JournalTOCs

Urologia Journal
Journal Prestige (SJR): 0.189

Number of Followers: 0

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0391-5603 - ISSN (Online) 1724-6075
Published by Sage Publications

[1176 journals]

Early versus delayed ureterolithotripsy following obstructive acute
pyelonephritis treatment
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  Authors: Huseyin Ozgur Kazan, Muhammet Cicek, Hulya Caskurlu, Ramazan Gokhan Atis, Asif Yildirim
  Abstract: Urologia Journal, Ahead of Print.
  Background and objectives:There is no recommendation on the timing of ureterolithotripsy after the treatment of obstructive acute pyelonephritis (APN). The effect of early and delayed ureterolithotripsy on postoperative urinary tract infection (UTI) and other complications was investigated.Methods:Patients who underwent ureterolithotripsy after obstructive APN treatment between February 2017 and August 2021 were divided into two groups, those operated during hospitalization and those operated within 3 months after discharge. Two groups were compared in terms of stone-free status, postoperative complications, postoperative UTI, and urosepsis rates.Results:Of the 91 patients included in the study, 68 were in the early ureterolithotripsy group, while 23 patients were in the delayed ureterolithotripsy group. The postoperative UTI rate was significantly higher in patients who underwent early ureterolithotripsy (29.4% vs 8.7%, p = 0.045). Patients with postoperative UTI had a higher moderate/severe perinephric fat stranding (PFS) on non-contrast CT at hospital admission (52.2% vs 29.4%, p = 0.048). Among the laboratory parameters, white blood cells were significantly higher in the group with postoperative UTI (21604.5 vs 14728.9, p = 0.042). In the multivariate analysis, early ureterolithotripsy and moderate/severe PFS were independent predictors for postoperative UTI. In the created model, the probability of postoperative UTI after ureterolitripsy after obstructive APN treatment was 3.5% in patients without risk factors, while this rate was 51.9% in patients with both risk factors.Conclusion:There is no consensus on the timing of stone removal after treatment of obstructive APN. Early ureterolithoripsy and moderate/severe perinephric fat stranding on non-contrast CT are risk factors for postoperative UTI.
  Citation: Urologia Journal
  PubDate: 2023-11-27T09:35:20Z
  DOI: 10.1177/03915603231210604
Thulium fiber laser as a novel technique with shallow and accurate
cutting, high-quality hemostasis, and no ballistic effect in the treatment
of non-muscle invasive bladder cancer
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  Authors: Richard Mallet
  Abstract: Urologia Journal, Ahead of Print.
  
  Citation: Urologia Journal
  PubDate: 2023-11-20T11:52:36Z
  DOI: 10.1177/03915603231211982
Changes in renal volume post Percutaneous nephrolithotomy based on
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  Authors: Pankaj Kanti Dey, Soumya Mondal, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Percutaneous nephrolithotomy (PCNL) is considered to be the gold standard management for renal calculi. The purpose of this study is to comprehend the overall alterations in renal volume occurring after PCNL. The changes in the kidney’s total volume in individual patients will be examined by ultrasonography pre and postoperatively, and it will be correlated with GFR.Materials and methods:It was a prospective observational study performed over 70 participants, conducted at the department of Urology of a tertiary care hospital in Eastern India. Each patients were evaluated with pre and post PCNL USG for kidney volume and GFR. The data was statistically evaluated by SPSS software.Results:The preoperative and post operative calculated mean GFR was 96.030 ± 18.922 ml and 86.681 ± 16.938 ml,volume was 127.258 ± 25.705 and 123,678 ± 26.357 respectively . There was statistically significant decrease in GFR and volume following PCNL. It also shows that patients who underwent single puncture PCNL had significantly less decrease in GFR and kidney volume compared to multiple puncture PCNL. Moreover, the calculated mean change in GFR and volume were significantly less seen in single puncture—one step dilatation and single puncture—serial dilatation as compared to multiple puncture—one step dilatation and multiple puncture—serial dilatation.Conclusion:Our study showed that there was significant changes in the renal volume and GFR following PCNL . So, a sonographic estimation of renal dimensions and GFR calculation after PCNL will help in the prognosis and further follow up of patients. A Single puncture had a better operative outcome and less adverse consequences with respect to GFR, volume change and for renal function as compared to multiple puncture.
  Citation: Urologia Journal
  PubDate: 2023-11-15T12:27:09Z
  DOI: 10.1177/03915603231209071
Perioperative outcomes between laparoscopic versus open versus robotic
partial nephrectomy: Current Review
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  Authors: Ruby Wong, Bijendra Patel, Chandra Shekhar Biyani
  Abstract: Urologia Journal, Ahead of Print.
  Background:Surgical treatment of small renal tumours remain gold-standard for individuals who are suitable candidates. Over the last decade, minimally invasive surgery has provided significant advancements within the field of urological surgery. However, there is still a debate on which surgical modality is superior. This study aims to review the current literature on perioperative outcomes between laparoscopic (LPN), open (OPN) and robotic-assisted partial nephrectomy (RPN) using the standardised system, Clavien-Dindo Classification (CDC).Methods:A literature search was performed on Cochrane, Embase and PubMed databases. Articles between January 2016 and December 2021 were included. Perioperative outcomes investigated include estimated blood loss (EBL), operating time (OT), conversion rate (CR), warm ischaemia time (WIT), positive surgical margin (PSM) and postoperative complications using CDC. Relevant pieces of literatures were analysed and data were extracted.Results:This study included 12 studies, with a total of 3908 patients. (LPN = 1120, OPN = 1206 and RPN = 1580). LPN demonstrated a lower overall EBL (p = 0.004). There was no significant difference between OT (p = 0.291), CR (p = 0.200), WIT (p = 0.760), PSM (p = 0.549), CDC I (p = 0.556), CDC II (p = 0.779) and CDC⩾III (p = 0.663) of the three surgical approaches.Conclusion:Compared with OPN and RPN, LPN demonstrated a lower EBL. All other perioperative outcomes demonstrated similar results between the three treatment modalities. Future large-scale, prospective, randomised studies is necessary to draw a definitive conclusion from this analysis.
  Citation: Urologia Journal
  PubDate: 2023-11-14T06:26:06Z
  DOI: 10.1177/03915603231211975
Comparison of different urinary diversions after radical cystectomy in
Iran: Assessment of health-related quality of life and financial burden in
a Middle Eastern country
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  Authors: Abbas Basiri, Mazyar Zahir, Mohammad Soleimani, Ali Reza Khoshdel, Ali Tabibi, Mohammad Sajjad Imen, Alireza Soheilipour, Shabnam Golshan, Masoumeh Balafkan, Mahmoud Parvin, Shahrokh F Shariat
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran.Patients and methods:In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly.Results and limitations:In total 187 patients were identified—orthotopic neobladder (ONB) (N = 75), ileal conduit (IC) (N = 57), and cutaneous ureterostomy (CU) (N = 55)—and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning (p = 0.003, 0.011, 0.045) as well as better body image (p
  Citation: Urologia Journal
  PubDate: 2023-11-07T12:51:14Z
  DOI: 10.1177/03915603231209090
Camposampiero tubeless percutaneous nephrolithotomy (tPCNL): Easy, quick,
effective, safe
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  Authors: De Gobbi Alberto, Lupi Amalia, Massari Domenico, Stellato Alberto, Behr Astrid Ursula, Costa Giuseppe, Fiorello Mario
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To describe our technique to perform tubeless percutaneous nephrolithotomy (tPCNL) using hemostatic matrix (i.e. Floseal®) for the closure of the percutaneous tract, developed through the experience gained in our endourology specialized center. To evaluate the procedure efficacy and safety.Methods:tPCNL performed in our center with Floseal® application from February 2017 to December 2019 were retrospectively reviewed. Clinical and surgical data were collected in order to evaluate the success of the procedure and possible complications. Camposampiero technique is reported in detail.Results:Sixty-nine patients (45 males, mean age 58 years old) were included. In all patients the procedure was completed successfully and in 88% of subjects no further treatments were necessary; a low complication rate (6.9%) was reported.Conclusion:In our experience, tPCNL with Floseal application is feasible, safe, and effective.
  Citation: Urologia Journal
  PubDate: 2023-11-07T12:48:33Z
  DOI: 10.1177/03915603231210352
Sexual satisfaction and vaccine application in health professionals in the
COVID-19 pandemic
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  Authors: Metin Yığman, Fatih Yığman, Cihat Özcan, Cuma Aytekin
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:The negative effects of the COVID-19 pandemic on sexual satisfaction have been emphasized in many studies. However, there is not much information about the effects of the COVID-19 pandemic on the sexual satisfaction of healthcare professionals. In addition, it is not known exactly how vaccination application affects sexual satisfaction. Therefore, in this study, we aimed to evaluate whether the sexual satisfaction of male health personnel would change with vaccination.Materials and methods:One hundred and two unvaccinated and 95 vaccinated male healthcare professionals participated in this study. The COVID-19 Phobia Scale (C19P-S) and The New Sexual Satisfaction Scale (NSSS) were administered to the participants.Results:We did not detect any difference in sexual satisfaction according to vaccine administration. However, we found significant relationships between COVID-19 anxiety and sexual satisfaction. On the other hand, age, fear of COVID-19, and previous COVID-19 infection story were predictive factors on sexual satisfaction.Conclusion:The effects of the COVID-19 pandemic on sexual satisfaction are multifaceted. Our findings indicate that fear of COVID-19, rather than vaccination, determines sexual satisfaction.
  Citation: Urologia Journal
  PubDate: 2023-11-07T12:46:53Z
  DOI: 10.1177/03915603231210351
Prevalence of LUTS in young female population attending tertiary care
centre
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  Authors: Saurabh Kumar Negi, Nachiket Vyas, Sandip Desai, Gaurav Faujdar, Shivam Priyadarshi
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To obtain the prevalence of lower urinary tract symptoms (LUTS) in young female population in tertiary care centre.Method:We conducted a descriptive and analytic study with ques tionnaire based data collection. All subjects were interviewed using conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS form in the urology outpatient department, SMS medical college and hospital, Jaipur (India).Result:Total 1278 patients enrolled in study. Using the well-structured questionnaire using ICIQ-FLUTS form, the prevalence of LUTS was 78.01% while conventional method having only 35.8%. This result revealed that LUTS is a common condition among young Indian female population with vaginal delivery as the common risk factor.Conclusion:Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS form is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice.
  Citation: Urologia Journal
  PubDate: 2023-11-07T12:44:33Z
  DOI: 10.1177/03915603231210350
Percutaneous treatment of stone containing calyceal diverticula:
Strategies and outcomes from a University teaching hospital in a
developing country
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  Authors: Arun Chawla, Anshuman Singh, Vivek Pai, Surag KR, Anupam Choudhary, Bommireddy V Reddy, Kasi Viswanath Gali, Abhijit Shah
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:There is a dearth of research available on the outcomes, complications, and recurrence rates of the modalities employed in treatment of diverticula after stone clearance by PCNL. We present our experience of various approaches employed in our institute for treatment of caliceal diverticulum after stone clearance by PCNL. We aimed to review the outcomes, complications, and recurrence rates of these procedures which can provide valuable insights into the effectiveness of these techniques in the treatment of stone containing caliceal diverticulum.Methods:A retrospective analysis of a prospectively maintained database of patients diagnosed with caliceal diverticular stone was conducted. The primary outcome was the stone-free rate (SFR) at the time of hospital discharge, determined by a combined nephroscopic/fluoroscopic assessment, and the obliteration of the diverticular sac. Secondary outcomes included the evaluation of operative time, duration of hospital stay and postoperative complications.Results:A total of 53 patients were evaluated. The mean diverticulum size was 23.2 mm, most common location was the superior calyx (30 (56.7%)). Group 1 (diverticular neck treatment + DJ stent) included 27 patients, group 2 (diverticular wall fulguration + PCN) included 18 patients and group 3 (PCN alone) included 8 patients. Mean operating time was highest in group 1 (80 min). Stone clearance was 100% in group 1, 91% in group 2 and 88% in group 3. Obliteration of caliceal diverticulum was highest in group 1 (90%). Mean duration of hospital stay was lowest in group 1 (3.2 days). Overall complications were lowest in group 2 (3/18).Conclusion:PCNL followed by combination of diverticular wall fulguration and PCN or treatment of diverticular neck and DJ stenting is safe and effective in causing diverticular obliteration. Placement of nephrostomy tube alone was not found to be effective in causing diverticular obliteration in our study.
