Pub Date : 2021-02-15eCollection Date: 2021-01-01DOI: 10.1155/2021/8822186
Aino Fianu Jonasson, Karin Bryder, Elisabeth Sthengel
A multicenter, randomized, controlled clinical trial and four postmarket user acceptance investigations were carried out to document the safety, performance, and user acceptance of Efemia Bladder Support, a novel vaginal inlay for the temporary reduction of stress urinary incontinence (SUI). The clinical investigation enrolled 97 women diagnosed with SUI, randomized 3 : 1 to either treatment or standard care (control). The primary endpoint was reduction of urine leakage, measured as change in pad weight baseline week compared with treatment week. Secondary endpoints were treatment success, calculated as the percentage of subjects with >70% reduction in pad weight, reduction in incontinence episodes, and quality of life (QoL). 75 women (77%) completed the clinical investigation. No serious adverse events occurred. The treatment group reached a 55% (p < 0.001) mean reduction of total leakage compared to the control arm. A subanalysis, involving only leakage during provocation testing (coughing and jumping), showed a 67% (p < 0.001) mean reduction of leakage. No significant effect on QoL could be observed. 51% of the women answered "yes" to the question if they would use the device to reduce SUI. The user acceptance of the device was further investigated in four postmarket studies, using an improved device design with a slimmer centerpiece and a thinner handle, while keeping the effect achieving parts of the device unchanged. An average of 74% of the 102 participants in the postmarket studies reported that they were likely to continue using Efemia. The highest user satisfaction was seen in the two studies evaluating the use of Efemia during exercise, where 83% and 88% of the women were likely to continue using Efemia. It can be concluded that Efemia is a safe, well-tolerated, and effective alternative for reducing SUI, both in everyday life and during physical exercise.
{"title":"A Vaginal Inlay for Reduction of Stress Urinary Incontinence: Outcome of a Randomized Clinical Trial and Four User Acceptance Studies.","authors":"Aino Fianu Jonasson, Karin Bryder, Elisabeth Sthengel","doi":"10.1155/2021/8822186","DOIUrl":"https://doi.org/10.1155/2021/8822186","url":null,"abstract":"<p><p>A multicenter, randomized, controlled clinical trial and four postmarket user acceptance investigations were carried out to document the safety, performance, and user acceptance of Efemia Bladder Support, a novel vaginal inlay for the temporary reduction of stress urinary incontinence (SUI). The clinical investigation enrolled 97 women diagnosed with SUI, randomized 3 : 1 to either treatment or standard care (control). The primary endpoint was reduction of urine leakage, measured as change in pad weight baseline week compared with treatment week. Secondary endpoints were treatment success, calculated as the percentage of subjects with >70% reduction in pad weight, reduction in incontinence episodes, and quality of life (QoL). 75 women (77%) completed the clinical investigation. No serious adverse events occurred. The treatment group reached a 55% (<i>p</i> < 0.001) mean reduction of total leakage compared to the control arm. A subanalysis, involving only leakage during provocation testing (coughing and jumping), showed a 67% (<i>p</i> < 0.001) mean reduction of leakage. No significant effect on QoL could be observed. 51% of the women answered \"yes\" to the question if they would use the device to reduce SUI. The user acceptance of the device was further investigated in four postmarket studies, using an improved device design with a slimmer centerpiece and a thinner handle, while keeping the effect achieving parts of the device unchanged. An average of 74% of the 102 participants in the postmarket studies reported that they were likely to continue using Efemia. The highest user satisfaction was seen in the two studies evaluating the use of Efemia during exercise, where 83% and 88% of the women were likely to continue using Efemia. It can be concluded that Efemia is a safe, well-tolerated, and effective alternative for reducing SUI, both in everyday life and during physical exercise.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"8822186"},"PeriodicalIF":1.4,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402432","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}
Objective: To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. Material and Methods. We carried out a cross-sectional study over a seven years' period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups.
Results: 310 cases of UGF were included. IF accounted for 25.8% (n = 80) versus 74.2% (n = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05-3.1]), low level of education (OR = 5.4; CI = [2.3-12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7-6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1-4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1-20.5]).
Conclusion: OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair.
