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The Aging Bladder in Females Evaluated by Urodynamics

Open Journal of Urology 2017年第3期7卷 54-64页

作者： M. C. de Albuquerque Neto Leslie Clifford Noronha Araujo Thome Decio Pinheiro Barros Junior Joao Luiz Amaro Flavia Cristina Morone Pinto Fabio de Oliveira Vilar Salvador Vilar Correia Lima urologic Department Clinical Hospital Federal University of Pernambuco UFPE Recife Brazil urologic service Botucatu Medical School Paulista State University UNESP Botucatu Brazil Postgraduate Program in Surgery Department of Surgery Center for Health Sciences Federal University of Pernambuco UFPE Recife Brazil

Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.

关键词： Aging Urinary Bladder Diseases Urinary Bladder Neurogenic Overactive Urodynamics

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Partial Nephrectomy for Renal Cell Carcinoma: Risk Factors for Acute Post-Operative Hemorrhage and Impact on Subsequent Hospital Course and Complete Nephrectomy Rate. An Analysis of 200 Consecutive Cases

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International Journal of Clinical Medicine 2013年第12期4卷 5-9页

作者： James Cavalcante Alan Perrotti Philip Rabadi Alicia McCarthy Michael Perrotti urologic Oncology service Saint Peter’s Hospital Cancer Care Center Saint Peter’s Health Partners Albany New York USA

Purpose: Clinical guidelines recommend partial nephrectomy (PN) as the preferred method of surgical excision of the small renal tumor whenever feasible. PN has comparable cancer cure rates to that of radical nephrectomy in this setting, and decreased risk of chronic kidney disease. A recognized devastating complication following partial nephrectomy is acute post-operative hemorrhage (APOH) from the reconstructed kidney. Risk factors for hemorrhage following partial nephrectomy remain poorly elucidated, as does the impact of hemorrhage on subsequent hospital stay. Identification of risk factors for hemorrhage may lead to a better understanding of and reduction of this complication. Material and Methods: We utilized a prospectively managed database comprised of patients undergoing open partial nephrectomy at our institution by the same surgical team from January 2006 to July 2012. Clinicopathologic factors assessed APOH for their relationships, including patient age, gender, diabetes, smoking, hypertension, coronary artery disease, American Society of Anesthesia Score (ASA), tumor size, RENAL nephrotomy score, pathologic result, cancer margin status, operative time, and intra-operative blood loss. The impact of APOH on subsequent hospital course was evaluated and compared with the entire cohort. Results: Data were analyzed from 200 consecutive patients. We identified 7 patients (3.5%) who experienced APOH. Compared with the entire cohort, APOH resulted in an increased hospital length of stay (median, 5 days;range, 2-11 days, p = 0.001), an increased transfusion requirement (median, 6 units;range, 1-16 units. p = 0.001), a greater risk of selective angiographic embolization (median, 2 procedures;range, 0-3, p = 0.001), and completion nephrectomy (n = 2, p = 0.001). One patient in the APOH group experienced cardiac arrest and was resuscitated. Clinicopathologic factors associated

关键词： Kidney Neoplasms Partial Nephrectomy Renal Cell Carcinoma

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Professionalism and patient education in urologic surgery

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World Journal of Clinical Urology 2013年第3期2卷 42-45页

作者： C J Stimson Roger R Dmochowski Department of urologic Surgery Vanderbilt University Medical Center Nashville TN 37232-0001 United States

Medical professionalism provides the guidelines that govern the patient-physician relationship. This implicit contract requires that patients be informed before making decisions regarding their medical care. Educating patients about diagnostic and treatment decisions is critical to an informed decision-making process. Shared decision-making is a recent paradigm shift in patient education that allows patients to make decisions based both on the counsel of their physicians and according to their own preferences and values. This approach moves away from previous models that focused on physicians or third-party payers as the arbiters of diagnostic and treatment choices. urologic surgeons have been at the forefront of shared decision-making research and continue to promote this concept in the most recent American urological Association Guideline on Detection of Prostate Cancer. Unfortunately, the feefor-service financial structure that predominates in the United States' health care system provides a disincentive for shared decision-making. By promoting patient volume rather than time spent with patients, this system rewards physicians who spend less time educating patients about diagnostic and treatment options. Therefore, to promote adherence to the educational responsibility inherent in medical professionalism, werecommend physician payment reform that rewards physicians for time spent with patients rather than the volume of patients seen.

