had no voiding dysfunction. Conclusion: Patients with solitary kidney and obstructing megaureter require urgent diversion. After diversion, bladder cycling is required to prevent bladder dysfunction by protecting and developing bladder capacity. Using this concept, the kidney can be protected from further damage and treatment can be finalized around 6 months of age with minimum morbidity.
{"title":"A Rational Solution for Megaureter in Infants with Solitary Kidney: Temporary Loop Cutaneous Ureterostomy","authors":"S. Tekgül, B. Çıtamak, H. Doğan, T. Ceylan","doi":"10.4274/jus.galenos.2022.2021.0087","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0087","url":null,"abstract":"Objective: To define and discuss the new concept which using loop cutaneous ureterostomy (LCU) in patients with obstructing megaureter and solitary kidney. Materials and Methods: Two patients with solitary kidney with obstructive pattern were included. Both patients underwent LCU within the 1 st month to reduce the obstruction and to relieve the pelvicaliceal system. Thereafter, parents were taught to dilate the ureter and irrigate the bladder with sterile saline by a disposable 6F catheter via antegrade fashion through the distal ureter. Initially, 10 cc saline was used once a day, then it was increased to 20 cc once a day after 2 months. When the bladder capacity was sufficient (50 mL capacity at the 6 th month or by cystoscopic evaluation intraoperatively), we performed undiversion with ureteroneocystostomy and Double-J-stent placement. Results: Ureterorenal dilatations were followed-up by ultrasonography and renal function tests. No bladder dysfunction and renal insufficiency were observed during follow-up. At the postoperative controls, patients’ renal function tests were compatible with their ages and they had no voiding dysfunction. Conclusion: Patients with solitary kidney and obstructing megaureter require urgent diversion. After diversion, bladder cycling is required to prevent bladder dysfunction by protecting and developing bladder capacity. Using this concept, the kidney can be protected from further damage and treatment can be finalized around 6 months of age with minimum morbidity.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46631614","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0094
Wyatt MacNevin, R. Rendon, B. Colwell, Cheng Wang, K. D. Haché, J. Merrimen, R. Mason
Primary renal synovial sarcoma is a rare malignancy that may present similarly to other renal neoplasms. The diagnosis of synovial sarcoma is performed through the identification of a SYT-SSX gene fusion. Here, we present a case of a primary renal synovial sarcoma in a patient who presented with renal mass initially thought to be renal cell carcinoma until further pathological characterization. After undergoing radical open nephrectomy, the patient developed pulmonary and psoas metastases and was treated with systemic therapy.
{"title":"Primary Renal Synovial Sarcoma","authors":"Wyatt MacNevin, R. Rendon, B. Colwell, Cheng Wang, K. D. Haché, J. Merrimen, R. Mason","doi":"10.4274/jus.galenos.2022.2021.0094","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0094","url":null,"abstract":"Primary renal synovial sarcoma is a rare malignancy that may present similarly to other renal neoplasms. The diagnosis of synovial sarcoma is performed through the identification of a SYT-SSX gene fusion. Here, we present a case of a primary renal synovial sarcoma in a patient who presented with renal mass initially thought to be renal cell carcinoma until further pathological characterization. After undergoing radical open nephrectomy, the patient developed pulmonary and psoas metastases and was treated with systemic therapy.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49496706","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 : 2022-09-14DOI: 10.4274/jus.galenos.2022.2021.0008
B. Storey, S. Nalavenkata, S. Whitcher, A. Blatt
