1
|
Kim BS, Kwon TG. Chylous ascites in laparoscopic renal surgery: Where do we stand? World J Clin Urol 2016; 5:37-44. [DOI: 10.5410/wjcu.v5.i1.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/30/2015] [Accepted: 01/04/2016] [Indexed: 02/06/2023] Open
Abstract
Postoperative chylous ascites, which is caused by the disruption of lymphatic channels and persistent lymphatic leakage, was a rare complication in the urologic field before laparoscopic surgery was introduced. Now that laparoscopic urologic surgery, especially laparoscopic nephrectomy, is widely performed, chylous ascites as a complication of laparoscopic renal surgery has been reported more frequently. With these accumulated experiences and data comes knowledge about the proper diagnosis and management of chylous ascites, although there is still some debate regarding the correct protocol for diagnosis and management. Therefore, we performed a systematic review of the current literature regarding the etiology, incidence, diagnosis, management, and prognosis of chylous ascites after laparoscopic renal surgery, as well as strategies used to prevent it, and discuss current perspectives on overcoming this complication in the laparoscopic age.
Collapse
|
Minireviews |
9 |
9 |
2
|
Okorie CO. Is continuous bladder irrigation after prostate surgery still needed? World J Clin Urol 2015; 4:108-114. [DOI: 10.5410/wjcu.v4.i3.108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/10/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
Continuous bladder irrigation (CBI) is commonly prescribed after certain prostate surgeries to help prevent the clot formation and retention that are frequently associated with these sometimes hemorrhagic surgeries. However, it remains unknown how effective CBI is in preventing clot formation/catheter blockage because these complications still frequently occur in the presence of CBI. On the other hand, the outcome of prostate surgeries has significantly improved over the years, and these surgeries have generally become much safer and, in many hands, less hemorrhagic. Newer surgical options such as holmium laser enucleation of the prostate with associated improved hemorrhagic control have also been introduced, further creating the opportunity to eliminate CBI. Furthermore, there is a lack of review articles on CBI. Hence, this article will review the evolution and contemporary role of CBI in prostate surgeries. To eliminate CBI after prostate surgeries, it is important to achieve good hemostasis during the surgeries. Having in place a policy of non-irrigation after prostate surgeries is also important if less CBI is to be the norm. A non-irrigation policy will hopefully help reduce those cases of CBI prescribed out of long-standing surgical tradition while allowing for cases prescribed out of compelling necessity. The author’s policy of a consistent non-CBI during prostate surgeries over the last 9 years will be highlighted.
Collapse
|
Minireviews |
10 |
7 |
3
|
Dip N, Reis ST, Viana NI, Morais DR, Moura CM, Katz B, Abe DK, Iscaife A, Silva IA, Srougi M, Leite KRM. MiRNA in bladder carcinogenesis: A review. World J Clin Urol 2014; 3:238-248. [DOI: 10.5410/wjcu.v3.i3.238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/30/2014] [Accepted: 08/31/2014] [Indexed: 02/06/2023] Open
Abstract
Bladder cancer (BC) is the second urological malignancy in incidence, currently being one of the most neoplasms studied with profile and biology poorly defined. In the world, BC is responsible by about 386000 new cases and 150000 deaths annually with considerable economic impact and high costs for health systems. After its discovery more than 20 years, micro RNAs (miRNAs) have been recognized as molecules that work specifically in post-transcriptional control in majority of eukaryote genomes. MiRNAs are a family of small non-coding RNAs of 19-25 nucleotides in length, expressed in a wide variety of organisms, comprising plants, worms and mammals, including humans. They have a fundamental role in physiological and pathological processes in organs and tissues in a context-dependent manner. This review brings new roles of protective and oncogenic miRNAs linked to carcinogenesis of urothelial carcinoma of the bladder, and associated with behavior of disease. Many studies have demonstrated promising roles of miRNAs working as diagnostic and prognostic biomarkers or involved in target therapies, consolidating miRNAs as crucial players in human cancer. This review allowed a reflection about the true functions of miRNAs in bladder carcinogenesis. Not only by their wide capacities of action, but also by abilities in define the cell date. The future of anti-tumor target therapies will be based not in one, but in groups of miRNAs working together in several steps of carcinogenic process, being able to identify the disease, predicting behavior and effectively treat bladder cancer.
