{"title":"Primary unifocal penile follicular center non-Hodgkin lymphoma: Report of a rare case and review of the literature","authors":"Nikolaos Kostakopoulos, Christos Masaoutis, Vasileios Argyropoulos, Varvara Pantelaion, Panagiotis Theodoropoulos, Panagiotis Kouroupakis, Athanasios Kostakopoulos","doi":"10.1016/j.ajur.2023.03.003","DOIUrl":"10.1016/j.ajur.2023.03.003","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 134-136"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000395/pdfft?md5=bf9ebdeb9f271e089ab6142b3f01b4fe&pid=1-s2.0-S2214388223000395-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44126864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.
Methods
In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.
Results
Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).
Conclusion
Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.
{"title":"Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19: A randomized placebo-controlled trial","authors":"Iman Shamohammadi , Seyedmohammad Kazemeyni , Mohammadali Sadighi , Tara Hasanzadeh , Alireza Dizavi","doi":"10.1016/j.ajur.2022.05.006","DOIUrl":"10.1016/j.ajur.2022.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.</p></div><div><h3>Methods</h3><p>In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.</p></div><div><h3>Results</h3><p>Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (<em>p</em><0.05).</p></div><div><h3>Conclusion</h3><p>Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 128-133"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40715457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2022.05.008
Michele Marchioni , Giulia Primiceri , Alessandro Veccia , Marta Di Nicola , Umberto Carbonara , Fabio Crocerossa , Ugo Falagario , Ambra Rizzoli , Riccardo Autorino , Luigi Schips
Objective
Prostate cancer (PCa) patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia (BPH). Some of them might be treated for their lower urinary tract symptoms instead of PCa. We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery, namely complication and mortality rates.
Methods
Within the American College of Surgeons National Surgical Quality Improvement Program database (2011–2016), we identified patients who underwent transurethral resection of the prostate, photoselective vaporization, or laser enucleation. Patients were stratified according to postoperative diagnosis (PCa vs. BPH). Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality. A formal test of interaction between diagnosis and surgical technique used was performed.
Results
Overall, 34 542 patients were included. Of all, 2008 (5.8%) had a diagnosis of PCa. The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients (odds ratio: 0.9, 95% confidence interval: 0.7–1.1; p=0.252). Moreover, similar rates of perioperative mortality (p=0.255), major acute cardiovascular events (p=0.581), transfusions (p=0.933), and length of stay of more than or equal to 30 days (p=0.174) were found. Additionally, all tests failed to show an interaction between post-operative diagnosis and surgical technique used.
Conclusion
Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts. Moreover, the diagnosis seems to not influence surgical technique outcomes.
{"title":"Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates","authors":"Michele Marchioni , Giulia Primiceri , Alessandro Veccia , Marta Di Nicola , Umberto Carbonara , Fabio Crocerossa , Ugo Falagario , Ambra Rizzoli , Riccardo Autorino , Luigi Schips","doi":"10.1016/j.ajur.2022.05.008","DOIUrl":"10.1016/j.ajur.2022.05.008","url":null,"abstract":"<div><h3>Objective</h3><p>Prostate cancer (PCa) patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia (BPH). Some of them might be treated for their lower urinary tract symptoms instead of PCa. We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery, namely complication and mortality rates.</p></div><div><h3>Methods</h3><p>Within the American College of Surgeons National Surgical Quality Improvement Program database (2011–2016), we identified patients who underwent transurethral resection of the prostate, photoselective vaporization, or laser enucleation. Patients were stratified according to postoperative diagnosis (PCa <em>vs.</em> BPH). Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality. A formal test of interaction between diagnosis and surgical technique used was performed.</p></div><div><h3>Results</h3><p>Overall, 34 542 patients were included. Of all, 2008 (5.8%) had a diagnosis of PCa. The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients (odds ratio: 0.9, 95% confidence interval: 0.7–1.1; <em>p</em>=0.252). Moreover, similar rates of perioperative mortality (<em>p</em>=0.255), major acute cardiovascular events (<em>p</em>=0.581), transfusions (<em>p</em>=0.933), and length of stay of more than or equal to 30 days (<em>p</em>=0.174) were found. Additionally, all tests failed to show an interaction between post-operative diagnosis and surgical technique used.</p></div><div><h3>Conclusion</h3><p>Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts. Moreover, the diagnosis seems to not influence surgical technique outcomes.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 48-54"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000947/pdfft?md5=1ea81e3623c2c8615b73f4b32c7c6711&pid=1-s2.0-S2214388222000947-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44673322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2022.02.003
U Phun Loo, Chun Hou Yong, Guan Chou Teh
Objective
This study aimed to identify predictive factors for percutaneous nephrolithotomy (PCNL) bleeding risks. With better risk stratification, bleeding in high-risk patient can be anticipated and facilitates early identification.
