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1.
Arch Iran Med ; 24(7): 542-547, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34488319

RESUMEN

BACKGROUND: We aimed to investigate the factors predicting the need for ureteral J stent placement in the treatment of distal ureteral stones by ureteroscopy (URS). METHODS: Between January 2007 and June 2018, 550 consecutive patients who underwent URS with the diagnosis of distal ureteral stone disease were evaluated in a single center. The patients were divided into two groups as; group 1 who received a ureteral J stent, and group 2 without ureteral J stent. The two groups were compared in terms of possible preoperative, perioperative and postoperative risk factors. RESULTS: History of systemic disease, stone disease and extracorporeal shock wave lithotripsy (SWL) were significantly higher in group 1 (P<0.001, P=0.009, P=0.016). The operation time was longer in group 1 (P<0.001). The rate of impacted stones was higher in group 1 (61.7% vs 15.6%; P<0.001). In multivariate analysis, co-morbidities, previous SWL history, presence of impacted ureteral stone and prolongation of the operation time were found to be statistically significant in predicting ureteral J stent placement. CONCLUSION: In the treatment of distal ureteral stones by URS, not only perioperative complications, prolongation of the operation time, and the presence of residual stones but also preoperative factors, such as systemic disease, and impacted ureteral stones should be considered as predictive factors in assessing the need for a ureteral J stent and to avoid unnecessary stent procedures.


Asunto(s)
Litotricia , Cálculos Ureterales , Humanos , Estudios Retrospectivos , Stents , Resultado del Tratamiento , Cálculos Ureterales/cirugía , Ureteroscopía
2.
Med Princ Pract ; 30(1): 85-91, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32911466

RESUMEN

INTRODUCTION: This study aimed to compare the safety and efficacy of 2 single-incision mini-sling (SIMS) systems with different designs of anchoring mechanism. METHODS: The records of patients who have been operated for the treatment of female stress urinary incontinence (SUI) with 2 different SIMS systems were retrospectively evaluated. Patient characteristics, physical examination results, and quality of life (QoL) questionnaires were used to evaluate the patients. Primary efficacy endpoints were the cure and failure rates. Secondary efficacy endpoints were complications and differences in QoL questionnaires. RESULTS: Eighty-three patients from group 1 (Ophira SIMS system) and 77 patients from group 2 (Gallini SIMS system) were evaluated. There was no significant difference between the 2 groups regarding patient characteristics. The objective cure rates were found to be 83.1 and 79.2% in group 1 and group 2, respectively (p = 0.09). Mesh-related complications, such as anchor displacement, bladder erosion, vaginal erosion, and groin pain, were more common in group 1. No severe complications were observed. For both groups, a significant improvement in all scores of QoL questionnaires was observed after surgery; however, the differences between 2 groups were not significant. CONCLUSIONS: The present study showed that the treatment of female SUI with 2 different SIMS systems had similar efficacy, complication rates, and scores in QoL questionnaires.


Asunto(s)
Cabestrillo Suburetral , Incontinencia Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Calidad de Vida , Estudios Retrospectivos , Procedimientos Quirúrgicos Urológicos/efectos adversos
3.
Int J Clin Pract ; 75(4): e13844, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33231905

RESUMEN

OBJECTIVE: We aimed to investigate the predictive ability of the Hounsfield unit (HU) on non-contrast computed tomography (NCCT) for the success of medical expulsive therapy (MET) using silodosin in distal ureteric stones of 4-10 mm. METHODOLOGY: The data of patients who underwent MET were retrospectively screened. The patients were divided into two groups as Groups 1 and 2 depending on the presence or absence of stone expulsion, respectively. In addition to HU calculated using the NCCT images, state of the collecting systems, daily fluid intake, number of emergency department visits, and number of pain attacks were compared. RESULTS: A total of 88 patients were included in the study. Sixty-four patients (72.7%) expelled the stone after MET while the treatment was not successful in 24 patients (27.3%). The stone area was significantly larger in Group 2 (28.4 ± 15.7 mm2 vs 46.8 ± 16.1 mm2 ; P < .001). NCCT-HU was calculated as 542.5 ± 256.8 for Group 1 and 873.1 ± 335.2 for Group 2, indicating a significant difference (P < .001). The mean number of pain attacks was 1.5 ± 1.2 in Group 1 and 2.2 ± 1.4 in Group 2 (P = .048). The number of visits to the emergency department significantly differed between Groups 1 and 2 (1.1 ± 1.0 and 1.8 ± 1.3, respectively; P = .010). CONCLUSIONS: In this study, HU and stone area values calculated on NCCT were found to be effective factors in predicting the treatment success for MET. Therefore, we consider that it would be useful to consider these parameters in the selection of an appropriate treatment for distal ureteric stones.


