Arab Journal of Urology最新文献_第8页

Grooved vs smooth ureteric stent before extracorporeal shockwave lithotripsy: Single-blind randomised clinical trial 体外冲击波碎石术前带槽输尿管支架与光滑输尿管支架的比较：单盲随机临床试验

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-12-07 DOI: 10.1080/2090598X.2021.2004502

Abdulqadir Alobaidy, T. Ibrahim, W. El Ansari, H. Tawfik, A. Al-Naimi, S. Hussain, A. Al-Ansari

ABSTRACT Objective No study compared the grooved stent to the widely used standard smooth (non-grooved) stent in humans. We compared stone clearance, complications, and patient tolerance of the grooved stent vs standard JJ stent. Patients and Methods Single-blinded randomised trial among patients planned for pre-extracorporeal shockwave lithotripsy (ESWL) stenting. Adult patients with unilateral ureteric/renal stones planned for ESWL were randomly assigned to receive (Percuflex) smooth ureteric stent or (Visiostar) grooved lithotripsy stent and blinded to the stent type. We collected and compared the baseline data and outcomes (stone-free rate, complications, and stent-related symptoms) of both patient groups. Results A total of 96 adults were included (48 per arm). There were no significant differences between the groups at baseline in terms of demographics, body mass index, comorbidities, renal function, number of ESWL sessions, and stone characteristics, including pre-ESWL stone volume (mean [SD] smooth 310.2 [301.6] vs grooved 270.7 [278.6] mm3, P = 0.5). Stone clearance was statistically insignificant between the groups, although clinically relevant (smooth stent 70.8% vs grooved stent 81.2%, P = 0.2). Grooved-stent patients reported comparable urinary symptoms score (P = 0.05) and operative complications (P = 0.6), but significantly more urinary tract infections (UTIs) not requiring hospitalisation (P = 0.003). Conclusions Although statistically insignificant, the grooved stent exhibited higher stone clearance compared to the smooth stent, with similar complication rates excpet that patients with grooved stents reported more UTIs. A re-visit to the size of the outer diameter of the grooved stent could enhance its stone clearance properties, and further development of its coating material could lead to better patient satisfaction.

【摘要】目的没有研究将沟槽支架与广泛使用的标准光滑(非沟槽)支架进行比较。我们比较了沟槽支架与标准JJ支架的结石清除、并发症和患者耐受性。患者和方法在计划进行体外冲击波碎石(ESWL)支架置入术的患者中进行单盲随机试验。计划行ESWL的单侧输尿管/肾结石成年患者被随机分配接受(Percuflex)光滑输尿管支架或(Visiostar)沟槽碎石支架，并对支架类型进行盲测。我们收集并比较了两组患者的基线数据和结果(无结石率、并发症和支架相关症状)。结果共纳入96例成人(每组48例)。在基线时，两组在人口统计学、体重指数、合并症、肾功能、ESWL次数和结石特征(包括ESWL前结石体积)方面无显著差异(平均[SD]平滑310.2 [301.6]vs沟槽270.7 [278.6]mm3, P = 0.5)。尽管具有临床相关性(光滑支架70.8% vs沟槽支架81.2%，P = 0.2)，但两组间结石清除率差异无统计学意义。槽状支架患者报告的泌尿系统症状评分(P = 0.05)和手术并发症(P = 0.6)相当，但明显更多的尿路感染(uti)不需要住院(P = 0.003)。结论:虽然没有统计学意义，但与光滑支架相比，沟槽支架的结石清除率更高，并发症发生率相似，但沟槽支架患者报告的尿路感染更多。重新检查沟槽支架外径的大小可以提高其清除结石的性能，进一步开发其涂层材料可以提高患者的满意度。

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引用次数: 0

State of art of neuro-urology in the Moroccan context 摩洛哥背景下的神经泌尿科学现状

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-12-07 DOI: 10.1080/2090598X.2021.2007465

Jihad El Anzaoui, A. Ammani

The insufficiency of the practice of neuro-urology and functional urology in a general of epidemiological a of of in Moroccan

