Pub Date : 2024-05-12DOI: 10.1186/s12301-024-00428-z
Ahmed Samir, Osama EL Gamal, Samir El Gamal, Salah Nagla
Flexible ureteroscopy offers numerous advantages, such as increased reach, superior stone-free rate, reduced risk of bleeding, minimal surgical trauma, and faster recovery time. There are few studies discussing the effectiveness of single-use flexible ureteroscopy in children, and none so far have addressed its safety. This study aims to evaluate the effectiveness and safety of a single-use flexible ureteroscope for treating upper urinary tract stones in children. This study included children with single upper urinary tract stones measuring less than 2 cm who underwent single-use flexible ureteroscopy between October 2020 and January 2023. We assessed the following patient characteristics: age, gender, stone type, size, position, pre and postoperative stent placements, use of a ureteral access sheath, stone-free rate, operation duration, and the rate of complications. A patient was considered stone-free if there were no residual stone particles larger than 3 mm after surgery. Flexible ureteroscopy and holmium laser lithotripsy were undertaken for 44 participants, with an average age of 8.5 years (range: 2–16 years). The typical stone size was 14 mm (range: 6–20 mm). The average operation time was 74 min (range 35–110 min). Ureteral access sheaths were used in 81.8% (36 out of 44) of procedures. After a single FURS session, 86.36% (38 out of 44) of patients achieved stone-free status. Postoperative JJ stent application was noted in 86.4% (38 out of 44) of patients. Complications were categorized using the Calvien system, revealing that 25% (11 out of 44) of patients experienced mild hematuria, colic, and low-grade fever (Calvien I). No severe side effects like mucosal avulsion or ureteral perforation were reported. In the short-term, single-use flexible ureteroscopy is a safe and effective method for managing single renal and proximal ureteric stones, measuring 2 cm or less, in children.
{"title":"Safety of single-use flexible ureteroscopy for dusting of upper urinary tract calculi in children","authors":"Ahmed Samir, Osama EL Gamal, Samir El Gamal, Salah Nagla","doi":"10.1186/s12301-024-00428-z","DOIUrl":"https://doi.org/10.1186/s12301-024-00428-z","url":null,"abstract":"Flexible ureteroscopy offers numerous advantages, such as increased reach, superior stone-free rate, reduced risk of bleeding, minimal surgical trauma, and faster recovery time. There are few studies discussing the effectiveness of single-use flexible ureteroscopy in children, and none so far have addressed its safety. This study aims to evaluate the effectiveness and safety of a single-use flexible ureteroscope for treating upper urinary tract stones in children. This study included children with single upper urinary tract stones measuring less than 2 cm who underwent single-use flexible ureteroscopy between October 2020 and January 2023. We assessed the following patient characteristics: age, gender, stone type, size, position, pre and postoperative stent placements, use of a ureteral access sheath, stone-free rate, operation duration, and the rate of complications. A patient was considered stone-free if there were no residual stone particles larger than 3 mm after surgery. Flexible ureteroscopy and holmium laser lithotripsy were undertaken for 44 participants, with an average age of 8.5 years (range: 2–16 years). The typical stone size was 14 mm (range: 6–20 mm). The average operation time was 74 min (range 35–110 min). Ureteral access sheaths were used in 81.8% (36 out of 44) of procedures. After a single FURS session, 86.36% (38 out of 44) of patients achieved stone-free status. Postoperative JJ stent application was noted in 86.4% (38 out of 44) of patients. Complications were categorized using the Calvien system, revealing that 25% (11 out of 44) of patients experienced mild hematuria, colic, and low-grade fever (Calvien I). No severe side effects like mucosal avulsion or ureteral perforation were reported. In the short-term, single-use flexible ureteroscopy is a safe and effective method for managing single renal and proximal ureteric stones, measuring 2 cm or less, in children.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"24 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140941301","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 : 2024-05-09DOI: 10.1186/s12301-024-00426-1
Muhammad Ainul Mahfuz, Ikhlas Arief Bramono, Fakhri Rahman, Dewi Iriani, Edward Usfie Harahap, Rachmat Budi Santoso
The management of leiomyomas, the most common benign mesenchymal tumours, remains highly debated. This case report presents the first laparoscopic enucleation of an extravesical bladder leiomyoma in Indonesia. A 48-year-old man presented with a lower abdominal mass. An abdominopelvic computed tomography scan showed a solid tumour mass in the right anterolateral wall of the bladder. To excise the mass, it was planned for the patient to undergo laparoscopic enucleation. The mass was removed intact, and a frozen section was taken to determine the malignancy profile. Histopathological examinations, followed by immunohistochemical examinations, confirmed the diagnosis of leiomyoma. Laparoscopic enucleation is a promising option for managing bladder masses. It is a minimally invasive procedure with optimal results for preserving bladder function. Prior to the surgery, imaging studies and cystoscopy examination are mandatory.