  Citation: Urologia Journal
  PubDate: 2023-11-07T12:42:34Z
  DOI: 10.1177/03915603231210346
The first epidemiology of urolithiasis in Northern Vietnam: Urinary stone
composition, age, gender, season, and clinical features study
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  Authors: Lien D Nguyen, Trung T Nguyen, Luc V Mai, Phuong V Bui, Van Thi Nguyen, Giang TB Truong, Minh TN Luu, Hung T Duong, Loi D Vu, Thao TH Hoang
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:The aim of this study is to analyze the compositions of urinary stones and investigate their distributions in different ages, genders, seasons, and clinical features of Northern Vietnamese patients.Methods:A total of 231 patients with urinary stones from Northern Vietnam were collected and analyzed composition from 1/2021-12/2022. For all patients, age, sex, stone location, stone side, urine pH, and hospitalized date (month) were collected.Results:Kidney stones are more frequently found in men than women with the male: female urinary stones ratio in this study being 1.96:1. The highest stone prevalence appeared between 60 and 69 years old. The most common stone composition was calcium oxalate, followed by calcium phosphate, uric acid, struvite, and cysteine. Mix stones of CaOx and CaP were more prevalent than pure stones. Males submitted more CaOx, CaP, and UA stones, whereas females were susceptible to infectious stones. Stones were more frequently found on the left side of the upper urinary tract (51.9%) than on the right side (27.3%) and lower urinary tract (7.8%). Cultural tendency leads to a smaller number of stones during the Lunar new year (February), and Ghost month (August).
  Citation: Urologia Journal
  PubDate: 2023-11-02T12:24:11Z
  DOI: 10.1177/03915603231208090
Prognostic significance of preoperative pyuria & Neutrophil to lymphocyte
ratio in patients with non-muscle-invasive bladder cancer: A prospective
cohort study
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  Authors: Rahul Singh, Govind Sharma, Shivam Priyadarshi, Gaurav Fauzdar
  Abstract: Urologia Journal, Ahead of Print.
  Background:The most prevalent cancer of the urinary system and the fourth most frequent cancer in men is bladder cancer. Up to 45% of non-muscle-invasive bladder cancers (NMIBC), may develop into muscle-invasive disease within 5 years after initial diagnosis, depending on the risk profile. The neutrophil to lymphocyte ratio (NLR), which is an emerging marker of host inflammation and can be easily calculated from routine complete blood counts (CBCs) with differentials, has shown to be an independent prognostic factor for a variety of solid malignancies, including urinary tract cancer. Pyuria is a well-documented prognostic factor in urinary tract carcinomas, according to several research. The relationship between preoperative pyuria and recurrence in patients with NMIBC is unclear, even though some studies found that pyuria was a strong predictor of poor prognosis in patients with NMIBC. Our study’s objective was to compare the prognostic effect of pre-treatment pyuria and NLR on the likelihood of progression and recurrence in individuals with primary NMIBC.Materials and methodology:Data obtained from 100 bladder cancer patients who underwent transurethral resection of bladder tumor (TURBT) from June 2021 to January 2023 were evaluated prospectively.Inclusion criteria:Age more than 18 years, having tumor size less than 3 × 3 cm, single tumor, no H/O TURBT.Exclusion criteria:Age less than 18 years, size more than 3 × 3 cm, multiple tumors, H/O TURBT.Results:We demonstrated in the current study that, compared to NLR, preoperative pyuria was more substantially linked with intravesical recurrence, higher T stage and disease progression following TURBT for NMIBC.
  Citation: Urologia Journal
  PubDate: 2023-11-01T11:28:18Z
  DOI: 10.1177/03915603231203780
Comparative study between mitomycin C versus Bacillus Calmette-Guérin
(BCG) in high-risk non-muscle-invasive bladder cancer
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  Authors: Mohamed Mahmoud Abdelfatah Zaza, Tarek Abd El-Mageed Salem, Ahmed Mohamed El-Sadat, Mohammed Hassan Ali
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:We aimed to compare the efficacy and adverse events of Bacillus Calmette-Guérin (BCG) versus Mitomycin C (MMC) in high-risk Non-Muscle-Invasive Bladder Cancer (NMIBC) patients.Methods:This randomized controlled study was conducted over 24 months in four hospitals in Egypt. A sample of 90 patients was randomly assigned to either treatment group, with procedures including baseline examinations, a single postoperative instillation of chemotherapy, a 6-week induction cycle of the assigned drug, and regular follow-up cystoscopies and upper urinary tract imaging. Treatment results and side effects were monitored, with data analyzed via Statistical Package for Social Sciences (SPSS).Results:No significant differences were observed in mean age or tumor characteristics (p > 0.05). However, adverse reactions were significantly higher in the BCG group, including cystitis (40% vs. 17.78%, p = 0.020), hematuria (24.44% vs. 4.44%, p = 0.007), overall local reactions (75.56% vs. 26.67%, p
  Citation: Urologia Journal
  PubDate: 2023-10-31T10:26:44Z
  DOI: 10.1177/03915603231206603
Newer therapies and surgical management of ketamine-induced uropathy: A
review
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  Authors: Theodora Katsiari, Yeong Eun Bae, Danny Darlington Carbin Joseph, Wissam Abou Chedid, Dimitrios Moschonas, Venkata Ramana Murthy Kusuma, Krishna Patil, Matthew James Alexander Perry
  Abstract: Urologia Journal, Ahead of Print.
  Background and Aims:Ketamine use as a recreational drug is becoming more popular nowadays. Ketamine-induced uropathy (KIU) is a late finding observed with long-term use of ketamine. A systematic review of Ketamine-Induced Uropathy was performed to emphasise its key clinical manifestations, mechanism of action and establish an effective treatment pathway.Methods and Results:A literature search was conducted in MEDLINE via Pubmed and Cochrane using the keywords ketamine and bladder, ketamine and uropathy, and ketamine and epidemiology. The search strategy was limited to articles published from 2000 to 2023. Both animal and human studies were included. A total of 101 papers were reviewed based on topic relevance from the title and abstracts available. While ketamine is a controlled drug in the United Kingdom (UK) and other countries, 283 ketamine-related deaths have been reported in the UK. There is no definite pathogenesis but multiple potential mechanisms that cause KIU and its related symptoms. KIU involves chronic inflammation of the bladder, ureteral wall thickening, hydronephrosis and finally, chronic renal failure. A multidisciplinary approach is paramount when managing these patients to break the vicious cycle. The mainstay of medical and surgical treatment pathways is continued abstinence to prevent symptom relapse. This review included the pathophysiology, novel medical treatments and surgical management of KIU.Conclusion:KIU is a rare but significantly disabling condition often seen among ketamine abusers. With the rising trend in drug addiction, KIU is expected to be more common. Unfortunately, it is a late complication in chronic ketamine abusers and is only partially reversible even with abstinence. This review discusses this rare entity’s newer medical treatments and surgical options.
  Citation: Urologia Journal
  PubDate: 2023-10-28T11:48:26Z
  DOI: 10.1177/03915603231208094
Role of multiparametric MRI in predicting muscle invasiveness in urinary
bladder neoplasms with pathological correlations
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  Authors: Mrinal Tandon, Sumit Chakraborty, Bikramjit Barkondaj, Sunirmal Choudhury, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Urinary bladder cancer (BC) is one of the most frequent malignancies and the ninth most common malignancy worldwide. The objective of this study is to assess the role of multiparametric magnetic resonance imaging (mp-MRI) in predicting the invasiveness of urinary bladder space occupying lesions. Thirty-five patients diagnosed with bladder masses underwent an mp-MRI study. The results of three image sets were analysed and compared with the histopathological results as a reference standard: T2-weighted image (T2WI) plus dynamic contrast-enhanced (DCE), T2WI plus diffusion-weighted images (DWI), and mp-MRI, including T2WI plus DWI and DCE. The diagnostic accuracy of mp-MRI was evaluated using receiver operating characteristic curve analysis. We discovered a highly significant correlation between muscle invasiveness as staged by HPE (Histopathological examination) and mp-MRI utilising a VI-RADS score>3 (p 0.001) with a sensitivity of 100% and a specificity of 85.7%. With a diagnostic accuracy of 77.14%, a sensitivity of 92.31%, a specificity of 72.72%, a positive predictive value of 66.67%, and a negative predictive value of 94.11%, In terms of muscle invasiveness, there is good concordance between HPE staging and mp-MRI utilising the VI-RADS score. The mean apparent diffusion coefficient (ADC) values were higher in low grades than in high grades. The ROC curve study revealed a very strong correlation between HPE grade and ADC (p = 0.045). In 77.14% of patients, Mp-MRI correctly identified the local T stage. Mp-MRI is imaging biomarker for invasiveness and grade of tumour. The tumours with high grade are more invasive. However, the diagnostic accuracy of mp-MRI in determining muscle invasiveness is not very high and it overstages the disease in some cases (33.3%). Its clinical usefulness in determining muscle invasiveness before TURBT and histopathological examination can be questioned.
  Citation: Urologia Journal
  PubDate: 2023-10-27T08:59:51Z
  DOI: 10.1177/03915603231204078
Sudden cardiovascular collapse during the TUL procedure: A case series
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  Authors: Arash Farbood, Mohammad Ali Sahmeddini, Mahsa Jalilpour Aghdam, Mohammadhossein Eghbal, Ali Ariafar, Behzad Narouie, Hamidreza Momeni
  Abstract: Urologia Journal, Ahead of Print.
  Although ureteroscopy is a minimally invasive procedure, there have been reports of some minor and major complications, from self-limited to complicated events such as ureteral avulsion, urosepsis, and even death due to cerebrovascular accidents and deep vein thrombosis. Herein, we aim to report seven patients who presented with cardiovascular collapse during ureteroscopy in a 19-year period from January 2002 to January 2021.
  Citation: Urologia Journal
  PubDate: 2023-10-24T10:19:38Z
  DOI: 10.1177/03915603231208116
Adopting ultrasound guided PCNL in nephrolithiasis management
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  Authors: Binyamin B Neeman, Galia Raisin, Boris Chertin, Saeed Qadan, Ilan Kafka
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:This study aimed to evaluate the learning curve associated with the adoption of US guided PCNL and demonstrate that it can be carried out safely with results comparable to those obtained using standard PCNL.Methods:Prospective study with 65 patients who underwent PCNL between 2019 and 2020. all procedures were performed in supine position and an initial attempt to gain access to the kidney using US was made.Results:Mean procedure duration was 69.5 ± 27.8 min. Fluoroscopy was used with a mean dose of 276.68 ± 560.71 (cGycm3) and mean fluoroscopy time 40.25 ± 77.69 (s). Throughout the study there was a steady decrease in the use of fluoroscopy and amount of radiation to gain access to the kidney to only 25% at the study end. 76.5% of the patients were stone free at follow-up. Complication rate was 9.2%.Conclusions:Fluoroless US guided PCNL is safe, feasible and reproducible procedure.
  Citation: Urologia Journal
  PubDate: 2023-10-17T10:39:24Z
  DOI: 10.1177/03915603231198554
Youtube is an unreliable source of information about delayed ejaculation
treatment
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  Authors: Aykut Demirci, Halil Başar
  Abstract: Urologia Journal, Ahead of Print.
