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Impact of outcomes and costs for implementation of robotic radical cystectomy with full intracorporeal urinary diversion. 实施机器人根治性膀胱切除术并进行完全体外尿路转流对疗效和成本的影响。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 Epub Date: 2023-11-15 DOI: 10.5173/ceju.2023.203
Razvan George Rahota, Jean-Baptiste Beauval, Jean-Romain Gautier, Christophe Almeras, Valerie Garnault, Guillaume Loison, Ambroise Salin, Christophe Tollon, Guillaume Ploussard

Introduction: Radical cystectomy (RC) remains a surgery with important morbidity despite technical advances. Our aim was to determine the impact on outcomes and costs of robot-assisted radical cystectomy (RARC) with full intracorporeal diversion.

Material and methods: We retrospectively included 196 consecutive patients undergone RC for bladder cancer between 2017 and 2022. Comparisons were done between the open radical cystectomy (ORC; n = 166) and RARC with full intracorporeal diversion (n = 30) in the overall cohort and after matched pair analysis.

Results: More neobladders were performed in the RARC group (40% vs 18.7%, p = 0.011). Peri-operative parameters continuously improved over time in the RARC cohort despite an increased proportion of elderly patients with higher comorbidity index. RARC patients had lower prolonged stay (33.3% vs 68.3%, p = 0.002), lower grade 1 complication rates (26.7% vs 53.3%, p = 0.016) and blood loss (185 vs 611 ml, p <0.001) than ORC patients. RARC was an independent favorable predictor for prolonged stay (OR 0.199) and complication (OR 0.334). Cost balance favored ORC, with an increase of hospitalization cost at 816 euros for RARC.

Conclusions: After matching, RARC with full intracorporeal diversion was associated with improved outcomes and a moderated increase of post-operative costs mainly due to the use of robotic devices.

导言:尽管技术不断进步,根治性膀胱切除术(RC)仍然是一种发病率很高的手术。我们的目的是确定完全体腔内转流的机器人辅助根治性膀胱切除术(RARC)对预后和成本的影响:我们回顾性纳入了 2017 年至 2022 年间接受膀胱癌根治术的 196 例连续患者。在总体队列和配对分析后,比较了开放根治性膀胱切除术(ORC;n = 166)和全体外转流 RARC(n = 30):结果:RARC组进行新膀胱术的比例更高(40% vs 18.7%,p = 0.011)。尽管合并症指数较高的老年患者比例增加,但随着时间的推移,RARC 组患者的围手术期参数持续改善。经过匹配后,采用完全体腔内转流的 RARC 可改善疗效,但术后费用的增加有限,这主要是由于使用了机器人设备。
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引用次数: 0
Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre. 非钳式机器人辅助部分肾切除术:来自单一中心的手术经验。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2023.261
Matteo Zanoni, Fabio Grizzi, Paolo Vota, Giovanni Toia, Cinzia Mazzieri, Maria Chiara Clementi, Edoardo Beatrici, Gianluigi Taverna

Introduction: Robot-assisted partial nephrectomy (RAPN) is a minimally invasive treatment for localized renal tumours, which can sometimes result in extended warm ischaemic time and serious complications. This study reports on surgical outcomes including feasibility, positive margins, and complications during and after surgery.

Material and methods: From January 2011 to November 2022, a single centre performed off-clamp sutureless RAPN on 287 patients. The study recorded preoperative patient characteristics, estimated glomerular filtration rate, and tumour features according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification, and utilized the RENAL nephrometry scoring system. Intraoperative details and complications were documented. Postoperative complications within 30 days were classified according to the Clavien-Dindo system. Follow-up appointments were scheduled at 1, 3, and 6 months in the first year, followed by subsequent appointments every 6 months, and then annually.

