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aging urology

Jérôme Gas, François-Xavier Nouhaud, Mathieu Roumiguié, Séverine Lagarde, Marie-Charlotte Delchier, Éric Huyghe, Michel Soulié, Xavier Gamé, Jean-Baptiste Beauval
PURPOSE: To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas. MATERIALS AND METHODS: In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery. RESULTS: The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i...
March 15, 2018: International Urogynecology Journal
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Daniel Koh, Kenneth K Lau, Evonne Teoh
PURPOSE: To investigate if the presence of systemic inflammatory response syndrome (SIRS) in patients with urinary tract obstruction at time of presentation to the emergency department correlates with a subsequent positive urine culture and to determine if it could be used as a tool to predict the urgency of a percutaneous nephrostomy (PCN). The secondary aim of the study was to assess the incidence of in-hour and after-hour emergent PCNs performed in a tertiary center which has both interventional radiological and urological expertise...
March 13, 2018: Emergency Radiology
L Klotz, A Loblaw, R Siemens, P Ouellette, A Kapoor, M Kebabdjian, L Zhang, F Saad
BACKGROUND: In men initiating intermittent androgen deprivation therapy (IADT), a range of induction durations, between 3 and 12 months, have been employed. OBJECTIVE: To determine if the duration of induction ADT influences the duration of the off treatment interval and the recovery of serum testosterone (T). MANEUVER: This was a prospective, randomized, open label study. Men with biochemical recurrence after local therapy for prostate cancer, with a negative bone scan, were randomized between 4 and 10 months of monthly Degarelix...
March 10, 2018: Journal of Urology
Z Jia, C J Zhang, C G Xi, Y Q Gong, K W Yang, D Peng, L B Liu, J Li, X S Li, Z S He, L Q Zhou
Objective: To study the clinical characteristics, image findings, therapeutic method and prognosis of metanephric adenoma. Method: The clinical characteristic, image findings, operation methods and prognosis of 16 metanephric adenoma patients treated at Department of Urology, Peking University First Hospital from January 2004 to March 2016 were analyzed retrospectively. Results: There were 6 male and 10 female patients in the study. The mean age of patients was 33.7 years (ranging from 14 to 83 years). Two patients came to the hospital because of fever, while other 14 patients had no symptoms and found renal tumor by medical examination...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Y C Hao, C L Xiao, K Liu, Y Q Liu, L L Ma
Objective: To investigate application value of narrow-band imaging (NBI) flexible ureteroscopy in the diagnosis, treatment and follow-up of upper urinary tract transitional carcinomas (UTUC). Methods: From June 2015 to June 2017, 16 patients of UTUC were treated by flexible ureteroscopy with white light (WLI) and NBI at Department of Urology, Peking University Third Hospital , including 10 females and 6 males. The age of patients ranged from 43 to 84 years (average 68.9 years). There were 54 cases, including 16 cases with first-suspicion of cancer, and 38 cases with known of UTUC as follow-up...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Hakushi Kim, Chie Inomoto, Takato Uchida, Hiroyuki Furuya, Tomoyoshi Komiyama, Hiroshi Kajiwara, Hiroyuki Kobayashi, Naoya Nakamura, Akira Miyajima
The aim of the present study was to evaluate the validity of potential prognostic parameters of clear cell renal cell carcinoma (ccRCC) recommended by the 2012 International Society of Urological Pathology (ISUP) Consensus Conference in the Japanese population. We reviewed 406 Japanese patients with localized or locally advanced ccRCC who underwent curative surgery during 2004-2014 at Tokai University Hospital (Isehara, Japan) and were followed up for >2 years after surgery. A single pathologist reviewed all the histological slides...