Methods
A prospective observational study of PCNL performed at our institution was done. All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy, planned for additional procedures. Factors including gender, co-morbidities, body mass index, stone burden, puncture site, tract dilatation size, operative position, surgeon's seniority, and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin (Hb) deficiency.
Results
Overall, 4.86% patients (n=7) received packed cells transfusion. The mean estimated Hb deficiency was 1.3 (range 0–6.5) g/dL and the median was 1.0 g/dL. Stepwise multivariate regression analysis revealed that absence of hypertension (p=0.024), puncture site (p=0.027), and operative duration (p=0.023) were significantly associated with higher estimated Hb deficiency. However, the effect sizes are rather small with partial eta-squared of 0.037, 0.066, and 0.038, respectively. Observed power obtained was 0.621, 0.722, and 0.625, respectively. Other factors studied did not correlate with Hb difference.
Conclusion
Hypertension, puncture site, and operative duration have significant impact on estimated Hb deficiency during PCNL. However, the effect size is rather small despite adequate study power obtained. Nonetheless, operative position (supine or prone), puncture number, or tract dilatation size did not correlate with Hb difference. The mainstay of reducing bleeding in PCNL is still meticulous operative technique. Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient, without increasing risk of bleeding.
{"title":"Predictive factors for percutaneous nephrolithotomy bleeding risks","authors":"U Phun Loo, Chun Hou Yong, Guan Chou Teh","doi":"10.1016/j.ajur.2022.02.003","DOIUrl":"10.1016/j.ajur.2022.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to identify predictive factors for percutaneous nephrolithotomy (PCNL) bleeding risks. With better risk stratification, bleeding in high-risk patient can be anticipated and facilitates early identification.</p></div><div><h3>Methods</h3><p>A prospective observational study of PCNL performed at our institution was done. All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy, planned for additional procedures. Factors including gender, co-morbidities, body mass index, stone burden, puncture site, tract dilatation size, operative position, surgeon's seniority, and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin (Hb) deficiency.</p></div><div><h3>Results</h3><p>Overall, 4.86% patients (<em>n</em>=7) received packed cells transfusion. The mean estimated Hb deficiency was 1.3 (range 0–6.5) g/dL and the median was 1.0 g/dL. Stepwise multivariate regression analysis revealed that absence of hypertension (<em>p</em>=0.024), puncture site (<em>p</em>=0.027), and operative duration (<em>p</em>=0.023) were significantly associated with higher estimated Hb deficiency. However, the effect sizes are rather small with partial eta-squared of 0.037, 0.066, and 0.038, respectively. Observed power obtained was 0.621, 0.722, and 0.625, respectively. Other factors studied did not correlate with Hb difference.</p></div><div><h3>Conclusion</h3><p>Hypertension, puncture site, and operative duration have significant impact on estimated Hb deficiency during PCNL. However, the effect size is rather small despite adequate study power obtained. Nonetheless, operative position (supine or prone), puncture number, or tract dilatation size did not correlate with Hb difference. The mainstay of reducing bleeding in PCNL is still meticulous operative technique. Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient, without increasing risk of bleeding.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 105-109"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000042/pdfft?md5=f69635eed4ce7855ab94312efa88b599&pid=1-s2.0-S2214388222000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43495572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2021.11.009
Jia Hu , Yuan Zhang , Yong Liu , Xiao Yu , Shaogang Wang
Objective
This study was designed to evaluate the feasibility, efficacy, and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia.
Methods
From December 2015 to September 2017, 33 simple renal cyst patients who had surgical indications were enrolled. Under ultrasound guidance, the T10/T11, T11/T12, and T12/L1 paravertebral spaces were identified, and 7–10 mL 0.5% ropivacaine was injected at each segment. Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring. A guidewire was introduced followed by sequential dilation up to 28/30 Fr. The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser, and a pathological examination was performed.