{"title":"Characteristics of Obstetric and Iatrogenic Urogenital Fistulas in Burkina Faso: A Cross-Sectional Study.","authors":"Fasnéwindé Aristide Kabore, Stéphanie Dominique Amida Nama, Boureima Ouedraogo, Moussa Kabore, Adama Ouattara, Brahima Kirakoya, Gilles Karsenty","doi":"10.1155/2021/8838146","DOIUrl":"https://doi.org/10.1155/2021/8838146","url":null,"abstract":"<p><strong>Objective: </strong>To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. <i>Material and Methods</i>. We carried out a cross-sectional study over a seven years' period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups.</p><p><strong>Results: </strong>310 cases of UGF were included. IF accounted for 25.8% (<i>n</i> = 80) versus 74.2% (<i>n</i> = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05-3.1]), low level of education (OR = 5.4; CI = [2.3-12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7-6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1-4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1-20.5]).</p><p><strong>Conclusion: </strong>OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"8838146"},"PeriodicalIF":1.4,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25325160","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}
Pub Date : 2021-01-11eCollection Date: 2021-01-01DOI: 10.1155/2021/2410951
Gampo A Irdam, Bobby Sutojo, Putu A R Raharja
Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2-10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation (p < 0.001). We also found that donors with number of arteries more than 2 (p < 0.001) and prolonged warm ischemic time (p < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.
输尿管狭窄是肾移植术后最常见的泌尿系统并发症之一。它发生在2-10%的患者中,对患者来说是一个严重的问题,因为它可能导致肾脏损害的永久性损害。识别危险因素对预防输尿管狭窄的发生具有重要意义。因此,我们的目的是确定印度尼西亚人群输尿管狭窄的危险因素。这是对2014年至2018年在Cipto Mangunkusumo医院接受肾移植手术的487名患者的回顾性分析。我们收集并比较输尿管狭窄受者和未发生输尿管狭窄受者的供者和受者的人口学数据。输尿管狭窄定义为超声显示肾积水和血清肌酐增高。2014年1月至2018年6月,我中心肾移植术后输尿管狭窄总发生率为6.6%(487例患者中32例)。我们发现,肾移植术后输尿管狭窄的发生率较高的供体和受体年龄(p p p
{"title":"Risk Factors of Ureteral Stenosis in Kidney Transplant Recipients: A Retrospective Study in National Referral Hospital in Indonesia.","authors":"Gampo A Irdam, Bobby Sutojo, Putu A R Raharja","doi":"10.1155/2021/2410951","DOIUrl":"https://doi.org/10.1155/2021/2410951","url":null,"abstract":"<p><p>Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2-10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation (<i>p</i> < 0.001). We also found that donors with number of arteries more than 2 (<i>p</i> < 0.001) and prolonged warm ischemic time (<i>p</i> < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"2410951"},"PeriodicalIF":1.4,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38873619","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}
Pub Date : 2021-01-06eCollection Date: 2021-01-01DOI: 10.1155/2021/6612371
B M Zeeshan Hameed, Milap J Shah, Nithesh Naik, Mohan Amaresh, Padmaraj Hegde, Rahil Hussein Beary, Suraj Jayadeva, Bhaskar K Somani
Background: Forgotten ureteral stents (FUS) and stent-related symptoms (SRS) lead to increased postprocedural emergency department visits and add to the psychological and financial burden of the patients.
Purpose: To review the usage and benefits of ureteral stent tracking and symptom monitoring through a single smartphone-based application (App) platform with 2-way clinician-patient communication. This study also compared the features with other smartphone apps used for stent tracking.
Materials and methods: 100 patients were included in this single-center prospective study conducted between September 2019 and December 2019. Patients who had metallic or long-term indwelling stents, noncomprehensible patients, and those not willing to share their data were excluded from the study.
Results: Of 100 patients, 92 downloaded the Urostentz application, and 72 (78.2%) patients answered the pictorial symptom questionnaire. Symptom score analysis suggested that 62 patients (86.1%) had stent-related symptoms of which 3 required readmission and underwent early stent removal. The mean stent duration was 17.2 + 3.5 days (range: 11-23 days), with 69% of patients having their stent removed on the scheduled date and 25% of patients requesting a change of their appointment via the App.
Conclusion: In this study, there was no case of FUS encountered. The "Urostentz" App is a freely available patient safety stent tracking application that provides a secure and simplified interface, which can significantly reduce the incidence of FUS and provide digital remote assistance in the management of stent-related symptoms.