Asunto(s)
Cálculos Ureterales , Cálculos Urinarios , Humanos , Indoles , Estudios Retrospectivos , Cálculos Ureterales/diagnóstico por imagen , Cálculos Ureterales/tratamiento farmacológico
4.
Int J Clin Pract ; 75(4): e13866, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33236480

RESUMEN

OBJECTIVE: We aimed to compare the efficacy of silodosin and a terpene combination in the treatment of distal ureteral stones. METHODOLOGY: The data of the patients admitted to the urology policlinic with renal colic, diagnosed with distal ureteral stones, and followed up with medical expulsive therapy between December 2017 and June 2018 were retrospectively reviewed. The patients were divided into two groups: Group 1 comprised 72 patients that received 8 mg/day silodosin and Group 2 consisted of 51 patients that were given three capsules of a terpene combination daily. The groups were compared in terms of the patients' demographic characteristics, medical history, localisation of the present stone, renal collecting system status, daily fluid intake, number of emergency service visits, number of additional analgesic applications needed, number of pain attacks, number of days off work, stone expulsion rate and time to stone expulsion. RESULTS: Of the total 123 patients, 98 (79.7%) were stone-free. The stone-free rate was 75.0% in Group 1 and 86.3% in Group 2, with no statistical difference between the two groups. However, the number of visits to the emergency service because of pain, number of additional analgesic applications required, number of days off work, and time to stone expulsion were statistically significantly lower in Group 2 than in Group 1. CONCLUSIONS: The treatment of distal ureteral stones with silodosin is as effective as the terpene combination. However, the terpene combination is more effective than silodosin in managing pain and accelerating stone expulsion.


Asunto(s)
Cálculos Ureterales , Humanos , Indoles , Estudios Retrospectivos , Terpenos , Resultado del Tratamiento , Cálculos Ureterales/tratamiento farmacológico
5.
Int J Clin Pract ; 75(3): e13826, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33164270

RESUMEN

OBJECTIVE: We aimed to evaluate the use of computed tomography (CT) as the first imaging modality in patients with renal colic and microscopic haematuria. METHODOLOGY: The patients that presented to the emergency service of six health centers with renal colic between January 2017 and January 2018 and were found to have microscopic hematuria on urinalysis were retrospectively evaluated. Only patients for whom non-contrast CT was used as the first imaging modality were included in the study. Patients were divided into two groups according to the stone presence (stone +, stone -) and the groups were compared in terms of demographics and clinical characteristics of patients. RESULTS: A total of 834 patients were included in the study and 711 (85.3%) were diagnosed with urolithiasis. CT also revealed additional pathology in 26 (3.1%) patients. The male patients had a significantly higher rate of stones than female patients (89.5% vs 75.2%; P < .001) and the BMI values were also significantly higher in the male patients compared with the females (27.0 ± 2.1 vs 25.0 ± 4.0, P < .001). Right renal colic was more common in female patients and the rate of left renal colic was significantly higher in male patients. The male patients diagnosed with stone disease required treatment at a higher rate than the female patients (P = .005). CONCLUSIONS: Because of its high sensitivity and specificity values in the diagnosis of stone disease, easy applicability and fast results, CT can be safely used as the first imaging modality for the diagnosis of renal colic and microscopic haematuria.


