functional urology
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Author(s):  
Sakineh Hajebrahimi ◽  
Luis López‐Fando ◽  
Salvador Arlandis ◽  
Morteza Ghojazadeh ◽  
Hanieh Salehi‐Pourmehr ◽  
...  
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Author(s):  
Martin C. Michel ◽  
David Staskin

Combination treatment, i.e., the use of two or more drugs for the same condition, is frequent in medicine if monotherapy yields an insufficient therapeutic response. We here review and challenge clinical study designs and formats of reporting outcomes for the evaluation of the benefit/risk ratio of combination treatment over monotherapy. We demonstrate that benefits of combination treatment at the group level over-estimate the probability of benefit at the single patient level based on outcome simulations under almost any imaginable setting. Based on these findings we propose that studies testing combination treatment should always report on percentages of responders to monotherapy and combination treatment. We provide equations that allow calculation of the percentage of patients truly benefitting from combination (responders to both monotherapies) and that of patients exposed to risk of harm from adverse effects without a reasonable expectation of individual benefit. These considerations are explained based on real clinical data, mostly from the field of functional urology (male lower urinary tract symptoms).


Author(s):  
Hadi Mostafaei ◽  
Sandra Jilch ◽  
Greta Lisa Carlin ◽  
Keiichiro Mori ◽  
Fahad Quhal ◽  
...  

Author(s):  
Cyrille Guillot-Tantay ◽  
Grégoire Robert ◽  
Alain Ruffion ◽  
Xavier Gamé ◽  
Astrid Balanca ◽  
...  

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Lane ◽  
M Johnston ◽  
M Davies

Abstract There is no doubt that COVID-19 has had a profound impact on every medical and surgical speciality. In the height of the pandemic many non-emergency services were shut down, including dental services, with unexpected consequences. We present a case which highlights the unexpected and indirect consequences of a national lockdown on a Urology patient and discuss learning points. A 54-year-old male, previously fit and well suffered with a small dental abscess, media outlets were reporting that dental surgeries were closed, and he therefore attempted to drain the abscess himself. The infection spread to his epidural space, causing compression via a collection at L2 and consequently spinal cord injury. This was managed with urgent lumbar decompression and antibiotics. A specialist functional urology team were involved after his transfer to the tertiary spinal unit 3 months after his first presentation. He was catheterised but suffered with recurrent catheter blockages. Video urodynamics demonstrated a stable bladder with a low-pressure leak point, managed with urethral catheterisation. A repeat video urodynamics demonstrated a loss of compliance and stress incontinence. Unclear as to whether he would regain function rehabilitation techniques are currently being attempted prior for definitive operative management with an artificial sphincter. This case highlights the indirect impact of COVID-19 on UK urology services, and this has not been widely reported.


Author(s):  
Ahmet Tahra ◽  
Murat Dinçer ◽  
Rahmi Onur

Objective The Coronavirus pandemic has affected urological practice worldwide. In this study, we aimed to evaluate functional urology practice including outpatient clinic visits, routine examinations, diagnostic procedures and surgical interventions with an online survey. Method We conducted an online survey to evaluate Turkish urologists’ functional urology practices before and during the pandemic. In this survey, we asked questions about the respondents’ place of work, being part of a dedicated pandemic center, involvement with the pandemic and an interest in functional urology. We also examined outpatient clinics, routine examinations, diagnostic methods, and surgical practice before and during the pandemic. Results A total of 152 urologists completed the survey. The majority of the participants, (79.6%) were in tertiary centers. Nearly one-third of respondents (32.2%) stated that more than 50% of their routine practice is related to functional urology. In brief, 80.9% of the participants declared a decrease in the number of outpatient visits for functional urology. 68.4% of the participants declared a decrease in uroflowmetry practice, and 81.3% of had a decrease in urodynamic studies performed. According to respondents, 92.1% stated a decrease in botulinum injections for the bladder, and 93.4% of the participants declared a decrease in anti-incontinence surgery. Eighty-five percent of the participants declared a decrease in prolapse surgery. One-hundred and twenty-eight participants (84.2%) declared a decrease in surgery for benign prostate hyperplasia (BPH). Only 28.9% of the participants responded that they diagnosed their neuro-urology patients as they did prior to the pandemic. Conclusions The daily practice of urology changed, and functional urology was one of the most affected field. The large backlog of functional urology patients is challenging and although conditions, diagnostic tools and surgeries were classed as “benign”, we will have to face the effects of patients’ Quality of life in the near future.


2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
MaiAhmed Banakhar ◽  
SalehMohammed Bin Salman ◽  
TariqF Al-Shaiji ◽  
AymanElamin Younis ◽  
MaherSaleh Moazin ◽  
...  

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