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Chan VWS, Chiu PKF, Yee CH, Yuan Y, Ng CF, Teoh JYC. A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions. World J Urol 2021. [PMID: 32462305 DOI: 10.1007/s00345-%20020-%2003246-4] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
PURPOSE AND OBJECTIVE We performed a systematic review on COVID-19 and its potential urological manifestations. METHODS A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner. RESULTS There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30-13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46-100%) amongst them. 5.74% (95% CI 2.88-9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71-83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%. CONCLUSIONS Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures.
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Affiliation(s)
- Vinson Wai-Shun Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Peter Ka-Fung Chiu
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Chi-Hang Yee
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Yuhong Yuan
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China.
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Chan VWS, Chiu PKF, Yee CH, Yuan Y, Ng CF, Teoh JYC. A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions. World J Urol 2020; 39:3127-3138. [PMID: 32462305 PMCID: PMC7251800 DOI: 10.1007/s00345-020-03246-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose and objective We performed a systematic review on COVID-19 and its potential urological manifestations. Methods A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner. Results There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30–13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46–100%) amongst them. 5.74% (95% CI 2.88–9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71–83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%. Conclusions Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures. Electronic supplementary material The online version of this article (10.1007/s00345-020-03246-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vinson Wai-Shun Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Peter Ka-Fung Chiu
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Chi-Hang Yee
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Yuhong Yuan
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China.
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Bang H, Park H, Park S, Choi E, Cho MS, Sung SH, Choi SY, Cho YM, Jeong SU, Ro JY. Clinicopathologic study of 60 cases of urothelial neoplasms with inverted growth patterns: Reclassification by international consultation on urologic disease (ICUD) recommendations. Ann Diagn Pathol 2019; 44:151433. [PMID: 31785538 DOI: 10.1016/j.anndiagpath.2019.151433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 10/01/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most urothelial neoplasms of the bladder show an exophytic papillary pattern, but some show an inverted growth pattern. In 2004, the World Health Organization (WHO) released a detailed histologic classification system for papillary urothelial neoplasms, but not for inverted forms. The International Consultation on Urologic Disease (ICUD) recommendations of 2012 are applicable to inverted/endophytic papillary lesions as follows: 1) inverted papilloma (IP), 2) inverted papillary urothelial neoplasm of low malignant potential (IPUNLMP), 3) inverted papillary urothelial carcinoma, low grade, non-invasive (IPUCLG-NI), 4) inverted papillary urothelial carcinoma, high grade, non-invasive (IPUCHG-NI), 5) inverted papillary urothelial carcinoma, high grade, invasive (IPUCHG-I). However, only atypical cellular morphology was considered for classification in the 2012 ICUD recommendations, and data to support to validate this new grading system are lacking. METHODS Sixty cases of inverted urothelial papillary tumors were classified into 5 categories according to 2012 ICUD and 2016 WHO/ISUP recommendations to evaluate their clinical, pathological, and immunohistochemical characteristics. Two subgroups were defined as subgroup 1, IP and IPUNLMP, and subgroup 2, IPUCLG-NI, IPUCHG-NI, and IPUCHG-I. Clinical features (age, sex, history of urothelial carcinoma, smoking history, size, and multifocality) and histologic features (nuclear pleomorphism, mitotic count, mitosis level, apoptosis, luminal necrosis, trabecular thickening, anastomosing trabeculae, hypercellularity, loss of polarity, peripheral palisading, palisading with central streaming, and discohesiveness) were evaluated. Immunohistochemical stains for CK20, CD44, P53, p16, Ki-67, cyclin D1 and c-erbB2 were performed. RESULTS A total of 60 cases were classified as 10 cases of IP, 29 cases of IPUNLMPs, 15 cases of IPUCLG-NI, 4 cases of IPUCHG-NI, and 2 cases of IPUCHG-I. Compared to subgroup 1, subgroup 2 showed larger tumor size, more nuclear irregularity, higher mitotic count (hot spot and per 10 high power fields), more upper level mitosis (>1/2), and more frequent apoptosis, luminal necrosis, surface papillary component, trabecular thickening, anastomosing irregular trabeculae, hypercellularity, loss of polarity, peripheral palisading with central streaming, and discohesiveness, and absence of umbrella cells and urothelial eddies. CK20, Ki67, and c-erbB2 were the only markers that were differently expressed in the two subgroups, with more expression in subgroup 2. CONCLUSIONS The 2012 ICUD recommendations are valid to classify inverted papillary urothelial tumors. However, other histologic features besides atypical cellular morphology should also be considered to distinguish subgroup 1 and subgroup 2 inverted papillary urothelial tumors.
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Affiliation(s)
- Heejin Bang
- Department of Pathology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Heejung Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sanghui Park
- Departments of Pathology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Euno Choi
- Departments of Pathology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Min-Sun Cho
- Departments of Pathology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Sun Hee Sung
- Departments of Pathology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Sun Young Choi
- Department of Radiology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yong Mee Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Se Un Jeong
- Department of Pathology, Armed Forces Medical Research Institute, 90, Jaun-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Jae Y Ro
- Department of Pathology and Genomic Medicine, The Methodist Hospital and Weill Medical College of Cornell University, Houston, TX 77030, USA.
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Pelliccia P, Sferrazza Papa S, Cavallo F, Tagi VM, Di Serafino M, Esposito F, Persico A, Vezzali N, Vallone G. Prenatal and postnatal urinary tract dilation: advantages of a standardized ultrasound definition and classification. J Ultrasound 2019; 22:5-12. [PMID: 30484141 PMCID: PMC6430301 DOI: 10.1007/s40477-018-0340-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022] Open
Abstract
Urinary tract dilatation is identified sonographically in 1-2% of fetuses and reflects a spectrum of possible nephro-uropathies. There is significant variability in the clinical management of individuals with prenatal urinary tract dilatation to postnatal urinary pathologies, because of a lack of consensus and uniformity in defining and classifying urinary tract dilation. Ultrasonography is the first step to screen and diagnose kidneys and the urinary tract diseases of the children. The need for a correct ultrasound approach led to the realization of algorithms aimed at standardizing the procedures, the parameters and the classifications. Our objective was to highlight the strengths of the Classification of Urinary Tract Dilation (UTD) suggested by the Consensus Conference which took place in 2014 with the participation of eight Scientific Societies and was subsequently published on the Journal of Pediatric Urology. Before its spread out, the definition of UTD was not uniform and the ultrasonographic measurements were not clearly defined, leading to misunderstandings between physicians. The Classification by the Consensus Conference of 2014 represents a revolutionary tool for the diagnosis and management of UTD. Furthermore, the parameters suggested by the classification proposed are applicable for both prenatal and postnatal classification, ensuring a correct follow-up in children with UTD whose diagnosis had been already made during pregnancy.
