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A Review of Electronic Early Warning Systems for Acute Kidney Injury. 急性肾损伤电子预警系统回顾。
IF 1.8 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6456411
Xiangxiang Wang, Zhixiang Bian, Rui Zhu, Shunjie Chen

Acute kidney injury (AKI) is characterized by impaired renal function that can result in irreversible severe renal impairment or lifelong dependence on renal replacement therapy in some cases. Early intervention can significantly slow down the progression of AKI and reduce mortality. In recent years, electronic early warning systems for patients with AKI have been gaining attention as a potential clinical decision-support option. This paper presents a review of the application of electronic early warning systems for AKI from four aspects: development process, types of output, influencing factors, and system evaluation.

急性肾损伤(AKI)的特点是肾功能受损,可导致不可逆的严重肾功能损害,或在某些情况下终生依赖肾脏替代疗法。早期干预可以大大减缓 AKI 的进展,降低死亡率。近年来,作为一种潜在的临床决策支持方案,针对 AKI 患者的电子预警系统越来越受到关注。本文从开发过程、输出类型、影响因素和系统评估四个方面对 AKI 电子预警系统的应用进行了综述。
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引用次数: 0
Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer. 前列腺癌雄激素剥夺疗法后的患者人口统计学特征和主要不良心血管事件。
IF 1.8 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-09-27 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2988289
Christopher J D Wallis, Kevin C Chen, Stuart Atkinson, Deborah M Boldt-Houle

Background: The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of many demographic factors from one large, recent US dataset over a long period of time.

Materials and methods: The retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, representing >300M US patients from 1991 to 2020 across all US regions, was performed. Patients with PCa receiving ≥1 ADT injection were included. MACE risk after ADT initiation was evaluated for demographic and potential PCa-related risk factors. Kaplan-Meier survival curves were constructed, and Cox regression was used to evaluate the association between MACE risk and demographic/PCa-related risk factors.

Results: Overall, MACE risk was slightly lower in the first year after ADT initiation (3.9%) vs. years 2-4 (∼5.2%). In a multivariate Cox model, MACE risk after ADT initiation was significantly higher for older vs. younger patients (adjusted HR per increasing year = 1.08, 95% CI: 1.07-1.09), men with a history of MACE vs. without (HR = 2.22, 95% CI: 1.72-2.88), men with very low BMI vs. normal or high BMI (HR for decreasing BMI per kg/m2 = 1.02, 95% CI: 1.01-1.03), White vs. Black patients (HR = 1.30, 95% CI: 1.08-1.55), and patients who did not use statins vs. those who did (HR = 1.13, 95% CI: 1.00-1.27). Of the PCa-related risk factors, MACE risk after ADT initiation was significantly higher for oncology vs. urology treatment setting (HR = 2.47, 95% CI: 2.12-2.88), patients with baseline metastasis vs. those without (HR = 2.30, 95% CI: 1.72-3.07), and patients treated with antagonists vs. agonists (HR = 1.62, 95% CI: 1.25-2.10).

Conclusions: Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible.

背景:我们利用真实世界的数据评估了 ADT 后患者人口统计学特征与 CV 事件之间的关系。据我们所知,这项研究不仅涵盖的患者人数是以往所有 MACE 研究的 30 倍以上,而且是第一项从一个大型、最新的美国数据集中长期全面列出多种人口统计学因素的研究:我们对决策资源集团(现为 Clarivate)真实世界证据库中的数据进行了回顾性分析,这些数据代表了 1991 年至 2020 年间美国所有地区超过 3 亿的美国患者。纳入了接受≥1次ADT注射的PCa患者。根据人口统计学因素和潜在的 PCa 相关风险因素评估了 ADT 注射后的 MACE 风险。构建了 Kaplan-Meier 生存曲线,并使用 Cox 回归评估 MACE 风险与人口统计学/PCa 相关风险因素之间的关联:总体而言,ADT开始后第一年的MACE风险(3.9%)略低于第2-4年(5.2%)。在多变量 Cox 模型中,年龄较大的患者与年龄较小的患者(每增加一年的调整 HR = 1.08,95% CI:1.07-1.09)、有 MACE 病史的男性患者与无 MACE 病史的男性患者(HR = 2.22,95% CI:1.72-2.88)、BMI 很低的男性患者与 BMI 很高的男性患者(HR = 2.22,95% CI:1.72-2.88),在 ADT 开始后发生 MACE 的风险明显较高。88)、体重指数很低的男性与体重指数正常或很高的男性(体重指数每千克/平方米下降的HR = 1.02,95% CI:1.01-1.03)、白人患者与黑人患者(HR = 1.30,95% CI:1.08-1.55)以及未使用他汀类药物的患者与使用他汀类药物的患者(HR = 1.13,95% CI:1.00-1.27)。在与PCa相关的风险因素中,肿瘤科与泌尿科治疗环境(HR = 2.47,95% CI:2.12-2.88)、有基线转移的患者与没有转移的患者(HR = 2.30,95% CI:1.72-3.07)、使用拮抗剂治疗的患者与使用激动剂治疗的患者(HR = 1.62,95% CI:1.25-2.10)相比,开始ADT后的MACE风险明显更高:人口统计学因素是导致接受ADT治疗的男性PCa患者MACE风险增加的重要因素。临床医生应监测风险因素,并在可能的情况下进行调整。
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引用次数: 0
Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement. 与放置 SpaceOAR 水凝胶有关的并发症和围手术期影响因素。
IF 1.8 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI: 10.1155/2024/3439727
Kerith R Wang, Rishabh K Simhal, Cassra B Clark, Mark J Mann, James R Mark, Costas D Lallas, Robert Den, Edouard J Trabulsi