Collapse
|
Review |
11 |
5 |
4
|
Maruschke M, Anastasiadis AG, Hakenberg OW. Spontaneous regression of renal cell carcinoma: Reality or myth? World J Clin Urol 2014; 3:201-208. [DOI: 10.5410/wjcu.v3.i3.201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/29/2014] [Accepted: 08/29/2014] [Indexed: 02/06/2023] Open
Abstract
Spontaneous regression of a malignant tumor is a very rare phenomenon. Renal cell carcinoma (RCC) is an aggressive malignancy with an often unpredictable behaviour. The incidence of spontaneous regression in metastatic RCC has been estimated to lie between < 1% and 7%. The spontaneous regression of a primary RCC has been reported much less commonly. Our literature review assesses the published literature concerning spontaneous regression of either primary or metastatic RCC. In order to examine this phenomenon in more detail we performed a literature search in the PubMed Database using the Keywords “renal cell carcinoma”, “metastatic disease”, and “spontaneous regression” and included reports from the last 100 years. The incidence of spontaneous regressions in RCC has always been considered a special feature of RCC compared to other solid malignancies. The majority of case reports of spontaneously regressed RCC describe the regression of metastases after nephrectomy rather than the spontaneous regression of a primary tumor. In cases of reported regression of metastatic RCC, this mostly applied to pulmonary lesions. As possible reasons for spontaneous regressions host immune defense mechanisms against metastatic RCC tissue following nephrectomy are discussed as important factor. RCC is known to be highly immunogenic and the possible existence of cytotoxic serum factors and tumor-specific surface antigens may trigger a cell-mediated cytotoxicity as an immunological basis for regression. Histological verification of supposed regression of a primary tumor may cause diagnostic difficulties, since large central areas of necrosis and cystic lesions of the tumor can occur simultaneously. The well-known phenomenon of necrosis in a fast growing RCC at the time of nephrectomy must not be confused with true spontaneous regression. Therefore, in our opinion such reported cases of supposed partial spontaneous regressions of primary RCCs are highly questionable. Most cases of spontaneous regression of RCC metastases have been reported after nephrectomy as the only treatment. Debulking by tumor nephrectomy then gives the immune system the chance to cope effectively with the remaining much lower quantity of tumour antigens. However, the mechanisms leading to spontaneous regression of metastatic lesions after cytoreductive nephrectomy are still poorly understood.
Collapse
|
Review |
11 |
5 |
5
|
Pocsfalvi G, Stanly C, Vilasi A, Fiume I, Tatè R, Capasso G. Employing extracellular vesicles for non-invasive renal monitoring: A captivating prospect. World J Clin Urol 2014; 3:66-80. [DOI: 10.5410/wjcu.v3.i2.66] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/09/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
Extracellular vesicles (EVs) are fascinating nano-sized subjects extensively studied over the recent years across several disparate disciplines. EVs are endlessly secreted into the extracellular microenvironment by most cell types under physiological and pathological conditions. EVs encompass a variety of molecular constituents from their cell of origin, such as lipids, cell specific proteins and RNAs, thus constituting an informative resource for studying molecular events at the cellular level. There are three main classes of EVs classified based on their size, content, biogenesis and biological functions: exosomes, shedding microvesicles and apoptotic bodies. Besides cell culture supernatants, biological fluids have also been shown to contain different types of EVs. Amongst the various body fluids, the study of urinary extracellular vesicles (uEVs) as a source of candidate biomarkers gained much attention, since: (1) urine can be non-invasively collected in large amounts; and (2) the isolated uEVs are stable for a relatively long period of time. Here, we review the important aspects of urinary extracellular vesicles which are fast gaining attention as a promising future tool for the non-invasive monitoring of urinary tract. Recent advancements in the purification and analysis of uEVs and collection of their constituents in rapidly developing public databases, allow their better exploitation in molecular diagnostics. As a result, a growing number of studies have shown that changes in expression profile at the RNA and/or protein levels of uEVs reveal the molecular architectures of underlying key pathophysiological events of different clinically important diseases with kidney involvement.
Collapse
|
Review |
11 |
5 |
6
|
Karunasinghe N, Bishop K, Murray P, Xu Y, Goudie M, Ng L, Zhu S, Han DY, Ferguson LR, Masters J, Benjamin B, Holmes M. Role of β-microseminoprotein from prostate cancer initiation to recurrence: A mini-review. World J Clin Urol 2014; 3:20-30. [DOI: 10.5410/wjcu.v3.i1.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 12/19/2013] [Accepted: 02/18/2014] [Indexed: 02/06/2023] Open
Abstract
Medline/Pubmed articles relevant to this topic were considered using the search terms β-microseminoprotein, MSMB, prostate secretory protein of 94 amino acids and PSP94. Full articles were retrieved when the abstract was considered relevant. In addition, other data related to this topic including our own are discussed. Summary of findings-β-microseminoprotein (MSMB) is increasingly being considered as a marker for prostate cancer, as reduced levels have been associated with the disease. Here we review various aspects of this protein including its biological and physiological variants, binding proteins and immune modulation; its importance as a marker for biochemical recurrence of prostate cancer; prostate cancer related splice variants and its therapeutic utility. Two of the most important properties of MSMB are related to anticancer functions and immune modulation. Predominant expression of two (short and full-length) splice variants of MSMB has been observed from normal prostate and several other tissues. In benign prostate hyperplasia the short isoform is dominant, constituting 98% of this isoform, whereas in prostate cancer 96% constitute the full-length isoform. The MSMB promoter single nucleotide polymorphism rs10993994 with the C allele functions as an activated cyclic adenosine monophosphate response element binding protein binding site. This C variant of rs10993994 could be responsible for the production of splice variants under variable conditions. MSMB has binding motifs to a few known proteins including immunoglobulin G and several Cysteine-rich secretory proteins family proteins. MSMB bound to these proteins is considered as immune modulating. Use of MSMB as a urinary marker for detecting aggressive prostate cancers that could resist radiation and surgical treatments, seems possible, but needs further investigation. The ratio of MSMB splice variants could also be a possible approach in understanding prostate cancers, with higher ratios indicating severe disease.
