1,721,411 research outputs found
Editorial Comment on: Induction and maintenance adjuvant mitomycin C topical therapy for upper tract urothelial carcinoma: tolerability and intermediate term outcomes by metcalfe et al
No full textFlexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review
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Bladder utility symptom scale: a new patient reported outcome measure for health-related quality of life in bladder cancer
No full textA Complete World Literature Review of Quality of Life (QOL) in Patients with Kidney Stone Disease (KSD)
Get PDFPURPOSE OF REVIEW: The purpose of this study was to review the current evidence for quality of life (QOL) in patients with kidney stone disease (KSD).RECENT FINDINGS: A review of literature from inception to May 2016 for all prospective English language articles on QOL in patients with KSD was done. QOL studies post urological procedures or ureteric stents were excluded. Nine studies (1570 patients) were included of which most (n = 6) used the SF-36 QOL tool. Overall, seven of the nine studies demonstrated a lower QOL in patients with KSD. Bodily pain and general health were significantly lower in patients with KSD compared to their control groups. Patients with KSD have an overall lower QOL with most impact on bodily pain and general health domains. Compared to the scale of patients suffering from KSD, more work needs to be done in measuring QOL both in terms of 'Stone specific' QOL measuring tools and the quality/number of studies in this field.</p
Ureteroscopy for paediatric calculi: the twin-surgeon model
No full textWe describe our ‘Tips and tricks’ of ureteroscopy and lasertripsy (URSL) for paediatric ureteric calculi. All regional referrals directed to the paediatric urologist are discussed in a formal stone multidisciplinary team (MDT) meeting with urologists, radiologists, and biochemical pathologist. A paediatric urologist (SG) and an experienced adult endourologist (BS) do these stone procedures jointly as a twin-surgeon team approach for each patient.</p
Recent trends in postcystectomy health-related Quality of Life (QoL) favors neobladder diversion: Systematic Review of the Literature
No full textThe study aims to review the current evidence for quality of life posturinary diversion surgery comparing neobladder to other types of diversion. A review of literature from inception to July 2015 for all English-language articles was done. Based on our inclusion criteria, 22 studies (2450 patients) were included. Whereas none of the prospective studies showed any quality of life (QoL) advantage with ileal conduit diversion, 3 of the 5 prospective studies and 4 of the 6 studies published after 2011 show better QoL outcomes with neobladder than other urinary diversion types. All prospective studies published after 2011 have shown neobladder to have superior QoL outcomes than its comparators. Recent trends indicate that orthotopic neobladder postcystectomy is associated with better QoL outcomes compared to other urinary diversion types.</p
Safety and feasibility of day case ureteroscopy and laser lithotripsy (URSL) in patients with a solitary kidney
No full textINTRODUCTION: The management of nephrolithiasis in patients with a solitary kidney poses a treatment challenge. The study aimed to evaluate the outcomes of ureteroscopy and laser stone fragmentation (URSL) for renal stones in these patients treated in our university teaching hospital.MATERIAL AND METHODS: Between July 2012 and December 2014, seventeen cases of URSL for stones in a solitary kidney were reviewed. Patient demographics, stone dimensions, perioperative and post-operative outcomes were recorded in a prospectively maintained database. Serum creatinine levels pre-procedure and at follow-up were also compared.RESULTS: Seventeen cases of URSL were conducted with a mean age of 52.9 ±19.9 years. 8 of the 17 (47%) patients had stones in multiple locations and 13 (76%) were in the lower pole. The mean ± SD stone size and BMI were 13.0 ±8.9 mm and 31.6 ±5.8 kg/m(2), respectively. The stone free rate (SFR) was 82.5%. Fourteen (82.5%) patients were discharged the same day and 16 cases (94%) were discharged within 24 hours. For patients with deranged pre-operative serum creatinine, the mean serum creatinine level improved from 131.2 ±68.3 µmol/L pre-URSL to 106.5 ±36.7 µmol/L at follow-up. There was one Clavien grade II complication with a patient requiring additional antibiotics for post-operative urinary tract infection. There were no other major or minor complications.CONCLUSIONS: Day case ureteroscopy for stone disease in a solitary kidney is safe and feasible with a low complication rate and an overall improvement in renal function.</p
Lymphocytopenia may be a new indicator for infected obstructed kidneys secondary to urinary stone disease
No full textObjective: Infected obstructed kidney (IOK) is a urological emergency. We wanted to look at the role of serum inflammatory markers in these patients.
Materials and Methods: Patients with IOK requiring percutaneous nephrostomy (PCN) at our university hospital were identified, and data were collected on lymphocyte count, C-reactive protein (CRP) and microbiology results.
Results: Thirty-nine patients had PCN for IOK. Lymphocytopenia was seen in two-thirds of these patients. Severe lymphocytopenia was associated with a significant rise in CRP in all cases and following PCN, lymphocytopenia improved in the majority of cases.
Conclusions: Lymphocytopenia seems to be associated with the severity of infection and could be a surrogate marker on its own or in conjunction with CRP for initial diagnosis and monitoring response to treatment in patients with IOKs
Ureteroscopy for stone disease in the paediatric population: a systematic review
No full textThe aim of the present review was to look at the role of ureteroscopy (URS) for treatment of paediatric stone disease. We conducted a systematic review using studies identified by a literature search between January 1990 and May 2013. All English-language articles reporting on a minimum of 50 patients aged ≤ 18 years treated with URS for stone disease were included. Two reviewers independently extracted the data from each study. A total of 14 studies (1718 procedures) were reported in patients with a mean (range) age of 7.8 (0.25-18.0) years. The mean (range) stone burden was 9.8 (1-30) mm and the mean (range) stone-free rate (SFR) 87.5 (58-100)% with initial therapeutic URS. The majority of these stones were in the ureter (n = 1427, 83.4%). There were 180 (10.5%) Clavien I-III complications and 38 cases (2.2%) where there was a failure to complete the initial ureteroscopic procedure and an alternative procedure was performed. To assess the impact of age on failure rate and complications, studies were subcategorized into those that included children with either a mean age <6 years (four studies, 341 procedures) or a mean age >6 years. (10 studies, 1377 procedures). A higher failure rate (4.4 vs 1.7%) and a higher complication rate (24.0 vs 7.1%) were observed in children whose mean age was <6 years. URS for paediatric stone disease is a relatively safe procedure with a reasonably good SFR, but there seems to be a higher failure and complication rate in children aged <6 years.</p
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