{"title":"Are Technology-Driven Mobile Phone Applications (Apps) the New Currency for Digital Stent Registries and Patient Communication: Prospective Outcomes Using Urostentz App.","authors":"B M Zeeshan Hameed, Milap J Shah, Nithesh Naik, Mohan Amaresh, Padmaraj Hegde, Rahil Hussein Beary, Suraj Jayadeva, Bhaskar K Somani","doi":"10.1155/2021/6612371","DOIUrl":"https://doi.org/10.1155/2021/6612371","url":null,"abstract":"<p><strong>Background: </strong>Forgotten ureteral stents (FUS) and stent-related symptoms (SRS) lead to increased postprocedural emergency department visits and add to the psychological and financial burden of the patients.</p><p><strong>Purpose: </strong>To review the usage and benefits of ureteral stent tracking and symptom monitoring through a single smartphone-based application (App) platform with 2-way clinician-patient communication. This study also compared the features with other smartphone apps used for stent tracking.</p><p><strong>Materials and methods: </strong>100 patients were included in this single-center prospective study conducted between September 2019 and December 2019. Patients who had metallic or long-term indwelling stents, noncomprehensible patients, and those not willing to share their data were excluded from the study.</p><p><strong>Results: </strong>Of 100 patients, 92 downloaded the Urostentz application, and 72 (78.2%) patients answered the pictorial symptom questionnaire. Symptom score analysis suggested that 62 patients (86.1%) had stent-related symptoms of which 3 required readmission and underwent early stent removal. The mean stent duration was 17.2 + 3.5 days (range: 11-23 days), with 69% of patients having their stent removed on the scheduled date and 25% of patients requesting a change of their appointment via the App.</p><p><strong>Conclusion: </strong>In this study, there was no case of FUS encountered. The \"Urostentz\" App is a freely available patient safety stent tracking application that provides a secure and simplified interface, which can significantly reduce the incidence of FUS and provide digital remote assistance in the management of stent-related symptoms.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"6612371"},"PeriodicalIF":1.4,"publicationDate":"2021-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868634","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}
Pub Date : 2020-07-30eCollection Date: 2020-01-01DOI: 10.1155/2020/2108362
Anthony J Schaeffer, Patrick C Cartwright, Glen A Lau, Mark D Ebert, Nora F Fino, Flory L Nkoy, Rachel Hess
Purpose: The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. Study Design and Data Source. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. Data Collection. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. Primary Outcome. Sum of radiologic studies within the first year of life or prior to pyeloplasty. Statistical Analysis. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade.
Results: Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42-1.73) and severe (RR: 2.09; 95% CI: 1.88-2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders.
Conclusions: In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.
{"title":"Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life.","authors":"Anthony J Schaeffer, Patrick C Cartwright, Glen A Lau, Mark D Ebert, Nora F Fino, Flory L Nkoy, Rachel Hess","doi":"10.1155/2020/2108362","DOIUrl":"10.1155/2020/2108362","url":null,"abstract":"<p><strong>Purpose: </strong>The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. <i>Study Design and Data Source</i>. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. <i>Data Collection</i>. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. <i>Primary Outcome</i>. Sum of radiologic studies within the first year of life or prior to pyeloplasty. <i>Statistical Analysis</i>. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade.</p><p><strong>Results: </strong>Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42-1.73) and severe (RR: 2.09; 95% CI: 1.88-2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders.</p><p><strong>Conclusions: </strong>In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2020 ","pages":"2108362"},"PeriodicalIF":1.4,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2108362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10389260","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}
