The significance of preoperative estimated glomerular filtration rate on survival outcomes in patients who underwent radical cystectomy and non-continent urinary diversion.

PURPOSE: To evaluate the influence of preoperative renal function on survival outcomes in patients who underwent radical cystectomy (RC) with non-continent urinary diversion (UD). MATERIALS AND METHODS: A total of 132 patients with bladder cancer who underwent RC with non-continent UD due to urothelial carcinoma from January 2006 toMarch 2017 at our tertiary referral center were retrospectively evaluated. Patients were divided into 2 groups as those with estimated glomerular filtration rate (eGFR)<60mL/min/1.73 m2 and ≥60mL/min/1.73 m2 according to preoperative eGFR levels. Patients' characteristics, preoperative clinical data, operative data, pathologic data, oncologic data and complications were compared between the groups. RESULTS: The mean age was 64.5±8.7 (range: 32 - 83) years and the median follow-up was 30.9±31.7 (range: 1-113) months. There were 46 patients in Group 1 and 86 patients in Group 2. There was no difference in cancer-specific mortality (45.6% for group 1 and 30.2% for group 2, p=0.078) and survival (56.8±8.3 months for group 1 and 70.5±5.9 months for group 2, p=0.087) between the groups. Overall mortality was higher (63% for group 1 and 40.7% for group 2, p=0.014) and overall survival (43.6±6.9 months for group 1 and 62.2±5.8 months for group 2, p=0.03) was lower in Group 1 compared to Group 2. CONCLUSIONS: Overall mortality was higher and overall survival was lower in patients with preoperative eGFR<60mL/s. More patients had preoperative hydronephrosis with eGFR<60mL/s.

The significance of preoperative estimated glomerular filtration rate on survival outcomes in patients who underwent radical cystectomy and non-continent urinary diversion

ABSTRACT Purpose To evaluate the influence of preoperative renal function on survival outcomes in patients who underwent radical cystectomy (RC) with non-continent urinary diversion (UD). Materials and Methods A total of 132 patients with bladder cancer who underwent RC with non-continent UD due to urothelial carcinoma from January 2006 toMarch 2017 at our tertiary referral center were retrospectively evaluated. Patients were divided into 2 groups as those with estimated glomerular filtration rate (eGFR) <60mL/min/1.73 m2 and ≥60mL/min/1.73 m2 according to preoperative eGFR levels. Patients' characteristics, preoperative clinical data, operative data, pathologic data, oncologic data and complications were compared between the groups. Results The mean age was 64.5±8.7 (range: 32 - 83) years and the median follow-up was 30.9±31.7 (range: 1-113) months. There were 46 patients in Group 1 and 86 patients in Group 2. There was no difference in cancer-specific mortality (45.6% for group 1 and 30.2% for group 2, p=0.078) and survival (56.8±8.3 months for group 1 and 70.5±5.9 months for group 2, p=0.087) between the groups. Overall mortality was higher (63% for group 1 and 40.7% for group 2, p=0.014) and overall survival (43.6±6.9 months for group 1 and 62.2±5.8 months for group 2, p=0.03) was lower in Group 1 compared to Group 2. Conclusions Overall mortality was higher and overall survival was lower in patients with preoperative eGFR <60mL/s. More patients had preoperative hydronephrosis with eGFR< 60mL/s.

The effect of additional telerounding on postoperative outcomes, patient and surgeon satisfaction rates in the patients who underwent percutaneous nephrolithotomy. / El efecto de televisitas adicionales sobre los resultados postoperatorios y la satisfacción de pacientes y cirujanos tras Nefrolitotomía percutánea.

INTRODUCTION: We wanted to investigate the potential effect of additional telerounding system on postoperative outcomes, patient and surgeon satisfaction rates in the patients who underwent percutaneous nephrolithotomy (PNL). METHODS: Eighty patients who underwent PNL were included in the study. The patients were randomly divided to two groups. Group 1 included 40 patients who were followed-up with standard rounds and group 2 included 40 patients who were followed-up with telerounding in addition to standard rounds. Patient and surgeon satisfaction rates were assessed with a visual analog scale (VAS) where 0 point represents very dissatisfied and 100 points very satisfied. RESULTS: Mean time of preoperative telerounding visit was 3.65±0.59 (2-4) minutes. Mean time of telerounding visits on the postoperative 1st and 2nd days was 3.80±0.62 and 2.9±0.91 minutes respectively. The VAS score evaluating the surgeon's satisfaction rate for telerounding was 91±11.2 and patients expressed a high level of satisfaction with 72.5%. CONCLUSION: The use of additional telerounding in urological patient care provides high satisfaction rates for both the patients and the surgeon. However the findings of the present study don't underestimate the importance of personal surgeon-patient interaction.

