Taken together, the results suggest that a subset of inflammatory cytokines and chemokines provides a framework for development of highly optimized urinary biomarker assay for differential diagnosis and treatment of OAB.
Gracilis muscle transposition is an excellent procedure for treating complex rectourethral fistula. Several other local factors may affect the postoperative urinary and fecal outcome. The collaboration of colorectal and urological surgeons is necessary to achieve optimal results.
BackgroundNephrotoxicity is a major hazard complicating the use of platinum based drugs (PBD), which can hinder using higher doses protocols to maximize the therapeutic gain. Shortage of serum creatinine level as an accurate biomarker for acute kidney injuries (AKI) necessitates searching for novel biomarkers with better sensitivity and specificity in patients on PBD.MethodsIn a prospective cohort design, 132 patients receiving PBD were selected for the study. AKI was diagnosed by continuous follow up of serum creatinine level according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines 2012. Serum creatinine and urinary biomarkers (KIM-1, NGAL and cystatin C) was measured in the day of treatment and for 3 days after PBD cycle.ResultsAKI occurred in 35 patients (26.52% of patients). KIM-1, Cystatin C, and NGAL showed significant increase in samples collected in the day of AKI in comparison to their corresponding basal levels (P < 0.0001). In addition, significant increase in urinary levels of the biomarkers in samples collected 1 day before AKI in comparison to their basal levels (P < 0.0001, P < 0.0001, and P = 0.013 for KIM-1, NGAL and Cystatin C respectively). Furthermore KIM-1 data showed a significant increase 2 days before serum creatinine rise in comparison to the corresponding KIM-1 levels in patients who developed AKI (P = 0.001).ConclusionsUrinary KIM-1, Cystatin C and NGAL can predict PBD induced AKI in earlier stages than serum createnine. KIM-1 is the most sensitive biomarker for early detection of AKI in patients receiving PBD.
ObjectiveTo assess the reliability and reproducibility of abdominal ultrasonography (US) for measuring the postvoid residual urine volume (PVR), and to compare measurements by a radiologist and urologist, in men with lower urinary tract symptoms (LUTS), as a significant PVR is common in patients with LUTS and an assessment of the PVR could protect patients from unnecessary catheterisation.Patients and methodsThis was a prospective comparative study of 45 men aged ⩾45 years with LUTS attending a urological outpatient clinic from July 2011 to May 2012. A detailed history was taken, with an assessment of LUTS using the Arabic Validated International Prostate Symptom Score (IPSS) and complete general and local examination. The PVR was measured by US twice by a radiologist and urologist, and then repeated after 1 week. Within ⩽2 min after US a urethral catheter was used to measure the PVR.ResultsThe mean (range) age of the patients was 63.8 (45–88) years and the mean IPSS was 16.18. Reliability testing between the PVR measured by US and the catheterised measure of PVR showed that US was not reliable (Cronbach’s α < 0.7). The US measurement was reproducible for both single examiner over two sessions, and with two examiners in one session. The PVR obtained by the urethral catheter was significantly higher than the US measurement (P < 0.05).ConclusionsThe measurement of PVR by US is reproducible by either a urologist or radiologist, but it is not reliable, as the urethral catheter estimate gives a significantly higher PVR.
Dextranomer/hyaluronic acid copolymer (Zuidex(R)) is a new bulking agent. There is little data about the complications of using this substance as urethral bulking agent for the treatment of urinary stress incontinence. We are presenting a 59-year-old female patient who developed a suburethral mass and urinary retention after zuidex urethral injection. A stepwise approach for treatment was followed. Complete excision of the mass was the only curative procedure that succeeded.
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