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Nascimento M, Lourenço B, Coelho I, Aguiar J, Lázaro M, Silva M, Pereira C, Neves-Caldas I, Gomes F, Garcia S, Nascimento S, Pereira G, Nogueira V, Costa P, Nobre A. No man is an island: spatial clustering and access to primary care as possible targets for the development of new community mental health approaches. BMC Health Serv Res 2020; 20:344. [PMID: 32321489 PMCID: PMC7178966 DOI: 10.1186/s12913-020-05190-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND to understand if patients seen at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) live in geographical clusters or randomly throughout the city, as well as determine their access to the psychiatric hospital and primary care facilities (PCF). METHODS spatial autocorrelation statistics were performed (queen criterion of contiguity), regarding all patients observed at CHPL in 2017 (at the census subsection level), and considering not only their overall number but also main diagnosis, and admission to the psychiatric ward - voluntary or compulsory. Distance to the hospital and to the closest PCF was measured (for each patient and the variables cited above), and the mean values were compared. Finally, the total number of patients around each PCF was counted, considering specified radius sizes of 656 and 1000 m. RESULTS All 5161 patients (509 psychiatric admissions) were geolocated, and statistical significance regarding patient clustering was found for the total number (p-0.0001) and specific group of disorders, namely Schizophrenia and related disorders (p-0.007) and depressive disorders (p-0.0002). Patients who were admitted in a psychiatric ward live farther away from the hospital (p-0.002), with the compulsory admissions (versus voluntary ones) living even farther (p-0.004). Furthermore, defining a radius of 1000 m for each PCF allowed the identification of two PCF with more than 1000 patients, and two others with more than 800. CONCLUSIONS as patients seem to live in geographical clusters (and considering PCFs with the highest number of them), possible locations for the development of programs regarding mental health treatment and prevention can now be identified.
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Munier P, Nicolas M, Tricard T, Droupy S, Costa P, Saussine C. What if artificial urinary sphincter is not possible? Feasibility and effectiveness of ProACT for patients with persistent stress urinary incontinence after radical prostatectomy treated by sling. Neurourol Urodyn 2020; 39:1417-1422. [PMID: 32249971 DOI: 10.1002/nau.24355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 03/27/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Stress urinary incontinence (SUI) is a major component of the post radical prostatectomy (RP) trifecta. Surgical treatments are sub-urethral slings, artificial urinary sphincter (AUS) and adjustable peri-urethral balloons (PUB) ProACT. All options are imperfect at best and persistent SUI is challenging when AUS is not manageable. AIMS This study analyzed the cumulate experience of our 2 centers with offering PUB implantation for SUI post RP in patients with insufficient improvement from slings. MATERIALS & METHODS This retrospective study reviewed all patients implanted with second line ProACT. The primary endpoint was continence, defined as 0 pads per day (PPD). The secondary endpoints were 50% decrease in PPD and increases in the Incontinence Quality of Life score (IQOL). Refilling and complications were reported. RESULTS Between 2007 and 2016, 26 patients were implanted. Five patients have had adjuvant radiotherapy (18%). The mean follow-up was 36 months (±20; min 14-max 128). All patient presented with persistent SUI, using 2.3 PPD (±1; min 1-max 6), and only one sling was removed due to infection. After ProACT with an average 3 mL refilling (±1.2 min 2-max 6), 18 patients (66.7%) were continent. Eight of the remaining patients (29.6%) were improved; their number of PPD decreased from 2.6 to 1. The average IQOL score of those 8 patients increased by 20 points, from 53.4 up to 74.2 (P = .005). Overall 26 patients (96.3%) were improved. The remaining patient was not implanted because of an intraoperative urethral injury and is considered a failed case (3.7%). He had instead an AUS implantation. Three patients (14.8%) needed PUB replacement. CONCLUSION The limited population of patients from both our centers who presented with persistent SUI after RP, despite sling placement, improved with PUB ProACT implantations without significant complications.
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Costa P, Gonçalves S, Mora H, Carabineiro SAC, Viana JC, Lanceros-Mendez S. Highly Sensitive Piezoresistive Graphene-Based Stretchable Composites for Sensing Applications. ACS APPLIED MATERIALS & INTERFACES 2019; 11:46286-46295. [PMID: 31725262 DOI: 10.1021/acsami.9b19294] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Nanocarbonaceous materials with specific geometries and physicochemical properties allow the development of high-performance polymer-based smart composite materials. Among them, chemical treatments of graphene allow tailoring its electrical conductivity and, therefore, tuning functional response of materials for sensing applications. Polymer-based nanocomposites have been developed from styrene-ethylene-butylene-styrene (SEBS), a high deformation thermoplastic elastomer, and different graphene-based fillers, including graphene oxide (GO), reduced graphene oxide (rGO), and graphene nanoplatelets (G-NPLs). It is shown that the electrical conductivity shows a percolation threshold around 2 wt % for GO and rGO, remaining nearly independent of the filler content for G-NPL filler contents up to 6 wt %. Furthermore, GO/SEBS and rGO/SEBS composites show high piezoresistive sensibility with gauge factors ranging from 15 up to 120 for strains up to 10%. Thus, GO/SEBS and rGO/SEBS composites can represent a new generation of materials for strain sensor applications, as demonstrated in their implementation in a hand glove prototype with finger movement monitoring.