Objective: To examine one academic institution's experiences with SpaceOAR placement, its associated complications, and periprocedural characteristics that affect outcomes for the purpose of quality improvement.

Materials and methods: We conducted a retrospective review of 233 patients who received SpaceOAR from four surgeons and one radiation oncologist between 2018 and 2021. Variables such as demographics, oncologic parameters, radiation plan, and radiographic assessment of hydrogel placement were recorded. The Charlson Comorbidity Index (CCI) was used to assess comorbidity risk. Mann-Whitney and Fisher's exact tests were performed to compare patients with and without complications.

Results: Of the 233 patients who received SpaceOAR, 24 (10.3%) experienced toxicity. All complications were Clavien I or II, such as pelvic pain postplacement, pelvic fullness, bleeding, and lower urinary tract symptoms. 16 patients (6.9%) had some portion of the hydrogel injected into the rectal wall, but it was never clinically significant. The average CCI was 3.2 ± 0.95 for patients who experienced complications; the average CCI was 3.6 ± 1.6 (p=0.48) in the group without complications. Of the physicians with higher procedure volumes, Physician #1 had the highest rate of patient-reported complications at 11 out of 68 (16.2%) and Physician #2 had the lowest rate of complications at 4 out of 96 placements (4.2%). Multivariate analysis found that patients who had received hormone therapy previously had less odds of reporting complications after SpaceOAR placement.

Conclusions: The listed attending on the procedure had a significant correlation to complications with SpaceOAR placement on univariate analysis, and hormone therapy had some benefits to the tolerance for the procedure on multivariate analysis. Overall, the hydrogel placement was well tolerated with low incidence of mild and transient procedure-related toxicity.

摘要研究一家学术机构在放置SpaceOAR方面的经验、相关并发症以及影响疗效的围手术期特征,以达到提高质量的目的:我们对 2018 年至 2021 年期间接受四位外科医生和一位放射肿瘤科医生治疗的 233 名患者进行了回顾性研究。记录了人口统计学、肿瘤学参数、放射计划和水凝胶置入的放射学评估等变量。夏尔森合并症指数(CCI)用于评估合并症风险。对有并发症和无并发症的患者进行了曼-惠特尼检验和费雪精确检验:在接受 SpaceOAR 治疗的 233 名患者中,有 24 人(10.3%)出现了毒性反应。所有并发症均为克拉维恩Ⅰ型或Ⅱ型,如置入后盆腔疼痛、盆腔充盈、出血和下尿路症状。16名患者(6.9%)的部分水凝胶注射到了直肠壁,但并无明显临床症状。出现并发症的患者平均 CCI 为 3.2 ± 0.95;无并发症组的平均 CCI 为 3.6 ± 1.6(P=0.48)。在手术量较大的医生中,1 号医生的患者报告并发症发生率最高,68 例中有 11 例(16.2%),2 号医生的并发症发生率最低,96 例中有 4 例(4.2%)。多变量分析发现,之前接受过激素治疗的患者在植入 SpaceOAR 后报告并发症的几率较低:结论:在单变量分析中,手术中列出的主治医生与 SpaceOAR 置入术后并发症有显著相关性;在多变量分析中,激素治疗对手术耐受性有一定益处。总体而言,水凝胶置入术的耐受性良好,与手术相关的轻度和短暂毒性发生率较低。
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引用次数: 0
Photodynamic Therapeutic Effect during 5-Aminolevulinic Acid-Mediated Photodynamic Diagnosis-Assisted Transurethral Resection of Bladder Tumors. 在 5-Aminolevulinic Acid 光动力诊断辅助下经尿道切除膀胱肿瘤的光动力治疗效果。
IF 1.8 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-07-20 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7548001
Nobutaka Nishimura, Makito Miyake, Sayuri Onishi, Tomomi Fujii, Tatsuki Miyamoto, Mitsuru Tomizawa, Takuto Shimizu, Yosuke Morizawa, Shunta Hori, Daisuke Gotoh, Yasushi Nakai, Kazumasa Torimoto, Nobumichi Tanaka, Kiyohide Fujimoto