Results: The study included 145 males and 142 females, with a mean age of 58.9 years and a mean body mass index of 26.7 kg/m2. The mean PADUA score was 8.3, the average console time was 83 minutes, and the estimated blood loss was 280 mL. The average hospital stay was 3 days, and no intraoperative complications were observed. However, 4 patients (1.4%) experienced post-operative haemorrhage that required laparotomy (Clavien-Dindo stage IIIB), and 4 patients (1.4%) had positive surgical margins.

Conclusions: Off-clamp selective arterial clamping during minimally invasive partial nephrectomy is a safe and feasible approach for small renal tumours. Further randomized prospective studies are required to confirm if RAPN without clamping offers any renal functional benefits and reduces perioperative bleeding complications.

机器人辅助部分肾切除术(RAPN)是一种局部肾肿瘤的微创治疗方法,有时会导致热缺血时间延长和严重的并发症。本研究报告了手术结果,包括可行性、阳性切缘、手术中和术后并发症。材料与方法:2011年1月至2022年11月,某中心对287例患者进行了无钳外缝合RAPN。该研究记录了术前患者的特征,估计肾小球滤过率,根据术前的方面和尺寸进行解剖(PADUA)分类,并使用肾肾测量评分系统。记录术中细节及并发症。术后30天内的并发症按照Clavien-Dindo系统进行分类。随访预约安排在第一年的第1、3和6个月,随后每6个月随访一次,然后每年随访一次。结果:研究对象男性145人,女性142人,平均年龄58.9岁,平均体重指数26.7 kg/m2。平均PADUA评分8.3分,平均控制台时间83分钟,估计失血量280 mL,平均住院时间3天,无术中并发症。然而,4例(1.4%)患者出现术后出血,需要开腹手术(Clavien-Dindo IIIB期),4例(1.4%)患者手术切缘阳性。结论:在微创肾部分切除术中,非钳形选择性动脉夹持是一种安全可行的治疗小肿瘤的方法。需要进一步的随机前瞻性研究来证实不夹持的RAPN是否能提供任何肾功能益处并减少围手术期出血并发症。
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引用次数: 0
Treatment of 2-4 cm kidney stones: multicentre experience. Comparison of safety, efficacy, and costs of percutaneous nephrolithotomy and retrograde intrarenal surgery. 2-4厘米肾结石的治疗:多中心经验。经皮肾取石术和逆行肾内手术的安全性、疗效和成本比较。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 Epub Date: 2023-04-07 DOI: 10.5173/ceju.2023.119
Nicolò Fiorello, Andrea Di Benedetto, Andrea Mogorovich, Daniele Summonti, Massimo Aquilini, Giuseppe Silvestri, Chiara Gilli, Gregorio Romei, Michele Santarsieri, Francesca Manassero, Giorgio Pomara, Sandro Benvenuti, Carlo Alberto Sepich

Introduction: The objective of this study is to compare the safety and efficacy, through the stone-free rate (SFR), as well as the costs, between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), for 2-4 cm kidney stones.

Material and methods: We analysed the data relating to RIRS and PCNL performed in 3 reference centres for kidney stones, in the period between 1/2019 and 12/2021. The total number of procedures was 130 (63 RIRS and 67 PCNL). We defined SFR as the absence of lithiasic fragments or stones <3 mm. Results were compared between 2 groups depending on the stone size: 2-3 cm stones (group 1) and >3 cm stones (group 2).

Results: The duration of RIRS was 90 minutes for group 1 and 115 minutes for group 2, and for PCNL it was 135 minutes for group 1 and 145 minutes for group 2. RIRS had shorter duration with a significant difference in group 1 (p = 0.000014). SFR for RIRS was 78% for group 1 and 21% for group 2, and for PCNL it was 92% for group 1 and 81% for group 2. Therefore, there is a statistically significant difference, which is more evident for 3 cm and multiple stones (p = 0.0057 for group 1, p = 0.000146 for group 2). The difference in costs was estimated by calculating the expected costs for a single surgical procedure and the estimated cost per day for ordinary hospitalization.