  Background:Social platforms such as YouTube have become sources of information about diseases as they can be easily and rapidly accessed. However, this also has the risk of ill-intentioned content and misleading information.Objective:To evaluate the reliability of YouTube video content about delayed ejaculation treatment.Material and methods:YouTube videos were searched using the terms “delayed ejaculation,” “retarded ejaculation,” “inhibited ejaculation,” and “anejaculation.” Videos were excluded if they were not in English, were not related to the subject, or did not have audio and visual content. In accordance with the scientifically proven accurate information, the videos were separated as reliable (Group 2, n: 112) and unreliable videos (Group 1, n: 94). The groups were compared in respect of the video characteristics, and the scores obtained in the DISCERN-5, Global Quality Scale, the Patient Education Materials Assessment Tool Audiovisual, and the Journal of the American Medical Association scales. Intraclass correlation test was used to evaluate the level of agreement between the two investigators.Results:Of the 1200 videos, 994 were excluded. No significant difference was determined between the Group 1 and Group 2 in respect of the median number of views [1672 (4555) vs 1547 (28,559), p = 0.63] and likes [10 (42) vs 17 (255), p = 0.07]. There was a greater number of videos in the Group 2 (54.4%) and the points obtained on the scoring scales were significantly higher than the Group 1 (p
  Citation: Urologia Journal
  PubDate: 2023-10-11T10:49:54Z
  DOI: 10.1177/03915603231204077
Comparative analysis of standard, tubeless and total tubeless percutaneous
nephrolithotomy: A prospective study
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  Authors: Vaibhav Balu Kamble, Sandeep Gupta, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:This study was done to review and compare safety, effectiveness and advantages of total tubeless percutaneous nephrolithotomy (PCNL), tubeless PCNL with standard PCNL.Methodology:This prospective comparative study involving 30 patients in each total tubeless PCNL, tubeless PCNL and standard PCNL group from Feb 2021 to June 2022.Result:Significant difference was found in mean duration of surgery (p
  Citation: Urologia Journal
  PubDate: 2023-09-30T12:42:14Z
  DOI: 10.1177/03915603231203434
A comparative study between one step dilatation and serial dilatation
technique in percutaneous nephrolithotomy
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  Authors: Naveen Kumar Gupta, Noushim Akram Huda, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Background:Percutaneous nephrolithotomy (PCNL) is the first line treatment for treating kidney stones larger than 2 cm size with the advantages of lower morbidity and faster post-operative recovery. Creation of a nephrostomy access is one of the major steps of PCNL. It can be done either by single-step dilatation or by multi-step serial dilatation technique.Objectives:To compare the outcome and evaluate the efficacy of percutaneous nephrolithotomy done by single-step versus serial dilatation technique with specific reference to access time, fluoroscopy time, rate of blood transfusion, length of hospital stay (post-op) and complication rate.Methods:It was a prospective study with a sample size of 100 where 50 patients underwent one-step dilatation and other 50 patients underwent serial-dilatation technique. These patients were analysed on the basis of their demographic profile, renal access time, total fluoroscopy time for access, post-operative haematuria, duration of post-operative hospital stay and complications after operative procedure. Data was analysed and reported using statistical tools.Results:Demographic profile of the patients and stone characteristics were equivalent between two groups. Mean access tract dilatation time, mean total fluoroscopy time were significantly less in one of the groups. Requirement of blood transfusion, and post-operative complications rate were not significant between two groups.Conclusion:Both methods are safe and effective for tract dilatation. However, PCNL can be successfully performed by one-step dilatation with the added advantages of lesser time of renal access, lesser radiation exposure. Blood loss and hospital stay after operative procedure were not statistically significant between two groups.
  Citation: Urologia Journal
  PubDate: 2023-09-30T12:39:34Z
  DOI: 10.1177/03915603231202839
Effects of curcumin and ursolic acid in prostate cancer: A systematic
review
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  Authors: Benjamin D Besasie, Achinto Saha, John DiGiovanni, Michael A Liss
  Abstract: Urologia Journal, Ahead of Print.
  The major barriers to phytonutrients in prostate cancer therapy are non-specific mechanisms and bioavailability issues. Studies have pointed to a synergistic combination of curcumin (CURC) and ursolic acid (UA). We investigate this combination using a systematic review process to assess the most likely mechanistic pathway and human testing in prostate cancer. We used the PRISMA statement to screen titles, abstracts, and the full texts of relevant articles and performed a descriptive analysis of the literature reviewed for study inclusion and consensus of the manuscript. The most common molecular and cellular pathway from articles reporting on the pathways and effects of CURC (n = 173) in prostate cancer was NF-κB (n = 25, 14.5%). The most common molecular and cellular pathway from articles reporting on the pathways and effects of UA (n = 24) in prostate cancer was caspase 3/caspase 9 (n = 10, 41.6%). The three most common molecular and cellular pathway from articles reporting on the pathways and effects of both CURC and UA (n = 193) in prostate cancer was NF-κB (n = 28, 14.2%), Akt (n = 22, 11.2%), and androgen (n = 19, 9.6%). Therefore, we have identified the potential synergistic target pathways of curcumin and ursolic acid to involve NF-κB, Akt, androgen receptors, and apoptosis pathways. Our review highlights the limited human studies and specific effects in prostate cancer.
  Citation: Urologia Journal
  PubDate: 2023-09-30T12:37:15Z
  DOI: 10.1177/03915603231202304
A retrospective cohort study, analyzing trends in management of upper
urinary tract stones in the adult Israeli population
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  Authors: Dor Golomb, Amir Cooper, Orit Raz
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To assess trends of surgical intervention in adults with upper urinary tract stones in Israel.Methods:A retrospective cohort study utilizing administrative databases held at Clalit Health Services, to identify all adults (⩾18 years) who underwent their first surgical treatment for upper tract urolithiasis. Descriptive statistics were employed to summarize baseline patient demographics and surgical trends were analyzed using the Cochrane-Armitage test for trend.Results:Between 2003 and 2020, 36,624 adult patients were treated surgically for upper tract urinary stones. Mean age was 53.6 years (SD16.1). During the period investigated, the number of insured by Clalit Health Services increased by 25% and the total number of surgically treated stones increased by 98.7%. By type of procedure: Ureteroscopy (URS) increased by 351%, percutaneous nephrolithotripsy (PCNL) increased by 67%, shockwave lithotripsy (SWL) declined by 79%. The number of procedures per 100,000 population grew from to 37.5 in 2003 to 58.05 in 2022. The percentage increase in total number of surgical procedures was 103% and 90% in males and females, respectively.Conclusions:Our findings reveal significant increases in the total number of surgically treated stones over the investigated period. Notably, this increase far outpaced the growth in the number of individuals insured by Clalit Health Services. Further research and interventions are warranted to explore the underlying factors driving these trends and to develop targeted approaches for prevention, early detection, and minimally invasive treatment of upper urinary tract stones in Israel.
  Citation: Urologia Journal
  PubDate: 2023-09-30T09:12:13Z
  DOI: 10.1177/03915603231203430
Long-term results of clam enterocystoplasty in non-neurogenic refractory
urge incontinence
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  Authors: Türker Soydaş, Emrah Okulu, Halil Uzundal, Selman Ünal, Asım Özayar, Musab Ali Kutluhan, Önder Kayıgil
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:This study aims to assess the efficacy of Clam enterocystoplasty (CECP) surgery for the treatment of non-neurogenic refractory urgency urinary incontinence (UUI).Methods:We conducted a retrospective evaluation of 17 female patients who underwent CECP for non-neurogenic refractory UUI between May 2010 and November 2022.Results:The median of ICIQ-SF was 19 (15–21) before treatment, which decreased to a median of 0 (0–5) after treatment (p = 0.01). The average preoperative pad use among the participants was 4 (3–6), while it became 0 postoperatively (p
  Citation: Urologia Journal
  PubDate: 2023-09-30T06:33:55Z
  DOI: 10.1177/03915603231204088
Does mirabegron have a potential role as a medical expulsive therapy in
the treatment of distal ureteral stones' A prospective randomized
controlled study
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  Authors: Mohamed Samir, Ahmed Fouad Awad, Wael Ali Maged
  Abstract: Urologia Journal, Ahead of Print.
  Background:The existence of β3 receptors in the bladder and ureter was documented in many studies on animals and humans, it was documented that relaxation of the lower ureteral segment is achieved by the stimulation of these receptors. Our aim was to assess the efficacy and safety of mirabegron as a medical expulsive therapy (MET) for distal ureteral stones in comparison with silodosin and placebo.Methods:One hundred eighty patients with distal ureteral stone of 5–10 mm size were included in our study. They were divided into three groups, and each one consisted of 60 patients. Group I was given silodosin 8 mg, group II mirabegron 50 mg and group III placebo once daily. The treatment was prescribed for all the cases till stone expulsion or a maximum duration of 4 weeks. Primary outcome was the stone expulsion rate (SER). While secondary outcomes were stone expulsion time, side effects of the used drugs, hospital visits number for pain, and amount of analgesic taken.Results:We found that the SER was significantly higher in silodosin than mirabegron and placebo groups (61%, 38.6%, and 36.7%, respectively) (p = 0.013). Also, the stone expulsion interval was significantly shorter in silodosin than mirabegron and control groups (p
  Citation: Urologia Journal
  PubDate: 2023-09-30T06:30:37Z
  DOI: 10.1177/03915603231204081
Assessing pentafecta outcomes post radical cystectomy: A tertiary care
center study
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  Authors: Vikram Singh, Shakti Swarup Sarangi, Deepak Prakash Bhirud, Kartik Sharma, Shashank Shekhar Tripathi, Gautam Ram Choudhary, Mahendra Singh, Shiv Charan Navriya, Arjun Singh Sandhu
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Bladder cancer is a common and serious disease globally, often requiring radical cystectomy as the preferred treatment. However, this procedure carries substantial risks and complications. To evaluate its success, pentafecta, a five-component measure, was introduced. This study investigates the attainment of pentafecta following radical cystectomy and examines factors that influence its achievement.Methodology:This retrospective, single-group study was conducted at AIIMS Jodhpur. The study population included 42 patients who underwent radical cystectomy for bladder cancer. Various data, including demographic characteristics, clinical features, surgical techniques, and postoperative outcomes, were collected from medical records. The primary outcome measure was the rate of achieving pentafecta, which comprises five parameters.Results:Out of 42 patients, 26 (61.9%) achieved pentafecta. Age, gender, comorbidities and surgical approach did not significantly affect the attainment of pentafecta. Negative surgical margins were achieved in 95.2% of cases, and adequate lymph node dissection (>16 lymph nodes) was performed in 85.7% of cases. The absence of Clavien-Dindo grade 3–5 complications and recurrence was observed in 80.9% and 90.47% of cases, respectively. Uretero-enteric stricture was absent in 95.2% of cases.Conclusion:The study emphasizes the significance of negative surgical margins, thorough lymph node dissection, absence of complications, recurrence, and uretero-enteric strictures in evaluating the success of radical cystectomy as pentafacta outcomes. Patients with higher drain output and wound infections are less likely to achieve pentafacta outcome and indicates poorer outcome. By considering these factors, clinicians can assess patient outcomes and identify areas for improvement.
  Citation: Urologia Journal
  PubDate: 2023-09-30T06:23:17Z
  DOI: 10.1177/03915603231204080
Role of cystoscopy as primary initial investigation in interstitial
cystitis/bladder pain syndrome
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  Authors: Angadjot Singh, Shivam Priyadarshi, Somendra Bansal, Sanyam Nandwani
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic painful bladder condition characterized by pelvic pain and urinary symptoms without another identifiable cause. Cystoscopy as primary initial investigation for IC/BPS has not been accepted yet and needs more studies to definitely conclude.Aims and objectives:We aimed to assess cystoscopy findings in patients of interstitial cystitis/bladder pain syndrome and to prove role of cystoscopy as primary initial investigation for interstitial cystitis/bladder pain syndrome.Materials and methods:Our prospective observational study included 35 female patients aged 18–69 years presenting to the Urology OPD at SMS Hospital with suprapubic or pelvic pain for 6 months, bladder pain that worsens with bladder filling and reduced with voiding, dysuria, urinary frequency and urgency, nocturia, dyspareunia. Those with history of bladder capacity more than 350 ml, duration of symptoms less than 6 months, day time frequency less than eight times per day, diagnosis of bacterial cystitis or prostatitis, bladder or ureteral calculi, active genital herpes, any existing urological malignancy, radiation cystitis were excluded from the study. They were then subject to cystoscopy and the findings of the cystoscopy were analyzed.Results:Out of the 35 patients, 11 (31.43%) had a normal cystoscopy. Of the 24 patients (68.57%) who had a positive cystoscopy, cystoscopy in seven patients (20.0%) revealed an ulcer. All these seven patients underwent fulguration. In the remaining 17 patients the abnormal findings were petechiae, large submucosal bleed. The sensitivity of cystoscopy in detecting the ulcerative type of Interstitial cystitis was found to be 20.0%.Conclusion:Our study found that Cystoscopy, if employed in initial investigation can help early detection of ulcerative variety of IC/BPS and can act as therapeutic modality by using fulguration plus hydrodistension. Larger comparative studies are needed for diagnostic/Therapeutic value of cystoscopy.