Collapse
|
Minireviews |
11 |
4 |
7
|
Azadzoi KM, Yang J, Siroky MB. Neural regulation of sexual function in men. World J Clin Urol 2013; 2:32-41. [PMID: 34707982 PMCID: PMC8547275 DOI: 10.5410/wjcu.v2.i3.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 07/30/2013] [Accepted: 08/20/2013] [Indexed: 02/06/2023] Open
Abstract
Male sexual response is controlled by a series of neurally mediated phenomena regulating libido, motivation, arousal and genital responses such as penile erection and ejaculation. These neural events that occur in a hormonally defined milieu involve different neurophysiological, neurochemical, and neuropsychological parameters controlled by central mechanisms, spinal reflexes and peripheral nervous system. Epidemiologic studies have suggested the high prevalence of male sexual dysfunction worldwide with significant impact on the quality of life of patients suffering from this problem. The incidence of sexual dysfunction is particularly high among men with neurologic disorders. Sexual dysfunction in men, such as loss of sexual desire, erectile dysfunction (ED), changes in arousal, and disturbances in orgasm and ejaculation may involve organic causes, psychological problems, or both. Organic male sexual disorders include a wide variety of neurologic, vasculogenic, neurovascular or hormonal factors that interfere with libido, erection, ejaculation and orgasm. Neurogenic sexual dysfunction may result from a specific neurologic problem or it could be the presenting symptom of a developing neurologic disease. Neurologic ED could result from complications of chronic neurologic disorders, trauma, surgical injury or iatrogenic causes. These etiologic factors and the underlying pathophysiologic conditions could overlap, which should be considered when making a diagnosis and selecting a treatment. A detailed history of physical examination, neurologic disorders, as well as any past history of psychological and psychiatric disturbances, and a thorough neurological examination will provide better understanding of the underlying causes of neurogenic sexual dysfunction. In patients with spinal cord injury, the location of the lesion and the time of onset of injury should be determined. Therapeutic strategies against erectile dysfunction are initiated with the least invasive options using the phosphodiesterase inhibitors. When oral medication options are exhausted, intraurethral and intracavernosal therapies and ultimately vacuum constriction devices and penile implants are considered. Recent basic research has suggested the potential role of stem cell-based therapeutic strategies to protect penile neural integrity and reverse cavernosal neurodegeneration in experimental models. Further insight into the central, spinal and peripheral neural mechanisms of male sexual response may help precise diagnosis and better management of neurogenic sexual dysfunction in men.
Collapse
|
Minireviews |
12 |
4 |
8
|
Campos-Juanatey F, Bugeja S, Ivaz SL, Frost A, Andrich DE, Mundy AR. Management of penile urethral strictures: Challenges and future directions. World J Clin Urol 2016; 5:1-10. [DOI: 10.5410/wjcu.v5.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/15/2015] [Accepted: 02/24/2016] [Indexed: 02/06/2023] Open
Abstract
The anatomy of the penile urethra presents additional challenges when compared to other urethral segments during open stricture surgery particularly because of its unsuitability for excision and primary anastomosis and its relatively deficient corpus spongiosum. Stricture aetiology, location, length and previous surgical intervention remain the primary factors influencing the choice of penile urethroplasty technique. We have identified what we feel are the most important challenges and controversies in penile urethral stricture reconstruction, namely the use of flaps vs grafts, use of skin or oral mucosal tissue for augmentation/substitution and when a single or a staged approach is indicated to give the best possible outcome. The management of more complex cases such as pan-urethral lichen-sclerosus strictures and hypospadias “cripples” is outlined and potential developments for the future are presented.
Collapse
|
Review |
9 |
4 |
9
|
Ito H, Yokoyama O. Metabolic syndrome and lower urinary tract symptoms. World J Clin Urol 2014; 3:330-335. [DOI: 10.5410/wjcu.v3.i3.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 06/21/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Recently, clinical and epidemiologic data indicating the involvement of metabolic syndrome (MetS) in the pathogenesis and progression of lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH) are reported. This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH, and discusses possible clinical implications for the management and treatment of this disease. Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia, a key element of the MetS, might be responsible. An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels, which leads the production of reactive oxygen species, which can damage the bladder detrusor. Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment. Studies suggest an association of MetS with LUTS/BPH, although further research is needed to understand how MetS influences LUTS/BPH. MetS should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.
Collapse
|
Minireviews |
11 |
3 |
10
|
Bollée G, Daudon M, Ceballos-Picot I. Adenine phosphoribosyltransferase deficiency: Leave no stone unturned. World J Clin Urol 2014; 3:218-226. [DOI: 10.5410/wjcu.v3.i3.218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/04/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disease leading to generation of large amounts of 2,8-dihydroxyadenine (DHA). DHA is excreted in urine, where it precipitates into crystals due to its low solubility. DHA crystals can aggregate into stones or cause injury to the renal parenchyma (DHA nephropathy). Recurrent urolithiasis and DHA nephropathy are the two clinical manifestations of APRT deficiency. Diagnosis of APRT deficiency can be made during childhood as well as adulthood. Diagnosis mainly relies on the recognition of DHA in stones or urine crystals. Measurement of APRT activity and genetic testing are useful for confirmation of diagnosis, for family screening and should be considered in difficult cases of urolithiasis or crystalline nephropathy. Allopurinol therapy is the cornerstone of treatment and is highly effective in preventing recurrence of stones and kidney disease. High fluid intake and dietary modifications are also recommended. Early diagnosis and treatment are of paramount importance to prevent renal damage. Unfortunately, diagnosis of APRT deficiency is often overlooked and irreversible renal failure still occurs in a substantial proportion of patients. Clinicians must be alert to the possibility of APRT deficiency and consider the appropriate diagnostic tests in certain cases. This review discusses the genetic and biochemical mechanisms of APRT deficiency, and the issues of diagnosis and management.
