1
|
Hod N, Levin D, Ben-Arie G, Pinsk I, Osyntsov L, Mekayten M. Uncommon Detection of Leiomyoma in the Penile Corpus Spongiosum Using FDG PET/CT: A Case Report. Clin Nucl Med 2024; 49:e175-e178. [PMID: 38350071 DOI: 10.1097/rlu.0000000000005079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
ABSTRACT Primary tumors of the penile corpus spongiosum are rare. Hereby we describe the scintigraphic findings of a case of penile leiomyoma within the corpus spongiosum tissue, which was incidentally detected on FDG PET/CT. The benign neoplasm was growing in close proximity to the urethra showing increased focal FDG uptake on sequential PET/CT studies. Subsequently, the patient experienced obstructive urinary symptoms, and the tumor was resected. We concluded that the possibility of neoplasm should be kept in mind while evaluating a patient with persistent focal penile FDG uptake, which may be the first and only manifestation of the disease.
Collapse
Affiliation(s)
- Nir Hod
- From the Institute of Nuclear Medicine and Molecular Imaging
| | - Daniel Levin
- From the Institute of Nuclear Medicine and Molecular Imaging
| | | | | | | | - Matan Mekayten
- Urology Department, Soroka University Medical Center, Beer-Sheva, Israel (Affiliated to Ben Gurion University of the Negev, Faculty of Health Sciences)
| |
Collapse
|
2
|
Mekayten M, Heifetz EM, Sompolinsky Y, Lorber A, Duvdevani M, Strahilevitz J. Correction to: Timing of midstream urine culture before endourological procedure-can we do better?-A comparative study. Urolithiasis 2023; 51:116. [PMID: 37747535 DOI: 10.1007/s00240-023-01492-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
- Matan Mekayten
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Yishai Sompolinsky
- Obstetrics and Gynecology Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Amitay Lorber
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Strahilevitz
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
| |
Collapse
|
3
|
Mekayten M, Heifetz EM, Sompolinsky Y, Lorber A, Duvdevani M, Strahilevitz J. Timing of midstream urine culture before endourological procedure-can we do better?-A comparative study. Urolithiasis 2023; 51:110. [PMID: 37634153 DOI: 10.1007/s00240-023-01483-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
Endourological procedures are the mainstay of treatment for stone disease in the upper urinary system. Infection is a common complication, and urine cultures (UC) are often obtained preoperatively. In this study, we sought to investigate the role of positive UC in the 90 days prior to surgery (90PreOp) in predicting postoperative infectious complications in comparison to a single positive preoperative UC (PreOP). We compared the correlation between positive PreOp UCs and positive 90PreOp UCs with postoperative urosepsis, and a positive UC obtain proximal to obstruction (Prox UC) during percutaneous nephrolithotomy, ureteroscopy and a placement of nephrostomy tube or ureteral stent. Data from 140 consecutive patients were collected. PreOp UCs were positive in 15 (11%) of patients versus 31 of 140 (22%) positive 90PreOp UCs. All six sepsis events had a positive 90PreOp UC, and five had a positive PreOp UC. Fourteen (93.3%) out of 15 positive Prox UC had a positive 90PreOp UC, whereas only 7 (38.9%) had a positive 90PreOp UC. Positive 90PreOp UC outperformed PreOp UC in predicting positive Prox UC, OR = 12.8 (95% CI 3.70-44.30, p < 0.001), versus OR of 88.9 (95% CI 11.0-720.7, p < 0.001); sensitivity 93%(95% CI 68-100%) versus 47%(95% CI 21-73%); as well as area under the ROC curve(AUC), 0.90 (CI 0.80-0.95) for 90PreOp versus 0.70 (CI 0.56-0.82) for positive Prox UC. Uropathogen persistence was better identified when using 90PreOp UC (27%) than using PreOp UC (12%). We suggest reviewing UCs taken within 90 days preoperatively as this was found superior to a single preoperative midstream UCs in predicting postoperative infectious sequela after stone procedure.
