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Risk factors for urologic postoperative complications

Magnus J Grabe, Karl-Johan Lundström
PURPOSE OF REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed...
March 2017: Current Opinion in Urology
Ronald J Caras, Michael B Lustik, Sean Q Kern, Leah P McMann, Joseph R Sterbis
INTRODUCTION: Multiple studies have linked preoperative nutrition status to postoperative outcomes. This relationship has been little studied in urology. We used a standardized, national, risk-adjusted surgical database to evaluate 30-day outcomes of patients undergoing common urologic oncologic procedures as they related to preoperative albumin. METHODS: The American College of Surgeons National Surgical Quality Improvement Program is a risk-adjusted dataset analyzing preoperative risk factors, demographics, and 30-day outcomes...
September 23, 2016: Clinical Genitourinary Cancer
G Pic, J E Terrier, B Ozenne, N Morel-Journel, P Paparel, A Ruffion
INTRODUCTION: Stress urinary incontinence (SUI) is a degradation of the quality of life factor in the consequences of radical prostatectomy. Artificial urinary sphincter (AUS) is the standard treatment. Screening and preoperative treatment of anastomotic strictures (AS) is an essential step for the success of the intervention. The objective of the study was to assess the impact of AS on the results of AUA. METHODS: We retrospectively studied 147 AUS settlements from 2005 to 2013 in the urology department of the Centre Hospitalier Lyon by three operators...
September 2016: Progrès en Urologie
Guofang Fang, Zihai Ding, Zhihui Song
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is a standard technique for the treatment of lumbar disc hernia. Thus far, most surgeons have recommended local anesthesia. However, in clinical practice, some patients experience pain and are unable to cooperate with the surgery during intervertebral foramen hemp expansion. The use of general anesthesia may create a greater risk of complications because of nerve root anomalies; thus, intraoperative neurophysiological monitoring should be utilized...
September 2016: Pain Physician
Onur Telli, Cihat Ozcan, Nurullah Hamidi, Mehmet A Karagoz, Ahmet M Hascicek, Tarkan Soygur, Berk Burgu
OBJECTIVE: To evaluate preoperative predictive factors for postoperative complications of augmentation cystoplasty in children by using the modified Clavien classification system (MCCS). PATIENTS AND METHODS: A retrospective review of medical records between 1994 and 2014 identified 117 children (64 males and 53 females) who underwent augmentation cystoplasty. Complications were evaluated according to the MCCS. Univariate and multivariate analyses were used to determine predictive factors affecting complication rates...
November 2016: Urology
Win Shun Lai, Dean Assimos
Postoperative sepsis is the most common cause of mortality after percutaneous nephrolithotomy (PCNL) procedures. Studies investigating the use of antibiotics in PCNL patients have shown that prophylactic antibiotic regimens can reduce the rate of postoperative infectious complications. In addition, several studies have identified risk factors for sepsis development that can help guide antibiotic treatment and perioperative care overall. This has led the American Urological Association to recommend antibiotic prophylaxis for PCNL as a best practice policy statement...
2016: Reviews in Urology
Tendo Sato, Shingo Hatakeyama, Teppei Okamoto, Hayato Yamamoto, Shogo Hosogoe, Yuki Tobisawa, Tohru Yoneyama, Eiji Hashiba, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Kazuyoshi Hirota, Chikara Ohyama
OBJECTIVES: The aim of this study was to identify risk factors associated with postoperative delirium in patients undergoing urological surgery. METHODS: We prospectively evaluated pre- and postoperative risk factors for postoperative delirium in consecutive 215 patients who received urological surgery between August 2013 and November 2014. Preoperative factors included patient demographics, comorbidities, and frailty assessment. Frailty was measured by handgrip strength, fatigue scale of depression, fall risk assessment, and gait speed (the timed Get-up and Go test)...
2016: PloS One
Ricardo Palmerola, Christopher Hartman, Nithin Theckumparampil, Anudeep Mukkamala, Joanna Fishbein, Michael Schwartz, Louis R Kavoussi
PURPOSE: Surgical complications have a significant impact on intended quality of care. The aim of our study was to identify factors that contribute to the propagation of additional postoperative complications. MATERIALS AND METHODS: Over a 1-year period, we prospectively identified and retrospectively reviewed data on all patients who experienced a surgical complication within 30 days of their procedure. A complication was defined as any deviation from the expected postoperative course and was described using the Clavien-Dindo classification...
