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Urology
Kinds of Urology Terms modified by Urology Selected AbstractsIntroduction: LESS AND NOTES SURGERY IN UROLOGYBJU INTERNATIONAL, Issue 6b 2010Jihad H. Kaouk MD No abstract is available for this article. [source] MINIMALLY INVASIVE SURGERY IN UROLOGY: IS THE WINNER NATURAL-ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY OR LAPAROENDOSCOPIC SINGLE-SITE SURGERY?BJU INTERNATIONAL, Issue 1 2010Abhay Rane No abstract is available for this article. [source] ,I WILL NOT CUT . . . ': THE OATH THAT DEFINED UROLOGYBJU INTERNATIONAL, Issue 7 2008Harry W. Herr OBJECTIVE To explore different interpretations of the clause embedded in the Hippocratic Oath, prohibiting surgery for stones, and its relevance for urology. METHODS Various translations of the Oath, from the original Greek edition to historical revisions, were reviewed. RESULTS Controversy surrounds different translations and interpretations of the Oath about the practice of lithotomy among ancient healers. The reasons Hippocratic physicians were prohibited from performing lithotomy are several, but the consensus is that untrained physicians pledged not to undertake such a complicated procedure, but to refer their patients to other healers who specialized in that practice. CONCLUSION The Hippocratic Oath actually defined, identified and legitimized urology as the first medical speciality. [source] Clinical and metabolic evaluation of subjects with erectile dysfunction: a review with a proposal flowchartINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 3 2009C. Foresta Summary Erectile function is a haemodynamic phenomenon depending on the integrity of neurological, vascular, endocrinological, tissue (corpora cavernosa), psychological and relational factors; changes in any one of these components may lead to erectile dysfunction (ED). ED and its comorbid conditions share common risk factors such as endothelial dysfunction, atherosclerosis and metabolic and hormonal abnormalities. Furthermore, although cross-sectional studies have shown a clear age-dependent association between ED, diabetes mellitus, hypertension, metabolic syndrome (MetS) and cardiovascular diseases, longitudinal evidence has recently emphasized that ED could be an early marker of these conditions. Recently, the European Association of Urology and American Urology Association provided consensus guidelines for the management of ED patients. However, the metabolic aspect of ED is rather neglected or not sufficiently treated. In this study, more emphasis will be placed on the presence of ED comorbid metabolic factors. The primary and secondary goals of therapy, according to current guidelines and to prevent their clinical evolution, will also be provided. We review the concepts of metabolic diseases related to ED and their treatment. Criteria for the diagnosis and treatment of hypogonadism, metabolic and vascular disease related to ED were analysed. ED can mark the starting point for the evaluation and prevention of significant severe diseases (such as diabetes, MetS, dyslipidaemia, arteriosclerosis, hypertension, ischaemic cardiopathy, neuropathy, etc.) hitherto unknown by the patients. Most widely used criteria for the diagnosis and treatment of these diseases were reported. We suggest a clinical approach which allows the identification of metabolic and others systemic pathologies contributing to the development of ED. This approach may constitute an improvement in disease prognosis and either induce a spontaneous reduction of ED or facilitate its specific therapy. [source] Controversies in perioperative management and antimicrobial prophylaxis in urologic surgeryINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2008Shingo Yamamoto Abstract: The Japanese Urological Association (JUA) recently published guidelines for the prevention of perioperative urologic infections. Although the general remarks in the JUA guidelines are almost similar to those in guidelines previously published by the Centers for Disease Control and Prevention (CDC) and in the European Association of Urology (EAU) guidelines, their differences leave several questions that need to be answered. To clarify agreements and differences in guidelines for perioperative management in urologic interventions for development of more optimal guidelines, reports and reviews previously published were overlooked and discussed. In terms of surgical site infections (SSI) in urologic surgery, consensus for open and endoscopic-instrumental procedures is still somewhat controversial, while a consensus has not yet emerged for its use in laparoscopic procedures. Further