Asunto(s)
Hematuria , Cólico Renal , Femenino , Hematuria/diagnóstico por imagen , Hematuria/etiología , Humanos , Masculino , Cólico Renal/diagnóstico por imagen , Cólico Renal/etiología , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X
6.
Arch Iran Med ; 23(12): 827-834, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33356340

RESUMEN

BACKGROUND: We aimed to assess the results of first- and fifth-year outcomes and the effect on quality of life (QoL) of transobturator tape (TOT) treatment in patients with stress urinary incontinence (SUI). METHODS: The patients who underwent TOT surgery between January 2008 and June 2013 were screened retrospectively. The QoL was evaluated with Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6). The subjective evaluation of patients in terms of incontinence outcome was classified as worsened (UDI-6 and IIQ-7 if pre-operative < postoperative), improved (UDI-6 and IIQ-7 if pre-operative > postoperative), or cured (UDI-6 and IIQ-7 postoperative <10). The first-year and fifth-year success rates were compared between the IIQ-7 and UDI-6 results. RESULTS: A total of 109 patients were included in the study. There was a significant improvement (P<0.001) in the patients' UDI-6 and IIQ-7 scores when the preoperative and postoperative first-year results were compared. Comparing the postoperative first-year and fifth-year total UDI-6 and IIQ-7 scores, a significant improvement was observed and the patients' complaints were significantly reduced (P<0.001). The results of the IIQ-7 and UDI-6 questionnaire revealed that the TOT surgery success rate was 93.3% at the end of the first year and 88.7% at the end of the fifth year. CONCLUSION: The postoperative first-year and fifth-year data reveal that TOT surgery has a high success rate and positive effects on QoL. Low complication rates and the ease of application make TOT a good alternative to other treatment modalities in surgical treatment of SUI.


Asunto(s)
Calidad de Vida , Cabestrillo Suburetral , Incontinencia Urinaria de Esfuerzo/cirugía , Incontinencia Urinaria , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Análisis de Regresión , Estudios Retrospectivos , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento
7.
Int. braz. j. urol ; 46(5): 716-724, Sept.-Oct. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1134212

RESUMEN

ABSTRACT Purpose: We aimed to investigate the effects of menopause on long-term outcomes of transobturator tape (TOT) surgery. Materials and Methods: Patients who underwent TOT surgery were evaluated under two groups as postmenopausal and premenopausal. The International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) questionnaires were completed by the patients at the 1st and 5th-year follow-up sessions. Patients with a postoperative UDI-6 and IIQ-7 score of <10 were considered as cured, those with lower postoperative scores compared to the preoperative period were regarded as improved, and the cases that had higher postoperative scores than preoperative values were interpreted as TOT failure. The TOT success rates were compared between the results obtained from UDI-6 and IIQ-7. Results: A total of 109 patients were included in the study (53 postmenopausal and 56 premenopausal). We contacted with 90 (48 premenopausal and 42 postmenopausal) women at 1st year control and 80 (44 premenopausal and 36 postmenopausal) women at 5th year control. There was a significant improvement in all of three questionnaires between the preoperative and post-operative 1st year control (ICIQ-SF: 15.5±2.5 vs. 1.8±4.3, p <0.001; IIQ-7: 68.9±9.8 vs. 2.75±15.2, p <0.001; UDI-6: 27.1±11.1 vs. 6.0±14.6, p <0.001) and the preoperative and post-operative 5th year control (ICIQ-SF: 15.5±2.5 vs. 3.1±5.3, p <0.001; IIQ-7: 68.9±9.8 vs. 9.6±26.7, p <0.001; UDI-6: 27.1±11.1 vs. 5.1±10.0, p <0.001). When we compared the premenopausal and postmenopausal patients in terms of recurrent urinary tract infection (UTI); 5 (12%) patients had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 1st year follow-up (p=0.039) and similarly the same 5 (13.9%) patients in follow-up had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 5th year follow-up (p=0.045). There were no significant differences between the premenopausal and postmenopausal patients in terms of TOT success rates at 1st and 5th year control, evaluated with UDI-6 (1st year: p=0.198 and 5th year: p=0.687) and IIQ-7 (1st year: p=0.489 and 5th year: p=0.608) questionnaires. Conclusions: Transobturator tape surgery is an effective and reliable method according to the long-term outcomes reported in this paper. In the current study, we determined that the TOT success rates were not affected by the presence of menopause.