Conclusions: 2-4 cm stones can be safely treated with both RIRS and PCNL, but RIRS should not be chosen as an option for stones >3 cm, except in selected cases. PCNL remains the gold standard for the treatment of complex stones, especially for stones >3 cm. Risk of postoperative complications is higher in PCNL, even if this difference is not great. The costs associated with RIRS, even when recalculating with the need for new treatments, remain cheaper.

引言:本研究的目的是通过肾内逆行手术(RIRS)和经皮肾取石术(PCNL)治疗2-4 cm肾结石的无结石率(SFR)和成本来比较其安全性和有效性。材料和方法:我们分析了2019年1月至2021年12月期间在3个肾结石参考中心进行的RIRS和PCNL的相关数据。手术总数为130例(63例RIRS和67例PCNL)。结果:第1组RIRS持续时间为90分钟,第2组为115分钟,PCNL持续时间为135分钟,第二组为145分钟。RIRS持续时间较短,在第1组中有显著差异(p=0.0000114)。RIRS的SFR在第1和第2组分别为78%和21%,PCNL在第1、第2组中分别为92%和81%。因此,存在统计学上的显著差异,这在3cm和多发结石中更为明显(第1组p=0.0057,第2组p=0.0000146)。费用差异是通过计算单个手术的预期费用和普通住院的估计每日费用来估计的。结论:RIRS和PCNL可以安全地治疗2-4 cm的结石,但RIRS不应被选为大于3 cm的结石的选择,除非在选定的病例中。PCNL仍然是治疗复杂结石的金标准,尤其是对于大于3cm的结石。PCNL术后并发症的风险更高,即使这种差异不大。与RIRS相关的成本,即使在重新计算新治疗的需求时,仍然更便宜。
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引用次数: 0
Laparoscopic radical nephrectomy in Trendelenburg position - technical modifications for a pelvic kidney. 腹腔镜Trendelenburg位根治性肾切除术-骨盆肾的技术改良。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2022.237
Andreia Cardoso, Sara Anacleto, Catarina Laranjo Tinoco, Ana Sofia Araújo, Nuno Morais, Emanuel Carvalho-Dias
14.6 g/dl to 11.9 g/dl. The histopathologic examination revealed an 808 g surgical specimen, 8.8*8.0*6.5 cm kidney, with 7.0*6.0*4.5 cm clear cell RCC, in the middle and infe - rior pole, G3 pT3aNxR0, with focal invasion of hilar and perirenal fat. There was also vascular invasion. In conclusion, this was a challenging but success - ful surgery, using only standard laparoscopic mate-rial. Robot-assistance or CT-scan 3D reconstruction might have been helpful, if available, but we showed these are not essential
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引用次数: 0
Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant. 根治性膀胱切除术及肾移植术后输尿管-肠良性狭窄的腔内治疗。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2022.238
Angelo Territo, Paolo Verri, Alessandro Uleri, Pietro Diana, Andrea Gallioli, Michael Baboudjian, Josep Maria Gaya, Francesco Sanguedolce, Julia Aumatell, Giuseppe Basile, Alejandra Bravo, Joan Palou, Alberto Breda
Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant. Cent European
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引用次数: 1
The impact of antithrombotic therapy on the time of detection of bladder cancer. 抗栓治疗对膀胱癌检出时间的影响。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2022.193
Dora Jakus, Marijan Šitum, Petra Čepin, Ivana Vrhovac, Josip Anđelo Borovac

Introduction: The aim of this article was to investigate the impact of chronic antithrombotic therapy (AT) use on the time of detection of bladder cancer, assuming that patients taking AT experience episodes of macroscopic hematuria earlier, and therefore have a more favorable histopathological grade and stage, as well as a smaller number and size of tumors compared to patients not taking AT.

Material and methods: A retrospective, cross-sectional study was conducted, including 247 patients who underwent bladder cancer surgery for the first time at our institution during the three-year period (2019-2021) and who experienced macroscopic hematuria.