Background: Photodynamic diagnosis-assisted transurethral resection of bladder tumors (PDD-TURBT) enhances detection of elusive lesions compared to standard white light-transurethral resection of bladder tumors (WL-TURBT). If minimal light exposure during PDD-TURBT induces the accumulation of reactive oxygen species (ROS), potentially resulting in phototoxicity in small lesions, apoptosis may be triggered in residual small tumors, allowing them to escape resection. We investigated the hypothesis of a potential photodynamic therapeutic effect during PDD-TURBT.

Methods and materials: Our study, conducted between January 2016 and December 2020 at Nara Medical University Hospital, focused on a specific emphasis on ROS production. Immunohistochemical analysis for thymidine glycol and N ε -hexanoyl-lysine was performed on 69 patients who underwent 5-aminolevulinic acid-mediated PDD-TURBT and 28 patients who underwent WL-TURBT. Additionally, we incrementally applied the minimal irradiation energy to T24 and UM-UC-3 cells treated with 5-aminolevulinic acid using instruments similar to those used in PDD-TURBT and evaluated intracellular ROS production and phototoxicity.

Results: Immunohistochemical analysis revealed a significant increase in production of thymidine glycol and N ε -hexanoyl-lysine within the PDD-TURBT group. In T24 and UM-UC-3 cells treated with 5-aminolevulinic acid and light exposure, immunofluorescent staining demonstrated a dose-dependent increase in intracellular ROS production. In addition, higher irradiation energy levels were associated with a greater increase in ROS production and phototoxicity, as well as more significant decrease in mitochondrial membrane potential.

Conclusion: Although the irradiation energy used in PDD-TURBT did not reach the levels commonly used in photodynamic therapy, our findings support the presence of a potential cytotoxic effect on bladder lesions during PDD-TURBT.

背景:与标准的白光经尿道膀胱肿瘤切除术(WL-TURBT)相比,光动力诊断辅助经尿道膀胱肿瘤切除术(PDD-TURBT)可提高对难以发现的病灶的检测能力。如果 PDD-TURBT 期间的最小光照射会诱导活性氧(ROS)的积累,从而可能导致小病灶的光毒性,那么残留的小肿瘤可能会触发凋亡,从而逃脱切除。我们研究了 PDD-TURBT 期间潜在光动力治疗效果的假设:我们的研究于 2016 年 1 月至 2020 年 12 月在奈良医科大学附属医院进行,重点关注 ROS 的产生。我们对 69 例接受 5-aminolevulinic acid 介导的 PDD-TURBT 的患者和 28 例接受 WL-TURBT 的患者进行了胸腺嘧啶乙二醇和 N ε -己酰赖氨酸的免疫组化分析。此外,我们还使用与 PDD-TURBT 类似的仪器,对接受 5-aminolevulinic acid 治疗的 T24 和 UM-UC-3 细胞逐步施加最小辐照能量,并评估细胞内 ROS 的产生和光毒性:免疫组化分析表明,在 PDD-TURBT 组中,胸苷乙二醇和 N ε -己酰基赖氨酸的产生量显著增加。在用 5-氨基乙酰丙酸和光照射处理的 T24 和 UM-UC-3 细胞中,免疫荧光染色显示细胞内 ROS 生成的增加呈剂量依赖性。此外,辐照能量越高,ROS 生成和光毒性增加越多,线粒体膜电位下降越明显:尽管 PDD-TURBT 使用的辐照能量没有达到光动力疗法常用的水平,但我们的研究结果支持 PDD-TURBT 对膀胱病变存在潜在的细胞毒性作用。
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引用次数: 0
Effects of the Surgical Ligation of the Ureter in Different Locations on the Kidney over Time in the Rat Model. 大鼠模型中不同位置输尿管手术结扎对肾脏随时间变化的影响
IF 1.8 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6611081
Abdolreza Mohammadi, Leila Zareian Baghdadabad, Parisa Zahmatkesh, Hedieh Moradi Tabriz, Alireza Khajavi, Gholamreza Mesbah, Parsa Nikoofar, Seyed Mohammad Kazem Aghamir

Purpose: To evaluate the effects of the surgical ligation of the ureter in different locations on the kidney over time in the rat model.