research is required to determine what is an optimal prophylactic protocol to effectively prevent both SSI and remote infections (RI). [source] Adrenocortical carcinoma: Retrospective study of 14 patients experienced at a single institution over 34 yearsINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2007Sachiyo Nishida Objective: To review clinical outcome of patients with adrenocortical carcinoma experienced at a single institute over 34 years. Methods: The study included 14 patients who were diagnosed as having the disease and were treated at the Department of Urology, Sapporo Medical University Hospital between 1973 and 2006. Their clinical features and outcomes were reviewed. Results: Of the 14 patients, there were nine men and five women. The median follow-up period was 13.0 months (range, 1,213). Two patients were classified as having stage II disease, seven as stage III and five as stage IV. The disease was completely removed in eight patients and incompletely in three. Two other patients received exploratory laparotomy only. The remaining one patient had no indication for surgery. The median survival periods were 2 months in patients with stage IV and 108 months in those with stages II and III (P = 0.136). Mitotane treatment in the adjuvant setting did not clearly affect the clinical courses of patients without metastasis. However, the treatment was effective for metastasis that was repeatedly developed as late recurrence in one patient. Three patients with metastasis at diagnosis received combination chemotherapy with etoposide, doxorubicin and cisplatin (EDP) with or without mitotane treatment, to which lung metastasis completely responded in one patient. Conclusions: Adrenocortical carcinoma is a rare disease but frequently recurs. The best chance of survival may be achieved by early detection and complete surgical removal. There may be patients who possibly benefit from mitotane treatment with or without EDP, although this remains to be conclusively determined. [source] Author Index: International Journal of Urology 2005INTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2005Article first published online: 20 DEC 200 First page of article [source] Subject Index: International Journal of Urology 2005INTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2005Article first published online: 20 DEC 200 First page of article [source] Primary ureteroscopic treatment for obstructive ureteral stone-causing fornix ruptureINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2004PANAGIOTIS KALAFATIS Abstract, Background:, Management of fornix rupture (FR) by obstructive stone is comprised of extravasation control and the elimination of the obstruction. For all patients, management initially remains conservative under close follow up. Endoscopic management of FR involved with an obstructive stone of the ureter or the pelvi-ureteric junction (UPJ) consists mainly of stenting the ureter. Our endoscopic approach to this pathological entity comprises of the sole stenting of the ureter, as well as primary ureteroscopic lithotripsy followed by ureter stenting. Patients and methods:, In the Department of Urology at the General Hospital of Rhodos Island, Rhodos, Greece, over the last 15 years, 51 of 86 patients with FR due to an obstructive stone, were treated endoscopically. Twenty-two patients underwent sole stenting of the ureter (option A) and 29 patients underwent primary ureteroscopic lithotripsy and stenting (option B). Results:, The overall primary ,successful outcome' was achieved in nine of the 22 patients (40.9%) in the group treated with sole stenting, while the remaining 59.1% required secondary interventions. However, 27 of the 29 patients (93.1%) treated with primary ureteroscopic lithotripsy and stenting required no auxiliary treatment. The primary successful outcome results for obstructive middle and lower ureteral stones with FR were eight out of 12 (66.6%) and 26 out of 27 (96.3%) for therapeutic options A and B, respectively. Upper obstructive ureteral stones with FR required secondary intervention in most cases, regardless of the therapeutic option chosen. (In nine out of 10 and one out of two cases for options A and B, respectively). The mean duration of hospitalization for options A and B were 7.6 and 5.3 days, respectively. The mean duration that the ureter stent remained in situ for A and B treatment options was 30.9 and 10.2 days, respectively. Conclusions:, Sole stenting of the ureter is reserved for infected FR or for stones of the upper ureter or the UPJ. Ureteroscopic lithotripsy followed by double-J stenting of the ureter may offer a quick and safe therapeutic alternative