Pub Date : 2019-12-12eCollection Date: 2019-01-01DOI: 10.1155/2019/2614586
John Barnard, Tyler Overholt, Ali Hajiran, Chad Crigger, Morris Jessop, Jennifer Knight, Chad Morley
<p><p>Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder injuries from time of injury to catheter removal. A retrospective review was performed on 34,413 blunt trauma cases to identify traumatic bladder ruptures over the past 10 years (January 2008-January 2018) at our tertiary care facility. Patient data were collected including age, gender, BMI, mechanism of injury, and type of injury. The primary treatment modality (surgical repair vs. catheter drainage only), length of catheterization, and post-injury complications were also assessed. Review of our institutional trauma database identified 44 patients with bladder trauma. Mean age was 41 years, mean BMI was 24.8 kg/m<sup>2</sup>, 95% were Caucasian, and 55% were female. Motor vehicle collision (MVC) was the most common mechanism, representing 45% of total injuries. Other mechanisms included falls (20%) and all-terrain vehicle (ATV) accidents (13.6%). 31 patients had extraperitoneal injury, and 13 were intraperitoneal. Pelvic fractures were present in 93%, and 39% had additional solid organ injuries. Formal cystogram was performed in 59% on presentation, and mean time to cystogram was 4 hours. Gross hematuria was noted in 95% of cases. Operative management was performed for all intraperitoneal injuries and 35.5% of extraperitoneal cases. Bladder closure in operative cases was typically performed in 2 layers with absorbable suture in a running fashion. The intraperitoneal and extraperitoneal injuries managed operatively were compared, and length of catheterization (28 d vs. 22 d, <i>p</i>=0.46), time from injury to normal fluorocystogram (19.8 d vs. 20.7 d, <i>p</i>=0.80), and time from injury to repair (4.3 vs. 60.5 h, <i>p</i>=0.23) were not statistically different between cohorts. Patients whose catheter remained in place for greater than 14 days had prolonged time to initial cystogram (26.6 d vs. 11.5 d) compared with those whose foley catheter was removed within 14 days. The complication rate was 21% for catheters left more than 14 days while patients whose catheter remained less than 14 days experienced no complications. The present study provides a 10-year retrospective review characterizing the presentation, management, and follow-up of bladder trauma patients at our level 1 trauma center. Based on our findings, we have developed an institutional proto
膀胱破裂仅发生在 1.6% 的腹盆腔钝性创伤病例中。膀胱破裂虽然罕见,但如果未得到诊断或处理不当,会导致严重的发病率。AUA 泌尿创伤指南建议,无论是否需要手术修复,尿道导管引流都是腹膜外和腹膜内膀胱破裂的标准治疗方法。但是,对于导尿时间的长短并没有给出具体的指导。本研究旨在总结我们三级医疗中心对膀胱创伤的当代管理方法,评估导尿时间对膀胱损伤和并发症的影响,并制定从损伤到拔除导尿管的膀胱损伤管理方案。我们对 34,413 例钝性外伤病例进行了回顾性审查,以确定过去 10 年(2008 年 1 月至 2018 年 1 月)在我们的三级医疗机构发生的外伤性膀胱破裂。收集的患者数据包括年龄、性别、体重指数、损伤机制和损伤类型。此外,还评估了主要治疗方式(手术修复与仅导管引流)、导管插入时间以及伤后并发症。通过查阅本机构的创伤数据库,共发现 44 名膀胱创伤患者。平均年龄为 41 岁,平均体重指数为 24.8 kg/m2,95% 为白种人,55% 为女性。机动车碰撞(MVC)是最常见的受伤机制,占总受伤人数的45%。其他原因包括摔伤(20%)和全地形车(ATV)事故(13.6%)。31例患者为腹膜外损伤,13例为腹膜内损伤。93%的患者有骨盆骨折,39%的患者有其他实体器官损伤。59%的患者在就诊时进行了正式的膀胱造影,膀胱造影的平均时间为4小时。95%的病例出现毛细血尿。所有腹膜内损伤和35.5%的腹膜外损伤病例均接受了手术治疗。手术病例的膀胱闭合一般分为两层,采用可吸收缝合线进行缝合。对腹膜内和腹膜外损伤的手术处理进行了比较,结果发现导尿时间(28 d vs. 22 d,p=0.46)、从损伤到膀胱荧光造影正常的时间(19.8 d vs. 20.7 d,p=0.80)以及从损伤到修复的时间(4.3 h vs. 60.5 h,p=0.23)在不同组别之间没有统计学差异。与 14 天内拔除导尿管的患者相比,导尿管留置时间超过 14 天的患者初次膀胱造影时间较长(26.6 天 vs. 11.5 天)。导尿管留置时间超过 14 天的患者并发症发生率为 21%,而导尿管留置时间少于 14 天的患者没有并发症发生。本研究对我们一级创伤中心的膀胱创伤患者的发病、管理和随访情况进行了为期 10 年的回顾性分析。根据我们的研究结果,我们制定了一项机构协议,其中包括关于外伤性膀胱破裂后导尿时间长短的建议。我们希望通过为初始随访膀胱造影和气管插管拔除提供具体指导,降低患者因长时间导尿而导致的发病率。进一步的研究将使多学科创伤团队能够对膀胱外伤患者进行标准化管理、简化护理并将并发症降至最低。
