Urological Complaints Research Articles

Recovery and Return to Work After a Pelvic Fracture.

BackgroundPelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF.MethodsDuring the years 2003–2012, 282 injured individuals aged 20–55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment.ResultsAlmost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626–25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092–6.720) were identified as independent predictive factors of full RTW.ConclusionPRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

The relationship of enuresis nocturna and adenoid hypertrophy.

This study was organized to assess the relationship of enuresis nocturna (EN) and upper airway obstruction (UAO) in children. This study was multi-centrically and prospectively designed including 79 children who presented to a urology clinic with symptoms of EN between January 2013 and February 2014. Sixty-four age-matched children with no history of urological complaints were randomly recruited from children admitted to a pediatric clinic as a control group. All children and parents were asked to fill out a dysfunctional elimination syndrome (DES) questionnaire and children were examined by an ear, nose and throat (ENT) specialist to evaluate the UAO. Descriptive statistics, chisquare and Mann-Whitney-U tests were used to compare variables. The mean ages of the 79 children (48 male, 31 female) in the study group and the 64 children (41 male, 23 female) in the control group were 10.14+/-3.38 and 9.17+/- 2.85, respectively. Family history of the study showed that 19% of the children's mothers, 10% of the children's fathers and 37% of the children's siblings had experienced EN. There was a significant difference between the study and the control groups in terms of urge to urinate, bladder emptying, bowel symptoms and psychological stress. There was also a significant difference between rates of tonsillar hypertrophy and nasopharynx obstruction in the EN group (p = 0.009). In this study we found that half of the children with EN had tonsillar hypertrophy, which was significantly higher than in the control group. Further studies are needed to clarify the exact relationship between UAO and EN.

Identifying Prevalence and Risk Factors for Mild Cognitive Impairment in Adults Presenting for Urological Evaluation

To examine mild cognitive impairment (MCI) in a young and older adult urology population, and which external factors were associated with diminished cognitive status at baseline. We enrolled patients >18 years of age presenting to a large, urban tertiary care center for a wide variety of urologic complaints. Cognitive status was determined by the Montreal Cognitive Assessment (MoCA) screening test. A score of 26-30 on the MoCA is considered cognitively intact, whereas <26 indicates MCI. Patient charts were retrospectively reviewed; a backwards-stepwise logistic regression was constructed to compare MCI with potential risk factors. One hundred ninety-seven patients were included. There were 10/33 (30%) patients aged 18-40 who had MCI. Moreover, 32/68 (47%) patients aged 41-64 had MCI. Of older adults age 65+, MCI was seen in 65/96 (68%) patients. Factors associated with MCI in age group 41-64 included opioid use. Patients with stone disease were less likely to demonstrate MCI, when compared to other general categories of urologic chief complaints. For patients in age group 65+, associations with MCI included a cancer-related chief complaint, increased age, depressive symptoms, and less education. There were no significant associations with MCI in age group 18-40. These results demonstrate a significant prevalence of MCI in an adult urology population and factors that may be associated with its prevalence. We believe that this study lays the groundwork for urology providers to be able to identify patients who may have MCI at baseline.