  Citation: Urologia Journal
  PubDate: 2023-09-30T06:19:13Z
  DOI: 10.1177/03915603231203431
Evaluation of the results of urodynamic studies in patients with
vesicoureteral reflux
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  Authors: Farzaneh Sharifiaghdas, Behzad Narouie, Ali Mirzakhanlouei, Mohadese Ahmadzade, Hamidreza Rouientan, Mehdi Dadpour
  Abstract: Urologia Journal, Ahead of Print.
  Background:To investigate urodynamic abnormalities associated with vesicoureteral reflux (VUR) in toilet-trained children.Methods:The data of 157 children who were diagnosed with vesicoureteral reflux and referred to our hospital between 2013 and 2022 were retrospectively examined. The urodynamic parameters were analyzed and correlated with age, gender, lower urinary tract symptoms (LUTS), reflux severity, and laterality.Results:Overall, 131 (83.4%) patients had abnormal urodynamic findings with a male-to-female ratio of 1:1.4. The most common pathological finding was detrusor overactivity (DO), identified in 101 (64.3%) patients, followed by dysfunctional voiding (DV) in 74 (50.3%) patients. Children with VUR grades II and III exhibited a greater percentage of abnormal urodynamic findings than children with grades IV and V. The prevalence of DO was higher in children younger than 10 years old with unilateral and lower-grade VURs. DV was more frequent in children older than 10 years, with bilateral VUR, and higher grade VUR. The prevalence of LUTS, bowel and bladder dysfunction (BBD), and urinary tract infection (UTI) was higher among children with abnormal urodynamic findings.Conclusions:Children with VUR have a high incidence of urodynamic disorders. Urodynamic dysfunction may contribute to the pathogenesis of VUR, especially in mild cases.
  Citation: Urologia Journal
  PubDate: 2023-09-26T10:24:32Z
  DOI: 10.1177/03915603231198556
Letter to the editor: Comparison of perineal urethrostomy versus
augmentation urethroplasty in anterior urethral stricture disease
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  Authors: Ines M Pina, Ahmad M Omar, Michael S Floyd
  Abstract: Urologia Journal, Ahead of Print.
  
  Citation: Urologia Journal
  PubDate: 2023-09-25T12:35:58Z
  DOI: 10.1177/03915603231199809
The effect of no oral antibiotic versus 7 days oral antibiotic during
discharge in double J stented patients on stent related urinary tract
infection: A randomized study
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  Authors: Saurabh Kumar Negi, Pritam Kumar, Sandip Desai, Nachiket Vyas, Shivam Priyadarshi
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To evaluate effects of 7 days oral antibiotic prophylaxis versus no antibiotics in the patients with DJ stents after 3 days iv antibiotic on discharge with respect to urinary tract infection and stent related symptoms.Material and methods:A prospective randomized study in 90 patients being stented post PCNL/URSL. Group A: no oral antibiotics was given at the time of discharge, Group B: 7 days of oral antibiotic was given at the time of discharge. Patients were followed up and outcomes were assessed in the form of lower urinary symptoms (LUTS), urine culture and sensitivity at 1 and 3 weeks and DJ stent culture and sensitivity on removal at 3 weeks.Results:There was no significant difference in age, gender, type of surgery (PCNL/URSL), duration of DJ stent between the two groups. Patients in group A and Group B have comparable UTI and stent related symptoms at 1 and 3 weeks respectively (p = 0.95 and p = 0.916 respectively). Similarly, there were no marked difference in urine culture at 1 and 3 weeks, respectively between two groups (p = 0.71 and p = 0.63, respectively). Overall there were no significant differences in Urinary symptoms, urine culture/sensitivity at 1 and 3 weeks and also DJ stent culture and sensitivity on removal at 3 weeks between the two groups.Conclusion:The incidence of UTI and stent related symptoms are same in both the groups. Therefore, prescribing oral antibiotics on discharge in selected patient with DJ stent has no added benefit and should be avoided.
  Citation: Urologia Journal
  PubDate: 2023-09-13T12:55:41Z
  DOI: 10.1177/03915603231199524
Letter to the editor: Classification and management of sexual dysfunctions
in multiple sclerosis patients: A review of current literature, Campetella
et al
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  Authors: Andrew A Atayi, Rauf N Khadr, Michael S Floyd, Carolyn A Young
  Abstract: Urologia Journal, Ahead of Print.
  
  Citation: Urologia Journal
  PubDate: 2023-09-13T11:55:38Z
  DOI: 10.1177/03915603231199529
Post-operative chyle leak following nephrectomy: Inference from tertiary
care center and review of literature
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  Authors: Shakti Swarup Sarangi, Deepak Prakash Bhirud, Arjun Singh Sandhu, Amit Aggarwal, Mahendra Singh, Shiv Charan Navriya, Gautam Ram Choudhary
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:Lymphatic channels (LC) are not as prominent as blood vessels, so they tend to get damaged during surgical procedures. It can present with chyle leak in the postoperative period. We aimed to study the occurrence of chyle leak in patients undergoing nephrectomy and its management.Methods:During the period of January 2021 and January 2023, 158 adult patients underwent nephrectomy for various reasons like non-functioning kidney, donor nephrectomy, and malignancy. We retrospectively analyzed data of patients who had chyle leak after nephrectomies.Results:Eight patients out of the 158 patients (5.06%) undergoing nephrectomy developed chyle leak. One out of these eight patients underwent nephrectomy by open approach while seven underwent laparoscopic approach. All eight patients who had chyle leak undergone left sided nephrectomy. Six patients of chyle leak could be managed with dietary modification while two patients needed octreotide therapy for treatment. Higher Body Mass Index (BMI; p-value = 0.012), left sides nephrectomy (p-value = 0.013), h/o pyelonephritis (p-value = 0.005) were associated with higher incidence of chyle leak on univariate analysis. While on multivariate analysis no factor was found to be independently associated with chyle leak. Hospital stay was significantly prolonged in patients with chyle leak (p-value = 0.007).Conclusion:Chyle leak is not a very rare complication after nephrectomy. Patients with higher BMI, who undergo left sided nephrectomies and patients who had history of pyelonephritis or infectious complications had higher incidence of chyle leak. Most cases can be managed with conservative management (CM). Chyle leak is associated with a prolonged hospital stay.
  Citation: Urologia Journal
  PubDate: 2023-08-31T09:47:49Z
  DOI: 10.1177/03915603231193189
The potential effect of ambrisentan as monotherapy and combined with
tadalafil on diabetic erectile dysfunction in rats
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  Authors: Omnia Azmy Nabeh, Fatma Ahmed El-Batrawy, Omayma Anwar Khorshid, Ghada Farouk Soliman
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:This study investigated the role of ambrisentan; the selective endothelin type-A receptor (ETAR) blocker on experimental diabetic erectile dysfunction in rats.Materials and methods:Eighty-four adult male Sprague Albino rats were divided randomly into 7 groups. Three control groups received 1 mL saline, 0.2 mg/kg/d ambrisentan and 1.5 mg/kg/d tadalafil, respectively orally for 4 weeks. The remaining four groups were fed high fat diet for 14 days. Diabetes was induced by a single intra-peritoneal injection of 40 mg/kg streptozotocin. After 72 h, diabetes was confirmed by plasma glucose level ⩾250 mg/dL. Diabetic rats were divided randomly into four groups, numbered from 4 to 7. The fourth group was the diabetic-control group, while the fifth and sixth groups received ambrisentan and tadalafil respectively. The seventh group received a combination of both drugs. Treatment continued for 4 weeks then, copulatory, intracavernous pressure measurement, and laboratory tests were conducted.Results:In diabetic rats, ambrisentan and tadalafil improved fasting glucose, insulin, insulin resistance, testosterone, nitric oxide, and rho kinase (ROCK) values compared to diabetic group with the maximum improvement achieved in ambrisentan/tadalafil group (p
  Citation: Urologia Journal
  PubDate: 2023-08-29T01:21:08Z
  DOI: 10.1177/03915603231192737
The effect of systemic inflammatory index and systemic inflammatory
response index on success of varicoselectomy
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  Authors: Omer Erdogan, Fesih Ok
  Abstract: Urologia Journal, Ahead of Print.
  Background:Varicocele is the most common correctable cause of male infertility. The treatment of varicocele is surgery. However, which patients will benefit from the surgery is controversial. Our aims to investigate the effect of systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) on varicocelectomy success.Methods:Patients who underwent varicocelectomy in our clinic between January 2016 and June 2022 were analyzed retrospectively. Varicocelectomy success was defined as>50% increase in post-operative total motile sperm count (TMSC) in those with pre- operative TMSC > 5 million and at least 100% increase in those with
  Citation: Urologia Journal
  PubDate: 2023-08-26T12:01:16Z
  DOI: 10.1177/03915603231192739
Correlation of urinary continence recovery with various factors after
Robot assisted radical prostatectomy
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  Authors: Vikram Singh, Kartik Sharma, Gautam Ram Choudhary, Mahendra Singh, Shashank Shekhar Tripathi, Deepak Prakash Bhirud, Arjun Singh Sandhu, Shiv Charan Navriya
  Abstract: Urologia Journal, Ahead of Print.
  Background:In addition to ensuring cancer control, prevention of incontinence which significantly impact patients’ quality of life, is also an important issue in robot-assisted radical prostatectomy (RARP) operations. In this study, we aimed to find the correlation of urinary continence recovery with various factors after Robot assisted radical prostatectomy.Methods:This study included 162 patients treated with RARP with perioperative data and at least 1 year of follow-up. Also, the preoperative, intraoperative, and postoperative parameters of the patients were analyzed. The continence recovery rate in our study was assessed at 6th week, 3rd month, 6th month, 9th month, and 12th month, post-surgery. Logistic regression analysis evaluated the association between the predictive factors and urinary continence recovery in the early and late stages.Results:The majority of patients with prostate cancer present in sixth decade of life. The majority of our patients (56.7%) were categorized as high risk using D’Amico classification. The continence rate in our study at 6th week, 3rd month, 6th month, 9th month, and 12th month were 40.1%, 72.2%, 85.2%, 89.5%, and 91.4%, respectively. No improvement in continence status was observed after 1 year in our study. There was significant correlation of age with continence status at 6th week, 3rd month, and 6th month. The young age is associated with early recovery of continence. At 3 and 9 months, the non-diabetics cases achieved significantly higher continence rates than diabetics (p
  Citation: Urologia Journal
  PubDate: 2023-08-26T11:54:01Z
  DOI: 10.1177/03915603231191269
Calcutta position: A new modified supine decubitus for supine PCNL
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  Authors: Sunirmal Choudhury, Partha Pratim Sinha Roy, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:PCNL (percutaneous nephrolithotripsy) is considered the gold standard treatment for renal stone more than 2 cm. In today’s scenario, supine PCNL is considered equally effective as prone PCNL. The ideal position for supine PCNL is still debatable. We hereby describe our initial experiences of supine PCNL in a novel position.Methods and materials:This prospective study includes 60 patients who underwent supine PCNL in the ‘Calcutta position’ in our institute from August 2021 to August 2022. Successful procedure was defined as a complete stone free rate or a clinically insignificant residual stone (
  Citation: Urologia Journal
  PubDate: 2023-08-26T11:49:01Z
  DOI: 10.1177/03915603231191268
A practical guide on the non-antibiotic options available in the
prevention of recurrent urinary tract infections in women
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  Authors: Anushree Kucheria, Sagar Kanabar, Christopher Blick, Bob Yang
  Abstract: Urologia Journal, Ahead of Print.