摩洛哥流行病学研究中神经泌尿学和功能泌尿学实践的不足

引用次数: 0

Creation and validation of the harmonized Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) 用于临床实践的扩展前列腺癌指数复合(EPIC-CP)的统一阿拉伯语版本的创建和验证

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-11-28 DOI: 10.1080/2090598X.2021.2002636

Mohannad A. Awad, Luke Hallgarth, Ghassan A. Barayan, M. Shahait, R. Abu-Hijlih, Ala'a Farkouh, Raed A. Azhar, Musab M. Alghamdi, A. Bugis, Said M. Yaiesh, S. Aldousari, Alaeddin Barham, Mohamed Saed, A. Moussa, W. Hassen, S. Naud, M. Plante, R. Grunert

ABSTRACT Objectives Tocreate and validate a translated Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP), a validated patient-reported outcome (PRO) widely used for assessing the quality of life in patients with prostate cancer (PCa). Patients and Methods Using the established protocol as defined by the Professional Society for the Health Economics and Outcomes Research (ISPOR) for translating patient care questionnaires, a harmonised translated Arabic version of EPIC-CP was created. The questionnaire was tested in native Arabic speakers from four different Arabic countries (Saudi Arabia, United Arab Emirates, Jordan, and Kuwait). Cronbach’s alpha and interclass coefficient correlation (ICC) analyses were used to test the internal consistency and test–retest reliability, respectively. In addition, PCa characteristics were collected for participants. Results In total, 168 patients with PCa participated in the study (39 from Saudi Arabia, 23 from United Arab Emirates, 65 from Jordan, and 41 from Kuwait). In all, 52 (31%) participants repeated the questionnaire for test–retest reliability analysis. The median (interquartile range [IQR]) age of patients included in the study was 66 (61–71) years. The median (IQR) PSA level was 9.8 (6–19) ng/mL. Most patients had Grade Group 2 PCa at diagnosis (31%), clinical stage cT1 (42%), managed primarily by urology (79%), and the primary treatment was radical prostatectomy (71%). The total Cronbach’s alpha coefficient was 0.84 demonstrating an acceptable internal consistency. The total ICC was also acceptable at 0.64. Conclusion The Arabic version of the EPIC-CP is a reliable and valid tool for assessing health-related quality of life for Arabic patients with PCa.

摘要目的创建并验证阿拉伯版扩展前列腺癌症临床实践综合指数（EPIC-CP），这是一种经验证的患者报告结果（PRO），广泛用于评估癌症（PCa）患者的生活质量。患者和方法使用卫生经济与结果研究专业协会（ISPOR）定义的既定方案翻译患者护理问卷，创建了一个统一的阿拉伯语翻译版EPIC-CP。问卷在来自四个不同阿拉伯国家（沙特阿拉伯、阿拉伯联合酋长国、约旦和科威特）的母语为阿拉伯语的人中进行了测试。Cronbachα和类间系数相关性（ICC）分析分别用于检验内部一致性和测试-再测试可靠性。此外，还收集了参与者的前列腺癌特征。结果共有168名前列腺癌患者参与了研究（39名来自沙特阿拉伯，23名来自阿拉伯联合酋长国，65名来自约旦，41名来自科威特）。总共有52名（31%）参与者重复问卷进行测试-再测试可靠性分析。纳入研究的患者的中位（四分位间距[IQR]）年龄为66（61-71）岁。中位（IQR）PSA水平为9.8（6-19）ng/mL。大多数患者在诊断时患有2级PCa（31%），临床分期为cT1（42%），主要通过泌尿外科治疗（79%），主要治疗方法为根治性前列腺切除术（71%）。总的克朗巴赫α系数为0.84，显示出可接受的内部一致性。总ICC为0.64也是可以接受的。结论阿拉伯语版EPIC-CP是评估阿拉伯语前列腺癌患者健康相关生活质量的可靠有效工具。

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引用次数: 0

The effect of stone size on the results of extracorporeal shockwave lithotripsy versus semi-rigid ureteroscopic lithotripsy in the management of upper ureteric stones 输尿管上段结石的治疗:体外冲击波碎石与半刚性输尿管镜碎石对结石大小的影响

