Original Article

Vesicostomy button: how is it placed, in whom, and how is quality of life affected?

Vol. 45 (x): 2019 April 4.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0686


ORIGINAL ARTICLE

Kelly J. Nast 1,2, George Chiang 1,2, Sarah Marietti 1,2
1 University of California, San Diego, CA, USA; 2 Rady Children’s Hospital, San Diego, CA, USA

ABSTRACT

Purpose: The vesicostomy button has been shown to be a safe and effective bladder management strategy for short- or medium-term use when CIC cannot be instituted.
This study reports our use with the vesicostomy button, highlighting the pros and cons of its use and complications. We then compared the quality or life in patients with vesicostomy button to those performing clean intermittent catheterization.
Materials and Methods: Retrospective chart review was conducted on children who had a vesicostomy button placed between 2011 and 2015. Placement was through existing vesicostomy, open or endoscopically. We then evaluated placement procedure and complications. A validated quality of life questionnaire was given to patients with vesicostomy button and to a matched cohort of patients performing clean intermittent catheterization.
Results: Thirteen children have had a vesicostomy button placed at our institution in the 4 year period, ages 7 months to 18 years. Indications for placement included neurogenic bladder (5), non-neurogenic neurogenic bladder (3), and valve bladders (5). Five out of 7 placed via existing vesicostomy had leakage around button. None of the endoscopically placed buttons had leakage. Complications were minor including UTI (3), wound infection (1), and button malfunction/leakage (3). QOL was equal and preserved in patients living with vesicostomy buttons when compared to CIC.
Conclusion: The vesicostomy button is an acceptable alternative to traditional vesicostomy and CIC. The morbidity of the button is quite low. Endoscopic insertion is the optimal technique. QOL is...

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Low serum vitamin D is associated with an increased likelihood of acquired premature ejaculation

Vol. 45 (x): 2019 April 4.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0887


ORIGINAL ARTICLE

Lütfi Canat 1, Recep Burak Degirmentepe 1, Hasan Anil Atalay 1, Suleyman Sami Çakir 1, Ilter Alkan 1, Mehmet Gokhan Çulha 1, Sait Ozbir 1, Masum Canat 2
1 Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey; 2 Department of Endocrinology and Metabolism, Şişli Etfal Training and Research Hospital, Istanbul, Turkey

ABSTRACT

Purpose: To investigate the relationship between 25-hydroxyvitamin D (25 (OH) D) levels and acquired premature ejaculation (PE).
Materials and Methods: A total of 97 patients with acquired PE and 64 healthy men as a control group selected from volunteers without PE attending our Andrology Outpatient Clinic between November 2016 and April 2017 were included the study. All patients were considered to have acquired PE if they fulfi lled the criteria of the second Ad Hoc International Society for Sexual Medicine Committee. Premature ejaculation diagnostic tool questionnaires were used to assessment of PE and all participants were instructed to record intravaginal ejaculatory latency time. Vitamin D levels were evaluated in all participants using high performance liquid chromatography method included in the study.
Results: Compared to men without PE, the patients with acquired PE had signifi cantly lower 25 (OH) D levels (12.0 ± 4.5 ng/mL vs. 18.2 ± 7.4 ng/mL, p < 0.001). In the logistic regression analysis, 25 (OH) D was found to be an independent risk factor for acquired PE, with estimated odds ratios (95% CI) of 0.639 (0.460-0.887, p = 0.007) and the area under curve of the ROC curve of 25 (OH) D diagnosing acquired PE was 0.770 (95% CI: 0.695 to 0.844, p < 0.001). The best cut-off value was 16 ng/mL with a sensitivity of 60.9%, specifi city of 83.5%, PPV of 70.9%, and NPV of 76.4% to indicate...

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Cross-cultural adaptation and validation of the neurogenic bladder symptom score questionnaire for Brazilian Portuguese

Vol. 45 (x): 2019 April 4.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0335


ORIGINAL ARTICLE

Lisley Keller Liidtke Cintra 1, José de Bessa Junior 2, Victor Ikky Kawahara 2, Thereza Phitoe Abe Ferreira 1, Miguel Srougi 2, Linamara Rizzo Battistella 1, Daniel Rubio de Souza 1, Homero Bruschini 2, Cristiano Mendes Gomes 2
1 Instituto de Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil; 2 Divisão de Urologia da Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil

ABSTRACT

Objective: To cross-culturally adapt and check for the reliability and validity of the neurogenic bladder symptom score questionnaire to Brazilian portuguese, in patients with spinal cord injury and multiple sclerosis.
Materials and Methods: The questionnaire was culturally adapted according to international guidelines. The Brazilian version was applied in patients diagnosed with neurogenic bladder due to spinal cord injury or multiple sclerosis, twice in a range of 7 to 14 days. Psychometric properties were tested such as content validity, construct validity, internal consistency, and test-retest reliability.
Results: Sixty-eight patients participated in the study. Good internal consistency of the Portuguese version was observed, with Cronbach α of 0.81. The test-retest reliability was also high, with an Intraclass Correlation Coeffi cient of 0.86 [0.76 – 0.92] (p<0.0001). In the construct validity, the Pearson Correlation revealed a moderate correlation between the Portuguese version of the NBSS and the Qualiveen-SF questionnaire (r = 0.66 [0.40-0.82]; p <0.0001).
Conclusions: The process of cross-cultural adaptation and validation of the NBSS questionnaire for the Brazilian Portuguese in patients with neurogenic lower urinary tract dysfunction was...