  Urinary Tract infection (UTI) is one of the most common infections worldwide, patients present to multiple different specialities in the community, primary and secondary care. Antibiotics are considered standard first line therapy in the treatment of urinary tract infections, however there is an alarming rise in global antibiotic resistance rates, so much so that the World Health Organisation has labelled antibiotic resistance as one of the biggest challenges to public health in our lifetime, publishing a global action plan to tackle this challenge. As a result, there is an increasing need to discover non-antibiotic alternatives, recently a number of novel therapies have been introduced into clinical practice. These are divided into oral, topical, intravesical and immunomodulation therapies. The aim of this paper is to summarise the current non-antibiotic treatments as a practical guide to utilise in patient care.
  Citation: Urologia Journal
  PubDate: 2023-08-22T11:39:08Z
  DOI: 10.1177/03915603231193060
Prevention of complications of surgical treatment of stage III-IV
cystocele using light polypropylene mesh
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  Authors: Roman Banakhevych, Klavdiia Akymova, Kateryna Pariienko, Vsevolod Nechaiev
  Abstract: Urologia Journal, Ahead of Print.
  Objective:The purpose of study was to report the subjective and objective results of different methods of surgical treatment of cystocele using the transvaginal Mesh-system.Methodology:A prospective study was conducted from January 2017 to December 2020 comparing anterior colporrhaphy with vaginal mesh and two distinct types of vaginal wall repair sutures in the surgical treatment of cystocele. The primary endpoint was the incidence rate of vaginal wall erosion complications 12 months after surgery. Secondary endpoints were anatomic outcomes, TVM-related morbidity, and patient satisfaction measured using validated questionnaires.Results:In total, 102 patients with stage III-IV cystocele and the average age of 67.2 ± 3.1 years (age range of 47–79 years old) took part in the study. Of the 102 women initially enrolled, 102 (100%) were successfully followed up 12 months after primary surgery. The primary result, the objective erosion development, was radically different in the comparison groups (1.6% against 23.5%, respectively). Analysis of the improved method of operative treatment showed a prominent level of positive, uncomplicated, surgery results of 98.4% (60/61). The anatomic success rate of recovery from cystocele was 99.9% (101/102) 12 months after surgery.Conclusion:The suggested method of restoring the anterior vaginal wall in stage III-IV isolated cystocele without signs of incomplete and complete prolapse of the uterus showed a radically positive result. The number of complications was relatively high in the comparison group, but no difference was observed in satisfaction with the anatomical results of the surgery. The percentage of the vaginal wall erosion when using a single-layer suture is 23.5%, when using a two-layer suture is 1.6%
  Citation: Urologia Journal
  PubDate: 2023-08-22T11:35:55Z
  DOI: 10.1177/03915603231193059
Immediate effect of alpha-blockers in predicting LUTS improvement in BPH
patients
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  Authors: Prashant Sevach, Govind Sharma, Shivam Priyadarshi, Gaurav Faujdar
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Indications for treating Benign Prostatic Hyperplasia include reversing signs and symptoms or preventing the progression of the disease. Alpha-blockers are the most effective, least costly, and best tolerated of the drugs for relieving LUTS. The aim of the study is to investigate the immediate impact of alpha-blocker medications on lower urinary tract symptoms (LUTS).Materials and methodology:About 100 patients were included in the study—50 patients in each of the groups A (tamsulosin) and B (silodosin). The first visit was the baseline examination before starting alpha-blockers and included history, DRE, UFM, USG KUBP with PVR, IPSS, serum PSA, serum creatinine, urine analysis, urine culture, and sensitivity. All above parameters were also at 1 week, 1 month, and 3 months following starting of alpha-blockers respectively, and compared with baseline.Result:As of the first, second, third, and fourth visits, the mean Qmax in group A was 10.3 ± 3.3 s, 15.08 ± 2.80 s, 15.66 ± 3.18 s, and 15.12 ± 3.24 s, respectively, while in group B it was 10.1 ± 3.1 s, 14.88 ± 2.80 s, 15.18 ± 3.18 s, and 15.08 ± 3.24 s, respectively (p
  Citation: Urologia Journal
  PubDate: 2023-08-22T11:32:55Z
  DOI: 10.1177/03915603231192738
Anogenital distance, a biomarker of fetal androgen exposure and the risk
of prostate cancer: A case-control study
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  Authors: Florencio Manuel Marín-Martínez, Julian J Arense-Gonzalo, Miriam Artes Artes, Emny Rochell Bobadilla Romero, Víctor Javier García Porcel, Pablo Alcon Cerro, Mabel Coromoto Suárez-Pineda, Pablo Luis Guzmán Martínez- Valls, Jaime Mendiola
  Abstract: Urologia Journal, Ahead of Print.
  Anogenital distance (AGD) is a biomarker and a sexual dimorphism measure that can be modulated by hormonal factors, like anti-androgens, responding to gestational exposure along fetal period. There seems to be a prenatal window period in which specific environmental exposures can result in increased risk of suffer hormone-dependent neoplasms, like prostate cancer (PCa).Objective:Evaluate the association between AGD and the risk of PCa.Methods:Incident case-control study, conducted on 153 patients. All patients underwent prostate biopsy for abnormal digital rectal exam and/or prostate antigen elevation. Two variants of AGD [anus to scrotum base (AGDas) and anus to dorsal insertion of penis (AGDap) were measured. Student’s t-test was used to analyze continuous variables and chi-square for discrete variables. Differences in AGD (raw and adjusted) measures between cases and controls were assessed using the ANCOVA test.Results:There is significant association between the diagnose of PCa and both AGD, patients diagnosed with PCa had both AGD measures shortened, in the crude and the full adjusted models.Conclusions:This research suggests that the same gestational environmental exposures, could represent a weak androgen signaling and may also have an increased risk of prostate cancer.
  Citation: Urologia Journal
  PubDate: 2023-08-22T11:30:03Z
  DOI: 10.1177/03915603231192736
Mini-laparotomy in-situ pyeloplasty for repair of the ureteropelvic
junction obstruction: Outcome of 150 cases
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  Authors: Hazem El Moghazy, Tarek Mahmoud, Ahmed Mamdoh, El Nisr Rashed, Mohamed Eissa
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To evaluate the functional and cosmetic outcomes of using the mini-laparotomy technique In Situ pyeloplasty to repair UPJ obstruction in young infants less than 6 months.Materials and methods:Between January 2014 and March 2020, 150 young infants (less than 6 months) diagnosed with unilateral ureteropelvic junction obstruction (UPJO) and treated by mini-laparotomy In Situ pyeloplasty were included in this analysis. Once the UPJ has been identified, it was grasped by an Allis forceps for gentle traction. Two facing transverse incisions were made in the dilated pelvis facing the upper ureter. The transverse ureteric incision was then opened longitudinally. An anastomosis was done between the most dependent part of the lower lip of the pelvis and the apex of ureteric spatulation using 6/0 polyglactin (Vicryl®) sutures in the direction of “out-in-in-out.” Follow-up was scheduled for 1 month and then every 3 months for a year with abdominal ultrasonography. DTPA was done for all patients 1 year after repair.Results:The mean age was 3 ± 0.5 months, and the mean follow-up was 1.5 ± 0.3 years. Our technique was done in all included patients with a functional success of 96% (all patients restored normal function, and no obstruction was reported). Parents were satisfied with the cosmetic appearance of the wound in 91% of cases. Major complications occurred in 4% of cases.Conclusion:Successful repair of ureteropelvic junction obstruction in young infants can be achieved by using mini-laparotomy In Situ pyeloplasty technique with satisfactory functional and cosmetic outcomes.
  Citation: Urologia Journal
  PubDate: 2023-08-12T10:44:11Z
  DOI: 10.1177/03915603231175710
Comprehensive study of anxiety and depression in females with urinary
incontinence
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  Authors: Debansu Sarkar, Mrinal Tandon, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Background:Anxiety and depression are commonly seen with urinary incontinence (UI) and its association is strongest for urgency and mixed UI. It affects the quality of life and functional status.Aims:To assess the prevalence and severity of anxiety and depression in SUI (Stress urinary incontinence) and UUI/MUI (Urge or mixed urinary incontinence), to assess the severity of SUI and UUI/MUI and its association with anxiety and depression and to identify various factors associated with anxiety and depression.Materials and methods:An observational study using various tools as history regarding urinary incontinence, history of other prior events which can lead to anxiety or depression, age, educational level, BMI (Body mass index), HADS scale (Hospital anxiety and depression scale) for anxiety and depression and ICIQ-UI-SF score (International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form).Results:The Prevalence of anxiety and depression in UUI/MUI was higher. More women were overweight (BMI > 25) in the UUI/MUI group. Higher prevalence of anxiety and depression in the very severe urinary incontinence group. No association of the level of education with anxiety and depression in women with urinary incontinence.Conclusion:Anxiety and depression are more in UUI/MUI patients compared to SUI. In obese ladies, UUI is more prevalent compared to SUI. Anxiety and depression are more with increasing severity of incontinence. Anxiety and depression have no association with the educational status of the patients.
  Citation: Urologia Journal
  PubDate: 2023-08-09T11:38:48Z
  DOI: 10.1177/03915603231191837
How has Covid-19 impacted the training of Urology trainees in South
Wales'
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  Authors: Mustafa Rashid, Martin Steggall, Gareth Brown
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To determine whether Covid19 had a tangible effect on urology training in Wales. There has been no Welsh data available concerning how training has changed during the covid pandemic. This survey evaluated the overall impact on training, with the primary aims to identify changes in clinical and academic activities and evaluate a trainees’ wellbeing during the crisis.Materials and methods:Online questionnaires were sent to all Urology Trainees; n = 20 (83% response) working in the Welsh deanery in the United Kingdom, asking about changes in training particularly within operating list, out-patient clinics, diagnostic activities, educational courses, teaching sessions and examinations.Results:Across Wales trainees experienced a reduction in operating procedures, clinics and teaching courses. Due to a redesign of services, there was only a minimal impact on training for cancer diagnostics and Multi-Disciplinary Team (MDT) meetings. The majority of trainees felt their index procedures and ability to complete training will be affected.Conclusion:Cancer work, including cancer related theatre lists, diagnostics and MDT were maintained. Trainees lacked confidence that they would reach their operative competencies and struggle to successfully complete training. Following BAPIO discussion, we suggest that training programmes readjust to focus on areas where exposure has been lacking.
  Citation: Urologia Journal
  PubDate: 2023-08-01T10:13:40Z
  DOI: 10.1177/03915603231189315
Positive independent association between preoperative endogenous
testosterone density and tumor load density in surgical specimen of
patients undergoing radical prostatectomy
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  Authors: Antonio Benito Porcaro, Alberto Bianchi, Sebastian Gallina, Emanuele Serafin, Giovanni Mazzucato, Andrea Panunzio, Alessandro Tafuri, Francesca Montanaro, Giulia Marafioti Patuzzo, Alberto Baielli, Francesco Artoni, Stefano Vidiri, Francesco Cianflone, Damiano D’Aietti, Matteo Brunelli, Salvatore Siracusano, Maria Angela Cerruto, Alessandro Antonelli
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To evaluate the influence of endogenous testosterone density (ETD) and tumor load density (TLD) in the surgical specimen of prostate cancer (PCa) patients.Methods:ETD was assessed as the ratio of endogenous testosterone (ET) to prostate volume (PV). TLD was calculated as the ratio of tumor load (TL) to prostate weight. Preoperative prostate-specific antigen relative densities (PSAD) and percentage of biopsy-positive cores (BPCD) were also assessed. The association of high TLD (above the first quartile) with clinical and pathological factors was assessed by the logistic regression model (univariate and multivariate analysis).Results:Between November 2014 and December 2019, ET was measured in 805 cases treated with radical prostatectomy (RP). Median (IQR) of ET and ETD was 412 (321.4–519 ng/dL) and 9.8 (6.8–14.4 ng/(dLxmL)) as well as for TL and TLD was 20 (10-30%) and 0.33 (0.17-0.58%/gr), respectively. As a result, high TLD was detected in 75% of cases. A positive independent association was found between high TLD and ETD. Accordingly, as ETD levels increased, the risk of detecting high TLD in the surgical specimen increased, regardless of PSAD and BPCD.Conclusions:At diagnosis of PCa, a positive independent association was found between ETD and risk of high TLD. Subjects with increasing ETD levels were more likely to have high TLD, associated with unfavorable pathology features. The positive association between ETD and TLD in the prostate microenvironment might adversely influence PCa’s natural history.