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-11-26 DOI: 10.1080/2090598X.2021.1996820

A. El-abd, A. Tawfeek, S. El-Abd, T. Gameel, H. El-Tatawy, Magdy A. El-Sabaa, M. Soliman

ABSTRACT Objectives To evaluate the role of stone size on the efficacy and safety of extracorporeal shockwave lithotripsy (ESWL) monotherapy vs ureteroscopy (URS) for managing upper ureteric stones. Patients and methods The study design was a randomised prospective study of a total cohort of 180 patients with upper ureteric single stones of 0.5–1.5 cm. Half of the patients were managed by ESWL monotherapy, while the other half underwent URS with stone fragmentation using an ultrasound lithotripter (URSL). The success rate, re-treatment rate, auxiliary procedure (AP) rate, efficacy quotient, and complications were compared between the two groups. Results After single URSL and ESWL procedures 70/90 (77.8%) and 35/90 (38.9%) of the stones were successfully cleared, respectively (P < 0.001). The re-treatment rate after ESWL was significantly higher than in the URSL group (38.9% vs 11.1%, P < 0.001). Requiring an AP was not significantly different following ESWL (22.2%) and URSL (24.4%) treatment. The overall stone-free rate (SFR) at 3 months was significantly superior in the URSL group (88.9% vs 77.8%); however, both procedures had excellent results with no significant difference for stones of <1 cm (95.5% vs 92.9%, P > 0.05), compared to better results following URSL for stones of >1 cm (82.6% vs 64.6%, P < 0.05). Conclusion Our present study supports that ESWL is recommended as a first-line non-invasive monotherapy for upper ureteric opaque stones of <1 cm, while URSL is recommended as a first-line treatment for stones of >1 cm. The results for URSL were superior with lower a re-treatment rate, rapid stone clearance in a very short time, and less radiation exposure. Therefore, stone size is an important factor for the final decision of the initial management of upper ureteric stones because it has a direct relation to the efficacy of ESWL, but it has no effect on the results of URSL.

摘要目的评估结石大小对体外冲击波碎石（ESWL）单药治疗与输尿管镜（URS）治疗输尿管上段结石的疗效和安全性的影响。患者和方法该研究设计是一项随机前瞻性研究，共有180名患者患有0.5-1.5 cm的上输尿管单结石。其中一半患者接受ESWL单药治疗，另一半患者使用超声碎石术（URSL）进行输尿管镜碎石术。比较两组的成功率、再治疗率、辅助手术（AP）率、疗效商和并发症。结果单次URSL和ESWL治疗后，结石清除率分别为70/90（77.8%）和35/90（38.9%）（P＜0.001）。ESWL后的再治疗率明显高于URSL组（38.9%和11.1%，P＜0.001。URSL组3个月时的总结石清除率（SFR）显著高于URSL组（88.9%对77.8%）；然而，与URSL治疗>1cm结石的疗效更好（82.6%对64.6%，P＜0.05）相比，两种方法的疗效都很好，对结石的疗效无显著差异（0.05）。结论我们目前的研究支持ESWL作为治疗1cm上输尿管不透明结石的一线非侵入性单一疗法。URSL的结果优越，再次治疗率较低，结石在很短的时间内快速清除，辐射暴露较少。因此，结石大小是最终决定上输尿管结石初始治疗的重要因素，因为它与ESWL的疗效直接相关，但对URSL的结果没有影响。

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引用次数: 1

Planned percutaneous nephrolithotomy in patients who initially presented with urosepsis: Analysis of outcomes and complications 最初出现尿脓毒症的患者计划经皮肾镜取石:结果和并发症分析

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-11-26 DOI: 10.1080/2090598X.2021.2002635

