scholarly journals Percutaneous Treatment Options of Lower Urinary Tract Fistulas and Leakages

2018 ◽  
Vol 190 (08) ◽  
pp. 692-700 ◽  
Author(s):  
Daniel Kuetting ◽  
Claus Pieper
Keyword(s):  
Radiation Therapy ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Lower Urinary Tract ◽  
Treatment Options ◽  
Percutaneous Treatment ◽  
Tissue Adhesive ◽  
Number Of Patients ◽  
Ureteral Occlusion ◽  
Lower Urinary

Background Lower urinary tract fistulas are currently a rather rare, but severe condition associated with considerable morbidity. Treatment is challenging, especially in fistulas caused by pelvic malignancy or radiation therapy. Surgical treatment attempts fail in a considerable number of patients, especially in those with pelvic malignancies/prior radiation therapy or are precluded altogether due to severe comorbidity. For such patients percutaneous approaches can provide alternative treatment. Method This review is based on case studies and case reports dealing with percutaneous treatment options of lower urinary tract fistulas and leakages from the past four decades (1979 – 2017). The included techniques were ureteral fulguration, tissue adhesive-based embolization, non-detachable and detachable balloon occlusion, ureteral coiling, ureteral clipping, silicone or nylon plug as well as modified vascular plug embolization. Results and Conclusion Percutaneous treatment options of lower urinary tract fistulas and leakages allow for either permanent or temporary, instant ureteral occlusion. In general, transrenal ureteral occlusion is a safe and reliable alternative to surgical treatment of ureteral fistulas and leakages. So far, no technique has been proven to be superior to the others. Depending on the underlying disease, the optimal percutaneous technique may vary and should be chosen according to the individual needs of the patients. Key Points  Citation Format

scholarly journals Prostatic basal cell carcinoma treated by chemoradiation with weekly cisplatine: case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
S. Ridai ◽  
C. Moustakbal ◽  
A. Lachgar ◽  
H. Jouhadi ◽  
A. Benider ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Urinary Tract ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Lower Urinary Tract Symptoms ◽  
Basal Cell ◽  
Lower Urinary Tract ◽  
Locally Advanced ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Abstract Background Basal cell carcinoma of the prostate is a relatively rare entity. Their evolution is characterized by the frequency of local and/or distant relapses. Due to their rarity, the treatment is not consensual in the literature. We report here a case of Basal cell carcinoma of the prostate in a 40-year-old patient. Case presentation Our patient initially presented an obstructive lower urinary tract symptoms with a normal initial level of prostate specific antigen (PSA) test (3.5 ng/m). The transurethral resection of the prostate (TURP) was in favor of a prostatic basal cell carcinoma with its specific anatomopathological and immunohistochemical characteristics. The prostatic MRI and thoraco-abdominal CT realized after the TURP revealed a tumoral lesion of the prostatic peripheral zone with extra-capsular extension combined with right seminal vesicle invasion and a suggestion of posterior bladder wall adherence. No evidence of visceral or nodal metastases at this point. Considering the tumor being locally advanced, a concurrent chemoradiotherapy with intensity modulated technique was indicated after a multidisciplinary meeting with a 70 Gy total target dose delivered in 35 fractions and weekly Cisplatin. A year and a half after, he developed a cerebellous metastases revealed by intracranial hypertension with no other visceral lesion and complete local remission with the disappearance of the lower urinary tract symptoms and the pain and the appearance of a prostatic atrophy. The PSA level was still on the upper limit of normal. He underwent metastasectomy, and the anatomopathological study was in favor of a cerebellous metastasis of the known BCC. The patient presented postoperatively paraparesis of lower limbs with balance problems for which he was placed in palliative care with indication of postoperative radiation therapy in case of improvement of his general condition. He did not recover and deceased three months later. Conclusions The prostatic basal cell carcinoma is a rare aggressive entity often non-evoked at the clinical or radiological stages because of its unspecific appearance. The diagnostic of these tumors is based on histological examination and a large immunohistochemistry panel. Given its scarity, very few data is available for locally advanced non-metastatic stages treated by radiation therapy. We assess here a good local response with concurrent chemoradiation therapy.