关键词： Urology Health care reform Professionalism Patient education Decision making Informed consent

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LOOP CYSTOURETHRAL CATHETERIZATION IN POSTERIOR URETHRAL TRAUMATIC STRICTURE

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Chinese Medical Journal 1980年第11期

作者：张振湘 urologic service Department of SurgeryAffiliated HospitalShandong Medical CollegeJinanShandong

A safe and reliable method of postoperativeurethral sounding for the treatment of traumaticstricture of the posterior urethra is *** the urethral catheter and suprapubic tubeare being removed,a plastic tube is introducedinto the urethra and bladder with one end lead-ing out through the suprapubic wound and theother through the external urethral meatus andthe 2 ends are fixed together to form a loop toprevent *** urethral sounding is tobe performed,the loop is opened and a filiformbougie is inserted firmly into the urethral endof the plastic *** by the bougie,themetallic follower can be put in without *** far no significant complications havebeen observed.

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Structure and function of epididymal protein cysteine-rich secretory protein-1

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Asian Journal of Andrology 2007年第4期9卷 508-514页

作者： Kenneth P. Roberts Daniel S. Johnston Michael A. Nolan Joseph L. Wooters Nicole C. Waxmonsky Laura B. Piehl Kathy M. Ensrud-Bowlin David W. Hamilton Department of urologic Surgery Cell Biology and Development University of Minnesota Minneapolis MN 55455 Contraception Women＇s Health ＆ Musculoskeletal Biology Woman＇s Health Research Institute Wyeth Research Collegeville PA 19426 USA Inflammation Department Molecular Profiling and Biomarker Discovery Wyeth Research Cambridge MA 02140 USA Biological Technologies Molecular Profiling and Biomarker Discovery Wyeth Research Cambridge MA 02140 USA Department of Genetics Cell Biology and Development University of Minnesota Minneapolis MN 55455 USA

Cysteine-rich secretory protein-1 （CRISP-1） is a glycoprotein secreted by the epididymal epithelium. It is a member of a large family of proteins characterized by two conserved domains and a set of 16 conserved cysteine residues. In mammals, CRISP-1 inhibits sperm-egg fusion and can suppress sperm capacitation. The molecular mechanism of action of the mammalian CRISP proteins remains unknown, but certain non-mammalian CRISP proteins can block ion channels. In the rat, CRISP-1 comprises two forms referred to as Proteins D and E. Recent work in our laboratory demonstrates that the D form of CRISP-1 associates transiently with the sperm surface, whereas the E form binds tightly. When the spermatozoa are washed, the E form of CRISP-1 persists on the sperm surface after all D form has dissociated. Cross-linking studies demonstrate different protein-protein interaction patterns for D and E, although no binding partners for either protein have yet been identified. Mass spectrometric analyses revealed a potential post-translational modification on the E form that is not present on the D form. This is the only discernable difference between Proteins D and E, and presumably is responsible for the difference in behavior of these two forms of rat CRISP- 1. These studies demonstrate that the more abundant D form interacts with spermatozoa transiently, possibly with a specific receptor on the sperm surface, consistent with a capacitation-suppressing function during sperm transit and storage in the epididymis, and also confirm a tightly bound population of the E form that could act in the female reproductive tract. （Asian J Androl 2007 July; 9： 508-514）

关键词： cysteine-rich secretory protein-1 epididymis sperm capacitation

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World Journal of Orthopedics 2013年第1期4卷 19-23页

作者： Gary A Fantini Abhijit Y Pawar Spinal Surgical service Department of Orthopaedic Surgery Hospital for Special Surgery and Weill Cornell Medical College New York NY 10021 United States

The new millennium has witnessed the emergence of minimally invasive, non-posterior based surgery of the lumbar spine, in particular via lateral based methodologies to discectomy and fusion. In contrast, and perhaps for a variety of reasons, anterior motion preservation(non-fusion) technologies are playing a comparatively lesser, though incompletely defined, role at present. Lateral based motion preservation technologies await definition of their eventual role in the armamentarium of minimally invasive surgical therapies of the lumbar spine. While injury to the major vascular structures remains the most serious and feared complication of the anterior approach, this occurrence has been nearly eliminated by the use of lateral based approaches for discectomy and fusion cephalad to L5-S1. Whether anterior or lateral based, non-posterior approaches to the lumbar spine share certain access related pitfalls and complications, including damage to the urologic and neurologic structures, as well as gastrointestinal and abdominal wall issues. This review will focus on the recognition, management and prevention of these anterior and lateral access related complications.