April 2018: International Journal of Oncology
Laura N Nguyen, Jamie Bartley, Kim A Killinger, Priyanka Gupta, John Lavin, Ayad Khourdaji, Jason Gilleran, Natalie Gaines, Judith A Boura, Kenneth M Peters
AIMS: To evaluate whether baseline symptoms and outcomes are influenced by gender in a matched cohort undergoing neuromodulation. METHODS: Patients in our prospective neuromodulation database that had a tined lead placed were reviewed. Those that had implantable pulse generator (IPG) placed were matched on age and urologic diagnosis. History, voiding diaries, satisfaction, Interstitial Cystitis Symptom/Problem Index (ICSIPI), and overactive bladder symptom severity (OABq ss)/health-related quality of life (HRQOL) preimplant and over 3 years were evaluated using descriptive statistics, repeated measures, and matched pair GEE or mixed analyses...
March 13, 2018: International Urology and Nephrology
Raffaella Santi, Tommaso Cai, Stefania Nobili, Ilaria Camilla Galli, Andrea Amorosi, Eva Comperat, Gabriella Nesi
The current WHO/ISUP classification and grading system subdivides urothelial tumours into prognostically distinct categories. Understanding the molecular pathways involved in bladder cancer development can improve patient stratification and management. This study aims to investigate the relationship between Snail, Slug and E-cadherin expressions and clinico-pathological features of non-muscle invasive bladder carcinoma (NMIBC). All patients attending the same urological centre from January to May 2002, who were pathologically diagnosed with NMIBC, were enrolled in this longitudinal cohort study...
March 10, 2018: Virchows Archiv: An International Journal of Pathology
Eric J Kirshenbaum, Robert H Blackwell, Belinda Li, Anai N Kothari, Paul C Kuo, Robert C Flanigan, Alex Gorbonos, Gopal N Gupta
INTRODUCTION: The purpose of this article is to assess the incidence of pulmonary aspiration following major urologic surgery, predictors of an aspiration event, and subsequent clinical outcomes. MATERIALS AND METHODS: The Healthcare Cost and Utilization Project State Inpatient Database for California between 2007-2011 was used to identify cystectomy, prostatectomy, partial and radical nephrectomy patients. Aspiration events were identified within 30 days of surgery...
February 2018: Canadian Journal of Urology
Quentin Manach, Olivier Cussenot, Morgan Rouprêt, Xavier Gamé, Emmanuel Chartier-Kastler, Christine Reus, Philippe Camparo, Eva Compérat, Véronique Phé
INTRODUCTION: To establish if the validated tumor biomarkers of luminal and basal bladder cancers in non neuro-urological patients are applicable to a neuro-urological population. MATERIALS AND METHODS: We retrieved bladder cancer samples from neuro-urological patients (n = 20) and non-neurological controls (n = 40). The expression of GATA3 and CK5/6 was analyzed using immunohistochemistry of microarray tissue sections. We also assessed the correlation between previous biomarker expression, gender, age, tumor stage (non-muscle-invasive bladder cancer (NMIBC)/muscle-invasive bladder cancer (MIBC)), squamous-cell differentiation and basal/luminal subtypes using Pearson's correlation coefficient (r)...
February 2018: Canadian Journal of Urology
Kyoung Lee, Jae Min Chung, Sang Don Lee
Purpose: Local anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery. Materials and Methods: Fifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3-4 years, and group III: 5 years and above)...
March 2018: Investigative and Clinical Urology
Carlos Augusto F Molina, Jose Bessa Junior, Andrey G Estevanato, Gustavo S Viana, Inalda Facincani, Jose Murillo Bastos Netto, Silvio Tucci Junior
Introduction We evaluated the applicability of laparoscopic nephrectomy in the treatment of multicystic dysplastic kidney (MCDK) in children, including procedures performed by resident physicians or trainees in surgical urology. Methods We retrospectively evaluated the medical records of 20 children with MCDK who underwent laparoscopic nephrectomy over a six-year period. Data collected included gender, laterality of the affected kidney, age at the time of surgery, the largest diameter of the multicystic kidney and associated urological diagnoses, surgical, and postoperative data...