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Affiliation(s)
| | | | - Federica Cavallo
- Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy
| | | | - Marco Di Serafino
- Department of Emergency Radiology, Antonio Caldarelli Hospital, Naples, Italy
| | - Francesco Esposito
- Department of Radiology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Antonello Persico
- Department of Pediatric Surgery, University of Chieti-Pescara, Pescara, Italy
| | - Norberto Vezzali
- Department of Radiology, Regional Hospital of Bolzano, Bolzano, Italy
| | - Gianfranco Vallone
- Paediatric Radiology Department, "Federico II" University Hospital, Naples, Italy
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Reitz A, Doggweiler R. [Not Available]. Praxis (Bern 1994) 2017; 106:71-76. [PMID: 28103167 DOI: 10.1024/1661-8157/a002582] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Die funktionelle Urologie befasst sich mit der Diagnostik und Therapie von Störungen der Harnblasen- und Beckenbodenfunktion und der Harninkontinenz. Die urodynamische Funktionsdiagnostik als zentrale diagnostische Methode ermöglicht durch die Messung einfacher physiologischer Parameter eine direkte Beurteilung der Funktion des unteren Harntraktes. Die Urodynamik dient dazu, klinische Symptome quantitativ zu reproduzieren, die Änderung physiologischer Parameter während der Messung in einen pathophysiologischen Zusammenhang zu stellen, eine Diagnose abzuleiten, eine Behandlung einzuleiten und im Verlauf deren Erfolg zu kontrollieren. Facetten der funktionellen Urologie sind die Neurourologie, die Urologie der Frau, die funktionelle Kinderurologie, die psychosomatische Urologie und die Behandlung der Harninkontinenz bei Frauen und Männern jeglichen Alters.
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Affiliation(s)
- André Reitz
- 1 KontinenzZentrum Hirslanden, Klinik Hirslanden, Zürich
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Guan X, Zhao C, Ou ZY, Wang L, Zeng F, Qi L, Tang ZY, Dun JG, Liu LF. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study. Asian J Androl 2015; 17:120-3. [PMID: 25248659 PMCID: PMC4291855 DOI: 10.4103/1008-682x.138189] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/22/2014] [Accepted: 07/15/2014] [Indexed: 12/20/2022] Open
Abstract
The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness (UPOINT) phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI) was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores (r = 0.796, P< 0.001). Symptom duration was associated with a greater number of positive domains (r = 0.589, P< 0.001). With 6 months follow-up at least, 75.0% (105/140) had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P< 0.0001). Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.
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Affiliation(s)
- Xiao Guan
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Cheng Zhao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhen-Yu Ou
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Long Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Feng Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lin Qi
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zheng-Yan Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jin-Geng Dun
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Long-Fei Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
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Kremsdorf R. Commentary to 'Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)'. J Pediatr Urol 2014; 10:998-9. [PMID: 25434296 DOI: 10.1016/j.jpurol.2014.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Robin Kremsdorf
- The Warren Alpert Medical School of Brown University, Hasbro Children's Hospital, Department of Pediatrics, 593 Eddy St., Potter 200, Providence RI 02903, USA.
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Talebian S. Transitioning to ICD-10. Urol Nurs 2014; 34:29-37. [PMID: 24716378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Frazier KS, Seely JC, Hard GC, Betton G, Burnett R, Nakatsuji S, Nishikawa A, Durchfeld-Meyer B, Bube A. Proliferative and nonproliferative lesions of the rat and mouse urinary system. Toxicol Pathol 2012; 40:14S-86S. [PMID: 22637735 DOI: 10.1177/0192623312438736] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying lesions observed in the urinary tract of rats and mice. The standardized nomenclature of urinary tract lesions presented in this document is also available electronically on the Internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous developmental and aging lesions as well as those induced by exposure to test materials. A widely accepted and utilized international harmonization of nomenclature for urinary tract lesions in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.
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Affiliation(s)
- Kendall S Frazier
- GlaxoSmithKline-Safety Assessment, King of Prussia, Pennsylvania 19406, USA.
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Yu JH, Kim SH, Sohn SH, Paik KH, Lee JZ, Kim JH, Park JK, Ryu KS, Jun JK, Cho YK, Chung JY. Development of Korean Academy of Medical Sciences Guideline rating the physical impairment; kidney, bladder, urethra, male and female reproductive systems (preliminary report). J Korean Med Sci 2009; 24 Suppl 2:S277-87. [PMID: 19503685 PMCID: PMC2690061 DOI: 10.3346/jkms.2009.24.s2.s277] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2009] [Accepted: 05/04/2009] [Indexed: 11/20/2022] Open
Abstract
For the evaluation of the kidney impairment, serum creatinine concentrations or glomerular filtration rates are mainly used, and the conditions of solitary or transplanted kidney and chronic dialysis are also taken into the considerations. Some symptoms and signs of the chronic renal disability in spite of adequate treatment add one additional grade. For evaluating bladder and urethral impairment, the criteria include voiding symptoms and signs. The patients with urinary diversions have impairment grades depending on the alteration of upper urinary tract function. For penile impairment, the degrees are evaluated using the international index of erectile function, nocturnal penile tumescence and color doppler ultrasonography. For evaluating impairment of other male reproductive organs, functional and anatomical changes of these organs, analysis of the semen or hormones and the state of solitary testis are used as the criteria. For evaluating impairment of female reproductive organs, pregnancy potential, requirement of continuous treatment and the ability of sexual intercourse are used. Also, degree of impairment is modified according to the ages in evaluating female reproductive systems. We have tried to make this evaluation system objective, scientific, and convenient, but still find it leaving much to be desired.