Methods: A total of 155 rats were enrolled and randomly divided into the case (n = 150) and control (n = 5) groups. The case group included three separate groups (fifty rats in each group) that underwent surgical ureteral ligation at the proximal, middle, and distal ureter. The laboratory tests, and tumor necrosis factor α (TNF-α), were measured in groups. The pathological evaluation for glomerular changes, tubular dilation, interstitial fibrosis, and interstitial infiltration of the inflammatory cells following the obstruction was performed (severity of tubular atrophy categorized too mild (+), moderate (++), and severe (+++)). To compare the continuous variables between the groups and between the measurement times, the analysis of variance (ANOVA) was used.

Results: Our results revealed that the creatinine four weeks after the obstruction was significantly higher in the proximal group obstruction (p value: 0.046). The three groups had no significant differences regarding urine creatinine, serum sodium, and serum TNF (p value: 0.261). Obstruction did not change the glomerular morphology in three intervention groups after six weeks. The commencing of severe tubular atrophy in proximal, middle, and distal ureteral obstruction was at weeks three, four, and six, respectively.

Conclusion: The location of ureteral obstruction is also crucial in deciding to intervene to relieve the complete ureteral obstruction. Severe tubular damage occurs in weeks three, four, and six in proximal, middle, and distal ureteral obstruction, respectively.

目的:在大鼠模型中评估不同位置的输尿管结扎手术对肾脏的长期影响:方法:共招募 155 只大鼠,随机分为病例组(n = 150)和对照组(n = 5)。病例组包括三组(每组 50 只),分别在输尿管近端、中间和远端进行手术结扎。各组均进行了实验室检查和肿瘤坏死因子α(TNF-α)测定。对梗阻后的肾小球变化、肾小管扩张、肾间质纤维化和炎症细胞间质浸润进行病理评估(肾小管萎缩的严重程度分为轻度(+)、中度(++)和重度(+++))。为了比较组间和测量时间间的连续变量,采用了方差分析(ANOVA):结果显示,近端阻塞组患者阻塞四周后的肌酐明显更高(P 值:0.046)。三组在尿肌酐、血清钠和血清 TNF 方面无明显差异(P 值:0.261)。六周后,阻塞没有改变三个干预组的肾小球形态。输尿管近端、中间和远端梗阻的肾小管开始严重萎缩的时间分别为第三周、四周和六周:结论:输尿管梗阻的位置也是决定是否干预以缓解完全性输尿管梗阻的关键。输尿管近端、中间和远端梗阻的严重肾小管损伤分别发生在第 3、4 和 6 周。
{"title":"Effects of the Surgical Ligation of the Ureter in Different Locations on the Kidney over Time in the Rat Model.","authors":"Abdolreza Mohammadi, Leila Zareian Baghdadabad, Parisa Zahmatkesh, Hedieh Moradi Tabriz, Alireza Khajavi, Gholamreza Mesbah, Parsa Nikoofar, Seyed Mohammad Kazem Aghamir","doi":"10.1155/2024/6611081","DOIUrl":"10.1155/2024/6611081","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of the surgical ligation of the ureter in different locations on the kidney over time in the rat model.</p><p><strong>Methods: </strong>A total of 155 rats were enrolled and randomly divided into the case (<i>n</i> = 150) and control (<i>n</i> = 5) groups. The case group included three separate groups (fifty rats in each group) that underwent surgical ureteral ligation at the proximal, middle, and distal ureter. The laboratory tests, and tumor necrosis factor <i>α</i> (TNF-<i>α</i>), were measured in groups. The pathological evaluation for glomerular changes, tubular dilation, interstitial fibrosis, and interstitial infiltration of the inflammatory cells following the obstruction was performed (severity of tubular atrophy categorized too mild (+), moderate (++), and severe (+++)). To compare the continuous variables between the groups and between the measurement times, the analysis of variance (ANOVA) was used.</p><p><strong>Results: </strong>Our results revealed that the creatinine four weeks after the obstruction was significantly higher in the proximal group obstruction (<i>p</i> value: 0.046). The three groups had no significant differences regarding urine creatinine, serum sodium, and serum TNF (<i>p</i> value: 0.261). Obstruction did not change the glomerular morphology in three intervention groups after six weeks. The commencing of severe tubular atrophy in proximal, middle, and distal ureteral obstruction was at weeks three, four, and six, respectively.</p><p><strong>Conclusion: </strong>The location of ureteral obstruction is also crucial in deciding to intervene to relieve the complete ureteral obstruction. Severe tubular damage occurs in weeks three, four, and six in proximal, middle, and distal ureteral obstruction, respectively.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2024 ","pages":"6611081"},"PeriodicalIF":1.8,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pelvic Pain of Myofascial Origin in Women: Correlation with Lower Urinary Tract Symptoms. 女性肌筋膜源性骨盆疼痛:下尿路症状的相关性
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-03-15 eCollection Date: 2024-01-01 DOI: 10.1155/2024/5568010
Sabrina Einig, Esther Ruess, Andreas Schoetzau, Kerstin Ayllon Bartet, Viola Heinzelmann-Schwarz, Francesco Vigo, Tilemachos Kavvadias