A. Fahmy, K. Saad, W. Sameh, O. Elgebaly

ABSTRACT Objective To compare the outcomes and complications of planned percutaneous nephrolithotomy (PCNL) in patients with a prior urosepsis episode to those without. Patients and Methods We recorded patients who presented initially with obstructive urosepsis, as identified by systemic inflammatory response syndrome and obstructing kidney stones. We compared the surgical outcomes and complications among those patients who had planned PCNL after control of prior urosepsis with urgent decompression and antibiotics (Group A) to a group who presented for PCNL with no previous history of a septic presentations (Group B). A 1:1 matched-pair analysis was performed using four parameters (age, gender, body mass index, and American Society of Anesthesiologists classification) to eliminate potential allocation bias. Primary outcomes included were stone-free rate (SFR) and complication rate. Secondary outcomes included were operative time, estimated blood loss, and duration of postoperative hospital stay. Results A total of 80 patients underwent PCNL (48 male and 32 females) divided equally between both treatment groups, with a mean (interquartile range) age of 47 (19–75) years. There were no differences in demographic data or stone characteristics between both groups. Both groups had comparable SFRs (92.5% vs 97.5%, P = 0.212) and mean operative time (77 vs 74 min, P = 0.728) (Table 2). Patients in Group A had a significantly higher overall complications rate (35% vs 10%, P = 0.03) . There were no postoperative mortalities and the mean length of hospital stay was significantly longer in Group A patients compared to group B (4.2 vs 1.5 days, P = 0.042). Conclusions : Planned PCNL after decompression for urolithiasis-related sepsis has comparable operative time and SFR but higher complication rates and longer postoperative hospital stay. This is critical in counselling patients prior to definitive treatment of kidney stones after urgent decompression for urosepsis and for adequate preoperative planning and preparation. Abbreviations: ASA: American Society of Anesthesiologists; BMI: body mass index; ICU: intensive care unit; IQR: interquartile range; KUB: plain abdominal radiograph of the kidneys, ureters and bladder; PCN: percutaneous nephrostomy; PCNL: percutaneous nephrolithotomy; SFR: stone-free rate; URS; ureteroscopy; US: ultrasonography

【摘要】目的比较有尿脓毒症与无尿脓毒症患者计划经皮肾镜取石术(PCNL)的预后和并发症。患者和方法我们记录了最初表现为梗阻性尿脓毒症的患者，并通过全身炎症反应综合征和梗阻性肾结石进行鉴定。我们比较了在控制既往尿脓毒症后计划PCNL的患者(A组)和没有脓毒症病史的PCNL患者(B组)的手术结果和并发症。使用四个参数(年龄、性别、体重指数和美国麻醉师学会分类)进行1:1配对分析，以消除潜在的分配偏倚。主要结果包括无结石率(SFR)和并发症发生率。次要结局包括手术时间、估计失血量和术后住院时间。结果接受PCNL的患者共80例(男性48例，女性32例)，两组平均分为两组，平均年龄(四分位数间距)为47(19-75)岁。两组之间的人口统计数据和结石特征没有差异。两组患者的SFRs (92.5% vs 97.5%， P = 0.212)和平均手术时间(77 vs 74 min, P = 0.728)相当(表2)。A组患者的总并发症发生率显著高于A组(35% vs 10%， P = 0.03)。与B组患者相比，A组患者无术后死亡，平均住院时间明显更长(4.2 vs 1.5天，P = 0.042)。结论:尿石症相关脓毒症减压后计划PCNL手术时间和SFR相当，但并发症发生率较高，术后住院时间较长。这对于尿脓毒症紧急减压后肾结石最终治疗前的咨询和充分的术前计划和准备是至关重要的。缩写词:ASA:美国麻醉师学会;BMI:身体质量指数;ICU:重症监护病房;IQR:四分位间距;KUB:肾脏、输尿管和膀胱的腹部平片;PCN:经皮肾造口术;PCNL:经皮肾镜术;SFR:无石率;用户需求说明书;输尿管镜;我们:超声

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引用次数: 0

Gonadotoxic effect of tramadol administration: A prospective controlled study 曲马多给药的促性腺毒性作用:一项前瞻性对照研究

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-11-26 DOI: 10.1080/2090598X.2021.2002634

