The present study confirms the effectiveness of augmentation cystoplasty in increasing bladder capacity, improving bladder compliance and reducing detrusor overactivity. The preservation of renal function and low metabolic complication rate provide solid evidence for carrying out this time-honored procedure in patients with neurogenic or non-neurogenic bladder dysfunction.
Renal cell carcinoma is well known for its varied presentation and its potential of metastasizing to virtually any organs. Metastasis to the ureter or bladder is extremely rare. To date only 52 cases of metastatic renal cell carcinoma to ureter have been reported. We report a case of metachronous solitary metastasis of renal cell carcinoma to the ipsilateral ureteric stump one year after radical nephrectomy of the primary tumour. Completion ureterectomy and partial cystectomy was performed and pathology confirmed metastatic renal cell carcinoma. Six months later the patient was found to have bladder recurrence again. Contrast computed tomography scan of abdomen showed multiple liver metastases. The disease progressed despite use of target therapy. He finally succumbed 29 months after the initial nephrectomy.
Aim The aim of the present study was to evaluate the perioperative, oncological and functional outcomes of laparoscopic radical prostatectomy (LRP) and robot‐assisted radical prostatectomy (RARP) performed at our centres. Patients and Methods All LRP and RARP performed from January 2011 to June 2016 were reviewed through electronic patient records. The preoperative cancer characteristics, perioperative parameters, pathology, oncological and functional outcomes were studied. Results A total of 136 men were included in the analysis. RARP had a significantly less estimated blood loss (933 mL vs 361 mL, P < 0.01) than LRP. Positive surgical margins were noted in 42.6 and 35.2 per cent for LRP and RARP. Four‐year biochemical recurrence‐free survival was 79.4 per cent. There were no difference across the two groups. The 3‐, 12‐, 24‐ and 36‐month continence rates were 51.6, 86.8, 86.6 and 84.6 per cent, respectively. Early continence was better in RARP. The Urogenital Distress Inventory‐6 was significantly lower for RARP at 6 weeks and 3 and 12 months, while the Incontinence Impact Questionnaires‐7 was lower for RARP at 6 weeks and at 3 months. The 3‐, 12‐, 24‐ and 36‐month erection sufficient for intercourse (ESI) rates were 11.6; 25.5; 28.4 and 21.4 per cent, respectively. More men achieved ESI after 12 months in RARP. The International Index of Erectile Function 5‐item version score was higher in RARP from 12 months onwards. Conclusion RARP appears to be a promising approach for greater minimally‐invasive benefit and functional outcome, without jeopardizing oncological control.
Aim:The aim of the present study was to reduce the complication rate and postoperative morbidity after transurethral prostatectomy by routine urine culture before surgery. Patients and Methods: Urine culture was saved 2 weeks prior to surgery for all patients undergoing transurethral prostatectomy at the United Christian Hospital from May 2013 to October 2013. The urine culture result was screened before surgery. Antibiotic treatment was given according to the bacteria-sensitivity profile if the culture was positive. Urine culture was repeated 1 h before surgery to review the efficacy of antibiotic treatment. Postoperative outcome measures included urinary tract infection (UTI) rate, postoperative fever rate, hospital stay and 30-day readmission rate. A retrospective comparison was made with patients undergoing surgery from November 2012 to April 2013. Results: A total of 247 cases were included in the study, with 97 cases (39.3 per cent) in the study group and 150 (60.7 per cent) in the control group. Overall, 8.5 per cent of patients had postoperative UTI. Episodes of postoperative fever (11.3 per cent vs 22 per cent, P = 0.032) were lower and postoperative hospital stay was shorter for the study group. The 30-day unplanned readmission rate (8 per cent vs 19.3 per cent, P = 0.017) was also significantly lower in the study group. Multivariate analysis showed that the treatment of preoperative bacteriuria was the only significant variable determining the length of hospital stay (P = 0.001). Total resection time (P = 0.017), days of postoperative bladder irrigation (P = 0.007) and the presence of postoperative fever (P = 0.035) were significant variables with a positive correlation for 30-day readmission. Conclusion: Routine reviews of urine culture and treatment of bacteriuria before transurethral prostatectomy can reduce episodes of postoperative fever, hospital stay and the 30-day unplanned readmission rate after surgery.
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