Selection process for the new Editor-in-Chief of the International Brazilian Journal of Urology

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 normal group was higher than those of the overweight and obese groups (26.8% vs. 14.0%, P=0.010; 26.8% vs. 0.0%, P=0.000). Overweight children showed higher complete response than obese ones (14.0% vs. 0.0%, P=0.009). Logistic regression analysis revealed that obesity level and enuresis frequency were significantly related to the treatment failure of behavioral intervention. Conclusions: Obesity is associated with severe enuresis and low effi cacy of behavioral therapy in children with nocturnal enuresis. Keywords: Nocturnal Enuresis; Behavior Therapy; Treatment Failure [Full...

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 of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed. Conclusions: VS-Open may predict better voiding dysfunction than VS-Directed in women. Keywords: Urination; Women; Retrospective Studies [Full...

read more

Nonsecretory intestinocystoplasty: postoperative outcomes of 25 years

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0595 ORIGINAL ARTICLE Rose A. F. Dantas 1, Fernanda C. F. S. Calisto 1, Fabio O. Vilar 2, Luiz A. P. Araujo 3, Salvador V. C. Lima 4 1 Programa de Pós-Graduação em Cirurgia, Centro de Ciências da Saúde, Universidade Federal de Pernambuco-UFPE, Pernanbuco, PE, Brasil; 2 Departamento de Urologia, Hospital das Clínicas da Universidade Federal de Pernambuco-UFPE, Pernanbuco, PE, Brasil; 3 Departamento de Cirurgia Pediátrica, Universidade Federal de Pernambuco-UFPE, Pernanbuco, PE, Brasil; 4 Departamento de Cirurgia, Centro de Ciências da Saúde da Universidade Federal de Pernambuco-UFPE, Pernanbuco, PE, Brasil ABSTRACT Objective: The objective of bladder augmentation (BA) is to create a low-pressure reservoir with adequate capacity. Despite its benefi ts, the use of intestinal patches in bladder enlargement provides a high risk of developing complications and BA with demucosalised bowel represents a potential alternative. Therefore, this study evaluated urological parameters and long-term clinical follow-up of patients submitted to nonsecretory BA in a single center with 25 years of experience. Materials and Methods: Patients treated with BA underwent urological evaluation, which included history, physical examination and urodynamic study. The main urodynamic parameters (bladder capacity and bladder compliance) were assessed in the pre and postoperative moments, and compared by the Wilcoxon Signed Rank test. The main long-term complications were described. Results: 269 patients (mean age 14±13 years, 47% male) underwent BA with the use of demucolised intestinal segments. Among the patients in the sample, 187 (69.52%) had neurogenic bladder, 68 (25.28%) had bladder exstrophy, nine had tuberculosis (3.34%), four had a posterior urethral valve (1.49%) and one with hypospadia (0.37%). After the surgical procedure, a signifi cant increment in both urodynamic parameters was found, with a 222% increase in bladder capacity and 604% in bladder compliance (p <0.001 in both analyzes). Mean follow-up time ranged from 2 to 358 months, with a median of 72 months (IQR 74-247). Among all patients, 5 presented spontaneous perforation. Conclusion: The study showed statistically signifi cant increase in both compliance and bladder capacity after non-secretory BA, with a low rate of severe complications. Keywords: Hypopituitarism; Urinary Bladder; Disease [Full...

read more

Study of kidney morphologic and structural changes related to different ischemia times and types of clamping of the renal vascular pedicle

