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Urinary diversion

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https://www.readbyqxmd.com/read/28813037/concomitant-bladder-cancer-and-prostate-cancer-challenges-and-controversies
#1
REVIEW
Antonio Lopez-Beltran, Liang Cheng, Francesco Montorsi, Maria Scarpelli, Maria R Raspollini, Rodolfo Montironi
Radical cystoprostatectomy (RCP) followed by bilateral pelvic lymphadenectomy and urinary diversion remains the gold-standard therapy for men with localized muscle-invasive bladder cancer (MIBC). Prostate cancer might be incidentally detected at the time of RCP with a reported prevalence of 24-51%. Typically, these patients are considered to have clinically insignificant disease, but data from emerging series challenge this assumption and suggest that some of these tumours might be aggressive, or somehow increase the aggressiveness of the associated MIBC, and can negatively influence the patient's overall survival outcomes...
August 16, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28810248/antibiotic-susceptibility-and-molecular-characterization-of-escherichia-coli-o157-isolates-from-urinary-tract-infections
#2
Zonglan Xie, Ziqiang Dong, Ping Zhu, Lusheng Zhang, Xiaobo Chen, Chuanjiang Dong
BACKGROUND: Escherichia coli O157 is an important food-borne pathogen that can cause diarrhoea, hemorrhagic colitis, and hemolytic uraemic syndrome. Enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR) and multilocus sequence typing (MLST) are good methods for molecular typing and the extensive use of antibiotics is a contributing factor to the increasing incidence of antimicrobial-resistant for these strains. OBJECTIVES: The aim of this study was to determine the prevalence, antimicrobial resistance, and genetic diversity of E...
August 16, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28808913/modified-double-barrelled-wet-colostomy-after-total-pelvic-exenteration
#3
Antonio Macrì
Pelvic exenteration is a radical surgery that can require urinary and faecal diversions. Double-barreled wet colostomy, a viable alternative to the traditional ileal conduit with separate colostomy technique, is not always applicable due to the shortness of an ureter. To overcome this problem, I modified the original technique, replacing the two uretero-colic anastomoses with an ureteroureterostomy and an uretero-colic anastomosis.
August 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28807017/the-urinary-microbiota-of-men-and-women-and-its-changes-in-women-during-bacterial-vaginosis-and-antibiotic-treatment
#4
Cornelia Gottschick, Zhi-Luo Deng, Marius Vital, Clarissa Masur, Christoph Abels, Dietmar H Pieper, Irene Wagner-Döbler
BACKGROUND: The urinary microbiota is similarly complex as the vaginal and penile microbiota, yet its role as a reservoir for pathogens and for recurrent polymicrobial biofilm diseases like bacterial vaginosis (BV) is not clear. RESULTS: Here, we analysed the urinary microbiota of healthy men and women and compared it with that of women during BV and after antibiotic treatment using next-generation sequencing of the 16S rRNA gene V1-V2 regions. Eight different community types, so called urotypes (UT), were identified in healthy humans, all of which were shared between men and women, except UT 7, dominated in relative abundance by Lactobacillus crispatus, which was found in healthy women only...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28803034/variations-in-the-costs-of-radical-cystectomy-for-bladder-cancer-in-the-usa
#5
Jeffrey J Leow, Alexander P Cole, Thomas Seisen, Joaquim Bellmunt, Matthew Mossanen, Mani Menon, Mark A Preston, Toni K Choueiri, Adam S Kibel, Benjamin I Chung, Maxine Sun, Steven L Chang, Quoc-Dien Trinh
BACKGROUND: Radical cystectomy (RC) for muscle-invasive bladder cancer (BCa) has potential for serious complications, prolonged length of stay and readmissions-all of which may increase costs. Although variations in outcomes are well described, less is known about determinants driving variation in costs. OBJECTIVE: To assess surgeon- and hospital-level variations in costs and predictors of high- and low-cost RC. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 23 173 patients who underwent RC for BCa in 208 hospitals in the USA from 2003 to 2015 in the Premier Healthcare Database...
