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Urological Emergencies at the University Hospital of Brazzaville: Epidemiological, Clinical, and Therapeutic Aspects

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Open Journal of Urology 2024年第5期14卷 333-345页

作者： Roland Bertile Banga-Mouss Yannick Dimi Nyanga Irène Ondima Armel Melvin Atipo Ondongo Steve Aristide Ondziel-Opara Joseph Junior Damba Nick Arnaud Monabeka Christ Ondzé Daniella Gloire Ngassiele Gidmard Onguele Henock Songa Jetsvy Mayala Anani Wensels Severin Odzebe Prosper Alain Bouya Departement of Urology and Andrology University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.

关键词： Urological Emergencies Urinary Retention hematuria Renal Colic

Safety and efficacy of transcatheter arterial embolization for management of refractory hematuria of prostatic origin

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Journal of Interventional Medicine 2022年第2期5卷 84-88页

作者： Jinlong Zhang Quanyu Wang Hongwei Zhao Bing Yuan Xuedong Sun Yang Guan Zhuting Fang Maoqiang Wang Department of Radiology Bejing Tongren HospitalCapital Medical UniversityBejing 100730China Intrventional Department Huabei Petroleum General HospitalRengu062552China Departments of Interentional Radiology Chinese PLA General HospitalBejfing100853PR China Shengli Clinical Medical College of Pujian Medical University Fuchou350122PR China Deparment of Intervendional Radiology Fyjian Provincial HopitalFuzhou350001PR China

Objective: To estimate the safety and efficacy of transcatheter arterial embolization(TAE) in the treatment of refractory hematuria of prostatic origin(RHPO).Methods: This retrospective study included 23 patients who underwent TAE for RHPO between May 2013 and August 2021. Technical and clinical success rates were calculated, and arteriogram findings and complications were detected.Results: Embolization was performed 24 times in 23 patients. Technical success was achieved in 24/24(100%)embolization procedures. Contrast agent extravasation was detected during 2 of the 24 angiographic procedures.Bilateral embolization was performed in 23(95.8%) of the 24 procedures. The clinical success rate was 21/23(91.3%), and hematuria stopped 1–4 days after TAE. No serious complications were observed.Conclusion: TAE is a safe and effective minimally invasive technique for treating patients with RHPO.

关键词： Transcatheter arterial embolization hematuria Benign prostatic hyperplasia

Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia

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Chinese Medical Journal 2010年第9期123卷 1154-1157页

作者： GUO Li-jun TANG Yuan GUO Chao-ming ZHANG Xiang-hua Department of Urology Peking University First HospitalInstitute of UrologyPeking UniversityBeijing 100034China Department of Urology Gansu Province People HospitalLanzhouGansu 730000China

Background Both benign prostatic hyperplasia （BPH） and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.Methods All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor （VEGF） was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension. Results The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH （P〈0.01）. Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years （P 〈0.01）. Both microvessel density （MVD） based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH （P〈0.01, P〈0.05）.Conclusions Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.

关键词： benign prostatic hyperplasia hypertension hematuria angiogenesis

Post-coital gross hematuria： an unusual presentation of benign prostatic hyperplasia

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Asian Journal of Andrology 2007年第6期9卷 856-858页

作者： Yi-Hong Chen Pei-Yu Lin Yu-Sheng Cheng Johnny Shinn-Nan Lin Yung-Ming Lin Department of Urology College of Medicine National Cheng Kung University Tainan Taiwan 704 China

Aim： To describe an unusual symptom of benign prostatic hyperplasia （BPH）. Methods： A patient presented to our urology clinic having experienced post-coital gross hematuria for 2 years. He had not experienced lower urinary tract symptoms （LUTS）. A series of examinations were performed to determine the source of bleeding. Results： The prostate was defined as the active bleeding source responsible for the patient＇s post-coital hematuria. Endoscopic fulguration did not alleviate the symptom. The use of dutasteride, a dual inhibitor of 5α-reductase, solved the problem. Conclusion： This study reports for the first time that post-coital gross hematuria is one of the clinical presentations of BPH, which can be successfully treated with 5α-reductase inhibitor.

关键词： prostate coitus hematuria

The Comparison of Acute Clinical Outcome between 30 and 40 Sessions of Hyperbaric Oxygen Therapy for Management of Visible hematuria from Radiation-Induced Hemorrhagic Cystitis

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Open Journal of Urology 2022年第5期12卷 248-256页

作者： Prachya Supakitthanaroj Ronnarith Singpru Komson Vudthiprasert Urology Unit Department of Surgery Somdechprapinklao Hospital Bangkok Thailand Center of Hyperbaric Medicine Somdechprapinklao Hospital Bangkok Thailand

Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric stricture. The hematuria condition from radiation-induced hemorrhagic cystitis is the most common adverse event suffering the patients, losing properties, wasting time, and deteriorating quality of life. One of the most effective treatments for radiation-induced hemorrhagic cystitis is the hyperbaric oxygen therapy with no necessity for patients to be hospitalized, no need of anesthesia use, and also non-invasion. However, it requires that patients spend 90 - 120 minutes a day for 40 days administered out-patient treatment session. The transportation cost as well as the accommodation one will greatly burden the self-pay health care patients. In addition, there is still no definite standardized number of HBOT treatment session assignment at present. Objectives: To compare the treatment outcome (bladder mucosal characteristics, red blood cells in urine) between 30 and 40 sessions of HBOT for treatment of radiation-induced hemorrhagic cystitis. Methods: Prospective cohort observational study of patients (n = 15) who were diagnosed with radiation-induced hemorrhagic cystitis that were treated with hyperbaric oxygen therapy in Somdechprapinklao Hospital between October 2020 and September 2021. We compared the parameter about hemoglobin concentration, red blood cell number in urine during the course of HBOT treatment every 10 sessions and cystoscopic finding severity as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis in Table 1 before treatment, and after 30 and 40 sessions of treatment. Results: From 15 of treated patients, 93.3% of patients had evidence of posterior wall lesion. The mean duration from radiotherapy (radiation and brachytherapy) to the first episode gross hematuria is 112 months. This study shows no statistically different cystoscopic findings as EORTC/RTOG classificatio