Collapse
|
Review |
11 |
3 |
11
|
Söhnel O, Grases F. Urinary supersaturation as a diagnostic measure in urolithiasis. World J Clin Urol 2017; 6:40-43. [DOI: 10.5410/wjcu.v6.i2.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To demonstrate that urinary supersaturation per se is not a reliable diagnostic measure of the risk for stone formation.
METHODS Available physical and chemical data for calcium oxalate monohydrate (COM) and calcium hydrogen phosphate dihydrate (brushite, BRU), and urinary supersaturations with respect to COM and BRU in healthy individuals and stone formers, were obtained from the literature. Classical theory of nucleation was used for calculations.
RESULTS It was found that the rate of homogeneous nucleation (unaided by substrates) of COM and BRU is nil at all conceivable supersaturations of urine. Consequently spontaneous formation of crystals in urine requires the presence of nucleation substrates for (heteronuclei).
CONCLUSION Urinary supersaturation with respect to lithiatic compounds is a necessary, but not a sufficient condition for nephrolithiasis. The absence of crystallization inhibitors and the presence of efficient nucleation promoters (heteronuclei) in urine are further necessary conditions of urolithiasis occurrence. Urinary supersaturation per se is not a reliable diagnostic measure of the risk of kidney stone formation.
Collapse
|
Basic Study |
8 |
3 |
12
|
Popovics P, Schally AV, Block NL, Rick FG. Preclinical therapy of benign prostatic hyperplasia with neuropeptide hormone antagonists. World J Clin Urol 2014; 3:184-194. [DOI: 10.5410/wjcu.v3.i3.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/26/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is a pathologic condition of the prostate described as a substantial increase in its number of epithelial and stromal cells. BPH may significantly reduce the quality of life due to the initiation of bladder outlet obstruction and lower urinary tract syndromes. Current medical therapies mostly consist of inhibitors of 5α-reductase or α1-adrenergic blockers; their efficacy is often insufficient. Antagonistic analogs of neuropeptide hormones are novel candidates for the management of BPH. At first, antagonists of luteinizing hormone-releasing hormone (LHRH) have been introduced to the therapy aimed to reduce serum testosterone levels. However, they have also been found to produce an inhibitory activity on local LHRH receptors in the prostate as well as impotence and other related side effects. Since then, several preclinical and clinical studies reported the favorable effects of LHRH antagonists in BPH. In contrast, antagonists of growth hormone-releasing hormone (GHRH) and gastrin-releasing peptide (GRP) have been tested only in preclinical settings and produce significant reduction in prostate size in experimental models of BPH. They act at least in part, by blocking the action of respective ligands produced locally on prostates through their respective receptors in the prostate, and by inhibition of autocrine insulin-like growth factors-I/II and epidermal growth factor production. GHRH and LHRH antagonists were also tested in combination resulting in a cumulative effect that was greater than that of each alone. This article will review the numerous studies that demonstrate the beneficial effects of antagonistic analogs of LHRH, GHRH and GRP in BPH, as well as suggesting a potential role for somatostatin analogs in experimental therapies.
Collapse
|
Review |
11 |
3 |
13
|
Zhang KY, Zuo L. Vitamin C supplementation in patients on maintenance dialysis. World J Clin Urol 2014; 3:344-350. [DOI: 10.5410/wjcu.v3.i3.344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 05/28/2014] [Accepted: 09/10/2014] [Indexed: 02/06/2023] Open
Abstract
As one of the most important water-soluble non-enzymatic antioxidants, vitamin C consists of ascorbic acid and its oxidized form, dehydroascorbic acid. Maintenance hemodialysis (MHD) patients have a generally lower plasma vitamin C level compared with general population. Moreover, dialysis patients also exhibit a low plasma vitamin C level, which is largely related with increased inflammation, refractory anemia and oxidative stress. In this review, we described, in great detail, the vitamin C deficiency in MHD patients and its effects on anti-oxidation, anti-inflammation, pro-oxidation and secondary hyperparathyroidism. In addition, we described the possible potential value of vitamin C in anemia, and the side effects of over-doses of vitamin C supplementation in this particular population. In summary, MHD patients may benefit from vitamin C administration. However, further research should be carried out to confirm its potential beneficial effects, optimal dosage and side effects from vitamin C supplementation.
Collapse
|
Minireviews |
11 |
3 |
14
|
Sharma G, Sharma A. Postnatal management of antenatally detected hydronephrosis. World J Clin Urol 2014; 3:283-294. [DOI: 10.5410/wjcu.v3.i3.283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 08/05/2014] [Accepted: 08/29/2014] [Indexed: 02/06/2023] Open
Abstract
With the increasing use of ultrasonography, congenital anomalies are often picked in utero. Antenatally detected hydronephrosis is amongst the most commonly detected abnormality. The management of this condition has raised considerable debate amongst clinicians dealing with it. This article is written with an idea to provide comprehensive information regarding the postnatal management of antenatally detected hydronephrosis. A detailed review of the current literature on this topic is provided. Also, guidelines have been given to facilitate the management of this condition.