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Mendes-Felipe C, Oliveira J, Costa P, Ruiz-Rubio L, Iregui A, González A, Vilas JL, Lanceros-Mendez S. Stimuli responsive UV cured polyurethane acrylated/carbon nanotube composites for piezoresistive sensing. Eur Polym J 2019. [DOI: 10.1016/j.eurpolymj.2019.109226] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Vicente J, Costa P, Lanceros-Mendez S, Abete JM, Iturrospe A. Electromechanical Properties of PVDF-Based Polymers Reinforced with Nanocarbonaceous Fillers for Pressure Sensing Applications. MATERIALS 2019; 12:ma12213545. [PMID: 31671810 PMCID: PMC6862525 DOI: 10.3390/ma12213545] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 11/16/2022]
Abstract
Polymer-based composites reinforced with nanocarbonaceous materials can be tailored for functional applications. Poly(vinylidene fluoride) (PVDF) reinforced with carbon nanotubes (CNT) or graphene with different filler contents have been developed as potential piezoresistive materials. The mechanical properties of the nanocomposites depend on the PVDF matrix, filler type, and filler content. PVDF 6010 is a relatively more ductile material, whereas PVDF-HFP (hexafluropropylene) shows larger maximum strain near 300% strain for composites with CNT, 10 times higher than the pristine polymer. This behavior is similar for all composites reinforced with CNT. On the other hand, reduced graphene oxide (rGO)/PVDF composites decrease the maximum strain compared to neat PVDF. It is shown that the use of different PVDF copolymers does not influence the electrical properties of the composites. On the other hand, CNT as filler leads to composites with percolation threshold around 0.5 wt.%, whereas rGO nanocomposites show percolation threshold at ≈ 2 wt.%. Both nanocomposites present excellent linearity between applied pressure and resistance variation, with pressure sensibility (PS) decreasing with applied pressure, from PS ≈ 1.1 to 0.2 MPa−1. A proof of concept demonstration is presented, showing the suitability of the materials for industrial pressure sensing applications.
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Costa P, Silva T, Ribeiro KB, Fernandes PP, Terra R. P1.10-10 Social Vulnerability and Survival in Lung Cancer in Emerging Country. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kourbanhoussen K, Cecchi M, Chevrot A, Costa P, Droupy S, Wagner L. Sphincter urinaire artificiel robot chez la femme : début d’expérience. Prog Urol 2019; 29:371-377. [DOI: 10.1016/j.purol.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
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Wagner L, Chevrot A, Llinares E, Costa P, Droupy S. Long-term anatomic and functional results of laparoscopic sacrocolpopexy: a prospective study. Int Urol Nephrol 2019; 51:795-802. [PMID: 30875028 DOI: 10.1007/s11255-019-02124-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/05/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of our study was to assess the impact of laparoscopic sacrocolpopexy on pelvic symptoms, quality of life and sexual function in patients with symptomatic pelvic organ prolapse. Secondary goals included the assessment of anatomical correction, recurrence and complication rates. METHODS This is a prospective, single-center study that included 82 patients between 2009 and 2016. A clinical evaluation took place before surgery, and was repeated at 3, 12, 36 and 60 months postoperatively. Patients routinely received an anterior prosthesis, associated with a posterior prosthesis in case of symptomatic rectocele. Patients included self-administered questionnaires for functional pelvic problems (PFDI-20), quality of life (PFIQ-7), and sexual function (PISQ-12), and a clinical examination with POP-Q staging, at each medical visit. RESULTS Functional pelvic problems derived from prolapse (PFDI-20 scores) and their impact on patients' quality of life (PFIQ-7 score) significantly improved at 3, 12, 36 and 60 months postoperatively. Improvement on sexual activity was significant at 3 and 60 months postoperatively. Effective prolapse anatomical correction (POP-Q score < 2) was found in 94.4% and 97.2% of patients at the anterior and middle stages, respectively, at the end of follow-up, but only in 80.3% at the posterior stage. Symptomatic recurrence required surgical intervention in 4 patients (5.3%). CONCLUSIONS This long-term follow-up prospective analysis confirms the good functional and anatomical results of laparoscopic sacrocolpopexy for pelvic organ prolapse.