{"title":"Laparoscopic Enucleation of an Extravesical Bladder Leiomyoma: A Case Report","authors":"Muhammad Ainul Mahfuz, Ikhlas Arief Bramono, Fakhri Rahman, Dewi Iriani, Edward Usfie Harahap, Rachmat Budi Santoso","doi":"10.1186/s12301-024-00426-1","DOIUrl":"https://doi.org/10.1186/s12301-024-00426-1","url":null,"abstract":"The management of leiomyomas, the most common benign mesenchymal tumours, remains highly debated. This case report presents the first laparoscopic enucleation of an extravesical bladder leiomyoma in Indonesia. A 48-year-old man presented with a lower abdominal mass. An abdominopelvic computed tomography scan showed a solid tumour mass in the right anterolateral wall of the bladder. To excise the mass, it was planned for the patient to undergo laparoscopic enucleation. The mass was removed intact, and a frozen section was taken to determine the malignancy profile. Histopathological examinations, followed by immunohistochemical examinations, confirmed the diagnosis of leiomyoma. Laparoscopic enucleation is a promising option for managing bladder masses. It is a minimally invasive procedure with optimal results for preserving bladder function. Prior to the surgery, imaging studies and cystoscopy examination are mandatory.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"71 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140941300","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 : 2024-05-06DOI: 10.1186/s12301-024-00427-0
Uleng Bahrun, Yohanes Kusumo Adi Arji Atmanto, Asvin Nurulita, Fitriani Mangarengi, Muhammad Asykar Palinrungi, Burhanuddin Bahar
Benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS) are pro-inflammatory cytokine interleukin-8 (IL-8)-associated which causes epithelial hyperplasia of the prostate transitional zone. This study aimed to determine the correlation between the levels of IL-8 serum and the prostate volume with the degree of LUTS severity in patients with BPE. Determination of the correlation between serum IL-8 levels and prostate volume with the LUTS severity degree was conducted using a cross-sectional approach. The International Prostate Symptom Score was used to measure the LUTS severity degree, the enzyme-linked immunosorbent assay (ELISA) technique was used to measure the serum IL-8 level, and the transabdominal ultrasonography (TAUS) was used to measure the prostate volume. The sample used in this study was 32 patients with BPE grouped by the degree of LUTS severity of the patients. The correlation between variables was then analyzed using the Pearson correlation test. The prostate volume was higher in severe LUTS degree (38.19 cc) than in the mild LUTS degree (13.05 cc). The levels of serum IL-8 were higher in the severe LUTS degree (21.65 pg/mL) than in the mild LUTS degree (8.44 pg/m). Both the levels of serum IL-8 and the degree of LUTS did not have a significant correlation with the volume of prostate (p > 0.05). On the other side, the prostate volume and the degree of LUTS severity had a significant positive correlation (p = 0.001, R = 0.913). The prostate volume and the levels of serum IL-8 are higher in the severe LUTS degree. There is a trend of increasing prostate volume with the severity of LUTS symptoms and higher serum IL-8 levels. The severity of prostate enlargement can be assessed by measuring the levels of IL-8 in the serum.
