Pub Date : 2023-07-01DOI: 10.1097/ju9.0000000000000036
Constantin Rieger, Max Hübers, Lucas Kastner, D. Pfister, H. Holling, Axel Heidenreich
Fournier gangrene is a life-threatening urological disease that requires rapid surgical intervention. Despite major improvements in medical therapy, the mortality of Fournier gangrene has not changed during the past 25 years. To potentially improve the outcome, we analyzed different medical processes for overall mortality in the treatment of Fournier gangrene. We performed a retrospective single-center study of 21 patients with Fournier gangrene. Patients were grouped according to initial symptoms, first medical advice, blood tests, medical history, and further clinical processes and compared using a t test, χ2 test, or Fisher exact test. A t test for heterogeneous variances was used if a Levene test showed significantly different variances, otherwise a t test for homogeneous variances was used. The log-rank test was applied for survival analysis. Logistic regression was applied to identify potential clinical predictors for mortality. Follow-up was performed until 130 days after the first surgical intervention. There were no significant differences in the mortality rate of patients depending on the day and time of presentation in the hospital. Of the patients first consulting a urologist (either outpatient or hospital), no patient died within the first 120 days. By contrast, approximately 70% of patients who were transferred by a hospital without urologic specialization or a nonurologic outpatient clinic (P = .008) died within the first 130 days after surgery. Multivariate survival analysis showed that the type of first doctor's advice could serve as a significant factor in determining patients' mortality (P = .031), which also correlated with a significantly shorter duration of the first surgical procedure (110 vs 54 minutes, P = .019). Despite the small cohort, we were able to show a significant correlation between the initial doctor's advice, either by a urologist or nonurologist, and the patient's mortality. Considering the life-threatening potential of Fournier gangrene, professionals should develop strategies to educate nonurologists and raise awareness about this disease and its clinical presentation to optimize rapid intervention and reduce mortality.
富尼尔坏疽是一种危及生命的泌尿系统疾病，需要快速手术干预。尽管医学治疗取得了重大进展，但在过去25年中，富尼耶坏疽的死亡率并没有改变。为了潜在地改善结果，我们分析了富尼耶坏疽治疗中不同的医疗过程对总死亡率的影响。我们对21例富尼尔坏疽患者进行了回顾性单中心研究。根据患者的初始症状、首次医疗建议、血液检查、病史和进一步的临床过程进行分组，并使用t检验、χ2检验或Fisher精确检验进行比较。如果Levene检验显示显著不同的方差，则使用异质性方差的t检验，否则使用同质方差的t检验。生存分析采用log-rank检验。应用逻辑回归来确定死亡率的潜在临床预测因素。随访至第一次手术干预后130天。在医院就诊的日期和时间不同，患者的死亡率没有显著差异。在首次咨询泌尿科医生(门诊或住院)的患者中，没有患者在前120天内死亡。相比之下，由非泌尿科专科医院或非泌尿科门诊转院的患者中约有70% (P = 0.008)在手术后130天内死亡。多变量生存分析显示，首次医生建议的类型可能是决定患者死亡率的重要因素(P = 0.031)，这也与首次手术时间明显缩短相关(110 vs 54分钟，P = 0.019)。尽管这个队列很小，但我们能够证明，泌尿科医生或非泌尿科医生最初的医生建议与患者的死亡率之间存在显著的相关性。考虑到富尼耶坏疽可能危及生命，专业人员应该制定策略来教育非泌尿科医生，提高对这种疾病及其临床表现的认识，以优化快速干预和降低死亡率。
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Pub Date : 2023-06-01DOI: 10.1097/ju9.0000000000000030
K. Krughoff, Morgan R. Sturgis, Kristen Logan, A. Peterson
{"title":"Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting","authors":"K. Krughoff, Morgan R. Sturgis, Kristen Logan, A. Peterson","doi":"10.1097/ju9.0000000000000030","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000030","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61631595","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 : 2023-06-01DOI: 10.1097/ju9.0000000000000020
B. Rocco, F. Turri, M. Sangalli, S. Centanni, Matteo Stocco, D. Chiumello, S. Assumma, R. Coelho, L. Sarchi, A. Grasso, I. Piacentini, P. Dell'Orto, T. Calcagnile, M. Sighinolfi