  Citation: Urologia Journal
  PubDate: 2023-08-01T10:11:28Z
  DOI: 10.1177/03915603231189623
The effect of acute urinary retention on the results of transurethral
resection of the prostate
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  Authors: Caner Baran
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Acute urinary retention (AUR) is one of the most severe symptoms of Benign Prostatic Hyperplasia (BPH). There are some studies in the literature describing the risk factors for the development of AUR in BPH patients. However, the studies that summarize the effect of AUR on Transurethral resection of Prostate (TUR-P) surgery results are limited. The aim of this study is to assess the effect of AUR on TUR-P results.Methods:Between 2018 and 2020, patients who underwent TUR-P for AUR or lower urinary tract symptoms (LUTS) were included in the study. The inclusion criteria were, men over 50 years old with a BPH diagnosis and who underwent monopolar TUR-P by a single surgeon. The exclusion criteria were; patients who had prostate cancer, multiple sclerosis, or neurogenic bladder were diagnosed or had previous lower urinary tract surgeries such as TUR-P, TUR-Bladder, Urethrotomy, had a chronic indwelling catheter, and patients who did not accept immediate TUR-P and preferred trial without catheter (TWOC) protocol. The age, PSA, prostate volume, pre- and post-operative flow rates, duration of hospitalization, and complications were recorded. Two groups were constituted for comparison such as AUR and Elective Group and p values
  Citation: Urologia Journal
  PubDate: 2023-07-26T06:54:38Z
  DOI: 10.1177/03915603231189627
Outcomes of primary ureteroscopic lithotripsy: The role of maximum
ureteral wall thickness at the site of stone impaction
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  Authors: Tonino Morena, Andrea Vismara Fugini, Alessandro Veccia, Marianna Riva, Angelo Peroni
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To verify if the maximum thickness of the ureteral wall at the stone site (m-UWT) can affect the outcomes of primary retrograde ureteroscopic lithotripsy (P-URSL) within a single-center dataset.Material and methods:We retrospectively reviewed data on 354 consecutive URSL performed from January 2020 to May 2022 at “Fondazione Poliambulanza” in Brescia (Italy). We included patients older than 18 years who underwent URSL for a single ureteral stone with a maximum diameter ranging from 5 to 10 mm. Patients with anatomical abnormalities, a positive preoperative urinary culture, or without a NCCT performed during the acute event were excluded. Patients were treated in an emergency setting (P-URSL within 48 h from the diagnosis of acute ureteral colic) or in a delayed one (D-URSL after a period of maximum 90 days of ureteral double-j stenting). For the resulting 139 patients we recorded demographic, clinical and stone-related features and perioperative data. We processed these data by univariate and multivariate analysis, and with a logistic regression analysis.Results:Of the 139 included procedures, 63 were P-URSL and 76 D-URSL. At the univariate analysis we found that stone diameter (OR 0.845, p = 0.017), stone volume (OR 0.023, p = 0.001), stone density (OR 0.998, p = 0.000) and m-UWT (OR 0.499, p = 0.013) are predictors of P-URSL. Stone density (OR 0.998, p = 0.002) is an independent predictor of P-URSL at the multivariate analysis. At a logistic regression analysis, a distal ureteric position (OR 0.189, p = 0.014), stone diameter (OR 1.289, p = 0.006), and m-UWT (OR 2.297, p = 0.02) were found to be statistically significant predictors of incomplete stone clearance in patients undergoing P-URSL. m-UWT is the only predictor of short-term postoperative adverse events in patients undergoing P-URSL (OR 3.386, p 2 mm) significantly correlates to an endoscopic finding of ureteritis’ signs and to an increase in operative time, hospital stay and post-procedural stenting time. A m-UWT greater than 2 mm also correlates with a lower stone free rate (SFR) and with a significant increase in both short and long-term postoperative complications.Conclusions:Our study confirmed a connection between m-UWT and poor endoscopic findings, as well as a direct correlation with the main morphometric parameters of the stone and finally with the outcomes of P-URSL itself. Further studies are necessary to validate our results, so that m-UWT might be routinely considered a useful tool in the decision-making process for P-URSL.
  Citation: Urologia Journal
  PubDate: 2023-07-26T06:51:57Z
  DOI: 10.1177/03915603231189618
Preputial advancement flap for delayed urethrocutaneous fistula of the
glans following urethral insertion of an ‘AAA’ battery
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  Authors: Andrew A Atayi, Ahmad M Omar, Michael S Floyd
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Foreign body insertion associated with sexual gratification is known as polyembolokoilomania. Following removal of the foreign body, long-term complications are infrequently seen. Whilst conservative and endoscopic approaches usually suffice, in extreme cases open surgical approaches are required. We describe an unusual case of polyembolokoilomania in a 25-year-old male involving a single ‘AAA’ battery who developed a urethrocutaneous fistula requiring delayed reconstructive surgery.Case presentation:Following an initial successful open extraction of an ‘AAA’ battery from the mid penile urethra the patient developed a delayed urethrocutaenous fistula of the glans. This was managed using a single stage closure with a preputial graft on its vascular pedicle thereby preserving the foreskin and avoiding a buccal graft. No intra-operative or post-operative complications occurred with a catheter left in situ for 2 weeks. Formal histology confirmed a foreign body type reaction. Following outpatient review successful cosmetic, functional, and sexual outcomes were recorded with questionnaires and medical photography.Conclusion:Preputial advancement flap with foreskin preservation for distal urethrocutaenous fistula is a successful method of treating delayed urethrocutaenous fistula of the distal urethra in cases of polyembolokoilomania.
  Citation: Urologia Journal
  PubDate: 2023-07-26T06:49:07Z
  DOI: 10.1177/03915603231189026
Male infertility and urological tumors: Pathogenesis and therapeutical
implications
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  Authors: G Gulino, A Distante, A Akhundov, PF Bassi
  Abstract: Urologia Journal, Ahead of Print.
  Most genitourinary tract cancers have a negative impact on male fertility. Although testicular cancers have the worst impact, other tumors such as prostate, bladder, and penis are diagnosed early and treated in relatively younger patients in which couple fertility can be an important concern. The purpose of this review is to highlight both the pathogenetic mechanisms of damage to male fertility in the context of the main urological cancers and the methods of preserving male fertility in an oncological setting, in light of the most recent scientific evidence. A systematic review of available literature was carried out on the main scientific search engines, such as PubMed, Clinicaltrials.Gov, and Google scholar. Three hundred twenty-five relevant articles on this subject were identified, 98 of which were selected being the most relevant to the purpose of this review. There is a strong evidence in literature that all of the genitourinary oncological therapies have a deep negative impact on male fertility: orchiectomy, partial orchiectomy, retroperitoneal lymphadenectomy (RPLND), radical cystectomy, prostatectomy, penectomy, as well as radiotherapy, chemotherapy, and hormonal androgen suppression. Preservation of fertility is possible and includes cryopreservation, hormonal manipulation with GnRH analogs before chemotherapy, androgen replacement. Germ cell auto transplantation is an intriguing strategy with future perspectives. Careful evaluation of male fertility must be a key point before treating genitourinary tumors, taking into account patients’ age and couples’ perspectives. Informed consent should provide adequate information to the patient about the current state of his fertility and about the balance between risks and benefits in oncological terms. Standard approaches to genitourinary tumors should include a multidisciplinary team with urologists, oncologists, radiotherapists, psycho-sexologists, andrologists, gynecologists, and reproductive endocrinologists.
  Citation: Urologia Journal
  PubDate: 2023-07-26T05:30:57Z
  DOI: 10.1177/03915603221146147
Factors influencing the decision-making in laparoscopic partial
nephrectomy for small renal masses
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  Authors: Ozgur Kazan, Mehmet Caglar Cakici, Alihan Kokurcan, Gorkem Ozenc, Nihat Karakoyunlu, Gokhan Atis, Muhammet Abdurrahim Imamoglu, Asif Yildirim
  Abstract: Urologia Journal, Ahead of Print.
  Background and Objectives:We analyzed the factors affecting the decision on surgical approach such as hilum dissection, vessel clamping, and the warm ischemia time (WIT) in laparoscopic partial nephrectomy (LPN) for small renal masses (SRMs).Methods:Patients who underwent LPN for SRMs between 2011 and 2021 in two centers were retrospectively screened. Standardized R.E.N.A.L. nephrometry score (RNS) and each of the components were scored on a Likert scale and the effect on the surgical approach was examined by using them separately.Results:A total of 133 patients, 85 of whom were on-clamp and 48 were off-clamp, were included in the study. Greater tumor size, low BMI, higher RNS, upper pole tumor, low exophytic rate, and nearness to the collecting system were statistically significant for both on/off-clamp and hilar dissection decisions. In multivariate analysis, greater tumor size, upper pole tumor, lower rate of exophytic part (E2), nearness to the collecting system (N3) were independent risk factors for vessel clamping. Greater tumor size and lower exophytic tumor rate (E2) were independent risk factors for hilum dissection. We could not identify any factor affecting WIT.Conclusion:Individual components of RNS may serve as a better tool for decision-making on vessel clamping and hilum dissection during LPN for SRMs.
  Citation: Urologia Journal
  PubDate: 2023-07-20T11:24:30Z
  DOI: 10.1177/03915603231189025
The efficacy of hyperthermic intravesical chemotherapy in high-risk
non-muscle-invasive bladder cancer patients with BCG intolerance
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  Authors: Fatih Akbulut, Yasar Pazir, Abdullah Esmeray, Akif Erbin, Faruk Ozgor, Omer Sarilar
  Abstract: Urologia Journal, Ahead of Print.
  Background and Aim:Some patients with high-risk non-muscle-invasive bladder cancer (NMIBC) are unable to receive adequate BCG instillations due to intolerance. In this study we aimed to investigate the efficacy and tolerability of hyperthermic intravesical chemotherapy (HIVEC®) treatment using Mitomycin C (MMC) in BCG-intolerant NMIBC patients.Methods:Retrospectively collected data from a total of 22 high-risk papillary NMIBC patients who received adjuvant HIVEC therapy for BCG intolerance were analyzed. The primary outcomes of the study were recurrence-free survival (RFS), time to recurrence, progression-free survival (PFS), and time to progression following initial TURB. Detection of histologically confirmed urothelial carcinoma during follow-up was considered as recurrence, while detection of muscle-invasive disease was defined as progression. The secondary outcome was adverse events of HIVEC treatment.Results:The median follow-up was 32.2 (IQR: 17.8–42.8) months. The RFS and PFS rates were 81.8% and 95.4%, respectively. The mean time to tumor recurrence and progression was 29.2 ± 14.3 and 16.7 months, respectively. Adverse events occurred in 50% of patients, and 95% of adverse events were mild to moderate.Conclusion:This study demonstrated that adjuvant HIVEC with MMC is an effective and safe alternative bladder sparing treatment in BCG intolerant high risk papillary NMIBC patients.
  Citation: Urologia Journal
  PubDate: 2023-07-20T11:16:00Z
  DOI: 10.1177/03915603231189022
Bladder diary for illiterates: A novel method
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  Authors: Nikita Shrivastava, Shakti Swarup Sarangi, Shashank Tripathi, Priyank Bhargava, Deepak Prakash Bhirud, Rahul Jena
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:Bladder diary is an integral part of urologic evaluation of lower urinary tract symptoms. One of its limitations is the requirement of a literate patient or attendant to complete it. We propose a novel method for recording bladder diary in illiterate individuals, with the aid of easily available materials from hospital, without any expenditure from the patients.Methods:Forty-nine patients, who were required to fill the bladder diary as a part of their urological assessment, and were either illiterate or not literate enough to complete it themselves, were enrolled and admitted in the urology ward for 1 and a half days. Patients were provided with two 500 mL empty normal saline bottles for collection of each void, and a chart separately for day and night with diagrams of saline bottles to mark the corresponding level of urine. The amount of urine and frequency was also noted simultaneously by nursing staff each time for 24 h. The investigator interpreted the data marked on the charts by the patient and compared it with the data collected by the nursing officers.Results:No statistically significant difference was found between the data collected by the nursing staff and patient data interpreted by the investigators, which included 24-h urine volume(p = 0.562), nocturnal output (p = 0.941), average voided volume (p = 0.709), maximum voided volume (p = 0.369), fluid intake (p = 0.401), frequency, nocturia and episodes of urgency and incontinence (p = 1).Conclusion:This method of recording bladder diary is a feasible, genuine, reliable and cost-free method which can be used in illiterates.