{"title":"Correlation of serum interleukin-8 levels and prostate volume to the degree of lower urinary tract symptoms in patients with benign prostate enlargement: a cross-sectional study","authors":"Uleng Bahrun, Yohanes Kusumo Adi Arji Atmanto, Asvin Nurulita, Fitriani Mangarengi, Muhammad Asykar Palinrungi, Burhanuddin Bahar","doi":"10.1186/s12301-024-00427-0","DOIUrl":"https://doi.org/10.1186/s12301-024-00427-0","url":null,"abstract":"Benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS) are pro-inflammatory cytokine interleukin-8 (IL-8)-associated which causes epithelial hyperplasia of the prostate transitional zone. This study aimed to determine the correlation between the levels of IL-8 serum and the prostate volume with the degree of LUTS severity in patients with BPE. Determination of the correlation between serum IL-8 levels and prostate volume with the LUTS severity degree was conducted using a cross-sectional approach. The International Prostate Symptom Score was used to measure the LUTS severity degree, the enzyme-linked immunosorbent assay (ELISA) technique was used to measure the serum IL-8 level, and the transabdominal ultrasonography (TAUS) was used to measure the prostate volume. The sample used in this study was 32 patients with BPE grouped by the degree of LUTS severity of the patients. The correlation between variables was then analyzed using the Pearson correlation test. The prostate volume was higher in severe LUTS degree (38.19 cc) than in the mild LUTS degree (13.05 cc). The levels of serum IL-8 were higher in the severe LUTS degree (21.65 pg/mL) than in the mild LUTS degree (8.44 pg/m). Both the levels of serum IL-8 and the degree of LUTS did not have a significant correlation with the volume of prostate (p > 0.05). On the other side, the prostate volume and the degree of LUTS severity had a significant positive correlation (p = 0.001, R = 0.913). The prostate volume and the levels of serum IL-8 are higher in the severe LUTS degree. There is a trend of increasing prostate volume with the severity of LUTS symptoms and higher serum IL-8 levels. The severity of prostate enlargement can be assessed by measuring the levels of IL-8 in the serum.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"13 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140886754","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 : 2024-04-29DOI: 10.1186/s12301-024-00421-6
Abdelnaser Khalifa Elgamasy
Stress urinary incontinence (SUI) is a common social problem that affect about 4–35% of adult women adult. There are multiple surgical options for treatment of SUI but midurethral slings are the most effective and durable form of treatment. In this study, transobturator vaginal sling (TOT-VS, Elgamasy technique) was used to overcome the unique risks associated with synthetic mesh placement, as well as the higher rate of voiding dysfunction and harvest site complications associated with pubovaginal sling placement. To assess the short-term outcome of transobturator vaginal wall sling (TOT-VS) for the treatment of SUI. This is a prospective study included 20 females who underwent TOT-VS placement for SUI from January 2021 to March 2022 at Tanta Urology Department–Tanta University Hospitals. Two-parallel longitudinal vaginal mucosal incisions were performed 2 cm below the bladder neck, and 6 × 2 cm graft was harvested from the anterior vaginal wall, with a prolene suture on each side and fixed around the urethra via the transobturator rout. Patients were followed in the outpatient clinic after one week, two weeks, 3, 6 months and one year postoperatively. Outcomes were measured subjectively by the Bristol Female Lower Urinary Tract Symptoms (B-FLUTS) score comparing preoperative and postoperative scores and objectively by cough stress test. The median age of patients was 42 years, and the median BMI was 30.0 kg/m2. The technique was performed, and the patient was discharged the next day after surgery. Mean operative time was 50.5 ± 9 min. All patients completed B-FLUTS at the last follow-up. Compared to preoperative scores, all patients showed significant improvement in all domains. Nineteen cases (95%) showed negative cough stress test 6 months postoperatively, and none of them suffered from severe (Clavien III-V) complications or required reoperation to release the sling. The procedure was failed in one case (5%). At one-year follow-up, no recurrence of SUI was recorded in any case. In the treatment of female stress urinary incontinence, transobturator vaginal wall slings can be a viable, autologous and cost-effective option with excellent short-term outcome, no recurrence, short operative periods, minor complications and short hospital stays.
