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Journal articles on the topic 'Urological Diagnostic Techniques'
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Dalpiaz, Amanda, Jason Gandhi, Noel L. Smith, Gautam Dagur, Richard Schwamb, Steven J. Weissbart, and Sardar Ali Khan. "Mimicry of Appendicitis Symptomatology in Congenital Anomalies and Diseases of the Genitourinary System and Pregnancy." Current Urology 9, no. 4 (2015): 169–78. http://dx.doi.org/10.1159/000447136.
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Introduction: Appendicitis is a prevailing cause of acute abdomen, but is often difficult to diagnose due to its wide range of symptoms, anatomical variations, and developmental abnormalities. Urological disorders of the genitourinary tract may be closely related to appendicitis due to the close proximity of the appendix to the genitourinary tract. This review provides a summary of the urological complications and simulations of appendicitis. Both typical and urological symptoms of appendicitis are discussed, as well as recommended diagnostic and treatment methods. Methods: Medline searches were conducted via PubMed in order to incorporate data from the recent and early literature. Results: Urological manifestations of appendicitis affect the adrenal glands, kidney, retroperitoneum, ureter, bladder, prostate, scrotum, and penis. Appendicitis in pregnancy is difficult to diagnose due to variations in appendiceal position and trimester-specific symptoms. Ultrasound, CT, and MRI are used in diagnosis of appendicitis and its complications. Treatment of appendicitis may be done via open appendectomy or laparoscopic appendectomy. In some cases, other surgeries are required to treat urological complications, though surgery may be avoided completely in other cases. Conclusion: Clinical presentation and complications of appendicitis vary among patients, especially when the genitourinary tract is involved. Appendicitis may mimic urological disorders and vice versa. Awareness of differential diagnosis and proper diagnostic techniques is important in preventing delayed diagnosis and possible complications. MRI is recommended for diagnosis of pregnant patients. Ultrasound is preferred in patients exhibiting typical symptoms.
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Tiang, Kor Wei, Keng Lim Ng, Antonio Vega-Vega, and Simon Wood. "Rapidly enlarging renal tumor during pregnancy: diagnostic and management dilemma." Journal of Kidney Cancer and VHL 1, no. 1 (April 30, 2014): 12–16. http://dx.doi.org/10.15586/jkcvhl.2014.6.
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Urological tumors diagnosed during pregnancy are rare. However, the incidence seems to be increasing largely due to advancements in modern imaging techniques and improved antenatal care. The diagnosis and management of renal tumors during pregnancy poses a dilemma to clinicians. This case report highlights the challenges in managing a large chromophobe renal cell carcinoma in a young primigravida patient. Proper antenatal assessment, a multidisciplinary team approach and appropriate discussion with patient are important determinants to achieve the best clinical outcomes for both the mother and the baby.
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Smelov, Vitaly, Kurt Naber, and Truls E. Bjerklund Johansen. "Letter to the Editor: Diagnostic Criteria in Urological Diseases do not Always Match with Findings by Extended Culture Techniques and Metagenomic Sequencing of 16S rDNA." Open Microbiology Journal 10, no. 1 (February 29, 2016): 23–26. http://dx.doi.org/10.2174/1874285801610010023.
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Some diseases of the urinary tract are defined by the presence of microorganisms while others are defined by their absence. The underlying idea has always been that urine from healthy subjects is sterile and a negative urine culture has usually been taken as discriminative for an infection to be absent. Several disorders with symptoms that resemble infections are regarded as separate entities based on the exclusion of bacterial growth such as overactive neurogenic bladder and pelvic pain syndromes. During the recent years two paradigmata related to the role of bacteria in urological disease classification have changed completely. Firstly, bacteriuria does not necessarily mean an infection, and secondly, if extended sets of culture media for identification of fastidious and anaerobic bacteria or culture-independent metagenomic sequencing (MGS) is applied, a broad range of even non-culturable bacteria has been detected in the ”sterile” bladder urine in healthy individuals. The aim of this editorial is to initiate a discussion to redefine the criteria for urinary tract infections and non-infectious urological disorders with similar symptoms. Clinical studies, in which extended sets of culture media and MGS are integrated, are needed to clarify the pathogenesis of urological disorders where bacteria may play a role. The pure detection of bacteria in the urine does not by itself prove an infectious etiology of a specific disorder. It is important to avoid that results of new technologies lead to unnecessary antibiotic consumption with unwanted collateral damage and adverse events.
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Ignjatovic, Ivan. "Appearance of urology at the beginining of xxth century -from the general surgeon up to the highly trained specialist." Srpski arhiv za celokupno lekarstvo 131, no. 1-2 (2003): 92–95. http://dx.doi.org/10.2298/sarh0302092i.
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Evolvement of urology as a separate scientific discipline depends on several factors. Endoscopic diagnostics, radiological diagnostics, and operative techniques in general surgery, had provided an ability to perform more complex and longer operations. Urology had evolved from the great schools of surgery in Germany and France, and their the most important surgeons, who were intersted in urological surgery. The first endoscope was introduced in 1806, and received today?s form in 1879. Application of "X" rays in medicine started in 1895, and it was later applied as a cystography, retrograde pyelography as well as intravenous urography. The most important thing for the operative technique evolution were application of anhestesia, asepsis and new hemostatic devices. During the one century long development, urology had passed the way from completely unknown field, up to the discipline with the best diagnostic preciseness.
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Bittencourt, Leonardo Kayat, Daniel Hausmann, Natalia Sabaneeff, Emerson Leandro Gasparetto, and Jelle O. Barentsz. "Multiparametric magnetic resonance imaging of the prostate: current concepts." Radiologia Brasileira 47, no. 5 (October 2014): 292–300. http://dx.doi.org/10.1590/0100-3984.2013.1863.
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Multiparametric MR (mpMR) imaging is rapidly evolving into the mainstay in prostate cancer (PCa) imaging. Generally, the examination consists of T2-weighted sequences, diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) evaluation, and less often proton MR spectroscopy imaging (MRSI). Those functional techniques are related to biological properties of the tumor, so that DWI correlates to cellularity and Gleason scores, DCE correlates to angiogenesis, and MRSI correlates to cell membrane turnover. The combined use of those techniques enhances the diagnostic confidence and allows for better characterization of PCa. The present article reviews and illustrates the technical aspects and clinical applications of each component of mpMR imaging, in a practical approach from the urological standpoint.
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De Carvalho, J. J. M., K. J. Syrjänen, M. Jacobino, N. T. Rosa, and L. Z. M. Carvalho. "Prevalence of genital human papillomavirus infections established using different diagnostic techniques among males attending a urological clinic." Scandinavian Journal of Urology and Nephrology 40, no. 2 (January 2006): 138–43. http://dx.doi.org/10.1080/00365590500191241.
