We present a case of a 17-year-old male with a testicular tumour diagnosed after trauma. A 17-year-old male patient came to our clinic with swelling in the right hemiscrotum. The patient had a history of right scrotal blunt trauma 3 weeks before the admission and had no history of urological surgery or chronic disease. The patient doesn't use tobacco, alcohol, or illicit drugs. Genitourinary system examination revealed swelling and tenderness on palpation in the right hemiscrotum. The right testicle was not palpable. The left hemiscrotum was normal. The left testicle had a normal size and shape. Testicular tumour markers were high (AFP:196 μg/L (N: 0–8 μg/L), b-HCG: 916 mIU/mL (N: <10 mIU/mL), LDH: 364 U/L (N: 0–265 U/L). Scrotal ultrasonography and magnetic resonance imaging revealed that there were areas of 9 × 9 × 11 cm in size of the right scrotal region without viable testis tissue, hematoma area, and areas compatible with necrosis. These findings were related to intratesticular rupture due to trauma. Abdominal tomography revealed lymphadenopathies of approximately 6 × 3 cm in the anterior paracaval area and approximately 4 × 3 cm in the anterior aspect of the psoas muscle. We performed right radical inguinal orchiectomy on the patient. Testicular tumour markers were still high on the 8th postoperative day (AFP:120 μg/L (N: 0–8 μg/L), bHCG: 680 mIU/mL (N: <10 mIU/mL), LDH: 200 U/L (N: 0–265 U/L)). The testicular tumour was diagnosed as mixed germ cell tumour (50% Yolk Sac, 30% Embryonal Carcinoma, 20% Teratoma). The tumour diameter was 9 cm, surgical margins were intact, there was rete testis invasion, and no tumour was detected in the tunica vaginalis. No tumour invasion was seen in the soft tissue around the spermatic cord (pT2). The patient received 3 cycles of chemotherapy with bleomycin, etoposide, and cisplatin. We suggest that patients presenting with scrotal trauma should be carefully evaluated for testicular malignancy, and if malignancy is suspected, radical inguinal orchiectomy should be preferred for the operation.
Research has demonstrated that systematic preoperative oral hygiene reduces nosocomial infections after elective thoracic surgery. However, the impact of preoperative oral hygiene on patients undergoing urologic procedures is unknown. Therefore, the aim of this study was to investigate the effects of systematic preoperative oral hygiene on prescriptions with antibiotics following cystectomy or urethroplasty. A quasi-experimental study design included all patients undergoing elective radical cystectomy or urethroplasty from 1 January 2018 to 31 May 2021. Patients undergoing cystectomy or urethroplasty were grouped into a prospective intervention group and a retrospective control group. Patients in the intervention group were admitted from 1 January 2020 to 31 May 2021, and were recommended to brush their teeth and rinse their mouths with chlorhexidine gluconate 0.12% four times a day starting 2 days before surgery and continuing until the morning of the operation. Patients admitted from 1 January 2018 to 31 December 2019 received no oral hygiene recommendations and were used as a retrospective control group. Data on oral hygiene performance were self-reported and collected at admission and data on prescription of antibiotics were collected through the patients' records. The relative risk was calculated to report the effect of the intervention. In total, 39 patients with cystectomy were in the intervention group, whereas 31 were in the control group. For patients having urethroplasty, 27 were in the intervention group and 98 were in the control group. The effect of oral hygiene on the prescription of antibiotics for patients who completely adhered to the oral hygiene recommendations showed a relative risk of 0.554 (95% CI 0.333–0.921) p = 0.02 for cystectomy and 0.825 (95% 0.308–2.209) p = 0.70 for urethroplasty. This study showed a statistically significant reduction in the prescription of antibiotics following oral hygiene recommendations for patients undergoing cystectomy. However, no statistically significant effect was demonstrated for patients undergoing urethroplasty. Despite this result, it seems important to be aware of oral hygiene in patients undergoing surgery to potentially reduce the number of infections and the use of antibiotics because of the antimicrobial resistance that the healthcare system faces.
Patients with neurological diseases often suffer from overactive bladder. Posterior tibial nerve stimulation is mentioned in guidelines as a treatment when antimuscarinics fail or cannot be tolerated by patients, but the evidence is scant. This article summarizes the evidence on the practical aspects of tibial nerve stimulation for neurogenic overactive bladder (NOAB), such as electrical parameters and treatment duration, and identifies areas requiring further investigation. Scoping review. Literature search on PubMed, CINAHL, and Cochrane Library, including studies from 2010 to 2024 regarding tibial nerve stimulation for NOAB. Sixteen papers were considered: seven on transcutaneous tibial nerve stimulation (TTNS), seven on percutaneous tibial nerve stimulation (PTNS) and two protocols. Most studies enrolled neurological and non-neurological patients or studied non-randomized samples of a few patients. Clinical outcomes, treatment duration, number of sessions, and follow-up times showed considerable heterogeneity, but some practical recommendations could be drawn. For PTNS, most authors suggest using 20 Hz and 200 μs, but the amplitude is highly variable among studies. For TTNS, 10 Hz and 200 μs are suggested, with considerable variability in the number of sessions and overall treatment duration. Most papers propose similar criteria regarding the frequency and duration of the stimulation, and all of them support the efficacy of tibial nerve stimulation, except for one. The areas requiring research include long-term results, allowing for shaping adequate maintenance programmes to avoid losing the results achieved.
