scholarly journals Predictive Factors for Acute Urinary Retention After Transperineal Template-Guided Mapping Biopsy

2021 ◽  
Vol 19 (3) ◽  
pp. 148-154
Author(s):  
Si Hyun Sung ◽  
Chung Un Lee ◽  
Jae Hoon Chung ◽  
Wan Song ◽  
Minyong Kang ◽  
...  

Purpose: We investigated the predictive factors for acute urinary retention (AUR) after transperineal template-guided mapping biopsy (TTMB).Materials and Methods: We retrospectively reviewed the records of 459 patients who had undergone TTMB between May 2017 and July 2020. Overall complications after TTMB were analyzed and categorized according to the Clavien-Dindo classification. Factors that were likely to affect AUR were analyzed using a logistic regression model.Results: Overall complications after TTMB were observed in 95 of the 459 patients (20.7%), of which AUR was the most commonly reported (17.4%, n=80), followed by hematuria (3.1%, n=14). Hematuria in one patient was categorized as Clavien-Dindo grade IIIa. All remaining complications were Clavien-Dindo grade I. In the multivariate regression model, age ≥65 (odds ratio, 2.44; 95% confidence interval [CI], 1.42–4.17; p=0.001), prostate volume ≥30 mL (odds ratio, 3.72; 95% CI, 1.19–11.62; p<0.02), and number of biopsy cores ≥30 (odds ratio, 2.89; 95% CI, 1.29–6.43; p=0.01) were identified as the predictors for AUR after TTMB.Conclusions: AUR is the most common complication after TTMB. Age ≥65 years, prostate volume ≥30 mL, and number of biopsy cores ≥30 were significant predictors of AUR following TTMB.

2000 ◽  
Vol 38 (5) ◽  
pp. 563-568 ◽  
Author(s):  
M.J. Marberger ◽  
J.T. Andersen ◽  
J.C. Nickel ◽  
M.-P. Malice ◽  
M. Gabriel ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Leonardo Oliveira Reis ◽  
Gustavo Borges De Mendonça ◽  
Bruno D. Carneiro ◽  
Edson Schneider ◽  
Eduardo Varella Gewehr ◽  
...  

Patients who failed a catheter-free trial after acute urinary retention and one week of full dose alpha-blocker and 5-alpha-reductase inhibitor were offered Diethylstilbestrol 1 mg plus Aspirin 100 mg over 4 weeks. Prostate volume, age, serum creatinine, and initial retention drained urine volume were recorded. After excluding cardiovascular morbidity (n=7), upper urinary tract dilation (n=3), compromised renal function (n=2), urinary tract infection (n=2), neurological diagnosis (n=2), or preferred immediate channel transurethral resection of prostate (n=5), 48 of 69 consecutive patients ≥70 years were included. Mean age was 76.6 years (70–84), mean prostate volume 90 cm3(42–128), and mean follow-up 204 days; 58% (28/48) were passing urine and 42% (20/48) were catheter dependent after 4 weeks Diethylstilbestrol trial. Mean age and drained urine volume of catheter dependent patients were 82.4 years and 850 mL compared with 74.6 years and 530 mL in catheter-free men, respectively. Age and drained urine volume were independent predictors of catheter-free trial (bothP<0.01). Seventy-five percent (6/8) of patients 80 years and older were catheter dependent. Transient nipple/breast tenderness and gynecomastia were the only adverse effects reported by 21% (10/48) and 4% (2/48), respectively. No patient presented severe complications.


2020 ◽  
Vol 24 (3) ◽  
pp. 333-337
Author(s):  
Wishyar Al-Bazzaz ◽  
Omar Alkhayat ◽  
Ali AlKhayat

Background and objectives: Most benign prostatic hyperplasia patients do not present obvious indicators for surgical intervention, so most of these patients are treated initially with medical therapy. This study aimed to compare the incidence of acute urinary retention after treatment with monotherapy with the incidence after combination therapy and determine the need for surgery in both methods. Methods: This is a retrospective study of the medical records of 248 benign prostatic hyperplasia patients who had attended Rizgary Teaching Hospital from May 2012 to June 2017. These patients were divided into two groups of 138 and 110 patients who have been treated by 0.4 mg tamsulosin capsule once daily and 0.4 mg tamsulosin capsule plus 5mg finasteride tablet once daily, respectively. Benign prostatic hyperplasia outcomes (acute urinary retention, benign prostatic hyperplasia related surgery) were compared between these two groups according to prostate volume and serum prostate specific antigen. Results: The combined treatment had significantly reduced the incidence of acute urinary retention and benign prostatic hyperplasia related surgery than monotherapy (P = 0.006 and 0.044, respectively). Similarly, when prostate volume and prostate specific antigen were above the cutoff value, both acute urinary retention and benign prostatic hyperplasia related surgery were lower in the combination therapy group than the monotherapy group. Conclusion: Combined therapy (0.4 mg tamsulosin plus 5mg finasteride) was significantly superior to 0.4 mg tamsulosin alone in the reduction of the incidence of acute urinary retention and benign prostatic hyperplasia related surgery among benign prostatic hyperplasia patients. Keywords: Benign prostatic hyperplasia; Acute urinary retention; Benign prostatic hyperplasia related surgery; Prostate volume; Prostate specific antigen.