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0559 ORIGINAL ARTICLE Angela Mazzeo 1, Anna Paula Weinhardt Baptista Sincos 1, Katia Ramos Moreira Leite 2, Miguel Angelo Góes Jr. 1, 3, Oscar Fernando Santos dos Pavão 1, Oskar Grau Kaufmann 1 1 Hospital Israelita Albert Einstein, São Paulo, Brasil; 2 Laboratório de Urologia, Faculdade de Medicina da Universidade São Paulo – USP, SP, Brasil; 3 Disciplina de Nefrologia, Escola Paulista de Medicina, Universidade Federal de São Paulo – Unifesp, SP, Brasil ABSTRACT Purpose: This study aimed to study morphological and renal structural changes in relation to different ischemic times and types of renal vascular pedicle clamping. Methods: Sixteen pigs were divided into two groups (n = 8): Group AV – unilateral clamping of the renal artery and vein and Group A – unilateral clamping of the renal artery only, both with the contralateral kidney used as control. Serial biopsies were performed at 0, 10, 20, 30, 40, 50, 60, 70, 80, and 90 minutes after clamping. Results: there is a correlation between the occurrence of renal damage as a function of time (p <0.001), with a higher frequency of Group A lesions for cellular alterations (vascular congestion and edema, interstitial infl ammatory infi ltrate, interstitial hemorrhage and cell degeneration), with the exception of in the formation of pigmented cylinders that were evidenced only in the AV Group. Conclusion: the number of lesions derived from ischemia is associated with the duration of the insult, there is a signifi cant difference between the types of clamping, and the AV Group presented a lower frequency of injuries than Group A. The safety time found for Group A was 10 minutes and for Group AV 20 minutes. Keywords: Kidney; Ischemia; Nephrectomy [Full...

read more

A census of laparoscopic and robotic urological practice: a survey of minimally invasive surgery department of the Brazilian Society of Urology

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0724 ORIGINAL ARTICLE Marcos Flávio Holanda Rocha 1, Rafael Ferreira Coelho 2, Anibal Wood Branco 3, Pedro Henrique de Oliveira Filgueira 1, Rômolo Guida Júnior 4 1 Hospital Monte Klinikum, Fortaleza, CE, Brasil; 2 Hospital Albert Einstein, São Paulo, SP, Brasil; 3 Hospital Marcelino Champagnat, Curitiba, PR, Brasil; 4 Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brasil ABSTRACT Minimally invasive urologic surgery has been developing in Brazil and now is a routine part of care in many regions and patients with different conditions benefi t from it. Training in laparoscopic and robotic surgery has evolved and concerns exist both over the quality of surgical training and the practical effect on results of the urological training. This is an unprecedented study which undertook a census to determinate the current state of laparoscopic and robotic urological practice and to know the mains barriers to adequate practice in Brazil. In august 2017, surveys, consisting of an anonymous questionnaire with 15 questions, were sent via internet to the mailing list of the Brazilian Society of Urology (SBU). With these data, activities related to laparoscopy and robotic surgery of our urologists and the mains diffi culties and barriers to practice laparoscopy and robotic surgery were evaluated. In our survey, 413 questionnaires were completed. Majority of the responders were currently working in the southeast region of Brazil (52.1%) and 75.5% of the surgeons performed laparoscopic surgery while, only 12.8%, robotic surgery. The lack of experience on the technique and the lack of equipment were the mains barriers and diffi culties for not executing laparoscopic and robotic surgeries, respectively. Proper longitudinal training and access to good equipment in minimally invasive surgery are still barriers for urologists in our country. Keywords: Education; Robotic Surgical Procedures; Urology [Full...

read more

Novel homozygous mutation in a colombian patient with persistent müllerian duct syndrome: expanded phenotype

Vol. 45 (x): 2019 June 6.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0808 CHALLENGING CLINICAL CASES Mary García Acero 1, Olga Moreno 1, Andrés Gutiérrez 2, Catalina Sánchez 2, Juan Guillermo Cataño 2, Fernando Suárez-Obando 1, 3, Adriana Rojas 1 1 Human Genetic Institute, Pontifi cia Universidad Javeriana, Bogotá, Colombia; 2 Department of Urology, Hospital Universitario San Ignacio, Bogotá, Colombia; 3 Genetic Service, Hospital Universitario San Ignacio, Bogotá, Colombia ABSTRACT The anti-Müllerian hormone triggers the regression of uterus and fallopian tubes in male embryos; if there are problems in the synthesis or action of this protein, Müllerian structures persist in an otherwise phenotypic male. The most frequent clinical presentation of Persistent Mullerian Duct syndrome is cryptorchidism and inguinal hernia. The few cases reported in adults are incidental fi ndings or inguinal hernias. However, we present an adult male with history of bilateral cryptorchidism with unsuccessful orchidopexy, who presents with a large abdominal mass with the fi nding of a seminomatous tumor and persistence of Müllerian structures, in whom the variant c.916delC (p.Leu306Cysfs*29) in the AMHR2 gene not previously reported was documented. Keywords: Mullerian Ducts; Anti-Mullerian Hormone; Persistent Mullerian duct syndrome [Supplementary Concept]; Disorders of Sex Development [Full...