T. Soliman, H. Shaher, Ahmed Mohey, W. El-Shaer, A. Sebaey

ABSTRACT Objective To detect the possible gonadotoxic effects of tramadol dependence on seminal fluid parameters, and prolactin and testosterone hormone levels. Patients, Subjects, and Methods There were 94 participants who were divided into a tramadol-dependent group (T-group; 56 patients) and a control group (C-group; 38 healthy volunteers). The following variables were evaluated: testosterone level, prolactin level, erectile function, libido, semen parameters, and effect of tramadol dose and dependence duration. Results There was a significant increase in erectile dysfunction (ED) and decreased libido in the T-group vs C-group. Also, the serum testosterone level was lower in the T-group vs the C-group, while the serum prolactin level was significantly higher in the T-group vs the C-group. All semen parameters were low in the T-group except for abnormal forms, which were high. As the dose of tramadol increased there was a more negative effect on the previous parameter, while ED, libido, semen volume and concentration showed no significant changes. When comparing tramadol doses of 400–1000 mg/day to >1000 mg/day, the tramadol blood level increased with high doses, while serum testosterone level decreased when the dose increased and the prolactin level increased when the dose increased. Progressive motility of the sperm decreased and abnormal forms increased. Also increased duration of tramadol administration was also accompanied by a more negative effect on these parameters Conclusion Tramadol administration has a negative effect on hormone levels, libido, erectile function, and semen characters.Abbreviations: ED: erectile dysfunction; EF: erectile function

【摘要】目的探讨曲马多依赖性对精液参数、催乳素和睾酮水平可能产生的促性腺毒性作用。患者、受试者和方法94名受试者分为曲马多依赖组(t组;56例患者)和对照组(c组;38名健康志愿者)。评估以下变量:睾酮水平、催乳素水平、勃起功能、性欲、精液参数、曲马多剂量和依赖时间的影响。结果t组与c组相比，勃起功能障碍(ED)明显增加，性欲下降。血清睾酮水平t组低于c组，血清催乳素水平t组明显高于c组。除异常形态外，t组精液各项指标均较低。随着曲马多剂量的增加，上述参数的负向影响越明显，而ED、性欲、精液量和浓度无明显变化。曲马多剂量400 ~ 1000mg /d与> 1000mg /d比较，高剂量曲马多血药浓度升高，血清睾酮水平随剂量增加而降低，催乳素水平随剂量增加而升高。精子的进行性活力下降，异常形态增加。结论曲马多给药对激素水平、性欲、勃起功能和精液特征均有负面影响。缩写:ED:勃起功能障碍;EF:勃起功能

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引用次数: 5

The effect of neoadjuvant chemotherapy among patients undergoing radical cystectomy for variant histology bladder cancer: A systematic review 新辅助化疗对异型组织学膀胱癌根治性膀胱切除术患者的影响:一项系统综述

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-11-07 DOI: 10.1080/2090598X.2021.1994230

M. Álvarez-Maestro, F. Chierigo, G. Mantica, J. Quesada-Olarte, D. Carrion, J. Gómez-Rivas, Álvaro Pinto-Marín, A. Aguilera Bazan, L. Martínez-Piñeiro

ABSTRACT Objective To systematically review the evidence about the effect of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) with pure urothelial carcinoma (pUC) in radical cystectomy (RC) candidates affected by variant histology (VH) bladder cancer. Methods A review of the current literature was conducted through the Medline and National Center for Biotechnology Information (NCBI) PubMed, Scopus databases in May 2020. The updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this systematic review. Keywords used were ‘bladder cancer’, ‘bladder carcinoma’, ‘bladder tumour’ and ‘bladder cancer variants’ and ‘neoadjuvant chemotherapy’. Only original articles in English published after 2000 and reporting oncological outcomes a series of more than five patients with VH were included. We excluded series in which the oncological outcomes of patients with pUC and VH were undistinguishable. Results The literature search identified 2231 articles. A total of 51 full-text articles were assessed for eligibility, with 17 eventually considered for systematic review, for a cohort of 450,367 patients, of which 5010 underwent NAC + RC. The median age at initial diagnosis ranged from 61 to 71 years. Most patients received cisplatin-gemcitabine, methotrexate-vinblastine-adriamycin-cisplatin, or carboplatin-based chemotherapy. Only one study reported results of neoadjuvant immunotherapy. The median follow-up ranged from 1 to 120 months. The results showed that squamous cell carcinoma (SCC) is less sensitive to NAC than pUC and that SCC predicts poorer prognosis. NAC was found to be a valid approach in treating small cell carcinoma and may have potential benefit in micropapillary carcinoma. Conclusions NAC showed the best oncological outcomes in small cell variants and micropapillary carcinoma, while NAC survival benefit for SCC and adenocarcinoma variants needs further studies. Drawing definite considerations on the efficacy of NAC in VH is complicated due to the heterogeneity of present literature. Present results need to be confirmed in randomised controlled trials.