压力性尿失禁（SUI）是一种常见的社会问题，影响着约 4%-35% 的成年女性。治疗 SUI 有多种手术选择，但尿道中段吊带是最有效、最持久的治疗方式。在这项研究中，采用了经尿道阴道吊带（TOT-VS，Elgamasy 技术）来克服合成网片置入带来的独特风险，以及耻骨阴道吊带置入带来的较高排尿功能障碍率和收获部位并发症。评估经尿道阴道壁吊带（TOT-VS）治疗 SUI 的短期疗效。这是一项前瞻性研究，研究对象包括2021年1月至2022年3月期间在坦塔大学医院泌尿科接受经尿道阴道壁吊带术（TOT-VS）治疗SUI的20名女性。在膀胱颈下 2 厘米处做了两个平行的纵向阴道粘膜切口，从阴道前壁采集了 6 × 2 厘米的移植物，两侧各缝合一针，通过经尿道溃疡固定在尿道周围。术后一周、两周、3 个月、6 个月和一年，患者在门诊接受随访。结果通过布里斯托尔女性下尿路症状（B-FLUTS）评分比较术前和术后评分进行主观测量，并通过咳嗽压力测试进行客观测量。患者年龄中位数为 42 岁，体重指数中位数为 30.0 kg/m2。患者术后第二天即可出院。平均手术时间为 50.5 ± 9 分钟。所有患者在最后一次随访时都完成了 B-FLUTS。与术前评分相比，所有患者在各方面均有明显改善。19例患者（95%）术后6个月咳嗽压力测试呈阴性，无一例出现严重（Clavien III-V）并发症或需要再次手术松解吊带。有一例（5%）手术失败。在一年的随访中，无一例 SUI 复发。在治疗女性压力性尿失禁方面，经尿道阴道壁吊带是一种可行的、自体的和经济有效的选择，具有良好的短期效果、无复发、手术时间短、并发症少和住院时间短等优点。
{"title":"Transobturator vaginal wall sling (Elgamasy technique) for the treatment of female stress urinary incontinence: a pilot study","authors":"Abdelnaser Khalifa Elgamasy","doi":"10.1186/s12301-024-00421-6","DOIUrl":"https://doi.org/10.1186/s12301-024-00421-6","url":null,"abstract":"Stress urinary incontinence (SUI) is a common social problem that affect about 4–35% of adult women adult. There are multiple surgical options for treatment of SUI but midurethral slings are the most effective and durable form of treatment. In this study, transobturator vaginal sling (TOT-VS, Elgamasy technique) was used to overcome the unique risks associated with synthetic mesh placement, as well as the higher rate of voiding dysfunction and harvest site complications associated with pubovaginal sling placement. To assess the short-term outcome of transobturator vaginal wall sling (TOT-VS) for the treatment of SUI. This is a prospective study included 20 females who underwent TOT-VS placement for SUI from January 2021 to March 2022 at Tanta Urology Department–Tanta University Hospitals. Two-parallel longitudinal vaginal mucosal incisions were performed 2 cm below the bladder neck, and 6 × 2 cm graft was harvested from the anterior vaginal wall, with a prolene suture on each side and fixed around the urethra via the transobturator rout. Patients were followed in the outpatient clinic after one week, two weeks, 3, 6 months and one year postoperatively. Outcomes were measured subjectively by the Bristol Female Lower Urinary Tract Symptoms (B-FLUTS) score comparing preoperative and postoperative scores and objectively by cough stress test. The median age of patients was 42 years, and the median BMI was 30.0 kg/m2. The technique was performed, and the patient was discharged the next day after surgery. Mean operative time was 50.5 ± 9 min. All patients completed B-FLUTS at the last follow-up. Compared to preoperative scores, all patients showed significant improvement in all domains. Nineteen cases (95%) showed negative cough stress test 6 months postoperatively, and none of them suffered from severe (Clavien III-V) complications or required reoperation to release the sling. The procedure was failed in one case (5%). At one-year follow-up, no recurrence of SUI was recorded in any case. In the treatment of female stress urinary incontinence, transobturator vaginal wall slings can be a viable, autologous and cost-effective option with excellent short-term outcome, no recurrence, short operative periods, minor complications and short hospital stays.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"57 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810115","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 : 2024-04-27DOI: 10.1186/s12301-024-00419-0
Chaimae Samtal, Laila Bouguenouch, Nabil Ismaili, Marwa El Baldi, Badreddine El Makhzen, Karima El Rhazi, Mohammed Mzyiene, Moulay Hassan Farih, Karim Ouldim, Hassan Ghazal, Hicham Bekkari
Prostate cancer stands as the most frequently diagnosed cancer among men globally, with over 600,000 new cases annually. In-depth epidemiological studies play a pivotal role in delineating the unique characteristics of specific populations. This study endeavors to comprehensively document the histopathological pattern of Moroccan prostate cancer patients while assessing the extent of underdiagnosis risk within the Moroccan population. A retrospective cross-sectional study, encompassing 141 cases of prostate cancer, was conducted. Prostate cancer-confirming biopsies were executed at both the University Hospital Hassan II in Fez and the University Hospital Mohammed VI in Oujda between 2015 and 2021. Statistical analysis employed SPSS version 21 software. The mean age at presentation was 72 years. Prostatic adenocarcinoma emerged as the only histopathological type observed in our patients. Clinically staged diseases (T2, T3, and T4) were manifested in 71.1% of patients. Poorly differentiated tumors (Gleason grades 8, 9, and 10) were identified in 29.2% of cases. The majority of enrolled patients exhibited an intermediate to high-risk disease state. Our findings underscore the significance of prostate cancer as a substantial public health burden, given the severity of this pathology and the limited accessibility to diagnosis within the population. These results substantiate the necessity for further research into the epidemiology of prostate cancer in Morocco.
