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Journal Cover Journal of Clinical Urology
   [9 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 2051-4158 - ISSN (Online) 2051-4166
     Published by Sage Publications Homepage  [737 journals]
  • Editorial
    • Authors: Pearce; I.
      Pages: 147 - 147
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415814530755|hwp:resource-id:spuro;7/3/147
      Issue No: Vol. 7, No. 3 (2014)
  • Clinical Research Toolkit
    • Authors: Pickard; R.
      Pages: 148 - 148
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415814529871|hwp:resource-id:spuro;7/3/148
      Issue No: Vol. 7, No. 3 (2014)
  • Getting to grips with clinical research
    • Authors: Forrest, R; Peacock, J, Robson, W.
      Pages: 149 - 151
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415814529870|hwp:resource-id:spuro;7/3/149
      Issue No: Vol. 7, No. 3 (2014)
  • The role of uroflowmetry in the assessment and management of men with
           lower urinary tract symptoms - revisiting the evidence
    • Authors: Veeratterapillay, R; Pickard, R, Harding, C.
      Pages: 154 - 158
      Abstract: Uroflowmetry is variably used for the assessment of men with lower urinary tract symptoms (LUTS). There is discrepancy in practice guidelines regarding recommendations for use of uroflowmetry in the initial assessment of men with LUTS. To explain this discrepancy, we systematically reviewed relevant literature to detail currently available evidence and identify evidence gaps requiring further research. PubMED, EMBASE and Medline literature databases were searched for the period between January 1970 and July 2012 to identify articles pertaining to uroflowmetry and outcomes of treatment for men with LUTS. We identified 30 studies for inclusion – none of which had a randomised design. The majority of the studies were prospective or retrospective cohort studies with some cross-sectional and observational reports. The methodology of measurement and reporting urine flow rate has been standardised by reports from the International Continence Society. The current available literature on the reproducibility of urine flow rate is inconclusive and suggests that there may be variability between measurements for a number of different reasons and that repeated tests could be of value clinically. There is also general agreement that a Qmax cut-off of 10 ml/s–1 is suggestive of bladder outlet obstruction. Despite guideline recommendations, there remains a lack of high-quality evidence from studies with robust design to fully ascertain the clinical utility of uroflowmetry and its place in the care pathway for men with LUTS. Future well-designed studies should focus on this evidence gap.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813498874|hwp:master-id:spuro;2051415813498874
      Issue No: Vol. 7, No. 3 (2014)
  • Utilization of information resources among urology outpatients
    • Authors: Lendrum, H; Pearce, I.
      Pages: 159 - 164
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813514968|hwp:master-id:spuro;2051415813514968
      Issue No: Vol. 7, No. 3 (2014)
  • The time-less urologic question, "Now why would you do that'" A case
           series and literature review of self-inserted urethral foreign bodies
    • Authors: Boyle, A; Martinez, D. R, Mennie, P. A, Rafiei, A, Carrion, R.