The aim of this study was to investigate the relationship between the quality of life (QoL) and self-efficacy in older adults with benign prostatic hyperplasia (BPH), as well as the factors affecting their QoL. Previous research has shown that self-efficacy is one of the factors affecting the QoL of individuals. Diminished self-efficacy can impair cognitive and behavioural function, while heightened self-efficacy can drive changes in treatment acceptance behaviour and, subsequently, physical and mental health. Although past research has investigated QoL among patients with BPH, no known studies have investigated the impact of self-efficacy on QoL, specifically among the Chinese aged population who may have a different disease status. The study followed a cross-sectional design and included 372 older adults with BPH. The Chinese version of the Benign Prostatic Hyperplasia QoL Scale (BPH-QLS), the Chinese version of the Self-rated Abilities for Health Practices Scale (SRAHP) and General Survey Questionnaire were used. One-way ANOVA and multiple regression analysis were employed to identify factors influencing QoL and evaluate the relationship between self-efficacy and QoL. The results indicated a positive correlation between QoL and self-efficacy. Educational level, sexual intercourse, disease duration, marital status, monthly family income and self-efficacy were identified as factors influencing QoL in older adults with BPH. Multiple linear regression analysis revealed that self-efficacy for health responsibility had the most significant impact on QoL scores. To enhance QoL in older adults with BPH, active measures are needed. Future studies should focus on intervention programmes that target self-efficacy, which is a modifiable factor with significant potential for improvement.
Sexuality in cancer patients is a complex area. It is estimated that 81% of patients with urological cancer develop problems in their sexual functionality, even from the moment of diagnosis and aggravated during treatment due to direct injury to the genitalia. Currently, there are few avenues of care within the field of urology that address sexual health and quality of sexual life in penile cancer survivors, which causes many of them to lose self-esteem and have problems with their partners. To review the literature on what are the consequences on the sexual life of penile cancer survivors in terms of their performance, including risk factors associated with penile cancer and what are the alternatives they must recover their sexual life. Most penile cancer survivors develop alterations in sexual performance and functionality, such as loss of sexual interest, dysfunctional ejaculation, and loss of orgasm, increasing the risk of depression and anxiety. Sex therapy is presented as an alternative to improve the quality of life of these patients, proposing sexuality as something more than genitalia and helping to lead a better life. Sex therapy is an alternative and should be contemplated in the therapeutic plan of patients with urological cancer, especially penile cancer, since sexuality is part of an individual's life, and its loss affects the quality of life.
Experts define the Genitourinary Syndrome of Menopause (GSM) as a collection of signs and symptoms associated with decreased oestrogen levels. Its prevalence ranges between 13% and 87% in postmenopausal women.
We aimed to describe the main pathophysiology mechanisms of GSM affecting the lower urinary tract and the manifestations and treatment options for lower urinary tract dysfunction in GSM.
Several treatments and recommendations have been proposed to enhance patients' ability to manage their symptoms, such as regular sexual activity or masturbation, to increase this physiological response and reduce the severity of GSM.
GSM is a multifactorial and complex syndrome that affects postmenopausal women. Impairment of urogenital structures implies diverse manifestations of genital atrophy and lower urinary tract symptoms.
Urinary retention is a common post-operative complication in the older patients. The use of hot and cold compresses can be considered a safe and non-invasive method to relieve urinary retention. In this study, the effects of these two methods are compared. In this randomised clinical trial study, 52 older patients with urinary retention underwent general surgery in two groups underwent local intervention of hot and cold water compresses. After the intervention, success in relieving retention and the exact duration of urine flow were measured and recorded. The mean age of the hot compress group was 69.38 ± 7.82 and the cold compress group was 68.96 ± 7.28 years and the majority of both groups were male. The mean duration of post-operative urinary retention was not significantly different between the two groups. Urinary retention was eliminated in 46.2% of patients in the hot compress group and 53.8% in the cold compress group without the need for catheterization. This difference was not statistically significant (p = 0.782). The duration of urination after compression did not show a statistically significant difference between the two groups. Due to very little research on the use of cold compresses in relieving urinary retention, the findings of this study showed that the success rate of cold compresses in relieving retention was slightly higher than hot compresses. Therefore, this type of compress can also be used to relieve retention.
The aim of this study protocol is to examine the effect of telephone-assisted smoking cessation programme based on the information motivation behavioural skills model on the self-efficacy, smoking behaviour, tumour recurrence and progression in patients diagnosed with non-muscle-invasive bladder cancer. A single-center, single-blind, parallel-group, randomized control trial. The intervention group will receive telephone-assisted smoking cessation programme, while no intervention will be applied to the control group. Face-to-face smoking cessation training will be provided for the information component of the programme, motivational interview will be conducted via WhatsApp for its motivation component. Motivational interviews will be undertaken in total of six sessions organized at two-week intervals. The patients' chronic disease management self-efficacy, smoking behaviour will be evaluated at the third, sixth, 12th months. Tumour recurrence, progression will be followed up by cystoscopy at the third, 12th months. This is a randomized controlled study protocol, results are not available at the time of the submission. All results will be reported on the completion of this study. This study protocol, will involve the implementation of comprehensive smoking cessation programme that is much needed for the target population around the world. It is expected that the use of this programme will increase the self-efficacy of smokers with bladder cancer, decrease their smoking behaviour and amount of smoking, eliminate tumour recurrence. Smoking is the most important, modifiable risk factor for bladder cancer. In this study, it is expected that the implementation of telephone-assisted smoking cessation programme based on the information–motivation–behavioural skills model will increase self-efficacy in cancer management and decrease smoking behaviour, tumour recurrence in patients diagnosed with bladder cancer. In the literature, there is no smoking cessation programme based on this model intended for patients diagnosed with bladder cancer.
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