August 9, 2017: European Urology
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#6
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28800865/contemporary-reviews-in-critical-care-medicine-anaphylaxis
#7
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or non-allergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#8
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28798823/radical-cystectomy-in-patients-with-disseminated-disease-an-assessment-of-perioperative-outcomes-using-the-national-surgical-quality-improvement-program-database
#9
Christopher Wallis, Suneil Khana, Mohammad Hajiha, Robert K Nam, Raj Satkunasivam
INTRODUCTION: We sought to determine the effect of the presence of disseminated disease on perioperative outcomes following radical cystectomy for bladder cancer. METHODS: We identified 4108 eligible patients who underwent radical cystectomy for bladder cancer using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. We matched patients with disseminated cancer at the time of surgery to those without disseminated cancer using propensity scores...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28797714/profiling-the-urinary-microbiome-in-men-with-positive-versus-negative-biopsies-for-prostate-cancer
#10
Eva Shrestha, James R White, Shu-Han Yu, Ibrahim Kulac, Onur Ertunc, Angelo M De Marzo, Srinivasan Yegnasubramanian, Leslie A Mangold, Alan W Partin, Karen S Sfanos
PURPOSE: Studies demonstrating bacterial DNA and cultivable bacteria in urine samples have challenged the clinical dogma that urine is sterile. Furthermore, studies now indicate that dysbiosis of the urinary microbiome is associated with pathological conditions. We propose that the urinary microbiome may influence chronic inflammation observed in the prostate, leading to prostate cancer development and progression. We therefore aimed to profile the urinary microbiome in men with positive versus negative biopsies for prostate cancer...
August 7, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28791879/management-of-colon-perforation-during-percutaneous-nephrolithotomy-12-years-of-experience-in-a-referral-center
#11
Robab- Maghsoudi, Massoud Etemadian, Amir Hossein Kashi, Kaveh Mehravaran
INTRODUCTION: The management protocol for colon perforation during percutaneous nephrolithotomy (PNL) is controversial due to the scarcity of reported cases and their management diversity. We present our management experience of colon perforation during PNL. MATERIALS AND METHODS: All PNL operations between April 2004 and September 2016 in our center (N=11376) were reviewed for the occurrence and management of colon perforation. We typically performed PNL with insertion of nephrostomy tube before mid 2007...
August 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28791228/management-of-bladder-neck-stenosis-and-urethral-stricture-and-stenosis-following-treatment-for-prostate-cancer
#12
REVIEW
Helen L Nicholson, Yasser Al-Hakeem, Javier J Maldonado, Vincent Tse
The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment...
July 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28789635/simultaneous-antegrade-and-retrograde-endoscopic-treatment-of-non-malignant-ureterointestinal-anastomotic-strictures-following-urinary-diversion
#13
Weiguo Hu, Boxing Su, Bo Xiao, Xin Zhang, Song Chen, Yuzhe Tang, Yubao Liu, Meng Fu, Jianxing Li
BACKGROUND: The ureterointestinal anastomosis stricture (UAS) is a common complication of urinary diversion after radical cystectomy. For decades, open anastomotic revision remained the gold standard for the treatment of UAS. However, with the advancement in endoscopic technology, mini-invasive therapeutic approaches have been used in its management. Here, we report our experience with and long-term results of combined simultaneous antegrade and retrograde endoscopy (SARE) in the treatment of non-malignant UASs after urinary diversion in a consecutive series of patients...
August 8, 2017: BMC Urology
https://www.readbyqxmd.com/read/28777480/serous-lined-stapled-pouch-wall-plication-initial-results-of-a-simple-and-quick-novel-continence-mechanism-in-troubleshooting-secondary-to-continent-cutaneous-urinary-diversion
#14
Hubertus Riedmiller, Arkadius Kocot, Charis Kalogirou
OBJECTIVES: To report a novel and straightforward technique of a secondary continent outlet for continent cutaneous urinary diversion (CCUD) reservoirs without the need for further bowel resection, reducing operation time and hospitalization. PATIENTS AND METHODS: From 2015 to 2017, 6 patients with unreconstructable, incontinent outlets (out of a total pool of n=595 CCUD patients) have undergone the technique described here at our department. It relies on the Mitrofanoff principle, using a stapled full-thickness pouch wall plication, which creates a flap-valve continence mechanism...
August 4, 2017: BJU International
https://www.readbyqxmd.com/read/28776126/management-of-urethral-stricture-and-bladder-neck-contracture-following-primary-and-salvage-treatment-of-prostate-cancer
#15
REVIEW
Brendan Michael Browne, Alex J Vanni
PURPOSE OF REVIEW: This article discusses the incidence, evaluation, and treatment of bladder outlet obstruction from urethral stricture, vesicourethral anastomotic stricture, and bladder neck contracture following primary and salvage treatment of prostate cancer. RECENT FINDINGS: Rates of stenosis after prostate cancer treatment appear similar across all primary treatment modalities including radical prostatectomy, radiation therapy, cryoablation, and high-intensity focused ultrasound in contemporary series...