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Choudhury, AM Anamur Rashid, Md Waliul Islam, Tasmina Parveen, Husne Ara, and Md Abdus Salam. "Intra-prostatic Local Anaesthesia for Ultrasonoguided Transrectal Prostate Biopsy - A Review Literature." Bangladesh Journal of Urology 16, no. 2 (March 11, 2020): 57–62. http://dx.doi.org/10.3329/bju.v16i2.45942.
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Carcinoma prostate is a common disease in urological aspect. Diagnosis of prostate cancer has evolved through the past century. In additions to estimations of serum PSA which has more predictive value than diagnostic value. In previous days diagnosis of prostatic cancer relied on three measures - DRE, needle biopsy and open biopsy. With development of medical science different biopsy techniques have evolved for prostatic biopsy. Each techniques has its own merits and demerits. This review article presented here discusses on ultrasonoguided transrectal prostatic biopsy following intraprostatic local anaesthesia. A thorough review literature search was done to resolve theses issues and finally a recommendation is drawn to develop a recommendated policy of biopsy for accurate diagnosis of prostatic cancer.
Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.57-62
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Eun, Sung-Jong, Jun Young Lee, Han Jung, and Khae-Hawn Kim. "Personalized Urination Activity Management Based on an Intelligent System Using a Wearable Device." International Neurourology Journal 25, no. 3 (September 30, 2021): 229–35. http://dx.doi.org/10.5213/inj.2142276.138.
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Purpose: In this study, a urinary management system was established to collect and analyze urinary time and interval data detected through patient-worn smart bands, and the results of the analysis were shown through a web-based visualization to enable monitoring and appropriate feedback for urological patients.Methods: We designed a device that can recognize urination time and spacing based on patient-specific posture and consistent posture changes, and we built a urination patient management system based on this device. The order of body movements during urination was consistent in terms of time characteristics; therefore, sequential data were analyzed and urinary activity was recognized using repeated neural networks and long-term short-term memory systems. The results were implemented as a web (HTML5) service program, enabling visual support for clinical diagnostic assistance.Results: Experiments were conducted to evaluate the performance of the proposed recognition techniques. The effectiveness of smart band monitoring urination was evaluated in 30 men (average age, 28.73 years; range, 26–34 years) without urination problems. The entire experiment lasted a total of 3 days. The final accuracy of the algorithm was calculated based on urological clinical guidelines. This experiment showed a high average accuracy of 95.8%, demonstrating the soundness of the proposed algorithm.Conclusions: This urinary activity management system showed high accuracy and was applied in a clinical environment to characterize patients’ urinary patterns. As wearable devices are developed and generalized, algorithms capable of detecting certain sequential body motor patterns that reflect certain physiological behaviors can be a new methodology for studying human physiological behaviors. It is also thought that these systems will have a significant impact on diagnostic assistance for clinicians.
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Gadhvi, Ashvin S., Udit I. Gadhvi, Nimesh B. Thakkar, Nidhi D. Shah, and Ranjit Zapadiya. "Spontaneous intravesical knotting of infant feeding tube: a rare case report." International Journal of Research in Medical Sciences 6, no. 9 (August 25, 2018): 3179. http://dx.doi.org/10.18203/2320-6012.ijrms20183666.
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Infant Feeding tube is universally used in Paediatric Patients for many diagnostic as well as therapeutic purposes. Intravesical knotting of IFT is rare but having significant morbidity. We here present such a rare case report in 6 month old patient treated endoscopically. Sometimes it is very difficult to remove knotting with various techniques discussed later, but it may cause more trauma to urethra. There are only few reported cases worldwide about it in few journals. But Endoscopic removal being safe among all. In such Urological Emergency, always early Identification is most important to prevent further complications. As neonate and infant’s urethra is small compared to the available smallest Foley catheter (8Fr), a 5 Fr and 8 Fr feeding tubes are practical alternatives to drain urine from the bladder. Intravesical catheter knotting of small feeding tubes placed as urinary diversion from the bladder is rare. The first case of catheter knotting in a pediatric patient was reported in 1976.
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Fulco, Andrea, Francesco Chiaradia, Luigi Ascalone, Vincenzo Andracchio, Antonio Greco, Manlio Cappa, Marcello Scarcia, et al. "Multiparametric Magnetic Resonance Imaging-Ultrasound Fusion Transperineal Prostate Biopsy: Diagnostic Accuracy from a Single Center Retrospective Study." Cancers 13, no. 19 (September 28, 2021): 4833. http://dx.doi.org/10.3390/cancers13194833.
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The management of prostate biopsy in men with clinical suspicion of prostate cancer has changed in the last few years, especially with the introduction of imaging techniques, to overcome the low efficacy of risk stratification based on PSA levels. Here, we aimed to compare the diagnostic accuracy of multiparametric MRI with fusion ultrasound-guided prostate biopsy and standard biopsy, both performed through the transperineal route. To this end, we retrospectively analyzed 272 patients who underwent combined transperineal targeted and standard biopsy during the same session. The primary outcome was to compare the cancer detection rate between targeted and standard biopsy. The secondary outcome was to evaluate the added value of combined targeted and standard biopsy approach as compared to only targeted or standard biopsy. Results showed that a rate of 16.7% clinically significant tumors (International Society of Urological Pathology (ISUP) grade ≥ 2) would have been lost if only the standard biopsy had been used. The combined targeted and standard biopsy showed an added value of 10.3% and 9.9% in reducing the risk of prostate cancer missing after targeted or standard biopsy alone, respectively. The combined targeted and standard biopsy pathway is recommended to reduce the risk of missing clinically significant prostate cancer.
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Bschleipfer, Thomas, and Isabell Karl. "Bladder Microbiome in the Context of Urological Disorders—Is There a Biomarker Potential for Interstitial Cystitis?" Diagnostics 12, no. 2 (January 22, 2022): 281. http://dx.doi.org/10.3390/diagnostics12020281.
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Since the development of modern cultivation and sequencing techniques, the human microbiome has increasingly become the focus of scientific attention. Even in the bladder, long considered to be a sterile niche, a highly variable and complex microbial colonization has now been demonstrated. Especially in the context of diseases such as interstitial cystitis, whose etiopathogenesis is largely unknown, and whose diagnosis is based on a process of exclusion of confusable diseases, science hopes to gain far-reaching insights for etiology and diagnosis, including the identification of potential biomarkers. While for functional disorders such as urge urinary incontinence and overactive bladder syndrome, initial associations have been demonstrated between reduced microbial diversity and increased symptomatology, as well as shifts in the abundance of specific microorganisms such as Lactobacillus or Proteus, studies in interstitial cystitis show conflicting results and have failed to identify a putative organism or urotype that clearly distinguishes the urinary microbiome of patients with IC/BPS from that of healthy controls. At the present time, therefore, the new insights into the bladder microbiome and its potential influence on urologic disease cannot yet be used in the context of elucidating possible etiopathogenetic causes, as well as in the use of a biomarker for diagnostic or prognostic purposes. Further studies should focus primarily on uniform procedures and detection methods to achieve better comparability of results and increase the likelihood of detecting hidden patterns.