PD25-05 EVALUATING THE EFFECTIVENESS OF UROLOGIC TELEMEDICINE IN MALE PRISONERS

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost and Outcomes Measures I1 Apr 2016PD25-05 EVALUATING THE EFFECTIVENESS OF UROLOGIC TELEMEDICINE IN MALE PRISONERS Brenton Sherwood, Kenneth Nepple, and Bradley Erickson Brenton SherwoodBrenton Sherwood More articles by this author , Kenneth NeppleKenneth Nepple More articles by this author , and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.235AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Healthcare resources are limited in prison populations, and patient transportation for healthcare adds significant cost and burden. The purpose of this study was to analyze our use of telemedicine (TM) to provide urologic care to prisoners. We hypothesize that TM is a safe and effective means to provide general urologic care to populations with poor access to healthcare specialists. METHODS We reviewed 376 medical records of male prisoners in our state whose initial urologic complaint was evaluated with TM from 1/2007- 7/2014. Distance from the prison ranged from 6 to 236 miles away. We analyzed the effectiveness of the TM visit using three measures: 1) concordance of TM diagnosis with the (eventual) face-to-face visit (F2F) diagnosis, 2) compliance with radiologic and pharmacologic orders placed prior to F2F and 3) number of F2F avoided using TM, defined when any of the following conditions were met: a) TM visit orders (e.g. radiology) were completed prior to F2F b) follow-up was via TM or PRN c) the patient had >1 TM visit before a F2F. Finally, we estimated the percentage of patients who required an eventual F2F (i.e. could not have been handled solely by TM) using the following criteria: a) the patient complaint could not be evaluated completely using TM b) a procedure (e.g. cystoscopy) or surgery was required c) F2F was for interventional treatment. RESULTS The most common TM diagnosis was scrotal pain, followed by symptoms from lower urinary tract dysfunction (LUTD) (Figure). TM care alone was sufficient for 27%, F2F was scheduled for 56%, and 17% were lost to follow-up. TM orders included radiology (47%), medication (40%) and labs (38%). Compliance with the TM management was high (medication 91%, radiology 88%). Of men that had F2F, the TM and F2F diagnoses were the same in 90% of cases, the most common incorrect diagnoses being urethral stricture (27%). We estimated that TM saved at least one F2F in 94% of patients and that less than 50% of patients required eventual F2F. CONCLUSIONS We found TM to be a safe and effective method to increase access to urologic care, effectively replacing 94% of initial visits in this access-poor population. We estimated that with refined, prospective protocols, over 50% of the patients could have eliminated the F2F completely. Expansion to other access-poor populations is underway. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e589 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Brenton Sherwood More articles by this author Kenneth Nepple More articles by this author Bradley Erickson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Urodynamic outcomes of detethering in children: experience with 46 pediatric patients.

Tethered cord syndrome (TCS) manifests with neurological and urological complaints. Surgical detethering is the main treatment for TCS. Children with urological symptoms are required objective pre- and postoperative evaluations in order to predict urological outcome. The aims of this study are to investigate the effects of detethering procedure on the urodynamic tests and to determine the relationship between the changes of urodynamic tests and the patients' age and gender. The data of urodynamic tests in 46 pediatric patients, who underwent surgery for TCS, were retrospectively evaluated. Bladder capacity, post-voiding residual urine volume, maximum intravesical pressure, and bladder compliance of each patient were measured in preoperative period and at the third month after surgery. These parameters were statistically compared, and the correlations of these parameters with age, gender, and etiology of the TCS were also investigated. Bladder capacity and post-voiding residual urine volume were decreased and maximum intravesical pressure and bladder compliance were increased after surgery for TCS. The decrease in bladder capacity was significant in patients older than 10years (p<0.05). The increase in maximum intravesical pressure was also positively correlated with age (p<0.05). But the increase in bladder compliance was negatively correlated with age (p<0.05). Bladder capacity, post-voiding residual urine volume, and bladder compliance are mainly affected by surgery in patients with TCS. From the urological viewpoint, children older than 10years are most likely to benefit from surgery for TCS.

Is there a difference between Parkinson disease patients and a control group in terms of urinary symptoms and quality of life?

The aim of this study is to research whether urinary symptoms and disruption of quality of life observed in Parkinson disease patients are different than those of their healthy peers. Additionally, whether these complaints were affected by characteristics such as age at onset of Parkinson disease, sex, disease duration, and severity was investigated. This study comprised a total of 79 individuals, 39 Parkinson patients and a control group of 40 individuals. Parkinson diagnosis was provided by a neurology expert according to the UK Parkinson's Disease Society Brain Bank Criteria. All patients were evaluated by a urologist with the International Prostate Symptom Score (IPSS) and an overactive bladder (OAB) questionnaire. Compared with the control group, the Parkinson patient group had statistically significantly higher rates of urological complaints (P < 0.001), irritative symptoms (P < 0.001), voiding symptoms (P < 0.001), OAB score (P < 0.001), IPSS total score (P = 0.007), and treatment requirements (P < 0.001). Urologic complaints were observed more frequently in the Parkinson patient group compared to the control group. Another important result of this study is that in the Parkinson patient group there was no difference found between urologic complaints in terms of sex.

Effects of adenotonsillar hypertrophy corrective surgery on nocturnal enuresis of children.

