scholarly journals Stenting of the upper urinary tract: from bottom, from top, from side...

2020 ◽  
Vol 7 (4) ◽  
pp. 105-117
Author(s):  
A. B. Novikov ◽  
V. P. Sergeev ◽  
D. V. Ergakov ◽  
E. A. Galliamov ◽  
A. G. Martov

Internal stenting of the upper urinary tract is a widespread urological surgery. Its frequency in modern practice is high and continues to grow due to the widespread use of endourological, percutaneous, and laparoscopic interventions. The presence of a stent in the patient's body often leads to a decrease in the quality of life due to the occurrence of stent-dependent symptoms, which often requires urgent hospitalization. According to various data, they are registered in at least 80% of patients. The most common stent-dependent symptoms are frequent and / or painful urination, urge to mix (up to imperative), nocturia, pain in the lumbar region, macrohematuria. According to existing data, a fair share of responsibility for the development of these symptoms lies with the distal (vesicular) curl of the internal stent, especially if the technology of its installation is not followed or the length of the drainage is incorrectly selected. The review describes methods for correct installation of internal ureteral stents by transurethral retrograde, antegrade, and laparoscopic approaches, as well as a method for installing and removing mono-pigtail drains. The internal drainage procedure is standard, so the focus is on the nuances and details of this widespread manipulation. The given cohort of patients and the range of surgical interventions indicate a significant experience of the authors in this issue. All illustrations are author's own and taken from the daily workflow. It should be noted that the modern understanding of the process and technological equipment ensure correct stenting when performing any interventions with any access. An adequate choice of installation method and correct positioning of the stent, knowledge of simple details and "secrets" allow not only to restore urodynamics, but also to effectively prevent the development of stent-dependent symptoms, thereby preserving patients quality of life.

2020 ◽  
Vol 24 (3) ◽  
pp. 200-210 ◽  
Author(s):  
Seong Jin Jeong ◽  
Seung-June Oh

Augmentation enterocystoplasty (AEC) is a surgical procedure in which the bladder is enlarged using an intestinal segment in patients with lower urinary tract dysfunction who fail to achieve satisfactory results with all conservative treatments. Currently, surgical materials and procedures, concomitant correction of upper urinary tract abnormalities, or bladder neck reconstruction may vary depending on the experience and preferences of the surgeons. AEC has been proven to be successful with respect to surgical goals, such as achieving urinary continence, improving quality of life, and preserving the upper urinary tract over the long term. The advantage of AEC over intravesical injection of botulinum toxin—a more recent and less invasive procedure—is that the prevention of upper urinary tract damage and the improvement of urinary incontinence are more reliably guaranteed, especially considering that these surgical effects are permanent. Compared to less invasive treatments, the quality of life of patients after surgery is also much higher, and AEC may be more cost-effective in the long run. Thus, in patients with neurogenic bladder, AEC is still the gold standard surgical procedure with strong evidence in support of its efficacy. In this article, the indications, surgical methods, possible complications, long-term follow-up, and current positioning of AEC in lower urinary tract dysfunction is discussed.


2006 ◽  
Vol 175 (4S) ◽  
pp. 410-411
Author(s):  
Germar M. Pinggera ◽  
Michael Mitterberger ◽  
Leo Pallwein ◽  
Peter Rehder ◽  
Ferdinand Frauscher ◽  
...  

2020 ◽  
pp. 3-25
Author(s):  
D. Lukanin ◽  
G. Rodoman ◽  
M. Klimenko ◽  
A. Sokolov ◽  
A. Sokolov

The article presents the results of a prospective controlled parallel clinical study of a new modification of laparoscopic antireflux surgery in the treatment of gastroesophageal reflux disease in combination with a hiatal hernia compared with laparoscopic Nissen fundoplication in terms of assessing quality of life after surgery. Clinical and instrumental examination of patients was carried out a year after surgical interventions. In accordance with the results of instrumental examination after surgery, the proposed modification of laparoscopic partial fundoplication is not inferior to laparoscopic Nissen fundoplication both, in terms of relief of reflux esophagitis symptoms and in relation to the recurrence of hiatal hernia. Clinical monitoring indicates a significantly higher quality of life for patients after the modified antireflux surgery, which is associated with a number of factors. The implementation of this fundoplication led to a decrease in the number of patients with complaints of dysphagia, the development of which is directly related to the surgery performance, as well as to a statistically significant reduction of bloating in the upper abdomen. Another advantage of the modified surgery is a significantly smaller number of cases of gas-bloat syndrome. In addition, the disorders developing in the framework of the gas bloat syndrome after laparoscopic Nissen fundoplication are more severe.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iori Kisu ◽  
Kanako Nakamura ◽  
Tetsuro Shiraishi ◽  
Tomoko Iijima ◽  
Moito Iijima ◽  
...  