      Pages: 165 - 169
      Abstract: Objective: Self-inserted urethral foreign bodies are relatively uncommon with few cases reported in the literature. Urethral sounding may result in a retained urethral foreign body commonly occurring in men as a form of masturbation. We present a retrospective case review from a single facility over an eight-month period; discuss the limited literature available rationale and management of self-inserted urethral foreign bodies. Material and methods: In an 8-month period of time, there were eight reported cases of intentional self-inserted urethral foreign bodies, involving three male patients. The patient characteristics varied in age, race, and type of foreign body. The reasons for placement also varied, with sexual gratification being most common. All three patients had a diagnosis of schizophrenia. Diagnosis was made using clinical history, physical examination, imaging studies, and confirmation done with endoscopic visualization of the foreign body. Results: All eight cases were successfully treated via minimally-invasive procedures, either with endoscopic removal or by manual expression of the foreign body out of the urethra. None of the eight required open surgery, and most were treated successfully at the bedside in the emergency room. Only two of the cases required endoscopic removal under anesthesia. After removal of the foreign bodies, all of the patients were able void without difficulty, and also underwent psychiatric evaluation prior to discharge. Conclusion: Urethral foreign bodies can be a result of sexual foreplay in the form of urethral sounding. It has been reported that 10% of 2122 men surveyed admitted to recreational urethral sounding. Common motivations were sexual or erotic in nature. Risky behavior including substance abuse was also reported. Psychiatric disorders have also been reported and psychiatric evaluation is recommended in all cases. A minimally invasive approach should always be attempted. Although rarely reported in the literature, self-inserted urethral foreign bodies should be on the differential in a patient with appropriate symptoms. This is especially true if the patient has a history of substance abuse, psychiatric illness, mental retardation or dementia.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813496562|hwp:master-id:spuro;2051415813496562
      Issue No: Vol. 7, No. 3 (2014)
  • Radical prostatectomy outcomes during prostate-specific antigen era in
           Ireland compared to a matched American population
    • Authors: McGuire, B. B; Anglim, B, Loeb, S, Helfand, B. T, Grainger, R, Flynn, R, McDermott, T, Hu, Q, Cooper, P. R, Fennell, A, Catalona, W. J, Thornhill, J.
      Pages: 170 - 175
      Abstract: Objectives: To examine temporal trends in clinico-pathological outcomes following radical prostatectomy (RP) in Ireland over time, and perform matched comparison of between Ireland and the USA based upon initiation of prostate-specific antigen (PSA) screening. Methods: Between 2000–2010, 651 RPs were carried out at a single institution in Ireland. Clinic-pathologic tumor features were compared to 1302 men treated in the USA from the same time interval (matching on year of diagnosis, 1:2 ratio). As historical comparison, we included a separate group of 150 USA men who underwent RP during the early PSA era (1990–1992). Results: We observed a downward migration in biopsy tumor burden (p=0.002), RP tumor volume (p
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813496995|hwp:master-id:spuro;2051415813496995
      Issue No: Vol. 7, No. 3 (2014)
  • Prostate cancer in Scotland: does geography matter' An analysis of
           incidence, disease characteristics and survival between urban and rural
    • Authors: Laing, K. A; Bramwell, S. P, McNeill, A, Corr, B. D, Lam, T. B.
      Pages: 176 - 184
      Abstract: Objective: The objective of this article is to identify whether there is a difference in survival from prostate cancer in urban and rural areas of Scotland and to identify potential inequalities in incidence, disease characteristics and the treatment of prostate cancer between these areas. Subjects/patients and methods: A retrospective cohort study was undertaken. Retrospective analysis of data from Information Services Division and regional cancer databases from 2005 to 2010 was performed. A comparison of NHS Highland & Western Isles as the rural group with NHS Lothian as the urban group was made. Data were collected on patient and disease characteristics, first treatment and mortality. Non-parametric continuous data were analysed using the Mann-Whitney U test. Categorical data were assessed using a two-tailed Z test. The p value for statistical significance was set at < 0.05. Results: The incidence of prostate cancer was higher in rural areas. Rural patients were older at diagnosis (p < 0.0001), presented with higher risk disease (p < 0.0001) and underwent less curative treatment (p < 0.0001). There was potentially poorer survival in rural areas. Conclusions: Men living in rural areas of Scotland present with more aggressive prostate cancer and may have poorer survival. This could be due to high levels of PSA testing in urban areas, therefore further studies are needed to identify patterns of PSA testing in Scotland. These inequalities will be highlighted to the Scottish Government to inform the ‘Detect Cancer Early’ campaign for its second phase in 2015.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813512303|hwp:master-id:spuro;2051415813512303
      Issue No: Vol. 7, No. 3 (2014)
  • Anorectal toxicity of external beam radiotherapy in the treatment of
           prostate cancer
    • Authors: Bajwa, A; Raeburn, A, Taylor, S, Cohen, R, Payne, H, Emmanuel, A.