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Affiliation(s)
- Ji Hyeong Yu
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sang Hyun Kim
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Seung Hwan Sohn
- Department of Internal Medicine, Dr. Sohn's Hemodialysis Center, Seoul, Korea
| | - Kyung Hoon Paik
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jeong Zoo Lee
- Department of Urology, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea
| | - Jang Hwan Kim
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju, Korea
| | - Ki-Sung Ryu
- Department of Obstetrics & Gynecology, St. Mary's Hospital, the Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jong Kwan Jun
- Department of Obstetrics & Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Kyoon Cho
- Department of Obstetrics & Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Yong Chung
- Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Crevoisier J, Poindessous JL. [6/11 Re-education and probing of intermittent urination]. Soins 2008:59-60. [PMID: 18770990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Joël Crevoisier
- Service de médecine physique et réadaptation Hôpital Victor-Jousselin, Dreux.
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12
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Bilginer Y, Aki FT, Topaloglu R, Tekgul S, Demirkaya E, Düzova A, Besbas N, Ozen S, Erkan I, Bakkaloglu A, Bakkaloglu M. Renal transplantation in children with lower urinary tract dysfunction of different origin: a single-center experience. Transplant Proc 2008; 40:85-6. [PMID: 18261552 DOI: 10.1016/j.transproceed.2007.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Renal transplantation in patients with lower urinary tract dysfunction (LUTD) of various origins is a challenging issue in the field of pediatric transplantation. We report our single-center experience to evaluate patient and graft survivals as well as the risks of the surgery and immunosuppressive therapy. PATIENTS AND METHODS Among 70 pediatric transplant patients, 11 displayed severe LUTD. Videourodynamic tests were performed on all patients preoperatively as well as postoperatively if required. The cause of urologic disorders were neurogenic bladder (n = 5) and urethral valves (n = 6). Clean intermittent catheterization (CIC) was needed in six patients to empty the bladder. To achieve a low-pressure reservoir with adequate capacity pretransplantation augmentation ileocystoplasty was created in four patients and gastrocystoplasty in one patient. Three of the patients received kidneys from cadaveric and eight from living donors. All patients were treated with calcineurin-based immunosuppressive therapy. RESULTS The mean age at transplantation was 15 +/- 4.7 years. The median follow-up after transplantation was 36 months (6 to 62 months). At their last visit the median creatinine level was 0.95 mg/dL (0.8 to 2.4 mg/dL). Three patients had recurrent symptomatic urinary tract infections who had augmented bladder on CIC. One patient with ileocystoplasty who developed urinary leak and ureteral stricture in the early postoperative period was treated by an antegrade J stent. CONCLUSION Severe LUTD carried high risks for the grafted kidney. However, our data suggested that renal transplantation is a safe and effective treatment modality, if the underlying urologic diseases properly managed during the transplantation course. Since surgery and follow-up is more complicated, patient compliance and experience of transplantation team have significant impacts on outcomes.
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Affiliation(s)
- Y Bilginer
- Department of Pediatrics Nephrology Unit, Hacettepe University School of Medicine, Ankara, Turkey
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Clavagnier I. [Urinary tract sounding: position and surveillance]. Rev Infirm 2007:27-29. [PMID: 18159687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Stengel B, Antignac C, Baverel G, Choukroun G, Cussenot O, Dussaule JC, Friedlander G, Lang P, Lelièvre-Pégorier M, Massy Z, Monteiro R, Parini A, Soulillou JP, Baud L, Ronco P. [Renal and urinary tract disease national research program]. Nephrol Ther 2007; 3:157-62. [PMID: 17658443 DOI: 10.1016/j.nephro.2007.05.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Accepted: 05/22/2007] [Indexed: 11/29/2022]
Abstract
The National Institute of Health and Medical Research (Inserm), the Society of Nephrology, and the French Kidney Foundation recognized the need to create a National Research Program for kidney and urinary tract diseases. They organized a conference gathering 80 researchers to discuss the state-of-the art and evaluate the strengths and weaknesses of kidney and urinary tract disease research in France, and to identify research priorities. From these priorities emerged 11 of common interest: 1) conducting epidemiologic studies; 2) conducting large multicenter cohorts of well-phenotyped patients with blood, urine and biopsy biobanks; 3) developing large scale approach: transcriptomics, proteomics, metabolomics; 4) developing human and animal functional imaging techniques; 5) strengthening the expertise in renal pathology and electrophysiology; 6) developing animal models of kidney injury; 7) identifying nontraumatic diagnostic and prognostic biomarkers; 8) increasing research on the fetal programming of adult kidney diseases; 9) encouraging translational research from bench to bedside and to population; 10) creating centers grouping basic and clinical research workforces with critical mass and adequate logistic support; 11) integrating and developing european research programs.
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Affiliation(s)
- Bénédicte Stengel
- Inserm U780, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France.
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15
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Urological diseases cost Americans $11 billion a year, NIH reports. Hosp Health Netw 2007; 81:72-3. [PMID: 17695171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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16
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Bonniaud V, Paratte B, Tatu L, Vuillier F, Monnier G, Labat JJ, Chartier-Kastler E, Ruffion A. Chapitre D - Troubles vésico-sphinctériens et hernies discales. Prog Urol 2007; 17:365-70. [PMID: 17622060 DOI: 10.1016/s1166-7087(07)92331-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Lower urinary tract dysfunction related to herniated disk can raise complex diagnostic and management problems. This article reviews the two main clinical situations encountered: documented lower urinary tract dysfunction in a context of cauda equina syndrome secondary to herniated disk and lower urinary tract dysfunction representing the only clinical sign of herniated disk with no other alteration of the neurological examination. Regardless of the neurological signs, urodynamic assessment is essential to characterize any lower urinary tract dysfunction and to determine the modalities of long-term surveillance.
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Affiliation(s)
- V Bonniaud
- Service de Médecine Physique et de Réadaptation, Centre hospitalo-universitaire de Dijon, France.