read more

Antioxidant action of alpha lipoic acid on the testis and epididymis of diabetic rats: morphological, sperm and immunohistochemical evaluation

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0774 ORIGINAL ARTICLE Lanna Beatriz Neves Silva Corrêa 1, Carlos Alberto Soares da Costa 2, José Antônio Silva Ribas 3, Gilson Teles Boaventura 2, Mauricio Alves Chagas 1 1 Departamento de Morfologia, Laboratório de Biomorfologia Celular e Extracelular, Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil; 2 Departamento de Nutrição e Dietética, Nutrição Experimental, Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil; 3 Departamento de Fisiologia e Farmacologia, Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil ABSTRACT Introduction: Chronic hyperglycemia is caused by diabetes mellitus-committed genital morphophysiology, and oxidative stress is one of the main factors involved in this process. Alpha lipoic acid (ALA) can prevent metabolic and morphological changes in diabetic individuals. Objectives: In present study, we evaluated the effects of regular ALA consumption on the spermatogenesis and histoarchitecture in the male genital system of diabetic rats. Materials and Methods: Thirty-two Wistar rats were divided into groups: Control (CG); Diabetic Control (DCG), receiving commercial diet: ALA Group (ALAG) and Diabetic ALA Group (DALAG), fed diets with added ALA (300 mg/Kg bw). The diabetic groups received a single injection of streptozotocin (60 mg/kg). After sixty days of the diet, the animals were euthanized, and semen, testis and epididymis samples were collected. A histomorphometric analysis was performed to determine the epithelial height, tubular and luminal diameter, tubular and luminal area of seminiferous tubules and each epididymal region. Sertoli cells were evidenced using the antivimentin antibody and were quantifi ed. The results were statistically analyzed by the ANOVA test. Results: At the end of the experiment, the DALAG glycemia was significantly lower than DCG. The histomorphometric parameters of the seminiferous and epididymal tubules did not show improvement in the DALAG. However, there was an improvement in the DALAG in terms of the concentration, motility and percentage of spermatic pathologies, as well as in the number of Sertoli cells (p<0.001). Conclusions: The results demonstrated that supplementation with the ALA antioxidant retards testicular lesions and preserve the process of spermatogenesis in diabetes. Keywords: Testis; Epididymis; Morphological and Microscopic Findings; Spermatozoa [Full...

read more

REPLY BY THE AUTHORS: Re: Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury. Is there an indication?

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0193.1 LETTER TO THE EDITOR Marcello Torres da Silva 1, André Luis Barboza 2, Maria Malen Pijoán 3, Paulo Sergio Siebra Beraldo 4 1 Serviço de Urologia, Rede Sarah de Hospitais de Reabilitação, São Luís, MA, Brasil; 2 Serviço de Urologia, Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil; 3 Instituto Universitario Italiano de Rosario – Ciências Biomédicas, Rosario, Santa Fe, Argentina; 4 Serviço de Lesão Medular, Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil ABSTRACT Not available [Full...

read more

Re: Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury. Is there an indication?

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0193 LETTER TO THE EDITOR Michael S. Floyd Jr. 1, Rauf N. Khadr 1 1 Department of Urology & Northwest Regional Spinal Cord Injury Unit Southport & Ormskirk NHS Foundation Trust, Town Lane, Kew, Southport, Merseyside, United Kingdom ABSTRACT Not available [Full...

read more

Re: The role of 68Ga-PSMA-PET/CT in radiotherapy planning in prostate cancer

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2019.0130 LETTER TO THE EDITOR Yasemin Benderli Cihan 1 1 Kayseri Education and Research Hospital, Department of Radiation Oncology, Turkey ABSTRACT Not Available [Full...

read more