It is known that emphysematous pyelonephritis is a severe and life threatening illness that does not have a clearly defined treatment algorithm. This paper shows the experience of treating this disease over 12 years and reinforces that there remains a role for both minimally invasive therapy as well as extensive surgical intervention, but further research into this condition is Abstract Objective: To examine outcomes and prognostic features of patients admitted with emphysematous pyelonephritis (EPN) at a regional tertiary centre. Materials and Methods: Nineteen patients with EPN were identified between January 2007 and December 2019. Patients were grouped into two “mild” (grade I or II); and “severe” (grade III or IV) based on their Huang and Tseng classification. The two groups were compared using Fisher’s Exact tests to determine prognostic features associated with poor outcome, defined as extensive surgical intervention or death. Results: Thirteen patients had mild disease and six patients had severe disease. 69% of patients had ureteric obstruction, 58% were diabetic, 26% were thrombocytopaenic, and there was a female predominance (12:7). Poor outcomes were significantly more common in patients with severe disease (83%), versus mild disease (8%) (p<0.0001). Half of the patients managed with sole medical management died (two of four patients) and only two patients required escalation to extensive surgical management, both of whom survived. Overall mortality during admission was 19%; encompassing three of six patients with severe disease (50%) and one of thirteen patients with mild disease (8%). Conclusion: EPN is dangerous, requiring prompt recognition and intervention, and is of increasing importance given the aging population and increased prevalence of comorbidities associated with the disease. This study of the largest recorded cohort of patients with EPN in Australia it was found that poor outcomes were significantly more common in patients with high radiological-grade disease, and severe thrombocytopaenia.
{"title":"Emphysematous Pyelonephritis: A Twelve-year Review in A Regional Centre","authors":"B. Storey, S. Nalavenkata, S. Whitcher, A. Blatt","doi":"10.4274/jus.galenos.2022.2021.0008","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2021.0008","url":null,"abstract":"It is known that emphysematous pyelonephritis is a severe and life threatening illness that does not have a clearly defined treatment algorithm. This paper shows the experience of treating this disease over 12 years and reinforces that there remains a role for both minimally invasive therapy as well as extensive surgical intervention, but further research into this condition is Abstract Objective: To examine outcomes and prognostic features of patients admitted with emphysematous pyelonephritis (EPN) at a regional tertiary centre. Materials and Methods: Nineteen patients with EPN were identified between January 2007 and December 2019. Patients were grouped into two “mild” (grade I or II); and “severe” (grade III or IV) based on their Huang and Tseng classification. The two groups were compared using Fisher’s Exact tests to determine prognostic features associated with poor outcome, defined as extensive surgical intervention or death. Results: Thirteen patients had mild disease and six patients had severe disease. 69% of patients had ureteric obstruction, 58% were diabetic, 26% were thrombocytopaenic, and there was a female predominance (12:7). Poor outcomes were significantly more common in patients with severe disease (83%), versus mild disease (8%) (p<0.0001). Half of the patients managed with sole medical management died (two of four patients) and only two patients required escalation to extensive surgical management, both of whom survived. Overall mortality during admission was 19%; encompassing three of six patients with severe disease (50%) and one of thirteen patients with mild disease (8%). Conclusion: EPN is dangerous, requiring prompt recognition and intervention, and is of increasing importance given the aging population and increased prevalence of comorbidities associated with the disease. This study of the largest recorded cohort of patients with EPN in Australia it was found that poor outcomes were significantly more common in patients with high radiological-grade disease, and severe thrombocytopaenia.","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44121149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-04DOI: 10.4274/jus.galenos.2022.2022.0011
Hilal Gören, Semih Öz, D. BURUKOĞLU DÖNMEZ, M. Üstüner, İhsan Hız, H. Özden, Ş. Kabay
{"title":"Protective Effects of Capsaicin on Experimental Testicular Torsion and Detorsion Injury","authors":"Hilal Gören, Semih Öz, D. BURUKOĞLU DÖNMEZ, M. Üstüner, İhsan Hız, H. Özden, Ş. Kabay","doi":"10.4274/jus.galenos.2022.2022.0011","DOIUrl":"https://doi.org/10.4274/jus.galenos.2022.2022.0011","url":null,"abstract":"","PeriodicalId":42050,"journal":{"name":"Journal of Urological Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48357852","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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