Results
Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients. None of the patients complained of pain during surgery. No serious complications occurred perioperatively. After the surgery, all patients recovered their lower limb muscle strength quickly, got out of bed, resumed oral feeding, and left the hospital within 24 h of admission. The pathologic diagnosis of all cyst walls was a simple renal cyst. The mean follow-up was 35.8 months. At the end of follow-up, the cyst units were reduced in size by more than 50% compared to the preoperative size, and no patient experienced a recurrence.
Conclusion
Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible, safe, and effective for the treatment of simple renal cysts in selected patients.
{"title":"Ultrasound-guided paravertebral nerve block anesthesia for percutaneous endoscopic laser unroofing treatment of symptomatic simple renal cysts—An innovative ambulatory surgery mode","authors":"Jia Hu , Yuan Zhang , Yong Liu , Xiao Yu , Shaogang Wang","doi":"10.1016/j.ajur.2021.11.009","DOIUrl":"10.1016/j.ajur.2021.11.009","url":null,"abstract":"<div><h3>Objective</h3><p>This study was designed to evaluate the feasibility, efficacy, and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia.</p></div><div><h3>Methods</h3><p>From December 2015 to September 2017, 33 simple renal cyst patients who had surgical indications were enrolled. Under ultrasound guidance, the T10/T11, T11/T12, and T12/L1 paravertebral spaces were identified, and 7–10 mL 0.5% ropivacaine was injected at each segment. Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring. A guidewire was introduced followed by sequential dilation up to 28/30 Fr. The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser, and a pathological examination was performed.</p></div><div><h3>Results</h3><p>Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients. None of the patients complained of pain during surgery. No serious complications occurred perioperatively. After the surgery, all patients recovered their lower limb muscle strength quickly, got out of bed, resumed oral feeding, and left the hospital within 24 h of admission. The pathologic diagnosis of all cyst walls was a simple renal cyst. The mean follow-up was 35.8 months. At the end of follow-up, the cyst units were reduced in size by more than 50% compared to the preoperative size, and no patient experienced a recurrence.</p></div><div><h3>Conclusion</h3><p>Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible, safe, and effective for the treatment of simple renal cysts in selected patients.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 65-71"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388221001132/pdfft?md5=394c9938b7173ab39fc57a76854e8f27&pid=1-s2.0-S2214388221001132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43410786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2022.03.012
Awad Elsid Osman , Sahar Alharbi , Atif Ali Ahmed , Asim Ali Elbagir
Objective
Genome-wide association studies have demonstrated that single nucleotide polymorphisms (SNPs) are important risk factors for the development of prostate cancer (PCa). Preliminary studies have suggested that the incidence of PCa in Saudi males is low but is probably familial or genetically related.
Methods
To identify any possible association of SNP with PCa development in Saudi patients, we investigated a group of SNPs in Saudi PCa patients (n=85) and compared the outcomes to healthy normal controls (n=115) and nodular hyperplasia patients (n=120). DNA was extracted from paraffin-embedded formalin fixed tissue or whole blood from both patients’ groups and healthy control group. A total of thirteen SNPs were genotyped using TaqMan® minor groove binder polymerase chain reaction assay.
Results
The rs16901979A, s629242T and rs1447295A alleles were found at significantly higher frequency in PCa patients than controls (p<0.05). The rs16901979 CA genotype was found at significantly greater frequency in PCa patients than in healthy controls (43% vs. 14%, odds ratio=4.6, p=0.0001) and benign hyperplasia group (43% vs. 25%, odds ratio=2.2, p=0.009).
Conclusion
Our study has highlighted the association of rs16901979 SNP with PCa in Saudi males. Such findings have important implications in the PCa diagnosis and in screening unaffected family members of Saudi patients.