{"title":"Traumatic Bladder Ruptures: A Ten-Year Review at a Level 1 Trauma Center.","authors":"John Barnard, Tyler Overholt, Ali Hajiran, Chad Crigger, Morris Jessop, Jennifer Knight, Chad Morley","doi":"10.1155/2019/2614586","DOIUrl":"10.1155/2019/2614586","url":null,"abstract":"<p><p>Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder injuries from time of injury to catheter removal. A retrospective review was performed on 34,413 blunt trauma cases to identify traumatic bladder ruptures over the past 10 years (January 2008-January 2018) at our tertiary care facility. Patient data were collected including age, gender, BMI, mechanism of injury, and type of injury. The primary treatment modality (surgical repair vs. catheter drainage only), length of catheterization, and post-injury complications were also assessed. Review of our institutional trauma database identified 44 patients with bladder trauma. Mean age was 41 years, mean BMI was 24.8 kg/m<sup>2</sup>, 95% were Caucasian, and 55% were female. Motor vehicle collision (MVC) was the most common mechanism, representing 45% of total injuries. Other mechanisms included falls (20%) and all-terrain vehicle (ATV) accidents (13.6%). 31 patients had extraperitoneal injury, and 13 were intraperitoneal. Pelvic fractures were present in 93%, and 39% had additional solid organ injuries. Formal cystogram was performed in 59% on presentation, and mean time to cystogram was 4 hours. Gross hematuria was noted in 95% of cases. Operative management was performed for all intraperitoneal injuries and 35.5% of extraperitoneal cases. Bladder closure in operative cases was typically performed in 2 layers with absorbable suture in a running fashion. The intraperitoneal and extraperitoneal injuries managed operatively were compared, and length of catheterization (28 d vs. 22 d, <i>p</i>=0.46), time from injury to normal fluorocystogram (19.8 d vs. 20.7 d, <i>p</i>=0.80), and time from injury to repair (4.3 vs. 60.5 h, <i>p</i>=0.23) were not statistically different between cohorts. Patients whose catheter remained in place for greater than 14 days had prolonged time to initial cystogram (26.6 d vs. 11.5 d) compared with those whose foley catheter was removed within 14 days. The complication rate was 21% for catheters left more than 14 days while patients whose catheter remained less than 14 days experienced no complications. The present study provides a 10-year retrospective review characterizing the presentation, management, and follow-up of bladder trauma patients at our level 1 trauma center. Based on our findings, we have developed an institutional proto","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2019 ","pages":"2614586"},"PeriodicalIF":1.8,"publicationDate":"2019-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37523580","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}
Donald Fedrigon, Kareem Alazem, S. Sivalingam, M. Monga, Juan Calle
Introduction Both elevated testosterone and polycystic ovary syndrome (PCOS) have been speculated as possible risk factors for kidney stone formation; however, the details of this potential relationship with regards to 24-hour urine metabolic panels and stone composition have not previously been characterized. Methods A total of 74 PCOS patients were retrospectively identified and matched with a cohort of female stone formers at a 3 : 1 ratio (by age and BMI). All patients had 24-hour urinary metabolic panels and stone compositions. These groups were compared using Pearson chi-square and Student t-tests. Additionally, the PCOS group was differentiated based on free testosterone using multivariate analysis. Results The case-control cohort showed that PCOS patients had significantly lower sodium excretion (p=0.015) and hypernatriuria rates (28.9% vs 50.9%, p=0.009). The PCOS-testosterone cohort demonstrated that high testosterone patients had significantly higher citrate values (p=0.041) and significantly lower odds of hypocitraturia (36.7% vs 54.2%, OR = 0.2, p=0.042). The high testosterone group also had higher sodium excretion (p=0.058) with significantly higher odds of having hypernatriuria (40.0% vs 13.6%, OR = 13.3, p=0.021). No significant patterns were revealed based on stone composition analysis. Conclusions Compared to healthy stone formers, PCOS patients did not demonstrate significant differences in 24-hour urine and stone composition values. Elevated free testosterone in PCOS patients has a significant association with higher urinary citrate and sodium values: findings that in and of themselves do not confirm the hypothesized increased risk of stone formation. This patient cohort may provide deeper insight into the interplay between androgens and stone formation; however, further study is needed to fully characterize the possible relationship between PCOS and stone formation.