      Pages: 185 - 189
      Abstract: Introduction: Maximising radiotherapy dosage is associated with better tumour response in prostate cancer. High dose three-dimensional conformal radiotherapy (3D CRT) has allowed dose escalation to be safely achieved and the current standard dose in the UK with this technique is 74 Grays (Gy). Documenting normal tissue tolerance is critical and forms the basis of this prospective study of anorectal toxicity. Patients and methods: Seventeen consecutive men (median age 72 (range 50–79) years) with localised or locally advanced prostate cancer treated with 74 Gy of 3D CRT were studied. Wexner incontinence scores, comprehensive anorectal physiology and endoanal ultrasound were measured before and four months after completing treatment. Results: Wexner incontinence scores increased from a median of 0 to 1 (range 0–6) with treatment (p=0.001). Patients developed faecal urgency (7/17), passive faecal loss (5/17) or a combination of both (3/17) as new anorectal symptoms. No patients reported episodes of frank faecal incontinence. A significant decline in rectal mucosal electrosensitivity (mean (standard deviation (SD)) thresholds increasing from 24.7 (10.7) to 34.3 (9.3) mA after treatment, p=0.003) and an increase in rectal elastance (mean (SD) of 0.056 (0.03) mm Hg/ml to 0.078 (0.036) mm Hg/ml pre- and post-treatment respectively, p=0.0181) was seen. No changes in anal canal manometry, rectal distension volumes and endoanal ultrasound were noted. Conclusions: Early anorectal symptoms are common after 3D CRT for prostate cancer. Rectal injury is evident with an increase in wall stiffness and a decrease in mucosal sensitivity. Longer term studies monitoring anorectal toxicity are warranted.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813506578|hwp:master-id:spuro;2051415813506578
      Issue No: Vol. 7, No. 3 (2014)
  • Is postoperative epidural analgesia better than patient-controlled
           analgesia for radical cystectomy'
    • Authors: Autran Gomez, A. M; Clarke, C, Smith, D, Yutkin, V, Alzahrani, A, Izawa, J. I.
      Pages: 190 - 197
      Abstract: Background: The purpose of this study was to evaluate postoperative epidural analgesia (EPA) and intravenous patient-controlled analgesia (PCA) in terms of morbidity and mortality in patients undergoing radical cystectomy for bladder cancer. Methods: A retrospective study on patients undergoing radical cystectomy for clinical Tis-4N0M0 urothelial carcinoma of the bladder was performed. Patients were separated into two groups: primary EPA or PCA for postoperative analgesia. The surgical complication severity was determined according to the Clavien system. Mann-Whitney U tests, 2 with Yates’ correction, or Fisher’s exact test were used. Predictive risk factors were explored using univariable and multivariable Cox regression models. Results: Of the 274 patients studied, 209 (76%) received EPA and 65 (24%) had PCA. Baseline balance was observed. Similar complication rates were observed between the EPA (36%) and PCA (34%) (p=0.382). Patients greater than 70 years of age had more complications (35% vs 21%, p=0.002). PCA patients had higher rates of high-grade complications compared with EPA patients [40% vs 20% (p=0.0007)]. Only age at time of surgery (p=0.032) was associated with complications. Patients with pulmonary disease had a higher risk of complications (p=0.001). EPA or PCA were not predictors for overall survival. Conclusions: There does not appear to be a significant difference in terms of morbidity or mortality between EPA and PCA following radical cystectomy (RC). Rare, catastrophic complications specific to EPA may occur. Standardized reporting of surgical complications is essential to compare studies and appropriately counsel patients.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813500954|hwp:master-id:spuro;2051415813500954
      Issue No: Vol. 7, No. 3 (2014)
  • Socioeconomic demographics of patients referred to the Scottish National
           Service: Sacral Nerve Stimulation for Urinary Dysfunction
    • Authors: Lim, D; Ramsay, A, Small, D, Conn, I.