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Simões e Silva, Ana Cristina, Flávia Cordeiro Valério, Mariana Affonso Vasconcelos, Débora Marques Miranda, and Eduardo Araújo Oliveira. "Interactions between Cytokines, Congenital Anomalies of Kidney and Urinary Tract and Chronic Kidney Disease." Clinical and Developmental Immunology 2013 (2013): 1–14. http://dx.doi.org/10.1155/2013/597920.
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Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound, affecting 1–5% of pregnancies. Postnatal investigation has the major aim in detecting infants with severe urinary tract obstruction and clinically significant urinary tract anomalies among the heterogeneous universe of patients. Congenital uropathies are frequent causes of pediatric chronic kidney disease (CKD). Imaging techniques clearly contribute to this purpose; however, sometimes, these exams are invasive, very expensive, and not sufficient to precisely define the best approach as well as the prognosis. Recently, biomarkers have become a focus of clinical research as potentially useful diagnostic tools in pediatric urological diseases. In this regard, recent studies suggest a role for cytokines and chemokines in the pathophysiology of CAKUT and for the progression to CKD. Some authors proposed that the evaluation of these inflammatory mediators might help the management of postnatal uropathies and the detection of patients with high risk to developed chronic kidney disease. Therefore, the aim of this paper is to revise general aspects of cytokines and the link between cytokines, CAKUT, and CKD by including experimental and clinical evidence.
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Kierstan, Andrzej, Tomasz Konecki, and Zbigniew Jabłonowski. "Assessment of complications after laparoscopic surgery of kidney tumors using Clavien-Dindo classification." Polish Journal of Surgery 92, no. 3 (April 17, 2020): 1–5. http://dx.doi.org/10.5604/01.3001.0014.1131.
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Summary. Introduction Surgical procedures are accepted, basic method of treating kidney cancer. Objective of the work The aim of the study was to assess postoperative complications according to the Clavien-Dindo classification after laparoscopic procedures in the treatment of kidney cancer. Material and methods A retrospective study involved 112 patients. The research was based on the analysis of data from the medical records of the clinic and the documentation of the urological polyclinic. Classification of postoperative complications according to Clavien and Dindo in the operated patients were assessed on a 7-point scale. Results Less severe complications occurred in 24 patients (21.4%). All the above-mentioned complications were conservatively managed by the administration of drugs and blood transfusions. Grade IIIb complication occurred in one patient (0.9%) and required kidney removal. Conclusions The use of the Clavien - Dindo classification in the assessment of postoperative complications of laparoscopic renal procedures is a simple and objective diagnostic tool for the postoperative condition of patients. Discussion The assessment of postoperative complications is a generally accepted way to compare the results of surgical treatment, but it should be emphasized that the occurrence of intraoperative complications also affects the subsequent postoperative course of the operated person. For kidney surgery, there was no consensus on how to report it, resulting in a wide range of types and frequencies of complications reported. In addition, many different surgical techniques used in renal surgery and the continuous development of new ones require a standardized way of reporting complications to facilitate comparison. Criteria introduced by Clavien and Dindo surgeons have been used in everyday practice for many years as an objective method of accurate and comprehensive reporting of postoperative complications also after urological procedures
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Oto, Julia, Emma Plana, Álvaro Fernández-Pardo, Fernando Cana, Manuel Martínez-Sarmiento, César D. Vera-Donoso, Francisco España, and Pilar Medina. "Identification of miR-29c-3p as a Robust Normalizer for Urine microRNA Studies in Bladder Cancer." Biomedicines 8, no. 11 (October 22, 2020): 447. http://dx.doi.org/10.3390/biomedicines8110447.
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Bladder cancer (BC) is among the most frequent malignancies worldwide, being the most expensive cancer to treat and monitor and the most lethal urological cancer. Urine microRNAs (miRNAs) have been proposed as novel non-invasive biomarkers to early diagnose and monitor BC patients in order to avoid the performance of current aggressive diagnostic techniques. However, huge discrepancies arise among studies mainly due to the lack of standardization in the normalization, a crucial step in all miRNA studies. Our aim was to identify the best miRNA normalizer for miRNA studies in urine of BC patients. We evaluated the performance of 110 candidate miRNAs in urine of 35 BC patients and 15 healthy controls by Real Time quantitative Polymerase Chain Reaction (RT-qPCR) followed by a stability analysis with RefFinder. In this screening stage, miR-29c-3p arose as the most stably expressed miRNA in BC and controls, with a good expression level. Stability of miR-29c-3p expression was validated in an independent cohort of 153 BC patients and 57 controls. Finally, we evaluated the robustness of miR-29c-3p as normalizer in the expression study of miR-200c-3p, a potential diagnostic marker for BC. We propose miR-29c-3p as a normalizer for miRNA studies in BC urine. This is the first study that characterizes a reliable normalizer that may allow the comparison of future urine miRNA studies as non-invasive biomarkers for BC diagnosis and monitoring.
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Cinque, Alessandra, Riccardo Vago, and Francesco Trevisani. "Circulating RNA in Kidney Cancer: What We Know and What We Still Suppose." Genes 12, no. 6 (May 28, 2021): 835. http://dx.doi.org/10.3390/genes12060835.
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Renal cancer represents the 7th most common tumor worldwide, affecting 400,000 people annually. This malignancy, which is the third most frequent cancer among urological diseases, displays a completely different prognosis if the tumor is detected in the early stages or advance phases. Unfortunately, more than 50% of renal cancers are discovered incidentally, with a consistent percentage of cases where the tumor remains clinically silent till the metastatic process is established. In day-to-day clinical practice, no available predictive biomarkers exist, and the existent imaging diagnostic techniques harbor several gaps in terms of diagnosis and prognosis. In the last decade, many efforts have been reported to detect new predictive molecular biomarkers using liquid biopsies, which are less invasive in comparison to renal biopsy. However, until now, there has been no clear evidence that a liquid biopsy biomarker could be relevant to the creation of a precise and tailored medical management in these oncological patients, even though circulating RNA biomarkers remain among the most promising. Given the idea that liquid biopsies will play a future key role in the management of these patients, in the present review, we summarize the current state of circulating RNA (miRNA, lncRNAs, and circRNAs) as possible biomarkers of renal cancer presence and aggressiveness in patients.
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Feldenzer, John A., James L. McGauley, and John E. McGillicuddy. "Sacral and Presacral Tumors: Problems in Diagnosis and Management." Neurosurgery 25, no. 6 (December 1, 1989): 884–91. http://dx.doi.org/10.1227/00006123-198912000-00006.
