1,721,020 research outputs found
Benign prostatic hyperplasia: correlations between receptor density and binding affinity of alpha(1)-adrenoceptors and several clinical parameters.
No full textThe aim of the study was to determine whether relations do exist between the concentration and activity of alpha(1)-adrenoceptors, both inside the prostatic adenoma and the periurethral zone corresponding to the bladder neck, and clinical and biological parameters such as symptoms, evaluated by the American Urological Association (AUA) score, age, weight of the prostate, PSA, and the flow rate. Twenty patients with symptomatic benign prostatic hyperplasia were selected for an open prostatectomy. One gram of tissue was dissected from inside the adenoma and 1 g from the periurethral zone corresponding to the bladder neck. The alpha(1)-adrenoceptors were evaluated for the apparent dissociation constant (K(d)) and the maximal number of binding sites (B(max)). A correlation seems to exist between receptor density inside the adenoma and the bladder neck and an inverse correlation between receptor density and the AUA total symptoms score. Finally, a highly significant difference was found in patients with an AUA score of 15. No relationship was found between receptor binding affinity and the considered clinical parameters
Ureterorenoscopy: avoiding and managing the complications
No full textRetrograde exploration of the ureter and kidneys is currently a widely used and well-established procedure to deal with problems of a diagnostic and therapeutic nature with reduced invasiveness. The process of miniaturizing the instruments combined with the steady improvement in video quality has continuously amplified its potential applications, maintaining the procedure safe and rapid. During an operation, however, unexpected events may condition a change to the programme or determine the onset of even more serious complications. Our aim is to analyze such events and complications and recommend potential solutions to prevent and/or deal with such happenings
Prospective Comparison of Outcomes of Percutaneous Nephrolithotomy in Elderly Patients Versus Younger Patients
No full textPurpose: The purpose of the study was to prospectively compare operative and postoperative characteristics and outcomes in elderly patients undergoing percutaneous nephrolithotomy (PCNL) compared with younger patients.
Patients and Methods: Prospectively collected data from the Clinical Research Office of the Endourological Society (CROES) Global PCNL Study database were used. Elderly patients were defined as those aged 70 years and above, while younger patients were those between 18 and 70 years of age. Matched and unmatched group comparisons were performed based on imaging modality used for assessing stone-free status. Patient characteristics, operative data, and postoperative outcomes were compared.
Results: The median age of the elderly group vs the young group was 74 years (range 70–93 years) vs 49 years. In the unmatched analysis, staghorn stones were seen at higher rates in the elderly group (27.8% vs 21.8%, P=0.014); however, the mean stone size was not significantly different (465.0 vs 422.8, P=0.063). The length of hospitalization was significantly longer in the elderly group compared with the young group in the unmatched analysis (5 days vs 4.1 days, P<0.001). The same difference was not apparent in the matched analysis (5.0 days vs 4.4 days, P=0.288). Overall complication rates were not significantly different in the unmatched analysis. In the matched analysis, however, a statistically significant higher rate of overall complications was seen. Stone-free rates were similar among all groups.
Conclusion: PCNL in elderly patients over the age of 70 years produces results comparable to those seen in younger patients. With only a slightly higher—be it statistically significant—complication rate, the stone-free rate in older patients was the same as in the younger group
An introduction to biomaterials in urology
No full textAim of this paper is to provide a brief introduction on the biomaterials used in urology, discussing issues of biocompatibility and biomaterials available for use. Information will moreover be provided on basic elements of Tissue engineering and Regenerative medicine, rapidly advancing technologies that could finally shift in the next future from the laboratory to clinical practice, with special interest to possible urological application
When to suspect a genetic disorder in a patient with renal stones, and why
No full textNephrolithiasis is a common disorder, with a rising prevalence in the general population. Its pathogenesis is still unclear, but a role for genetics has long been recognized, especially in cases of the more common calcium nephrolithiasis. Although relatively rare, monogenic causes of hypercalciuria and nephrolithiasis do exist and their timely recognition is important from a prognostic and therapeutic viewpoint. This article reviews the clinical and laboratory findings characterizing inherited causes of nephrolithiasis with a view to helping clinicians to recognize and manage these rare conditions
Penile curvature: an update for management from 20 years experience in a high volume centre
No full textOur aim was to review the literature and discuss about penile curvature in order to have an update for management after 20 years experience in the field.Penile curvature may be congenital or acquired. Congenital penile curvature is a relatively uncommon condition that may present in late adolescent or early adult life. The incidence is estimated to be 0.6 %. On the other side, acquired penile curvature has an overall prevalence of 0.5-13%. Three main factors seem to increase the risk of developing an acquired penile curvature, often related to Peyronie's disease: penile traumatism, genetic and familiar conditions and a history of diseases of the genital tract. In treating Peyronie's disease, no medical therapy is fully effective, and surgery remains the gold standard in cases of severe deformity and/or erectile disfunction. Peyronie's disease is associated with significant psychological stress for patients and their partners. Appropriate treatment should be individualized and tailored to the patient's goals and expectations. There is not the 'best' surgical technique and outcomes are satisfactory when proper treatment decisions are made
Ayurvedic medicine and NADPH oxidase: a possible approach to the prevention of ESRD in hyperoxaluria.
