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Charbonnel C, Neuville P, Paparel P, Reichenbach A, Ruffion R. Feasibility of EXIME® temporary prosthesis placement and removal in men with acute or chronic urinary retention after failure or inability to selfcatheterize. Prog Urol 2022; 32:717-725. [DOI: 10.1016/j.purol.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/03/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
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[Assessment of a post-emergency pathway with early urological regulation]. Prog Urol 2020; 30:1051-1059. [PMID: 33055003 DOI: 10.1016/j.purol.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/09/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Urological emergencies represent 7 % of the outpatients at the emergency department (ED). We assessed the effect of setting up a post-emergency consultation (CPU) after deferred urological medical regulation. METHODS All patients admitted to the ED in a university center over the period December 2017 to July 2018 and for whom a CPU was scheduled were included. The regulation concerned the date of CPU and supplementary exams. The main outcome was the ability to provide an efficient response according to a predefined grid of specific solutions. RESULTS One hundred and twenty-eight patients were included. The median age was 57 years (18-97). Efficacy of the CPU was 76 %. This rate was lower in no-show patients or consulting for rare and complex motives (47 %, n=60). The no-show were not reachable on the first call in 51.6 % of cases, with a similar age and motives distribution to the others. Only 6,9 % (n=128) of all consultants (n=1863) had been referred to the CPU by emergency physicians. The decision was a second consultation in 70 % (48), a new exam in 10 % (7), deferred emergency surgery in 12 % (8) and finally 18 % (12) of no follow-up. CONCLUSION CPU following early regulation by a urologist provides an effective response in 76 % of situations. Assessment of "no-shows" helped to identify groups at risk. LEVEL OF EVIDENCE III.
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A systematic review of dedicated models of care for emergency urological patients. Asian J Urol 2020; 8:315-323. [PMID: 34401338 PMCID: PMC8356060 DOI: 10.1016/j.ajur.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/20/2020] [Accepted: 04/21/2020] [Indexed: 11/09/2022] Open
Abstract
Objective To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Results Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs (“Acute Urological Unit”) or dedicated registrars or operating theatres (“Hybrid structures”). In some services, EUPs bypassed emergency department assessment and were referred directly to urology (“Urological Assessment Unit”) or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Conclusion Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models.
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Cortial M, Mewasing BI, Tligui M, Dautheville S, Valentian M, Mintandjian A, Ray P. Évaluation de l'intérêt d'une consultation post-urgence d'urologie : étude rétrospective sur trois ans. ANNALES FRANCAISES DE MEDECINE D URGENCE 2018. [DOI: 10.3166/s13341-017-0809-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : L'objectif principal de ce travail était d'évaluer l'intérêt de la consultation post-urgence d'urologie (CPUU) mise en place dans notre institution.
Patients et méthodes : Il s'agit d'une étude transversale, monocentrique et rétrospective sur trois années distinctes : 2014, 2015 et 2016 de trois mois consécutifs (janvier à mars). Seuls les patients de plus de 18 ans ayant consulté aux urgences pour un motif urologique et relevant de la CPUU ont été inclus.
Résultats : Au total, 465 patients ont été programmés en CPUU, dont 265 (57 %) se sont présentés à la consultation. Deux cent vingt-deux patients (48 %) ont finalement répondu aux critères d'inclusion. Les principaux diagnostics relevant de la CPUU étaient principalement les coliques néphrétiques (45 %), la rétention aiguë d'urine (14 %) et les infections de l'appareil urinaire (16 %). On note une diminution significative du délai de CPUU passant à moins de deux semaines pour 60 % des patients en 2016 contre 30 et 38 % respectivement en 2014 et 2015 (p = 0,003). Le nombre de modifications diagnostiques à la sortie de la CPUU reste faible (6 % sur les trois ans ; p = 0,94). La modification thérapeutique par les urologues était principalement chirurgicale (22 % ; p = 0,75). La CPUU a permis d'instaurer un suivi au long cours pour plus de la moitié des patients (60 % ; p = 0,31).
Conclusion : La CPUU semble démontrer un intérêt tant sur le plan diagnostique que sur le plan du suivi spécialisé dans notre centre.
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Gas J, Liaigre-Ramos A, Beauval JB, Roumiguié M, Tostivint V, Patard PM, Huyghe E, Soulié M, Charpentier S, Gamé X. [Epidemiology of emergency consultations for acute urine retention]. Prog Urol 2018; 28:107-113. [PMID: 29337127 DOI: 10.1016/j.purol.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 11/16/2017] [Accepted: 12/01/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Acute urinary retention (AUR) is a common reason for emergency consultation. It may be spontaneous or precipitated and affects both men and women. The purpose of this study was to determine the profile of men visiting emergency departments for an AUR. MATERIEL AND METHODS A retrospective monocentric study including all men who consulted the emergency department between January 2014 and December 2016 for AUR was conducted. RESULTS In 3 years, 731 patients were admitted for AUR (611 men and 120 women). The mean age was 71.6±14 years with a mean retention volume of 948±668mL drained for 96% of patients (n=584) through a bladder catheter and 4% (n=27) with a suprapubic catheter. Most patients had an urological (66%, n=104) or neurologic (40%, n=242) history and 23% (n=136) already had an episode of AUR. In 28% of cases (n=173), the globe was not painful. A majority of AUR were spontaneous, 53% (n=326) versus 46% (n=279) who were precipitated, secondary to a recent surgical procedure (<1 month) (15%, n=89), hematuria (9%, n=54), or male urinary tract infections (7%, n=42). Patients were treated externally in 71% (n=436), 25% (n=153) were hospitalized with significantly more comorbidities. CONCLUSION Men consulting emergency for AUR are 72 years old, with a globe volume of 942mL. Thirty-three percent have a history of BPH, with a prostate treatment like alpha-blockers type. Almost all patients were treated with a bladder catheter and the majority was treated externally. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- J Gas
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France.