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Mottet N, Lehmann M, Cicorelli S, Dagues F, Louis JF, Costa P, Daures JP, Navratil H. Transrectal Ultrasonography in
Prostatic Cancer: Interexaminer
Variability of Interpretation. Eur Urol 2019. [DOI: 10.1159/000480849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Apóstolo J, Bobrowicz-Campos E, Gil I, Silva R, Costa P, Couto F, Cardoso D, Barata A, Almeida M. Cognitive Stimulation in Older Adults: An Innovative Good Practice Supporting Successful Aging and Self-Care. Transl Med UniSa 2019; 19:90-94. [PMID: 31360672 PMCID: PMC6581488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The project Cognitive Stimulation in Older Adults: Intervention on Cognitive Frailty and Promotion of Self-Care (in brief the ECOG project) arises in a context of worldwide demographic aging, and is fostered by the need to provide a sustainable solution to the progressive increase in the prevalence of age-related cognitive impairment. The main goal of the ECOG project is to promote active citizenship in old age through the empowerment for autonomy and self-care. Namely, the ECOG team is working on the development of evidence-based programs and tools that promote gains in health in cognitively frail and cognitively impaired older adults from the community. It is also working on the transfer of ECOG products to the practice of health and social care, promoting active involvement of geriatric care institutions in the implementation of the ECOG programs and tools, and ensuring appropriate training of professionals. Finally, the ECOG team is deploying a digital platform to reach out to the broadest audience possible and support the remote access and scaling up of the ECOG products. The impacts expected at an individual level include improvements in cognition, functionality, and autonomy of older adults, with simultaneous reduction of depressive symptomatology, and increase in quality of life of both person cared and his/her caregiver. Regarding societal gains, we anticipate an increase in life expectancy and significant postponement of institutionalization associated with geriatric problems. We also believe that the wide implementation of the ECOG products will reduce the costs of interventions for cognitively impaired citizens, contributing to sustainability and efficiency of health systems.
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Nicolas M, Droupy S, Costa P. Efficacité des ballons Pro-ACT™ dans le traitement de seconde ligne de l’incontinence urinaire d’effort post-prostatectomie après échec des bandelettes sous-urétrales. Prog Urol 2019; 29:36-44. [DOI: 10.1016/j.purol.2018.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 05/28/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
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Costa P, Borio A, Marmolino S, Mogno M, Serpella D, Della Cerra E, Morrone O, Garbarino M, Berardino M. Intraoperative recording of nociceptive flexion reflex. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Costa P, Giacobbi M, Ricci F, Gaglini P, Palmitessa A, Peretta P. Intraoperative recording of laryngeal adduction reflex (LAR) in IV ventricle tumor removal: Case report. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Barbato L, Casabona R, Mancuso S, Schinco P, Costa P, Marra S, Comoglio C. EP03 A GOOD BLOOD MANAGEMENT IS NOT AN OPTION. IT IS POSSIBLE TO TREAT AN AORTIC DISSECTION IN JEHOVAHʼS WITNESSES IN EMERGENCY? J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549991.68680.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wagner L, Douvier S, Ruffion A, Saussine C, Soustelle L, Rigaud J, Meurette G, Phé V, Vidart A, Manunta A, Vincens E, Dorez M, Cayrac M, Hoepffner J, Costa P, Droupy S. Essai randomisé, ouvert, multicentrique comparant le taux de complications de la promontofixation (PF) laparoscopique robot-assistée à la promontofixation laparoscopique classique pour le traitement des prolapsus pelviens (PP). Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Barry Delongchamps N, Wagner L, Sapetti J, oinard F, Bénard S, Bensaid E, Kaegi F, Costa P. Développement d’un nouveau sphincter urinaire artificiel pour le traitement de l’incontinence urinaire d’effort chez la femme. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wagner L, Roumeguere T, Yiou R, Costa P, Hegarty P, Ryckebusch H, Chartier Kastler E. Essai européen virtue© pour le traitemnet de l’incontinence urinaire après prostatectomie radicale : résultats intermédiaires à 1 an. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fernandes E, Costa P, Graveto J, Santos C, Osório N, Alarico S, Albano H, Oliveira V, Ferreira S. Are nurses uniforms a reservoir for Methicillin-resistant Staphylococcus aureus? Lessons to be learned from Portugal. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Costa P, Bellin Z, Canning T, Blair B, Millheiser L. 075 Sex & Relationship Peer Support Groups: A Mixed Method Study on the Impact on Female Sexual Health. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Oliveira L, Rolo A, Carvalho C, Faustino I, Alpoim C, Calçada C, Costa A, Fonseca G, Conde J, Teixeira A, Fardilha C, Costa P, Coutinho C. Preoperative chemoradiation in locally advanced rectal cancer: A single center experience. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chasseigne V, Leguelinel-Blache G, Nguyen T, de Tayrac R, Prudhomme M, Kinowski J, Costa P. Assessing the costs of disposable and reusable supplies wasted during surgeries. Int J Surg 2018; 53:18-23. [DOI: 10.1016/j.ijsu.2018.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/12/2018] [Accepted: 02/03/2018] [Indexed: 10/18/2022]
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Dallera F, Gamoletti R, Costa P. Unilateral Seizures following Vincristine Intravenous Injection. TUMORI JOURNAL 2018; 70:243-4. [PMID: 6429913 DOI: 10.1177/030089168407000307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A case of acute central nervous system toxicity following the intravenous injection of vincristine was observed in a patient treated with a chemotherapy regimen including cyclophosphamide, doxorubicin and prednisone for non-Hodgkin lymphoma. The neurological symptoms consisted of right-sided epileptiform jacksonian seizures limited to the face, that lasted about 10 min, followed by spontaneous recovery. A cerebrospinal fluid study and computed tomographic scan of the brain failed to reveal any central nervous system lymphomatous involvement.