Abstract Background Robert’s uterus is a rare Mullerian anomaly, which can be described as an asymmetric, septate uterus with a non-communicating hemicavity. Herein, we present the case of a misdiagnosed Robert’s uterus, resulting in an invasive and disadvantageous surgery. Case presentation A 16-year-old woman was referred to our department because of dysmenorrhea and suspicion of uterine malformation. We misdiagnosed Robert’s uterus as a unicornuate uterus with a non-communicating rudimentary horn and hematometra, and performed laparoscopic hemi-hysterectomy. Although the patient’s symptoms were relieved, our surgical procedure left the lateral uterine wall weak, making the patient’s uterus susceptible to uterine rupture in any future pregnancy. Conclusions Although the early diagnosis of Robert’s uterus is challenging, it is important in order to determine appropriate surgical interventions and management for maintaining the quality of life and ensuring safety in future pregnancies.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Maurizio Nicola D’Alterio ◽  
Stefania Saponara ◽  
Mirian Agus ◽  
Antonio Simone Laganà ◽  
Marco Noventa ◽  
...  

AbstractEndometriosis impairs the quality of life (QoL) of many women, including their social relationships, daily activity, productivity at work, and family planning. The aim of this review was to determine the instruments used to examine QoL in previous clinical studies of endometriosis and to evaluate the effect of medical and surgical interventions for endometriosis on QoL. We conducted a systematic search and review of studies published between January 2010 and December 2020 using MEDLINE. Search terms included “endometriosis” and “quality of life.” We only selected studies that used a standardized questionnaire to evaluate QoL before and after medical or surgical interventions. Only articles in the English language were examined. The initial search identified 720 results. After excluding duplicates and applying inclusion criteria, 37 studies were selected for analysis. We found that the two scales most frequently used to measure QoL were the Short Form-36 health survey questionnaire (SF-36) and the Endometriosis Health Profile-30 (EHP-30). Many medical and surgical treatments demonstrated comparable benefits in pain control and QoL improvement. There is no clear answer as to what is the best treatment for improving QoL because each therapy must be personalized for the patient and depends on the woman’s goals. In conclusion, women must be informed about endometriosis and given easily accessible information to improve treatment adherence and their QoL.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Isaac Samir Wasfy ◽  
Enayat Mohamed Soltan ◽  
Hassan A. Abdelwahab ◽  
Hend Mikhail Salama

Abstract Background This study aims to assess the severity of lower urinary tract symptoms, and to assess predictors of impaired quality of life among Egyptian adults complain of lower urinary tract symptoms. Methods An observational cross-sectional research was done using an online anonymous poll survey. The survey was implemented through sharing on different social media applications. The survey was posted from June 1, 2020, to June 10, 2020. The overall communities of the Egyptian adults who satisfied the incorporation rules and consented to take an interest in the research were incorporated using convenience and snowball collecting methods (188 adults). A semi-structured questionnaire on socio-demographic characteristics and Arabic Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) short forms were used. Results Approximately 220 Egyptian adults shared in the research but only 188 fulfilled inclusion and exclusion criteria. Approximately 92% of them had at least one symptom of lower urinary tract manifestations. Irritative symptoms presented in 65 (85.5%) of males and 102 (91.1%) of females. Stress symptoms presented in 44 (57.9%) of males and 63 (56.2%) of females with higher statistically significant mean of stress symptoms. Obstruction/discomfort symptoms presented in 51 (67.1%) of males, and 77 (68.8%) of females. Seeking help and duration of the urological problem were statistically significant independent positive predictors of UDI-6-total. The Irritative score, obstruction/discomfort score, and duration of the urological problem were statistically significant independent positive predictors of IIQ-7-total. Conclusions Urological problems are common and have an impact on the quality of life in various domains of physical activity, social relationships, travel, and emotional health.


2010 ◽  
Vol 8 (Suppl_7) ◽  
pp. S-38-S-55 ◽  
Author(s):  
Jennifer M. Hinkel ◽  
Edward C. Li ◽  
Stephen L. Sherman

Management of anemia in patients with cancer presents challenges from clinical, operational, and economic perspectives. Clinically, anemia in these patients may result from treatment (chemotherapy, radiation therapy, or surgical interventions) or from the malignancy itself. Anemia not only contributes to cancer-related fatigue and other quality of life issues, but also affects prognosis. From the operational perspective, a patient with cancer who is also anemic may consume more laboratory, pharmacy, and clinical resources than other patients with cancer.


2013 ◽  
Vol 15 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Gael J. Yonnet ◽  
Anette S. Fjeldstad ◽  
Noel G. Carlson ◽  
John W. Rose

Bladder dysfunction in multiple sclerosis (MS) can be socially disabling, have negative psychological and economic consequences, and impair patients' quality of life. Knowledge of the functional anatomy and physiology of the urinary tract is essential to understand the symptoms associated with central nervous system lesions and the pharmacotherapies used to treat them. Treatments for neurogenic detrusor overactivity (NDO) have consisted mainly of administration of anticholinergic drugs, which have been shown to provide suboptimal clinical benefits and be poorly tolerated. The US Food and Drug Administration (FDA) approval of intravesicular botulinum toxin therapy provides a second-line option for MS patients with NDO not responsive to anticholinergic drugs. We performed a review of key literature pertaining to the intravesicular application of botulinum toxin. In the management of NDO, administration of intravesicular botulinum toxin using clean intermittent catheterization decreases the incidence of urinary tract infections, promotes urinary continence, and improves quality of life for 9 months after a single injection; moreover, those benefits are maintained with repeated injections over time.


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