for distal and middle obstructive ureteral stones with FR. [source] Bacteria of preoperative urinary tract infections contaminate the surgical fields and develop surgical site infections in urological operationsINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2004RYOICHI HAMASUNA Abstract Background: The risk factors for surgical site infection (SSI) following urological operations have not been clearly identified, although the presence of a preoperative urinary tract infection (UTI) is thought to be one risk factor. We studied potential risk factors to clarify when and how bacteria contaminate wounds and SSI develop. Methods: Objects of the present study were patients with SSI after open urological operations that were performed at the Department of Urology, Miyazaki Medical College Hospital, University of Miyazaki, Kiyotake, Miyazaki, Japan, during the period between June 1999 and December 2000. Endourological operations, operations on children and short operations of less than 2 h duration were excluded. Patients were screened for the presence of UTI before the operation and subcutaneous swabs for culture were collected at the end of the operation by brushing with a sterile cotton-swab just before skin closure. Results: Surgical site infections occurred in 20 of 134 patients. Bacteria from the subcutaneous swabs were detected in 15 (75.0%) of the patients with SSI. All patients received antimicrobial prophylaxis (AMP), but bacteria from the subcutaneous swabs of patients with SSI were less susceptible to the agents (20.0%). Preoperative UTI were observed in 11 (55.0%) of the patients with SSI. In these patients, four had the same species of bacteria detected from urine, swab and wound, three had the same species from swab and wound and one had the same species from urine and wound. Conclusions: Preoperative UTI was the most important risk factor for SSI following urological operations. It is most likely that the bacteria in the urine contaminated the surgical fields and the AMP resistant strains produced SSI. [source] Usefulness of PSA screening in outpatients with bladder cancer: Preliminary resultsINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2002Kohei Kurokawa Abstract Background: We performed prostate-specific antigen (PSA) screening and evaluated its usefulness in outpatients with bladder cancer who may have an elevated risk for prostate cancer. Methods: Sixty-one new or followed-up outpatients with bladder cancer were examined between September 1999 and December 2000 in the Department of Urology, Gunma University Hospital, Japan. PSA was measured after informed consent was obtained, and patients in whom the PSA level was 4.1 ng/mL or higher were selected for thorough examination. In the examination, one examiner performed DRE (digital rectal examination) and, based on DRE and TRUS (transrectal ultrasonography) findings, determined whether prostate biopsy was indicated. Results: The average age of the 61 cases was 69.1 ± 8.6 years, and the average PSA level was 3.5 ± 5.8 ng/mL. The PSA level was 4.1 ng/mL or higher in 11 (18.0%) patients, nine of whom underwent six-sextant biopsy under TRUS guidance. Of these nine cases, four (6.6%) were diagnosed as having prostate cancer. The Gleason score was 7 in three cases and 9 in one case. The clinical stage was T2N0M0 in three cases and T3N0M0 in one case. Conclusions: On PSA screening in patients with bladder cancer and patients with a history of transurethral resection of the bladder tumor (TUR-BT), prostate cancer was found in 6.6%. This rate is higher than in the general population. These cancers were classified into intermediate to high-risk groups, and the prognosis of prostate cancers could be more important than those of the bladder cancers in two cases (50%). We conclude that PSA screening for inpatients with bladder cancer may be useful. [source] Assessment of referral patterns for CT KUB in a tertiary settingJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 6 2009H Jo Summary The purpose of this study was to assess the referral patterns and the use of unenhanced renal tract CT (CT KUB) for investigating patients presenting with clinically suspected renal colic. We retrospectively reviewed 500 consecutive CT KUB studies requested for suspected renal colic carried out at a single institution between December 2006 and July 2007. Follow-up radiology reports and discharge summaries on the hospital clinical Intranet were also reviewed. Studies were analysed for characteristics including patient demographics, referring clinical team, time of referral, final diagnosis and requirement for further imaging. The majority of requests