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Abstract We reviewed 9 cases of sacral tumors with presacral extension. These included 2 chordomas. 1 metastatic renal cell carcinoma, 2 schwannomas (1 malignant, 1 benign), 1 neurofibroma, 1 neurofibrosarcoma, 1 aneurysmal bone cyst, and an exceedingly rare meningioma. The sex of the patients was not significant. The age of the patients at diagnosis ranged from 13 to 68 years (mean, 47 years). Initial symptoms of low back and radiating leg pain were present in all but 1 patient. The duration of symptoms prior to diagnosis ranged from 1 month to 9 years (mean, 2.6 years). A delay in diagnosis of 2 years or more occurred in 6 of the 9 patients. Progressive perineal numbness and/or sphincter dysfunction were seen in 6 patients, and a palpable rectal mass was noted in 6 of 9 patients. The efficacy of various diagnostic tests is presented, as are the surgical options—needle biopsy and anterior and posterior approaches. Despite improved radiographic imaging techniques, these unusual tumors are often diagnosed at an advanced stage, and may masquerade as discogenic radiculopathy. Late diagnosis contributes to the difficulty of surgical extirpation. Anterior and posterior surgical approaches involving general, orthopedic, and urological surgeons may be required.
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Redman, John F. "Female Urologic Diagnostic Techniques." Urologic Clinics of North America 17, no. 1 (February 1990): 5–8. http://dx.doi.org/10.1016/s0094-0143(21)00284-6.
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Schubert, Tina, Steffen Rausch, Omar Fahmy, Georgios Gakis, and Arnulf Stenzl. "Optical improvements in the diagnosis of bladder cancer: implications for clinical practice." Therapeutic Advances in Urology 9, no. 11 (September 4, 2017): 251–60. http://dx.doi.org/10.1177/1756287217720401.
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Background For over 100 years white-light cystoscopy has remained the gold-standard technique for the detection of bladder cancer (BCa). Some limitations in the detection of flat lesions (CIS), the differentiation between inflammation and malignancy, the inaccurate determination of the tumor margin status as well as the tumor depth, have led to a variety of technological improvements. The aim of this review is to evaluate the impact of these improvements in the diagnosis of BCa and their effectiveness in clinical practice. Methods A systematic literature search was conducted according to the PRISMA statement to identify studies reporting on imaging modalities in the diagnosis of NMIBC between 2000 and 2017. A two-stage selection process was utilized to determine eligible studies. A total of 74 studies were considered for final analysis. Results Optical imaging technologies have emerged as an adjunct to white-light cystoscopy and can be classified according to their scope as macroscopic, microscopic and molecular. Macroscopic techniques including photodynamic diagnosis (PDD), narrow-band imaging (NBI) and the Storz Professional Image Enhancement System (IMAGE1 S, formerly known as SPIES) are similar to white-light cystoscopy, but are superior in the detection of bladder tumors by means of contrast enhancement. Especially the detection rate of very mute lesions in the bladder mucosa (CIS) could be significantly increased by the use of these methods. Microscopic imaging techniques like confocal laser endomicroscopy and optical coherence tomography permit a real-time high-resolution assessment of the bladder mucosa at a cellular and sub-cellular level with spatial resolutions similar to histology, enabling the surgeon to perform an ‘optical biopsy’. Molecular techniques are based on the combination of optical imaging technologies with fluorescence labeling of cancer-specific molecular agents like antibodies. This labeling is intended to favor an optical distinction between benign and malignant tissue. Conclusions Optical improvements of the standard white-light cystoscopy have proven their benefit in the detection of BCa and have found their way into clinical practice. Especially the combination of macroscopic and microscopic techniques may improve diagnostic accuracy. Nevertheless, HAL-PDD guided cystoscopy is the only approach approved for routine use in the diagnosis of BCa by most urological associations in the EU and USA to date.
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Kornyenko, Oleksii, Mariia Scherbak, and Mykola Turchak. "Assessment of the Algorithms for Diagnostics and the Possibilities of Treating Patients with a Penile Dysmorphie Disorder." Health of Man, no. 1 (June 2, 2021): 8–14. http://dx.doi.org/10.30841/2307-5090.1.2021.232313.
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The article discusses issues related to the choice of diagnostic algorithms and planning tactics for treating patients with penile dysmorphophobia. The psychological characteristics of this group of patients, methods of diagnosis, psychotherapy correction and the choice of surgical tactics are sounded.
The manifestations of penile dysmorphophobia and dysmorphomania, as disorders of a deeper level, are considered as an integrative problem solved from the standpoint of urology, psychotherapy, and aesthetic surgery. In conjunction with an andrologist, the involvement of a psychotherapist and, if necessary, a psychiatrist is required. At the initial stages of working with a patient, narrowly focused psychotherapy is used. The next level of correction is cognitive behavioral psychotherapy (CBT) with the technique of “exposure and prevention of reactions” or “cognitive restructuring”. The “mindfulness CBT” technique is considered important for teaching the patient the ability to stop subjective perception of personal experiences.
To consolidate the result, individual hypnosuggestational therapy and group (family) psychotherapy are used. The indications for surgical enlargement of the penis are divided into medical, functional and aesthetic. Penile dysmorphophobia is an aesthetic indication for surgery. Contradictions in carrying out such interventions include the lack of standardized methods with a high positive prognosis, overestimated patient expectations, and the lack of a result to improve a man’s self-esteem even with a positive result of the operation.
The clinic of the Department of Sexopathology and Andrology of the State Institution «Institute of Urology of the National Academy of Medical Sciences of Ukraine» uses a ligamentotomy technique to lengthen the penis and implant a polypropylene mesh under the superficial fascia of the penis to thicken it. For patients with manifestations of penile dysmorphophobia simultaneously with severe forms of erectile dysfunction, a number of operations have been proposed for the simultaneous installation of penile implants and augmentation of the tunica albuginea using a graft: corporoplasty with a circular graft, Sliding Technique, modification of the sliding technique (MoST), Multiple-slid-Technique (MuST) augmentation technique.
These techniques are not included in the list of recommendations offered by the urological community; they have high predictable risks of complications requiring urgent explantation of the prosthesis and irreversible loss of penile length.
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Synetar, E. A., and O. I. Brych. "The dynamics of biofilm overgrowth of Enterococcus faecalis." Visnyk of Dnipropetrovsk University. Biology, medicine 6, no. 2 (August 6, 2015): 146–50. http://dx.doi.org/10.15421/021526.