Results: A lower frequency of high-grade bladder cancer (40.6% vs 60.1%, P = 0.006), T2 stage (7.2% vs 20.2%, P = 0.014), and a lower frequency of tumors larger than 3.5 cm (29% vs 57.9%, P <0.001) were found in patients using AT compared to patients not using them. The patients using AT had a smaller mean tumor size (2.98 vs 4.51 cm, P <0.001). A multivariable regression analysis, adjusted for age, sex, and number of comorbidities, showed a lower probability of having a high-grade cancer (OR 0.393, 95% CI 0.195-0.792, P = 0.009), T2 stage (OR 0.276, 95% CI 0.090-0.849, P = 0.025), and tumors larger than 3.5 cm (OR 0.261, 95% CI 0.125-0.542, P <0.001) in patients using AT.

Conclusions: More favorable histopathological grades, stages, and smaller tumor sizes were found in patients with bladder cancer who experienced macroscopic hematuria and were using AT compared to patients not taking AT.

前言:本文的目的是研究慢性抗血栓治疗(AT)的使用对膀胱癌发现时间的影响,假设服用AT的患者更早经历宏观血尿发作,因此具有更有利的组织病理学分级和分期,并且与未服用AT的患者相比,肿瘤的数量和大小更小。材料与方法:回顾性、横断面研究,纳入我院三年内(2019-2021年)首次行膀胱癌手术并出现宏观血尿的患者247例。结果:膀胱癌高级别(40.6% vs 60.1%, P = 0.006)、T2期(7.2% vs 20.2%, P = 0.014)、肿瘤大于3.5 cm的发生率较低(29% vs 57.9%, P)。结论:与未行AT的患者相比,有宏观血尿且行AT的膀胱癌患者有更有利的组织病理学分级、分期和更小的肿瘤大小。
{"title":"The impact of antithrombotic therapy on the time of detection of bladder cancer.","authors":"Dora Jakus,&nbsp;Marijan Šitum,&nbsp;Petra Čepin,&nbsp;Ivana Vrhovac,&nbsp;Josip Anđelo Borovac","doi":"10.5173/ceju.2022.193","DOIUrl":"https://doi.org/10.5173/ceju.2022.193","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this article was to investigate the impact of chronic antithrombotic therapy (AT) use on the time of detection of bladder cancer, assuming that patients taking AT experience episodes of macroscopic hematuria earlier, and therefore have a more favorable histopathological grade and stage, as well as a smaller number and size of tumors compared to patients not taking AT.</p><p><strong>Material and methods: </strong>A retrospective, cross-sectional study was conducted, including 247 patients who underwent bladder cancer surgery for the first time at our institution during the three-year period (2019-2021) and who experienced macroscopic hematuria.</p><p><strong>Results: </strong>A lower frequency of high-grade bladder cancer (40.6% vs 60.1%, P = 0.006), T2 stage (7.2% vs 20.2%, P = 0.014), and a lower frequency of tumors larger than 3.5 cm (29% vs 57.9%, P <0.001) were found in patients using AT compared to patients not using them. The patients using AT had a smaller mean tumor size (2.98 vs 4.51 cm, P <0.001). A multivariable regression analysis, adjusted for age, sex, and number of comorbidities, showed a lower probability of having a high-grade cancer (OR 0.393, 95% CI 0.195-0.792, P = 0.009), T2 stage (OR 0.276, 95% CI 0.090-0.849, P = 0.025), and tumors larger than 3.5 cm (OR 0.261, 95% CI 0.125-0.542, P <0.001) in patients using AT.</p><p><strong>Conclusions: </strong>More favorable histopathological grades, stages, and smaller tumor sizes were found in patients with bladder cancer who experienced macroscopic hematuria and were using AT compared to patients not taking AT.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 1","pages":"33-37"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/6d/CEJU-76-193.PMC10091894.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316748","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
Temperature effect of Moses™ 2.0 during flexible ureteroscopy: an in vitro assessment. 柔性输尿管镜检查过程中 Moses™ 2.0 的温度效应:体外评估。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 Epub Date: 2023-11-14 DOI: 10.5173/ceju.2023.127
José M Villena, Vicente Elorrieta, José A Salvadó

Introduction: One of the main issues related to the use of high-power lasers is the associated rise in temperature. The aim of this study was to characterize temperature variations with activation of the Moses™ 2.0 laser.

