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Relationship between renal pelvis pressure and post‐ureteroscopy infection in a live swine model 活体猪模型中肾盂压力与输尿管镜检查后感染之间的关系
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-25 DOI: 10.1111/bju.16539
David Hinojosa‐Gonzalez, Christina Kottooran, Jennifer Saunders, Erin L. Chaussee, Jay Budrewicz, Brian H. Eisner
ObjectiveTo evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.Materials and MethodsIn anaesthetised pigs, a 1‐h ureteroscopy was performed using a pressure‐sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 107 colony‐forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.ResultsIn 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.ConclusionIn this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.
目的 使用活猪模型评估输尿管镜检查后肾盂压力与感染之间的关系。材料和方法在麻醉猪体内使用压力传感导丝进行了 1 小时的输尿管镜检查,整个过程中肾盂压力保持在 37 mmHg 或 75 mmHg,并注入生理盐水或标准浓度的尿路致病性大肠杆菌菌株 CFT073(1.5 × 107 菌落总数形成单位 [CFU]/mL)。手术过程中和手术后都进行了静脉采血。对生命体征、炎症生物标志物、肾组织和血液培养进行了评估:37 mmHg生理盐水冲洗组(n = 3);75 mmHg生理盐水冲洗组(n = 4);37 mmHg生理盐水冲洗加1.5 × 107 CFU/mL大肠杆菌组(n = 7);75 mmHg生理盐水冲洗加1.5 × 107 CFU/mL大肠杆菌组(n = 7)。与对照组和接受 37 毫米汞柱大肠杆菌灌洗组相比,75 毫米汞柱生理盐水灌洗+大肠杆菌组的炎症生物标志物明显升高,在统计意义上变化最为明显。结论在这一输尿管镜检查猪模型中,肾盂压力为 75 mmHg 的生理盐水+大肠杆菌灌洗导致的菌血症和炎症生物标志物升高明显高于肾盂压力保持在 37 mmHg 的大肠杆菌灌洗组和对照组。
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引用次数: 0
Insurance remains a major source of disparity for patients with testicular cancer: call for advocacy 保险仍是造成睾丸癌患者不平等的主要原因:呼吁宣传
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-25 DOI: 10.1111/bju.16568
Savannah Starr, Jj Zhang, Lin Lin, Jolie Shen, Giovanni Gamalong, Mark S. Litwin, Alexandra Drakaki, Karim Chamie
To evaluate the effects of socioeconomic factors, including insurance status, on treatment and survival for patients with testicular cancer.
评估社会经济因素(包括保险状况)对睾丸癌患者的治疗和生存期的影响。
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引用次数: 0
November's reviewers of the month 11 月份的月度评论员
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-24 DOI: 10.1111/bju.16541
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引用次数: 0
MRI, Prostate cancer diagnosis, and Artificial Intelligence; What are the implications? 核磁共振成像、前列腺癌诊断和人工智能;有什么影响?
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-24 DOI: 10.1111/bju.16540
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引用次数: 0
Mini-percutaneous nephrolithotomy vs flexible ureteroscopy for 1–2 cm lower pole renal stones: a randomised controlled trial 治疗 1-2 厘米下极肾结石的微型经皮肾镜取石术与柔性输尿管镜检查:随机对照试验
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-22 DOI: 10.1111/bju.16567
Hazem Elmansy, Moustafa Fathy, Amr Hodhod, Amer Alaref, Ruba Abdul Hadi, Loay Abbas, Husain Alaradi, Yasser Labib, Walid Shahrour, Ahmed S. Zakaria
To compare the safety and efficacy of flexible ureteroscopy (f-URS) and ambulatory tubeless mini-percutaneous nephrolithotomy (mini-PCNL) in the treatment of 1–2 cm lower calyceal renal stones.
比较柔性输尿管镜检查(f-URS)和非卧床无管微型经皮肾镜碎石术(mini-PCNL)治疗 1-2 厘米下肾盏结石的安全性和有效性。
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引用次数: 0
Accuracy of MRI in detecting seminal vesicle invasion in prostate cancer: a systematic review and meta-analysis. 磁共振成像检测前列腺癌精囊侵犯的准确性:系统回顾和荟萃分析。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-22 DOI: 10.1111/bju.16547
Thomas Li, Petra L Graham, Brooke Cao, Sunny Nalavenkata, Manish I Patel, Lawrence Kim

Objective: To determine the diagnostic test accuracy of multiparametric magnetic resonance imaging (mpMRI) in detecting seminal vesicle invasion (SVI).

Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, the Excerpta Medica dataBASE (EMBASE) and Cochrane databases were search up to May 2023. We included studies that investigated the accuracy of mpMRI in detecting SVI when compared to radical prostatectomy specimens as the reference standard. Data extraction was performed by two independent reviewers to construct 2 × 2 tables, as well as patient and study characteristics. The methodological quality of the included studies was assessed with the Quality of Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and presented graphically with summary receiver operator characteristic (SROC) plots.

Results: A total of 27 articles with 4862 patients were included for analysis. The summary sensitivity and specificity were 0.57 (95% confidence interval [CI] 0.45-0.68) and 0.95 (95% CI 0.92-0.99), respectively. Meta-regression indicated that there was no evidence that coil strength (P = 0.079), coil type (P = 0.589), year of publication (P = 0.503) or use of the Prostate Imaging-Reporting and Data System (P = 0.873) significantly influenced these results. The summary diagnostic odds ratio was 28.3 (95% CI 15.0-48.8) and the area under the curve for the SROC curve was 0.87. The I2 statistic was a modest 11.9%. In general, methodological quality was good.

Conclusion: The use of mpMRI in detecting SVI has excellent specificity but poor sensitivity. Both endorectal coils and magnetic field strength do not significantly impact the accuracy of MRI. These findings suggest that mpMRI cannot reliably rule out SVI in patients with prostate cancer.

目的确定多参数磁共振成像(mpMRI)在检测精囊受侵(SVI)方面的诊断准确性:检索医学文献分析和检索系统在线(MEDLINE)、PubMed、Excerpta Medica dataBASE(EMBASE)和 Cochrane 数据库,检索时间截至 2023 年 5 月。我们纳入了调查 mpMRI 与作为参考标准的根治性前列腺切除术标本相比在检测 SVI 方面准确性的研究。数据提取由两名独立审稿人完成,以构建 2 × 2 表格,并记录患者和研究的特征。纳入研究的方法学质量采用诊断准确性研究质量评估工具(Quality of Assessment of Diagnostic Accuracy Studies-2)进行评估。对敏感性和特异性进行了汇总,并用受体运算特征汇总图(SROC)进行了图解:共有 27 篇文章、4862 名患者被纳入分析。汇总的敏感性和特异性分别为 0.57(95% 置信区间 [CI] 0.45-0.68)和 0.95(95% CI 0.92-0.99)。元回归表明,没有证据表明线圈强度(P = 0.079)、线圈类型(P = 0.589)、发表年份(P = 0.503)或前列腺成像报告和数据系统的使用(P = 0.873)对上述结果有显著影响。诊断几率比为 28.3 (95% CI 15.0-48.8),SROC 曲线下面积为 0.87。I2 统计量仅为 11.9%。总体而言,研究方法质量良好:结论:使用 mpMRI 检测 SVI 具有极佳的特异性,但敏感性较差。肛门直肠内线圈和磁场强度对磁共振成像的准确性没有明显影响。这些发现表明,mpMRI 无法可靠地排除前列腺癌患者的 SVI。
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引用次数: 0
Decision regret and long-term success rates after ventral buccal mucosa graft urethroplasty 腹侧颊粘膜移植尿道成形术后的后悔决定和长期成功率
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-21 DOI: 10.1111/bju.16566
Javier E. Santiago, Michael D. Gross, João Pedro Accioly, Bryan B. Voelzke, Benjamin N. Breyer, Roger K. Khouri, Molly E. DeWitt-Foy, Kenneth W. Angermeier, Hadley M. Wood
To characterise the long-term success rate of ventral onlay buccal mucosa graft urethroplasty (vBMG) in the management of bulbar urethral stricture disease (USD), assess patient-reported postoperative satisfaction and decision regret, and delineate clinical factors impacting patient-reported metrics.
目的:描述腹侧颊粘膜移植尿道成形术(vBMG)在治疗球部尿道狭窄疾病(USD)中的长期成功率,评估患者报告的术后满意度和决定后悔度,并阐明影响患者报告指标的临床因素。
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引用次数: 0
Comparative effectiveness of robot-assisted radical cystectomy with intracorporeal urinary diversion vs open radical cystectomy for bladder cancer. 膀胱癌机器人辅助根治性膀胱切除术与体外尿路转流术与开放式根治性膀胱切除术的疗效比较。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-21 DOI: 10.1111/bju.16565
Pierre-Etienne Gabriel, Ugo Pinar, Louis Lenfant, Jérôme Parra, Christophe Vaessen, Pierre Mozer, Emmanuel Chartier-Kastler, Morgan Rouprêt, Thomas Seisen

Objectives: To assess the comparative effectiveness of robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) vs open radical cystectomy (ORC) for bladder cancer (BC).