睾丸激素升高和多囊卵巢综合征(PCOS)被推测为肾结石形成的可能危险因素;然而,关于24小时尿液代谢组和结石组成的这种潜在关系的细节以前没有被描述过。方法回顾性分析74例PCOS患者,并将其与女性结石患者按3:1的比例(按年龄和BMI)进行匹配。所有患者均有24小时尿代谢组和结石组成。这些组使用Pearson卡方检验和学生t检验进行比较。此外,采用多变量分析,根据游离睾酮水平对PCOS组进行区分。结果PCOS患者的钠排泄量(p=0.015)和高钠尿率(28.9% vs 50.9%, p=0.009)明显低于PCOS患者。pcos -睾酮队列显示,高睾酮患者的柠檬酸盐值显著升高(p=0.041),低尿率显著降低(36.7% vs 54.2%, OR = 0.2, p=0.042)。高睾酮组的钠排泄量也较高(p=0.058),高钠尿的发生率明显较高(40.0% vs 13.6%, OR = 13.3, p=0.021)。根据岩石成分分析,没有发现明显的图案。结论与健康结石患者相比,PCOS患者24小时尿液和结石组成值无显著差异。PCOS患者游离睾酮水平升高与尿中柠檬酸盐和钠值升高有显著相关性:研究结果本身并不能证实结石形成风险增加的假设。该患者队列可能为雄激素与结石形成之间的相互作用提供更深入的见解;然而,需要进一步的研究来充分表征多囊卵巢综合征和结石形成之间的可能关系。
{"title":"Nephrolithiasis and Polycystic Ovary Syndrome: A Case-Control Study Evaluating Testosterone and Urinary Stone Metabolic Panels","authors":"Donald Fedrigon, Kareem Alazem, S. Sivalingam, M. Monga, Juan Calle","doi":"10.1155/2019/3679493","DOIUrl":"https://doi.org/10.1155/2019/3679493","url":null,"abstract":"Introduction Both elevated testosterone and polycystic ovary syndrome (PCOS) have been speculated as possible risk factors for kidney stone formation; however, the details of this potential relationship with regards to 24-hour urine metabolic panels and stone composition have not previously been characterized. Methods A total of 74 PCOS patients were retrospectively identified and matched with a cohort of female stone formers at a 3 : 1 ratio (by age and BMI). All patients had 24-hour urinary metabolic panels and stone compositions. These groups were compared using Pearson chi-square and Student t-tests. Additionally, the PCOS group was differentiated based on free testosterone using multivariate analysis. Results The case-control cohort showed that PCOS patients had significantly lower sodium excretion (p=0.015) and hypernatriuria rates (28.9% vs 50.9%, p=0.009). The PCOS-testosterone cohort demonstrated that high testosterone patients had significantly higher citrate values (p=0.041) and significantly lower odds of hypocitraturia (36.7% vs 54.2%, OR = 0.2, p=0.042). The high testosterone group also had higher sodium excretion (p=0.058) with significantly higher odds of having hypernatriuria (40.0% vs 13.6%, OR = 13.3, p=0.021). No significant patterns were revealed based on stone composition analysis. Conclusions Compared to healthy stone formers, PCOS patients did not demonstrate significant differences in 24-hour urine and stone composition values. Elevated free testosterone in PCOS patients has a significant association with higher urinary citrate and sodium values: findings that in and of themselves do not confirm the hypothesized increased risk of stone formation. This patient cohort may provide deeper insight into the interplay between androgens and stone formation; however, further study is needed to fully characterize the possible relationship between PCOS and stone formation.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2019 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2019-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3679493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42381711","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}
Renal cell carcinoma (RCC) accounts for up to 85% to 90% of all kidney cancers. Clear cell RCC (ccRCC), the major subtype of RCC, is mainly characterized by the inactivation of the tumor suppressor gene VHL. pVHL as an E3 ubiquitin ligase targets the hydroxylated form of HIF-α for proteasomal degradation. The loss of VHL function leads to HIF-α aggregation as the main mechanism of ccRCC. Recently, the regulations of ccRCC through other E3 ubiquitin ligases are emerging. Moreover, most of them are associated with the VHL-HIF axis. In this review, we mainly focus on seven E3 ubiquitin ligases JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF. Based on reported researches of these ligases on ccRCC, they are divided into two groups: JADE1, SIAH1, CHIP, and FBXW7 that negatively regulate the growth of ccRCC; MDM2, SPOP, and HAF that promote ccRCC progression. In addition, we further verify these possible links between these E3 ligases and VHL-HIF axis in ccRCC based on The Cancer Genome Atlas RNA-seq and Clinical data. Understanding the mechanisms by which these ligases regulate ccRCC, especially the interplay between these ligases and VHL-HIF axis may enable the development of novel therapeutic approaches for ccRCC. Overall, the present review reveals the potential mechanism by which seven ligases (JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF) regulate ccRCC progression in detail, especially their relationship to VHL-HIF axis.