{"title":"Update on prostate cancer epidemiology in Morocco","authors":"Chaimae Samtal, Laila Bouguenouch, Nabil Ismaili, Marwa El Baldi, Badreddine El Makhzen, Karima El Rhazi, Mohammed Mzyiene, Moulay Hassan Farih, Karim Ouldim, Hassan Ghazal, Hicham Bekkari","doi":"10.1186/s12301-024-00419-0","DOIUrl":"https://doi.org/10.1186/s12301-024-00419-0","url":null,"abstract":"Prostate cancer stands as the most frequently diagnosed cancer among men globally, with over 600,000 new cases annually. In-depth epidemiological studies play a pivotal role in delineating the unique characteristics of specific populations. This study endeavors to comprehensively document the histopathological pattern of Moroccan prostate cancer patients while assessing the extent of underdiagnosis risk within the Moroccan population. A retrospective cross-sectional study, encompassing 141 cases of prostate cancer, was conducted. Prostate cancer-confirming biopsies were executed at both the University Hospital Hassan II in Fez and the University Hospital Mohammed VI in Oujda between 2015 and 2021. Statistical analysis employed SPSS version 21 software. The mean age at presentation was 72 years. Prostatic adenocarcinoma emerged as the only histopathological type observed in our patients. Clinically staged diseases (T2, T3, and T4) were manifested in 71.1% of patients. Poorly differentiated tumors (Gleason grades 8, 9, and 10) were identified in 29.2% of cases. The majority of enrolled patients exhibited an intermediate to high-risk disease state. Our findings underscore the significance of prostate cancer as a substantial public health burden, given the severity of this pathology and the limited accessibility to diagnosis within the population. These results substantiate the necessity for further research into the epidemiology of prostate cancer in Morocco.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"106 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140803135","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 : 2024-04-09DOI: 10.1186/s12301-024-00425-2
Ahmed M. Ragheb, Ahmed G. Mohamed, Ahmed S. Mostafa, Ahmed Abd Elatif, Akram A. Elmarakbi, Rabie M. Ibrahim, Ahmed M. Elbatanouny
Tamsulosin, an alpha-blocker in medical expulsive therapy, selectively relaxes ureteral smooth muscle, while Tadalafil, a PDE5-Is, is recommended for treating lower urinary tract symptoms. This study compares the effectiveness of Tadalafil and Tamsulosin as medical expulsive therapy for distal ureteric stones at the Urology Department, Beni-Suef University Hospital, Egypt, using baseline demographics, preoperative data, intraoperative data, and outcome analysis. A randomized comparative study that is prospective and was from March 2019 to March 2021. Although 280 instances were eligible, 30 were eliminated & 250 were randomized, and only 164 patients completed the study. 83 patients were in the study Tadalafil group (Group A), 54 males (65.1%) & 29 (34.9%) and 81 patients were assigned to the Tamsulosin group (Group B), 47 males (58%) &34 females made up the Tadalafil group (Group A). The study was completed by 34 females (42%). Additionally, there was a significant difference in the meantime for stone expulsion between groups A (8.8 ± 3.1 days) and B (10.8 ± 3.4 days, (p = 0.001). With fewer episodes of colic, Group A needed less analgesia than Group B. Tadalafil is a safer and more effective treatment for 5–9 mm lower ureteric end stones, offering a higher stone expulsion rate, earlier passage, lower analgesic requirements, and fewer colic episodes.