目的全基因组关联研究表明，单核苷酸多态性（SNPs）是前列腺癌（PCa）发病的重要风险因素。为了确定 SNP 与沙特患者 PCa 发病之间可能存在的关联，我们对沙特 PCa 患者（85 人）的一组 SNP 进行了调查，并将结果与健康正常对照组（115 人）和结节性增生患者（120 人）进行了比较。从患者组和健康对照组的石蜡包埋福尔马林固定组织或全血中提取 DNA。结果 rs16901979A、s629242T 和 rs1447295A 等位基因在 PCa 患者中的频率显著高于对照组（p<0.05）。rs16901979 CA 基因型在 PCa 患者中的出现频率明显高于健康对照组（43% vs. 14%，几率比=4.6，p=0.0001）和良性增生组（43% vs. 25%，几率比=2.2，p=0.009）。这些发现对 PCa 诊断和筛查沙特患者未受影响的家庭成员具有重要意义。
{"title":"Single nucleotide polymorphism within chromosome 8q24 is associated with prostate cancer development in Saudi Arabia","authors":"Awad Elsid Osman , Sahar Alharbi , Atif Ali Ahmed , Asim Ali Elbagir","doi":"10.1016/j.ajur.2022.03.012","DOIUrl":"10.1016/j.ajur.2022.03.012","url":null,"abstract":"<div><h3>Objective</h3><p>Genome-wide association studies have demonstrated that single nucleotide polymorphisms (SNPs) are important risk factors for the development of prostate cancer (PCa). Preliminary studies have suggested that the incidence of PCa in Saudi males is low but is probably familial or genetically related.</p></div><div><h3>Methods</h3><p>To identify any possible association of SNP with PCa development in Saudi patients, we investigated a group of SNPs in Saudi PCa patients (<em>n</em>=85) and compared the outcomes to healthy normal controls (<em>n</em>=115) and nodular hyperplasia patients (<em>n</em>=120). DNA was extracted from paraffin-embedded formalin fixed tissue or whole blood from both patients’ groups and healthy control group. A total of thirteen SNPs were genotyped using TaqMan® minor groove binder polymerase chain reaction assay.</p></div><div><h3>Results</h3><p>The rs16901979A, s629242T and rs1447295A alleles were found at significantly higher frequency in PCa patients than controls (<em>p</em><0.05). The rs16901979 CA genotype was found at significantly greater frequency in PCa patients than in healthy controls (43% <em>vs.</em> 14%, odds ratio=4.6, <em>p</em>=0.0001) and benign hyperplasia group (43% <em>vs.</em> 25%, odds ratio=2.2, <em>p</em>=0.009).</p></div><div><h3>Conclusion</h3><p>Our study has highlighted the association of rs16901979 SNP with PCa in Saudi males. Such findings have important implications in the PCa diagnosis and in screening unaffected family members of Saudi patients.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 26-32"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000820/pdfft?md5=f31853f9b875ff3d9fb2669600a1564d&pid=1-s2.0-S2214388222000820-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46543601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2022.02.011
Bryan Kwun-Chung Cheng , Steffi Kar-Kei Yuen , Daniele Castellani , Marcelo Langer Wroclawski , Hongda Zhao , Mallikarjuna Chiruvella , Wei-Jin Chua , Ho-Yee Tiong , Yiloren Tanidir , Jean de la Rosette , Enrique Rijo , Vincent Misrai , Amy Krambeck , Dean S. Elterman , Bhaskar K. Somani , Jeremy Yuen-Chun Teoh , Vineet Gauhar
Objective
To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists’ knowledge, attitudes, and practices for benign prostatic obstruction surgeries.
Methods
A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were “agree or strongly agree” and less than or equal to 15% responses were “disagree or strongly disagree” (consensus agree), or when more than or equal to 70% responses were “disagree or strongly disagree” and less than or equal to 15% responses were “agree or strongly agree” (consensus disagree).
Results
The top three qualities for defining MIST were minimal blood loss (n=466, 80.3%), fast post-operative recovery (n=431, 74.3%), and short hospital stay (n=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (n=361, 62.2%), Rezum® (n=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (n=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL.
Conclusion
Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.
{"title":"Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey","authors":"Bryan Kwun-Chung Cheng , Steffi Kar-Kei Yuen , Daniele Castellani , Marcelo Langer Wroclawski , Hongda Zhao , Mallikarjuna Chiruvella , Wei-Jin Chua , Ho-Yee Tiong , Yiloren Tanidir , Jean de la Rosette , Enrique Rijo , Vincent Misrai , Amy Krambeck , Dean S. Elterman , Bhaskar K. Somani , Jeremy Yuen-Chun Teoh , Vineet Gauhar","doi":"10.1016/j.ajur.2022.02.011","DOIUrl":"10.1016/j.ajur.2022.02.011","url":null,"abstract":"<div><h3>Objective</h3><p>To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists’ knowledge, attitudes, and practices for benign prostatic obstruction surgeries.</p></div><div><h3>Methods</h3><p>A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were “agree or strongly agree” and less than or equal to 15% responses were “disagree or strongly disagree” (consensus agree), or when more than or equal to 70% responses were “disagree or strongly disagree” and less than or equal to 15% responses were “agree or strongly agree” (consensus disagree).</p></div><div><h3>Results</h3><p>The top three qualities for defining MIST were minimal blood loss (<em>n</em>=466, 80.3%), fast post-operative recovery (<em>n</em>=431, 74.3%), and short hospital stay (<em>n</em>=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (<em>n</em>=361, 62.2%), Rezum® (<em>n</em>=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (<em>n</em>=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL.</p></div><div><h3>Conclusion</h3><p>Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 55-64"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221438822200090X/pdfft?md5=1d0370646ce1dbb1bc027110cb07a160&pid=1-s2.0-S221438822200090X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49115332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ajur.2022.03.014
Samer Mahmoud Morsy , Dalia Farouk , Sara Hassan , Ahmed Yehia Abdelaziz , Hussein Aly Hussein
Objective
We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator (TVT-O) in the treatment of de novo overactive bladder symptoms that appear after surgery.
