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When should we give up on expectant management for patients with proximal ureteral stones?

Current Urology 2022年第1期16卷 9-14页

作者： igal shpunt Etay Elbaz Yuval Avda Jonathan Modai Dan Leibovici Brian Berkowitz Yaniv Shilo Department of Urology Kaplan Medical CenterRehovot7661041Israel Department of Earth and Planetary Sciences Weizmann Institute of ScienceRehovotIsrael

Background:Proximal ureteral stones(PUS)have relatively low rates of spontaneous ***,some patients do on expectant *** aim was to compare risk factors for surgical intervention in patients with PUS who underwent primary intervention to those subjected to expectant *** and methods:We retrospectively reviewed the medical charts of patients presented to the emergency room with symptoms of renal colic and underwent computerized tomography between August 2016 and August 2017.A total of 97 consecutive patients were identified with up to 10 mm *** collected patient demographics,clinical,and imaging data,and performed binary regression analysis for risk of ***:The average age was 49years(range 17-97)and average stone size was 7.1 mm(range 3-10).Forty-one patients underwent immediate intervention while the remaining 56 patients were treated *** the 56 patients treated conservatively,26 underwent delayed intervention while 30 reported spontaneous stone *** univariate analysis of all 97 patients,statistically significant risk factors for intervention were found based on stone size,age,serum lymphocyte,platelet counts,and stone *** these risk factors,stone size≥7mm(p=0.012,odds ratio=5.4)and platelet count?230K/mL(p=0.027,odds ratio=4.9)remained statistically significant on multivariate ***:Stone size and platelet count were found to be risk factors for surgical intervention in patients with up to 10 mm *** findings may assist in identifying patients who are more suitable for conservative approach.

关键词： Nephrolithiasis Renal colic Ureteral calculi Ureterolithiasis Urolithiasis

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Adjuvant chemotherapy after radical cystectomy:Do all patients who need chemotherapy after surgery actually receive it?

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Current Urology 2023年第2期17卷 109-112页

作者： Roy Croock Jonathan Modai Yuval Avda igal shpunt Morad Jaber Yamit Peretz Yaniv Shilo Dan Leibovici Department of Urology Kaplan Medical CenterRehovotIsrael

Background:Compliance with the guideline recommendations for neoadjuvant chemotherapyin patients with muscle-invasive bladder cancer is *** adjuvant chemotherapy approach has the advantage of pathology-based decision-making,allowing for patient *** addition,radical surgery is not delayed and treatment-related toxicity does not impair surgical *** proportion of patients who completed chemotherapy after cystectomy among those who were fit and in need of treatment were *** reasons for not completing adjuvant chemotherapy were *** and methods:We retrospectively evaluated all patients who had undergone radical cystectomy at our center over thelast 7 *** for adjuvant chemotherapy included pathological T>2,any node+,or surgical margin *** patients who were fit for chemotherapy before surgery were included in the ***:Of the 52 patients with muscle-invasive bladder cancer,14 received neoadjuvant chemotherapy or unfit for chemotherapy were *** the remaining 38 patients,14(37%)had bladder-confined cancers and did not require additional *** the 24 patients who needed chemotherapy and were fit to receive it,8 patients completed treatment(33%),and 3 discontinued treatment due to *** patients(50%)declined chemotherapy,whereas 1 patient became unfit for chemotherapy after ***:While the adjuvant chemotherapy approach could save unnecessary treatment in 37%of patients,two-thirds of those who needed chemotherapy did not complete *** refusal was the primary reason for not receiving treatment.

关键词： Adjuvant chemotherapy Muscle-invasive bladder cancer Neoadjuvant chemotherapy

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