were from Emergency (ED) or Urology Departments (49%, 245 out of 500, and 37%, 186 out of 500, respectively). The positive rate for urolithiasis was 67% (337 out of 500), the negative rate was 25% (123 out of 500), and 8% (40 out of 500) of patients had alternative significant findings. Female patients were more likely to have a negative study than male patients (35 versus 20%, P < 0.0001) and more likely to have alternative significant pathology (12 versus 6%, P < 0.0001). Patients referred by specialities other than Urology and ED were more likely to be female and have a negative or alternative finding (P < 0.0001). CT KUB is a widely used first method of investigation for patients with suspected renal colic with a high positive predictive value allowing rapid diagnosis and intervention. However, given the high rate of negative or alternative findings on CT KUB in young women, especially those referred by specialities other than ED or Urology, ultrasound should be considered as an alternative imaging method to minimise unnecessary radiation exposure. [source] The standardization of terminology of lower urinary tract function in children and adolescents: Report from the standardization committee of the International Children's Continence Society (ICCS),NEUROUROLOGY AND URODYNAMICS, Issue 1 2007Tryggve Nevéus Abstract Purpose We updated the terminology in the field of pediatric lower urinary tract function. Materials and Methods Discussions were held in the board of the International Children's Continence Society and an extensive reviewing process was done involving all members of the International Children's Continence Society, the urology section of the American Academy of Pediatrics, the European Society of Pediatric Urology, as well as other experts in the field. Results and Conclusions New definitions and a standardized terminology are provided, taking into account changes in the adult sphere and new research results. Neurourol. Urodynam. 26:90,102, 2007. © 2006 Wiley-Liss, Inc. [source] Joint Annual Meeting of the Society for Urodynamics and Female Urology and the International Society of Pelvic Neuromodulation February 24,27, 2005: ProgramNEUROUROLOGY AND URODYNAMICS, Issue 2 2005Article first published online: 2 FEB 200 [source] Robotics in urology: an updateTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 2 2005T G Nedas Abstract Urology has been quick to realise the advantages of surgical robots. We describe the main devices currently in use, the advantages and disadvantages of robotic-assisted surgery and the current and potential urological applications focussing on robot-assisted radical prostatectomy. Copyright © 2005 Robotic Publications Ltd. [source] Premature Ejaculation: On Defining and Quantifying a Common Male Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 2006Gregory A. Broderick MD ABSTRACT Introduction., Premature ejaculation (PE) and its individual and relationship consequences have been recognized in the literature for centuries. PE is one of the most common male sexual dysfunctions, affecting nearly one in three men worldwide between the ages of 18 and 59 years. Until recently, PE was believed to be a learned behavior predominantly managed with psychosexual therapy; however, the past few decades have seen significant advances in understanding its etiology, diagnosis, and management. There is, as yet, no one universally agreed upon definition of PE. Aim., To review five currently published definitions of PE. Methods., The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24,26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives. Main Outcome Measure., Data were utilized from the World Health Organization, the American Psychiatric Association, the European Association of Urology, the Second International Consultation on Sexual Dysfunctions, and the American Urological Association. Results., The current published definitions of PE have many similarities; however, none of these provide a specific "time to ejaculation," in part because of the absence of normative data on this subject. While investigators agree that men with PE have a shortened intravaginal ejaculatory latency time (IELT; i.e., time from vaginal penetration to ejaculation), there is now a greater appreciation of PE as a multidimensional dysfunction encompassing several components, including time and subjective parameters such as "control,""satisfaction," and "distress." Conclusion., There is a recent paradigm shift away from PE as a unidimensional disorder of IELT toward a multidimensional description of PE as a biologic dysfunction with psychosocial components. Broderick GA. Premature ejaculation: On defining and quantifying a common male sexual dysfunction. J Sex Med 2006;3(suppl 4):295,302. [source] HISTORY: Adrian Walton Zorgniotti (1925,1994): Renaissance UrologistTHE JOURNAL OF SEXUAL MEDICINE, Issue 2 2005Eli F. Lizza MD Abstract Adrian Zorgniotti was born on March 3, 1925 and died on July 6, 1994. During his 47 years as a physician, he brought innovation and imagination to the field of Urology, especially in the field of erectile dysfunction (ED). Biographical information was obtained from Dr. Zorgniotti's curriculum vitae, his published articles, and his eulogies. Several of his colleagues and peers were also interviewed by telephone. In addition, personal experiences of this author, from the 9 years we spent as associates, and of several other friends were recounted. Dr. Zorgniotti's involvement with the history of Urology began in 1970 when he published his first historical treatise on Rome's first doctor, Arcagathus. He continued his involvement when he served as moderator for the History Forum of the American Urological Association (AUA) from 1975 to 1988 and as Historian for the AUA from 1979 to 1988. This innovator brought vision to the field of ED when he introduced the combination of papaverine and phentolamine as an intracavernous injection for the treatment of ED. He also organized the first International Conference on Corpus Cavernolum Revascularization in 1978 at New York University and published long-term results with this therapy. Adrian Zorgniotti will probably be best remembered by the multitude of Urologists whose lives he has touched for his generosity of spirit and for his ability to help shape our careers with a kind gesture, suggestion, or phone call. I am proud to call him a mentor, a colleague, and a friend. [source] The alchemy of jargon: Etymologies of urologic neologisms.THE PROSTATE, Issue 3 2009Number 2: Basic biochemical nomenclature Abstract Background As the scientific community is increasingly severed from the study of linguistics, once an imperative for all scholars, the underlying significance of their common technical words is becoming blurred. This series of notes will focus on the etymologies of a series of technical scientific terms pertinent to the biomedical sciences in general and to Urology in particular. Methods These notes will give a detailed background of the history of each technical term, including how it came into being, whence it was derived, and how it impacted the scientific community through the ages. Results In this installment, the following terms will by analyzed: Biology, Biochemistry, Hormone, Protein, Lipid, Carbohydrate, Enzyme, Metabolism, and finally Chemistry. Conclusions This analysis of the history and significance of scientific terms common to the urological community works toward a fortification of their power by offering a reminder of their origins. Prostate 69:231,233, 2009. © 2008 Wiley-Liss, Inc. [source] AL01 SURGICAL AUDIT IN DIFFICULT SITUATIONSANZ JOURNAL OF SURGERY, Issue 2009A. J. Green Approved peer reviewed surgical audit activity is a necessary for annual and Triannual Professional Standards requirements. Surgeons working in large hospitals, usually as part of surgical teams have resources to facilitate this. There are situations where the surgeon or surgeons need to organise a process themselves and may need more assistance. Three problem areas that will be particularly discussed include: 1Audit for remote surgeons 2Audit for urban/suburban surgeons with no teaching hospital attachments (often in smaller private facilities with no audit programs) 3Regional surgeons particularly in the Specialities eg ENT, Urology, Plastics where there are small numbers (1,3) Practical ways to achieve successful audits will be addressed [source] Paediatric Surgery and Urology , Long Term OutcomesANZ JOURNAL OF SURGERY, Issue 9 2008FRACS, T. Muthurangam Ramanujam MB BS No abstract is available for this article. [source] Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic reviewBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2009B Feiner Background, Vaginal mesh kits are being used to surgically treat apical vaginal prolapse; however, their safety and efficacy are currently unknown. Objectives, To summarise success and complication rates for commonly used vaginal mesh kits in the treatment of apical prolapse. Search strategy, MEDLINE and other scientific databases were queried for primary research addressing the use of vaginal mesh kits for apical prolapse published between 1950 and 2007, including abstracts presented in major scientific meetings. Selection criteria, Studies describing the use of mesh to support either