肾细胞癌(RCC)占所有肾癌的85%至90%。透明细胞RCC (Clear cell RCC, ccRCC)是RCC的主要亚型,其主要特征是肿瘤抑制基因VHL失活。pVHL作为E3泛素连接酶靶向HIF-α的羟基化形式进行蛋白酶体降解。VHL功能丧失导致HIF-α聚集是ccRCC的主要机制。近年来,通过其他E3泛素连接酶调控ccRCC的研究不断出现。此外,它们大多与VHL-HIF轴有关。本文主要综述了7种E3泛素连接酶JADE1、SIAH1、CHIP、FBXW7、MDM2、SPOP和HAF。根据已报道的ccRCC连接酶的研究,将其分为两组:JADE1、SIAH1、CHIP和FBXW7,它们负调控ccRCC的生长;MDM2、SPOP和HAF促进ccRCC进展。此外,我们基于The Cancer Genome Atlas RNA-seq和临床数据进一步验证了这些E3连接酶与ccRCC中VHL-HIF轴之间的可能联系。了解这些连接酶调节ccRCC的机制,特别是这些连接酶与VHL-HIF轴之间的相互作用,可能有助于开发新的ccRCC治疗方法。总之,本综述揭示了7种连接酶(JADE1、SIAH1、CHIP、FBXW7、MDM2、SPOP和HAF)详细调控ccRCC进展的潜在机制,特别是它们与VHL-HIF轴的关系。
{"title":"Insights into the Regulatory Roles of E3 Ubiquitin Ligases Associated with VHL-HIF Axis in Clear Cell Renal Cell Carcinoma","authors":"Wuping Yang, Zhi Li, B. Hong, Y. Gong, K. Gong","doi":"10.1155/2019/2967183","DOIUrl":"https://doi.org/10.1155/2019/2967183","url":null,"abstract":"Renal cell carcinoma (RCC) accounts for up to 85% to 90% of all kidney cancers. Clear cell RCC (ccRCC), the major subtype of RCC, is mainly characterized by the inactivation of the tumor suppressor gene VHL. pVHL as an E3 ubiquitin ligase targets the hydroxylated form of HIF-α for proteasomal degradation. The loss of VHL function leads to HIF-α aggregation as the main mechanism of ccRCC. Recently, the regulations of ccRCC through other E3 ubiquitin ligases are emerging. Moreover, most of them are associated with the VHL-HIF axis. In this review, we mainly focus on seven E3 ubiquitin ligases JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF. Based on reported researches of these ligases on ccRCC, they are divided into two groups: JADE1, SIAH1, CHIP, and FBXW7 that negatively regulate the growth of ccRCC; MDM2, SPOP, and HAF that promote ccRCC progression. In addition, we further verify these possible links between these E3 ligases and VHL-HIF axis in ccRCC based on The Cancer Genome Atlas RNA-seq and Clinical data. Understanding the mechanisms by which these ligases regulate ccRCC, especially the interplay between these ligases and VHL-HIF axis may enable the development of novel therapeutic approaches for ccRCC. Overall, the present review reveals the potential mechanism by which seven ligases (JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF) regulate ccRCC progression in detail, especially their relationship to VHL-HIF axis.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48978826","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}
José Pablo Saffon Cuartas, C. Sandoval-Salinas, Juan M. Martínez, H. Corredor
Priapism may present as a side effect in patients treated with medications for erectile dysfunction, in which it should be controlled in a timely manner to avoid complications. There is little information regarding the use of local measures for the treatment of this condition. This study was done with the objective to describe the management of priapism secondary to erectile dysfunction drugs in a cohort of men. Records of emergencies and adverse events were reviewed by two researchers to identify patients diagnosed with erectile dysfunction who received oral or intracavernosal drugs for their illness and presented priapism. Sociodemographic data, clinical background, and information on the duration, management, and evolution of the priapism were extracted. Priapism incidence, percentage of improvement by type of treatment subgroups, and frequency of complications were estimated. 698 patients were treated with PDE-5 inhibitors and 2,135 with intracavernosal drugs. Thirty-one patients (1.4%) reported at least one priapism event during treatment, all with intracavernosal drugs. Treatment with local measures was effective for 10 (32.2%) patients, 1 (3.2%) required terbutaline, 19 (61.2%) used intracavernosal etilefrine, and 1 (3.2%) required drainage and flushing of cavernous bodies. After the priapism episode, 3 (9.6%) patients required an increased dose of the drug in order to achieve satisfactory erection. The results suggest that in men treated for priapism secondary to the use of sexual impotence drugs, initial treatment with local measures and etilefrine can achieve detumescence, decreasing the need for invasive procedures or surgery as a first-line therapy alternative. It is necessary to carry out research studies to confirm this hypothesis.
