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Alotaibi T, Alsahafi M, Alariany O, Alqarni AA, Abuzenada M, Almutairi E, Nakshabandi Z, Alyami F, Alsaywid B, Lytras M. The Analysis of Job Satisfaction of Health Practitioners in Saudi Arabia: Determinants and Strategic Recommendations for Health Workforce Planning. Cureus 2023; 15:e50891. [PMID: 38249243 PMCID: PMC10799632 DOI: 10.7759/cureus.50891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Job satisfaction plays an important foundation in the health system to deliver high-quality care services to patients. Job satisfaction describes the inside feeling of workers about their jobs whether they like it or not. Job satisfaction of health practitioners is considered an essential factor that affects their efficiency, well-being, and mental health. AIM This research study is part of an integrated research aiming to understand the determinants of a revised Workforce Planning Strategy in Saudi Arabia, in close relevance to the demand and supply side in Saudi Arabia. RESULTS This study showed that males were significantly more satisfied than females in relation to specialty, organization, and overall global score. There is also evidence for a significant association between age groups and job satisfaction. Older health practitioners had a higher level of satisfaction than younger ones. Regarding nationality, we found that Saudi health practitioners were less satisfied in all aspects, while non-Saudi (Arab) healthcare practitioners were the most satisfied in all aspects except city happiness. CONCLUSION Our study found statistically significant differences that medicine and surgery practitioners are the most satisfied professionals and the least satisfied are dentist practitioners. Health practitioners with more than five years of experience were significantly the most satisfied.
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Affiliation(s)
- Talal Alotaibi
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Mohammed Alsahafi
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Osama Alariany
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ayman A Alqarni
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Maha Abuzenada
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Eman Almutairi
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Ziad Nakshabandi
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | | | - Basim Alsaywid
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Miltiades Lytras
- Computer Science, Effat College of Engineering, Effat University, Jeddah, SAU
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El Helaly A, Alotay A, Alfaddagh A, Alhagbani M, Bashareef A, Alghanbar M, Nakshabandi Z, Sarhan O. Children with Meningomyelocele (MMC) with normal initial renal ultrasound, follow up plan. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00667-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Hejazi MM, Al-Rubaki SS, Bawajeeh OM, Nakshabandi Z, Alsaywid B, Almutairi EM, Lytras MD, Almehdar MH, Abuzenada M, Badawood H. Attitudes and Perceptions of Health Leaders for the Quality Enhancement of Workforce in Saudi Arabia. Healthcare (Basel) 2022; 10:891. [PMID: 35628028 PMCID: PMC9141873 DOI: 10.3390/healthcare10050891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIM Besides the unique exposure and experience of health leaders in facing challenges and overcoming them, and the relatively fewer articles relating to the perception of health leaders in workforce quality enhancement, health leadership plays a crucial role in redirecting the workforce, increasing job satisfaction, professional development, and burnout prevention. Thus, this study aimed to understand the current healthcare workforce quality and future expectations from the attitudes and perceptions of health leaders. METHODS A qualitative research was carried out using semi-structured interviews consisting of 24 different questions. Participants of the study were healthcare leaders from different backgrounds and governmental institutions. All interviews were recorded, transcribed, and then analyzed using thematic analysis via the N-Vivo program. RESULTS Eleven participants were involved in the study, with one female and ten males. A thematic analysis and N-Vivo program yielded 5 main themes: (1) workforce competency, (2) health transformation, (3) leadership, (4) workforce planning, and (5) healthcare quality, with 22 emerging sub-themes. Moreover, participants responded with different attitudes and perceptions. CONCLUSION Health leaders are satisfied with the current direction of workforce competency and planning, yet fragmentation of the system and poor accessibility may need further enhancement. Furthermore, misutilization of services and the uncertainty of the future and talent pool are potential barriers for capability building. Moreover, with the existing gap in the workforce, health leaders believe that privatization and corporatization may have a positive effect. Aside from that, Saudization with the current plan of having a minimum standard of accepting non-Saudis in certain areas might benefit in maintaining competition and enriching experience. However, catching up with further research in healthcare quality in Saudi Arabia is needed because of the ongoing health transformation.