October 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28774749/sexual-and-reproductive-health-behaviors-and-experiences-reported-by-young-women-with-cystic-fibrosis
#16
Traci M Kazmerski, Gregory S Sawicki, Elizabeth Miller, Kelley A Jones, Kaleab Z Abebe, Lisa K Tuchman, Sigrid Ladores, Ronald C Rubenstein, Scott D Sagel, Daniel J Weiner, Joseph M Pilewski, David M Orenstein, Sonya Borrero
BACKGROUND: The prevalence of general and disease-specific sexual and reproductive health (SRH) concerns is unknown in the United States (U.S.) female CF population. This study aimed to describe and compare the SRH experiences and behaviors of young women with CF with the general U.S. POPULATION: HASH(0x49efcb8) METHODS: Young women with CF ages 15-24years from five geographically diverse U.S. CF centers participated in a survey investigating SRH...
August 1, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28768589/journal-club-developing-a-user-friendly-report-for-electronically-assisted-surveillance-of-catheter-associated-urinary-tract-infections
#17
Michael Fritz Estinville, Amanda Hessels, James Davis
The article chosen for this Journal Club commentary describes the development and testing of a report format using automated data to report urinary catheter utilization and catheter-associated urinary tract infections (CAUTIs).(1) This research sought to address a gap in knowledge regarding the optimal display and content of data reports, communicating to diverse audiences, which used surveillance data from Department of Veterans Affairs' electronic health records. The specific research aim of this project was to develop and pilot test report formats deemed usable and trustworthy by the end user, and discover the best way to deliver to the ideal audience automated data, which is formatted and presented in a way that is acceptable to the end user...
August 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28763116/urodynamic-characteristics-of-pelvic-lipomatosis-with-glandular-cystitis-patients-correlate-with-morphologic-alterations-of-the-urinary-system-and-disease-severity
#18
Yuke Chen, Yang Yang, Wei Yu, Yunxiang Xiao, Yu Fan, Jihong Duan, Yuan Tang, Jie Jin, Huihui Wang, He Wang, Sainan Zhu, Zhijun Xi, Shiliang Wu
AIMS: To explore urodynamic characteristics and their clinical value in pelvic lipomatosis (PL) patients. METHODS: We reviewed the clinical information of 84 PL patients. A voiding pressure-flow study was used to classify patients into nonoutlet obstruction (NOO), latter-half-section obstruction (LHSO), or whole-section bladder outlet obstruction (BOO) groups. Urinary morphologic features were measured by imaging examination and cystoscopy. RESULTS: A unique LHSO that presented as sudden increasing detrusor pressure (Pdet) and decreasing flow rate in the latter half of voiding was observed for 52...
August 1, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28753885/gastrointestinal-complications-following-radical-cystectomy-using-enhanced-recovery-protocol
#19
Soroush T Bazargani, Hooman Djaladat, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K Schuckman, Siamak Daneshmand
BACKGROUND: The development of enhanced recovery after surgery (ERAS) protocols for patients undergoing radical cystectomy (RC) represents a significant advance in perioperative care. OBJECTIVE: To evaluate gastrointestinal (GI) complications following RC and urinary diversion (UD) using our institutional ERAS protocol. DESIGN, SETTING, AND PARTICIPANTS: We identified 377 consecutive cases of open RC and UD for which our ERAS protocol was used from May 2012 to December 2015...
April 25, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753875/islam-and-the-urinary-stoma-a-contemporary-theological-and-urological-dilemma
#20
Saiful Miah, Altaf Mangera, Nadir I Osman, Suresh Venugopal, James Catto, Derek Rosario
BACKGROUND: The prayer ritual is an essential component of Islam that requires entry into a state of physical purity (wudhu) through ablution, which is invalidated by voiding. An important dilemma for patients and surgeons may arise when a Muslim patient is counselled on cystectomy because of the belief by some that an incontinent urinary diversion will automatically invalidate their wudhu. OBJECTIVE: To determine if there are any religious barriers and implications for Muslim patients undergoing an incontinent urinary diversion...
July 13, 2017: European Urology Focus
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