| | - A Liaigre-Ramos
- Service d'accueil des urgences, CHU de Toulouse, 31059 Toulouse, France
| | - J B Beauval
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - M Roumiguié
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - V Tostivint
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - P-M Patard
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - E Huyghe
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - M Soulié
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - S Charpentier
- Service d'accueil des urgences, CHU de Toulouse, 31059 Toulouse, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
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Prise en charge du priapisme ischémique aigu à l’Hôpital National de Lamordé de Niamey. AFRICAN JOURNAL OF UROLOGY 2017. [DOI: 10.1016/j.afju.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Talreja S, Banerjee I, Teli R, Agarwal N, Vyas N, Priyadarshi S, Yadav S, Tomar V. A Spectrum of Urological Emergency Reported at a Tertiary Care Teaching Hospital: An Experience. J Clin Diagn Res 2015; 9:PC12-5. [PMID: 26675409 PMCID: PMC4668464 DOI: 10.7860/jcdr/2015/15793.6821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 09/28/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION A substantial number of urology admissions constitute of emergency cases and sizeable proportion are urology emergency referral cases. There have been few studies conducted on this aspect but there lie geographical variations in the presentations of urological emergencies. Hence, this study was conducted to analyse various urological emergency presentations and their interventions. OBJECTIVE To estimate the proportion of urological emergencies and analyse the different type of urological emergencies with the required management. MATERIALS AND METHODS A hospital based observational descriptive study was undertaken in our institution over a period of one year. RESULTS A total of 11,139 cases were admitted in the urology department; of which a significant percentage (21.05%) was from emergency room. Majority of cross references came from the Department of Medicine (22.59 %). Renal colic (24.2%) happened to be the most common presentation in emergency room followed by acute urinary retention (14.7%). Among referred cases, hematuria was the leading presentation with 17.75% followed by traumatic catheterization (11.97%). Most common urological intervention in referred cases was supra pubic catheterization (27.20%) while it was percutaneous nephrostomy (32.78%) in directly admitted cases. CONCLUSION Urological emergencies constitute a significant proportion of total urology admissions (27.18%). The most common non-traumatic injury was renal colic whereas traumatic was traumatic catheterization in our study. Most common surgical intervention in direct admitted emergency cases was percutaneous nephrostomy whereassuprapubic catheterization in within hospital emergency referral cases.
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Affiliation(s)
- Shyam Talreja
- Senior Resident, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Indraneel Banerjee
- Senior Resident, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Ramdayal Teli
- Medical Officer, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Neeraj Agarwal
- Assistant Professor, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Nachiket Vyas
- Associate Professor, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Shivam Priyadarshi
- Professor, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Shersingh Yadav
- Professor, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
| | - Vinay Tomar
- Professor and Head of the Department, Department of Urology, SMS Medical College & Hospital, Jaipur, Rajasthan, India
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Bailly V, Le Ray I, Bardonnaud N, Pillot P, Martin L, Pastori J, Balssa L, Guichard G, Bittard H, Kleinclauss F. [Meteo-U-rology: climate impact on urological emergencies]. Prog Urol 2014; 24:535-9. [PMID: 24975786 DOI: 10.1016/j.purol.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/10/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to analyze the weather influence on the onset of renal colic (RC), acute urinary retention (AUR) and testicular torsion (TT). MATERIALS AND METHODS We correlated the daily number of RC, AUR and TT cases admitted to our urology department and weather conditions between 2005 and 2009 on day-to-day basis. Eight hundred and seventy-six RC, 453 AUR and 50 TT were analyzed. Information on temperature, atmospheric pressure, relative humidity, vapor pressure, wind force, evapotranspiration and sunshine level were collected from the national meteorological office (Meteo-France) in Besançon, France. We performed a univariate and a multivariate Stepwise method in linear regression using Akaike Information Criterion. RESULTS We reported a statistically significant increased risk of renal colic at higher vapor pressure. Likewise, temperature seemed to be a risk factor for occurrence of renal colics. We determined an increased daily rate when maximal daily temperature rises above 20 Celsius degrees (P = 0.05). Furthermore, we observed a positive link between mean (P = 0.05) and minimal (P = 0.08) daily temperature and urolithiasis. Contrarywise AUR was more frequent when the mean temperature falls below zero Celsius degree. We also demonstrated a non-significant influence of temperature on TT, with 3 fold higher events during cold period. Much more mystic, we noted a higher AUR rate on new moon days, and fewer renal colic on full moon. CONCLUSIONS Further investigations are necessary to understand the mechanisms underlying the relationship between urologic diseases and climate. But our findings could help us justify healthy living messages.
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Affiliation(s)
- V Bailly
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - I Le Ray
- Inserm 803, centre d'investigation, clinique plurithématique, CHU de Dijon, 21000 Dijon, France
| | - N Bardonnaud
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - P Pillot
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Martin
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - J Pastori
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Balssa
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - G Guichard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - H Bittard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - F Kleinclauss
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France.
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