Collapse
|
Review |
11 |
3 |
15
|
Soga H, Imanishi O. Case of intramedullary spinal cord metastasis of renal cell carcinoma. World J Clin Urol 2016; 5:72-74. [DOI: 10.5410/wjcu.v5.i1.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 09/05/2015] [Accepted: 12/18/2015] [Indexed: 02/06/2023] Open
Abstract
Intramedullary spinal cord tumors are rare. The improved survival resulting from more effective treatments for many cancers has led to an increased number of publications concerning intramedullary spinal cord metastasis (ISCM), including case reports and literature reviews; however, ISCM remains extremely rare in renal cancer. A 69-year-old man with a medical history of renal cell carcinoma (RCC) presented with urinary retention and bilateral paralysis of the lower extremities. A neurological examination revealed bilateral paraparesis below L1. Although brain magnetic resonance imaging (MRI), bone scintigraphy, and abdominal contrast-enhanced computed tomography revealed no abdominal findings, the thracolumbar MRI indicated a spot on the spinal cord at the Th12 level that exhibited hyperintensity on T2-weighted imaging and gadolinium diethylenetriaminepentaacetic acid enhancement on T1-weighted imaging. Accordingly, an ISCM of RCC was diagnosed. The patient rejected all treatments for these metastases except the steroid therapy. The patient’s condition deteriorated owing to metastatic progression, and he died 3 mo after the appearance of ISCM symptoms. The prognosis of this condition was poor. The mean survival durations were 8 mo with surgical treatment, 4 mo with irradiation, and 2 mo with palliative treatments. In cases involving neurological features and if brain or bone metastasis or spinal cord compression is not clearly observed, gadolinium-enhanced MRI should be performed to determine the existence of ISCM. Recently, some authors have reported the efficacy of ISCM resection. Surgical treatment could potentially yield improvements in the nervous symptoms or a longer survival after treatment. Although the prognosis was poor in most cases of ISCM, surgical treatment may improve the patient’s quality of life.
Collapse
|
Case Report |
9 |
3 |
16
|
Qu CY, Xu DF. Comprehensive urodynamics: Being devoted to clinical urologic practice. World J Clin Urol 2014; 3:96-112. [DOI: 10.5410/wjcu.v3.i2.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/12/2014] [Accepted: 06/16/2014] [Indexed: 02/06/2023] Open
Abstract
As a combined electrophysiological system for evaluating the lower urinary tract (LUT), comprehensive urodynamics (UDS) aims at duplicating patient’s micturition process, either normal or abnormal, and further seeking for possible causative origin, either neurogenic or non-neurogenic, in order to guide treatment. Through thorough analysis, some so-called cut-off values, for example, bladder outlet obstruction (BOO) degree or dyssynergic degree between the detrusor and sphincter, could be gained; however, in most cases, their qualitative description, such as stress urinary incontinence, idiopathic detrusor underactivity (DUA), detrusor overactivity (IDO), low compliance, and idiopathic sphincter overactivity (ISO), is more preferable and important. In aged neurologically intact male patients with symptoms of the LUT (LUTS) including benign prostatic hyperplasia, a combined UDS system, which coupled BOO with compliance, was constructed. The patients may be categorized into one of the seven subgroups, including equivocal or mild BOO with sphincter synergia with or without IDO (pattern A), equivocal or mild BOO with ISO (B), classic BOO with sphincter synergia (C) or ISO (D), BOO with only low compliance (E), BOO with both DUA and low compliance (F), and potential BOO with DUA (G). This new system can be used to optimize diagnosis and treatment according to a derived guideline diagram.
Collapse
|
Review |
11 |
2 |
17
|
Gallagher SM, Selman SH. From the battlefield to the bladder: The development of thioTEPA. World J Clin Urol 2014; 3:195-200. [DOI: 10.5410/wjcu.v3.i3.195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/01/2014] [Accepted: 08/29/2014] [Indexed: 02/06/2023] Open
Abstract
Effective medications for the treatment of cancer were nonexistent in the early twentieth century. Ironically the widespread use of toxic chemical weapons, chlorine and sulfur mustard gas, during the “Great War” led to the first successful chemotherapeutic treatment of cancer patients. Soon after the introduction of poisonous gas on the battlefield, reports of the resulting pancytopenia in exposed combatants appeared in the medical literature. The biologic effect of chemical weaponry on rapidly dividing cells eventually was recognized for its salutary potential in the treatment of cancer. Once this potential was appreciated, hundreds of similar compounds were synthesized and evaluated as chemotherapeutic agents. One such compound, thioTEPA, would eventually open the era of intravesical treatment of urothelial cancer.
Collapse
|
Review |
11 |
2 |
18
|
Bertó RR, López-Acón JD, Marco SL, Jurado DGO, Oliva FD, Baenas MAC, Tormo FB. Penile prosthesis: Patient satisfaction, use and preference for malleable vs inflatable. World J Clin Urol 2014; 3:134-138. [DOI: 10.5410/wjcu.v3.i2.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/05/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate and compare long-term patient satisfaction and use after either malleable penile prosthesis (MPP) or inflatable penile prosthesis (IPP) implantation.