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Abstract
Urologic complications, observed since the beginning of renal transplantation, cause significant morbidity and mortality. In the first few years the procedure was performed, incidence of urologic complications was reported to be 10% to 25%. Recently, the incidence of urologic complications after renal transplantation has decreased to 2.5% to 12.5%; unfortunately, a higher incidence exists in pediatric recipients, reaching approximately 20% with an associated 58% and 74% graft survival rates for cadaveric and living-related transplantation, respectively. We retrospectively analyzed the postoperative urologic complications reported in the medical charts of 1523 consecutive kidney transplantations (1130 men, 74.2%; 393 women, 25.8%; mean age, 31.9 +/- 10.9 years; range, 7 to 64 years; 354 cadaveric, 23.2%; 1169 living, 76.8%) performed by our team since 1975. The first 321 procedures took place at Hacettepe University Hospital in Ankara, Turkey, and the remaining 1202 were performed at Baskent University Hospital in Ankara. Urologic complications occurred in 46 (3%) recipients. Twenty-three (1.5%) of these patients had urine leakage, 15 (1%) had urinary obstruction due to ureteral stricture, 6 (0.4%) had distal ureter necrosis, and 2 (0.1%) developed renal calculi in the late postoperative period. Twenty-four out of 46 required reoperation for urologic complications. The remaining 22 patients were treated conservatively in our interventional radiology department with excellent results. In conclusion, urologic complications will always occur in the posttransplant period. Early diagnosis by experienced personnel and use of interventional radiology can greatly reduce the need for surgical treatment.
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Affiliation(s)
- A Dalgic
- Baskent University Hospital, Department of General Surgery, Ankara, Turkey
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18
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Abstract
BACKGROUND Urological complications are frequent in Menkes syndrome, a very rare X-linked recessive disorder of copper (Cu) metabolism. AIM To evaluate the role of Cu therapy in preventing the progression of urological complications. SUBJECTS AND METHODS We retrospectively enrolled 57 patients with Menkes syndrome (55 published case reports and two of our own unpublished cases) and investigated the reported urological complications, distinguishing the patients with or without Cu replacement therapy and evaluating the efficacy of this therapy in the prevention of urological complications. RESULTS The most frequent urological complication was bladder diverticulum (38.6% of the total patients); obstruction bladder outflow and rupture of the kidney were less frequent (both 1.8% of the total). The number of congenital urological complications increased progressively by age category; in fact, 77.8% of patients did not report urological complications at the age of 0.4+/-0.2 y, and 28.6% of them displayed > or = two congenital urological complications at the age of 9.3+/-2.6 y. The percentage of urological complications found in younger patients not on Cu therapy did not differ from that of older patients treated with Cu therapy. A comparison between patients of the same age interval, who were or were not treated with Cu, showed that treated children had fewer urological complications than untreated children. CONCLUSION Our investigation suggests that Cu therapy in patients with Menkes syndrome does not prevent the progression of urological complications; however, it might delay their worsening.
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Affiliation(s)
- Marco Zaffanello
- Department of Mother and Child, Biology-Genetics, Section of Paediatrics, University of Verona, Verona, Italy.
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19
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Matsumoto A, Tobe T, Kamijima S, Araki K, Naya Y, Igarashi T, Ichikawa T. The usefulness of ureterorenoscopic examination in evaluation of upper tract disease. Int J Urol 2006; 13:509-14. [PMID: 16771717 DOI: 10.1111/j.1442-2042.2006.01352.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The objective of the present study was to clarify the indications, usefulness and limitations of ureterorenoscopy. MATERIAL AND METHODS From January 1998 to June 2004, 72 consecutive patients (48 men and 24 women) with a mean age of 66 years (range, 27-83 years) underwent ureterorenoscopy to diagnose upper urinary tract tumors (UUT). Median follow-up was 24 months (range, 1-73 months). Patients were divided into four subgroups by voided urine cytology and preoperative radiographic findings. Group A (n=11, 15.3%), positive voided urine cytology and positive preoperative radiographic findings; group B (n=5, 6.9%), positive cytology and negative radiographic findings; group C (n=48, 66.7%), negative cytology and positive radiographic findings and group D (n=8, 11.1%), frank hematuria originating from the UUT but negative cytology and negative radiographic findings. We compared the findings of ureterorenoscopic examination and biopsy with the results of retrograde pyelography and cytology of upper tract urine. For each examination, the following diagnostic indices were assessed: sensitivity, specificity, positive-predictive-value (PPV) and negative-predictive-value (NPV) and accuracy. Statistical analysis was performed using McNemar's test. RESULTS For ureterorenoscopy, sensitivity was 94%, specificity 59%, PPV 72%, NPV 92% and accuracy 76%. For biopsy, sensitivity was 77%, specificity 100%, PPV 100%, NPV 80% and accuracy 88%. Accuracy of ureterorenoscopy tended to be superior to that of retrograde pyelography. Ureterorenoscopy was most useful in the group which consisted of 48 patients (66.7%) with negative voided urine cytology and positive preoperative radiographic findings. This group was the only group in which accuracy of ureterorenoscopic biopsy was superior to that of urine cytology, significantly (P=0.03). CONCLUSION Results indicated that ureterorenoscopy is most suitable and gives superior accuracy in patients with positive radiographic findings and negative voiding cytology. Ureterorenoscopic biopsy of the upper urinary tract would provide useful information when considering therapeutic strategies, such as nephron-sparing management.
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Affiliation(s)
- Akihiro Matsumoto
- Department of Urology, Graduate School of Medicine, Chiba University Hospital, Chiba, Japan
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20
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Zargar MA, Shahrokh H, Mohammadi Fallah MR, Zargar H. Comparing Taguchi and anterior Lich-Gregoir ureterovesical reimplantation techniques for kidney transplantation. Transplant Proc 2006; 37:3077-8. [PMID: 16213310 DOI: 10.1016/j.transproceed.2005.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Urologic complications are common in renal transplant surgery. Numerous innovations have been developed to circumvent ureterovesical anastomotic failure. In addition to the popular modified Lich-Gregoir technique, we evaluated Taguchi's method which is both quick and easy to perform. One hundred forty four patients were prospectively compared using Taguchi (n = 44) or the modified Lich-Gregoir (n = 100) for anastomotic time, which differed significantly (10.2 minutes for Taguchi, vs. 24.6 minutes to Lich-Gregoir; P < .005). Minor complications, however, were less among Lich-Gregoir patients (P < .02). We concluded to continue using the modified Lich-Gregoir ureteroneocystostomy despite taking longer time to perform.
