首页 > 最新文献

Advances in Urology最新文献

英文 中文
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。
{"title":"A Review of Electronic Early Warning Systems for Acute Kidney Injury.","authors":"Xiangxiang Wang, Zhixiang Bian, Rui Zhu, Shunjie Chen","doi":"10.1155/2024/6456411","DOIUrl":"https://doi.org/10.1155/2024/6456411","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387247","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
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。
{"title":"Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer.","authors":"Christopher J D Wallis, Kevin C Chen, Stuart Atkinson, Deborah M Boldt-Houle","doi":"10.1155/2024/2988289","DOIUrl":"10.1155/2024/2988289","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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/m<sup>2</sup> = 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).</p><p><strong>Conclusions: </strong>Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379882","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
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。
{"title":"Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement.","authors":"Kerith R Wang, Rishabh K Simhal, Cassra B Clark, Mark J Mann, James R Mark, Costas D Lallas, Robert Den, Edouard J Trabulsi","doi":"10.1155/2024/3439727","DOIUrl":"https://doi.org/10.1155/2024/3439727","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i>=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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278965","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
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。
{"title":"Photodynamic Therapeutic Effect during 5-Aminolevulinic Acid-Mediated Photodynamic Diagnosis-Assisted Transurethral Resection of Bladder Tumors.","authors":"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","doi":"10.1155/2024/7548001","DOIUrl":"10.1155/2024/7548001","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods and materials: </strong>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 <sup><i>ε</i></sup> -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.</p><p><strong>Results: </strong>Immunohistochemical analysis revealed a significant increase in production of thymidine glycol and N <sup><i>ε</i></sup> -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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892651","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
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":null,"pages":null},"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
Routine Surveillance of Upper Urinary Tract Imaging for Diagnosing Upper Urinary Tract Urothelial Cancer Recurrence in Patients with Nonmuscle Invasive Bladder Cancer 常规监测上尿路成像以诊断非肌层浸润性膀胱癌患者的上尿路上皮癌复发
IF 1.4 Q3 Medicine Pub Date : 2024-05-21 DOI: 10.1155/2024/5894288
N. Nishimura, M. Miyake, Tatsuki Miyamoto, T. Shimizu, Tomomi Fujii, Y. Morizawa, S. Hori, D. Gotoh, Y. Nakai, K. Torimoto, N. Tanaka, K. Fujimoto
Background. Although routine surveillance imaging to examine upper urinary tract urothelial cancer recurrence during follow-up of nonmuscle invasive bladder cancer is recommended, its necessity remains invalidated. A single-institute long-term follow-up cohort study to evaluate the clinical impact of routine surveillance imaging and identify risk factors for upper urinary tract urothelial cancer recurrence after nonmuscle invasive bladder cancer treatment was conducted. Methods and Materials. A retrospective chart review of 864 patients with primary nonmuscle invasive bladder cancer who underwent initial transurethral resection of bladder tumor between 1980 and 2020 was conducted. The opportunities to diagnose its recurrence were examined. Moreover, oncological outcomes included upper urinary tract urothelial cancer recurrence-free survival and overall survival. Results. Of 864 patients, 19 (2.2%) experienced upper urinary tract urothelial cancer recurrence. Among 19 patients, recurrence was detected through routine imaging in 12 (63.2%), cystoscopy in 2 (10.5%), urine cytology in 2 (10.5%), and presence of gross hematuria in 1 (5.3%). All patients had high- or highest-risk NMIBC at diagnosis of primary nonmuscle invasive bladder cancer. On multivariate Fine-Gray proportional regression analyses, a tumor size of ≥30 mm and carcinoma in situ were independently associated with short upper urinary tract urothelial cancer recurrence-free survival (P=0.040 and 0.0089, respectively). Conclusion. Most patients experiencing upper urinary tract urothelial cancer recurrence were diagnosed by routine surveillance imaging, suggesting its clinical importance, especially for patients with nonmuscle invasive bladder cancer accompanied by a tumor size of ≥30 mm and carcinoma in situ.