Material and methods: An in vitro experimental study was designed using a high-fidelity uretero-nephroscope simulation model to assess changes in temperature during intracorporeal laser lithotripsy. Renal and ureteral temperature records were obtained from the treatment of BegoStones positioned in the renal pelvis. Different laser settings over three time periods and two possible irrigation flow speeds were evaluated. We considered 43°C as the threshold since it is associated with denaturation of proteins. The Wilcoxon-Mann-Whitney test was used to assess quantitative variables and the Kruskal-Wallis test for categorical variables.

Results: The highest increase in intrarenal temperature was reached with 30 seconds of laser activation at a laser setting of 0.5 J/100 Hz (50 W) and a flow of 10 mL/min. Only 15 seconds of activation was sufficient for most settings to exceed 43°C. The ureteral temperature did not increase significantly, regardless of the combination of laser setting, time, or irrigation flow, except when 30 W was used for a 30 second period. Multivariate analysis showed that an irrigation flow of 20 mL/min produced an intrarenal temperature decrease of 4.7-9.2°C (p <0.001).

Conclusions: Use of high-power lasers, both for the ureter and kidney, should involve consideration of temperature increases evidenced in this study, due to the potential biological risk entailed.

介绍:使用高功率激光的主要问题之一是相关的温度升高。本研究的目的是描述 Moses™ 2.0 激光激活时的温度变化:使用高保真输尿管-肾镜模拟模型设计了一项体外实验研究,以评估体外激光碎石过程中的温度变化。通过对放置在肾盂中的 BegoStones 进行治疗,获得了肾脏和输尿管的温度记录。对三个时间段内不同的激光设置和两种可能的灌洗流速进行了评估。我们将 43°C 作为阈值,因为它与蛋白质变性有关。对定量变量采用 Wilcoxon-Mann-Whitney 检验,对分类变量采用 Kruskal-Wallis 检验:结果:在激光设置为 0.5 J/100 Hz(50 W)、流量为 10 mL/min 的情况下,激光激活 30 秒后肾内温度升高最高。大多数设置下,只需激活 15 秒钟即可使温度超过 43°C。无论激光设置、时间或冲洗流量如何组合,输尿管温度都没有明显升高,只有在 30 W 的激光持续 30 秒时除外。多变量分析表明,20 毫升/分钟的冲洗流量可使肾内温度降低 4.7-9.2°C (p 结论):使用大功率激光治疗输尿管和肾脏时,应考虑到本研究中证实的温度升高问题,因为这会带来潜在的生物风险。
{"title":"Temperature effect of Moses™ 2.0 during flexible ureteroscopy: an <i>in vitro</i> assessment.","authors":"José M Villena, Vicente Elorrieta, José A Salvadó","doi":"10.5173/ceju.2023.127","DOIUrl":"10.5173/ceju.2023.127","url":null,"abstract":"<p><strong>Introduction: </strong>One of the main issues related to the use of high-power lasers is the associated rise in temperature. The aim of this study was to characterize temperature variations with activation of the Moses™ 2.0 laser.</p><p><strong>Material and methods: </strong>An in vitro experimental study was designed using a high-fidelity uretero-nephroscope simulation model to assess changes in temperature during intracorporeal laser lithotripsy. Renal and ureteral temperature records were obtained from the treatment of BegoStones positioned in the renal pelvis. Different laser settings over three time periods and two possible irrigation flow speeds were evaluated. We considered 43°C as the threshold since it is associated with denaturation of proteins. The Wilcoxon-Mann-Whitney test was used to assess quantitative variables and the Kruskal-Wallis test for categorical variables.</p><p><strong>Results: </strong>The highest increase in intrarenal temperature was reached with 30 seconds of laser activation at a laser setting of 0.5 J/100 Hz (50 W) and a flow of 10 mL/min. Only 15 seconds of activation was sufficient for most settings to exceed 43°C. The ureteral temperature did not increase significantly, regardless of the combination of laser setting, time, or irrigation flow, except when 30 W was used for a 30 second period. Multivariate analysis showed that an irrigation flow of 20 mL/min produced an intrarenal temperature decrease of 4.7-9.2°C (p <0.001).</p><p><strong>Conclusions: </strong>Use of high-power lasers, both for the ureter and kidney, should involve consideration of temperature increases evidenced in this study, due to the potential biological risk entailed.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 4","pages":"331-335"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477176","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
Guillain-Barré Syndrome following intravesical Bacillus Calmette-Guérin therapy for bladder cancer: a rare and intriguing case report. 膀胱癌膀胱内卡介苗治疗后的格林-巴利综合征:一份罕见而有趣的病例报告。
IF 1.2 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 Epub Date: 2023-11-20 DOI: 10.5173/ceju.2023.91
Vincent Khor, Omar Fahmy, Christopher Kheng Siang Lee, Mohd Ghani Khairul-Asri

