Typical value ranges and signal patterns in patients with neurogenic bladder: Quality control in urodynamics using an air-charged catheter system.

PURPOSE: To establish typical value ranges (TVRs) of the air-charged catheter (ACC) system, and analyze the typical signal patterns (TSPs) of cough under different bladder volumes for quality control of a urodynamic study using the ACC system. MATERIALS AND METHODS: The urodynamic traces of 1977 patients with neurogenic bladder (NB) were analyzed for intravesical pressure (pves ), abdominal pressure (pabd ), and detrusor pressure (pdet ) in the cough test at our center from July 2017 to December 2021. The pdet cough signals were described and classified. The pdet cough signal patterns in different bladder volumes and postures were analyzed. RESULTS: The 50% range of the initial resting pves , pabd , and pdet in the supine and sitting positions were 7-15, 7-14, and 0-0 cmH2 O, and 24-33, 24-33, and 0-0 cmH2 O, respectively. The cough amplitudes for pves and pabd were similar in the 50% range, as follows: 10-27 and 8-25 cmH2 O in the supine position, respectively; and 18-43 and 17-40 cmH2 O in the sitting position, respectively. The cough amplitude of pves and pabd was not related to bladder volume (p > 0.05). The cough spikes of pdet were divided into three types: type I, in which pdet has a minimal change (<5 cmH2 O); type II, a monophasic cough spike, in which could be a positive (IIa, ≥5 cmH2 O) or negative spike (IIb, ≥5 cmH2 O); and type III, a biphasic spike, in which could be a positive-to-negative biphasic (IIIa) or negative-to-positive spike (IIIb). Under different bladder volumes, the cough signals of pdet were all expressed as type I, II, or III, and the cough signals were unrelated to bladder volume (p > 0.05). CONCLUSIONS: TVRs of the initial resting state in patients with NB were established to provide guidance for quantitative quality control of the ACC system. The TSPs of the pdet cough signal under different bladder volume and posture were described, which could be used for qualitative quality control of the ACC system.

Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis.

BACKGROUND: Obesity has been found to be closely related to the increased risk of fatal prostate cancer (PCa), however there remains no evidence that further clarifies the relationship between obesity and the postoperative recurrence and poor prognosis of PCa. In this study, a systematic review and meta-analysis were performed to systematically evaluate the effect of obesity on the prognosis and recurrence of PCa after radical prostatectomy (RP). METHODS: A literature search of the PubMed, Web of Science, and Embase databases was performed covering articles published between January 2013 and January 2020. Articles regarding the correlation between body mass index (BMI) and the prognosis and recurrence of PCa following RP were included in the meta-analysis. Two investigators independently screened the literature and extracted relevant data including publication information, key results, number of cancer cases, and multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Meta-analysis was performed using RevMan 5.3 and Stata 16.0 software, and forest plots, funnel plots, and sensitivity analysis were also conducted. RESULTS: A total of 14 articles were included, all of which were analyzed for clinicopathological characteristics. Eight articles reported the biochemical recurrence (BCR) with prostate-specific antigen (PSA) as the predictor, and six articles reported the positive surgical margins (PSM). The meta-analysis showed that obese PCa patients had more postoperative recurrence and poor prognosis compared with the normal weight PCa patients, and the difference was statistically significant (OR =1.25, 95% CI: 1.10, 1.43). BCR exhibited no significant difference between obese and non-obese PCa patients after surgery (OR =1.2, 95% CI: 0.96, 1.46), and there were also no notable differences in PSM between the groups (OR =1.16, 95% CI: 0.99, 1.36). Subgroup analysis showed that obese PCa patients in the Americas (95% CI: 1.11, 1.37) and Europe (95% CI: 1.11, 1.78) were more likely to have surgical recurrence and poor prognosis (OR =1.40). Obese patients in the Americas were also more likely to have BCR after surgery (95% CI: 1.07, 1.36). CONCLUSIONS: Obesity easily leads to poor prognosis and recurrence of PCa after RP.

Tamsulosin Monotherapy Is Effective in Reducing Ureteral Stent-related Symptoms: A Meta-analysis of Randomized Controlled Studies.

This study aimed to evaluate the effectiveness of tamsulosin monotherapy for the treatment of ureteral stent-related symptoms (SRSs) and compare it with that of solifenacin monotherapy and combined therapy of tamsulosin and silifenacin. Randomized controlled trials (RCTs), which evaluated the effectiveness of tamsulosin for the treatment of SRSs, were searched from the databases PubMed, EMBASE and the Cochrane Library published up to November 2018. Eight RCTs involving 1087 participants were finally included in this meta-analysis. The results showed that tamsulosin monotherapy could significantly decrease the urinary symptoms [mean difference (MD) -7.56, 95% confidence interval (CI) (-11.47, -3.65), P=0.0001] and body pain [MD -5.25, 95% CI (-8.03, -2.46), P=0.0002], and improve the sexual performance [MD -1.06, 95% CI (-1.89, -0.24), P=0.01] compared with the control group. Moreover, there was no significant difference between tamsulosin monotherapy and solifenacin monotherapy in all outcomes except for significantly better sexual performance in solifenacin group [MD 0.29, 95% CI (0.06, 0.51), P=0.01]. In addition, the effectiveness of combined therapy of tamsulosin and solifenacin was not superior to that of tamsulosin monotherapy. Our study demonstrated that tamsulosin monotherapy was effective for the treatment of patients with SRSs; evident superiority could not be found for therapy of tamsulosin and solifenacin combined.