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Affiliation(s)
- M A Zargar
- Hasheminejad Medical Center, Tehran, Iran.
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21
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22
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Höfner K. Diagnostik der Obstruktion des unteren Harntraktes beim Mann. Urologe A 2004; 43:1301-5. [PMID: 15338137 DOI: 10.1007/s00120-004-0675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- K Höfner
- Klinik für Urologie und Kinderurologie, Evangelisches Krankenhaus Oberhausen.
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Türkölmez S, Atasever T, Türkölmez K, Gögüs O. Comparison of Three Different Diuretic Renal Scintigraphy Protocols in Patients With Dilated Upper Urinary Tracts. Clin Nucl Med 2004; 29:154-60. [PMID: 15162983 DOI: 10.1097/01.rlu.0000113852.57445.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To compare 3 different diuretic renal scintigraphy protocols in patients with dilated upper urinary tract. MATERIALS AND METHODS Three diuresis renography protocols were performed in 22 adult patients (28 kidneys) with upper urinary tract dilatation. The diuretic was given 20 minutes after (F+20), at the same time as (F+0), and 15 minutes before (F-15) radionuclide administration. The mean age was 29.8 years (range, 18-43 years). The 3 protocols were identical, except for the time of injection of furosemide. The F+0 protocol could not be performed in 1 and F-15 in 2 of the patients. Each of the 3 protocols was performed for the rest of the patients. The results were classified as nonobstructive, equivocal, and obstructive according to the renogram images and curves. RESULTS None of the patients showed equivocal results in both F+0 and F-15 protocols. In the F+20 studies, 7 of the 28 kidneys were evaluated as equivocal. Of these, 5 kidneys showed nonobstructive and 2 kidneys revealed obstructive renogram patterns with the other 2 protocols (F+0 and F-15). Moreover, one kidney, which was evaluated as nonobstructive in the F+20 protocol, showed an obstructive pattern in both F+0 and F-15 protocols. All of the kidneys showing obstructive patterns in the F+20 study also revealed obstruction in the F+0 and F-15 investigations. We could not find any difference between the renogram patterns of F+0 and F-15 investigations. CONCLUSIONS F+0 and F-15 protocols allow clarification in cases of equivocal F+20 studies. Because the F+0 study is more practical and shorter, we suggest the F+0 method when equivocal results are obtained by an F+20 study or as a single test when there is only one opportunity to confirm or exclude the presence of obstruction.
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Affiliation(s)
- Seyda Türkölmez
- Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey.
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24
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Shaw C, Matthews RJ, Perry SI, Williams K, Spiers N, Assassa RP, McGrother C, Dallosso H, Jagger C, Mayne C, Clarke M. Validity and reliability of a questionnaire to measure the impact of lower urinary tract symptoms on quality of life: The Leicester impact scale. Neurourol Urodyn 2004; 23:229-36. [PMID: 15098218 DOI: 10.1002/nau.20017] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To develop a condition specific quality of life measure for males and females with urinary storage symptoms of urgency, frequency, nocturia and incontinence. MATERIALS AND METHODS A sample of community dwelling males and females aged 40 years or more who were taking part in an epidemiological study provided data for development and validation of the scale. Questions were developed from literature review and discussions with clinicians and patients. Inclusion of items was dependent on levels of missing data and principal components analysis. Validity was assessed by comparison with the Hospital Anxiety and Depression Scale, the Bradburn Negative Affect Scale and single questions concerning the problematic nature of symptoms. Construct validity was assessed by comparing cases and non-cases, and patients with different symptom patterns. Test-retest and inter-rater reliability statistics were calculated for individual items. Responsiveness to change was measured in subjects taking part in a randomised controlled trial of a nursing intervention. RESULTS The scale showed high levels of internal consistency and measures of construct validity were as hypothesised. Test-retest and inter-rater reliability was moderate to excellent. The distribution of scores was skewed with low levels of impact but the questionnaire was responsive to conservative treatments in patients receiving a nursing intervention. CONCLUSIONS The questionnaire proved to be a valid and reliable interviewer administered instrument for measuring impact of urinary symptoms.
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Affiliation(s)
- C Shaw
- Department of General Practice, University of Wales College of Medicine, Maelfa, Llanedeyrn, Cardiff, Wales, United Kingdom.
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Pinney SM, Freyberg RW, Levine GE, Brannen DE, Mark LS, Nasuta JM, Tebbe CD, Buckholz JM, Wones R. Health effects in community residents near a uranium plant at Fernald, Ohio, USA. Int J Occup Med Environ Health 2003; 16:139-53. [PMID: 12921382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVES Health outcomes in persons who lived in the area surrounding a U.S. Department of Energy (DOE) uranium processing plant near Fernald, Ohio were evaluated using data of Fernald Medical Monitoring Program (FMMP) participants. METHODS Residential history information was used to identify participants who lived in close proximity to the plant (less than 2 miles), in the direction of groundwater runoff (south of the plant), or used a well or cistern as a drinking water source. Standardized prevalence ratios (SPRs) for certain disease endpoints were calculated using the U.S. National Health Interview Survey(NHIS) and the National Health and Nutrition Examination Survey (NHANES) data files for comparison rates. RESULTS Findings suggest that prior living within the Fernald exposure domain is related to increased prevalence of urinary system disease. Statistically significant elevations of bladder disease (standardized prevalence ratio or SPR = 1.32) and kidney disease (SPR = 2.15), including sub-categories, kidney stones (SPR = 3.98) and chronic nephritis (SPR = 2.03) were noted, as well as increased rates for hematuria and urethral stricture. In regression analyses with adjustment forage and sex, serum creatinine levels were increased in those who had lived close to the plant. Increased white blood cell count and hemoglobin levels, and decreased mean corpuscular volume were also found in those living less than 2 miles from the plant. Those who used a well or cistern for drinking water were found to have increased urinary microalbumin, red blood cell count and hematocrit. CONCLUSIONS These preliminary findings will provide the basis for future hypothesis testing incorporating important determinants of exposure not included in this study, such as duration and calendar year of exposure, location relevant to prevailing wind direction, and age at exposure.