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Alonzi R, Costa P, Benjamin L, Hardiman C, Lowe G, Fischer A, Lad R, Killen H. EP-2266: The first use of a biodegradable balloon spacer device for high dose rate prostate brachytherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32575-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cussenot O, Renard Penna R, Comperat E, Azzouzi AR, Costa P, Larre S, Ruffion A, Fasla L, Delavierre D, Rebillard X, Pfister C, Fendler JP, Villamizar Vesga J, Staerman F. LBA18 IMPACT OF TRANSIENT ANDROGEN DEPRIVATION THERAPY (ADT) WITH LEUPRORELIN LP 11.25 MG ON THE HISTOLOGICAL PROGRESSION OF INDOLENT PROSTATE CANCER (PC)–RESULTS OF A PHASE III TRIAL VERSUS ACTIVE SURVEILLANCE (AS)IMPACT OF TRANSIENT ANDROGEN DEPRIVATION THERAPY (ADT) WITH LEUPRORELIN LP 11.25 MG ON THE HISTOLOGICAL PROGRESSION OF INDOLENT PROSTATE CANCER (PC)–RESULTS OF A PHASE III TRIAL VERSUS ACTIVE SURVEILLANCE (AS). J Urol 2018. [DOI: 10.1016/j.juro.2018.03.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lam Van Ba O, Soustelle L, Wagner L, Siegler N, Boukaram M, Naoum KB, Droupy S, Chevrot A, Costa P. Impact on quality of life and sexual satisfaction of continent cystostomy with enterocystoplasty in an adult neurologic population. Neurourol Urodyn 2018; 37:1405-1412. [PMID: 29464756 DOI: 10.1002/nau.23461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/31/2017] [Accepted: 11/04/2017] [Indexed: 01/14/2023]
Abstract
AIMS To evaluate long-term general and urinary quality of life (QOL) and sexual satisfaction in adult neurologic patients undergoing continent cystostomy surgery associated with a bladder enlargement to treat neurogenic lower urinary tract dysfunction. METHODS Monocentre, retrospective series of adult neurologic patients who underwent continent cystostomy with bladder enlargement and followed-up in the long-term. We assessed during follow-up, urinary and renal function and patients filled QOL questionnaires on general QOL, sexuality and urinary (short form Qualiveen) disability. RESULTS Fifty-three patients were included and followed-up 77 months on average. Rates of patients' satisfaction, stomal and urethral continences were respectively of 98.7% (n = 51), 94.1% (n = 48), and 80.4% (n = 41). Impact of surgery on general QOL and autonomy were strong and positive (respective mean scores of 4.8 and 4.7 on a scale ranging from 1 to 5). Mean overall urinary Qualiveen QOL score was 0.8 (0.09-2.67) indicating a low negative impact of urinary disability on QOL. In patients <45 years, 52.6% (n = 10) reported a moderate to important improvement of their sexuality after surgery. Renal function remained stable during follow-up. CONCLUSION In the long-term, continent cystostomy with bladder enlargement provides great satisfaction to almost most patients. It has a strong positive impact on general and specific urinary QOL, patients' autonomy and urinary continence. In young patients a positive impact on sexuality was also noticed. These encouraging data, that need to be confirmed, constitute interesting information to provide to neurologic patients to help them deciding whether they are willing to undergo continent cystostomy surgery.
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