  Citation: Urologia Journal
  PubDate: 2023-07-20T11:11:24Z
  DOI: 10.1177/03915603231187684
Thulium fiber laser cystolithotripsy under local anesthesia: A day care
procedure
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  Authors: Rahul Gupta, Yaser Rahman, Arti Mahajan, Anjali Mehta
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Bladder stones account for 5% of all urolithiasis. Patients present with LUTS or acute urinary retention. Thus, warranting an early intervention. Minimally invasive approach with laser lithotripsy is the present gold standard to treat bladder stones.Aims and objectives:To evaluate the outcomes of TFL (60 W) for bladder stones performed under local anesthesia as a day-care procedure.Materials and methods:This was a retrospective single-center study conducted after obtaining IRB approval. Study period was between June 2021 and June 2022 were included. All patients were operated under local anesthesia as a day care procedure. The procedure was carried out using an 18 Fr laser sheath and calculus dusted using TFL energy (15–30 W). Parameters including operative time in minutes, complications were recorded. Patients were encouraged oral and normal voiding in the immediate post-op period.Results:A total of 47 patients with bladder stones presented during this period. Of these, 30 underwent laser lithotripsy (TFL) for bladder calculi. The clinical presentation of patients was LUTS in 28 (93%) and 5 (16%) patients had AUR. The average size of the stone in this series was 15 ± 2.8 mm. The mean duration of laser lithotripsy was 15 ± 5.4 min. Energy to dust the stone was variable with mean LASER energy of 18.23 ± 10 W. All patients tolerated the procedure well and none required conversion to conventional anesthesia. One patient failed to void in the post-op period. 100% clearance rate was documented in all patients.Conclusion:Thulium fiber laser for transurethral cystolithotripsy of bladder stones under local anesthesia is a feasible technique with minimal morbidity and good outcome.
  Citation: Urologia Journal
  PubDate: 2023-07-08T11:00:19Z
  DOI: 10.1177/03915603231186286
Relationship between sexual quality of life and life satisfaction in women
with urinary incontinence: A cross-sectional survey
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  Authors: Alime Güleryüz, Birsen Altay
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:This study aims to investigate the relationship between the sexual quality of life and life satisfaction in women with urinary incontinence.Methods:This research is Correlational-descriptive research. Sample of the study consisted of 210 women with urinary incontinence. The data of the study were collected using “The Patient Information Form,” “The Sexual Quality of Life Questionnaire” and “The Satisfaction with Life Scale.” In analyzing; Mann-Whitney U tests, Kruskal Wallis variance analysis were used.Results:It has been found that educational status, income status, menopause status, and frequency of urinary incontinence affect the sexual quality of life. A statistically significant positive moderate linear relationship was found between the mean SWLS scores and the mean SQOL scores (p
  Citation: Urologia Journal
  PubDate: 2023-07-08T10:56:16Z
  DOI: 10.1177/03915603231184088
Comparison of perineal urethrostomy versus augmentation urethroplasty in
anterior urethral stricture disease
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  Authors: Govind Sharma, Sandip Desai, Shivam Priyadarshi, Saurabh Negi
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:Perineal urethrostomy and urethroplasty are very good options for complex and long anterior urethral strictures. A perineal urethroplasty is usually a neglected option. To our knowledge, a comparative study between augmentation urethroplasty and perineal urethrostomy has been not conducted regarding subjective and patient reported outcome measures. We compared both these groups in a high volume tertiary care hospital.Materials and methods:A prospective comparative study of augmentation urethroplasty and perineal urethroplasty for long anterior urethral stricture. it was defined by strictures of more than 3 cm. We compared demographic data, urinary and sexual function; and quality of life using validated PROMs (patient-reported outcome measures) between both above groups.Results:Both groups had 40 patients each. IPSS score improvement for PU and AUP were 20 and 19.6, respectively(p = 0.1223); IIEF-5 score improvement for PU and AUP at baseline and after 6 months were 14.3 and 16.7, respectively(p = 0.1433); QOL score improvement for PU and AUP were 3.45 and 3.05, respectively; which was statistically significant (p ⩽ 0.001).Conclusions:Perineal urethrostomy is a good but neglected option for complex and long anterior urethral strictures and it should be considered one of the reliable treatment option for patients with long-segment urethral strictures.
  Citation: Urologia Journal
  PubDate: 2023-07-05T06:54:02Z
  DOI: 10.1177/03915603231178392
Classification and management of sexual dysfunctions in multiple sclerosis
patients: A review of current literature
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  Authors: Marco Campetella, Filippo Marino, Filippo Gavi, Carlo Gandi, Mauro Ragonese, Simone Coluzzi, Marco Racioppi, Emilio Sacco, Riccardo Bientinesi
  Abstract: Urologia Journal, Ahead of Print.
  Multiple sclerosis (MS) is the most frequent neurological disease in young adults, with the greatest incidence between age of 30 and 35 years. Sexual dysfunctions (SDs) are frequent, but are often underestimated in patients with MS, and can have a significantly high impact on patient’s quality of life. Aim of this review is to summarize sexual dysfunctions in male and female MS patients and to illustrate current and emerging therapeutic options for treatment.
  Citation: Urologia Journal
  PubDate: 2023-06-30T09:55:02Z
  DOI: 10.1177/03915603231183751
Impact of positive surgical margins (PSMs) after robotic prostatectomy on
biochemical recurrence (BCR): Multicenter analysis
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  Authors: Nicolò Fiorello, Andrea Di Benedetto, Luca Brizzi, Andrea Mogorovich, Daniele Summonti, Giuseppe Silvestri, Sandro Benvenuti, Carlo Alberto Sepich
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To study and analyze any correlations between positive surgical margins after RARP and biochemical recurrence.Methods:We enrolled 105 patients who underwent robot-assisted radical prostatectomy (RARP) from 2016–2020 with PSMs on final pathology, all performed or supervised by a senior surgeon in two tertiary referral center. Pathology has been described indicating also the area (apical, base, mediolateral, anterior, or multiple) and the extent of PSMs: focal (≤3 mm) or extensive (>3 mm). Cox univariable and multi-variable regression models were used to find the correlation between clinico-pathologic factors: age, local staging, PSA, grading, area, and size of PSMs).Results:We found a good correlation between PSA and grading and between PSA and local staging (T) (p
  Citation: Urologia Journal
  PubDate: 2023-06-24T08:35:04Z
  DOI: 10.1177/03915603231183478
Review of prognostic factors for kidney transplant survival
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  Authors: Nargiz Zulkhash, Nasrulla Shanazarov, Saule Kissikova, Guldauren Kamelova, Gulzhaina Ospanova
  Abstract: Urologia Journal, Ahead of Print.
  Transplantation is the most effective treatment for end-stage chronic kidney disease, as this procedure prolongs and improves the patient’s quality of life. One of the key problems is the risk of graft rejection. The purpose of this research was to identify and analyse prognostic factors that will prevent rejection. In particular, the prognostic factors grouped by methods of synthesis, generalisation and statistical processing with calculation and graphical representation of hazard ratio and correlation coefficient were grouped, namely: age of donor and recipient, time of cold kidney ischaemia, duration of preoperative dialysis, body mass index, presence of concomitant diseases (diabetes mellitus, hypertension), primary causes causing transplantation. Several molecular genetic and biochemical prognostic markers (transcription factors, immunocompetent cell signalling and receptors, cytostatin C, creatinine, citrate, lactate, etc.) are annotated. It has been demonstrated that creatinine reduction rate determines the risk of rejection, displaying the dynamics of cystatin C and creatinine changes in the postoperative period. Young recipients who underwent prolonged preoperative dialysis were identified as having the highest risk of rejection. Diabetes and hypertension bear a non-critical but commensurately equal risk of rejection. The survival rate of the graft is better when transplanted from a living donor than from a deceased donor. A correlation between cold ischaemia time, body mass index and the probability of graft failure has been proven, namely, the greater the donor and recipient body mass index and the longer the cold ischaemia time, the lower the chance of successful long-term organ acclimation. The data obtained can be used as prognostic factors for graft accommodation at different intervals after surgery.
  Citation: Urologia Journal
  PubDate: 2023-06-23T08:29:31Z
  DOI: 10.1177/03915603231183754
Effect of COVID-19 on sexual and reproductive functions of Egyptian males
following recovery: A cross sectional study
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  Authors: Sameh Fayek GamalEl Din, Nashaat Nabil Ismail, Amr Kaddah, Mohamed Ahmed Abdel Salam, Mahmoud Sayed Korani, Mostafa Ahmed Hamed
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:We aimed to assess the sexual and the reproductive functions in males post COVID-19 infection in Beni-Suef Governorate.Methods:One hundred men were recruited in the current study. All participants were assessed by the Arabic validated version of the International Index of the Erectile Function 5 (ArIIEF-5), semen analysis, and Hospital Depression and Anxiety Scale (HADS). Finally, morning testosterone serum level was measured.Results:There were significant decreases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 3 months when compared to the controls. However, there were significant increases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 6 months group when compared to the post COVID-19 patients after 3 months group. Moreover, there was a significant increase in the HADS score in the post COVID-19 patients after 3 months when compared to the controls. In contrast, there was a significant decrease in the HADS score in the post COVID-19 patients after 6 months when compared to the post COVID-19 patients after 3 months.Conclusion:Our study had shown temporary impairment of sexual and reproductive functions in post COVID-19 convalescent males especially after 6 months from the onset of the infection.
  Citation: Urologia Journal
  PubDate: 2023-06-19T06:45:03Z
  DOI: 10.1177/03915603231181723
Effects of continuous use of Tadalafil on male sexual function after
posterior urethroplasty: A clinical trial
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  Authors: Hamedreza Nourian Kafshgari, Danial Farhadi, Morad Kohandel Gargari, Sajjad Pourasghary, Fateme Tahmasbi, Farzin Soleimanzadeh
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Posterior urethral injuries in men commonly occur following pelvic and perineal trauma. Erectile dysfunction (ED), whether brought on by the severity of the initial trauma or the surgery itself, is one of the complications in these patients.Materials and methods:In this study, we divided candidates of posterior urethroplasty due to traumatic urethral injury into intervention and placebo groups; the former received continuous treatment with tadalafil (10 mg daily), and the latter received a placebo. Other services were provided equally to both groups. Before and after the intervention, both groups completed the International Index of Erectile Function version 5 (IIEF-5) questionnaire, and the findings were analyzed.Results:Forty patients were studied in groups of 20 with a mean age of 43.87 ± 15.70 years. The patient’s most common cause of urethral injury was a pelvic fracture. Before the intervention, the mean scores of IIEF for patients in the intervention group and placebo group were 14.85 ± 7.39 and 14.77 ± 6.48, respectively with no statistical significance (p = 0.962) and patients of the groups were similar in terms of the severity of ED. The mean IIEF score in the intervention group was 20.12 ± 4.94 and in the placebo group, it was 18.05 ± 4.88 at the three-month follow-up, with no statistically significant difference (p = 0.063). In both the intervention and placebo groups, the IIEF score was significantly increased by 5.27 ± 4.04 (p
  Citation: Urologia Journal
  PubDate: 2023-06-12T09:50:05Z
  DOI: 10.1177/03915603231179533
Complications and device failures associated with urolift: Findings from
the MAUDE database
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  Authors: Patrick Juliebø-Jones, Bhaskar K Somani, Lazaros Tzelves, Julie Nøss Haugland, Christian Arvei Moen, Alfred Honoré, Christian Beisland
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Urolift is an established intervention for symptoms of bladder outflow obstruction caused by benign prostate enlargement. Reported advantages include its minimally invasive profile, short learning curve and feasibility as a day case procedure. Our aim was to use a national registry as a means to evaluate the nature of complications and device failures that have been documented to occur.Methods:Retrospective review was performed of the US Manufacturer and User Facility Device Experience (MAUDE) database, a prospective register, which contains voluntarily submitted adverse events associated with surgical devices. Information collected include event timing, underlying cause, procedural completion, complications and mortality status.Results:Between 2016 and 2023, 103 device failures, 5 intra-operative complications and 165 post-operative complications (early: 151, late: 14) were registered. The commonest device problem (56%, n = 58) was failure of the implant to deploy with subsequent requirement for complete replacement. There were 50 cases of documented urosepsis. 62 patients with post operative haematuria were registered including 12 that underwent emergency embolisation. Other complications included stroke (n = 5), pulmonary embolism (n = 3) and necrotising fasciitis (n = 1). Twelve ITU admissions were registered. In the reports, 22 cases were filed that recorded a hospital stay of 7 days or more. Eleven deaths were captured in the database over the study period.Conclusion:While urolift is recognised as less invasive intervention compared to alternatives such as transurethral resection of the prostate, serious adverse events have been reported to occur including death. Our findings can provide learning points for surgeons and allow for improved patient counselling and treatment planning accordingly.
