The Effect of Shock Wave Lithotripsy on Male and Female Sexual Dysfunction in Patients with Proximal Ureteral Stones

<b><i>Introduction:</i></b> This study aims to investigate the effects of shock wave lithotripsy (SWL) treatment for proximal ureteral stones on the sexual functions of patients of both genders. <b><i>Methods:</i></b> In this prospective study, 30 female and 72 male patients who had received SWL treatment for proximal ureteral stones in our clinic between August 2019 and October 2020 were evaluated. CT, creatinine, urinary analysis, and culture were performed during the initial consultation for all patients. Information regarding the age, BMI, and stone burden of the patients was recorded. Male patients answered the International Index of Erectile Function-5 (IIEF-5) questionnaire, and female participants answered the Female Sexual Function Index (FSFI) 3 times: pre-procedural and post-procedural first and third month. CT was repeated on the first month, and any residues were noted. <b><i>Results:</i></b> The mean IIEF-5 scores of the male patients were 23.11 ± 8.11 prior to surgery, and it decreased to 19.74 ± 7.65 in the first month and 23.88 ± 9.23 in the third, <i>p</i> = 0.001. The mean FSFI scores of female patients were 18.2 ± 9.9, which decreased to 12.8 ± 6.12 in the first month and 17.8 ± 8.66 in the third, <i>p</i> = 0.001. Univariate analysis revealed that the patients’ age (male: <i>p</i> = 0.004 and female: <i>p</i> = 0.008) and BMI (male: <i>p</i> = 0.044 and female: <i>p</i> = 0.027) were related to the poorer scores for both genders. However, there were not any significant findings regarding stone burden (male: <i>p</i> = 0.054 and female: <i>p</i> = 0.078). <b><i>Conclusions:</i></b> The possibility of developing temporary sexual dysfunction should be taken into account for patients who are candidates for SWL treatment. As the patient’s age and BMI increase, SWL-related sexual dysfunction becomes more severe.

Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019

Background Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported. Methods Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated. Results Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12–23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54–140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr &gt;200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively. Conclusion Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.

Characterisation of Acute Kidney Injury in Critically Ill Patients with Severe Coronavirus Disease-2019 (COVID-19)

BackgroundCOVID-19-associated acute kidney injury frequency, severity and characterisation in critically ill patients has not been reported.MethodsSingle-center cohort performed from March 3, 2020, to April 14, 2020 in 4 intensive care units in Bordeaux University Hospital, France. All patients with COVID19 and pulmonary severity criteria were included. AKI was defined using KDIGO criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterisation (transient vs. persistent acute kidney injury; proteinuria, hematuria and glycosuria), and short-term outcomes was evaluated.Results71 patients were included, with basal serum creatinine of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median follow-up was 17 [12–23] days. AKI developed in a total of 57/71 (80%) patients with 35% Stage 1, 35% Stage 2, and 30% Stage 3 acute kidney injury; 10/57 (18%) required renal replacement therapy. Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median urine protein/creatinine of 82 [54–140] (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20 indicating predominant tubulo-interstitial injury. Only 2 (4%) patients had glycosuria. At Day 7 onset of after AKI, six (11%) patients remained dependent on renal replacement therapy, nine (16%) had SCr > 200 µmol/L, and four (7%) died. Day 7 and day 14 renal recovery occurred in 28% and 52 % respectively.ConclusionCOVID-19-associated AKI is frequent, persistent severe and characterised by an almost exclusive tubulo-interstitial injury without glycosuria.

Case-control study about exposure to BPA and DEHP and risk of endometriosis

Background BPA and DEHP are endocrine disruptors. BPA-G and MEHP are their main metabolites. The main exposure route for human is the diet. Endometriosis is a pathology with uncertain etiopathogenesis, characterized by disturbances in sex hormones balance with a prevalence in women ranged from 1% to 7% in women aged 15-45 years. Methods A case-control study should highlight a possible relationship between exposure to DEHP and BPA and endometriosis. Patients (n = 40) with a surgical diagnosis of endometriosis will compose the group of cases; healthy women (n = 40) will compose the control group. Cases and controls will be studied by means of questionnaires and by means of urinary analysis of these endocrine disruptors concentration. Results BPA values ranged between 0.05-8.55 and 0.05-1.84 in cases and in controls, respectively; BPA-G values ranged between 0.05-16.1 and 0.05-7.38 in cases and in controls, respectively; total BPA values ranged between 0.05-3.26 and 0.05-3.51 in cases and in controls, respectively. DEHP values ranged between 13.63-57.78 and 16.66-61.93 in cases and in controls, respectively; MEHP values ranged between 1.74-6.16 and 4.26-14.16 in cases and in controls, respectively; total DEHP ranged between 15.27-63.93 and 21.72-72.73 in cases and in controls, respectively. A reverse correlation was found between endometriosis and phthalates, while a direct correlation was found between BPA and endometriosis. Conclusions The direct correlation between BPA and endometriosis suggests the decreasing the use of plasticizer in food packaging and the importance to implement interventions and strategy to minimize exposure. The reverse correlation between endometriosis and DEHP could be explained by the small size of sample and by the monitoring of urine that are representative of a short-time exposure. Key messages Improve epidemiological studies with analysis of alternative matrices that are more representative of long-time exposure. Implement interventions and strategy to minimize exposure to plasticizer.