Asunto(s)
Humanos , Femenino , Incontinencia Urinaria , Incontinencia Urinaria de Esfuerzo/cirugía , Cabestrillo Suburetral , Calidad de Vida , Menopausia , Encuestas y Cuestionarios , Resultado del Tratamiento
8.
Int Braz J Urol ; 46(5): 716-724, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32539254

RESUMEN

PURPOSE: We aimed to investigate the effects of menopause on long-term outcomes of transobturator tape (TOT) surgery. MATERIALS AND METHODS: Patients who underwent TOT surgery were evaluated under two groups as postmenopausal and premenopausal. The International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) questionnaires were completed by the patients at the 1st and 5th-year follow-up sessions. Patients with a postoperative UDI-6 and IIQ-7 score of <10 were considered as cured, those with lower postoperative scores compared to the preoperative period were regarded as improved, and the cases that had higher postoperative scores than preoperative values were interpreted as TOT failure. The TOT success rates were compared between the results obtained from UDI-6 and IIQ-7. RESULTS: A total of 109 patients were included in the study (53 postmenopausal and 56 premenopausal). We contacted with 90 (48 premenopausal and 42 postmenopausal) women at 1st year control and 80 (44 premenopausal and 36 postmenopausal) women at 5th year control. There was a significant improvement in all of three questionnaires between the preoperative and post-operative 1st year control (ICIQ-SF: 15.5±2.5 vs. 1.8±4.3, p <0.001; IIQ-7: 68.9±9.8 vs. 2.75±15.2, p<0.001; UDI-6: 27.1±11.1 vs. 6.0±14.6, p<0.001) and the preoperative and post-operative 5th year control (ICIQ-SF: 15.5±2.5 vs. 3.1±5.3, p<0.001; IIQ-7: 68.9±9.8 vs. 9.6±26.7, p<0.001; UDI-6: 27.1±11.1 vs. 5.1±10.0, p<0.001). When we compared the premenopausal and postmenopausal patients in terms of recurrent urinary tract infection (UTI); 5 (12%) patients had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 1st year follow-up (p=0.039) and similarly the same 5 (13.9%) patients in follow-up had recurrent UTI in postmenopausal group but no patients had recurrent UTI in premenopausal group at 5th year follow-up (p=0.045). There were no significant differences between the premenopausal and postmenopausal patients in terms of TOT success rates at 1st and 5th year control, evaluated with UDI-6 (1st year: p=0.198 and 5th year: p=0.687) and IIQ-7 (1st year: p=0.489 and 5th year: p=0.608) questionnaires. CONCLUSIONS: Transobturator tape surgery is an effective and reliable method according to the long-term outcomes reported in this paper. In the current study, we determined that the TOT success rates were not affected by the presence of menopause.


Asunto(s)
Cabestrillo Suburetral , Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Femenino , Humanos , Menopausia , Calidad de Vida , Encuestas y Cuestionarios , Resultado del Tratamiento , Incontinencia Urinaria de Esfuerzo/cirugía
9.
Aging Male ; 23(1): 66-70, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30907218

RESUMEN

Objective: To evaluate the effects of hyperbaric oxygen therapy (HBOT) on erectile functions and serum testosterone levels in patients with erectile dysfunction (ED).Methods: The patients treated by HBOT for several diseases between July 2017-May 2018 and had erectile dysfunction were included in the study. All patients filled the International Index of Erectile Function (IIEF) questionnaire form; serum total testosterone (TT) and free testosterone (FT) levels were examined before the first day and after the last day of HBOT. The effects of demographic characteristics of patients on erectile functions were evaluated. Patients were categorized according to the risk factors. The IIEF scores, TT and FT levels of patients in first day and after last day of HBOT were compared.Results: Totally 43 patients were included in the study. The mean post-HBOT IIEF-EF score was significantly higher than the mean pre-HBOT IIEF-EF score of patients (25.4 ± 5.3 vs 20.6 ± 5.1; p < .001). There was no statistical difference between the pre-HBOT and post-HBOT serum TT and FT levels of patients (4.0 ± 2.3 ng/ml vs 4.1 ± 2.0 ng/ml, p = .797; 8.6 ± 3.8 pg/ml vs 8.9 ± 3.5 pg/ml, p = .658).Conclusions: HBOT improved the erectile functions in ED patients however we cannot detect any effect on testosterone levels in our study.