Methods
This is a prospective randomized controlled study performed in the Urology and Gynecology Departments, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt. Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study. Patients were divided into two groups, 105 patients in Group A (treatment group) and 105 patients in Group B (control group). Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months, while patients in Group B underwent transvaginal TVT-O only. The study included any postmenopausal female with urodynamic stress urinary incontinence. All patients had to fulfill a 3-day bladder diary, overactive bladder symptoms score, urine analysis, urodynamic study, and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.
Results
At 6-month follow-up, daytime frequency was reduced to 8% in Group A (increased to 21% in Group B) with a statistically significant difference between both groups (p=0.009). At 6-month follow-up, nocturia was 8% in Group A (11% in Group B) with no statistically significant difference between both groups (p=0.469). There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up (p=0.024). There was a statistically significant difference in postoperative wound healing events as regards to cure, hyperemia, gapping, and wound infection 1 week after intervention between both groups (p=0.008). No local or systemic side-effects were reported from local estrogen use.
Conclusion
Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency. Long-term follow-up is needed.
{"title":"Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study","authors":"Samer Mahmoud Morsy , Dalia Farouk , Sara Hassan , Ahmed Yehia Abdelaziz , Hussein Aly Hussein","doi":"10.1016/j.ajur.2022.03.014","DOIUrl":"10.1016/j.ajur.2022.03.014","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator (TVT-O) in the treatment of <em>de novo</em> overactive bladder symptoms that appear after surgery.</p></div><div><h3>Methods</h3><p>This is a prospective randomized controlled study performed in the Urology and Gynecology Departments, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt. Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study. Patients were divided into two groups, 105 patients in Group A (treatment group) and 105 patients in Group B (control group). Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months, while patients in Group B underwent transvaginal TVT-O only. The study included any postmenopausal female with urodynamic stress urinary incontinence. All patients had to fulfill a 3-day bladder diary, overactive bladder symptoms score, urine analysis, urodynamic study, and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.</p></div><div><h3>Results</h3><p>At 6-month follow-up, daytime frequency was reduced to 8% in Group A (increased to 21% in Group B) with a statistically significant difference between both groups (<em>p</em>=0.009). At 6-month follow-up, nocturia was 8% in Group A (11% in Group B) with no statistically significant difference between both groups (<em>p</em>=0.469). There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up (<em>p</em>=0.024). There was a statistically significant difference in postoperative wound healing events as regards to cure, hyperemia, gapping, and wound infection 1 week after intervention between both groups (<em>p</em>=0.008). No local or systemic side-effects were reported from local estrogen use.</p></div><div><h3>Conclusion</h3><p>Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency. Long-term follow-up is needed.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 86-92"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222001382/pdfft?md5=f94355a54b299a67cdad5884a7f1c95a&pid=1-s2.0-S2214388222001382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48693439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy (npPCNL) for the management of large proximal ureteral stones.
Methods
We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL. Depending on stone size, in-toto stone removal or lithotripsy using the Lithoclast® Trilogy (EMS Medical, Nyon, Switzerland) was performed. Perioperative parameters including operative time (from start of puncture to the skin suturing), stone extraction time (from the first insertion of the nephroscope to the extraction of all stone fragments), and the stone-free rate were evaluated.
Results
Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi. The median age and stone size of treated patients were 58 (interquartile range [IQR]: 51–69) years and 19.3 (IQR: 18.0–22.0) mm, respectively. The median operative time and stone extraction time were 25 (IQR: 21–29) min and 8 (IQR: 7–10) min, respectively. One case (2.7%) of postoperative bleeding and two cases (5.4%) of prolonged fever were managed conservatively. The stone-free rate at a 1-month follow-up was 94.6%.