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Affiliation(s)
- Majid M. Hejazi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
| | - Shayma S. Al-Rubaki
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Othman M. Bawajeeh
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia
| | - Ziad Nakshabandi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- National Center for Health Workforce Planning, Riyadh 11614, Saudi Arabia
| | - Basim Alsaywid
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Saudi National Institute of Health Education and Research Skills, Riyadh 12382, Saudi Arabia
| | - Eman M. Almutairi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Health Academy, Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
| | - Miltiadis D. Lytras
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Effat College of Engineering, Effat University, Jeddah 21551, Saudi Arabia
| | - Manal H. Almehdar
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Maha Abuzenada
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Halla Badawood
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Occupational Therapy Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
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Al Otay A, El Helaly A, Alharbi F, Alswaigh A, Aljaafar M, Alghanbar M, Nakshabandi Z, Sarhan O. Surgical correction of gliding testes, single incision is enough. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00865-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sarhan O, El Helaly A, Al Otay A, Al Bedaiwi K, Al Ghanbar M, Nakshabandi Z. Crossed fused renal ectopia: Diagnosis and prognosis as a single-center experience. J Pediatr Surg 2021; 56:1632-1637. [PMID: 33004190 DOI: 10.1016/j.jpedsurg.2020.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Crossed fused renal ectopia (CFRE) is a rare congenital malformation. Renal bladder ultrasound (RBUS) is a good tool for establishing the diagnosis, however, additional imaging with a voiding cystourethrogram (VCUG) and dimercaptosuccinic acid scan (DMSA) might be required. We assessed the need for postnatal evaluation and the long-term consequences in patients with this diagnosis. METHODS A retrospective review of the records of all patients diagnosed with CFRE between 2004 and 2014 was done. We included all patients who underwent postnatal evaluation with RBUS, DMSA and VCUG. Long-term radiological and functional outcomes were assessed. RESULTS A total of 29 patients with CFRE were identified. Majority of cases were detected antenatally (79%) and left to right crossed ectopia constituted the majority of cases (65%). RBUS revealed associated hydronephrosis (HN) in 11 patients (38%). DMSA scans confirmed the diagnosis in all patients and showed impaired renal function in 10 ectopic kidneys (34%). Vesicoureteral reflux was detected in 12 patients (41%); one third of them needed surgical intervention. Extra-urinary anomalies were present in 14 patients (48%) mainly of cardiac origin. After a mean follow-up of 4.5 years, 4 patients (14%) with extra-urinary anomalies developed chronic kidney disease and two of them died. CONCLUSIONS Crossed fused renal ectopia is commonly associated with both urinary and extraurinary malformations. Postnatal RBUS is usually sufficient for diagnosis, however, additional imaging may aid for confirming the diagnosis and detection of associated urinary anomalies. Presence of extra-urinary malformations with crossed fused ectopia carries a higher risk of morbidity. TYPE OF THE STUDY Retrospective study [diagnostic/prognostic study]. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Osama Sarhan
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Ahmed El Helaly
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulhakim Al Otay
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled Al Bedaiwi
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mustafa Al Ghanbar
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ziad Nakshabandi
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Sarhan O, Al Awwad A, Al Otay A, Al Faddagh A, El Helaly A, Al Ghanbar M, Al Kawai F, Nakshabandi Z. Comparison between internal double J and external pyeloureteral stents in open pediatric pyeloplasty: A multicenter study. J Pediatr Urol 2021; 17:511.e1-511.e7. [PMID: 33865709 DOI: 10.1016/j.jpurol.2021.