Asunto(s)
Disfunción Eréctil/terapia , Oxigenoterapia Hiperbárica , Testosterona/sangre , Humanos , Masculino , Persona de Mediana Edad
10.
Int Urogynecol J ; 31(8): 1641-1646, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-31377840

RESUMEN

INTRODUCTION AND HYPOTHESIS: Our aim was to investigate the efficacy of the EndoFast Reliant™ system, which is a novel trocarless mesh technology for the treatment of pelvic organ prolapse (POP). METHODS: This was a retrospective cohort study including 31 female patients with POP who underwent vaginal repair. Total follow-up duration was 24 months. All patients were evaluated with a clinical history, POP-Q measures, pelvic ultrasound, body mass index (BMI), questionnaires on symptoms, and quality of life scoring system. RESULTS: The mean age was 53 ± 9.7 years, and the mean BMI was 28.5 ± 3.9 kg/m2. The BMI of 20 patients was < 30 kg/m2. No intraoperative complications occurred. Prolapse was anatomically resolved in 87.1% of patients at 2-year follow-up. Four patients presented stage 1 non-symptomatic prolapse recurrence. De novo stress urinary incontinence developed in four (12.9%) cases and de novo urgency developed in two (6.4%) cases; all were diagnosed and treated easily with oral medication. One case of mesh exposure was found and treated conservatively. There was no migration of fasteners or mesh. Urinary retention, postoperative groin pain, and dyspareunia were not observed. CONCLUSIONS: The EndoFast Reliant™ system was found successful with high success rates, short learning time and very low complication rates in our study. However, further prospective studies with higher patient numbers and longer follow-up durations are needed to reach definitive conclusions.


Asunto(s)
Prolapso de Órgano Pélvico , Mallas Quirúrgicas , Adulto , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Prolapso de Órgano Pélvico/cirugía , Estudios Prospectivos , Calidad de Vida , Estudios Retrospectivos , Mallas Quirúrgicas/efectos adversos , Resultado del Tratamiento
11.
Can Urol Assoc J ; 14(5): E209-E213, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31793863

RESUMEN

INTRODUCTION: We aimed to evaluate factors predictive of negative ureteroscopy (URS) in ureteral stones. METHODS: Patients who underwent URS between January 2007 and June 2018 were included in the study. Patients were divided into two groups: group 1- positive URS (841 patients); and group 2 -negative URS (75 patients). These two groups were compared in terms of demographic data, stone characteristics, and postoperative outcomes. RESULTS: The mean age of the study patients was 44.5±15.1 years. The absence of collecting system dilatation due to the present stone was found to be a significant predictive factor for negative URS in univariate analysis, but there was no significant difference in multivariate analysis. In the multivariate analysis, low body mass index (BMI), no history of stone surgery, stone located in the distal ureter, small stone area, longer time between the last imaging procedure and URS, and medical expulsive therapy (MET) application were statistically significant in predicting negative URS. CONCLUSIONS: In this study, the parameters that significantly predicted negative URS were found to be low BMI, no history of stone surgery, distal localization of the stone, small stone area, longer time between the last imaging procedure and URS, and MET applied for the current stone. These parameters should be considered to avoid negative URS and patients should be informed of the possibility of negative URS prior to operation.

12.
Minim Invasive Ther Allied Technol ; 27(3): 148-152, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28697638

RESUMEN

OBJECTIVES: We aimed to compare the effect of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URS) on health-related quality of life (HRQoL) for the treatment of proximal ureteral stones. MATERIAL AND METHODS: Between April 2014 and July 2015, patients with proximal ureteral stones who were successfully treated with URS or SWL in seven different centers were included. Patients were divided into two groups according to stone size: stones ≤10 mm and >10 mm. HRQoL subscales which were evaluated by the Medical Outcome Study Short-Form 36-item survey (SF-36) Turkish version were compared for URS and SWL in these two groups one month after the performed procedure. RESULTS: A total of 273 patients were included in the study. While 116 (52.5%) patients were treated with ureteroscopic lithotripsy, SWL was used for 105 (47.5%) patients. Fifty-two patients were excluded from the study. In proximal ureteral stones ≤10 mm, there were no statistically significant differences for any of the eight subscales of the SF-36 questionnaire. Regarding stones >10 mm, it was found that the three subscales of the SF-36 questionnaire - role limitations because of physical health problems (RP), bodily pain (BP), and general health perception (GH) - were significantly lower in the SWL group compared with the URS group. CONCLUSIONS: Patients with proximal ureteral stones >10 mm who were treated with URS generally may have a more favorable HRQoL than those treated with SWL in short-term follow-up.