关键词： Anterior spinal exposure Lumbar spine Complications

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Gangrene of the External Genitalia at the Regional University Hospital Center of Ouahigouya: Epidemiological Profile and Therapeutic Aspects

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Open Journal of Urology 2020年第6期10卷 184-191页

作者： Tiéoulé Mamadou Traore Clô taire Alexis Marie Kiemdiba Donega Yameogo Moussa Kabore Souleymane Ouedraogo service de chirurgie du CHU régional de Ouahigouya Ouahigouya Burkina Faso service d’urologie du CHU Yalgado Ouédraogo Ouagadougou Ouaga Ouagadougou Burkina Faso

Introduction: Gangrene of extern genitary organs is a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that results from a polymicrobial infection. Mortality remains high despite advances in resuscitation. We report the experience of the surgery department of the Regional University Hospital Center (CHUR) of Ouahigouya in order to describe the epidemiological profile and the therapeutic aspects of GOGE. Patients and methods: We carried out a descriptive and analytical retrospective study collecting 41 cases of Fournier’s gangrene treated over 63 months (from March 2013 to July 2018) in the surgical department of the Ouahigouya regional university hospital center. Ethical clearance was taken from the institutional ethics committee. Results: The mean age of the patients was 65.02 ± 17.92 years with extremes of 23 years and 95 years. All patients were male. urologic causes were the most common with 36.58% of cases. The average consultation time was 15.44 ± 16.04 days with extremes of 1 day and 60 days. All patients received resuscitation, bi or triantibiotherapy and surgical debridement. The mortality rate was 24.39%. The mean duration of hospitalization was 10.83 ± 6.257 days with extremes of 1 day and 60 days. Conclusion: The Fournier’s gangrene always has a very high lethality. Improving the prognosis requires fast and effective management.

关键词： Fournier’s Gangrene Epidemiology Emergency Mortality

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Management of urological Lesions Secondary to Obstetrical Gyneco Surgery in the Urology Department of the Gabriel Toure University Hospital Centre

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Surgical Science 2018年第7期9卷 203-209页

作者： Amadou Berthé Mamadou Tidiane Coulibaly Adama Toutou Diallo Moumine Zié Diarra Ibrahim Yattara Zanafon Outtara Amidou Domegué Ouattara Thièrno Madane Diop Urology service Gabriel Touré University Hospital Bamako Mali Urology service of the CHU du Point G Bamako Mali Anesthesia Unit Resuscitation at Gabriel Touré University Hospital Bamako Mali

Summarizes: The objective of this work was to study the clinical, diagnostic, therapeutic and evolutionary aspects of urological lesions secondary to gynaeco-obstetrical surgery in the urology department of the Gabriel Touré University Hospital. Material and method: It was a transversal and retrospective study carried out in the urology department of the Gabriel Touré University Hospital Centre in Bamako over 8 years. It focused on the files of 25 patients operated on for a urological lesion secondary to gynaeco-obstetrical surgery. Sociodemographic, epidemiological, diagnostic, therapeutic and evolutionary parameters were analysed. Results: urologic lesions secondary to gynaeco-obstetrical surgery were found in 0.72% of urologically operated patients. The mean age of the patients was 39 ± 10.4 years (extremes: 18 and 60 years). The average time to diagnosis was 121, 88 ± 15 days (extremes: 0 and 365 days). Clinical signs were: oligo anuria (16%), urine leakage (52%), lumbar pain (24%). The diagnosis was made by the methylene blue test in 56% of patients, by the uro-scanner (20%) and by intravenous urography (16%). In 8% of patients, the diagnosis was made during surgery. The surgical interventions involved were: hysterectomy (48%), cesarean section (40%), genital prolapse cure (8%), ovarian cystectomy (4%). Lesions were dominated by vaginal vesico fistulas (48%) followed by ureterovaginal fistulas (20%), ureteral ligatures (16%). Treatment consisted of ureterovesical reimplantation according to Lich Gregory with ureteral intubation (36%), fistulography (48%). Healing was achieved in 92% of patients. Conclusion: Hysterectomy for cervical malignancy and cesarean section are the main etiologies of urological lesions secondary to gynaeco-obstetrical surgery. Open surgery is the only alternative for the management of these lesions in our context. Controlling anatomy is the main preventive measure.

关键词： urologic Lesions Gyneco-Obstetrical Surgery

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Prazosin:a potential new management tool for iatrogenic autonomic dysreflexia in individuals with spinal cord injury?

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Neural Regeneration Research 2015年第4期10卷 557-558页

作者： Mei M.Z.Zheng Aaron A.Phillips Stacy L.Elliott Andrei V.Krassioukov Experimental Medicine Program Faculty of MedicineUniversity of British ColumbiaVancouver V5Z 1M9Canada International Collaboration on Repair Discoveries (ICORD) University of British ColumbiaVancouver V5Z 1M9Canada Centre for Heart Lungand Vascular HealthFaculty of Health and Social DevelopmentUniversity of British ColumbiaKelowna V1V 1V7Canada Department of Psychiatry University of British Columbiaancouver V6T 2A1Canada Department of and urologic Sciences University of British ColumbiaVancouver V5Z 1M9Canada Vancouver Sperm Retrieval Clinic Vancouver Coastal Health AuthorityVancouver V5Z 1M9Canada G.F.Strong Rehabilitation Center Sexual Health Rehabilitation ServiceVancouver V5Z 2G9Canada Division of Physical Medicine and Rehabilitation Department of MedicineUniversity of British ColumbiaVancouver V5Z 2G9Canada