May 2016: Journal of Endourology
V Rossi, G Torino, S Gerocarni Nappo, E Mele, M Innocenzi, G Mattioli, N Capozza
Surgical complications during kidney transplantation can seriously affect renal outcomes. We assess occurrence, risk factors, and results of all urological complications in a series of renal transplants in a single center. Children who underwent renal transplant between January 2008 and December 2014 were retrospectively evaluated. Postoperative urological complications were reviewed. Demographic details, cause of ESRD, donor type, and surgical procedures at transplant were analyzed. For statistical analysis, the chi-square test or Fisher's exact test were used as appropriate...
June 2016: Pediatric Transplantation
Daryl J McLeod, Lindsey Asti, Justin B Mahida, Katherine J Deans, Peter C Minneci
BACKGROUND: Preoperative risk assessment is standard in adult surgery, but often these risk assessments cannot be applied to children. Previous studies emphasize the differences between pediatric and adult populations and variability by surgical procedure types. OBJECTIVE: We investigated preoperative risk factors for several outcomes in children undergoing major urologic surgery using the National Surgical Quality Improvement Program (NSQIP) Pediatric. STUDY DESIGN: A cohort of 2-18-year-old children who underwent major urologic surgery was identified by Current Procedure Terminology (CPT) codes in the 2012-2013 NSQIP-Pediatric...
February 2016: Journal of Pediatric Urology
Nurettin Ay, Mehmet Veysi Bahadır, Melih Anıl, Vahhac Alp, Şafak Kaya, Utkan Sevük, Mesut Gül, Ramazan Danış
OBJECTIVES: There are studies that show that double J stenting (DJS) increase BK nephropathy (BKN) 4 fold. DJS may cause vesicoureteral reflux (VUR) with normal bladder contraction. The aim of this study is to comparison risk of BKN, urinary tract infections (UTI) and postoperative urologic complications with the use DJS with anti-reflux device (ARD-DJS) and standart double J stent (St-DJS). Matherial and methods: Ninety patients (male/female: 50/40) that had undergone kidney transplantations in Diyarbakır Training and Research Hospital and Dicle University, Faculty of Medicine Hospital between January 2012 and April 2015 were enrolled in the study...
2015: International Journal of Clinical and Experimental Medicine
Alexandre Gryn, Benoit Peyronnet, Andréa Manunta, Jean-Baptiste Beauval, Elie Bounasr, François-Xavier Nouhaud, Nathalie Rioux-Leclercq, Philippe Caron, Mathieu Thoulouzan, Grégory Verhoest, Michel Soulie, Karim Bensalah, Eric Huyghe
INTRODUCTION: The use of laparoscopy for the excision of adrenal metastasis remains controversial. We aimed to report oncological and perioperative outcomes of laparoscopic excision of adrenal metastases and to seek for predictive factors of unfavorable oncological outcomes. METHODS: A retrospective chart review was conducted and all consecutive patients who underwent laparoscopic adrenalectomy (LA) in the setting of metastatic cancer in two academic urology departments from November 2006 through January 2014 were included...
December 2015: International Journal of Surgery
Russell S Terry, Travis Gerke, James B Mason, Matthew D Sorensen, Jason P Joseph, Philipp Dahm, Li-Ming Su
This study aimed at reviewing a contemporary series of patients who underwent robotic renal and adrenal surgery by a single surgeon at a tertiary referral academic medical center over a 6-year period, specifically focusing on the unique and serious complication of post-operative rhabdomyolysis of the dependent lower extremity. The cases of 315 consecutive patients who underwent robotic upper tract surgery over a 6-year period from August 2008 to June 2014 using a standardized patient positioning were reviewed and analyzed for patient characteristics and surgical variables that may be associated with the development of post-operative rhabdomyolysis...
