Review Article

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

Vol. 45 (4): 658-670, July – August, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0880


REVIEW ARTICLE

Giovanni S. Marchini 1,2, Fabio C. Torricelli 1,2, Carlos A. Batagello 1,2, Manoj Monga 1,2, Fabio C. Vicentini 1, Alexandre Danilovic 1, Miguel Srougi 1, William C. Nahas 1, Eduardo Mazzucchi 1
1 Seção de Endourologia da Divisão de Urologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil; 2 Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, United States

ABSTRACT 

Purpose: to critically review all literature concerning the cost-effectiveness of flexible ureteroscopy comparing single-use with reusable scopes.

Materials and Methods: A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. All factors potentially affecting surgical costs or clinical outcomes were considered. Prospective assessments, case control and case series studies were included.

Results: 741 studies were found. Of those, 18 were duplicated and 77 were not related to urology procedures. Of the remaining 646 studies, 59 were considered of relevance and selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. Operative time was in average 20% shorter with digital scopes, single-use or not. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Longer scope longevity is achieved with Cidex and if a dedicated nurse takes care of the sterilization process. The main surgical factors that negatively impact device longevity are lower pole pathologies, large stone burden and non-use of a ureteral access...

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Brazilian consensus in enuresis–recomendations for clinical practice

Vol. 45 (5): 889-900, September – October, 2019

doi: 10.1590/S1677-5538.IBJU.2019.0080


REVIEW ARTICLE

José Murillo B. Netto 1, Atila Victal Rondon 2, George Rafael Martins de Lima 3, Miguel Zerati Filho 4, Edison Daniel Schneider-Monteiro 5, Carlos Augusto F. Molina 6, Adriano de Almeida Calado 7, Ubirajara Barroso Jr. 8
1 Universidade Federal de Juiz de Fora (UFJF) e Hospital e Maternidade Therezinha de Jesus da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ-SUPREMA), Juiz de Fora, MG, Brasil; 2 Universidade do Estado do Rio de Janeiro (UERJ) e Hospital Federal Cardoso Fontes (HFCF), Rio de Janeiro, RJ, Brasil; 3 Hospital Infantil Albert Sabin, Fortaleza, CE, Brasil; 4 Instituto de Urologia e Nefrologia de São José do Rio Preto (IUN) e Faculdade Regional de Medicina(FAMERP), Hospital de Base, São José do Rio Preto, SP, Brasil; 5 Hospital da Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brasil; 6 Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brasil; 7 Faculdade de Medicina da Universidade de Pernambuco (UPE), Recife, PE, Brasil ; 8 Universidade Federal da Bahia (UFBA) e Escola Bahiana de Medicina (BAHIANA), Salvador, BA, Brasil

ABSTRACT

Introduction: Enuresis, defi ned as an intermittent urinary incontinence that occurs dur- ing sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many studies in Enuresis and recent advances in scientifi c and technological knowledge there is still considerable heterogeneity in evaluation methods and therapeutic approaches.

Materials and Methods: The board of Pediatric Urology of the Brazilian Society of...

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Role of Adiponectin in prostate cancer

Vol. 45 (2): 220-228, March – April, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0261


REVIEW ARTICLE

Xiaobo Hu 1,2, Cong Hu 2, Caiping Zhang 2, Min Zhang 2, Shiyin Long 2, Zhaohui Cao 1,2
1 Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China; 2 Department of Biotechnology, School of Pharmacy and Biosciences, University of South China, Hengyang, China

ABSTRACT

Obesity is defined as a chronic and excessive growth of adipose tissue. It has been associated with a high risk for development and progression of obesity-associated malignancies, while adipokines may mediate this association. Adiponectin is an adipose tissue-derived adipokines, with significant anti-diabetic, anti-inflammatory, anti-atherosclerotic and anti-proliferative properties. Plasma adiponectin levels are decreased in obese individuals, and this feature is closely correlated with development of several metabolic, immunological and neoplastic diseases. Recent studies have shown that prostate cancer patients have lower serum adiponectin levels and decreased expression of adiponectin receptors in tumor tissues, which suggests plasma adiponectin level is a risk factor for prostate cancer. Furthermore, exogenous adiponectin has exhibited therapeutic potential in animal models. In this review, we focus on the potential role of adiponectin and the underlying mechanism of adiponectin in the development and progression of prostate cancer. Exploring the signaling pathways linking adiponectin with tumorigenesis might provide a potential target for therapy.

Keywords: Prostatic Neoplasms; Obesity; Stress, Physiological

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A review of the possibility of adopting financially driven live donor kidney transplantation

Vol. 44 (6): 1071-1080, November – December, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0693


REVIEW ARTICLE

Aline Adour Yacoubian 1, 2, Rana Abu Dargham 1, 2, Raja B. Khauli 1, 2
1 Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon; 2 Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Beirut, Lebanon

ABSTRACT

Kidney transplantation for end-stage renal disease remains the preferred solution due to its survival advantage, enhanced quality of life and cost-effectiveness. The main obstacle worldwide with this modality of treatment is the scarcity of organs. The de­mand has always exceeded the supply resulting in different types of donations. Kidney donation includes pure living related donors, deceased donors, living unrelated do­nors (altruistic), paired kidney donation and more recently compensated kidney dona­tion. Ethical considerations in live donor kidney transplantation have always created a debate especially when rewarding unrelated donors. In this paper, we examine the problems of financially driven kidney transplantation, the ethical legitimacy of this practice, and propose some innovative methods and policies that could be adopted to ensure a better practice with accepted ethical guidelines.

Keywords:  Kidney Transplantation; Kidney Diseases; Review [Publication Type]

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5-alpha Reductase Inhibitors and risk of male breast cancer: a systematic review and meta-analysis

Vol. 44 (5): 865-873, September – October, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0531


REVIEW ARTICLE

Jiamin Wang 1, Shankun Zhao 1, Lianmin Luo 1, Ermao Li 1, Xiaohang Li 1, ZhiGang Zhao 1
1 Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China

 ABSTRACT

 Objective: To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC).

Material and Methods: We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC.

Results: Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity.

Conclusion: We did not observe a positive association between the use of 5ARIs and MBC. The small number of...

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Review of post bariatric surgery effects on common genitourinary physiology

Vol. 44 (4): 680-687, July – August, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0416


REVIEW ARTICLE

Aline A. Yacoubian 1, Rami Nasr 1
1 Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon

ABSTRACT

Background: Obesity is a worldwide challenging health problem. Weight loss through medical management of obesity has not always been successful, thus, giving rise to the need for surgical intervention. Bariatric surgery has been shown to be helpful for morbidly obese patients. However, studies have also shown the effect of surgery on stone formation, fertility and erectile function. This review summarizes the main find­ings of several studies that analyze stone formation and fertility in men as well as erectile function post bariatric surgery. The underlying pathophysiologic alterations post bariatric surgery include increased absorption of oxalate leading to hyperoxaluria, hypocitraturia and increased urinary calcium oxalate supersaturation. Contradicting data exist on the effect of bariatric surgery on fertility and erectile function. Further studies are needed to analyze the mechanisms.

Keywords: Obesity; Bariatric Surgery; Nephrolithiasis; Fertility

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