背景。尽管建议在非肌层浸润性膀胱癌随访期间进行常规监测成像以检查上尿路尿路癌复发情况,但其必要性仍未得到证实。为了评估常规监测成像的临床影响并确定非肌层浸润性膀胱癌治疗后上尿路尿路上皮癌复发的风险因素,我们进行了一项单一机构的长期随访队列研究。方法和材料。对 1980 年至 2020 年间接受初次经尿道膀胱肿瘤切除术的 864 例原发性非肌层浸润性膀胱癌患者进行回顾性病历审查。研究还考察了诊断复发的机会。此外,肿瘤学结果包括上尿路尿路上皮癌无复发生存率和总生存率。研究结果在864名患者中,19人(2.2%)经历了上尿路尿路癌复发。在19名患者中,12人(63.2%)通过常规影像学检查发现复发,2人(10.5%)通过膀胱镜检查发现复发,2人(10.5%)通过尿液细胞学检查发现复发,1人(5.3%)通过毛细血尿发现复发。所有患者在确诊为原发性非肌层浸润性膀胱癌时均患有高风险或最高风险的 NMIBC。在多变量Fine-Gray比例回归分析中,肿瘤大小≥30毫米和原位癌与上尿路尿路上皮癌无复发生存期短独立相关(P=0.040和0.0089)。结论大多数上尿路尿路上皮癌复发患者是通过常规监测成像诊断出来的,这表明其临床重要性,尤其是对于肿瘤大小≥30毫米和原位癌的非肌层浸润性膀胱癌患者。
{"title":"Routine Surveillance of Upper Urinary Tract Imaging for Diagnosing Upper Urinary Tract Urothelial Cancer Recurrence in Patients with Nonmuscle Invasive Bladder Cancer","authors":"N. Nishimura, M. Miyake, Tatsuki Miyamoto, T. Shimizu, Tomomi Fujii, Y. Morizawa, S. Hori, D. Gotoh, Y. Nakai, K. Torimoto, N. Tanaka, K. Fujimoto","doi":"10.1155/2024/5894288","DOIUrl":"https://doi.org/10.1155/2024/5894288","url":null,"abstract":"Background. Although routine surveillance imaging to examine upper urinary tract urothelial cancer recurrence during follow-up of nonmuscle invasive bladder cancer is recommended, its necessity remains invalidated. A single-institute long-term follow-up cohort study to evaluate the clinical impact of routine surveillance imaging and identify risk factors for upper urinary tract urothelial cancer recurrence after nonmuscle invasive bladder cancer treatment was conducted. Methods and Materials. A retrospective chart review of 864 patients with primary nonmuscle invasive bladder cancer who underwent initial transurethral resection of bladder tumor between 1980 and 2020 was conducted. The opportunities to diagnose its recurrence were examined. Moreover, oncological outcomes included upper urinary tract urothelial cancer recurrence-free survival and overall survival. Results. Of 864 patients, 19 (2.2%) experienced upper urinary tract urothelial cancer recurrence. Among 19 patients, recurrence was detected through routine imaging in 12 (63.2%), cystoscopy in 2 (10.5%), urine cytology in 2 (10.5%), and presence of gross hematuria in 1 (5.3%). All patients had high- or highest-risk NMIBC at diagnosis of primary nonmuscle invasive bladder cancer. On multivariate Fine-Gray proportional regression analyses, a tumor size of ≥30 mm and carcinoma in situ were independently associated with short upper urinary tract urothelial cancer recurrence-free survival (P=0.040 and 0.0089, respectively). Conclusion. Most patients experiencing upper urinary tract urothelial cancer recurrence were diagnosed by routine surveillance imaging, suggesting its clinical importance, especially for patients with nonmuscle invasive bladder cancer accompanied by a tumor size of ≥30 mm and carcinoma in situ.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114269","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}
引用次数: 0
SLAP Trial: Shock Wave Lithotripsy and Mechanical Percussion Therapy Post ESWL for Renal Calculi SLAP试验:肾结石 ESWL 后的冲击波碎石和机械冲击疗法
IF 1.4 Q3 Medicine Pub Date : 2024-03-26 DOI: 10.1155/2024/7870425
Nishal Patel, Adrian Roe, Donna Stanton, Jay Roberts, Akshay Kothari