{"title":"Tadalafil versus tamsulosin for distal ureteric stone expulsion; a prospective randomized comparative study","authors":"Ahmed M. Ragheb, Ahmed G. Mohamed, Ahmed S. Mostafa, Ahmed Abd Elatif, Akram A. Elmarakbi, Rabie M. Ibrahim, Ahmed M. Elbatanouny","doi":"10.1186/s12301-024-00425-2","DOIUrl":"https://doi.org/10.1186/s12301-024-00425-2","url":null,"abstract":"Tamsulosin, an alpha-blocker in medical expulsive therapy, selectively relaxes ureteral smooth muscle, while Tadalafil, a PDE5-Is, is recommended for treating lower urinary tract symptoms. This study compares the effectiveness of Tadalafil and Tamsulosin as medical expulsive therapy for distal ureteric stones at the Urology Department, Beni-Suef University Hospital, Egypt, using baseline demographics, preoperative data, intraoperative data, and outcome analysis. A randomized comparative study that is prospective and was from March 2019 to March 2021. Although 280 instances were eligible, 30 were eliminated & 250 were randomized, and only 164 patients completed the study. 83 patients were in the study Tadalafil group (Group A), 54 males (65.1%) & 29 (34.9%) and 81 patients were assigned to the Tamsulosin group (Group B), 47 males (58%) &34 females made up the Tadalafil group (Group A). The study was completed by 34 females (42%). Additionally, there was a significant difference in the meantime for stone expulsion between groups A (8.8 ± 3.1 days) and B (10.8 ± 3.4 days, (p = 0.001). With fewer episodes of colic, Group A needed less analgesia than Group B. Tadalafil is a safer and more effective treatment for 5–9 mm lower ureteric end stones, offering a higher stone expulsion rate, earlier passage, lower analgesic requirements, and fewer colic episodes.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"25 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597386","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 : 2024-04-09DOI: 10.1186/s12301-024-00412-7
Jithin P. Johnson, Arushi Dhall, Arun Chawla, K Prakashini
To analyze preoperatively the composition of renal calculi using dual-energy computed tomography (DECT) and compare it with reference standard biochemical stone analysis. Eighty-one participants who were diagnosed with renal calculi underwent DECT at 80 kVp and 140 kVp. Spectral analysis was performed, and the energy map generated was used to classify the calculus based on available preset data. Average Hounsfield units (HU) were calculated for the two energy levels, and ratio of HU was derived (DE ratio) and calculus was categorized into different stone compositions. Hounsfield units of each calculus was measured at 120 kVp standard dose CT, and Hounsfield density (HU/largest transverse diameter) was derived. Comparison of results of spectral analysis and DE ratio was done and correlated with the biochemical laboratory analysis as reference standard wherever available. Spectral analysis and CT prediction of stone were performed for all 81 patients. CT prediction of stone based on DE ratio into “uric acid,” “struvite,” “calcium oxalate” and “calcium carbonate apatite” was performed. Assessment of stone composition by biochemical analysis was done for 65 patients who eventually underwent PCNL for stone extraction. Both DE ratio and spectral analysis were able to differentiate calculus into various types based on composition with statistically significant p values. However, spectral analysis proved to be marginally better in renal stone characterization particularly for mixed stones. The DE ratio for uric acid stones was derived as 0.9–1.1, 0.9–2.3 for mixed stones and 1.0–2.4 for calcium stones. Spectral analysis promises a practical approach to predicting calculus composition preoperatively, thereby avoiding unnecessary surgical intervention.
{"title":"Renal calculus composition analysis using dual-energy CT: a prospective observational study","authors":"Jithin P. Johnson, Arushi Dhall, Arun Chawla, K Prakashini","doi":"10.1186/s12301-024-00412-7","DOIUrl":"https://doi.org/10.1186/s12301-024-00412-7","url":null,"abstract":"To analyze preoperatively the composition of renal calculi using dual-energy computed tomography (DECT) and compare it with reference standard biochemical stone analysis. Eighty-one participants who were diagnosed with renal calculi underwent DECT at 80 kVp and 140 kVp. Spectral analysis was performed, and the energy map generated was used to classify the calculus based on available preset data. Average Hounsfield units (HU) were calculated for the two energy levels, and ratio of HU was derived (DE ratio) and calculus was categorized into different stone compositions. Hounsfield units of each calculus was measured at 120 kVp standard dose CT, and Hounsfield density (HU/largest transverse diameter) was derived. Comparison of results of spectral analysis and DE ratio was done and correlated with the biochemical laboratory analysis as reference standard wherever available. Spectral analysis and CT prediction of stone were performed for all 81 patients. CT prediction of stone based on DE ratio into “uric acid,” “struvite,” “calcium oxalate” and “calcium carbonate apatite” was performed. Assessment of stone composition by biochemical analysis was done for 65 patients who eventually underwent PCNL for stone extraction. Both DE ratio and spectral analysis were able to differentiate calculus into various types based on composition with statistically significant p values. However, spectral analysis proved to be marginally better in renal stone characterization particularly for mixed stones. The DE ratio for uric acid stones was derived as 0.9–1.1, 0.9–2.3 for mixed stones and 1.0–2.4 for calcium stones. Spectral analysis promises a practical approach to predicting calculus composition preoperatively, thereby avoiding unnecessary surgical intervention.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"94 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597511","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 : 2024-04-05DOI: 10.1186/s12301-024-00423-4
Mayank Gupta, Gaurav Aggarwal, Sujoy Gupta, Midhun P. Gopalakrishnan
Bladder explosion during transurethral resection of bladder tumors (TURBTs) is a rare and less recognised, but terrifying complication. We present a case of 72-year-old male patient of a large bladder tumour who sustained an intravesical explosion during TURBT requiring an emergency exploratory laparotomy and repair. Urologists should be cognizant of this unique complication and ensure the necessary techniques and precautions for its prevention.