Introduction: Women with lower urinary tract symptoms (LUTS) and high-tone pelvic floor often experience pain and have positive trigger points upon pelvic floor examination. However, the correlation of these findings has not yet been systematically examined and sufficiently understood. The aim of this cross-sectional study is to examine the correlation of pelvic myofascial pain with LUTS and pelvic floor tone.

Materials and methods: All participants filled a standardized pelvic floor questionnaire to assess LUTS, which consists of a total of 43 questions regarding bladder, bowel, and sexual function as well as prolapse symptoms. Myofascial trigger points in different muscle groups including pubococcygeus, iliococcygeus, and obturator as well as pelvic floor muscle tone were assessed using a standardized digital examination technique.

Results: 110 women were included in the study. There was a significant correlation between pain in various muscle groups and LUTS as well as high-tone pelvic floor muscle. A significant correlation could also be found between high pelvic floor muscle tone and the overall questionnaire score (p < 0.001) as well as the bladder function score (p < 0.001) and various pain scores of the different groups. Individuals with high-tone pelvic floor were more likely to have more LUTS and higher pain scores.

Conclusions: The existence of myofascial pelvic floor trigger points and high pelvic floor muscle tone seem to be reflective of pelvic floor symptoms, as assessed with a standardized pelvic floor questionnaire.

导言:患有下尿路症状(LUTS)和高音调骨盆底的女性在接受骨盆底检查时通常会感到疼痛,并有阳性触发点。然而,这些结果之间的相关性尚未得到系统的研究和充分的了解。本横断面研究旨在探讨盆腔肌筋膜疼痛与 LUTS 和盆底张力的相关性:所有参与者都填写了一份评估 LUTS 的标准化盆底问卷,该问卷由 43 个关于膀胱、肠道和性功能以及脱垂症状的问题组成。使用标准化数字检查技术评估了不同肌群(包括耻骨尾骨肌、髂尾骨肌和闭孔肌)的肌筋膜触发点以及盆底肌张力:110 名妇女参与了研究。不同肌群的疼痛与 LUTS 以及高张力盆底肌之间存在明显的相关性。盆底肌张力高与问卷总分(p < 0.001)、膀胱功能评分(p < 0.001)以及不同组别的各种疼痛评分之间也存在明显相关性。盆底肌张力高的人更可能有更多的LUTS和更高的疼痛评分:结论:盆底肌筋膜触发点的存在和盆底肌张力高似乎是盆底症状的反映,可通过标准化盆底问卷进行评估。
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引用次数: 0
Approach of Chronic Pelvic Pain with Top Flat Magnetic Stimulation. 上平面磁刺激治疗慢性盆腔疼痛。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-09-16 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9983301
Benedetta Salsi, Giulia Ganassi, Graziella Lopopolo, Silvia Callarelli, Alessandra Comito, Irene Fusco, Pablo González Isaza

Materials and methods: Vulvar Functional Status Questionnaire (VQ) was used for the evaluation of patient's chronic pelvic pain and muscle hypertone improvements. The interstitial cystitis was assessed by the Leary-Sant symptom and problem indexes (ICSI and ICPI). In this study, the scores resulting from the sum of the two indexes were evaluated as OSS (ICSI + ICPI).

Results: Women with chronic pelvic pain and muscle hypertone showed VQ mean values significantly lower than the controls (p  <  0.005) from the second treatment up to the sixth one. In 6 patients affected by interstitial cystitis, the mean score of OSS was significantly lower than the controls (p  <  0.005) from the second treatment up to 2 months follow-up after the last treatment session. No side effects were observed.

Conclusion: Based on these results, this technology may successfully manage muscle hypertonicity condition, the chronic pelvic pain, and interstitial cystitis.