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Affiliation(s)
- Susan M Pinney
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0056, USA.
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26
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Zomorrodi A, Bahluli A. Evaluation of urologic complications in 30 cases of kidney transplantation with technique of proper exposure edge of bladder mucosa and U-stitch ureteroneocystostomy. Transplant Proc 2003; 35:2662-3. [PMID: 14612061 DOI: 10.1016/j.transproceed.2003.08.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- A Zomorrodi
- Department of Urology, Division of Transplant, Emam Hospital, Tabriz University of Medicine Sciences, Tabriz, Iran.
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27
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Affiliation(s)
- C Reek
- Department of Urology, Rostock University Hospital, Rostock, Germany
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28
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O'Connor RC, Bales GT, Avila D, Gerber GS. Variability of the International Prostate Symptom Score in men with lower urinary tract symptoms. Scand J Urol Nephrol 2003; 37:35-7. [PMID: 12745741 DOI: 10.1080/00365590310008668] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The variability of the International Prostate Symptom Score (I-PSS) was tested in patients with benign prostatic hyperplasia (BPH) by comparing questionnaire results obtained in the physician's office and, 1 week later, in the patient's home. MATERIAL AND METHODS A total of 210 consecutive men with lower urinary tract symptoms (LUTS) completed the I-PSS questionnaire in the physician's office. One week later the questionnaire was mailed to each patient's home, completed by the patient and then returned. Scores were compared specifically in terms of clinically significant differences defined by a total symptom score difference of > or = 6 points and/or a difference of > or = 2 points in the quality-of-life (QOL) measure. RESULTS The mean patient age was 67 years. Questionnaires were completed and returned by 127/210 (60%) men. Pearson's correlation coefficient for the I-PSS and QOL results was 0.81 and 0.74, respectively. Clinically significant differences in results were seen in 33/127 (26%) patients. When grouping patients into mild, moderate and severe symptom categories based on the I-PSS results, 31/127 (24%) changed categories when comparing "office" and "home" results. CONCLUSIONS Clinically significant variations in I-PSS and QOL results may exist and may affect treatment decisions in > 25% of men.
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Affiliation(s)
- R Corey O'Connor
- Section of Urology, Department of Surgery, The University of Chicago Hospitals, Chicago, Illinois 60637, USA.
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29
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Whang M, Geffner S, Baimeedi S, Bonomini L, Mulgaonkar S. Urologic complications in over 1000 kidney transplants performed at the Saint Barnabas healthcare system. Transplant Proc 2003; 35:1375-7. [PMID: 12826163 DOI: 10.1016/s0041-1345(03)00519-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report the complication rate based on one urologist's experience over a 9-year period including over 1000 ureteral reimplants performed at the time of kidney transplantation. Among 1083 ureteral reimplant operations, there was a 4.3% urologic complication rate, including a 2.7% ureteral stricture rate and a less than 1% rate each of urine leak ureteropelvic junction obstruction, vesicoureteral reflux and clot obstruction. The factors that lead to a low urologic complication rate are believed to be the use of short ureteral segment using the Lich (compared to the Politano-Leadbetter) technique and the routine use of indwelling stents. In addition, a consistency in results was attributed to one transplant urologist performing all ureteral reimplants and managing all urologic complications.
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Affiliation(s)
- M Whang
- Division of Transplantation, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA
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30
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Affiliation(s)
- B Parada
- Department of Urology and Transplantation, Coimbra University Hospital, 3049 Coimbra, Portugal.
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31
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Rohrschneider WK, Haufe S, Clorius JH, Tröger J. MR to assess renal function in children. Eur Radiol 2003; 13:1033-45. [PMID: 12695825 DOI: 10.1007/s00330-003-1819-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2002] [Revised: 12/12/2002] [Accepted: 01/02/2003] [Indexed: 11/30/2022]
Abstract
Renal function evaluation in the pediatric patient is generally based on scintigraphic examinations where a baseline gamma-camera renography is used to determine single kidney function, and diuresis renography is obtained to assess urinary drainage from the pelvicalyceal system. Magnetic resonance imaging also permits the evaluation of renal functional processes using fast dynamic sequences. Principally, an agent cleared by renal excretion is intravenously injected and its cortical uptake, parenchymal transport, and eventually its urinary excretion are followed with serial images. Different approaches have been presented most of which are based on T1-weighted gradient-recalled echo sequences with short TR and TE and a low flip angle obtained after intravenous injection of Gd-DTPA or Gd-DOTA. These techniques permit renal functional assessment using different qualitative and quantitative parameters; however, most of these methods are not suitable for the evaluation of urinary tract dilatation in infants and children. For the diagnostic work-up of children with congenital urinary tract obstruction and malformation a technique was developed which permits quantitative determination of single kidney function, in addition to evaluating urinary excretion disturbances analogous to that possible with scintigraphy.
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Affiliation(s)
- Wiltrud K Rohrschneider
- Department of Pediatric Radiology, Radiological Clinic, University of Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg, Germany.
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Paparel P, Badet L, Tayot O, Fessy MH, Bejui J, Martin X. [Mechanisms and frequency of urologic complications in 73 cases of unstable pelvic fractures]. Prog Urol 2003; 13:54-9. [PMID: 12703355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES To analyse the urological complications of unstable pelvic fractures and to try to establish a correlation between the type of urological complication observed and the type of pelvic fracture. MATERIAL AND METHODS The urological complications of 73 unstable pelvic fractures observed between 1977 and 1996 were analysed. Fractures of the obturator foramen were excluded from the study. Pelvic fractures were classified according to the criteria of the Tile classification, comprising 3 main types: type A corresponds to stable fractures not involving the pelvic brim; type B corresponds to fractures with rotary instability and type C corresponds to fractures with vertical instability. RESULTS 12 men (12.5%) developed urological complications: 7 ruptures of the membranous urethra (3 type C, 4 type B), 4 intraperitoneal ruptures of the bladder (3 type C and 1 type B) and one extraperitoneal rupture of the bladder (type A). The mean age of these patients was 37 years (range: 14 to 56). The mortality was 50%. CONCLUSION Urological complications are rare after pelvic fractures, but must be systematically investigated. The Tile classification is useful to understand the mechanisms responsible for urological complications of pelvic fractures. Unstable fractures (type B and C) are at greatest risk of urological complications. Type B or C fractures are not correlated with a specific type of urological complication.