Collapse
Affiliation(s)
- Matan Mekayten
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Yishai Sompolinsky
- Obstetrics and Gynecology Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Amitay Lorber
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Strahilevitz
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
| |
Collapse
|
4
|
Mekayten M, Meir E, Yutkin V, Gofrit ON, Duvdevani M, Landau EH, Hidas G. Is there a correlation between meatal stenosis severity, lower urinary tract symptoms and uroflowmetry? J Pediatr Urol 2022; 18:342.e1-342.e6. [PMID: 35491305 DOI: 10.1016/j.jpurol.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION We have recently validated a meatal Stenosis (MS) severity grading system that is based on physical examination. OBJECTIVES The study objective was to examine the correlation between this grading system, patients' urinary symptoms, uroflowmetry and postvoid residual parameters. STUDY DESIGN Patients referred for our clinic for urinary and non-urinary complaints, were prospectively enrolled. Urinary symptoms questionnaire, uroflowmetry parameters and post-voiding residuals (PVR) were assessed, and photographs of the urethral meatus were taken for each patient. The photographs were graded blindly according to the previously validated grading system and correlated with urinary symptoms, uroflowmetry parameters and PVR. RESULTS Overall, 75 patients were assessed (20 grade 0, 23 grade 1 and 32 grade 2). When using grade 0 as a reference, the odds ratio (OR) for reporting narrow stream was 6.4 (95%CI 1.65-24.77) and 4 (95%CI 1.18-14.16) for grade 1 and 2 respectively. OR for prolonged urination was 6 (95% CI 1.47-24.89) for Grade 1 and 2; OR for upward stream deviation was10.08 (95%CI -2.43-41.82) for grade 1 and 15.12 (95%CI - 3.74-61.17) for grade 2. Uroflowmetry results showed lower Qmax from 16.8(SD ± 8.0) ml/sec in grade 0-9.6 ml/s on grade 1 and 2 (p < 0.001) (Figure 1). PVR was not statistically different in the three groups. DISCUSSION Our main findings were that meatal stenosis severity grade is associated with narrow stream as reported by parent, prolonged urination, and upward deviation of urinary stream, with increasing severity with worsening stenosis. MS grade was also associated with significant worsening of uroflow measures: a lower Qmax, Qmean and a longer time-to-Qmax. Post-void residual volume was not significantly different between the different severity grades. This study showed the clinical significance of the grading system. With subjective and objective measures. The implementation of this grading system in clinics, may aid in decision making regarding surgical intervention in the appropriate patients, and avoid unnecessary procedures. CONCLUSION The Severity of MS seen on physical examination correlates well with obstructive symptoms and decrease of urine stream seen on uroflowmetry. These findings confirm the importance of the grading system in the evaluation of patients with MS and may be additional measure that assist in consulting parents on the indications to meatotomy.
Collapse
Affiliation(s)
- Matan Mekayten
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| | - Eyal Meir
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| | - Vladimir Yutkin
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| | - Ofer N Gofrit
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| | - Ezekiel H Landau
- Pediatric Urology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Guy Hidas
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, PO Box 12000, Ein Kerem, Jerusalem 91120, Israel.