No full textN/
Test F+10 SP: un nuovo metodo angioscintigrafico per la diagnosi dell'uropatia ostruttiva
No full textScopo del lavoro
Lo scopo del nostro studio è stato quello di valutare i risultati ottenuti nella
diagnosi differenziale tra condizione di ostruzione e di non ostruzione in casi
di dilatazione dell’alta via urinaria, confrontando il metodo della scintigrafia
renale con paziente in clinostatismo ed iniezione di furosemide 15 minuti
prima del radiofarmaco (test F-15 classico) e un nuovo protocollo con paziente
in posizione seduta (SP=Sitting Position) ed iniezione di furosemide
10 minuti dopo quella del radiofarmaco (test F+10 SP).
Materiali e metodi
34 pazienti con diagnosi ecografica di idronefrosi (in 7 casi bilaterale)
sono stati sottoposti, con una settimana di intervallo, ai due esami angiofotoscintigrafici
a confronto (F-5 classico ed F+10 SP). I tracciati sono
stati analizzati tutti dallo stesso medico, non a conoscenza della storia
clinica dei pazienti. I risultati sono stati classificati come: “normale”, “dilatazione
non ostruttiva” (solo per test F+10 SP), “ostruzione”, “equivoco”
e “non applicabile”.
Risultati
Nelle 68 unità renali arruolate nello studio, il test F+10 SP ha documentato
condizione di normalità nel 30,8% dei casi (n=21), dilatazione senza ostruzione
nel 30,8% (n=21) ed ostruzione nel 36,8% (n=25); un caso è risultato
equivoco. Il test tradizionale F-15 ha documentato invece condizione di
nomalità nel 51,5% dei casi (n=35), ostruzione nel 29,4% (n=20); non è
stato applicabile nel 2,8% (n=2) ed è risultato equivoco nel 16,3% dei casi
(n=11). Non sono state registrate complicanze con utilizzo del test F+10 SP
mentre, durante il test F-15, 13 pazienti hanno lamentato senso di forte replezione
vescicale, 1 ipotensione, 3 colica renale e 4 hanno abbandonato lo
studio per il forte stimolo minzionale. Tutti i 20 renogrammi risultati “ostruiti”
al test F-15 lo sono stati anche al test F+10 SP.
Discussione
Il metodo che proponiamo sembra risultare particolarmente vantaggioso
nell’individuare l’eventuale ostruzione associata alla pielocalicectasia. Grazie
infatti alla combinazione tra posizione seduta ed un ottimizzato utilizzo
del Lasix, si è riusciti a diminuire sensibilmente la percentuale di esami
refertati come “equivoci”, dal 16% del test classico a meno dell’1,5% del
nuovo test (F+10 SP).
Messaggio conclusivo
Il test F+10 SP risulta ben tollerato dai pazienti e rappresenta uno degli
strumenti più promettenti nella diagnosi differenziale tra ostruzione e non
ostruzione nei casi di dilatazione delle alte vie urinarie
Is extracorporeal shock wave lithotripsy in pediatrics a safe procedure?
No full textRemoval of urinary calculi is an essential element in the successful treatment of patients with urinary stone disease. The new generation of lithotriptors allows the treatment without the need for general anesthesia. The patients, often outpatients, have a faster discharge from the hospital with a reduction of hospitalization time and operating costs. Shock wave lithotripsy (SWL) is currently considered a safe technique for treatment of pediatric urinary lithiasias, with a low percentage of complications and subsequent surgical retreatments. But can we define SWL as a safe procedure in pediatrics? Herein, we will review the literature to justify SWL safety in children, focusing on important parameters as the insertion of preoperative stenting, side effects, and complications after the procedure
Randall's plaques, plugs and the clinical workup of the renal stone patient
No full textRenal stone patients are generally considered to be affected with the idiopathic form of calcium nephrolithiasis. It is debated whether a comprehensive diagnostic evaluation should be performed in first stone patients. There is a substantial number of first or mildly recurrent stone formers who do not undergo any work-up to investigate stone etiology and in whom stone etiology is unknown. In this setting, the endourological approach can provide the treating physician with diagnostic information based on the presence of Randall's plaques and/or ductal plugs, thus triggering the need for further clinical investigations
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