Background:Nocturnal enuresis is considered a common urological complaint especially among children. Respiratory obstructive diseases have been one of the possible etiologies of such a condition. The most common type of upper respiratory obstructive diseases in childhood is adenotonsillar hypertrophy. In this study, it was tried to estimate the prevalence of nocturnal enuresis in adenotonsillar hypertrophy as an upper obstructive airway disease and cure rate after corrective operation.Materials and Methods:In this longitudinal study, 184 children with adenotonsillar hypertrophy as case group and 200 healthy children as control group were randomly compared for nocturnal enuresis incidence and risk factors. Then they were followed after 6 months to estimate the cure rate after corrective operation.Results:In case group, nocturnal enuresis was more common than control group (26% vs. 17%, P = 0.1). Factors which had a role in enuresis in case group were family history (P = 0.03) and male sex (P = 0.05). Three months after surgery, 48% of children totally cured from enuresis (P = 0.001) and 71% cured both partially or totally (P = 0.03). The response rate after moderate obstruction relieving was 100% while that in severe cases was 60% (P = 0.2).Conclusions:Nocturnal enuresis due to upper obstructive airway disease occurs more in male and in the presence of family history. The cure rate after 6 months of operation was more prominent in moderate obstruction which suggests enuresis in severe airway obstruction may need a longer time to subside. Cure rate of primary enuresis due to obstructive airway disease after 6 months of relieving was 48% in children over 5 years old.

Lower urinary tract dysfunction in patients with dysautonomia.

With the goal of better defining the types of bladder dysfunction observed in this population, we present the chief urologic complaints, results of urodynamic studies, and treatments of patients with dysautonomia-related urinary symptoms. All patients with dysautonomia referred to our neurourology clinic between 2005 and 2015 for management of lower urinary tract dysfunction were retrospectively reviewed. Each patient's chief urologic complaint was recorded and used to initially characterize the bladder storage or voiding symptoms. Patient evaluation included history and physical examination, urinalysis, post void bladder ultrasound, and urodynamic studies. Successful treatment modalities that subjectively or objectively improved symptoms were recorded. Of 815 patients with the diagnosis of dysautonomia, 82 (10 %) were referred for evaluation of lower urinary tract dysfunction. Mean age was 47 years (range 12-83) and 84 % were female. The chief complaint was urinary urgency ± incontinence in 61 % and hesitancy in 23 % of patients. Urodynamic findings demonstrated detrusor overactivity ± incontinence in 50 % of patients, although chief complaint did not reliably predict objective findings. Successful objective and subjective treatments were multimodal and typically non-operative. Lower urinary tract dysfunction may develop in at least 10 % of patients with dysautonomia, predominantly females. Bladder storage or voiding complaints do not reliably predict urodynamic findings. Urodynamically, most patients exhibited detrusor overactivity. The majority of patients were successfully managed with medical or physical therapy.

Veterans Affairs Telemedicine: Bringing Urologic Care to Remote Clinics

To report the use of telemedicine to deliver general urologic care to remote locations within the Veterans Affairs Greater Los Angeles Healthcare System. We describe the diagnoses managed, patient satisfaction, safety, and benefit to patients in terms of saved travel time and expense. We conducted a retrospective chart review examining care delivered through urology telemedicine clinics over a 6-month period. We examined the urologic conditions, patient satisfaction, and emergency department visits within 30days of the visit. We estimated patient benefit by calculating travel distance and time and the saved travel-associated costs using Google Maps and US Census income data. Ninety-seven unique telemedicine visits were conducted and a total of 171 urologic diseases were assessed. The most common conditions were lower urinary tract symptoms (35%), elevated prostate-specific antigen level (15%), and prostate cancer (14%). One patient was seen in the emergency department within 30days with an unpreventable urologic complaint. Patient satisfaction was "very good" to "excellent" in 95% of cases, and 97% would refer another veteran to the urology telemedicine clinic. Patients saved an average of 277 travel miles, 290minutes of travel time, $67 in travel expenses, and $126 in lost opportunity cost. Telemedicine was successfully and safely used to evaluate and treat a wide range of urologic conditionswithin the Veterans Affairs Greater Los Angeles Healthcare System, and saves patients nearly 5hours and up to $193 per visit. Further investigation of the potential of telemedicine for thedelivery of urologic care in a cost-effective manner is warranted.

Hidden prevalence of lower urinary tract symptoms in healthy nulligravid young women.