INTRODUCCIÓN: Queríamos investigar el efecto potencial de un sistema de televisita sobre los resultados postoperatorios y la satisfacción de pacientes y cirujanos en casos de nefrolitotomía percutánea (NLP)MÉTODOS: Se incluyeron en el estudio ochenta pacientes sometidos a NLP. Los pacientes se dividieron aleatoriamente en dos grupos. Grupo 1: incluyó 40 pacientes que hicieron un seguimiento estándar y grupo 2 con 40 pacientes que fueron seguidos con televisitas además del seguimiento estándar. La satisfacción del paciente yel cirujano se evaluó con una escala visual analógica (EVA) donde el 0 representa muy insatisfecho y el 100 muy satisfecho.RESULTADOS: El tiempo medio de la televisita preoperatoria fue de 3,65±0,59 (2-4) minutos. El tiempo medio de televisita en los días 1º y 2º postoperatorio fue de 3,80±0,62 y 2,9±0,91 minutos respectivamente. La puntuación de la EVA que evaluaba la satisfacción del cirujano para la televisita fue de 91±11,2 y lospacientes expresaron un alto nivel de satisfacción con el 72,5%.CONCLUSIONES: El uso de televisitas adicionales en la asistencia urológica ofrece una alta satisfacción tanto para el paciente como para el cirujano. Sin embargo, los hallazgos del presente estudio no infravaloran la importancia de la interacción personal paciente-cirujano.

Long-term outcomes of transobturator tape procedure in women with stress and mixed urinary incontinence: 5-year follow-up.

BACKGROUND: The aim of this study was to compare the postoperative outcomes and complications of transobturator tape (TOT) procedure in women with mixed urinary incontinence (MUI) and stress urinary incontinence (SUI) in long term follow-up. METHODS: A group of 193 women, who underwent TOT procedure, was documented in the study. Patients were divided into two groups in terms of incontinence type. Group 1 consists of patients with SUI and group 2 with MUI. All patients were evaluated with pelvic examination, including cough stress test and international consultation on incontinence questionnaire-short form at 3 and 12 months and annually. Visual Analog Scale (VA S) was used to evaluate postoperative patient satisfaction. Two groups were retrospectively compared for postoperative complication, patient satisfaction, objective and subjective cure rates. RESULTS: In this study, group 1 included 105 patients and 67 patients were in group 2. There was no significant difference between the objective cure rates in two groups; however subjective cure and patients satisfaction rates were significantly higher in SUI group (P<0.05). Complications were reported according to the Clavien-Dindo classification with Gr I 8.3%, Gr II 66.7%, Gr IIIa 8.3% and Gr IIIb 16.7% and Gr I 16.7%, Gr II 66.6%, Gr IIIa 16.7% and Gr IIIb 0% in group 1 and group 2, respectively. CONCLUSIONS: It is not easy to identify an ideal treatment modality for women with MUI but TOT procedure seems to be effective and safe in the surgical treatment of MUI after 5 years follow-up.

Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis.

UNLABELLED: What's known on the subject? and What does the study add? Milroy reported 84% success at a mean of 4.5 years follow-up by usage of a permanently implantable "urolume" spent in 1993. Memotherm was developed later, especially for urologic use. Our study is one of the largest in this urea, with a high number of patients and a long follow-up period. OBJECTIVE: • To evaluate the effectiveness and long-term results of permanent urethral stent (Memotherm) implantation in the treatment of recurrent bulbar urethral stricture. PATIENTS AND METHODS: • In all, 47 patients with a history of previous unsuccessful treatment for bulbar urethral stricture were treated using Memotherm bulbar urethral stents between 1998 and 2002. • Long-term follow-up data was analysed and discussed. RESULTS: • At the end of the 7-year period 37 of 47 patients (78.7%) had been treated successfully. • Post-micturition dribbling incontinence lasting up to 3 months after stent placement occurred in 32 (68.1%) patients, but this was reduced to only seven patients (14.9%) by the 7-year follow-up. • There was stress incontinence of various severities in nine (19.2%) patients at the 1-year follow-up. These patients were those who had stenosed urethral segments adjacent to the external sphincter. At the long-term follow-up <10% of the patients had stress incontinence complaints. CONCLUSION: • Memotherm is a good treatment option in patients with recurrent bulbar urethral stricture of any cause.