【摘要】目的系统回顾新辅助化疗(NAC)对肌肉浸润性膀胱癌(MIBC)合并纯尿路上皮癌(pUC)的根治性膀胱切除术(RC)患者合并变异组织学(VH)膀胱癌的疗效。方法于2020年5月通过Medline和国家生物技术信息中心(NCBI) PubMed、Scopus数据库对现有文献进行综述。本系统评价遵循更新后的首选报告项目系统评价和荟萃分析指南。使用的关键词是“膀胱癌”、“膀胱癌”、“膀胱肿瘤”和“膀胱癌变异”以及“新辅助化疗”。仅纳入2000年以后发表的英文原创文章，并报道了5例以上VH患者的肿瘤预后。我们排除了pUC和VH患者的肿瘤预后难以区分的系列。结果共检索到2231篇文献。共有51篇全文文章被评估为合格，其中17篇最终被考虑进行系统评价，涉及450,367例患者，其中5010例接受了NAC + RC。初次诊断时的中位年龄为61至71岁。大多数患者接受顺铂-吉西他滨、甲氨蝶呤-长春碱-阿霉素-顺铂或卡铂为主的化疗。只有一项研究报告了新辅助免疫治疗的结果。中位随访时间为1 ~ 120个月。结果表明，鳞状细胞癌(SCC)对NAC的敏感性低于pUC，且SCC预测预后较差。NAC是治疗小细胞癌的有效方法，对微乳头状癌也有潜在的疗效。结论NAC在小细胞变异体和微乳头状癌中表现出最佳的肿瘤预后，而NAC在SCC和腺癌变异体中的生存获益有待进一步研究。由于目前文献的异质性，明确考虑NAC在VH中的疗效是很复杂的。目前的结果需要在随机对照试验中得到证实。

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引用次数: 6

Relugolix: A new kid on the block among gonadotrophin-releasing hormone antagonists. Relugolix:促性腺激素释放激素拮抗剂中的新成员。

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-10-24 eCollection Date: 2021-01-01 DOI: 10.1080/2090598X.2021.1994231

Charalampos Fragkoulis, Ioannis Glykas, Athanasios Dellis, Iraklis Mitsogiannis, Athanasios Papatsoris

Androgen-deprivation therapy (ADT) is the cornerstone of metastatic prostate cancer treatment. ADT can be achieved through surgical castration, or it may be induced either by gonadotrophin-releasing hormone (GnRH) agonists or GnRH antagonists. GnRH antagonists provide a more rapid castration alongside with a safer profile regarding adverse events. Degarelix is the sole GnRH antagonist used in clinical practice. Injection site reactions are the commonest adverse events related to the use of degarelix. Relugolix, a novel molecule, represents the first orally administered United States Food and Drug Administration approved GnRH antagonist, with clinical efficacy equal to that of the established ADT regimens. The main advantages of relugolix are the avoidance of the injection site reactions of GnRH antagonists such as degarelix alongside its patient-friendly oral administration. The aim of the present review article is to present novel data regarding the role of relugolix as ADT for the treatment of prostate cancer. Abbreviations: ADT: androgen-deprivation therapy; FDA: United States Food and Drug Administration.