Introduction and hypothesisLower urinary tract symptoms (LUTS) and urinary incontinence (UI) may have a major impact on quality of life. However, not all individuals with urological complaints seek medical advice. The aim of this study was to investigate the prevalence of LUTS in young otherwise healthy nulligravid women and the accompanying burden.MethodsA total of 159 young presumably healthy female medical students aged 18–30 years were recruited at their university. All completed the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms. The prevalence of LUTS and the accompanying burden were measured. Correlations between symptoms and bother were analysed using Spearman’s rho.ResultsLUTS was found in 94.3 % of the women, urgency at least sometimes in 14.5 %, and hesitancy in 14.5 %. Nocturia once a night was reported by 18.2 % of the women; none reported nocturia of more than twice a night. Involuntarily loss of urine was reported by 20.1 % of the women but none reported this occurring more than twice a week. The median value of all bother scores was 0; the highest bother score was for urgency. For all questions a positive correlation was found between symptoms and bother; a strong correlation was found for bladder pain, urgency UI, stress UI and overall UI.ConclusionsIn a presumably healthy population of young nulligravid women the prevalence of LUTS and UI was high, but with relatively low bother.

Trends in Toilet Training and Voiding Habits among Children with Down Syndrome

Children with Down syndrome are at risk for lower urinary tract dysfunction and delayed toilet training. Comparative studies regarding voiding function in the Down syndrome population are lacking. We assessed urinary continence and voiding function in patients with Down syndrome and a control group. A questionnaire designed to assess toilet training, continence status, symptoms of lower urinary tract dysfunction and prior evaluation of urological complaints was sent to parents of 326 children with Down syndrome who had been seen at our institution previously. The same survey was administered to parents of patients without Down syndrome. Data were compiled, and descriptive and comparative statistical analyses were performed. A total of 77 patients comprised the Down syndrome group and 78 patients without Down syndrome comprised the control group. Average age of reported toilet training completion was 5.5 years in children with Down syndrome and 2.2 years in controls. Of children 5 years or older 79% with Down syndrome were toilet trained, compared to 100% of those without Down syndrome. Incontinence was reported in 46% of previously toilet trained children with Down syndrome and 24.5% of controls. These findings were statistically significant. No significant difference was observed in the rate of urinary tract infection, symptoms of lower urinary tract dysfunction or evaluation for urological complaints. Children with Down syndrome can experience marked delay in toilet training and are more likely to suffer incontinence afterward. This study was ineffective in determining whether symptoms of lower urinary tract dysfunction could be related to decreased continence rates.

MP25-14 THE TREATMENT OF CHRONIC ORCHALGIA WITH TMRTM: SUBSTANTIAL PAIN REDUCTION WITH DURABLE RESULTS

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2015MP25-14 THE TREATMENT OF CHRONIC ORCHALGIA WITH TMRTM: SUBSTANTIAL PAIN REDUCTION WITH DURABLE RESULTS Daniel H. Shin, and Aaron Spitz Daniel H. ShinDaniel H. Shin More articles by this author , and Aaron SpitzAaron Spitz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1217AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chronic orchalgia is a common urological complaint with treatments ranging from medication to denervation and orchiectomy. Here we report our five year experience in the treatment of chronic orchalgia with Therapeutic Magnetic Resonance (TMRTM), an FDA approved device for the treatment of pain. With TMRTM, an electric current is applied for 10-20 minutes directly to the skin overlying the spermatic cord via two metal probes positioned on opposite sides of the scrotum, reportedly altering nerve cell ion conduction and the sensation of pain. METHODS Men with chronic orchalgia who had failed conservative management and were treated with TMRTM were identified and contacted. Demographic and pain data were collected and results were analyzed with T-test and one-way ANOVA to determine statistical difference. Patients reported pain levels using the numerical (zero-ten) pain scale, which has been validated to correspond measurably to severity of painful stimuli. RESULTS Forty-nine patients met criteria. Mean age was 50 years (range 22-82). Forty-five percent reported left testicular pain, 25% right testicular pain, and 29% bilateral. Mean duration of pain prior to TMRTM was 84 months (range 3-408). Etiology was 39% post-surgical (vasectomy, varicocelectomy, and hernia surgery), 28% idiopathic, and 20% associated with anatomic abnormality such as varicocele or epididymal cyst. Mean pain level prior to treatment (baseline) was 5.7 (range 1-10, n=36). After treatment, mean nadir pain level was 39% lower than baseline (3.5, range 0-8, n = 26, p < 0.005). On followup, mean reported pain level was 58% lower than baseline (2.4, range 0-7, n = 24, p < 0.005). Mean number of treatments received was 3.2 (range 1-14). Mean years since treatment to the followup was 2.75 years (range 0.5-4.9 years). No adverse effects were reported from treatment. There were no significant differences in degree of pain improvement when patients were stratified by etiology of orchalgia. CONCLUSIONS TMRTM represents an effective treatment for chronic orchalgia, with substantial reductions in reported pain levels, durable response, and no reported side effects. Limitations to our study include a small sample size, lack of a control group, and reliance of post-treatment pain data on patient recall. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e290 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel H. Shin More articles by this author Aaron Spitz More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Urogenitalna tuberkuloza – klinični primer

Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis.Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.