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Affiliation(s)
- Philippe Paparel
- Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France.
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Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol 2002; 187:116-26. [PMID: 12114899 DOI: 10.1067/mob.2002.125704] [Citation(s) in RCA: 716] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kuczyńska R, Czerwionka-Szaflarska M. Incidence of vesicoureteral reflux in siblings of children with reflux--our own observations. Med Sci Monit 2001; 7:116-20. [PMID: 11208505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The aim of the study was to evaluate the incidence of primary vesicoureteral reflux in siblings of children with reflux. MATERIAL AND METHODS Ninety-four subjects aged 2-6, the siblings of children with reflux were examined. Our methods included: urinalysis, urine cultures, ultrasound examination of abdominal cavity in all the examined subjects. Voiding cystography was conducted in selected cases. RESULTS Primary vesicoureteral reflux was found in the total of 10% of the siblings of children with reflux. The incidence of reflux was the highest in the youngest age group. CONCLUSIONS The incidence of primary vesicoureteral reflux in the siblings of affected children being at least ten times higher than population risk supports the necessity of screening in this group.
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Affiliation(s)
- R Kuczyńska
- Department of Pediatrics, E. Warmiński Municipal Hospital, ul. Szpitalna 19, 85-826 Bydgoszcz, Poland
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35
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Hussain M, Khalique M, Askari H, Lal M, Hashmi A, Hussain Z, Naqvi A, Rizvi A. Surgical complications after renal transplantation in a living-related transplantation program at SIUT. Transplant Proc 1999; 31:3211. [PMID: 10616445 DOI: 10.1016/s0041-1345(99)00694-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Hussain
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan
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Carr SV, Scoular A, Elliott L, Ilett R, Meager M. A community based lesbian sexual health service - clinically justified or politically correct? Br J Fam Plann 1999; 25:93-5. [PMID: 10567057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Lesbian sexual health care is still a neglected issue. In order to address this, a needs assessment was carried out in Glasgow amongst the lesbian community and 200 responses were received. More than 40% of the respondents said they were unable to disclose their sexual orientation to their GP and were unable to discuss sexual health issues with them. Eighty-one percent said there was a need for a lesbian sexual health service and 71% said they would use such a service if it existed. Therefore a pilot clinic was set up in Glasgow and was co-ordinated by a multidisciplinary advisory group. The clinical component of the service was audited and it was found that gynaecology and fertility issues were the most common presenting condition (52%), followed by psychosocial issues (26%). Genitourinary problems, such as vaginal discharge, constituted 20% of presentations. Client satisfaction with the clinic was high. This pilot service showed that areas of sexual health care, such as the need for inclusion in cervical smear programmes and equality of access to assisted conception, are issues which are important to this minority group and which need to be addressed. The clinic is now ongoing as a result of the pilot scheme and is the only family planning based lesbian health service in the UK.
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Affiliation(s)
- S V Carr
- Centre for Family Planning and Sexual Health, Glasgow
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37
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Affiliation(s)
- C Park
- Department of Urology, Keimyung University School of Medicine, Taegu, South Korea
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38
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Abstract
A new anatomical classification specifies anatomical defects in the anterior, middle and posterior zones of the vagina as the cause of female lower urinary tract dysfunction. An external musculoelastic mechanism stretches the vagina to open and close the outflow tract. The same pelvic floor muscles provide a peripheral control mechanism for micturition. The stretched vagina prevents the filling bladder from activating the stretch receptors in the bladder neck. Vaginal laxity may weaken transmission of muscle forces, interfering with urethral opening and closure, a mechanical process. Laxity may also destabilize the peripheral control mechanism, a neurological process, causing bladder control to swing between the open and closed modes urodynamically interpreted as bladder instability. Specific symptoms, signs, and urodynamic tests can be arranged into a pictorial algorithm. This acts as a practical guide for locating the three zones of anatomical defects. It has been possible to reinterpret almost all the definitions and descriptions of the International Continence Society (ICS) in terms of this classification, and to explain how vaginal laxity may cause premature activation of the micturition reflex (detrusor instability), stress incontinence and abnormal emptying (dribble, overflow). This convergence in anatomical and urodynamic (ICS) concepts explains many previously unexplained phenomena, and potentially opens up a new approach to management, nonsurgical strengthening of specific ligaments, or surgical reinforcement thereof with ambulatory "microinvasive" methods which do not require catheterization.
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Affiliation(s)
- P P Petros
- Department of Gynaecology, Royal Perth Hospital, WA, Australia
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39
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Drossel HC, Leisse-Stankoweit M, Günthert EA, Lichtenauer P, Holthaus N, Neubauer H. [Somatoform disorders in urology. Notes on the work of H. Csef. Urologe [A] (1997) 36: 87-99. Urologe A 1997; 36:565. [PMID: 9487595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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40
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Rumiantsev VB, Lopatkin NA, Bukaev IN, Gorilovskiĭ LM. [The current approach to assessing the degree of risk in performing urological operations]. Urol Nefrol (Mosk) 1997:3-8. [PMID: 9206880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Upon analysis of all the available classification of urological operative risk the authors conclude that classification proposed by the Moscow Anesthesiology Scientific Society meets current requirements as it allows for the opinion of the surgeon, anesthesiologist and functional diagnosis specialist.
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41
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Panikratov KD. [The cause of urodynamic disorders]. Urol Nefrol (Mosk) 1996:7-10. [PMID: 9054111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The author offers a classification of urodynamic disorders, chronic and acute, of the upper and lower urinary tracts. The latter are subdivided into congenital and acquired, all the disorders are classified as organic and dynamic. Allowances for both etiological and pathogenetic aspects secure maximal hospitality of this classification which covers both known and expected nosological entities. Systematization of the causes underlying urodynamic disturbances is essential both fundamentally and clinically because it clarifies cause-effect relationships between the nosological entity and related complications, concomitant diseases; contributes to formulation of accurate diagnosis, this facilitating choice of diagnostic and therapeutic approaches.