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The TNM 8th edition: Validation of the proposal for organ – confined (pT2) prostate cancer

Vol. 45 (2): 229-236, March – April, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0338


ORIGINAL ARTICLE

Athanase Billis 1, Leandro L. L. Freitas 1, Larissa B. E. Costa 1, Icleia S. Barreto 1, Luis A. Magna 2, Wagner E. Matheus 3, Ubirajara Ferreira 3
1 Departamento de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil; 2 Departamento de Genética Médica / Bioestatística da Faculdade de Ciências Médicas (Unicamp), Campinas, SP, Brasil; 3 Departmento de Urologia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil

ABSTRACT

Purpose: The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance. A major change in prostate includes pathologically organ – confined disease to be considered pT2 and no longer subclassified by extent of involvement or laterality. The aim of this study was to validate this major change.

Materials and Methods: Prostates were step – sectioned from 196 patients submitted to radical prostatectomy with organ confined disease (pT2) and negative surgical margins. Tumor extent was evaluated by a semiquantitative point count method. The dominant nodule extent was recorded as the maximal number of positive points of the largest single focus of cancer from the quadrants. Laterality was considered as either total tumor extent (Group 1) or index tumor extent (Group 2). Time to biochemical recurrence was analyzed with the Kaplan – Meier product limit analysis and prediction of shorter time to biochemical recurrence with Cox proportional hazards model.

Results: In Group 1, 43 / 196 (21.9%) tumors were unilateral and 153 / 196 (78.1%) bilateral and in Group 2, 156 / 196 (79.6%) tumors were unilateral and 40 / 196 (20.4%)...

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Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics?

Vol. 45 (2): 237-245, March – April, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0039


ORIGINAL ARTICLE

Gustavo Arruda Viani 1, Ana Carolina Hamamura 1, Alexandre Ciuffi Correa 1, Felipe Teles de Arruda 1
1 Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil

ABSTRACT

Objective: To build a model to evaluate the impact of salvage radiotherapy (SRT) in men with PSA rise or persistent PSA after undergoing radical prostatectomy (RP).

Materials and Methods: The study included 107 node-negative patients treated with SRT after RP at a single institution. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP. All patients received local radiation to the prostate / seminal vesicle bed. The primary measured outcome was the biochemical recurrence (BCR) free survival. Multivariable Cox regression analysis was used to develop a risk-stratification group to identify predictive factors associated with the probability of BCR at 5yr.

Results: At a median follow-up of 52 months, the BCR free survival rate and overall survival in 5 years was 73% and 94%, respectively. At multivariable analysis, pre-SRT PSA level > 0.35ng / mL (p = 0.023), negative margins (p = 0.038), and seminal vesicles invasion (p = 0.001) were significantly associated with BCR free survival. Three risk groups using regression analysis for SRT administration was built. Low-, intermediateand the high-risk groups had a BCR free survival in 5-years of 96%, 84%, and 44% (p = 0.0001), respectively.

Conclusions: We developed a risk group stratification to show the impact of SRT based on prostate cancer characteristics. SRT showed to be extremely beneficial for patients with low- and intermediate-risk tumors. Moreover, the risk-group built could identify...

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Can expressed prostatic secretions effect prostate biopsy decision of urologist?

Vol. 45 (2): 246-252, March – April, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0292


ORIGINAL ARTICLE

Osman Ergün 1, Erdem Çapar 2, Yunus Emre Göğer 3, Ayşe Gül Ergün 4
1 Department of Urology, Medical Faculty, Süleyman Demirel University, Isparta, Turkey; 2 Department of Urology, Gediz State Hospital, Gediz,Turkey; 3 Department of Urology, Medical Faculty, Necmettin Erbakan University, Konya, Turkey; 4 Department of Microbiology, Isparta City Hospital, Isparta, Turkey

ABSTRACT

Objectives: To evaluate the frequency of NIH category IV prostatitis, and the use of expressed prostatic secretions tests in an effort to improve the reliability of prostate specific antigen as an indicator, to avoid unnecessary prostate biopsy.

Materials and Methods: 178 expressed prostatic secretion positive patients with serum prostate specific antigen levels of ≥ 2.5 ng / mL were included in present prospective study. The diagnostic evaluation included detailed history and physical examination, digital rectal examination, urine analysis, urine culture, and expressed prostatic secretions tests. Transrectal ultrasonography was used both to measure prostate volume and conduct 12 core prostate biopsy.

Results: The prevalence of NIH category IV prostatitis was 36.9% (178 / 482) in our population of men. In our study patients (n: 178) prostate biopsy results were classified as; 66 prostatitis, 81 BPH, and 31 Pca. In asymptomatic prostatitis group, expressed prostatic secretion mean leucocyte ratio was higher compared to other two groups (p < 0.0001). The relation between number of expressed prostatic secretion leucocytes and prostatitis, benign prostate hyperplasia, and prostate cancer is analyzed. If 16 is taken as the cut of number for leucocyte presence, its sensitivity is 0.92 (AUC = 0.78 p = 0.01).

Conclusions: The...

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