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The nature of microorganisms can exist in two physiological forms that allow microbes to preserve livelihoods and continue their life cycle. The first is the population of planktonic forms of microorganisms which live freely in the environment with the developed systems of active and passive mobility, contributing to the rapid spread of a liquid medium. The second forms are those expressing specific mechanisms of adhesion, and able to aggregate on biogenic and abiogenic surfaces. Even in the deep sea vast number of species of bacteria live in their inherent horizons. Thus, the study of biofilms tube life support systems, diagnostic, laparoscopic devices during prolonged catheterization of the urinary system is of great practical, theoretical and biological significance in medicine and biology. For almost 20% of catheter-associated infections antibiotic therapy is uneffective, particularly through the formation of microbial biofilms on the surface of urinary catheters. We characterized the dynamics of biofilm growth of Enterococcus faecalis on fragments ofsilicone catheter. The study was conducted using bacteriological and electron microscopic techniques. Study of the dynamics of biofilm formation was performed using E. faecalis strain 49, which is isolated from the urine of persons who are not the patients of the urological department of resuscitation and intensive therapy. Using scanning electron microscopy we have established dynamics and phase attachment ofE. faecalis bacteria and subsequent overgrowth of silicone catheter surface. Aftercalculations, index of adhesion on the turbulent wall amounted to 0,49 microbial cells. That is, every other cell of the monolayer adhered on the catheter. Area of biofilm growth of E. faecalis after 24 hour incubation was equal to 51.5 μm2, in 48 hours it increased to 231.5 μm2. After 72 hours of incubation we recorded the increase in biofilm growth of E. faecalisto 1922,8 μm2. The results were obtained on fragments of catheters, immersed in broth in vertical position. This orientation has excluded the deposition of germs by sedimentation, i.e. by gravity. It is known that after the logarithmic phase and achieving M-concentration for a few hours microbes starttodie and their possible deposition mayoccur. Therefore, our results confirm the formation of biofilm, instead of sedimentation of dead microbes. Our study shows that biofilm is “the way of overgrowth on artificial and natural surfaces by microorganisms that are kept on them by exopolymer membranes”.
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Cunneen, Colla, Michael Kelly, Gregory Nason, Eanna Ryan, Ben Creavin, and Des Winter. "The Role of Exenterative Surgery in Advanced Urological Neoplasms." Current Urology 14, no. 2 (2020): 57–65. http://dx.doi.org/10.1159/000499258.
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Pelvic exenterative surgery is both complex and challenging, especially in the setting of locally recurrent disease. In recent decades, improved surgical techniques have facilitated more extensive resection of both locally advanced and recurrent pelvic malignancies, but its role in urological cancer surgery is highly selective. However, it remains an important part of the armamentarium for the management of bladder and prostate cancer cases where there is local invasion into adjacent organs or localized recurrence. Better diagnostics, reconstructive options and centralized care have reduced associated morbidity considerably, and it is still used rarely in palliative settings. Despite this, there is sparse prospective evidence reporting on long-term oncological or quality of life outcomes.
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Bernstein, Darryl Ethan, and Brett Sydney Bernstein. "Urological technology: where will we be in 20 years’ time?" Therapeutic Advances in Urology 10, no. 8 (June 17, 2018): 235–42. http://dx.doi.org/10.1177/1756287218782666.
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Since prehistoric times, our understanding of urology has rapidly expanded. Whilst primitive urologists began by using urine as a therapeutic substance, modern urologists may find themselves removing a kidney remotely by driving a robotic arm, with seven degrees of movement, while using image overlay-augmented reality. This review provides an insight into the potential status of urological technology in 20 years’ time, assessed through an analysis of developments in imaging, diagnostics, robotics and further technologies. A particular emphasis is given to the promising fields of minimally invasive techniques, nanotechnology and tissue engineering, which likely hold the key to a new era for urology.
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Inci, Mehmet Fatih, Fuat Ozkan, Teik Choon See, and Servet Tatli. "Renal Transplant Complications: Diagnostic and Therapeutic Role of Radiology." Canadian Association of Radiologists Journal 65, no. 3 (August 2014): 242–52. http://dx.doi.org/10.1016/j.carj.2013.06.002.
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Kidney was the first and is the most frequently transplanted organ. Despite improved surgical techniques and transplantation technology, complications do occur and, if left untreated, may lead to catastrophic consequences. Renal transplantation complications may be vascular (eg, renal artery and vein stenosis and thrombosis, arteriovenous fistula, and pseudoaneurysms); urologic (eg, urinary obstruction and leak, and peritransplantation fluid collections, including hematoma, seroma, lymphocele, and abscess formation); and nephrogenic, including acute tubular necrosis, graft rejection, chronic allograft nephropathy, and neoplasm. Early diagnosis and treatment of these complications are paramount to prevent graft failure and other significant morbidities to the patients. Radiology plays a pivotal role in the diagnosis and treatment of these complications, with minimally invasive percutaneous techniques. In this article, we reviewed renal transplantation anatomy, a wide range of complications that may occur after renal transplantation surgery, typical imaging appearances of the complications on varies imaging modalities, and percutaneous interventional techniques that are used in their treatment.
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Smaldone, M. C., E. Polsky, D. J. Ricchiuti, and S. G. Docimo. "Advances in Pediatric Urologic Laparoscopy." Scientific World JOURNAL 7 (2007): 727–41. http://dx.doi.org/10.1100/tsw.2007.141.
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The spectrum of laparoscopic surgery in children has undergone a dramatic evolution. Initially used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are now being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery.
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Sapozhkova, Zhanna, Karina Kasoyan, Elena Kovalchuk, and Irina Shabalova. "Sperm Sediment Cytology: A New Technique for Diagnosing Occult Urologic Infections." Acta Cytologica 61, no. 3 (2017): 247–51. http://dx.doi.org/10.1159/000469653.
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Background: Ill-defined chronic symptoms such as itching, burning, urethral discharge, and pelvic pain are not uncommon in male urologic patients. Often, microscopic urinalysis, bacterial cultures, and laboratory testing are non-contributory. We have developed a technique for sperm sedimentation and used the cytologic examination of the sediment routinely in more than 4,000 patients with urologic complaints over the last 5 years. Case: We present 3 exemplary cases, documenting the diagnostic power of sperm sediment cytology (SSC). In all 3 cases, conventional laboratory testing failed to reveal a causative agent. Case 1 is that of a 28-year-old male patient with a history of occasional swelling of the lymph nodes in the left inguinal region for 1 year. Case 2 is that of a 51-year-old male patient with a history of itching and burning of the urethra of 2 months' duration. Case 3 is that of a 22-year-old female patient with copious vaginal discharge after intercourse for 18 months, non-responsive to treatment. Conclusion: We were able to identify causative pathologic organisms in the sediment of all patients or their partner. Subsequent specific treatment did clear and alleviate the symptoms documenting the clinical relevance of this new technique. In our experience, SSC has proven to be a valuable technique for diagnosing occult urologic infections.
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Lourenço, Catarina, Vera Constâncio, Rui Henrique, Ângela Carvalho, and Carmen Jerónimo. "Urinary Extracellular Vesicles as Potential Biomarkers for Urologic Cancers: An Overview of Current Methods and Advances." Cancers 13, no. 7 (March 26, 2021): 1529. http://dx.doi.org/10.3390/cancers13071529.
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Urologic cancers are a heterogeneous group of tumors, some of which have poor prognosis. This is partly due to the unavailability of specific and sensitive diagnostic techniques and monitoring tests, ideally non- or minimally invasive. Hence, liquid biopsies are promising tools that have been gaining significant attention over the last decade. Among the different classes of biomarkers that can be isolated from biofluids, urinary extracellular vesicles (uEVs) are a promising low-invasive source of biomarkers, with the potential to improve cancer diagnosis and disease management. Different techniques have been developed to isolate and characterize the cargo of these vesicles; however, no consensus has been reached, challenging the comparison among studies. This results in a vast number of studies portraying an extensive list of uEV-derived candidate biomarkers for urologic cancers, with the potential to improve clinical outcome; however, without significant validation. Herein, we review the current published research on miRNA and protein-derived uEV for prostate, bladder and kidney cancers, focusing on different uEV isolation methods, and its implications for biomarker studies.