the anterior or posterior compartment alone, for incontinence or fistula repair or not addressing the vaginal apex were excluded. Data collection and analysis, Identified studies were grouped by the mesh kit and complications categorised using the Dindo classification system. Weighted averages and confidence intervals were calculated on objective success, follow-up length and complications. Main results, Thirty studies totalling 2653 women met inclusion criteria. Objective success rates (95% CI) were ApogeeÔ (American Medical Systems Inc., Minnetonka, MN, USA) 95% (95,96), ProliftÔ (Ethicon Women's Health and Urology, Somerville, NJ, USA) 87% (86,87) and posterior intravaginal slingplasty 88% (87,89). Reoperations not requiring anaesthesia (Dindo IIIa) occurred in 0.4,2.3% and requiring anaesthesia (Dindo IIIb) in 1.5,6.0%, with a follow up between 26 and 78 weeks. Mesh erosion was the most commonly reported complication occurring in 4.6,10.7%. Author's conclusions, Overall objective success using transvaginal mesh kits in restoring apical vaginal prolapse is high. However, an increasing number of women require surgical intervention for mesh-related complications based on limited data quality and short follow up. Further research addressing functional outcomes and the impact of these procedures on women's symptoms and quality of life is mandatory. [source] A Gender Transformation in UrologyBJU INTERNATIONAL, Issue 12 2010Women find the specialty family-friendly, full of opportunities First page of article [source] Social Media and UrologyBJU INTERNATIONAL, Issue 4 2009JOHN M. FITZPATRICK Editor-in-Chief No abstract is available for this article. [source] FingerTip Urology: illustrations for patient dialogue at the click of your cursorBJU INTERNATIONAL, Issue 7 2008RA (FRANK) GARDINER Website Editor No abstract is available for this article. [source] Textbook of Female Urology and Urogynecology, Second EditionBJU INTERNATIONAL, Issue 2 2007Marcus Drake No abstract is available for this article. [source] The BJU International recently launched a new section on Laparoscopic and Robotic Urology and welcomes the entire urological community to submit manuscriptsBJU INTERNATIONAL, Issue 6 2006Ash Tewari MD No abstract is available for this article. [source] A multi-institutional studyof orthotopic neobladders: functional results in men and womenBJU INTERNATIONAL, Issue 6 2004R. Carrion Multi-institutional studies are extremely valuable whena new surgical technique is being introduced. The Confederationof American Urology conducted such a study into the functional results inmales and females of the orthotopic bladder. In a series of 138patients they found many interesting outcomes, which they presenthere. Authors from Sheffield describe their experience in developing tissue-engineeredbuccal mucosa for use in urethral reconstruction. They describetheir technique and report the successful culture of full-thicknessbuccal mucosa, which they found to be robust and safe for clinicaluse. OBJECTIVES To analyse the incidence of diurnal incontinence (DI) and nocturnalincontinence (NI), the need for intermittent catheterization (IC),and the rate of ureteric obstruction (UO) among a group of men andwomen with ileal and colonic orthotopic neobladders in four countries. PATIENTS AND METHODS In all, 138 patients (113 men and 25 women) had an orthotopicneobladder constructed after radical cystectomy for carcinoma. The mean(range) age was 61.3 (28,76) years and thefollow-up 41 (6,144) months. All patients underwentsurgery by experienced surgeons associated with the Confederationof American Urology. A retrospective evaluation was designed toreview the functional results and the incidence of UO. The techniqueof orthotopic neobladder construction was at each surgeon's discretion. Various detubularized bowelsegments were used, including ileum, colon or sigmoid. Patients werefollowed by chart reviews and personal interviews at 1, 3 and 6 monthsafter surgery and then every 6 months, and were evaluated bya physical examination, urine analysis, cytology and renal ultrasonography. RESULTS An ileal or colonic neobladder was constructed in 74 and 64 patients, respectively. Five (7%), 23 (31%), 10 (14%) and 14(9.6%) with an ileal neobladder developed DI, NI, IC andUO, respectively; the respective values for patients with a colonicneobladder were eight (12%), 19 (30%), seven (11%)and 15 (12%). Statistical analysis by Fisher'sexact test showed no significant differences between the ileal andcolonic neobladder groups or with gender. CONCLUSIONS Using this specific protocol for evaluating many men and womenwith ileal and colonic orthotopic