September 2015: Journal of Robotic Surgery
Michael P Kurtz, Erin R McNamara, Anthony J Schaeffer, Tanya Logvinenko, Caleb P Nelson
BACKGROUND: Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI is frequently not available in administrative databases. Here we report results from the first nationally based, prospectively assembled cohort analyzed with respect to the association of BMI with 30-day postoperative events for pediatric urologic procedures...
August 2015: Journal of Pediatric Urology
Simone Albisinni, Marco Oderda, Laurent Fossion, Virginia Varca, Jens Rassweiler, Xavier Cathelineau, Piotr Chlosta, Alexandre De la Taille, Franco Gaboardi, Thierry Piechaud, Peter Rimington, Laurent Salomon, Rafael Sanchez-Salas, Jens-Uwe Stolzenburg, Dogu Teber, Roland Van Velthoven
PURPOSE: To analyze postoperative complications after laparoscopic radical cystectomy (LRC) and evaluate its risk factors in a large prospective cohort built by the ESUT across European centers involved in minimally invasive urology in the last decade. METHODS: Patients were prospectively enrolled, and data were retrospectively analyzed. Only oncologic cases were included. There were no formal contraindications for LRC: Also patients with locally advanced tumors (pT4a), serious comorbidities, and previous major abdominal surgery were enrolled...
February 2016: World Journal of Urology
A S Grechenkov, P V Glybochko, Yu G Alyaev, E A Bezrukov, A Z Vinarov, D V Butnaru, R B Sukhanov
OBJECTIVE: To determine the risk factors for anterior urethral strictures after transurethral resection of benign prostatic hyperplasia. MATERIALS AND METHODS: The present study consists of a prospective and retrospective part. Prospective analysis of 110 patients who had undergone, at the urology clinic of First MSMU named after I.M. Sechenov in the period from January 2009 to February 2014 was performed transurethral resection (TUR) of the prostate. In the retrospective part, the case histories of 85 patients who were treated in the urology clinic First MSMU named after I...
January 2015: Urologii︠a︡
Jing Tan, Binghai Chen, Leye He, Guangming Yin, Zhiqiang Jiang, Kun Yao, Xianzheng Jiang
INTRODUCTION: Hemorrhage is a major complication after percutaneous nephrolithotomy (PCNL). In the current study, we analyzed the risk factors for severe bleeding after PCNL. MATERIAL AND METHODS: Medical records of 982 consecutive patients undergoing PCNL at the Department of Urology, the Third Xiangya Hospital, were reviewed. The type of stone included: solitary (n = 471), multiple (n = 192) and staghorn (n = 319). 139 patients had renal stones of solitary kidney or functional solitary kidney...
April 25, 2015: Archives of Medical Science: AMS
Yansheng Xu, Weimin Guan, Weihao Chen, Changliang Xie, Yun Ouyang, Yiguang Wu, Cuilong Liu
BACKGROUND AND OBJECTIVES: In urology, potassium-titanyl-phosphate (KTP) laser is mainly used in the treatment of benign prostatic hyperplasia with a low rate of intraoperative and postoperative complications. A prospective, randomized study was undertaken to investigate the treatment outcomes of KTP laser vaporization for primary non-muscle-invasive bladder tumors (NMIBTs) as compared with conventional monopolar transurethral resection of bladder tumors (TURBT). MATERIALS AND METHODS: This study was designed as a prospective, randomized trial...
April 2015: Lasers in Surgery and Medicine
Yong Seung Lee, Young Jae Im, Sang Hee Shin, Rosito T Bascuna, Ji Yong Ha, Sang Won Han
OBJECTIVE: To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. METHODS: When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches...
February 2015: Urology
Dzelaludin Junuzovic, Munira Hasanbegovic
INTRODUCTION: Endourological procedures are performed according to the principles of aseptic techniques, jet still in certain number of patients urinary tract infections may occur. Considering the risk of urinary tract infection, there is no unique opinion about the prophylactic use of antibiotics in endourological procedures. GOAL: The objective of this study was to determine the connection between endourological procedures and occurrence of urinary infections and to analyze the risk factors of urinary infection for patients who were hospitalized at the Urology Clinic of the Clinical Center University of Sarajevo CCUS...
August 2014: Medical Archives
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