| |
Collapse
|
5
|
Mekayten M, Mekayten H, Rimbrot D, Shmueli L, Duvdevani M. No-show after extracorporeal shock wave lithotripsy treatment in endourology clinic: Can we build a typical patient profile? Int J Urol 2022; 29:963-967. [PMID: 35304770 PMCID: PMC9545770 DOI: 10.1111/iju.14851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/20/2022] [Indexed: 11/29/2022]
Abstract
Objectives Patients “no‐show” in outpatient clinics is a worldwide challenge. Healthcare providers and patients suffer from negative impacts that include increased expenditure, clinical management ineffectiveness, and decreased access to care. This study aims to evaluate no‐show rate among extracorporeal shock wave lithotripsy patients visiting endourology clinic and to identify the demographic and clinical predictors of no‐show. Methods A cross‐sectional and historical cohort study using electronic medical records. We included 790 patients aged >18 years old referred for endourology clinic following shock wave lithotripsy during 2010–2017 at Hadassah Medical Center in Israel. We predicted no‐show rate following shock wave lithotripsy by various patient characteristics by a multivariate logistic regression model. Results Overall, 291 (36.8%) patients did not arrive for postoperative clinic. Of these, 91 (11.52%) patients referred to Emergency Department. Patients who were younger in age (odds ratio 1.49, 95% confidence interval 1.08–2.04), patients who underwent hospitalization ≥3 days (odds ratio 1.63, 95% confidence interval 1.11–2.41) and patients who had undergone a stent‐free shock wave lithotripsy (odds ratio 5.71, 95% confidence interval 2.40–13.57) were significantly associated with higher no‐show rate. Larger stone size was associated with reduction in no‐show rate with every millimeter increase of stone diameter was associated with a reduction of 6.1% probability for no‐show (odds ratio 0.94, 95% confidence interval 0.89–0.99). Conclusions Predicting patients' characteristics and no‐show patterns is necessary to improve clinical management efficiency, access to care, and costs. We showed that patients who were younger, patients who underwent stent‐free shock wave lithotripsy, patients who had a smaller stone, and patients who underwent a longer hospitalization were more prone to miss their appointment. Paying attention to the characteristics of individual patients may assist in implementing intervening program of patient scheduling.
Collapse
Affiliation(s)
- Matan Mekayten
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hadass Mekayten
- Department of Management, Bar-Ilan University, Ramat-Gan, Israel
| | - Daniel Rimbrot
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Liora Shmueli
- Department of Management, Bar-Ilan University, Ramat-Gan, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
6
|
Golomb D, Goldberg H, Lavi A, Kafka I, Kleinmann N, Shvero A, Verchovsky G, Boyarsky L, Darawasha AE, Sadeh O, Mekayten M, Stav N, Lifshitz D. Do weather parameters affect the incidence of renal colic in a predominantly warm country? A multicenter study. Journal of Clinical Urology 2022. [DOI: 10.1177/20514158221081313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To determine whether there is any effect of weather parameters on the incidence of renal colic patients presenting to emergency rooms (ERs) during the hottest season in Israel. Materials and Methods: This retrospective multicenter study involved all ER admissions related to renal colic in nine centres throughout Israel between 2010 and 2017. The collected data included the date of ER visits, the patients’ age and sex, and the weather features of ambient temperature, wind velocity, noon heat index, and barometric pressure. Multivariable logistic regression analyses identified predictors of increased ER visits for renal colic. Results: There were 85,501 renal colic-related ER visits during the study period, involving 62,935 (74%) males and 22,566 (26%) females ( p < 0.005). The mean ± standard deviation (SD) age of the males and females was 50 ± 5.8 and 48 ± 19.6 years, respectively ( p = 0.1). Most of the ER arrivals were in the 31- to 50-year-old age group (37%, 31,508) ( p = 0.02). The maximal ambient temperature (odds ratio (OR) = 2.213, 95% confidence interval (CI) = 2.148–2.279, p < 0.0001), lower heat index (i.e. low humidity; OR = 0.880, 95% CI = 0.872–0.887, p < 0.0001) and increased wind velocity (OR = 1.165, 95% CI = 1.149–1.182, p < 0.0001) had a significant linear effect on ER visits for renal colic events. Conclusion: Conditions that increase sweat evaporation during the hottest months, including a decreased heat index and increased wind velocity, correlated with more ER visits for renal colic events, probably due to dehydration associated with elevated sweat evaporation. Level of evidence: Not applicable