scholarly journals Lower Urinary Tract Neoplasia

2018 ◽  
Vol 5 (4) ◽  
pp. 96 ◽  
Author(s):  
Maureen Griffin ◽  
William Culp ◽  
Robert Rebhun
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Lower Urinary Tract ◽  
Treatment Options ◽  
Transitional Cell ◽  
Companion Animals ◽  
Disease Process ◽  
Life Threatening ◽  
Comparative Model ◽  
Lower Urinary

Lower urinary tract neoplasia in companion animals is a debilitating and often life-threatening disease. Tumors of the bladder, urethra, and prostate often occur independently, although extension of these tumors into adjacent regions of the lower urinary tract is documented frequently. The most common lower urinary tract tumor in dogs and cats is transitional cell carcinoma (TCC). In both dogs and cats, TCC affecting the urinary bladder is generally considered to be highly aggressive with both local and metastatic disease potential, and this disease poses unique treatment challenges. Whereas much literature exists regarding the TCC disease process, treatment options, and prognosis in dogs, relatively few studies on feline TCC have been published due to the lower incidence of TCC in this species. Prostate tumors, most commonly adenocarcinomas, occur less commonly in dogs and cats but serve an important role as a comparative model for prostate neoplasia in humans. This article serves as a review of the current information regarding canine and feline lower urinary tract neoplasia as well as the relevance of these diseases with respect to their human counterparts.

scholarly journals Impact of surgical treatment of benign prostate hyperplasia on lower urinary tract symptoms and quality of life

2019 ◽  
Vol 76 (1) ◽  
pp. 30-35
Author(s):  
Uros Babic ◽  
Ivan Soldatovic ◽  
Ivan Vukovic ◽  
Svetomir Dragicevic ◽  
Dejan Djordjevic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Operative Treatment ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostate Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background/Aim. Benign prostatic hyperplasia (BPH) is a pathological process, which is one of the most common causes of so-called lower urinary tract symptoms (LUTS). LUTS affect many aspects of daily activities and almost all domains of health-related quality of life (HRQoL). The objective of this study was to evaluate the effects of operative treatment of BPH using standard clinical diagnostic procedures and effects on LUTS using the symptom-score validated to Serbian language as well as implications on HRQoL. Methods. Seventy-four patients underwent surgical treatment for BPH. The study protocol included objective and subjective parameters of the following sets of variables measured before and after the surgery: voiding and incontinence symptoms were measured using the International Continence Society male Short Form (ICS male SF) questionnaire, HRQoL was measured using the SF-36 questionnaire along with standard clinical measurement of residual urine and urine flow. Results. After the surgery, all patients had decrease of voiding scores (13.5 ? 3.3 before and 1.5 ? 1.4 after surgery) and incontinence symptoms (5.7 ? 3.9 before and 0.6 ? 0.8 after surgery) in comparison to period before operative treatment. Significant improvements in all dimensions of HRQoL were noticed, particularly in emotional health. Although mental and physical total scores were significantly better than prior to the surgery, the level of improvement of voiding and incontinence scores were significantly correlated only with the level of improvement of mental score. Conclusion. After BPH surgery, patients are likely to have normal voiding symptoms, barely some involuntary control over urination and overll better HRQoL, particularly in emotional domain.

STUDY OF PREVALENCE OF LOWER URINARY TRACT SYMPTOMS IN PATIENTS UNDERGOING INGUINAL HERNIA REPAIR AT SKMCH, MUZAFFARPUR, BIHAR

2021 ◽  
pp. 51-53
Author(s):  
Sanjay Kumar ◽  
Kumar Vikram ◽  
Manoj Kumar ◽  
Debarshi Jana
Keyword(s):  
Inguinal Hernia ◽  
Urinary Tract ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urinary Symptoms ◽  
Number Of Patients ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background: Lower urinary tract symptoms (LUTS) are frequently associated with inguinal hernias. It is important to recognise and treat bladder outlet obstruction in patients before inguinal hernia repair to prevent recurrence of hernia. Methods: This prospective study was conducted at Department of Surgery, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. Hundred patients who presented with inguinal hernia repair were evaluated for LUTS using AUA scoring for urinary symptoms, uroowmetry (Qmax) and post voidal residual urine using ultrasonography along with urine routine microscopic examination and urine culture and sensitivity. Results: Eleven patients out of 100 who came for hernia repair had clinically signicant LUTS due to benign enlargement of prostate (BEP) and required treatment for BEP but none of these 11 patients had urinary symptoms as primary complaint. Ten patients were found to have urinary tract infection without any urinary symptom. Three patients had urethral stricture out of which 2 had Qmax of <10 ml/second. Conclusions: Signicant number of patients (14 percent) with inguinal hernia had lower urinary tract symptoms. An effort should be made to identify LUTS in patients presenting with inguinal hernia before surgery and treat the cause of LUTS. Ten percent of patients had asymptomatic UTI with AUA score less than 8 but Qmax on uroowmetry was in between 10-15 ml/second.