Methods We conducted a prospective randomised control trial. Included patients were males and females greater than 18 years of age with single or multiple ipsilateral renal calculi of total ≤10 mm on plain X-ray and noncontrast CT KUB. ESWL was performed at a single centre, at supine position under general anaesthesia with maximum 3000 shocks at a rate of 100 shocks per minute. Patients were discharged and randomised to either the control arm or MPI therapy. MPI therapy was self-directed in a home setting for 10 minutes a day, three times per week. Both arms had standard follow-up at 12 weeks with a plain X-ray KUB. Patients in the control group were offered cross over to the MPI arm after 12 weeks if residual stone fragments were detected. Statistical analysis was performed using SPSS software via Chi squared and Fisher's exact tests. Ethical approval was obtained via the Prince Charles Hospital HREC Committee, HREC/2022/QPCH/84961. Results 70 patients met inclusion criteria and underwent ESWL, and 5 were withdrawn. 33 patients were randomised to the MPI group and 32 to the control group. MPI significantly increased the stone clearance rate anywhere in the kidney (87.9% in the MPI group versus 59.4% in the control group, p=0.089), as well as the clearance rate in the lower pole (91.7% in the MPI group versus 63.2% in the control group, p=0.022). Delayed percussion did not improve the clearance rate over primary percussion (p=0.835). Conclusion This study has shown that MPI can be effectively performed in a home setting without the need for medical supervision and results in improved stone clearance rates post ESWL. The main limitations to the study were the use of X-ray over CT during the follow-up and variability in MPI compliance and administration. Further research is warranted into standardising home MPI protocols. This trial is registered with ANZCTR387061.
方法 我们进行了一项前瞻性随机对照试验。纳入的患者为年龄大于 18 岁的男性和女性,经 X 光平片和 KUB 非对比 CT 检查发现单侧或多发性同侧肾结石,结石总量小于 10 毫米。ESWL 在单个中心进行,全身麻醉下仰卧位,最多冲击 3000 次,每分钟 100 次。患者出院后被随机分配到对照组或 MPI 治疗组。MPI 治疗是在家庭环境中进行的自我指导,每天 10 分钟,每周三次。两组患者均在 12 周后接受标准随访,并接受普通 X 光 KUB 检查。对照组患者如果在12周后检测到残留的结石碎片,则可转入MPI治疗组。统计分析采用 SPSS 软件,通过卡方检验和费雪精确检验进行。该研究获得了查尔斯王子医院HREC委员会的伦理批准(HREC/2022/QPCH/84961)。结果 70 名患者符合纳入标准并接受了 ESWL,5 名患者退出。33 名患者被随机分配到 MPI 组,32 名患者被随机分配到对照组。MPI 能明显提高肾脏任何部位结石的清除率(MPI 组为 87.9%,对照组为 59.4%,P=0.089)以及下极结石的清除率(MPI 组为 91.7%,对照组为 63.2%,P=0.022)。与初级叩诊相比,延迟叩诊并未提高清除率(p=0.835)。结论 本研究表明,MPI 可在家庭环境中有效进行,无需医疗监护,并能提高 ESWL 后的结石清除率。本研究的主要局限性在于随访期间使用的是 X 光而不是 CT,以及 MPI 合规性和管理的可变性。有必要对家庭 MPI 方案的标准化进行进一步研究。该试验已注册为 ANZCTR387061。
{"title":"SLAP Trial: Shock Wave Lithotripsy and Mechanical Percussion Therapy Post ESWL for Renal Calculi","authors":"Nishal Patel, Adrian Roe, Donna Stanton, Jay Roberts, Akshay Kothari","doi":"10.1155/2024/7870425","DOIUrl":"https://doi.org/10.1155/2024/7870425","url":null,"abstract":"Methods We conducted a prospective randomised control trial. Included patients were males and females greater than 18 years of age with single or multiple ipsilateral renal calculi of total ≤10 mm on plain X-ray and noncontrast CT KUB. ESWL