{"title":"Bladder explosion during transurethral resection of bladder tumour: a case report and review of literature","authors":"Mayank Gupta, Gaurav Aggarwal, Sujoy Gupta, Midhun P. Gopalakrishnan","doi":"10.1186/s12301-024-00423-4","DOIUrl":"https://doi.org/10.1186/s12301-024-00423-4","url":null,"abstract":"Bladder explosion during transurethral resection of bladder tumors (TURBTs) is a rare and less recognised, but terrifying complication. We present a case of 72-year-old male patient of a large bladder tumour who sustained an intravesical explosion during TURBT requiring an emergency exploratory laparotomy and repair. Urologists should be cognizant of this unique complication and ensure the necessary techniques and precautions for its prevention.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"52 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597561","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 : 2024-04-01DOI: 10.1186/s12301-024-00422-5
Obadia Venance Nyongole, Nashivai Elias Kivuyo, Larry Onyango Akoko, Happiness Saronga, Njiku Kimu
Prostate cancer (PC) is a significant public health problem affecting men worldwide and ranks third in incidence and mortality in East Africa. Cost of prostate cancer management is high in low-income countries because majority of patients presents with advanced (metastatic) PC. The cost related to management of PC including castrate resistant cancer in Tanzania has remained unknown; hence, policy makers do not have enough information for planning and resource allocation. This study therefore aimed to document costs related to the management of patients with prostate cancer including castrate resistant prostate cancer (CRPC) at Muhimbili National Hospital in Tanzania. This was a retrospective descriptive hospital-based study which was conducted at Muhimbili National Hospital (MNH). Case notes of patients who were treated for prostate cancer were retrieved from medical records for review. A structured checklist was used to extract information regarding age, clinical presentation, investigations, stage of disease, type of treatment, payment modality and reimbursement. We considered data on the direct costs of prostate cancer management (diagnosis, treatment and follow-up) based on hospital price list of different categories. Costs reported were based on payment category in total and unit cost but also source of funding. Descriptive statistics were prepared and summarized as tables and figures. A total of 292 case notes of patients with prostate cancer were reviewed of which 189 patients received androgen deprivation therapy. Ninety-six (50.8%) met the criteria for the diagnoses of CRPC, and their mean age was 71.23 ± 4.2. Most of the patients had a poorly differentiated histology with prostate-specific antigen (PSA) over 100 ng/l. Bilateral orchiectomy was the most common treatment modality offered for advanced prostate cancer. Total cost for all PC patients was $148,136.4, equivalent to a unit cost per patient of $507.3. However, patients were in different categories of payment, 53% were public patients with an average cost of $471.3 per patient; 36.6% were cost sharing patients with an average cost of $441.8 per patient; 8.2% were National Health Insurance (NHIF) patients with an average cost of $893.8 per patient; and only 2.2% were private patients with an average cost of $1060.9 per patient. Costs related to prostate cancer management need harmonization to accommodate different categories of patients in need.