{"title":"Treatment of Priapism Secondary to Drugs for Erectile Dysfunction","authors":"José Pablo Saffon Cuartas, C. Sandoval-Salinas, Juan M. Martínez, H. Corredor","doi":"10.1155/2019/6214921","DOIUrl":"https://doi.org/10.1155/2019/6214921","url":null,"abstract":"Priapism may present as a side effect in patients treated with medications for erectile dysfunction, in which it should be controlled in a timely manner to avoid complications. There is little information regarding the use of local measures for the treatment of this condition. This study was done with the objective to describe the management of priapism secondary to erectile dysfunction drugs in a cohort of men. Records of emergencies and adverse events were reviewed by two researchers to identify patients diagnosed with erectile dysfunction who received oral or intracavernosal drugs for their illness and presented priapism. Sociodemographic data, clinical background, and information on the duration, management, and evolution of the priapism were extracted. Priapism incidence, percentage of improvement by type of treatment subgroups, and frequency of complications were estimated. 698 patients were treated with PDE-5 inhibitors and 2,135 with intracavernosal drugs. Thirty-one patients (1.4%) reported at least one priapism event during treatment, all with intracavernosal drugs. Treatment with local measures was effective for 10 (32.2%) patients, 1 (3.2%) required terbutaline, 19 (61.2%) used intracavernosal etilefrine, and 1 (3.2%) required drainage and flushing of cavernous bodies. After the priapism episode, 3 (9.6%) patients required an increased dose of the drug in order to achieve satisfactory erection. The results suggest that in men treated for priapism secondary to the use of sexual impotence drugs, initial treatment with local measures and etilefrine can achieve detumescence, decreasing the need for invasive procedures or surgery as a first-line therapy alternative. It is necessary to carry out research studies to confirm this hypothesis.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6214921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49078194","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 : 2019-04-23eCollection Date: 2019-01-01DOI: 10.1155/2019/3590623
Rahul Rajendran, Kevan Iffrig, Deepak K Pruthi, Allison Wheeler, Brian Neuman, Dharam Kaushik, Ahmed M Mansour, Karen Panetta, Sos Agaian, Michael A Liss
Objective: To develop software to assess the potential aggressiveness of an incidentally detected renal mass using images.
Methods: Thirty randomly selected patients who underwent nephrectomy for renal cell carcinoma (RCC) had their images independently reviewed by engineers. Tumor "Roughness" was based on image algorithm of tumor topographic features visualized on computed tomography (CT) scans. Univariant and multivariant statistical analyses are utilized for analysis.
Results: We investigated 30 subjects that underwent partial or radical nephrectomy. After excluding poor image-rendered images, 27 patients remained (benign cyst = 1, oncocytoma = 2, clear cell RCC = 15, papillary RCC = 7, and chromophobe RCC = 2). The mean roughness score for each mass is 1.18, 1.16, 1.27, 1.52, and 1.56 units, respectively (p < 0.004). Renal masses were correlated with tumor roughness (Pearson's, p=0.02). However, tumor size itself was larger in benign tumors (p=0.1). Linear regression analysis noted that the roughness score is the most influential on the model with all other demographics being equal including tumor size (p=0.003).
Conclusion: Using basic CT imaging software, tumor topography ("roughness") can be quantified and correlated with histologies such as RCC subtype and could lead to determining aggressiveness of small renal masses.
{"title":"Initial Evaluation of Computer-Assisted Radiologic Assessment for Renal Mass Edge Detection as an Indication of Tumor Roughness to Predict Renal Cancer Subtypes.","authors":"Rahul Rajendran, Kevan Iffrig, Deepak K Pruthi, Allison Wheeler, Brian Neuman, Dharam Kaushik, Ahmed M Mansour, Karen Panetta, Sos Agaian, Michael A Liss","doi":"10.1155/2019/3590623","DOIUrl":"https://doi.org/10.1155/2019/3590623","url":null,"abstract":"<p><strong>Objective: </strong>To develop software to assess the potential aggressiveness of an incidentally detected renal mass using images.</p><p><strong>Methods: </strong>Thirty randomly selected patients who underwent nephrectomy for renal cell carcinoma (RCC) had their images independently reviewed by engineers. Tumor \"Roughness\" was based on image algorithm of tumor topographic features visualized on computed tomography (CT) scans. Univariant and multivariant statistical analyses are utilized for analysis.</p><p><strong>Results: </strong>We investigated 30 subjects that underwent partial or radical nephrectomy. After excluding poor image-rendered images, 27 patients remained (benign cyst = 1, oncocytoma = 2, clear cell RCC = 15, papillary RCC = 7, and chromophobe RCC = 2). The mean roughness score for each mass is 1.18, 1.16, 1.27, 1.52, and 1.56 units, respectively (<i>p</i> < 0.004). Renal masses were correlated with tumor roughness (Pearson's, <i>p</i>=0.02). However, tumor size itself was larger in benign tumors (<i>p</i>=0.1). Linear regression analysis noted that the roughness score is the most influential on the model with all other demographics being equal including tumor size (<i>p</i>=0.003).</p><p><strong>Conclusion: </strong>Using basic CT imaging software, tumor topography (\"roughness\") can be quantified and correlated with histologies such as RCC subtype and could lead to determining aggressiveness of small renal masses.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2019 ","pages":"3590623"},"PeriodicalIF":1.4,"publicationDate":"2019-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3590623","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37307784","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}