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Anderson-Hynes dismembered pyeloplasty is considered the standard surgical treatment for ureteropelvic junction obstruction (UPJO). After pyeloplasty, stent drainage remains controversial. The commonly used stents are either an internal double-J (DJ) or an externalized pyeloureteral (PU) stents. We evaluated the outcome of using DJ versus PU stents following open pyeloplasty for UPJO in children. STUDY DESIGN We retrospectively evaluated 175 patients who underwent primary open pyeloplasty in two tertiary hospitals. A total of 110 patients underwent internal DJ stent insertion (63%) while 65 patients (37%) underwent placement of external PU stent. The type of stent used at the time of surgery was according to surgeon preference and experience. Operative time, postoperative hospital stay, overall complications and success rates were compared between the two groups. RESULTS The mean age was 3.8 years, and the mean follow-up was 4 years. Mean operative time was similar in the two groups (145 min). Mean hospital stay was 3.7 and 4.2 days in DJ and PU stent, respectively (p = 0.003) Summary Table . Postoperative complication developed in 9 out of 110 patients with DJ stent (8%), while complications developed in 6 out of 65 patients with PU stent (9%) (p = 0.81). Success rate of pyeloplasty was 95.5% for DJ group versus 97% for PU group (p = 0.63). DISCUSSION Dismembered pyeloplasty remains the standard treatment of choice as a surgical management for UPJO. A debate is still there in respect to the method of PU anastomotic stenting and which stent can be used. The major advantage for external PU stents is that it can be removed safely in the outpatient clinic without any sedation preventing the risk of repeated exposure to general anesthesia. Internal DJ stent provides a shorter hospital stay and comparable complication and success rates compared with PU stent. If we manage to overcome the longer DJ stent duration and facilitate early removal by an easy mode, that does not require another anesthesia at that moment we can find the optimal stent for all pyeloplasty cases. CONCLUSIONS The two types of stents are comparable as regard overall complication and success rates after pyeloplasty. Although internal DJ stent insertion provides a relatively shorter hospital stay, a second operating room visit and anesthesia for removal remains unavoidable.
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Affiliation(s)
- Osama Sarhan
- Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Urology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
| | - Ahmed Al Awwad
- Urology Department, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Abdulhakim Al Otay
- Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Ahmed El Helaly
- Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mustafa Al Ghanbar
- Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fouad Al Kawai
- Urology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Ziad Nakshabandi
- Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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El Helaly A, Al Otay A, Al Rumaih A, Ghanbar M, Al Hussain A, Nakshabandi Z, Sarhan O. Renal growth in children with vesicoureteral reflux, is it a significant clinical indicator? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sarhan O, El Helaly A, Al Otay A, Al Ghanbar M, Nakshabandi Z, Al Kawai F. Critical analysis of the outcome of primary unilateral vesicoureteral reflux in a medium volume center. Afr J Urol 2020. [DOI: 10.1186/s12301-020-00058-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Vesicoureteral reflux (VUR) is a common finding in pediatric age group. Here in we explored the possible risk factors that affect the rate of resolution in patients with primary unilateral VUR under conservative treatment.
Methods
Between 2006 and 2014, we retrospectively evaluated all VUR patients and included only patients with primary unilateral VUR. Records were reviewed for patient age at diagnosis, antenatal history, patient gender, mode of presentation, side, and grade of VUR, associated hydronephrosis (HN) on renal ultrasound, presence of scarring and split function on dimercaptosuccinic acid (DMSA) scan. Clinical and radiological outcomes were assessed. Both univariate and multivariate analysis were conducted.
Results
A total of 68 patients with primary unilateral VUR were included (32 boys and 36 girls) with a mean age of 10 months (range 1–32). Antenatal HN was detected in 50% of patients. In 15 cases (22%), VUR was of high grade (IV–V). Associated HN was evident in 39 patients (57%). DMSA scans showed renal scarring in 16 patients (23%). After a mean follow-up of 7 years, VUR resolved in 49 patients (72%). Significant predictors for VUR resolution were VUR grade, DMSA split function and associated high-grade HN. High-grade HN with VUR was the only significant independent risk factor.
Conclusions
The rate of resolution in primary unilateral VUR under conservative treatment is significantly affected by VUR grade, DMSA split renal function and the presence of associated HN. Association of high-grade HN with VUR carries a low chance for spontaneous resolution.