  Citation: Urologia Journal
  PubDate: 2023-06-09T06:56:24Z
  DOI: 10.1177/03915603231180016
SARS-CoV-2 infection (COVID-19) and male fertility: Something we should be
worried about'
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  Authors: Theodosia Zeginiadou, Evangelos N Symeonidis, Asterios Symeonidis, Ioannis Vakalopoulos
  Abstract: Urologia Journal, Ahead of Print.
  As of 2021, roughly 5 million deaths were linked to SARS-CoV-2 infection based on World Health Organization estimates. The pandemic takes its staggering death toll, severely affecting the healthcare systems and leading to detrimental implications globally. While the severe impact on the respiratory system is well-established, the exact effect on male reproduction is still largely uncharted territory. When it comes to gender, men appear more vulnerable compared to women. Increasing evidence suggests that COVID-19 adversely affects spermatogenesis and hormonal balance in diverse ways. Semen parameters seem to be compromised at least temporarily, while long-term worsening needs to be clarified in studies with extended follow-up. For the time being, no data support the adverse effect of COVID-19 vaccines on a male’s reproductive health. In the present article, we examine the available literature and briefly discuss the impact of the virus on reproduction and fertility. We further provide a comprehensive overview of the current status of vaccination and its potential effect on male fertility. Ultimately, we address the need for future well-designed large-scale trials before drawing definite conclusions on the exact impact of the virus on a male’s fecundity.
  Citation: Urologia Journal
  PubDate: 2023-06-06T06:16:20Z
  DOI: 10.1177/03915603231175941
Predictors of surgical intervention for antenatally detected ureteropelvic
junction obstruction (UPJO): A prospective multivariate analysis
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  Authors: Tarek Ahmed Mahmoud, Esam El din Salem Morsy, Hany Abd Elraoof Ali Morsy, Abdelmoneim Mohammed Abouzeid, Hazem Mohamed Elmoghazy
  Abstract: Urologia Journal, Ahead of Print.
  Objective:We aimed to identify clinical and radiological predictors of the need for surgical intervention in infants with antenatally detected UPJO.Material and methods:We prospectively followed infants born with antenatally diagnosed ureteropelvic junction obstruction (UPJO) presented at our outpatient clinics for evidence of obstructive injury with a standard protocol with ultrasonography and renal scintigraphy. Indications for surgery included progression of hydronephrosis on serial examinations, initial differential renal function (DFR) ⩽35% or>5% loss in sequential studies, and febrile urinary tract infection (UTI). Univariate and multivariate analyses were utilized to define the predictors for surgical intervention, while the appropriate cut-off value of the initial Anteroposterior diameter (APD) was determined using the receiver operator curve analysis.Results:Univariate analysis revealed a significant association between surgery, the initial APD, cortical thickness, Society for Fetal Urology grade, UTD risk group, initial DRF, and febrile UTI (p-value
  Citation: Urologia Journal
  PubDate: 2023-05-26T11:05:33Z
  DOI: 10.1177/03915603231173009
The impact of single-use digital flexible cystoscope for double J removal
on hospital costs and work organization: A multicentric evaluation
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  Authors: Marco Oderda, Antonio Amato, Jean de la Rosette, Steve Doizi, Vincent Estrade, Marco Falcone, Ben Grey, Bodo Knudsen, Jonathon Olsburgh, Amelia Pietropaolo, Nick Rukin, Omidreza Sedigh, Alhamri Saeed, Bhaskar K Somani, Paolo Gontero
  Abstract: Urologia Journal, Ahead of Print.
  Background:Isiris-α® is a single-use digital flexible cystoscope with an integrated grasper designed for double J (DJ) stent removal. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of stent removals performed with Isiris®-α in different hospitals and health systems, as compared to other DJ removal procedures.Methods:After gathering 10 institutions worldwide with experience on Isiris-α®, we performed an analysis of the reported costs of DJ removal with Isiris-α®, as compared to the traditional reusable equipment used in each institution. The cost evaluation included instrument purchase, Endoscopic Room (EnR)/ Operatory Room (OR) occupancy, medical staff, instrument disposal, maintenance, repairs, decontamination or sterilization of reusable devices.Results:The main factor affecting the costs of the procedure was OR/EnR occupancy. Decontamination and sterilization accounted for a less important part of total costs. Isiris-α® was more profitable in institutions where DJ removal is usually performed in the EnR/OR, allowing to transfer the procedure to outpatient clinic, with a significant cost saving and EnR/OR time saving to be allocated to other activities. In the only institution where DJ removal was already performed in outpatient clinics, there is a slight cost difference in favor of reusable instruments in high-volume institutions, given a sufficient number to guarantee the turnover.Conclusion:Isiris-α® leads to significant cost benefit in the institutions where DJ removal is routinely performed in EnR/OR, and brings significant improvement in organization, cost impact and turnover.
  Citation: Urologia Journal
  PubDate: 2023-05-08T12:07:30Z
  DOI: 10.1177/03915603231172543
The use of intelligent analysis (IA) in determining the tactics of
treating patients with nephrolithiasis
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  Authors: Neymark Alexander Izrailevich, Neymark Boris Alexandrovich, Ershov Artem Vladimirovich, Spivak Leonid Grigoryevich, Korolev Dmitry Olegovich, Tsarichenko Dmitry Georgievich, Rapoport Leonid Moiseevich
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:The use of modern information technologies allows to increase confidence in the choice of a surgical treatment method of kidney stones, as well as to improve the quality of treatment due to an adequate combination of therapeutic techniques.Materials and methods:In our study we analyzed the treatment results of 625 patients with kidney stones. We created a register with the information on more than 50 parameters for each patient. Each example had an output parameter representing a predefined treatment strategy (extracorporeal shock-wave lithotripsy [ESWL]—1, percutaneous nephrolithotomy [PCNL]—2, pyelolithotomy or nephrolithotomy—3). The initial database served as the basis for training the neural network estimation technique. The aim of our study was to assess the possibility of using neural network algorithms in choosing a method for surgical treatment of urolithiasis.Results:A prospective study was conducted to assess the clinical effectiveness of implementing the recommendations of the system. The average number of sessions in the group using the neural network assessment technique was 1.4. Residual fragments remained at the time of discharge in seven (15.6%) patients: four in the kidney, three in the lower third of the ureter “stone path.” Inversion of therapeutic tactics—PCNL—was performed in four cases. The efficiency of the ESWL was 91.1%. The indicators of the ESWL in the comparison groups differed statistically significantly: in the second group, the efficiency was higher due to more stone fragmentation, with lower energy costs (the average number of sessions was 0.4 less).Conclusion:The presented technique can be of help for a practicing urologist to choose the optimal treatment method for each patient, thereby minimizing the risk of early postoperative complications.
  Citation: Urologia Journal
  PubDate: 2023-04-03T07:15:33Z
  DOI: 10.1177/03915603231162881
Utility of preoperative urine cultures and cystoscopies before ureteral
reimplantation in pediatrics
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  Authors: Erin Davis, Dawson Hinkley, Mark E Quiring, Tyler Hamby, Kristy J Reyes, Kirk Pinto
  Abstract: Urologia Journal, Ahead of Print.
  Background:Ureteral reimplantation remains the primary surgical method used for patients with vesicoureteral reflux (VUR). Cystoscopy is commonly performed first to visualize anatomy and rule out possible abnormalities. Urine cultures may also be obtained. The objective of this study is to evaluate the prudency of preoperative urine cultures and cystoscopies in pediatric patients undergoing ureteral reimplantation.Methods:Pediatric urologists were surveyed regarding collecting urine cultures in asymptomatic patients and cystoscopies before reimplantation. A retrospective review was also conducted of patients who underwent ureteral reimplantation for VUR between March 2018 and April 2021 at Cook Children’s Medical Center.Results:When physicians were asked the frequency they obtain urine cultures before reimplantation on asymptomatic patients, 36% said “never” and 38% said “always.” Regarding cystoscopy, 53% said “never” and 32% said “always.” Inclusion criteria were met by 101 patients. Cystoscopies were performed in 46 patients and never altered the reimplantation. There were 20 preoperative, 90 intraoperative, and 61 postoperative urine cultures. Complications were associated with positive cultures of urine collected intraoperatively and postoperatively only.Conclusion:Cystoscopies and asymptomatic urine cultures obtained before ureteral reimplantation provide no additional benefit while increasing cost for patients’ families. Further research is needed to thoroughly identify the prudency of such practices in ureteral reimplantation for VUR.
  Citation: Urologia Journal
  PubDate: 2023-04-01T07:26:12Z
  DOI: 10.1177/03915603231166722
Concurrent two surgeon approach for bilateral synchronous percutaneous
nephrolithotomy: Initial experience at a University Teaching Hospital
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  Authors: Anshuman Singh, Mayank Kulshreshtha, Suraj Jayadeva Reddy, Padmaraj Hegde, Arun Chawla, Kothuri Sricharan Raj
  Abstract: Urologia Journal, Ahead of Print.
  Percutaneous nephrolithotomy (PNL) has long been considered the bench-mark intervention for complicated urinary stones and has undergone important advancements since it was first described. Given the proven safety and efficacy of PNL, simultaneous bilateral PNL has been attempted for bilateral renal calculi to cut down on total procedure costs. To further cut down on operative time, concurrent bilateral synchronous PNL (BS-PNL) has been performed involving two surgeons, each operating concurrently on one renal unit. We performed a retrospective study to evaluate the safety and efficacy of BS-PNL in patients who consented for the procedure. Mean operative time taken from percutaneous access to skin closure was 78 min which was lower than that taken during the single surgeon approach for simultaneous bilateral PNL. Two (12%) out of 16 renal units required multiple punctures for stone clearance. Sheath size varied between 26Fr to 30Fr depending on the stone burden. Mean duration of hospital stay was 2 days. Fourteen (88%) out of 16 renal units had complete stone clearance. Fifteen (94%) out of 16 renal units had a double J stent placed for drainage. Only two patients had complications in the form of postoperative fever. In the background of already proven safety and efficacy of SB-PNL, the concurrent two surgeon approach appears to be feasible and safe with additional advantage of reduced operative time. However, the number of patients in this series were limited and a bigger and preferably multi-institutional study would be required before we can come to a definitive conclusion.
  Citation: Urologia Journal
  PubDate: 2023-01-31T06:55:58Z
  DOI: 10.1177/03915603221148793
Effect of gender on presentation and outcome of renal colic
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  Authors: Dor Golomb, Amit Shemesh, Hanan Goldberg, Eyal Hen, Fahed Atmana, Eyal Barkai, Ben Shalom, Amir Cooper, Orit Raz
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones.Methods:Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected.Results:778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% (n = 609) were males and 22% (n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively (p = 0.08). Female patients presented with a higher body temperature (p = 0.01), pulse rate (p
  Citation: Urologia Journal
  PubDate: 2023-01-13T04:52:58Z
  DOI: 10.1177/03915603221150039