Asunto(s)
Litotricia/métodos , Calidad de Vida , Cálculos Ureterales/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Ureteroscopía
13.
Arch. esp. urol. (Ed. impr.) ; 69(8): 601-606, oct. 2016. tab, ilus
Artículo en Español | IBECS | ID: ibc-156805

RESUMEN

Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction. Moreover, although not widely used, it can be also applied for the treatment of posterior urethral stricture and bladder neck contracture, usually resulting in urinary incontinence and the need for subsequent procedures. Our main experience are with Allium urethral stents, and as such, we provide the latest updates in urethral stents with special emphasis on the various types of Allium urethral stents: bulbar, prostatic and bladder neck stents


Los estents uretrales se introdujeron por primera vez en 1988 y desde entonces han sufrido importantes mejoras. Sin embargo, no han ganado una gran popularidad y su uso está limitado a un número pequeño de centros alrededor del mundo. Los estents uretrales se pueden usar en toda la uretra y para indicaciones varias y diversas. En la uretra anterior, se puede usar para tratar estenosis uretrales. En la uretra prostática, se pueden utilizar para el tratamiento de la obstrucción prostática, incluyendo obstrucción prostática benigna, maligna y iatrogénica. Además, aunque no se utiliza ampliamente, también puede ser aplicado en el tratamiento de las estenosis de uretra posterior y la contractura del cuello vesical, resultando generalmente en incontinencia urinaria y la necesidad de procedimientos posteriores. Nuestra experiencia principal es con estents uretrales de Allium, y con ello, realizamos una puesta al día con lo ultimo en estents uretrales con énfasis especial en los varios tipos de estents uretrales de Allium: estents bulbares, prostáticos y del cuello vesical


Asunto(s)
Humanos , Masculino , Femenino , Stents Liberadores de Fármacos , Estrechez Uretral/cirugía , Obstrucción Ureteral/terapia , Obstrucción Ureteral , Enfermedad Iatrogénica/epidemiología , Enfermedad Iatrogénica/prevención & control , Constricción Patológica/complicaciones , Estrechez Uretral , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria
14.
Investig Clin Urol ; 57(5): 330-5, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27617314

RESUMEN

PURPOSE: To investigate the second primary cancers (SPCs) in patients with urothelial cancer (UC). MATERIALS AND METHODS: The records of 2,339 patients whose UC was diagnosed between January 1974 and December 2012 were reviewed. All data about characteristics of patients, of UC and, of SPC was, recorded digitally. We investigated the prevalence and the type of second or higher order cancers, and the factors associated with SPC. RESULTS: Total 260 patients (11.1%) had SPC, 14 had a third primary cancer and one had a fourth primary cancer. The most common SPC with UC was lung cancer (29.6%). Of all 260 with SPC, 64 (24.6%) had synchronous (within the 6 months) SPC, 120 (46.2%) had subsequent SPC and, 76 (29.2%) had antecedent SPC. The mean duration of SPC was 56 months in patients with subsequent SPC and 75.8 months in patients with antecedent SPC. The mean age at the time of diagnosis of UC was higher in patients with SPC. The ratio of male gender, body mass index, blood type, status of smoking and, occupational risk was similar in both groups. Total amount of smoking and the mean follow-up were higher in patients with SPC. CONCLUSIONS: The majority of the patients with UC have long life expectancy. In patients with UC, the risk of having another cancer is quite higher than normal population. The physicians managing patients with UC should look for SPC.