METHODS: we present a retrospective unicenter study of 108 patients implanted with either 2 or 3-piece American Medical System™ (AMS™) or Coloplast™ inflatable penile prosthesis (AMS 700CX™, AMS 700CXR™, AMS Ambicor™ or Coloplast TITAN™) or malleable (AMS Spectra™ or Coloplast Genesis™) in our Centre between 1993 and 2011. We collected data from the medical record including follow-up, age and type of prosthesis. We used a four-question telephone survey designed ad hoc by urologist in our Department, with three multiple choice questions and a grading answer. After verbal consent was obtained, proposed questions concerned global satisfaction regarding to the procedure, quality of sexual intercourses graded from 0 to 10, frequency of sexual intercourse and about undergoing the same procedure again. SPSS™ version 20.0 was used for the descriptive analysis of the data.
RESULTS: Sixty seven (64%) patients underwent a MPP and 41 (36%) an IPP. The mean age was 52.6 ± 3.6 years in the MPP group and 57.2 ± 2.8 years in the IPP group (P = 0.02). Total respond rate was 55.5% (60/108). Twenty six out of 33 MPP patients (78.9%) and 19 of the 27 IPP subjects (70.3%) were satisfied or very satisfied with the procedure. The quality of sexual intercourse was rated 7.13 ± 0.39 points in the MPP group and 6.16 ± 0.47 points in the IPP group. Frequency of sexual intercourse was 1 or more times per week in 15 (46.9%) patients with MPP and in 12 (46.1%) of the IPP patients. Twenty-eight (84.9%) patients who received a MPP would undergo the procedure for the same device again as well as 24 (88.9%) of the IPP group. There were no statistical differences between groups regarding the four items in the survey.
CONCLUSION: Patients show high satisfaction rate and no statistical differences exist regarding to global satisfaction, use of the device and quality of sexual intercourse depending on the type of penile prosthesis.
Collapse
|
Retrospective Study |
11 |
2 |
19
|
Cai T, Verze P, Bartoletti R, Mirone V, Johansen TEB. Infectious complications after prostate biopsy: Time to rethink our clinical practice. World J Clin Urol 2015; 4:78-82. [DOI: 10.5410/wjcu.v4.i2.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/28/2015] [Accepted: 06/11/2015] [Indexed: 02/06/2023] Open
Abstract
Prostate biopsy is a very common procedure performed worldwide which still represents the only way for prostate cancer diagnosis and reference point for subsequent treatments. Even if transrectal prostate biopsy is considered a safe procedure, it may be accompanied by infective complications, ranging from asymptomatic bacteriuria to symptomatic urinary tract infections and sepsis. During the recent decade we observed an increasing number of infectious complications and subsequent hospitalizations after and transrectal prostate biopsy. The most probable reason for the increasing rate of infectious complications after prostate biopsy is the increasing antimicrobial resistance, especially to the current first-line recommended fluoroquinolone antibiotics. We believe the time has come to re-think our current practice of diagnosing prostate cancer. We need to focus on the selection of patients at higher risk of infective complications, on microbiological sampling of the faecal flora prior to biopsy to identify resistance to specific agents, on the number of biopsy cores, on the biopsy route (perineal or transrectal approach) and, finally, consider alternative antibiotics with improved susceptibility to be used for prophylaxis.
Collapse
|
Editorial |
10 |
2 |
20
|
Ortega F, Díaz-Corte C, Valdés C. Adherence to immunosuppressor medication in renal transplanted patients. World J Clin Urol 2015; 4:27-37. [DOI: 10.5410/wjcu.v4.i1.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 05/27/2014] [Accepted: 12/17/2014] [Indexed: 02/06/2023] Open
Abstract
Non-adherence is a priority public health concern. Non-adherence means not taking medications, missing medications, taking too much, not taking enough, wrong timing, wrong dose and/or wrong pill, but may also refer to missing appointments, not booking appointments, not doing blood work, not returning calls and/or refusal to follow the treatment regimen. In renal transplantation, adherence to immunosuppressive medication is a fundamental requisite in order to preserve graft function, since non-adherence is one of the main causes for late acute rejection, incomplete recovery after rejection treatment, chronic graft dysfunction, graft loss, and death. Transplantation failure due to treatment non-adherence is economically, socially, ethically and morally unjustifiable. This is a very prevalent issue: in some studies, its incidence is as high as 70% of patients. The self-reported nonadherence levels found in certain studies, including those performed immediately after transplantation show the need for early and continued intervention after kidney transplantation in order to maximise adherence and consequently clinical outcomes. There is not a single method to assess non adherence, thus combining several measures increases diagnostic accuracy. Electronic monitoring with a microdevice that records each time a pill bottle is opened is considered the “gold standard” for measuring adherence, but self-report at a confidential interview was the best measure of adherence. Thus non-adherence risk can be effectively assessed using clinically available assessment tools. Medication Adherence Scale, Brief Medical Questionnaire, Immunosuppressant Therapy Adherence Scale, Immunosuppressant Therapy Barrier Scale, Long-Term Medication Behavior Self-Efficacy Scale and Simplified Medication Adherence Questionnaire are some of the self-reported questionnaires. There are multiple factors associated with non-adherence in immunosuppressant therapy: Younger patients (adolescent, especially), poor health coverage, poor social support, unmarried, no family, non-Caucasian, immigrant, lower income, lower socioeconomic class, greater parental distress and lower family cohesion; complex medical regimens, higher number of drugs, longer time after transplant, toxicity, side effects, poor tolerance to medication, higher number of physicians involved, poor provider-patient rapport; psychological (dependency, high levels of anxiety and hostility, poorer behavioral functioning and greater distress in children) and psychiatric (depression) illnesses, low self-efficacy with medicine intake, perception of immunosuppressive therapy as not been necessary to preserve kidney function, forgetfulness, rebelliousness, poor perception of health, poor satisfaction, low Health-related Quality of life, addictions, lack of coping strategies and avoidance behavior; patient morbidity: comorbidity, receiving a transplant from a live donor, retransplantation, and non-insulin-dependent diabetes. The most frequent strategies to promote medication-taking must focus on modifiable risk factors. Reasons for non-adherence are complex and diverse and any successful intervention aimed at improving adherence must be multidimensional. Although effective intervention strategies are needed to improve immunosuppressant therapy adherence, few intervention studies have been conducted in the adult renal transplant population. In this study, we perform an exhaustive review of the different strategies reported in the literature. A number of key reasons for non-adherence are also provided.