材料和方法:采用外阴功能状态问卷(VQ)对患者的慢性盆腔疼痛和肌肉张力增高的改善情况进行评估。间质性膀胱炎通过Leary-Sant症状和问题指数(ICSI和ICPI)进行评估。在本研究中,两项指标之和的得分被评估为OSS(ICSI + 结果:患有慢性盆腔疼痛和肌肉张力过大的女性的VQ平均值显著低于对照组(p  <  0.005)。在6例间质性膀胱炎患者中,OSS的平均得分显著低于对照组(p  <  0.005)至2 最后一次治疗后随访数月。未观察到副作用。结论:基于这些结果,该技术可以成功地治疗肌肉高渗、慢性盆腔疼痛和间质性膀胱炎。
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引用次数: 0
The Importance of Follow-Up and Evaluation of Intraoperative Findings to Determine Surgical Indications for Retractile Testis. 追踪和评估术中发现对确定睾丸回缩手术适应症的重要性。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-09-08 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8764631
Kazuro Kikkawa, Yuko Ueda, Shimpei Yamashita, Yasuo Kohjimoto, Isao Hara

Objectives: Ascending testis or acquired undescended testis develops in approximately 30% of cases of retractile testis, and orchiopexy is recommended for these cases. This study aimed at assessing the intraoperative anatomical findings of ascending testis and acquired undescended testis in search of better management for retractile testis.

Methods: We retrospectively collected data of patients with confirmed diagnosis of retractile testis between February 2012 and November 2021. Orchiopexy was performed for cases with ascending testis and for patients with increasing difference of right and left testicular volume. The site of gubernaculum attachment and patent processus vaginalis were evaluated during surgery.

Results: A total of 119 testes in 71 patients with retractile testis were included in this study. Sixteen retractile testes in 12 patients (17%) underwent orchiopexy. The weight at birth was significantly higher, and bilateral retractile testes were significantly more common in the follow-up group than in the surgical intervention group. In the surgical intervention group, the abnormal site of gubernaculum attachment was found in 12 out of 16 testes (75%), and patent PV was found in nine out of sixteen testes (56%). Sites of gubernaculum attachment in testes with patent PV were significantly higher than in sites with closed processus vaginalis, and all testes with patent processus vaginalis had abnormal site of gubernaculum attachment.

Conclusion: Patients with ascending testis and acquired undescended testis have clinical features and intraoperative abnormal findings similar to a cryptorchidism. Therefore, our surgical indication for retractile testis is considered appropriate.

目的:大约30%的睾丸回缩病例会发生睾丸上升或获得性睾丸下降,建议对这些病例进行睾丸切除术。本研究旨在评估升睾丸和获得性降睾丸的术中解剖结果,以寻求更好的睾丸回缩治疗方法。方法:我们回顾性收集了2012年2月至2021年11月期间确诊为睾丸回缩的患者的数据。对睾丸上升的患者和左右睾丸体积差异增大的患者进行了睾丸切除术。术中评估了引带附着部位和阴道突未闭。结果:本研究共纳入71例睾丸回缩患者的119个睾丸。12例患者中有16例(17%)接受了睾丸切除术。随访组出生时的体重明显高于手术干预组,双侧回缩睾丸明显更常见。在手术干预组中,16个睾丸中有12个(75%)发现了引带附着部位异常,16个(56%)睾丸中有9个发现了未闭PV。PV未闭的睾丸的引带附着部位明显高于阴道突闭合的睾丸,且所有阴道突未闭睾丸的引道附着部位均异常。结论:睾丸升沉和获得性睾丸降沉患者具有类似隐睾的临床特征和术中异常表现。因此,我们认为睾丸回缩的手术适应症是合适的。
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引用次数: 0
A Randomized Controlled Study of Robot-Assisted versus 3D Laparoscopic Radical Prostatectomy in Patients with Carcinoma Prostate. 机器人辅助与3D腹腔镜根治性前列腺切除术在前列腺癌患者中的随机对照研究。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/4666116
Ketan Kumar Kapoor, Anup Kumar

Materials and methods: A prospective randomized comparative study was performed from 1st January 2020 to 30th June 2021. All patients included were diagnosed with localized/locally advanced ca prostate. 60 patients fulfilling the inclusion and exclusion criteria were randomized into 2 groups. Groups A and B included patients who underwent robot-assisted radical prostatectomy and 3D laparoscopic transperitoneal radical prostatectomy, respectively. Various demographic, intraoperative, postoperative, and follow-up parameters were collected. Outcomes were evaluated in the form of the trifecta (continence, potency, and BCR-free status) and pentafecta rates (trifecta with no perioperative complications and negative surgical margins) in between the two groups.