      Pages: 198 - 201
      Abstract: Aim: Implantation of a permanent sacral nerve stimulation (SNS) device is reserved for patients who have demonstrated benefit during testing and patients selected for implantation must have shown a minimum level of understanding with the technology. The hypothesis behind this study was that the Scottish SNS for Urinary Dysfunction service unknowingly selected patients from higher socioeconomic classes, who seemed more likely to manage the technology. The objectives of this study were to analyse socioeconomic status of referrals and to compare socioeconomic classes of referrals which were (a) accepted for testing and (b) proceeding to permanent implantation. Methods and results: All patients referred to the service from April 2010–February 2013 were included in this study. Using the Scottish Index of Multiple Deprivation 2012, each patient’s postcode was matched to the corresponding datazone quintile (1–5, in descending order of deprivation). Altogether 178 referrals were analysed with no significant differences between each quintile observed: of these 56.7% progressed to testing, and 36.5 % progressed to permanent implantation with no significant difference in proportion between each quintile. Conclusion: Reassuringly, patient selection for sacral nerve stimulation in our study demonstrated no significant discrimination by socioeconomic status.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813506577|hwp:master-id:spuro;2051415813506577
      Issue No: Vol. 7, No. 3 (2014)
  • Introducing endourology to a developing country: how to make it
    • Authors: Biyani, C. S; Bhatt, J, Taylor, J, Gobeze, A. A, McGrath, J, MacDonagh, R.
      Pages: 202 - 207
      Abstract: Background: Endourological procedures are not routinely performed in low-income countries in sub-Saharan Africa. The problems that are involved in introducing endoscopic services are low level of medical personnel trained in endoscopic procedures and infrastructure development in these countries. Materials and methods: Recently, endourological facilities were created at the Hawassa Referral Hospital in Ethiopia. This work is the result of close collaboration between the UROLINK and the Hawassa Referral Hospital Link coordinator. Between 2010 and 2012, the UROLINK team visited Hawassa three times to set up endourological services. Results: A local surgeon has been trained in basic endoscopic procedures. Optical urethrotomy and flexible and rigid cystoscopy have been successfully introduced. We discuss the difficulties involved in such a project like initial assessment, providing equipment, maintenance of equipment, and, particularly, training of the surgical team. The follow up from the trips is short and the sustainability of the goal remains to be seen. Conclusions: The introduction of endourological services in Hawassa offers a chance of improving urological care locally. The experience of Hawassa is representative of other low-income countries and may provide valuable lessons. A few key principles (need, equipment, cost, surgical technique, and training) should be kept in mind.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813514971|hwp:master-id:spuro;2051415813514971
      Issue No: Vol. 7, No. 3 (2014)
  • Oral D-mannose in recurrent urinary tract infections in women: a pilot
    • Authors: Porru, D; Parmigiani, A, Tinelli, C, Barletta, D, Choussos, D, Di Franco, C, Bobbi, V, Bassi, S, Miller, O, Gardella, B, Nappi, R, Spinillo, A, Rovereto, B.
      Pages: 208 - 213
      Abstract: Background: In recurrent urinary tract infections (UTIs) usual prophylactic antibiotic regimes do not change the long-term risk of recurrence. Our aim was to evaluate the efficacy of D-mannose in the treatment and prophylaxis of recurrent UTIs. Methods: In this randomized cross-over trial female patients were eligible for the study if they had an acute symptomatic UTI and three or more recurrent UTIs during the preceding 12 months. Suitable patients were randomly assigned to antibiotic treatment with trimethoprim/sulfamethoxazole or to a regimen of oral D-mannose 1 g 3 times a day, every 8 hours for 2 weeks, and subsequently 1 g twice a day for 22 weeks. They received the other intervention in the second phase of the study, with no further antibiotic prophylaxis. The primary endpoint was evaluation of the elapsed time to recurrence; secondary endpoints were evaluation of bladder pain (VASp) and urinary urgency (VASu). Results: The results for quantitative variables were expressed as mean values and SD as they were all normally distributed (Shapiro–Wilk test). In total, 60 patients aged between 22 and 54 years (mean 42 years) were included. Mean time to UTI recurrence was 52.7 days with antibiotic treatment, and 200 days with oral D-mannose (p < 0.0001). Conclusions: Mean VASp, VASu score, and average numbers of 24-hour voidings decreased significantly. D-mannose appeared to be a safe and effective treatment for recurrent UTIs in adult women. A significant difference was observed in the proportion of women remaining infection free versus antibiotic treatment.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813518332|hwp:master-id:spuro;2051415813518332
      Issue No: Vol. 7, No. 3 (2014)
  • Exceptional diagnosis of testicular tumour in a patient with
           paraneoplastic encephalitis
    • Authors: Ramos, F. G; Sanchez, A. T, Gonzalez, L. G, Alcaide, E. J, Ospina Galeano, I. A, Pajares, A. A, Polo, J. M, Gonzalez, R. D.