{"title":"Concomitant Introduction of New Robotic Systems (Hugo RAS and Versius) at a Single Center: Analysis of First Clinical Cases of Radical Prostatectomy by a Single Surgeon","authors":"B. Rocco, F. Turri, M. Sangalli, S. Centanni, Matteo Stocco, D. Chiumello, S. Assumma, R. Coelho, L. Sarchi, A. Grasso, I. Piacentini, P. Dell'Orto, T. Calcagnile, M. Sighinolfi","doi":"10.1097/ju9.0000000000000020","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000020","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41595675","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 : 2023-06-01DOI: 10.1097/ju9.0000000000000026
Conor B. Driscoll, Daniel R. Greenberg, R. Sharifi, J. Cornfield
{"title":"Bipolar Transurethral Resection of Intravesical Fungal Bezoar Containing Multiple Multidrug Resistant Bacteria in a Chronic Catheter-Dependent Patient","authors":"Conor B. Driscoll, Daniel R. Greenberg, R. Sharifi, J. Cornfield","doi":"10.1097/ju9.0000000000000026","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000026","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46742665","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 : 2023-06-01DOI: 10.1097/ju9.0000000000000028
Ashley N. Gonzalez, Lee Cheng Zhao, Gary D. Steinberg, A. Corcoran, James S. Wysock, W. Huang
{"title":"Open vs Robotic Radical Cystectomy Outcomes at a Single Institution: A Retrospective Review of 152 Patients","authors":"Ashley N. Gonzalez, Lee Cheng Zhao, Gary D. Steinberg, A. Corcoran, James S. Wysock, W. Huang","doi":"10.1097/ju9.0000000000000028","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000028","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46540466","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 : 2023-06-01DOI: 10.1097/ju9.0000000000000037
John W. Davis
{"title":"JU Open Plus: More AUA 2023 Annual Meeting Behind the Scenes","authors":"John W. Davis","doi":"10.1097/ju9.0000000000000037","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000037","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43427547","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 : 2023-06-01DOI: 10.1097/ju9.0000000000000024
Zachary Corey, Erik Lehman, Jay D. Raman
{"title":"Expansion of Urology Residency Training Programs Has Not Had a Negative Impact on Trainee Case Log Experience","authors":"Zachary Corey, Erik Lehman, Jay D. Raman","doi":"10.1097/ju9.0000000000000024","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000024","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47357919","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 : 2023-05-01DOI: 10.1097/ju9.0000000000000027
J. Myrga, Christopher Staniorski, D. Sharbaugh, Bruce Jacobs
{"title":"Potential System Utilization and Cost Savings of Advanced Microbial Testing for Urinary Tract Infections","authors":"J. Myrga, Christopher Staniorski, D. Sharbaugh, Bruce Jacobs","doi":"10.1097/ju9.0000000000000027","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000027","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41783390","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 : 2023-05-01DOI: 10.1097/ju9.0000000000000021
Scott Durham, Nathan Cheng, N. Jain, Michael Stifelman, R. Schlussel
{"title":"Bilateral Robotic Nephrectomy in a Pediatric Female Patient: A Case Report","authors":"Scott Durham, Nathan Cheng, N. Jain, Michael Stifelman, R. Schlussel","doi":"10.1097/ju9.0000000000000021","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000021","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44753585","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 : 2023-05-01DOI: 10.1097/ju9.0000000000000022
D. Wong, J. Vetter, M. Keller, Joshua K. Palka, R. Venkatesh, Alana Desai
{"title":"Alpha Blocker Medical Expulsive Therapy for Ureteral Stones—Usage of Health Care Resources","authors":"D. Wong, J. Vetter, M. Keller, Joshua K. Palka, R. Venkatesh, Alana Desai","doi":"10.1097/ju9.0000000000000022","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000022","url":null,"abstract":"","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47845910","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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