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Wu, Yan, Young Suk Kwon, Mina Labib, David J. Foran, and Eric A. Singer. "Magnetic Resonance Imaging as a Biomarker for Renal Cell Carcinoma." Disease Markers 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/648495.
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As the most common neoplasm arising from the kidney, renal cell carcinoma (RCC) continues to have a significant impact on global health. Conventional cross-sectional imaging has always served an important role in the staging of RCC. However, with recent advances in imaging techniques and postprocessing analysis, magnetic resonance imaging (MRI) now has the capability to function as a diagnostic, therapeutic, and prognostic biomarker for RCC. For this narrative literature review, a PubMed search was conducted to collect the most relevant and impactful studies from our perspectives as urologic oncologists, radiologists, and computational imaging specialists. We seek to cover advanced MR imaging and image analysis techniques that may improve the management of patients with small renal mass or metastatic renal cell carcinoma.
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Velasco, Brian, Michael Ye, Bonnie Chien, John Y. Kwon, and Christopher P. Miller. "Incidental Findings on Foot and Ankle Radiographs as Compared to Other Anatomic Regions." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0007. http://dx.doi.org/10.1177/2473011419s00076.
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Category: Orthopedic Radiology Introduction/Purpose: Radiographs are one of the most common and widely available diagnostic imaging techniques that are used to evaluate orthopedic conditions. However, incidental findings on imaging may be observed as well, some of which may be very serious and have significant heath as well as legal ramifications if missed. This study evaluates the number of clinically relevant incidental findings reported for orthopaedic radiographs ordered in an academic orthopedic multispecialty group over one year. Methods: A retrospective review was conducted of 13,948 eligible radiographs recorded at our institution over a 12-month period. Reports were categorized based on exam type. Incidental findings were first categorized as either concern for malignancy or non-malignancy. The possibly malignant findings were further subdivided into malignancies in Bone or Lung tissues. The non- malignant findings were categorized into the following groups: Benign Bone Disease, Gastrointestinal Pathology, Gynecologic Pathology, Incidental Fracture, Infection, Inflammation, Respiratory Pathology, Soft Tissue Mass, Urologic Pathology, Vascular Pathology or Other. Results: Of the 13,948 radiographs, 286 radiographs reported at least one incidental finding totaling to 287 (2.06%) incidental findings. The 3 studies with the highest rates of incidental findings were Leg Length Alignment films (3.94%), Spine (3.88%), and Pelvis & Hip (2.76%). The three categories with the lowest rates of incidental findings were Hand & Wrist (0.56%), Tibia/Fibula Foot & Ankle (0.84%), and Forearm & Elbow (1.13%). Over one-third of incidental findings concerned malignancy or metastases with 87 (30.1%) and 18 (6.23%) identified in bone tissue and lung tissue, respectively. Benign Bone Disease (24.9%), Gastrointestinal Pathology (6.57%), and Gynecologic Pathology (5.88%) were categories with the highest rates of non-malignant incidental findings. Follow-up was recommended for 122 (42.5%) incidental findings. Conclusion: This study describes the rates of incidental findings on orthopedic radiographs. Radiographs of midline structures are more likely to report an incidental finding as opposed to radiographs of distal extremities. The exception is leg alignment films because these image the entirety of the lower extremity and the pelvis and thus a far larger volume of the body. Over one-third of incidental findings concerned possible malignancy or metastases and therefore follow-up with focused imaging should be recommended if suspicious. This information will be particularly useful for orthopaedic surgeons who read their own radiographs without a radiologist formally reviewing the films.
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Abbas Jafri, Syed Saleem, and Nawaz Chughtai Chughtai. "The diagnosis and management of the urological complications of Renal Transplantation: a series of 1100 patients." Annals of King Edward Medical University 11, no. 4 (April 21, 2016). http://dx.doi.org/10.21649/akemu.v11i4.1056.
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Objective: To analyse the Urological Complications after Renal Transplantation and their management. Material and methods: -A retrospective analysis of 1150 consecutive live donor renal transplants was performed. The study period extended from December 1995 to December 2004. The surgical procedure for ureteral reimplantation was modified Lich anastomosis. Ultrasonography, renal scanning, antegrade pyelography, retrograde pyelography and cystography were the diagnostic tools. Results: -Overall, 68 primary urological complications (5.9%) were identified during the 15-year experience in 65 patients. The Urological Complications in our series included 35 ureteral obstruction (3.0%), 25 ureteral or bladder leaks (2.17%), 05 out flow obstruction, 02 cases of vesicoureteral reflux and 01 case of ureteral stone. Conclusion: The incidence of Urological Complications in our study is 5.9%. Early exploration of the ureteric leaks and timely intervention to obstructed kidney reduced the morbidity and improves graft su rvival. The causes of these complications and techniques for their prevention are discussed in this study.
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Laimer, Gregor, Raphael Müller, Christian Radmayr, Andrea Katharina Lindner, Andrei Lebovici, and Friedrich Aigner. "Multiparametric ultrasound in torsion of the testicular appendages: a reliable diagnostic tool?" Medical Ultrasonography, September 11, 2021. http://dx.doi.org/10.11152/mu-3206.
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Aim: Torsion of the testicular appendages represents the most common cause of an acute scrotum in prepubertal boys. Its sonographic appearances on gray-scale US and color Doppler US have already been presented in several studies. The aim of this analysis was to expand those already established techniques with strain elastography and thus present typical features of this entity on multiparametric US.Material and methods: Retrospective analysis of all patients presented to the urological department with an acute scrotum between January 2018 and July 2020 identified eleven patients 6-17 years old (mean, 11.1 years), discharged with the diagnosis torsion of the testicular appendages that were examined with a high-end ultrasound device. Results: On gray-scale US all patients showed a round lesion with heterogenous echotexture adjacent to the upper pole of the testis/epididymis with a diameter of 4 to 11.1 mm (mean, 7.7 mm). Scrotal skin thickening and a concomitant hydrocele were found in 9 (81.8%) and 7 (63.6%) cases, respectively. On color Doppler images, all torsed appendages were avascular and in 9 (81.8%) patients we observed hyperemia of the adjacent epididymis. Strain elastography showed increased tissue stiffness in all documented images.Conclusion: Torsion of the testicular appendages has a set of features on multiparametric US. Awareness of this features can facilitate diagnosis of torsion of the testicular appendages and reduce unnecessary surgicalscrotal exploration or unwarranted antibiotic treatment.