2011 ◽  
Vol 64 (11-12) ◽  
pp. 533-538 ◽  
Author(s):  
Zeljka Aleksic ◽  
Aleksandar Aleksic

Amiodarone treatment is associated with the occurrence of thyroid dysfunction. The aim was to determine the incidence of amiodarone-induced thyroid dysfunctions and the influence of gender, age, treatment duration, goiter, thyroid antibodies, thyroid echogenicity and family history on their appearance. Of 248 consecutive patients, 144 males and 104 females, referred to thyroid status screening, 16% were with clinical dysfunction, 21% with sub-clinical dysfunction and 63% were euthyroid. The presence of goiter and thyroid peroxidase antibodies were the significant individual predictive factors for the occurrence of clinical dysfunction, and in the multivariate regression model, the presence of goiter was a significant predictive factor with the prognostic value of 80%. For sub-clinical dysfunction, the significant individual predictive factors were female gender and the presence of goiter, as well as in the multivariate regression model, with the prognostic value of 74.5% for female gender and 77.5 % for the presence of goiter. It is necessary to check the thyroid status both before and during amiodarone treatment. Administration of other anti-arrhythmic drugs and/or more frequent check-ups of the thyroid status should be taken into consideration in patients at higher risk, i.e. women with positive thyroid peroxidase antibodies and goiter.


2018 ◽  
Vol 5 (4) ◽  
pp. 1275 ◽  
Author(s):  
Ashish Mor ◽  
Surender Mohan Sharma ◽  
Sujoy Mukherjee ◽  
Rishi Jindal

Background: Benign prostatic hyperplasia (BPH) is the non-malignant enlargement of the prostate gland. Prolonged obstructions may eventually lead to acute urinary retention, recurrent urinary tract infection, hematuria, bladder calculi, and renal insufficiency.Methods: Hundred cases of benign enlargement of prostate were studied from November 2015 to 2016. Patients diagnosed as benign enlargement of prostate by clinical digital rectal examination, investigation like USG were included in this study. Patients with urinary retention due to strictures and urolithiasis, carcinoma were excluded.Results: Mean age of presentation was 64.4, and 34% were found to be in severe group of IPSS grading. There was a significant co-relation between the PVRU and prostate volume. There were 16% cases of acute urinary retention, 2% cases presented with bladder stones. Benign enlargement of prostate, IPSS score, Post voidal residual urine has a weak correlation with the increasing age as observed.Conclusions: Benign enlargement of prostate is a disease of elderly with peak incidence in the 5th and 6th decade of life, BPH has co-relation with inguinal hernia, AUR which is 16%. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. In present study there was a statistically significant relation were found between prostate volume and post voidal residual urine. Large amount of residual urine is the indication for surgery because it predisposes to infections and stone formation.


2009 ◽  
Vol 50 (10) ◽  
pp. 976 ◽  
Author(s):  
Young Eun Yoon ◽  
Jae Won Lee ◽  
Sung Yul Park ◽  
Hae Young Park ◽  
Tchun Yong Lee ◽  
...  

2020 ◽  
Vol 7 ◽  
pp. 2333794X2097198
Author(s):  
Kazue Ishitsuka ◽  
Kaori Yamawaki ◽  
Miwako Horikawa ◽  
Hisaya Nakadate ◽  
Akira Nagai ◽  
...  

Midodrine is widely used for orthostatic intolerance (OI); however, little is known about the prognostic factors of OI after midodrine treatment. We retrospectively reviewed electronic medical charts to investigate clinical prognostic factors of OI on 159 OI patients aged 7 to 18 years who were treated with midodrine at a children’s hospital. Logistic regression was conducted to clarify predictors for improving symptoms at the first month of the treatment. Patients with orthostatic uncomfortable feeling or fainting were significantly more likely to improve symptoms at the first month of the treatment (odds ratio [OR], 3.48; 95% confidence interval [95%CI], 1.36-8.89), but patients with underweight were significantly less likely to improve symptoms (OR, 0.19; 95%CI, 0.06-0.56). Our results suggest that predictive factors for OI by midodrine treatments are orthostatic symptoms and underweight in pediatric patients. These findings are useful to develop further studies for OI treatments.


2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986916 ◽  
Author(s):  
Kenneth Kam Leung Yeung ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung

Purpose: The purpose of this article is to investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with stand-alone tricortical iliac crest autograft and to determine predictive factors for poor neurological recovery, non-union, graft collapse and loss of C2–C7 sagittal alignment. Methods: This was a retrospective study involving patients with cervical myelopathy who underwent ACDF surgery with stand-alone tricortical iliac autograft between 2006 and 2016, with a minimum 2-year postoperative follow-up. Outcomes included the change in Japanese Orthopaedic Association (JOA) scores clinically and timing of fusion, graft height and C2–7 angle measured on lateral radiographs. Any complication such as neurological deterioration, non-union, graft collapse or loss of angle was recorded. Delayed union was considered as radiological union identified only beyond postoperative 6 months. Risk factors including age, smoking, drinking, comorbidities and operative levels were analysed through a multivariate regression for their respective influences on the various outcomes. Results: Of the 69 patients studied, none of the patients had non-union, while 33 (47.1%) achieved fusion in 6 months. The most common complications were anterior protrusion of graft (5.8%) and hoarseness (2.9%). The 1-year mean change in JOA score was 3.9 ± 2.7. The C2–7 angle gradually became more kyphotic, despite an initial lordosis correction intraoperatively. The graft height also gradually collapsed during subsequent follow-ups. Multivariate regression model suggested that diabetics (cumulative odds ratio 7.4) and drinkers (cumulative odds ratio 8.6) were associated with delayed union. Conclusion: ACDF using tricortical iliac crest autograft has satisfactory outcomes with low occurrence of complications. Diabetics and drinkers were predictors of delayed union.


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