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42
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Karakayali H, Bilgin N, Moray G, Demirbaş M, Ozkardes H. Major urological complications in 1051 consecutive renal transplants. Transplant Proc 1996; 28:2339-40. [PMID: 8769245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- H Karakayali
- Department of General Surgery, Başkent University School of Medicine, Ankara, Turkey
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Hashimoto Y, Nagano S, Ohsima S, Takahara S, Fujita T, Ono Y, Kinukawa T. Surgical complications in kidney transplantation: experience from 1200 transplants performed over 20 years at six hospitals in central Japan. Transplant Proc 1996; 28:1465-7. [PMID: 8658743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Y Hashimoto
- Department of Urology, Shakai Hoken Chukyo Hospital, Aichi, Japan
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Abstract
Lower urinary tract disorders of male and female cats may be caused by a variety of fundamentally different causes. The term Feline urologic syndrome should be abandoned and substituted with descriptive etiopathogenic terms whenever possible. If the underlying cause cannot be identified, the term Idiopathic lower urinary tract disease is recommended.
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Affiliation(s)
- C A Osborne
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, USA
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45
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Urenkov SB, Perlin DV. [Percutaneous surgical interventions and extracorporeal lithotripsy in the treatment of the urological complications after a kidney transplant]. Urol Nefrol (Mosk) 1995:45-9. [PMID: 7571204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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46
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Gel'dt VG. [The classification of the urological diseases of newborn and nursing infants]. Urol Nefrol (Mosk) 1994:17-9. [PMID: 7892713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In the attempt to classify most common urological diseases in neonates the authors have summarized more than 700 cases. The examinees' age ranged from a few hours to four months. The diagnosis was made antenatally or early in postnatal life according to the leading symptoms of abdominal, uropoietic, urination and urine quality defects. Depending on the urinary damage at different stages of intra- and extrauterine development and time of primary symptoms recognition, the authors propose to distinguish antenatal, intranatal and postnatal lesions. These include congenital conditions, dysfunctions, conditions caused by tissue and system immaturity, etc. Instructions on the choice of optimal therapeutic policy for each group are given.
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Abstract
The Diagnostic Related Group (DRG) hospital payment system may be inequitable for certain groups of Medicare patients. This study of 216 Medicare urology patients in the ten non-age stratified urology DRGs demonstrated that patients seventy years of age and older (70+) had higher resource consumption than patients under seventy years of age (70-). Findings were: (1) older patients (70+) had higher total hospital costs (+12,022 per patient) than younger patients (70-) (+9,872 per patient); (2) a longer hospital length of stay (14.2 days vs 11.6 days); (3) financial risk of +1,756 loss per (70+) patient vs +1,309 profit per (70-) patient (p less than 0.05); (4) more diagnoses and procedures per patient, and (5) a higher mortality (4.0% vs 3.3%). These findings suggest that the current DRG scheme may be inequitable vis-a-vis the older urology patient in non-age stratified DRGs, and thus could limit access and quality of care for these patients in the future.
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Affiliation(s)
- E Muñoz
- Department of Surgery, Queens Hospital Center, Jamaica, New York
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48
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Kiriyama I, Hata R, Amemiya H, Ueno M, Muramatsu H, Kariba T, Tsuchida H, Kumagai K, Sato H, Eguchi K. [Clinical statistics of urological inpatients 80 years old or older]. Hinyokika Kiyo 1987; 33:1975-8. [PMID: 3448921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A statistical analysis was performed on 85 inpatients admitted to our Urological Department during the past 12 years. These patients were 80 years old or older at the time of admission. The age, chief complaint, primary disease, mode of operation, and duration of admission of these patients were evaluated. According to our classification of diseases, urological tumors were the highest in frequency (77 cases). Frequent diseases among urological tumors were benign prostatic hyperplasia (60 cases), and therefore transurethral resection of prostate was the most frequent surgery. This analysis indicated that operations on elderly patients can be done safely under nongeneral anesthesia unless the case is accompanied by serious complications.
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Affiliation(s)
- I Kiriyama
- Department of Urology, Teikyo University School of Medicine
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Almenar Roig FD, González Segrelles A, Pascual FS, Andrés Barea J, Peiró Giménez A, Llorca Domaire N. [Morbidity at the urology ambulatory service of the Social Security program in the Province of Valencia]. Actas Urol Esp 1987; 11:537-45. [PMID: 3452990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Kato S, Ohnishi S, Saka T, Nakajima H, Tanda H. [Clinical statistics on outpatients during the 5 years period (from 1978 Nov. 1st to 1983 Dec. 31st) after the opening of the Urological Clinic of East Sapporo Sanjukai Hospital (II)]. Hinyokika Kiyo 1984; 30:1677-84. [PMID: 6528850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Our hospital is a private urological hospital. Currently we have 5 full time and 3 part time clinicians, 80 beds (100 beds: in Aug. 1984) and 23 hemodialyzers available for the patients. It is 5 years and 2 months (as of Dec. 31st 1983) since it was established on Nov. 1st 1978. We report the statistics on the new outpatients who have increased remarkably as years go by during this period. The total number of outpatients was 20,837 (male: 12,926, female: 7,911), and the male to female ratio was 1.6: 1. The outpatients who were referred to by other sources, accounted for 35% of the total number. The urogenital diseases definitely diagnosed numbered 15,800 (76%), those indefinitely diagnosed, 2,261 (11%), normal cases 802 (4%), and diseases other than urogenital 1974 (9%). The number of patients admitted was 4,088, and those operated on as outpatients was 887 (inpatients: 2,598). The major operations for outpatients were circumcision and vasectomy. The age range had a peak in the thirties for males and in the twenties for females. The clinical statistics for the outpatients according to the international disease classification are as follows; Cases of diseases transmitted by sexual contact increased year after year. Non-specific infection accounted for about half of the diseases and urogenital malignant tumor accounted for fewer than 2%. The major diseases of the new outpatients showed the same tendency every year, and they consisted of cystitis (18-22%), prostatitis (13-16%), upper urinary tract stone (10%), benign prostatic hypertrophy (8-10%), and balanoposthitis (3-7%).
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