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Al Otay A, Sarhan O, El-Tholoth HS, Alhelaly A, Al Akrash H, Al Ghanbar M, Al Bedaiwi K, Nakshabandi Z, Obeid A. Different managements of horseshoe kidney stones, any difference in the outcome? Urol Ann 2018; 10:287-290. [PMID: 30089987 PMCID: PMC6060601 DOI: 10.4103/ua.ua_116_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim is to assess the outcomes of different approaches for the management of renal stones associated with horseshoe kidneys (HSKs) in our institution over a 12-year period. Methods A retrospective review of 144 patients with HSKs who presented from 2000 to 2012 was performed. Twenty-eight patients (19.4%) were found to have renal stones. Demographic data were collected; the method of treatment and the outcomes of stone management were reviewed. We excluded patients with non-functioning moieties and associated genitourinary anomalies, and those with incomplete data. Results We included 25 patients, of which 16 males (64%) and 9 females (36%), with a mean age of 37 years. Mean serum creatinine level was 66 mmol/L. Eleven patients with a stone size <8 mm were treated expectantly with medical treatment, with only one patient requiring endoscopic intervention. Six patients (24%) with a stone size between 1 cm and ≤2 cm were treated with extracorporeal shock wave lithotripsy (ESWL) with the placement of double J stents, and seven patients (28%) with a stone size of >2 cm were treated with percutaneous nephrolithotomy. One patient with a 10 mm stone was treated using flexible ureteroscopy. No significant perioperative complications were encountered. Conclusions Indications, methods of treatment, and outcomes of management of stones associated with HSKs were comparable to those for stones associated with normal kidneys. Tailored approach based on stone size is highly recommended. ESWL accompanied with ureteric stenting is a promising strategy for the management of stones associated with HSKs in selected patients requiring intervention.
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Affiliation(s)
- Abdulhakim Al Otay
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Osama Sarhan
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hossam S El-Tholoth
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Alhelaly
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hamad Al Akrash
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mustafa Al Ghanbar
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled Al Bedaiwi
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ziad Nakshabandi
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ali Obeid
- Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Sarhan OM, Helaly AE, Al Otay A, Ghanbar MA, Nakshabandi Z. Isolated low grade prenatally detected unilateral hydronephrosis: do we need long term follow-up? Int Braz J Urol 2018; 44:812-818. [PMID: 29757579 PMCID: PMC6092662 DOI: 10.1590/s1677-5538.ibju.2017.0474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/27/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. Materials and Methods: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. Results: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. Conclusions: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.
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Affiliation(s)
- Osama M Sarhan
- Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahmed El Helaly
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Mansoura Health Insurance Hospital, Mansoura, Egypt
| | - Abdulhakim Al Otay
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mustafa Al Ghanbar
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ziad Nakshabandi
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Sarhan OM, El Helaly A, Al Otay AH, Al Ghanbar M, Nakshabandi Z. Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history? Can Urol Assoc J 2017; 12:E137-E141. [PMID: 29283090 DOI: 10.5489/cuaj.4587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Fetal hydronephrosis (HN) occurs in approximately 5% of pregnancies and its prognosis depends mainly on the grade of the dilation. We attempted to determine the fate of isolated, unilateral, high-grade HN in children with antenatal diagnosis, emphasizing the risk factors for progression. METHODS We retrospectively evaluated 424 children (690 kidney units) with antenatal HN in the period between 2010 and 2014. We included only those patients with isolated high-grade HN (Society for Fetal Urology [SFU] Grade 3 or 4). Patients with bilateral HN or unilateral HN associated with dilated ureter or reflux and patients with missed followup were excluded. The prognosis of HN (whether improved, stabilized, or progressed) and the need for surgical intervention in this subset of patients was evaluated. RESULTS A total of 44 children (34 boys and 10 girls) were identified. Ultrasounds showed SFU Grade 3 HN in 24 (54%) and SFU Grade 4 HN in 20 (46%). After a mean followup of three years (range 1-5), 10 children (23%) needed surgical intervention; four Grade 3 HN (16%) and six Grade 4 HN (30%). The majority of children with differential renal function (DRF) ≥40% (69.5%) were stable or improved. Five girls (50%) and five boys (17%) progressed and required surgical intervention. No patient with a renal pelvis anteroposterior diameter (APD) <1.5 cm needed surgical intervention. CONCLUSIONS Infants with isolated, unilateral, high-grade HN might be managed conservatively. Male gender, DRF ≥40%, SFU Grade 3 HN, and APD <1.5 cm were favourable prognostic factors.
