Original Article

Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0737


ORIGINAL ARTICLE

Alexandre Sallum Bull 1, Affonso Celso Piovesan 1, Giovanni Scala Marchini 1, Kleiton Gabriel Ribeiro Yamaçake 1, Ioannis Michel Antonopoulos 1, Renato Falci 1, Hideki Kanashiro 1, Gustavo Ebaid 1, Francisco César Carnevale 2, Gustavo Messi 1, William Carlos Nahas 1
1 Divisão de Urologia, Unidade de Transplante Renal, Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil; 2 Unidade de Radiologia Intervencionista da Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil

ABSTRACT

Objective: To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA.

Materials and Methods: We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS. Parameters analysed comprised technical aspects, arterial blood pressure variation, and renal function. A minimum follow-up of 24 months was considered.

Results: Of the 2221 renal transplants performed in the selected period, 22 (0.9%) patients were identifi ed with TRAS. Fourteen (63.6%) were male and mean age was 377±14.8years (12-69). Kidney graft was from deceased donnors in 20 (80%) cases.

On doppler evaluation, mean blood fl ow speed after transplantation, at TRAS diagnosis and after TAP was 210.6±99.5, 417±122.7 and 182.5±81.6mL/sec, respectively (p<0.001). For SBP and DBP, there was a signifi cant difference between between preintervention and all post-treatment time points (p<0.001). After 1 month of the procedure, there was stabilization of the Cr level with a signifi cant difference between mean Cr levels along time (p<0.001). After a mean follow-up of 16±4.2 (3-24) months, overall success rate was...

Read More

Portable model for vasectomy reversal training

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2019.0092


ORIGINAL ARTICLE

Luis Otávio Amaral Duarte Pinto 1, Charles Alberto Villacorta de Barros 1, Anderson Bentes de Lima 1, Deivid Ramos dos Santos 1, Herick Pampolha Huet de Bacelar 1
1 Programa de Mestrado Profissional em Cirurgia e Pesquisa Experimental, Universidade do Estado do Pará – Uepa, Belém, PA, Brasil

ABSTRACT

Objectives: to validate an experimental non-animal model for training of vasectomy reversal.

Materials and Methods: The model consisted of two artificial vas deferens, made with silicon tubes, covered by a white resin, measuring 10 cm (length) and internal and external diameters of 0.5 and 1.5 mm, respectively. The holder of the ducts is made by a small box developed with polylactic acid, using a 3D print. The objective of the invention is to simulate the surgical fi eld of vasovasostomy, when the vas deferens are isolated from other cord structures. For validation, it was verifi ed the acquisition of microsurgical skills during its use, in a capacitation course with 5 urology residents from a Hospital of the region. Along the training sessions, it was analyzed the time (speed) of microsurgical sutures, and quantifi cation of the performance using a checklist. Collected data were analyzed using de BioEstat®5.4 software.

Results: Medium time for the completion of microsurgical sutures improved considerably during the course, and reached a plateau after the third day of training (p=0.0365). In relation to the checklist, it was verified that during capacitation, there was significant improvement of the scores of each participant, that reached a plateau after the fourth day of training with the model (p=0.0035).

Conclusion: The developed model was able to allow the students that attended the course to gain skills in microsurgery, being considered...

Read More

Biological roles of filamin a in prostate cancer cells

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0535


ORIGINAL ARTICLE

Xue-Chao Li 1, Chuan-Xi Huang 2, Shi-Kui Wu 1, Lan Yu 3, Guang-Jian Zhou 3, Li-Jun Chen 1
1 Department of Urology, the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China; 2 College of Life Science, Hebei University, Hebei, China; 3 Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing, China

ABSTRACT

Objective: This study aims to investigate the association of filamin A with the function and morphology of prostate cancer (PCa) cells, and explore the role of filamin A in the development of PCa, in order to analyze its significance in the evolvement of PCa.

Materials and Methods: A stably transfected cell line, in which filamin A expression was suppressed by RNA interference, was first established. Then, the effects of the sup­pression of filamin A gene expression on the biological characteristics of human PCa LNCaP cells were observed through cell morphology, in vitro cell growth curve, soft agar cloning assay, and scratch test.

Results: A cell line model with a low expression of filamin A was successfully con­structed on the basis of LNCaP cells. The morphology of cells transfected with plasmid pSilencer-filamin A was the following: Cells were loosely arranged, had less connec­tion with each other, had fewer tentacles, and presented a fibrous look. The growth rate of LNCap cells was faster than cells transfected with plasmid pSilencer-filamin A (P <0.05). The clones of LNCap cells in the soft agar cloning assay was significantly fewer than that of cells stably transfected with plasmid pSilencer-filamin A (P <0.05). Cells stably transfected with plasmid pSilencer-filamin A presented with a stronger healing and migration ability compared to LNCap cells (healing rate was 32.2% and 12.1%, respectively; P...