January 1, 2018: Curēus
Darius Adomavicius, Mark Bock, Christian-Friedrich Vahl, Ekkehard Siegel
Background. Aerococcus urinae is a rare causative pathogen of infective endocarditis that results in a high risk of embolic events. The mortality rate for A urinae endocarditis is high. Old age and underlying urologic conditions are the best-known risk factors for infection. Case Description. We report the clinical course of the disease in a 49-year-old man who presented symptoms of a urinary tract infection. A few days later, transthoracic echocardiography showed a conspicuous mitral valve with myxomatous alterations...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Zahra Jarayedi, Fariba Asghari
OBJECTIVE: To evaluate the knowledge and performance of surgical residents regarding the person from whom informed consent should be taken for surgery and from whom the consent is taken in practice. MATERIALS AND METHODS: This study was done in 2013. The population of this study was all residents of urology, surgery, orthopaedic surgery and gynaecology of Tehran and Iran University of Medical Sciences. The study tool was a self-administered questionnaire, containing questions on their knowledge and performance regarding informed consent acquisition from patients with different conditions in terms of age, sex, marital status and their capacity to make treatment decisions...
March 6, 2018: Journal of Medical Ethics
Nicolas von Landenberg, Atiqullah Aziz, Friedrich C von Rundstedt, Jakub Dobruch, Luis A Kluth, Andrea Necchi, Aidan Noon, Michael Rink, Kees Hendricksen, Karel P J Decaestecker, Roland Seiler, Cédric Poyet, Harun Fajkovic, Shahrokh F Shariat, Evanguelos Xylinas, Florian Roghmann
OBJECTIVE: To determine conditional recurrence-free survival (RFS) and progression-free survival (PFS) and improve decision-making toward surveillance protocols and scheduling. Furthermore, evaluating the evolution of predictors for disease recurrence over time, because TaG1 non-muscle-invasive bladder cancer harbors a risk of disease recurrence and progression. MATERIAL AND METHODS: The retrospective multicenter design study includes 1,245 TaG1 bladder cancer patients with median follow-up of 62...
March 2, 2018: Urologic Oncology
Ranjana Jairam, Jamie Drossaerts, Desiree Vrijens, Carsten Leue, Philip van Kerrebroeck, Gommert van Koeveringe
AIMS: Sacral neuromodulation (SNM) is an effective treatment for patients with overactive bladder syndrome (OAB) or non-obstructive urinary retention (NOR). These lower urinary tract symptoms (LUTS) are the result of a functional urological cause but often coincide with psychological and/or psychiatric factors. It has been stated that there is an association between LUTS, depression and anxiety disorders. With this study we will investigate whether affective symptoms and quality of life (QoL) improve after successful SNM...
March 5, 2018: Neurourology and Urodynamics
Il-Young Jang, Chang Ki Lee, Hee-Won Jung, Sang Soo Yu, Young Soo Lee, Eunju Lee, Dae Hyun Kim
Purpose: Frailty is an important consideration in the management of lower urinary tract symptoms and erectile dysfunction in older men; frailty increases vulnerability to treatment-related adverse outcomes, but its burden is not known. The authors aimed to examine the burden of frailty and associated geriatric conditions in community-dwelling older men. Patients and methods: A cross-sectional study was conducted with 492 community-dwelling older men (mean age, 74...
2018: Clinical Interventions in Aging
Elisabeth Liek, Heiko Wunderlich, Klaus Elsebach, Hubert Göbel, Xaver Krah, Andreas W Krautschick-Wilkens, Josef Schweiger, Gabriel Steiner, Thomas Steiner, Joana Heinzelmann
Due to the recommendations in the urological guidelines to perform nephron-sparing surgery in patients with organ-confined renal cell carcinoma (RCC), the customary therapy regimen changed, but it is not well studied yet whether partial nephrectomy (PN) especially in the elderly is beneficial. From 2000 to 2015, 3,592 patients from 7 clinics undergoing surgery in RCC were identified; 2,323 had T1 tumours. We retrospectively compared the overall survival benefit of patients with T1 RCC who underwent either PN or radical nephrectomy (RN) and studied effects of age and gender...
March 2, 2018: Urologia Internationalis
A J Rensing, B M Whittam, K H Chan, M P Cain, A E Carroll, W E Bennett
INTRODUCTION: Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population...
February 21, 2018: Journal of Pediatric Urology
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