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Affiliation(s)
- Osama M Sarhan
- Mansoura Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed El Helaly
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Abdul Hakim Al Otay
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mustafa Al Ghanbar
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ziad Nakshabandi
- Pediatric Urology Division, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
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Sarhan OM, Albedaiwi K, Al Harbi B, Al Otay A, Al Ghanbar M, Nakshabandi Z. Unilateral Renal Agenesis: Necessity of Postnatal Evaluation in a Contemporary Series. Urology 2016; 98:144-148. [DOI: 10.1016/j.urology.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
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Sarhan O, Nakshabandi Z, Alghanbar M, Alotay A, Sherif I, Whitehead C, El-Husseini A. Posterior urethral valves: Metabolic consequences in a cohort of patients. J Pediatr Urol 2015; 11:216.e1-6. [PMID: 26096436 DOI: 10.1016/j.jpurol.2015.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/22/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Despite the improvements in diagnosis and management of posterior urethral valves (PUVs), about one third of patients develop chronic kidney disease (CKD). Children with PUVs might have abnormal calcium, phosphorus, vitamin D and parathyroid hormone levels, which could affect their bone growth and overall health. OBJECTIVE The aim was to determine the relationship between kidney function, vitamin D deficiency and secondary hyperparathyroidism in children with PUVs. PATIENTS AND METHODS Sixty-four children with PUVs were followed for a period of 3.64 ± 2.50 years after their initial presentation and management. Their laboratory parameters were compared with 20 age-, gender- and race-matched children in a control group, including: serum calcium, phosphorus, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D levels, and kidney function. RESULTS Children with PUVs had significantly lower estimated kidney function (P = 0.006) and vitamin D levels (P < 0.001) and higher iPTH levels (P = 0.042). There were no significant between-group differences in serum calcium, phosphorus, alkaline phosphatase, sodium, potassium, and bicarbonate levels. There was a strong correlation between the degree of vitamin D deficiency and hyperparathyroidism and the degree of kidney dysfunction (r = 0.52 and -0.52, respectively) in the PUV group. On a multivariate analysis, the kidney dysfunction was the only independent predictor of vitamin D deficiency (ρ = 0.271, P < 0.001), while kidney dysfunction, serum calcium and alkaline phosphatase were independent predictors for hyperparathyroidism (ρ = 0.925, P<0.001, ρ = 0.933, P<0.001 and ρ = 0.913, P < 0.001, respectively). DISCUSSION The prevalence of CKD in children with PUVs ranges from 30 to 60%. Patients with CKD are more likely to have vitamin D deficiency and display more-prominent hyperparathyroidism. Compared with a control group with normal kidney function, the present cohort had lower 25-hydroxyvitamin D and higher iPTH serum levels. Abnormal kidney function was a major predictor for both serum levels. In this cohort, there were no significant differences in serum calcium and phosphorus between children with PUVs and the control group, and also between those with and without CKD. On the contrary, vitamin D level decreased early in the disease and progressively declined thereafter, while iPTH was the opposite. These findings were comparable to previous studies. This study had some limitations because it was a single center cross-sectional non-randomized study. However, the findings in this study can be extrapolated to children with PUVs and CKD from other origins because the unit is considered as a referral center in the Middle East region. CONCLUSION Abnormal kidney function, vitamin D deficiency, and secondary hyperparathyroidism are prevalent in children with PUVs. Kidney function is the main determinant of vitamin D and parathyroid hormone levels. Efforts should be directed toward managing CKD, and controlling vitamin D deficiency and hyperparathyroidism in children after ablation of PUV.
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Affiliation(s)
- O Sarhan
- Division of Pediatric Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - Z Nakshabandi
- Division of Pediatric Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - M Alghanbar
- Division of Pediatric Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - A Alotay
- Division of Pediatric Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - I Sherif
- Biochemistry Department, Mansoura University, Mansoura, Egypt.
| | - C Whitehead
- Division of Nephrology, University of Kentucky, Lexington, KY, USA.
| | - A El-Husseini
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt; Division of Nephrology, University of Kentucky, Lexington, KY, USA.
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Alghanbar M, Sarhan O, Alotay A, Nakshabandi Z. PD4-09 MULTICYSTIC DYSPLASTIC KIDNEY: IMPACT OF IMAGING MODALITY SELECTION ON THE INITIAL EVALUATION AND PROGNOSIS. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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