Intravesical Bacillus Calmette-Guérin (BCG) therapy is a standard treatment for non-muscle invasive bladder cancer, but some patients experience side effects that lead to treatment discontinuation. Local side effects are typically mild, while systemic side effects can be severe and life-threatening. BCG therapy has immunotherapy effects on bladder cancer, but the mechanism is not fully understood. Due to its effect on the immune system, patients may also develop rare autoimmune complications, such as neuropathy. This case report suggests a potential association between BCG therapy and Guillain-Barré Syndrome (GBS), as a patient developed GBS after receiving intravesical BCG therapy for invasive bladder cancer.

静脉内卡介苗(BCG)疗法是治疗非肌层浸润性膀胱癌的标准疗法,但有些患者会出现副作用,导致治疗中断。局部副作用通常较轻,而全身副作用则可能很严重并危及生命。卡介苗疗法对膀胱癌有免疫治疗作用,但其机制尚不完全清楚。由于卡介苗对免疫系统的影响,患者还可能出现罕见的自身免疫并发症,如神经病变。本病例报告提示卡介苗疗法与吉兰-巴雷综合征(GBS)之间可能存在关联,因为一名患者在接受膀胱内卡介苗疗法治疗浸润性膀胱癌后出现了吉兰-巴雷综合征。
{"title":"Guillain-Barré Syndrome following intravesical Bacillus Calmette-Guérin therapy for bladder cancer: a rare and intriguing case report.","authors":"Vincent Khor, Omar Fahmy, Christopher Kheng Siang Lee, Mohd Ghani Khairul-Asri","doi":"10.5173/ceju.2023.91","DOIUrl":"10.5173/ceju.2023.91","url":null,"abstract":"<p><p>Intravesical Bacillus Calmette-Guérin (BCG) therapy is a standard treatment for non-muscle invasive bladder cancer, but some patients experience side effects that lead to treatment discontinuation. Local side effects are typically mild, while systemic side effects can be severe and life-threatening. BCG therapy has immunotherapy effects on bladder cancer, but the mechanism is not fully understood. Due to its effect on the immune system, patients may also develop rare autoimmune complications, such as neuropathy. This case report suggests a potential association between BCG therapy and Guillain-Barré Syndrome (GBS), as a patient developed GBS after receiving intravesical BCG therapy for invasive bladder cancer.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 4","pages":"311-314"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478284","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 perception and barriers with fluid hydration: A prospective face-to-face interview and counselling from a university hospital stone clinic 病人的感知和障碍与液体水合作用:一所大学医院结石诊所的前瞻性面对面访谈和咨询
Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2023.105
Introduction Kidney stone disease (KSD) has a lifetime prevalence of up to 14% in the United Kingdom. Primary and secondary prevention of KSD via dietary intervention is a low-cost public health intervention and remains the best preventative strategy against urolithiasis. Material and methods This prospective study was conducted on kidney stone patients attending a stone clinic at our tertiary endourology centre. Patients were taken through a questionnaire, which was completed in the clinic by a trained specialist endourology nurse. Results A total of 259 patients completed the questionnaire. 