关键词： Radiation-Induced Hemorrhagic Cystitis Irradiation Cystitis hematuria RIHC Hyperbaric Oxygen Therapy HBOT

Superselective embolisation of bilateral superior vesical arteries for management of intractable hematuria in context of metastatic bladder cancer

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Asian Journal of Urology 2017年第2期4卷 131-134页

作者： Ahmed Saadi Abderrazak Bouzouita Mohamed Hedi Rebai Mohamed Cherif Walid Kerkeni Haroun Ayed Amine Derouiche Hatem Rajhi Riadh Ben Slama Najla Mnif Mohamed Chebil Department of Urology Charles Nicolle University HospitalTunisTunisia Department of Radiology Charles Nicolle University HospitalTunisTunisia

hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia.After failure of endoscopic resections and“flush”of radiotherapy haemostatic and refusal of cystectomy by the patient,he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results.The technique is safe and effective in the short term.The longterm effectiveness requires further investigation.

关键词： Urinary bladder neoplasms hematuria Therapeutic embolisation

Intractable hematuria due to giant prostatic hyperplasia effectively treated with prostatic artery embolization

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Asian Journal of Urology 2020年第3期7卷 318-321页

作者： Issam Kably Alexander Bode Jackson Memorial Hospital Department of Vascular and Interventional Radiology(R-109)PO Box 016960MiamiFLUSA University of Miami Leonard M.Miller School of Medicine 1600 NW 10th Ave#1140MiamiFLUSA

Giant prostatic hyperplasia(GPH)is a rare pathology traditionally treated with an open suprapubic prostatectomy.This procedure is risky,and fatal hemorrhagic complications can occur.Often,patients with GPH present with diminished renal function due to obstructive nephropathy,making them unfit for less invasive endovascular therapies using traditional contrast agents.Here we present a case of a patient with intractable hematuria due to GPH,as well as diminished renal function,who was successfully treated using prostatic artery embolization with CO2 digital subtraction arteriography as a contrast agent.

关键词： hematuria Embolization Giant prostatic hyperplasia

Disseminated peritoneal leiomyomatosis with malignant transformation involving right ureter:A case report

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World Journal of Clinical Cases 2022年第5期10卷 1639-1644页

作者： Chen-Yueh Wen Herng-Sheng Lee Jen-Tai Lin Chia-Cheng Yu Division of Urology Department of SurgeryKaohsiung Veterans General HospitalKaohsiung 81346Taiwan Lee Department of Pathology and Laboratory MedicineKaohsiung Veterans General HospitalKaohsiung 81346Taiwan School of Medicine National Yang-Ming UniversityTaipei 814Taiwan Department of Pharmacy Tajen UniversityPingtung 900Taiwan

BACKGROUND Disseminated peritoneal leiomyomatosis(DPL)with myxoid leiomyosarcoma is a rare variant of leiomysosarcoma,and hematuria as a presenting symptom has never been reported.Through this case report,we emphasize the investigation of the etiology,clinical presentation,diagnosis,treatment,and prognosis of DPL with malignant changes mimicking metastatic urinary tract cancer and to help develop further clinical management.CASE SUMMARY We describe a case of DPL with malignant transformation involving the right ureter after laparoscopic hysterectomy.An exploratory laparotomy was performed and all visible nodules were surgically removed.DPL with focal malignant transformation to myxoid leiomyosarcoma was confirmed based on pathology results.CONCLUSION Professionals who preoperatively diagnose DPL with malignant change to myxoid leiomyosarcoma involving the genitourinary tract should consider symptoms of abdominal pain,hematuria,and imaging of disseminated pelvic tumors in women,especially those with prior history of laparoscopic hysterectomy.Early complete removal of all tumors is the cornerstone to prevent DPL from malignant changes.

关键词： Disseminated peritoneal leiomyomatosis Leiomyosarcoma Laparoscopic hysterectomy hematuria Ureteroneocystostomy Case report

The wrath of pancreatic enzymes:a rare case of hematuria

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Journal of Pancreatology 2019年第3期2卷 113-115页

作者： Twohig Patrick A. Rivington Jaclyn R. Soma David Becker Jeffery Department of Medicine Case Western Reserve UniversityMetroHealth HospitalClevelandOH 44109USA

Acute pancreatitis(AP)is an inflammatory disease of the pancreas.It is one of the most common diseases of the gastrointestinal tract,with an annual incidence of 4.9 to 73.4 cases per 100,000 worldwide.[1]AP is the most common gastroenterology hospital discharge diagnosis.[1]The most common cause of AP is gallstones impacting the distal common bile-pancreatic duct(38%)and alcoholism(36%).[2]It is associated with many local complications including peripancreatic fluid collections,pseudocysts,and necrosis(Fig.1).Many of these complications occur secondary to proteolytic damage and systemic inflammatory response syndrome,which significantly increase the morbidity and mortality risk of AP.[2]We present an unusual complication of AP:the first documented case of destruction of the ureter from pancreatic enzymes.

关键词： Acute pancreatitis Case report hematuria Ureteral damage