Conclusion
The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter. Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.
{"title":"Percutaneous antegrade management of large proximal ureteral stones using non-papillary puncture","authors":"Arman Tsaturyan , Angelis Peteinaris , Constantinos Adamou , Konstantinos Pagonis , Lusine Musheghyan , Anastasios Natsos , Theofanis Vrettos , Evangelos Liatsikos , Panagiotis Kallidonis","doi":"10.1016/j.ajur.2022.01.006","DOIUrl":"10.1016/j.ajur.2022.01.006","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy (npPCNL) for the management of large proximal ureteral stones.</p></div><div><h3>Methods</h3><p>We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL. Depending on stone size, <em>in-toto</em> stone removal or lithotripsy using the Lithoclast® Trilogy (EMS Medical, Nyon, Switzerland) was performed. Perioperative parameters including operative time (from start of puncture to the skin suturing), stone extraction time (from the first insertion of the nephroscope to the extraction of all stone fragments), and the stone-free rate were evaluated.</p></div><div><h3>Results</h3><p>Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi. The median age and stone size of treated patients were 58 (interquartile range [IQR]: 51–69) years and 19.3 (IQR: 18.0–22.0) mm, respectively. The median operative time and stone extraction time were 25 (IQR: 21–29) min and 8 (IQR: 7–10) min, respectively. One case (2.7%) of postoperative bleeding and two cases (5.4%) of prolonged fever were managed conservatively. The stone-free rate at a 1-month follow-up was 94.6%.</p></div><div><h3>Conclusion</h3><p>The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter. Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 110-114"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000522/pdfft?md5=944406bd4f2b0ac5c4f738c5d5243ea6&pid=1-s2.0-S2214388222000522-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48030281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Only a few numbers of studies have been published on the use of abobotulinumtoxinA (Dysport®) in idiopathic detrusor overactivity (IDO). This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport® injections.
Methods
Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500–900 units of Dysport® between April 2014 and July 2015. All patients were followed up for 5 years after their initial injection and interviewed on the phone.
Results
A total of 236 women with IDO aged from 18 years to 84 years (mean±standard deviation: 49.6±15.9 years) were included in our study. The median follow-up time for patients was 36.5 (range: 10–70) months, and the median recovery time after injection was 18.5 (range: 0–70) months. A total of 83 (35.2%) patients stated that they had subjective improvement of their symptoms whereas 84 (35.6%) patients did not report any improvement in symptoms. The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9 (standard deviation 3.4). There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire.
Conclusion
In a sub-population of overactive bladder patients with IDO who have failed first-line therapy, a single intravesical Dysport® injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.
{"title":"Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity","authors":"Mohammad Sajjad Rahnama'i , Amin Bagheri , Elham Jahantabi , Hanieh Salehi-Pourmehr , Hadi Mostafaei , Brigitte Schurch , Aida Javan Balegh Marand , Sakineh Hajebrahimi","doi":"10.1016/j.ajur.2022.02.012","DOIUrl":"10.1016/j.ajur.2022.02.012","url":null,"abstract":"<div><h3>Objective</h3><p>Only a few numbers of studies have been published on the use of abobotulinumtoxinA (Dysport®) in idiopathic detrusor overactivity (IDO). This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport® injections.</p></div><div><h3>Methods</h3><p>Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500–900 units of Dysport® between April 2014 and July 2015. All patients were followed up for 5 years after their initial injection and interviewed on the phone.</p></div><div><h3>Results</h3><p>A total of 236 women with IDO aged from 18 years to 84 years (mean±standard deviation: 49.6±15.9 years) were included in our study. The median follow-up time for patients was 36.5 (range: 10–70) months, and the median recovery time after injection was 18.5 (range: 0–70) months. A total of 83 (35.2%) patients stated that they had subjective improvement of their symptoms whereas 84 (35.6%) patients did not report any improvement in symptoms. The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9 (standard deviation 3.4). There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire.</p></div><div><h3>Conclusion</h3><p>In a sub-population of overactive bladder patients with IDO who have failed first-line therapy, a single intravesical Dysport® injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 93-98"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222001023/pdfft?md5=fc925f12199e8283109527884e2880e8&pid=1-s2.0-S2214388222001023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41269607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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