      Pages: 214 - 215
      Abstract: Testicular tumour diagnosis and its management are widely known by urologists, although there are some exceptional diagnoses with rare clinical profiles. We report the unusual case of a young man presenting neuropsychiatric symptoms with no evidence of neurological disease and increased serum anti-Ma2 antibodies, which are associated with germ cell tumours. Our patient was finally diagnosed with a likely left testicular tumour, an orchidectomy was performed and the symptoms disappeared. Only four cases with a similar clinical background and evolution have been reported in the literature.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813501673|hwp:master-id:spuro;2051415813501673
      Issue No: Vol. 7, No. 3 (2014)
  • Primary T-cell lymphoma of the testicle: a rare case report of its
           clinical presentation, radiologic findings, pathologic interpretation, and
    • Authors: Hebert, K; Woo, H, Halat, S.
      Pages: 216 - 218
      Abstract: Testicular T-cell lymphoma is an extremely rare disease, with a particularly poor prognosis. This report reviews the clinical, radiologic and pathologic features of a case of testicular T-cell lymphoma, as well as the current treatment recommendations and prognosis of this disease based on current literature. A 78-year-old male presented with unilateral testicular swelling. Ultrasound confirmed an intra-testicular mass, and subsequent orchiectomy was performed. Pathologic diagnosis was consistent with primary peripheral T-cell lymphoma of the testicle. There was no evidence of metastatic disease. He is currently undergoing CHOP chemotherapy followed by intrathecal chemotherapy. Primary testicular T-cell lymphoma is a very rare disease with few case reports in the literature. Evaluation should always include CT imaging, lumbar puncture and bone marrow biopsy. The diagnosis imparts a poor prognosis, with an overall median survival of 12–24 months.
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813504398|hwp:master-id:spuro;2051415813504398
      Issue No: Vol. 7, No. 3 (2014)
  • Prostatic carcinoma metastasis to testis
    • Authors: Chim, Y. R; Popplestone, C, Hawkyard, S.
      Pages: 219 - 220
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813501161|hwp:master-id:spuro;2051415813501161
      Issue No: Vol. 7, No. 3 (2014)
  • Comparing readmission rates: comparing apples and oranges, but not
    • Authors: Kirollos; M. M.
      Pages: 221 - 222
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415813517695|hwp:master-id:spuro;2051415813517695
      Issue No: Vol. 7, No. 3 (2014)
  • Response to: The six-hour rule for testis fixation in testicular torsion:
           is it history' Paul Hadway and John Reynard
    • Authors: Chetwood, A; Montgomery, B, Barber, N.
      Pages: 223 - 223
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415814528327|hwp:master-id:spuro;2051415814528327
      Issue No: Vol. 7, No. 3 (2014)
  • Letter to the Editor
    • Authors: Hadway, P; Reynard, J.
      Pages: 224 - 224
      PubDate: 2014-04-29T03:20:31-07:00
      DOI: 10.1177/2051415814529857|hwp:resource-id:spuro;7/3/224
      Issue No: Vol. 7, No. 3 (2014)
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