Collapse
|
Review |
10 |
2 |
21
|
Valdevenito JP, Walton-Diaz A. Diagnosis of voiding dysfunction by pressure-flow study in women. World J Clin Urol 2016; 5:29-36. [DOI: 10.5410/wjcu.v5.i1.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/05/2015] [Accepted: 12/02/2015] [Indexed: 02/06/2023] Open
Abstract
Pressure-flow study (PFS) of micturition is the best method to quantitatively analyse voiding function. It allows us to distinguish voiding lower urinary tract symptoms and low urine flow rate caused by bladder outlet obstruction (BOO) from those caused by detrusor underactivity (DU). Voiding dynamics are significantly different in men and women and the established criteria for urodynamic diagnosis in men do not apply to women. Basic principles of voiding mechanics and voiding patterns in asymptomatic women are analyzed. Although attempts have been made to establish a consensus for diagnosis of BOO in women with pressure-flow cutoff, video-urodynamics criteria and nomograms, currently there is no consensus. There is no standard urodynamic test to diagnose and quantify DU in women for which further investigations are needed. Modified projected isovolumetric pressure (to assess detrusor contraction strength) and pressure-flow cutoff criteria have been used. The diagnosis of voiding dysfunction in women is challenging, requiring PFS with very good quality control and often involves integrating clinical and radiographic data to make the final assessment.
Collapse
|
Minireviews |
9 |
2 |
22
|
Anderson C, Ayres B, Issa R, Perry M, Liatsikos E, Stolzenburg JU, Ghani KR. Extraperitoneal robot-assisted radical prostatectomy: Comparison with transperitoneal technique. World J Clin Urol 2013; 2:3-9. [DOI: 10.5410/wjcu.v2.i2.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine peri-operative, oncological, functional and safety profiles of extraperitoneal robot-assisted radical prostatectomy (eRARP) vs transperitoneal robot-assisted radical prostatectomy (tRARP) in a single centre.
METHODS: A total of 120 consecutive patients underwent 50 eRARP and 70 eRARP operations respectively by the same surgical team. Peri-operative and post-operative outcomes including blood loss, hospitalization, complications (Clavien grade), positive surgical margin (PSM) rates, continence and erectile function were compared. The performance of eRARP required several technical modifications. These included development of Retzius’ space by balloon insufflation, laparoscopic dissection of lateral extensions of this area; caudal port positioning; cranial digital stripping of peritoneum for sucker port and lodging the bagged prostate specimen adjacent to the lateral assistant port to permit space for urethro-vesical anastomosis.
RESULTS: Robotic console times were shorter with eRARP vs tRARP (145.1 min vs 198.3 min, P < 0.0001). There were no significant differences in blood loss, PSM rates (eRARP 17.7% vs tRARP 22%) or complications (eRARP 8.5% vs tRARP 8%). A drain was used in all patients after tRARP and in 25/70 eRARP cases. Length of hospital stay was shorter after eRARP (mean 1.94 d vs 3.6 d, P < 0.0002). There were no differences between techniques in continence or potency at 6 mo. eRARP required several technical modifications: development of Retzius’ space by balloon insufflation, laparoscopic dissection of lateral extensions of this area; caudal port positioning; and lodging the bagged prostate specimen adjacent to the lateral assistant port to permit space for urethro-vesical anastomosis.
CONCLUSION: eRARP demonstrated advantages in surgical times, hospital stay and equivalence in PSM rates, complications and functional outcomes. eRARP is a useful alternative to tRARP especially in patients with adhesions, pre-existing inguinal hernias, or those unable to withstand steep Trendelenburg position.