Patients and methods: We conducted a real-life monocentric study including all consecutive patients who underwent RARC with ICUD or ORC for BC at our institution from 2014 to 2023. Uni- and multivariable logistic and Cox regression analyses were used to compare perioperative, oncological and stricture outcomes between both groups by calculating odds (ORs) and hazard (HRs) ratios with their corresponding 95% confidence intervals (CIs), respectively.

Results: Overall, 316 patients underwent either RARC with ICUD (n = 228 [72.2%]) or ORC (n = 88 [27.8%]). The perioperative benefits of RARC vs ORC included decreased risks of major blood loss (OR 0.10, 95% CI 0.04-0.23; P < 0.001), perioperative transfusion (OR 0.30, 95% CI 0.16-0.57; P < 0.001), 90-day major complications (OR 0.56, 95% CI 0.29-0.99; P = 0.04), and prolonged initial length of hospital stay (OR 0.20, 95% CI 0.09-0.35; P < 0.001), as well as more days alive and out of the hospital within 90 days of surgery (OR 2.56, 95% CI 1.46-4.6; P < 0.01). In addition, the use of RARC vs ORC was associated with a higher lymph node (LN) count (OR 3.35, 95% CI 1.83-6.30; P < 0.001), while there was no significant difference in recurrence-free (HR 0.72, 95% CI 0.49-1.07; P = 0.1), cancer-specific (HR 0.69, 95% CI 0.43-1.10; P = 0.1), overall (HR 0.76, 95% CI 0.47-1.20; P = 0.3) and uretero-ileal stricture-free (HR 1.18, 95% CI 0.62-2.25; P = 0.6) survival between both groups after a median (interquartile range) follow-up of 42.3 (16.4-73.8) months.

Conclusion: Our real-world study supports the effectiveness of RARC with ICUD vs ORC for BC. We generally observed better perioperative outcomes, as well as similar oncological-except for higher LN count-and uretero-ileal stricture outcomes after RARC with ICUD vs ORC.

目的评估机器人辅助根治性膀胱切除术(RARC)与体外尿路转流术(ICUD)与开放根治性膀胱切除术(ORC)治疗膀胱癌(BC)的疗效比较:我们开展了一项真实的单中心研究,研究对象包括2014年至2023年期间在我院接受RARC加ICUD或ORC治疗膀胱癌的所有连续患者。采用单变量和多变量逻辑回归分析及 Cox 回归分析,通过计算几率(ORs)和危险(HRs)比值及其相应的 95% 置信区间(CIs),比较两组患者的围手术期、肿瘤和狭窄结局:共有316名患者接受了RARC加ICUD(228人[72.2%])或ORC(88人[27.8%])手术。RARC 与 ORC 相比,围手术期的益处包括降低大失血风险(OR 0.10,95% CI 0.04-0.23; P 结论:我们的真实世界研究证实了RARC联合ICUD与ORC治疗BC的有效性。我们普遍观察到,ICUD RARC 与 ORC 相比,围手术期疗效更好,除了 LN 计数较高外,肿瘤学疗效和输尿管-回肠狭窄疗效相似。
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引用次数: 0
Recent advancements in the Ward AdmSsion of Haematuria: an Observational mUlticentre sTudy (WASHOUT)—a large‐scale observational multicentre study of inpatient haematuria 血尿病房入院:多中心观察研究(WASHOUT)的最新进展--这是一项针对住院患者血尿的大规模多中心观察研究
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-18 DOI: 10.1111/bju.16557
Bing Jie Chow, Raghav Varma, Nikita Bhatt, Kevin Byrnes, Simona Ippoliti, Nikki Kerdegari, Quentin Mak, Aqua Asif, Alexander Ng, Arjun Nathan, Kevin Gallagher, Sinan Khadhouri, Veeru Kasivisvinathan
{"title":"Recent advancements in the Ward AdmSsion of Haematuria: an Observational mUlticentre sTudy (WASHOUT)—a large‐scale observational multicentre study of inpatient haematuria","authors":"Bing Jie Chow, Raghav Varma, Nikita Bhatt, Kevin Byrnes, Simona Ippoliti, Nikki Kerdegari, Quentin Mak, Aqua Asif, Alexander Ng, Arjun Nathan, Kevin Gallagher, Sinan Khadhouri, Veeru Kasivisvinathan","doi":"10.1111/bju.16557","DOIUrl":"https://doi.org/10.1111/bju.16557","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Female genital cosmetic surgery: a social trend driving surgical practice 女性生殖器整容手术:推动外科实践的社会趋势
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-18 DOI: 10.1111/bju.16551
Magdalena Simonis, Helen E. O'Connell
Click on the article title to read more.
点击文章标题阅读更多内容。
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引用次数: 0
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