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Zeinab Kamarkhani, Raheleh Rafiei-Sefiddashti, Leila Haghighi, and Alireza Badirzadeh. "Molecular Examination of Trichomonas vaginalis Infection and Risk of Prostate Cancer in the Biopsy of Patients with Different Prostate Lesions." Ethiopian Journal of Health Sciences 31, no. 2 (March 1, 2021). http://dx.doi.org/10.4314/ejhs.v31i2.5.
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BACKGROUND፡ Trichomoniasis is a sexually transmitted infectious disease caused by a flagellated protozoa, Trichomonas vaginalis (T.vaginalis) and is often asymptomatic in men. Benign prostatic hyperplasia (BPH) and prostate cancer (PCA) are the most common urological diseases in the elderly. Scientists have proposed various factors which trigger prostate cancer, including sexually transmitted diseases. Thus, this study aimed to evaluate the potential role of T. vaginalis as a risk factor for various prostate lesions such as hyperplasia and prostate cancer.METHODS: A total of 250 paraffin-embedded of different prostate lesion biopsies were analyzed by Polymerase Chain Reaction (PCR) using the beta-tubulin gene for identifying T. vaginalis.RESULT: All 250 pathologic specimens were negative for this parasite by using PCR technique.CONCLUSION: It seems that T. vaginalis may have not had a causative role for different prostate lesions and it seems proposed PCR technique is an insufficient method to find the parasite in paraffin-embedded tissues. Therefore, other diagnostic techniques to identify the parasite in biopsy samples are suggested.
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Popiel, Monika. "Defecography in contemporary coloproctological diagnostics." Nowa Medycyna 25, no. 4 (December 2018). http://dx.doi.org/10.25121/nm.2018.25.4.185.
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Evacuatory difficulty is a common problem covering a large spectrum of disorders, from constipation to faecal incontinence. In addition to a visit to a surgeon-proctologist, the diagnosis of impaired defecation often requires urological and gynaecological evaluation. Many pathologies causing evacuatory difficulty, such as full thickness rectal prolapse, reduced sphincter tone and haemorrhoidal disease, can be detected by clinicians already at the stage of physical examination. A large group of pathologies may be detected using standard diagnostic techniques such as colonoscopy and pelvic imaging, e.g. computed tomography, magnetic resonance, and transabdominal/transrectal/transvaginal ultrasonography. However, certain abnormalities are only visible during functional pelvic examination. These include rectocele, sigmoidocele, enterocele, internal intussusception, cystocele, and spastic pelvic floor syndrome. Defecography is guided by either X-ray or MRI. Pelvic function may be also assessed using transperineal ultrasonography. Defecography involves 4 phases: rest, forced contraction, strain, and defecation. The anorectal angle and, in the case of MRI, the PCL line (which is a reference point for most measurements), are determined in order to evaluate the position and mobility of pelvic organs. Pelvic function evaluation helps differentiate patients with evacuatory difficulties requiring surgical intervention from those who need conservative treatment (exercises, electrostimulation). Furthermore, it helps choose an appropriate technique and surgical access, as well as select patients requiring a more interdisciplinary approach.
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Ramalingam, Aishwarya J., Sameena Khan, Manonmoney J, and Archana R. "Unlocking The Human Urobiome: Impact On Health and Disease- A Review." International Journal of Life Science and Pharma Research, November 26, 2022. http://dx.doi.org/10.22376/ijlpr.2023.13.1.l81-95.
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The urinary microbiome or the urobiome are the group of microbes present in the urinary tract. They came into the limelight in the last decade due to advances in diagnostic technologies. Two complementary assays are widely used for research in urobiomes. Next-generation sequencing (NGS) of 16S ribosomal RNA (rRNA) paired with enhanced urine culture techniques (EUCT) are widely employed for research. This has paved the way for investigations on sterile body sites such as urine thereby breaking the myth of urine being considered sterile. EUCT, such as expanded quantitative urine culture (EQUC) contributed to the evidence that the microbes detected by the NGS are still alive. EQUC has been employed in clinical laboratories since the last decade and is indicated only when there are unexplained clinical symptoms and conventional urine culture is negative. Our aim is to have a comprehensive review study on the urobiome concerning health, its association with urological pathologies. Our main objective is to collect review and research articles using databases and review them for obtaining in-depth knowledge of the urobiome as well as to identify possible alternate study areas. The urobiome is a new area with minimal information available. This review helps the researcher to comprehend this upcoming area easily. Investigations into urobiome research, however, could have a considerable impact on our understanding of the pathogenesis of urogenital disorders and even reveal novel possibilities. Thus, the forthcoming years will open a ripe ground for future research into diagnosis, treatment and prevention strategies for urological pathologies.
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Ahmed, Islam Hussien Abd Elaziz, Hend Galal Eldeen Mohamed Ali Hassan, Mohamed El Gharib Abo ElMaaty, and Shaima El Metwally ElDaisty El Metwally. "Role of MRI in diagnosis of prostate cancer and correlation of results with transrectal ultrasound guided biopsy “TRUS”." Egyptian Journal of Radiology and Nuclear Medicine 53, no. 1 (June 14, 2022). http://dx.doi.org/10.1186/s43055-022-00755-7.
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Abstract Background Prostate cancer is the most common cancer in elderly men, and the second leading cause of cancer-related death in developed countries. For a long time, TRUS is used in screening, diagnosis of prostate lesions. Recently the implementation of multi parametric MRI into a screening program currently seems to be the most promising technique to improve the early detection of prostate cancer. Results Thirty Patients were referred from urological outpatient clinics complaining of urological symptoms (dysuria, frequency and urine retention). The study was carried, and the patients were submitted to Ultrasonography, conventional magnetic resonance, diffusion weighted images and MR spectroscopy techniques, these results were correlated with histopathological data. In this study Conventional MRI has moderate sensitivity 81.8% and low specificity 37.3% in diagnosing prostate malignancy. Using of mpMRI combination of diffusion-weighted, Dynamic contrast enhanced and MR spectroscopic imaging is a promising approach for discriminating between benign and malignant lesions in the PZ and increase sensitivity 100% and specificity 96.6% in diagnosing prostate malignancy. Conclusions The standard for the definitive diagnosis of prostate cancer is trans-rectal ultrasound biopsy. However, TRUS guided biopsy has a significant sampling error and can miss up to 30% of cancers and may show underestimation of Gleason grade, especially in anteriorly located tumors. It may lead to an increase in complications. MRI has an essential role to play in making safer in diagnosis. It can aid in staging also and surgery or radiation treatment planning. Although T2W MRI has been used widely for diagnosis on the basis of its excellent soft tissue resolution, but its accuracy for the detection and localization of cancer prostate is unsatisfactory. The implementation of multi parametric MRI: MR spectroscopy, Dynamic contrast enhanced and diffusion weighted imaging into a diagnosis program improve the diagnostic performance. These advances are beginning to translate into better treatment selection and more accurate image-guided therapies. In addition, early detection of local recurrence.