was performed at a single centre, at supine position under general anaesthesia with maximum 3000 shocks at a rate of 100 shocks per minute. Patients were discharged and randomised to either the control arm or MPI therapy. MPI therapy was self-directed in a home setting for 10 minutes a day, three times per week. Both arms had standard follow-up at 12 weeks with a plain X-ray KUB. Patients in the control group were offered cross over to the MPI arm after 12 weeks if residual stone fragments were detected. Statistical analysis was performed using SPSS software via Chi squared and Fisher's exact tests. Ethical approval was obtained via the Prince Charles Hospital HREC Committee, HREC/2022/QPCH/84961. Results 70 patients met inclusion criteria and underwent ESWL, and 5 were withdrawn. 33 patients were randomised to the MPI group and 32 to the control group. MPI significantly increased the stone clearance rate anywhere in the kidney (87.9% in the MPI group versus 59.4% in the control group, p=0.089), as well as the clearance rate in the lower pole (91.7% in the MPI group versus 63.2% in the control group, p=0.022). Delayed percussion did not improve the clearance rate over primary percussion (p=0.835). Conclusion This study has shown that MPI can be effectively performed in a home setting without the need for medical supervision and results in improved stone clearance rates post ESWL. The main limitations to the study were the use of X-ray over CT during the follow-up and variability in MPI compliance and administration. Further research is warranted into standardising home MPI protocols. This trial is registered with ANZCTR387061.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378151","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}
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 Medicine 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。
{"title":"Pelvic Pain of Myofascial Origin in Women: Correlation with Lower Urinary Tract Symptoms.","authors":"Sabrina Einig, Esther Ruess, Andreas Schoetzau, Kerstin Ayllon Bartet, Viola Heinzelmann-Schwarz, Francesco Vigo, Tilemachos Kavvadias","doi":"10.1155/2024/5568010","DOIUrl":"10.1155/2024/5568010","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i> < 0.001) as well as the bladder function score (<i>p</i> < 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206186","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
Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study 经直肠前列腺活检中,5 毫升 1%利多卡因的较低剂量比传统的 10 毫升更适合用于尾部阻滞:一项回顾性队列研究
IF 1.4 Q3 Medicine Pub Date : 2024-02-14 DOI: 10.1155/2024/9331738
Norichika Ueda, Mototaka Sato, Shunsuke Mori, Atsuki Matsukawa, Yuta Oki, Yuma Kujime, Ryoya Mizuno, Hiromu Horitani, Tetsuya Yamamoto, S. Fukae, Mitsuhiro Yoshinaga, Makoto Matsushita, Mai Akiyama, Satoshi Kamido, Ayako Honda, Jiro Nakayama, Norihide Tei, Osamu Miyake
Objectives. In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods. This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results. In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions. Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.