Read More

Preoperative proteinuria is associated with increased rates of acute kidney injury after partial nephrectomy

 Vol. 45 (x): 2019 March 3.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0776


ORIGINAL ARTICLE

Önder Kara 1, 2, Matthew J. Maurice 1, Pascal Mouracade 1, Ercan Malkoc 1, Julien Dagenais 1, Mustafa Çapraz 3, Jaya S. Chavali 1, Merve Yazici Kara 4, Jihad H. Kaouk 1
1 Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; 2 Kocaeli University, Medical School, Kocaeli, Turkey; 3 Amasya University, Medical School, Amasya, Turkey; 4 Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey

ABSTRACT

Purpose: We investigated the association between preoperative proteinuria and early postoperative renal function after robotic partial nephrectomy (RPN).

Patients and Methods: We retrospectively reviewed 1121 consecutive RPN cases at a single academic center from 2006 to 2016. Patients without pre-existing CKD (eGFR≥60 mL/min/1.73m2) who had a urinalysis within 1-month prior to RPN were included. The cohort was categorized by the presence or absence of preoperative proteinuria (trace or greater (≥1+) urine dipstick), and groups were compared in terms of clinical and func­tional outcomes. The incidence of acute kidney injury (AKI) was assessed using RIFLE criteria. Univariate and multivariable models were used to identify factors associated with postoperative AKI.

Results: Of 947 patients, 97 (10.5%) had preoperative proteinuria. Characteristics as­sociated with preoperative proteinuria included non-white race (p<0.01), preoperative diabetes (p<0.01) and hypertension (HTN) (p<0.01), higher ASA (p<0.01), higher BMI (p<0.01), and higher Charlson score (p<0.01). The incidence of AKI was higher in pa­tients with preoperative proteinuria (10.3% vs. 4.6%, p=0.01). The median eGFR pres­ervation measured within one month after surgery was lower (83.6% vs. 91%, p=0.04) in...

Read More

Association between enuresis and obesity in children with primary monosymptomatic nocturnal enuresis

Vol. 45 (x): 2019 June 6.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0603


ORIGINAL ARTICLE

Yanli Ma 1, 2, Ying Shen 1, 2, Xiaomei Liu 1, 2
1 Department of Nephrology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, China; 2 Beijing Key Laboratory of chronic kidney disease and blood purifi cation of children, South Lishi Road, Xicheng District, Beijing, China

ABSTRACT

Objective: The purpose of this study was to determine whether the presence of obesity was related with symptoms of nocturnal enuresis (NE) and the effi cacy of behavioral intervention in the treatment of NE.
Materials and Methods: The patients diagnosed with primary monosymptomatic nocturnal enuresis (PMNE) were studied retrospectively. NE severity was classified as mild, moderate, and severe according to the frequency of enuresis. The children were divided into three groups, namely normal weight (5th-84th percentile), overweight (85th-94th percentile), and obesity (≥95th percentile), according to their Body Mass Index (BMI) percentage. The relationship between obesity level and enuresis severity was analyzed.
After three months of behavioral therapy, the effi cacy of treatment among normal, overweight, and obese groups were evaluated. Moreover, the predictive risk factors for treatment failure were investigated.
Results: The rates of severe enuresis in patients with normal weight, overweight, and obesity were 63.9%, 77.5%, and 78.6%, respectively. Obese children depicted higher odds of having severe enuresis compared with normal-weight children (OR: 1.571; 95% confi dence interval [CI]: 1.196-2.065; P=0.001). The odds of presenting with severe enuresis were 1.99 times higher in children who are obese or overweight compared to children with normal weight (OR: 1.994; 95% CI: 1.349-2.946; P=0.001). The complete response of the...

Read More

Voiding symptoms obtained by open versus directed anamnesis as predictors of voiding dysfunction in women

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0556


ORIGINAL ARTICLE

Juan Pablo Valdevenito 1, 2, José Flores 1, Rodrigo Guzman Rojas 2, Valentin Manriquez 2, Leandro Arribillaga 3, Juan de Benito 4
1 Department of Urology, Urodynamics Unit, Hospital Clínico Universidad de Chile, Santiago, Chile; 2 Department of Obstetrics and Gynecology, Female Pelvic Floor Unit, Hospital Clínico Universidad de Chile, Santiago, Chile; 3 Centro Urológico Profesor Bengió, Córdoba, Argentina; 4 Department of Urology, Instituto Modelo de Cardiología SRL, Córdoba, Argentina

ABSTRACT

Objectives: To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VSDirected) to predict voiding dysfunction in women.
Materials and Methods: Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number fi ve of the UDI-6 questionnaire (“Do you experience any diffi culty emptying your bladder?”). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each of them, which were considered VS-Directed.
Voiding dysfunction was considered the presence of a maximum fl ow ≤ 12 mL/s and/ or a postvoid residual > 100 mL.
Results: Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence...

Read More