scholarly journals The impact of lower urinary tract symptomatology on urine volumes in stone formers

2018 ◽  
Vol 13 (8) ◽  
Author(s):  
Nathan Y. Hoy ◽  
Nick S. Dean ◽  
Jeremy Wu ◽  
Timothy A. Wollin ◽  
Shubha K. De
Keyword(s):  
Urinary Tract ◽  
Urine Output ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Urine Collection ◽  
Inclusion Criteria ◽  
Stone Formers ◽  
Number Of Patients ◽  
The Impact ◽  
Lower Urinary

Introduction: We aimed to determine if there is a correlation between International Prostate Symptom scores (IPSS) and 24-hour urine collection volumes, as patients experiencing lower urinary tract symptoms (LUTS) may have impaired ability to increase fluid intake for stone prevention.Methods: We conducted a single-centre, retrospective review was performed of stone-formers presenting from 2014‒2016. Inclusion criteria were completion of an IPSS questionnaire and a 24-hour urine collection. Exclusion criteria included symptomatic stone or urinary tract infection at time of IPSS completion, inadequate 24-hour collection, or incomplete IPSS questionnaire.Results: A total of 131 patients met inclusion criteria. Stratification by IPSS severity into mild (0‒7), moderate (8‒19), and severe (20‒35) yielded groups of n=96, 28, and 7, respectively. Linear regression modelling did not reveal a correlation between IPSS score and volume (p=0.10). When compared to those with adequate urine volumes (>2 L/day, n=65), low-volume patients (<1 L/day, n=10) had a significantly higher total IPSS (11.7 vs. 6.1; p=0.036). These groups showed significant differences in their responses to questions about incomplete emptying (p=0.031), intermittency (p=0.011), and stranguria (p=0.0020), with higher scores noted in the low urine output group.Conclusions: This study is the first to examine the correlation between IPSS and 24-hour urine volume. Though our data does not show a linear relationship between urine output and IPSS, those with lower urine volumes appear to have worse self-reported voiding symptoms when compared to those with adequate volumes (>2 L/day) for stone prevention. The overall number of patients in our study is relatively small, which may account for the lack of a relationship between IPSS and 24-hour urine volumes.

The combined symptoms of male lower urinary tract: current treatment options

Urologiia ◽  
2018 ◽  
Vol 4_2018 ◽  
pp. 135-141
Author(s):  
Z.K. Gadzhieva Gadzhieva ◽  
M.A. Gazimiev Gazimiev ◽  
Yu.B. Kazilov Kazilov ◽  
V.A. Grigoryan Grigoryan ◽  
◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Treatment Options ◽  
Current Treatment ◽  
Lower Urinary

scholarly journals Adherence and Persistence Patterns in Medication Use Among Men With Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia

2016 ◽  
Vol 11 (1) ◽  
pp. 164-169 ◽  
Author(s):  
Emily Shortridge ◽  
Craig Donatucci ◽  
Prina Donga ◽  
Michael Marcus ◽  
Rolin L. Wade
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Symptom Relief ◽  
Prostatic Hyperplasia ◽  
Number Of Patients ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Medication adherence and persistence patterns among patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) were analyzed. Electronic medical records of patients from the Reliant Medical Group were examined to evaluate adherence and persistence patterns. A total of 1,807 patients with LUTS/BPH were included in the study, and the number of patients at least 50 years of age was 1,748/1,807 (97%). Overall, 15.77% of patients were prescribed index prescription once, and no patients on combination alpha-blocker and 5-alpha reductase inhibitor therapies were prescribed their index prescriptions once. For all patients with LUTS/BPH, the mean number of prescriptions filled was 6.26, and the percentage of men persisting on index therapy for ≥4 years was 48%. Patients with LUTS/BPH showed a high proportion of both adherent and persistent treatment patterns, especially among patients taking combination therapy. The long follow-up time in our study provides evidence that patients are experiencing sufficient symptom relief to tolerate the challenges of remaining adherent and persistent.

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