目的。在日本,经直肠前列腺活检通常使用 1%利多卡因进行尾部阻滞。虽然通常使用 10 毫升 1%利多卡因,但 1%利多卡因的适当剂量尚未得到研究。我院在经直肠前列腺活检中常规使用两种不同剂量(5 毫升或 10 毫升)的 1%利多卡因进行尾部阻滞。在此,我们对两种剂量的 1%利多卡因的有效性和安全性进行了回顾性评估。方法。这项回顾性研究纳入了在我院接受经直肠前列腺活检并进行尾部阻滞的 869 例患者。1%利多卡因的用量由活检的星期决定,患者自愿选择活检的日子,并不知道当天使用的1%利多卡因剂量。对疼痛、肛门括约肌张力、癌症诊断率和早期并发症进行了比较。结果分别有 466 名和 403 名患者接受了 5 毫升和 10 毫升 1%利多卡因的尾部阻滞。根据患者特征进行倾向分数匹配后,每组各有 395 名患者。两组患者的疼痛评分、肛门括约肌张力评分或前列腺癌诊断率无明显差异。不过,10 毫升组直肠出血的频率和严重程度明显高于 5 毫升组(分别为 p=0.018 和 p=0.0036)。其他并发症的发生率在两组间无明显差异。结论。我们的研究结果表明,在经直肠前列腺活检过程中,5 毫升 1%利多卡因可能比 10 毫升更适合用于尾部阻滞。
{"title":"Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study","authors":"Norichika Ueda, Mototaka Sato, Shunsuke Mori, Atsuki Matsukawa, Yuta Oki, Yuma Kujime, Ryoya Mizuno, Hiromu Horitani, Tetsuya Yamamoto, S. Fukae, Mitsuhiro Yoshinaga, Makoto Matsushita, Mai Akiyama, Satoshi Kamido, Ayako Honda, Jiro Nakayama, Norihide Tei, Osamu Miyake","doi":"10.1155/2024/9331738","DOIUrl":"https://doi.org/10.1155/2024/9331738","url":null,"abstract":"Objectives. In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods. This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results. In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions. Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139778021","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}
引用次数: 0
Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study 经直肠前列腺活检中,5 毫升 1%利多卡因的较低剂量比传统的 10 毫升更适合用于尾部阻滞:一项回顾性队列研究
IF 1.4 Q3 Medicine Pub Date : 2024-02-14 DOI: 10.1155/2024/9331738
Norichika Ueda, Mototaka Sato, Shunsuke Mori, Atsuki Matsukawa, Yuta Oki, Yuma Kujime, Ryoya Mizuno, Hiromu Horitani, Tetsuya Yamamoto, S. Fukae, Mitsuhiro Yoshinaga, Makoto Matsushita, Mai Akiyama, Satoshi Kamido, Ayako Honda, Jiro Nakayama, Norihide Tei, Osamu Miyake
Objectives. In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods. This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results. In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions. Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.
目的。在日本,经直肠前列腺活检通常使用 1%利多卡因进行尾部阻滞。虽然通常使用 10 毫升 1%利多卡因,但 1%利多卡因的适当剂量尚未得到研究。我院在经直肠前列腺活检中常规使用两种不同剂量(5 毫升或 10 毫升)的 1%利多卡因进行尾部阻滞。在此,我们对两种剂量的 1%利多卡因的有效性和安全性进行了回顾性评估。方法。这项回顾性研究纳入了在我院接受经直肠前列腺活检并进行尾部阻滞的 869 例患者。1%利多卡因的用量由活检的星期决定,患者自愿选择活检的日子,并不知道当天使用的1%利多卡因剂量。对疼痛、肛门括约肌张力、癌症诊断率和早期并发症进行了比较。结果分别有 466 名和 403 名患者接受了 5 毫升和 10 毫升 1%利多卡因的尾部阻滞。根据患者特征进行倾向分数匹配后,每组各有 395 名患者。两组患者的疼痛评分、肛门括约肌张力评分或前列腺癌诊断率无明显差异。不过,10 毫升组直肠出血的频率和严重程度明显高于 5 毫升组(分别为 p=0.018 和 p=0.0036)。其他并发症的发生率在两组间无明显差异。结论。我们的研究结果表明,在经直肠前列腺活检过程中,5 毫升 1%利多卡因可能比 10 毫升更适合用于尾部阻滞。
{"title":"Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study","authors":"Norichika Ueda, Mototaka Sato, Shunsuke Mori, Atsuki Matsukawa, Yuta Oki, Yuma Kujime, Ryoya Mizuno, Hiromu Horitani, Tetsuya Yamamoto, S. Fukae, Mitsuhiro Yoshinaga, Makoto Matsushita, Mai Akiyama, Satoshi Kamido, Ayako Honda, Jiro Nakayama, Norihide Tei, Osamu Miyake","doi":"10.1155/2024/9331738","DOIUrl":"https://doi.org/10.1155/2024/9331738","url":null,"abstract":"Objectives. In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods. This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results. In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions. Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837723","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}
引用次数: 0
期刊
Advances in Urology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1