{"title":"Estimating cost of prostate cancer management: an experience from Tanzania","authors":"Obadia Venance Nyongole, Nashivai Elias Kivuyo, Larry Onyango Akoko, Happiness Saronga, Njiku Kimu","doi":"10.1186/s12301-024-00422-5","DOIUrl":"https://doi.org/10.1186/s12301-024-00422-5","url":null,"abstract":"Prostate cancer (PC) is a significant public health problem affecting men worldwide and ranks third in incidence and mortality in East Africa. Cost of prostate cancer management is high in low-income countries because majority of patients presents with advanced (metastatic) PC. The cost related to management of PC including castrate resistant cancer in Tanzania has remained unknown; hence, policy makers do not have enough information for planning and resource allocation. This study therefore aimed to document costs related to the management of patients with prostate cancer including castrate resistant prostate cancer (CRPC) at Muhimbili National Hospital in Tanzania. This was a retrospective descriptive hospital-based study which was conducted at Muhimbili National Hospital (MNH). Case notes of patients who were treated for prostate cancer were retrieved from medical records for review. A structured checklist was used to extract information regarding age, clinical presentation, investigations, stage of disease, type of treatment, payment modality and reimbursement. We considered data on the direct costs of prostate cancer management (diagnosis, treatment and follow-up) based on hospital price list of different categories. Costs reported were based on payment category in total and unit cost but also source of funding. Descriptive statistics were prepared and summarized as tables and figures. A total of 292 case notes of patients with prostate cancer were reviewed of which 189 patients received androgen deprivation therapy. Ninety-six (50.8%) met the criteria for the diagnoses of CRPC, and their mean age was 71.23 ± 4.2. Most of the patients had a poorly differentiated histology with prostate-specific antigen (PSA) over 100 ng/l. Bilateral orchiectomy was the most common treatment modality offered for advanced prostate cancer. Total cost for all PC patients was $148,136.4, equivalent to a unit cost per patient of $507.3. However, patients were in different categories of payment, 53% were public patients with an average cost of $471.3 per patient; 36.6% were cost sharing patients with an average cost of $441.8 per patient; 8.2% were National Health Insurance (NHIF) patients with an average cost of $893.8 per patient; and only 2.2% were private patients with an average cost of $1060.9 per patient. Costs related to prostate cancer management need harmonization to accommodate different categories of patients in need.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"64 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597549","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}
Urolithiasis is a unique disease that can cause emergencies and can impair kidney function over time, especially if infections overlap. This work aimed to compare urolithiasis in the pre- and post-pandemic era and to study the impact of the COVID-19 pandemic on patient preferences and decision-making for symptomatic urolithiasis and consequently complications. This case–control multi-center study was conducted at the Urology Department of two tertiary centers in XXX. Participants were divided into two groups: group A: patients who had urolithiasis from March 1, 2018, to February 29, 2020 (pre-COVID-19 period), and group B: patients who had urolithiasis from March 1, 2020, to February 28, 2022 (during COVID-19 period). Group A had a significantly higher incidence of percutaneous nephrolithotomy (PCNL) without double J stenting (DJ), nephrolithotomy + pyelolithotomy and total PCNL compared to group B which had a lower incidence of URS without DJ and total URS. The operation was delayed among 72 (15.9%) patients during the pandemic. In total, 116 (25.6%) were subjected to previous stone removal surgery. In total, 59 (13%) of patients had COVID-19 infection before stone diagnosis. One hundred thirty-two patients (29.1%) were on vitamin C. The presence of positive family history was statistically significant in patients who underwent ESWL in comparison with patients who underwent endoscopy or surgery (P = 0.03). COVID-19 significantly impacted endourological services for urinary stones in terms of surgical volume and case complexity.
{"title":"Egyptian urinary stones in the COVID-19 outbreak: a multi-center study","authors":"Sameh kotb, Mohamed Ezzat, Mohamed Galal Elsheikh, Galal Mohamed Elshorbagy","doi":"10.1186/s12301-024-00420-7","DOIUrl":"https://doi.org/10.1186/s12301-024-00420-7","url":null,"abstract":"Urolithiasis is a unique disease that can cause emergencies and can impair kidney function over time, especially if infections overlap. This work aimed to compare urolithiasis in the pre- and post-pandemic era and to study the impact of the COVID-19 pandemic on patient preferences and decision-making for symptomatic urolithiasis and consequently complications. This case–control multi-center study was conducted at the Urology Department of two tertiary centers in XXX. Participants were divided into two groups: group A: patients who had urolithiasis from March 1, 2018, to February 29, 2020 (pre-COVID-19 period), and group B: patients who had urolithiasis from March 1, 2020, to February 28, 2022 (during COVID-19 period). Group A had a significantly higher incidence of percutaneous nephrolithotomy (PCNL) without double J stenting (DJ), nephrolithotomy + pyelolithotomy and total PCNL compared to group B which had a lower incidence of URS without DJ and total URS. The operation was delayed among 72 (15.9%) patients during the pandemic. In total, 116 (25.6%) were subjected to previous stone removal surgery. In total, 59 (13%) of patients had COVID-19 infection before stone diagnosis. One hundred thirty-two patients (29.1%) were on vitamin C. The presence of positive family history was statistically significant in patients who underwent ESWL in comparison with patients who underwent endoscopy or surgery (P = 0.03). COVID-19 significantly impacted endourological services for urinary stones in terms of surgical volume and case complexity.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"3 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140298596","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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