Results: The mean operative time in Group A was 137.83 mins ± 17.27 compared to 148.20 mins ± 26.16 in Group B. Trifecta rates in Group A and Group B were 43.3%, 63.3%, and 76.6% and 40%, 53.3%, and 70% at 1, 3, and 6 months. Pentafecta rates in Group A and Group B were 36.6%, 53.3%, and 70% and 33.3%, 40%, and 53.3% at 1, 3, and 6 months. Complication rates were 10% in Group A and 13.3% in Group B, respectively. Only one patient in our study (Group B) had a positive surgical margin.

Conclusions: We conclude from our comparative study, that both robot-assisted and 3D laparoscopic transperitoneal radical prostatectomy are feasible and efficacious treatment modalities for achieving acceptable trifecta and pentafecta rates in managing ca prostate with earlier continence and shorter urethrovesical anastomosis time in the robotic arm.

材料和方法:从2020年1月1日至2021年6月30日进行了一项前瞻性随机比较研究。所有患者均被诊断为局限性/局部晚期前列腺癌。60例符合纳入和排除标准的患者随机分为两组。A组和B组分别为接受机器人辅助根治性前列腺切除术和3D腹腔镜经腹腔根治性前列腺切除术的患者。收集了各种人口统计学、术中、术后和随访参数。结果以两组之间的三联性(尿失禁、效力和无bcr状态)和五联性发生率(无围手术期并发症和阴性手术切缘的三联性)的形式进行评估。结果:A组平均手术时间为137.83 min±17.27 min, B组平均手术时间为148.20 min±26.16 min。1、3、6个月时,A组和B组三甲率分别为43.3%、63.3%、76.6%和40%、53.3%、70%。1、3、6个月时,A组和B组的Pentafecta发生率分别为36.6%、53.3%、70%和33.3%、40%、53.3%。A组并发症发生率为10%,B组并发症发生率为13.3%。在我们的研究中,只有1例患者(B组)手术切缘阳性。结论:我们通过对比研究得出结论,机器人辅助和3D腹腔镜经腹腔根治性前列腺切除术都是可行和有效的治疗方式,可以实现可接受的三连和五连率,治疗前列腺癌,早期失禁,机械臂内尿道膀胱吻合术时间短。
{"title":"A Randomized Controlled Study of Robot-Assisted versus 3D Laparoscopic Radical Prostatectomy in Patients with Carcinoma Prostate.","authors":"Ketan Kumar Kapoor,&nbsp;Anup Kumar","doi":"10.1155/2023/4666116","DOIUrl":"https://doi.org/10.1155/2023/4666116","url":null,"abstract":"<p><strong>Materials and methods: </strong>A prospective randomized comparative study was performed from 1st January 2020 to 30th June 2021. All patients included were diagnosed with localized/locally advanced ca prostate. 60 patients fulfilling the inclusion and exclusion criteria were randomized into 2 groups. Groups A and B included patients who underwent robot-assisted radical prostatectomy and 3D laparoscopic transperitoneal radical prostatectomy, respectively. Various demographic, intraoperative, postoperative, and follow-up parameters were collected. Outcomes were evaluated in the form of the trifecta (continence, potency, and BCR-free status) and pentafecta rates (trifecta with no perioperative complications and negative surgical margins) in between the two groups.</p><p><strong>Results: </strong>The mean operative time in Group A was 137.83 mins ± 17.27 compared to 148.20 mins ± 26.16 in Group B. Trifecta rates in Group A and Group B were 43.3%, 63.3%, and 76.6% and 40%, 53.3%, and 70% at 1, 3, and 6 months. Pentafecta rates in Group A and Group B were 36.6%, 53.3%, and 70% and 33.3%, 40%, and 53.3% at 1, 3, and 6 months. Complication rates were 10% in Group A and 13.3% in Group B, respectively. Only one patient in our study (Group B) had a positive surgical margin.</p><p><strong>Conclusions: </strong>We conclude from our comparative study, that both robot-assisted and 3D laparoscopic transperitoneal radical prostatectomy are feasible and efficacious treatment modalities for achieving acceptable trifecta and pentafecta rates in managing ca prostate with earlier continence and shorter urethrovesical anastomosis time in the robotic arm.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2023 ","pages":"4666116"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Potential Protective Effect of Alcohol Consumption in Male Genital Lichen Sclerosus: A Case-Control Study. 酒精消费对男性生殖器硬化地衣的潜在保护作用:一项病例对照研究。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/7208312
Joey El Khoury, Jessica Andraos, Anthony Kanbar, Rami Halabi, Serge Assaf, Anthony Mina, Sabine El Breidi, Charbel Dabal, Charbel El Hachem, Rodrigue Saad, Antoine Kassis, Maher Abdessater, Raghid El Khoury

Materials and methods: A nested case-control study design was chosen. Subjects enrolled were adult male patients who had a circumcision between January 2010 and December 2020 at our university hospital, with a confirmed LSc diagnosis on pathology. Cases were matched with controls by age with a ratio of 1 : 1, all of whom were circumcised and had a negative pathology report. Data collection consisted of sociodemographic, behavioral, and past medical and familial history characteristics.