neobladders showed no significant differencesin the incidence of DI, NI, IC or UO. Neobladders constructed fromdetubularized bowel, irrespective of bowel segment(s) used, canprovide satisfactory diurnal results. A moderate incidence of NIand UO continue to be a problem. [source] The urethral Kock pouch: long-term functional and oncological results in menBJU INTERNATIONAL, Issue 4 2003A.A. Shaaban The Department of Urology in Mansoura has a well-known experience in, among many things, urinary tract reconstruction in patients with bladder cancer. They review their results in 338 male patients who had a radical cystectomy and Kock pouch. They found good functional and oncological outcomes in properly selected patients. However, they also drew attention to several valve-related complications. OBJECTIVE To evaluate our experience with men who underwent radical cystectomy and urethral Kock pouch construction between January 1986 and January 1996. PATIENTS AND METHODS Complications were classified as early (within the first 3 months after surgery) or late. Continence was assessed by interviewing the patient; they were considered continent if they were completely dry with no need of protection by pads, condom catheter or medication. The patients were followed oncologically and Kaplan-Meier survival curves constructed. Urodynamic studies were used to define the possible causes of enuresis. RESULTS Three patients died after surgery from pulmonary embolism. There were 67 early complications in 63 patients. The mean (sd) follow-up was 87.8 (49.1) months. There were 111 treatment failures from cancer; of these, four men only had an isolated local recurrence in the urethra. Late complications included 72 pouch stones in 55 patients, and 36 deteriorated renal units caused by reflux (17), uretero-ileal stricture (11), nipple valve eversion (four) or stenosis (four). Interestingly, 65 renal units that were dilated before surgery improved significantly afterward. Ileo-urethral strictures occurred in seven men and anterior urethral strictures in six. Nine patients were totally incontinent and two had chronic urinary retention. Daytime continence was complete in 94% of men, with nocturnal enuresis in 55; the latter had significantly more residual urine, and a higher amplitude and duration of phasic contractions. CONCLUSIONS Orthotopic bladder substitution after cystectomy for cancer is feasible, with good functional and oncological outcomes in properly selected patients. Nevertheless, the use of a hemi-Kock pouch is associated with many valve-related complications. [source] Urology and the Internet: an evaluation of Internet use by urology patients and of information available on urological topicsBJU INTERNATIONAL, Issue 3 2000G.O. Hellawell Objective To determine the use of the Internet by urological patients for obtaining information about their disease, and to conduct an evaluation of urological websites to determine the quality of information available. Patients and methods Questionnaires about Internet use were completed by 180 patients attending a general urological outpatient clinic and by 143 patients attending a prostate cancer outpatient clinic. The Internet evaluation was conducted by reviewing 50 websites listed by the HotbotÔ search engine for two urological topics, prostate cancer and testicular cancer, and recording details such as authorship, information content, references and information scores. Results Of the patients actively seeking further information about their health, 19% of the general urological outpatient group and 24% of the prostate cancer group used the Internet to obtain this information. Most websites were either academic or biomedical (62%), provided conventional information (95%), and were not referenced (71%). The information score (range 10,100) was 44.3 for testicular cancer and 50.7 for prostate cancer; the difference in scores was not significant. Conclusion The use of the Internet by patients is increasing, with > 20% of urology patients using the Internet to obtain further information about their health. Most Internet websites for urological topics provide conventional and good quality information. Urologists should be aware of the need to familiarize themselves with urological websites. Patients can then be directed to high-quality sites to allow them to educate themselves and to help them avoid misleading or unconventional websites. [source] Urology: A Handbook for Medical Students S. Brewster, D. Cranston, J. Noble and J. Reynard 245 × 190 mm.BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2002No abstract is available for this article. [source] | |||||||||||||||||||||||||||||||