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Bullock, Nicholas, Andrew Simpkin, Sarah Fowler, Murali Varma, Howard Kynaston, and Krishna Narahari. "Pathological upgrading in prostate cancer treated with surgery in the United Kingdom: trends and risk factors from the British Association of Urological Surgeons Radical Prostatectomy Registry." BMC Urology 19, no. 1 (October 17, 2019). http://dx.doi.org/10.1186/s12894-019-0526-9.
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Abstract Background Accurate grading at the time of diagnosis if fundamental to risk stratification and treatment decision making in patients with prostate cancer. Whilst previous studies have demonstrated significant pathological upgrading and downgrading following radical prostatectomy (RP), these were based on historical cohorts and do not reflect contemporary patient selection and management practices. The aim of this national, multicentre observational study was to characterise contemporary rates and risk factors for pathological upgrading after RP in the United Kingdom (UK). Methods All RP entries on the British Association of Urological Surgeons (BAUS) Radical Prostatectomy Registry database of prospectively entered cases undertaken between January 2011 and December 2016 were extracted. Those patients with full preoperative PSA, clinical stage, needle biopsy and subsequent RP pathological grade information were included. Upgrade was defined as any increase in Gleason grade from initial needle biopsy to pathological assessment of the entire surgical specimen. Statistical analysis and multivariate logistic regression were undertaken using R version 3.5 (R Foundation for Statistical Computing, Vienna, Austria). Results A total of 17,598 patients met full inclusion criteria. Absolute concordance between initial biopsy and pathological grade was 58.9% (n = 10,364), whilst upgrade and downgrade rates were 25.5% (n = 4489) and 15.6% (n = 2745) respectively. Upgrade rate was highest in those with D’Amico low risk compared with intermediate and high-risk disease (55.7% versus 19.1 and 24.3% respectively, P < 0.001). Although rates varied between year of surgery and geographical regions, these differences were not significant after adjusting for other preoperative diagnostic variables using multivariate logistic regression. Conclusions Pathological upgrading after RP in the UK is lower than expected when compared with other large contemporary series, despite operating on a generally higher risk patient cohort. As new diagnostic techniques that may reduce rates of pathological upgrading become more widely utilised, this study provides an important benchmark against which to measure future performance.
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Badulescu, Maria Ramona, Mihai Adrian Socaciu, Tudor Moisoiu, Alexandra Andries, Gheorghiță Iacob, and Radu Badea. "Current status of imaging diagnosis in the transplanted kidney. A review of the literature with a special focus on contrast-enhanced ultrasonography." Medicine and Pharmacy Reports, March 25, 2020. http://dx.doi.org/10.15386/mpr-1536.
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Objectives. Ultrasonographic scanning is currently the most widespread imaging diagnostic procedure. The method provides real-time morphological, vascular and elastographic information in a non-invasive manner. In recent years, harmonic vascular examination has become accessible using intravenous contrast agents. In urological pathology, this procedure is used in the detection and evaluation of vascular and ischemic complications, in the classification of complex cysts according to the Bosniak system, also in the renal lesions with uncertain etiology and in acute pyelonephritis for the detection of abscesses. The contrast agent (SonoVue) is angiospecific and can be used in patients transplanted immediately after surgery without adverse effects or impaired renal function. Thus, it is desirable to be used in the nephrological pathology of the renal graft and to develop diagnostic models based on the evaluation of renal microvascularization, as well as the quantitative data resulting from the graphical representation of the specific parameters. The purpose of this review is to evaluate the current state of the literature regarding the place and role of contrast substance ultrasound in the early diagnosis of acute renal graft dysfunction and to make a differential diagnosis of this pathological entity.
Method. This review quantifies the role of contrast ultrasound in the diagnosis of acute complications of the renal graft. The research was conducted based on the databases PubMed, MedScape, Cochrane , according to the search criteria such as contrast-enhanced ultrasound + kidney transplant, "time intensity curves" + "kidney transplant”, filtered for the period 2004-2018.
Results. In the nephrological pathology of the renal graft, contrast-enhanced ultrasound is a valuable tool, superior to Doppler ultrasound in predicting the evolution of the renal graft, identifying very small early defects in renal microvascularization. A number of studies succeeded in identifying acute graft dysfunction, some of which establish its etiology - humoral rejection versus acute tubular necrosis. On the other hand, the contrast-enhanced ultrasound parameters do not have the ability to distinguish between cellular and humoral rejection.
Conclusions. If, at present, the histopathological examination is the only one that can differentiate with certainty the cause of acute renal graft dysfunction, we consider that contrast-enhanced ultrasound, as a non-invasive imaging technique, opens a favorable perspective for increasing the survival of the renal graft and decreasing the complications in the renal transplant. The combination of other ultrasound techniques, together with contrast-enhanced ultrasound, could lead to the development of new diagnostic models.
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Abolghasemi, Sara, Mohammad Alizadeh, Ali Hashemi, and Shabnam Tehrani. "Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran." Infectious Disorders - Drug Targets 20 (February 18, 2020). http://dx.doi.org/10.2174/1871526520666200218115400.
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Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.
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Carpagnano, F. A., L. Eusebi, S. Carriero, W. Giannubilo, F. Bartelli, and G. Guglielmi. "Prostate Cancer Ultrasound: Is Still a Valid Tool?" Current Radiology Reports 9, no. 7 (July 2021). http://dx.doi.org/10.1007/s40134-021-00382-6.
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Abstract Purpose of Review The main purpose of this paper review is to highlight the latest ultrasound (US) imaging technologies of the prostate gland, an organ increasingly at the center of attention in the field of oncological diseases of the male sex, which needs a 360° evaluation in order to obtain tailored therapeutic planning. Specialist urological evaluation is designated for this purpose, together with integrated prostate imaging which currently tends to focus more and more on the use of US imaging and its state-of-the-art technologies in iconographic diagnosis, biopsy and, sometimes, treatment of prostatic cancer. Recent Findings In particular, the main tools to which reference is made, represent a valid aid to basic US technologies already widely known and diffused, like the grayscale US or the Doppler US, for a "multiparametric" evaluation of the prostate cancer. The concept of multiparametricity is explained by the integration of prostate imaging obtained both with the US evaluation of the gland before and after administration of contrast medium, with the elaboration of parametric maps of quantitative measurement of the enhancement, and with elastography that provides information about the tissue consistency, a finding that strongly relates with the degree of cellularity and with the tumor grading. Summary Prostate cancer screening consists of dosing serum levels of prostate-specific antigen (PSA) and performing digit-rectal examination (DRE), more or less associated with transrectal prostate ultrasound (TRUS). However, although these are the most common techniques in clinical practice, they have numerous limitations and make the diagnosis of prostate cancer often challenging. The purpose of mp-US is to enrich the clinical-laboratory data and, above all, the standard US imaging with further details to strengthen the suspicion of malignancy of a prostate tumor, which needs to be addressed to diagnostic deepening with biopsy. This review article provides a summary of the current evidence on mp-US imaging in the evaluation of a clinically significant prostate cancer, comparing the data obtained to the imaging of mp-MRI, the reference tool both in diagnosis and staging.