Urogenital tuberculosis – case report

Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis. Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.

Attitudes of GP trainees towards the training received in urology on the GP training scheme.

The majority of patients with scrotal problems or urinary symptoms will first present to their general practitioner (GP). The importance of the initial examination performed by the GP is often underestimated; however, it frequently determines the course of investigation and ultimately treatment. Unfortunately, medical schools have devoted increasingly less time to teaching urology over the past decade. The impact of this decline in teaching on a GP trainee's assessment of urological complaints remains unclear. The aim of this study was to investigate the self-reported competency of GP trainees in assessing urological presentations. A questionnaire was circulated to 101 GP trainees from five separate training programmes. Respondents rated their confidence in evaluating four different urological presentations. They were also invited to give their opinion regarding the teaching of urology on their current scheme and whether they would be in favour of the addition of urology as an optional rotation. Only 18 trainees (19 %) felt urology was adequately covered on their curriculum. A small yet significant number of respondents felt uncomfortable in their assessment of testicular (28 %, 28/101) or prostate (35 %, 35/101) pathology and male (17 %, 17/101) or female (10 %, 10/101) urinary symptoms. Twenty-six trainees (26 %) would choose a rotation in urology if available. Another ten trainees felt that attending urology outpatient clinics would benefit training. This study highlights a number of concerns among GP trainees in relation to their training in urology. These issues should be addressed to ensure that the training scheme sufficiently prepares GPs to manage common urological conditions.

Primary congenital bladder diverticula: Where does the ureter drain?

Background:Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome.Materials and Methods:We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up.Results:We treated 10 cases (11 renal units - [RU]), predominantly males (9/10), mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4) or febrile urinary tract infection (5) and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon's preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120) without complications.Conclusions:PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%). We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

Prostate cancer incidence in Turkey: an epidemiological study.

This study aimed to determine the incidence of prostate cancer in Turkey in a population-based sample, and to determine clinical and pathological characteristics of the cases. All newly diagnosed prostate cancer patients were included in this national, multi-centered, prospective and non- interventional epidemiological registry study conducted in 12 cities representing the 12 regions of Turkey from July 2008 to June 2009. The population-based sample comprised 4,150 patients with a recent prostate cancer diagnosis. Age-adjusted prostate cancer incidence rate was 35 cases per 100,000 in Turkey. At the time of diagnosis, median age was 68, median PSA level was 10.0 ng/mL. Digital rectal examination was abnormal in 36.2% of 3,218 tested cases. Most patients had urologic complaints. The main diagnostic method was transrectal ultrasound guided biopsy (87.8%). Gleason score was ≤6 in 49.1%, 7 in 27.8% and >7 in 20.6% of the cases. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.000). The majority of patients (54.4%) had clinical stage T1c. This is the first population-based national data of incidence with the histopathological characteristics of prostate cancer in Turkey. Prostate cancer remains an important public health concern in Turkey with continual increase in the incidence and significant burden on healthcare resources.

Cook resonance metallic ureteric stent: Contemporary clinical series assessing feasibility, safety and efficacy

Cook resonance metallic ureteric stent: Contemporary clinical series assessing feasibility, safety and efficacy

Prise en charge diagnostique et thérapeutique de la tuberculose urogénitale

Genito-urinary tuberculosis is the fourth most common manifestation of the disease, but it is often underestimated by clinicians because of few and non-specific symptoms and insidious disease course. The most common urinary findings are multiple ureteral stenosis. The most common genital involvement is an epididymal nodule for men and a chronic salpingitis for women. The definite diagnosis of genito-urinary tuberculosis is obtained on the basis of culture studies. Due to the paucibacillary nature of the disease, especially of genital location in woman, a probable or presumptive diagnosis is frequently considered with several parameters including radiological imaging (abdominal CT-scan, pelvic ultrasound, pelvic MRI). Endoscopic and surgical procedures are frequently required to obtain specimens for histopathologic and bacteriological studies. Medical treatment is the method of choice, with a combination of four drugs, namely isoniazid, rifampicin, ethambutol and pyrazinamide, followed by a two-drug regimen, for a total of six month duration. Surgery might be indicated in complicated genito-urinary tuberculosis (decreased renal function, infertility, urologic complaints).