雄激素剥夺疗法(ADT)是转移性前列腺癌治疗的基石。ADT可以通过手术阉割来实现，也可以通过促性腺激素释放激素(GnRH)激动剂或GnRH拮抗剂来诱导。GnRH拮抗剂提供更快速的去势以及更安全的不良事件。Degarelix是临床唯一使用的GnRH拮抗剂。注射部位反应是与使用degarelix相关的最常见的不良事件。Relugolix是一种新型分子，是美国食品和药物管理局批准的第一种口服GnRH拮抗剂，其临床疗效与已建立的ADT方案相当。relugolix的主要优点是避免了GnRH拮抗剂(如degarelix)的注射部位反应以及患者友好的口服给药。这篇综述文章的目的是提供关于瑞路高利作为ADT治疗前列腺癌的新数据。ADT:雄激素剥夺疗法;FDA:美国食品和药物管理局。

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引用次数: 1

In memoriam: Dr Mohamed F. Sukkarieh (1952–2021) 纪念:穆罕默德·苏卡里耶博士(1952-2021)

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-10-02 DOI: 10.1080/2090598x.2021.2004036

M. Moussa, M. Chakra

引用次数: 0

Urethral instillation of chlorhexidine gel is an effective method of sterilisation. 尿道灌注洗必泰凝胶是一种有效的消毒方法。

IF 1.5 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology

Pub Date : 2021-09-16 eCollection Date: 2021-01-01 DOI: 10.1080/2090598X.2021.1956832

Osama Shaeer, Amr Abdel- Raheem, Haitham Elfeky, Ahmad Seif, Tarek M Abdel-Raheem, Amgad Elsegeiny, May Sherif Soliman, Emad B Basalious, Kamal Shaeer

Objective: To examine the effectiveness of preoperative urethral sterilisation with chlorhexidine gel in rendering the urethra as sterile as the skin of the genital area, with the skin sterilised as per the International Society for Sexual Medicine guidelines for penile prosthesis implantation. Patients and methods: A total of 111 male patients undergoing sterile andrological surgical procedures were divided into a control group (N = 61) and a chlorhexidine gel group (N = 50). Patients in the chlorhexidine group received urethral instillation with 6 mL of chlorhexidine preoperatively and on table. Patients from both groups received on-table skin preparation using povidone iodine and chlorhexidine povidone iodine. At the end of surgery, swabs were obtained from urethra and the penile skin. Skin and urethral swabs were compared for bacterial colonisation by culture and sensitivity. Results: Of the 111 patients, 16 had urethral colonisation and 10 had skin contamination, and they were all in the control group. The most common organism detected in both the urethral and skin samples was coagulase-negative Staphylococcus aureus. Urethral colonisation was significantly greater in the control group compared to the chlorhexidine group, at 16/61 vs 0/50 (P = 0.001). Similarly, skin colonisation was significantly greater in the control group compared to the chlorhexidine group, at 10/61 vs 0/50, (P = 0.002). Conclusion: Chlorhexidine gel is a powerful sterilising agent that will render the urethra sterile.

目的研究术前使用洗必泰凝胶对尿道进行消毒，使尿道与生殖器区域皮肤一样无菌的效果。患者和方法共有 111 名男性患者接受了无菌外科手术，他们被分为对照组（61 人）和洗必泰凝胶组（50 人）。洗必泰组患者在术前和手术台上接受 6 毫升洗必泰的尿道灌注。两组患者均在手术台上使用聚维酮碘和洗必泰聚维酮碘进行皮肤准备。手术结束后，从尿道和阴茎皮肤上取拭子。通过培养和灵敏度比较皮肤拭子和尿道拭子的细菌定植情况。结果：111 名患者中，16 人尿道定植，10 人皮肤感染，他们都属于对照组。在尿道和皮肤样本中检测到的最常见细菌均为凝固酶阴性金黄色葡萄球菌。与洗必泰组相比，对照组的尿道定植率明显更高，为 16/61 对 0/50（P = 0.001）。同样，对照组与洗必泰组相比，皮肤定植率明显更高，分别为 10/61 对 0/50 （P = 0.002）。结论洗必泰凝胶是一种强力杀菌剂，可使尿道无菌。

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