Collapse
Affiliation(s)
- Dor Golomb
- Department of Urology, Rabin Medical Center – Beilinson and Golda Campuses, Israel
| | - Hanan Goldberg
- Department of Urology, Rabin Medical Center – Beilinson and Golda Campuses, Israel
- Department of Urology, State University of New York Upstate Medical University, USA
| | - Arnon Lavi
- Department of Urology, Ha’Emek Medical Center, Israel
| | - Ilan Kafka
- Department of Urology, Shaare Zedek Medical Center, Israel
| | - Nir Kleinmann
- Department of Urology, Sheba Medical Center – Tel Hashomer, Israel
| | - Asaf Shvero
- Department of Urology, Sheba Medical Center – Tel Hashomer, Israel
| | - Guy Verchovsky
- Department of Urology, Assaf Harofeh Medical Center, Israel
| | | | | | - Omer Sadeh
- Department of Urology, Rambam Medical Center, Israel
| | | | - Nir Stav
- Israel Meteorological Services, Israel
| | - David Lifshitz
- Department of Urology, Rabin Medical Center – Beilinson and Golda Campuses, Israel
| |
Collapse
|
7
|
Abstract
An Indwelling suprapubic catheter is an established solution for patients with meningomyelocele neurogenic bladder. We report on a case in which a routinely replaced suprapubic catheter obstructed the left ureter orifice. The catheter drainage holes were inside the distal left ureter which compromised urinary drainage from the other kidney as well. As a result, the patient suffered from acute renal failure. During his hospitalization, the catheter was replaced and re-located, and renal function rapidly improved. This case emphasizes that even procedures that have been routinely performed for decades can manifest with an unusual complications.
Collapse
Affiliation(s)
- Matan Mekayten
- Faculty of Medicine, Hebrew University of Jerusalem, Israel, Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Duvdevani
- Faculty of Medicine, Hebrew University of Jerusalem, Israel, Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
8
|
Lorber A, Mekayten M, Levine H, Duvdevani M, Yutkin V, Landau E, Gofrit O, Hidas G. Educational intervention program reduced delayed treatment and improved the torqued testis survival: A quality of care study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33603-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
9
|
Mekayten M, Meir E, Ben-Chaim J, Landau EH, Khoury AE, Gofrit ON, Duvdevani M, Hidas G. Formulation and validation of meatal stenosis grading system. J Pediatr Urol 2020; 16:205.e1-205.e5. [PMID: 31964617 DOI: 10.1016/j.jpurol.2019.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Meatal stenosis (MS) is a common finding in circumcised children. Indication for surgical correction is based on urinary symptoms such as strength and direction of urine stream as well as physical examination, including direction and caliber of the urinary stream. There is no objective grading of MS severity, and therefore indications for surgery and management protocols are vague. OBJECTIVE We aimed to formulate a standardized, validated, and reliable grading system for MS severity based on the physical examination finding. STUDY DESIGN Photographs of the urethral meatus were taken in patients scheduled for meatotomy due to MS, whereas patients without this condition served as control. The photographs were rated by three experienced fellowship trained pediatric urologists. The study was conducted in two phases: 1) development of a grading system by the expert panel and 2) testing of the proposed grading system for inter- and intra-rater reliability. To estimate the correlation between different rates, the intra-class correlation coefficient (ICC) was calculated. RESULTS Three grades were generated: Grade 0 (wide open meatus, visible mucosa), Grade 1 (minimal mucosa/fibrotic tissue visible), and Grade 2 (pinpoint meatus/no mucosa visible/large fibrotic layer). A panel of 51 raters (pediatric urologist, community urologist, pediatricians) participated in the survey evaluating the representative photos from 86 patients. Inter-rater reliability was high ICC = 0.99 (95% confidence interval [CI] of 0.983-0.996, P < 0.0001) Cronbach's alpha = 0.992. In total, 18 raters participated in the same survey two weeks later for intra-rater reliability. An identical grading was obtained in 83.3% of photographs (kappa = 0.455 [P < 0.05]). CONCLUSION We propose a grading system that is a valid, reliable, and reproducible method to classify the severity of MS on physical exam. This grading system could improve the healthcare provider's and parent's communication and can be a building block for further research in this field. A further research should assess the correlation with clinical signs and symptoms.