141 (54.4%) had an active stone during the clinic visit with the remaining 118 (45.6%) with a history of stone treatment. Regarding barriers to fluid intake, 43 (16.6%) patients did not have a habit of drinking water or felt too bloated, 36 (13.9%) did not like the taste, 17 (6.6%) were not thirsty, 10 (3.9%) of patients were too busy. Of those who answered, 108 (46.8%) patients did not believe there was a link between fluid intake and stone formation. A belief of a link between fluid intake and stone formation significantly predicted fluid intake (p = 0.024) with people who did believe in this drinking less water. Conclusions There are numerous perceived barriers to adequate fluid intake, with almost half of all patients not believing that there is a link between fluid intake and stone formation. This misunderstanding may predict a lower fluid intake. More attention should therefore be focussed on patient education and primary prevention aspects to avoid kidney stone recurrence.
{"title":"Patient perception and barriers with fluid hydration: A prospective face-to-face interview and counselling from a university hospital stone clinic","authors":"","doi":"10.5173/ceju.2023.105","DOIUrl":"https://doi.org/10.5173/ceju.2023.105","url":null,"abstract":"Introduction Kidney stone disease (KSD) has a lifetime prevalence of up to 14% in the United Kingdom. Primary and secondary prevention of KSD via dietary intervention is a low-cost public health intervention and remains the best preventative strategy against urolithiasis. Material and methods This prospective study was conducted on kidney stone patients attending a stone clinic at our tertiary endourology centre. Patients were taken through a questionnaire, which was completed in the clinic by a trained specialist endourology nurse. Results A total of 259 patients completed the questionnaire. 141 (54.4%) had an active stone during the clinic visit with the remaining 118 (45.6%) with a history of stone treatment. Regarding barriers to fluid intake, 43 (16.6%) patients did not have a habit of drinking water or felt too bloated, 36 (13.9%) did not like the taste, 17 (6.6%) were not thirsty, 10 (3.9%) of patients were too busy. Of those who answered, 108 (46.8%) patients did not believe there was a link between fluid intake and stone formation. A belief of a link between fluid intake and stone formation significantly predicted fluid intake (p = 0.024) with people who did believe in this drinking less water. Conclusions There are numerous perceived barriers to adequate fluid intake, with almost half of all patients not believing that there is a link between fluid intake and stone formation. This misunderstanding may predict a lower fluid intake. More attention should therefore be focussed on patient education and primary prevention aspects to avoid kidney stone recurrence.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550679","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
The Role of Primary Nocturnal Enuresis in the Aetiology of Overactive Bladder Syndrome 原发性夜间遗尿在膀胱过度活动综合征病因中的作用
Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.5173/ceju.2023.56
Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 ±11.20 years (18–65), and the mean BMI of both groups was 26.62 ±3.34 (19.49–39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.
{"title":"The Role of Primary Nocturnal Enuresis in the Aetiology of Overactive Bladder Syndrome","authors":"","doi":"10.5173/ceju.2023.56","DOIUrl":"https://doi.org/10.5173/ceju.2023.56","url":null,"abstract":"Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 ±11.20 years (18–65), and the mean BMI of both groups was 26.62 ±3.34 (19.49–39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550685","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
Central European Journal of Urology
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