Spinal cord injury （SCI） is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions （Krassioukov and Claydon, 2006）. Autonomic dysreflexia （AD） is a life threatening episode of tran- sient hypertension that occurs up to 30x/day （1 Ix/day on average） in those with cervical or high thoracic SCI （Hubli et al., 2015）. Most common triggers of AD are from stimuli such as a full bowel and/or bladder, or sexual arousal （Teasell et al., 2000）. Penile vibrostimulation （PVS） is a clinical pro- cedure for sperm retrieval used for the purpose of family planning or fertility assessment that unfortunately iatrogenically induces episodes of AD （Elliott, 2006）. Recently, we published a clinical trial highlighting that prazosin may be a viable option for treating AD secondary to PVS （Phillips et al., 2014）.

关键词： Prazosin SCI AD DBP

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Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China:A nationwide,multi-center,population-based cross-sectional study

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Chinese Medical Journal 2024年第11期137卷 1324-1331页

作者： Weiyu Zhang Huixin Liu Ming Liu Shi Ying Renbin Yuan Hao Zeng Zhenting Zhang Sujun Han Zhannan Si Bin Hu Simeng Wen Pengcheng Xu Weimin Yu Hui Chen Liang Wang Zhitao Lin Tao Dai Yunzhi Lin Tao Xu Department of Urology Peking University People’s HospitalBeijing 100044China Department of Clinical Epidemiology and Biostatistics Peking University People’s HospitalBeijing 100044China Department of Urology Beijing HospitalNational Center of GerontologyBeijing 100005China Institute of Geriatric Medicine Chinese Academy of Medical SciencesBeijing 100005China Department of Urology Wuhan Union HospitalHuazhong University of Science&TechnologyWuhanHubei 430022China Department of Urology The Third People’s Hospital of ChengduChengduSichuan 610014China Department of Urology West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of urologic Oncology Tianjin Medical University Cancer Institute&HospitalTianjin 300060China Department of Urology Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China National Cancer Center Beijing 100021China National Clinical Research Center for Cancer Beijing 100021China Department of Urology Liaoning Cancer HospitalShenyangLiaoning 110801China Department of Urology The Second Hospital of Tianjin Medical UniversityTianjin 300141China Tianjin Institute of Urology Tianjin Medical UniversityTianjin 300141China Department of Urology Lu’an Affiliated Hospital of Anhui Medical UniversityLu’anAnhui 237322China Department of Urology Renmin Hospital of Wuhan UniversityWuhanHubei 430060China Department of Urology Harbin Medical University Affiliated Cancer HospitalHarbinHeilongjiang 150081China Department of Urology The Second Hospital of Dalian Medical UniversityDalianLiaoning 116023China Department of Urology Surgery Fujian Cancer HospitalFuzhouFujian 350014China Department of Urology Surgery Hunan Cancer HospitalChangshaHunan 410031China Department of Urology Surgery The First Affiliated Hospital of Fujian Medical UniversityFuzhouFujian 350004China

Background:Cardiovascular disease(CVD)has emerged as the leading cause of death from prostate cancer(PCa)in recent decades,bringing a great disease burden *** with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy(ADT).The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in ***:Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience *** was defined as myocardial infarction,arrhythmia,heart failure,stroke,ischemic heart disease,and *** risk was estimated by calculating Framingham risk scores(FRS).Patients were accordingly divided into low-,medium-,and high-risk groups.χ2 or Fisher’s exact test was used for comparison of categorical ***:A total of 4253 patients were enrolled in the present study.A total of 27.0%(1147/4253)of patients had comorbid PCa and CVD,and 7.2%(307/4253)had two or more *** enrolled population was distributed in six regions of China,and approximately 71.0%(3019/4253)of patients lived in urban *** imaging and pathological evaluation,most PCa patients were diagnosed at an advanced stage,with 20.5%(871/4253)locally progressing and 20.5%(871/4253)showing *** of them initiated prostatectomy(46.6%,1983/4253)or regimens involving ADT therapy(45.7%,1944/4253)for prostate *** the present PCa cohort,43.1%(1832/4253)of patients had hypertension,and half of them had poorly controlled blood *** FRS stratification,as expected,a higher risk of CVD was related to aging and metabolic ***,we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without *** was in accordance with clinical practice,i.e.,aged patients or patients at advanced oncological stages were inclined to accept sys

关键词： Prostate cancer Castration Cardiovascular disease Prevalence Cardiovascular risk

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