Asunto(s)
Neoplasias Primarias Secundarias/epidemiología , Neoplasias Urológicas/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Neoplasias Primarias Secundarias/patología , Prevalencia , Estudios Retrospectivos , Factores Sexuales , Turquía/epidemiología , Neoplasias Urológicas/patología , Adulto Joven
16.
Int Urogynecol J ; 27(11): 1667-1671, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26992728

RESUMEN

INTRODUCTION AND HYPOTHESIS: The purpose of this study was to investigate the success and complication rates of single-incision sling for treating stress urinary incontinence (SUI), with a 3-year follow-up. METHODS: This study comprised 173 female patients with SUI or mixed urinary incontinence (MUI) with dominant SUI who underwent minisling procedure. All patients had positive cough stress test preoperatively; they were followed up for 3 years after surgery (1, 3, 6, 12 months, and yearly). RESULTS: Total follow-up was 36 months, and mean age 51 years (44-77); 128 (74 %) patients presented SUI and 45 (26 %) MUI. Objective and subjective cure and failure rates were 83.8 % (145 cases), 6.4 % (11 cases), and 9.8 % (17 cases), respectively. There were no differences in cure rates between 1 and 3 years. Mean body mass index was 28.7 (26.1-35.2), and mean operating time 7.9 min. (6.5-11.9). There were no major intraoperative complications. Eleven patients (6.4 %) had de novo urge incontinence that resolved using anticholinergic drugs; no patient had urinary retention. Vaginal mesh extrusion was reported in nine (5.2 %) patients. CONCLUSIONS: The minisling system attained high success rates at 3 years' follow-up. The procedure was easy to learn and has lower complication rate.


Asunto(s)
Procedimientos Quirúrgicos Ginecológicos/métodos , Cabestrillo Suburetral , Incontinencia Urinaria de Esfuerzo/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Tempo Operativo , Periodo Posoperatorio , Estudios Prospectivos , Estadísticas no Paramétricas , Mallas Quirúrgicas/efectos adversos , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía , Vejiga Urinaria/diagnóstico por imagen
17.
Arch Ital Urol Androl ; 87(4): 280-5, 2016 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-26766798

RESUMEN

Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.


Asunto(s)
Litotricia , Nefrostomía Percutánea , Complicaciones del Embarazo/diagnóstico por imagen , Complicaciones del Embarazo/cirugía , Ureteroscopía , Cálculos Urinarios/diagnóstico por imagen , Cálculos Urinarios/cirugía , Adulto , Femenino , Humanos , Embarazo , Resultado del Tratamiento , Ultrasonografía
18.
J Endourol ; 30(3): 319-22, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26472166

RESUMEN

INTRODUCTION: Several prostatic stents were developed in the last three decades, none of which were able to provide a real alternative in patients unfit or unwilling to undergo classical prostatic surgeries. In this study, we report the results of the use of a newly developed prostatic stent--the Allium™ Triangular Prostatic Stent (TPS). PATIENTS AND METHODS: The Allium TPS is a highly flexible, nitinol-built polymer-covered stent, which prevents tissue ingrowth and reduces encrustations. Between 2008 and 2014, at two centers (Israel and Turkey), the stent was inserted under local or regional anesthesia in 51 patients with benign prostatic obstruction (BPO) who are unwilling or unfit for surgery. Patients were followed for 12 months from surgery. The primary outcome was symptom improvement as measured by the international prostate symptom score (IPSS) and improvement in peak urinary flow. RESULTS: Stent insertion was successful in all patients. The mean IPSS decreased from 26.4 to 7.7 on the last follow-up. The mean peak flow increased from 5.5 mL/second before stent insertion to 16.0 mL/second 1 year thereafter. The main adverse effect was transient pain in nine patients. No stent migration or obstruction was seen. Patients reported satisfaction and improvement in quality of life. CONCLUSION: Our short-term results show that Allium TPS is safe and effective for the treatment of patients with BPO.


Asunto(s)
Aleaciones , Endoscopía/métodos , Hiperplasia Prostática/cirugía , Stents , Obstrucción Uretral/cirugía , Anciano , Anciano de 80 o más Años , Cistoscopios , Diseño de Equipo , Humanos , Israel , Masculino , Persona de Mediana Edad , Hiperplasia Prostática/complicaciones , Calidad de Vida , Turquía , Obstrucción Uretral/etiología
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