Collapse
|
Brief Article |
12 |
2 |
23
|
Peracha J, Morgan MD. Urological manifestations and treatment of the primary systemic vasculitides. World J Clin Urol 2015; 4:5-20. [DOI: 10.5410/wjcu.v4.i1.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/17/2014] [Accepted: 12/31/2014] [Indexed: 02/06/2023] Open
Abstract
The primary systemic vasculitides (PSV) are a group of rare inflammatory disorders affecting blood vessels of varying size and multiple organs. Urological manifestations of PSV are uncommon. Testicular vasculitis is the most commonly reported finding and is associated with Polyarteritis Nodosa (PAN), Henoch-Schönlein Purpura (HSP), anti-neutrophil cytoplasm antibody associated Vasculitides (AAV), Giant Cell Arteritis (GCA) and Kawasaki disease. Prostatic vasculitis has been reported in association with GCA and AAV. Ureteric involvement has been noted in PAN, HSP and AAV. Other urogenital manifestations of PSV include genital ulceration and bladder dysfunction in Behçets Disease and haematuria which is commonly seen in many of the PSV. Finally, therapies used to treat the PSV, especially cyclophosphamide, are associated with urological side-effects including haemorrhagic cystitis and urothelial malignancy. The aim of this review is to examine how the urological system is involved in the PSV. Each PSV is examined in turn, with a brief clinical description of the disease followed by a description of the urological manifestations and management. Identification of urological manifestations of PSV is important as in many cases symptoms may improve with immunosuppressive therapy, avoiding the need for invasive surgery. Additionally, patients who present with isolated urogenital PSV are at higher risk of developing subsequent systemic vasculitis and will need to be followed up closely.
Collapse
|
Review |
10 |
2 |
24
|
Lukacs S, Tschobotko B, Mukerji G, Vale J, Mazaris E. How to improve a urology outpatient service? A survey of patient satisfaction. World J Clin Urol 2013; 2:46-52. [DOI: 10.5410/wjcu.v2.i3.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/18/2013] [Accepted: 11/03/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate and improve our out-patients department patient satisfaction, provide minimum consultation delay and appropriate consultation duration to meet with targets.
METHODS: We distributed the modified satisfaction with outpatient service (SWOPS) questionnaires developed for use in Irish hospitals by the Health Services Research between August and December 2012. The patient disclosed their age and sex and completed the modified SWOPS questionnaire anonymously. Every patient was eligible to participate in the study who attended any of the Urology Outpatient Clinics. Patients lacking capacity to consent were excluded. Additionally, each patient was only permitted to complete one questionnaire regardless of repeat attendances within the 4 mo study period. The answers to every question were presented as percentages. One-way ANOVA was used to establish whether there was a significant difference in appointment delay and “Overall Satisfaction” on the different clinic days. The unpaired t-test was applied to establish whether “Overall Satisfaction” was affected by diagnosis (benign or malignant). Paired t-test was used to establish whether “Overall Satisfaction” was affected by appointment delay and appointment length.
RESULTS: Three hundred and forty-eight questionnaires were completed with an overall > 65% participation rate. Eighty-one point six percent were male and 18.4% female with a mean age of 65 ± 21 years. Mean delay time was 32 min, which 30.6% stated should be an improvement priority. The delay times for Wednesday (mean 13 min) were significantly (P < 0.05) lower than for other days (mean 36 min). Generally 12-15 min outpatient appointment length is acceptable and adequate for patients as 97.70% suggested, however 31.60% of patients would favour longer duration. Eleven point four nine percent do not want to see different doctors each time, and 31.60% of the patient feel that no change is required. Average satisfaction was 84.65%. There was no significant relationship between satisfaction and clinic day, diagnosis and consultation length, whether the patient was reviewed by a registrar or consultant. Satisfaction was universally high and independent of consultation delay/length and diagnosis. Dissatisfaction in delay times with a significant improvement on Wednesday suggests necessary and achievable improvements. Notably, the Wednesday clinic has less patients per doctor per hour and enforces a 1 patient per 15 min slot with a no over-booking policy.
CONCLUSION: Surveying our patient dissatisfaction would require more frequent audits by clinicians to improve patient satisfaction and to achieve better quality of care.
Collapse
|
Brief Article |
12 |
1 |
25
|
Costantini E, Zucchi A. Reconstructive surgery in Peyronie’s disease: What’s new? World J Clin Urol 2015; 4:1-4. [DOI: 10.5410/wjcu.v4.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 01/19/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
Surgical treatment of Peyronie’s disease (PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The less invasive approach aims to correct curvature without intervening directly on the fibrous plaque while the more complex “corporoplasty” applies specific geometric criteria and uses different autologous and heterologous grafts. Each approach has its pros and cons and decision-making should be tailored to the individual patient’s expectations. Other surgical options include different use of patches to cover the tunica albuginea defect, with the choice depending on the surgeon’s personal experience. Despite the wide range of autologous (buccal mucosa, vein, dermis, etc.) and heterologous grafts (bovine pericardium, swine intestinal submucosa, porcine dermis, etc.) none currently represents the real “gold standard” because the data are extremely variable and frequently not representative. Several factors seem to favor buccal mucosa grafts over inert biocompatible materials: as vital tissue, buccal mucosa tends to heal rapidly, immediately integrating with the surrounding albuginea tissue. This translates into a more rapid resumption of spontaneous erections (after 3/4 d) and sexual activity and into a reduced risk of curvature relapse and erectile dysfunction after surgery. Another advantage of the buccal mucosa graft is its low cost. In conclusion, despite the recent development of some exciting new surgical techniques we are still unable to deliver a definitive take-home message about reconstructive surgery in PD because the majority of the studies reported insufficient data. However, since it is clear that major outcomes, besides the cosmetic result, are the patient’s and partner’s satisfaction and the economic impact of each technique, we recommend they be included among the outcome assessment parameters in further studies
Collapse
|
Editorial |
10 |
1 |