Collapse
Affiliation(s)
- Matan Mekayten
- Pediatric Urology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Eyal Meir
- Pediatric Urology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Jacob Ben-Chaim
- Tel Aviv Sourasky Medical Center, Paediatric UroIogy Unit, Department of Urology, Tel Aviv, Israel
| | - Ezekiel H Landau
- Pediatric Urology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Antoine E Khoury
- CHOC Children's Hospital of Orange County, Orange, CA, USA; Department of Urology, University of California, Irvine, CA, USA
| | - Ofer N Gofrit
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Guy Hidas
- Pediatric Urology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
10
|
Mekayten M, Lorber A, Katafigiotis I, Sfoungaristos S, Leotsakos I, Heifetz EM, Yutkin V, Gofrit ON, Duvdevani M. Will Stone Density Stop Being a Key Factor in Endourology? The Impact of Stone Density on Laser Time Using Lumenis Laser p120w and Standard 20 W Laser: A Comparative Study. J Endourol 2019; 33:585-589. [DOI: 10.1089/end.2019.0181] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Matan Mekayten
- Urology Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Amitay Lorber
- Urology Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | | - Stavros Sfoungaristos
- 1st Department of Urology, G. Gennimatas Hospital, Aristotle University, Thessaloniki, Greece
| | - Ioannis Leotsakos
- Urology Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | | - Vladimir Yutkin
- Urology Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Ofer Nathan Gofrit
- Urology Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | |
Collapse
|
11
|
Mekayten M, Yutkin V, Duvdevani M, Pode D, Hidas G, Landau EH, Youssef F, Gofrit ON. High frequency of bladder cancer after nephroureterectomy: justification for adjuvant intravesical treatment? Res Rep Urol 2018; 10:33-38. [PMID: 29872646 PMCID: PMC5973432 DOI: 10.2147/rru.s164166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Bladder recurrence after nephroureterectomy (NU) is common. However, there is no acceptable policy of adjuvant intravesical treatment after NU. Objective To assess the rate of bladder recurrence following NU and to identify the high-risk subgroups that may become candidates for adjuvant intravesical therapy after NU. Patients and methods Ninety-one patients (mean age 66.4 years) underwent NU. High-grade (HG) tumors were found in 63 patients and low-grade (LG) tumors in 28. Median follow-up was 72 months. The risk of bladder recurrence was assessed by uni- and multivariate analyses of patient and tumor characteristics. Results Bladder recurrence developed in 38 patients (41.8%) after a median period of 11 months. Among these, 25 patients with HG upper tract urothelial carcinoma (39.7%) and 13 patients with LG upper tract urothelial carcinoma (46.4%) developed recurrence. HG bladder recurrence developed in 24 patients (63.2%) and LG recurrence developed in 14 patients (36.8%). Stages pTa, pT1, pT2, or higher bladder recurrence developed in 26 (68.4%), 7 (18.4%), and 4 patients (10.5%), respectively, and pure pTis developed in 1 patient. On uni- and multivariate analyses, the risk of bladder recurrence was independent of any clinicopathologic characteristics. Conclusion High rate and short time interval of bladder recurrence after NU were found, with no specific subgroup of patients with increased risk. These findings support prescribing adjuvant intravesical therapy to all patients after NU.
Collapse
Affiliation(s)
- Matan Mekayten
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Vladimir Yutkin
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Duvdevani
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Dov Pode
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Guy Hidas
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ezekiel H Landau
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Fadi Youssef
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ofer N Gofrit
- Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|