Results: A total of 94 patients were enrolled. The mean age was 49.81 (±22.92) in the group of men with LSc. No significant differences in sociodemographic characteristics (age and BMI) were found between the two compared groups. Smoking cannot predict LSc as opposed to alcohol consumption, which we found to be a protective factor against the appearance of LSc (p=0.027). Men with LSc had significantly higher rates of diabetes (p=0.021) and hypertension (p=0.004). No associations were found between LSc and the presenting chief complaints, family history of LSc, and past penile trauma.

Conclusion: In this study, we were able to compare multiple variables between 47 circumcised patients diagnosed with LSc and a control group. We found that LSc patients showed higher rates of diabetes and hypertension. A potential protective effect of alcohol consumption is to be explored in future projects with bigger sample sizes and higher statistical powers.

材料与方法:采用巢式病例对照研究设计。纳入的受试者为2010年1月至2020年12月在我校医院行包皮环切术的成年男性患者,病理确诊为LSc。病例按年龄与对照按1:1的比例匹配,所有患者均行包皮环切术,病理报告阴性。数据收集包括社会人口学、行为、既往病史和家族史特征。结果:共纳入94例患者。LSc男性组平均年龄49.81(±22.92)岁。两组比较在社会人口学特征(年龄和BMI)上没有发现显著差异。与饮酒相反,吸烟不能预测LSc,我们发现饮酒是防止LSc出现的保护因素(p=0.027)。患有LSc的男性患糖尿病(p=0.021)和高血压(p=0.004)的几率明显更高。没有发现LSc与主诉、LSc家族史和既往阴茎创伤之间的联系。结论:在这项研究中,我们能够比较47例被诊断为LSc的包皮环切术患者和对照组之间的多个变量。我们发现LSc患者患糖尿病和高血压的比例更高。酒精消费的潜在保护作用将在未来更大的样本量和更高的统计能力的项目中进行探索。
{"title":"A Potential Protective Effect of Alcohol Consumption in Male Genital Lichen Sclerosus: A Case-Control Study.","authors":"Joey El Khoury,&nbsp;Jessica Andraos,&nbsp;Anthony Kanbar,&nbsp;Rami Halabi,&nbsp;Serge Assaf,&nbsp;Anthony Mina,&nbsp;Sabine El Breidi,&nbsp;Charbel Dabal,&nbsp;Charbel El Hachem,&nbsp;Rodrigue Saad,&nbsp;Antoine Kassis,&nbsp;Maher Abdessater,&nbsp;Raghid El Khoury","doi":"10.1155/2023/7208312","DOIUrl":"https://doi.org/10.1155/2023/7208312","url":null,"abstract":"<p><strong>Materials and methods: </strong>A nested case-control study design was chosen. Subjects enrolled were adult male patients who had a circumcision between January 2010 and December 2020 at our university hospital, with a confirmed LSc diagnosis on pathology. Cases were matched with controls by age with a ratio of 1 : 1, all of whom were circumcised and had a negative pathology report. Data collection consisted of sociodemographic, behavioral, and past medical and familial history characteristics.</p><p><strong>Results: </strong>A total of 94 patients were enrolled. The mean age was 49.81 (±22.92) in the group of men with LSc. No significant differences in sociodemographic characteristics (age and BMI) were found between the two compared groups. Smoking cannot predict LSc as opposed to alcohol consumption, which we found to be a protective factor against the appearance of LSc (<i>p</i>=0.027). Men with LSc had significantly higher rates of diabetes (<i>p</i>=0.021) and hypertension (<i>p</i>=0.004). No associations were found between LSc and the presenting chief complaints, family history of LSc, and past penile trauma.</p><p><strong>Conclusion: </strong>In this study, we were able to compare multiple variables between 47 circumcised patients diagnosed with LSc and a control group. We found that LSc patients showed higher rates of diabetes and hypertension. A potential protective effect of alcohol consumption is to be explored in future projects with bigger sample sizes and higher statistical powers.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2023 ","pages":"7208312"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Advances in Urology
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