This study demonstrates that the majority of patients with LC are not hypercoagulable. We also showed that LMWH once or twice a day might not provide sufficient thromboprophylaxis. We advocate screening for patients demonstrating hypercoagulable states and ensuring adequate thromboprophylaxis in this group of patients with careful monitoring.
To evaluate the medium and long-term results of abobotulinumtoxinA (aboBTX-A) injection treatment in the management of refractory overactive bladder (OAB) symptoms owing to idiopathic detrusor overactivity. Methods: Prospective data were collected from consecutive patients who underwent intravesical injection of 250 units of aboBTX-A under general anaesthetic for OAB symptoms that were refractory to antimuscarinic therapy. Overactive bladder symptom scores (OABSS), Likhart quality of life (QoL) indices and post-void residual volumes (PVR) were compared before and 6 weeks after treatment. The Wilcoxon Signed Ranks test was used to compare changes in OABSS, QoL and PVR from baseline scores. Results: Seventy-three patients received 93 aboBTX-A injection treatments over a 5-year period. Overall, OABSS and QoL improved by a mean of 3.7 + 4.17 (p<0.001) and 2.1 + 2.06 (p<0.001), respectively. An improvement in the combined OABSS and QoL scores of two or more points was observed following 68 (70.8%) procedures. De novo self-catheterisation was required following 16 procedures (16.8%) but was discontinued by 3 months in nine cases. In patients undergoing repeat injection treatment, the mean (+ SD) duration of symptomatic relief (until the resumption of antimuscarinic therapy) was 12.3 + 9.8 months, while the mean (+ SD) interval between injection treatments was 26.7 ± 14.3 months. Conclusion: AbobotulinumtoxinA injection treatment, employing a dose of 250 units per treatment, confers results that compare very favourably with those reported for onobotulinumtoxinA.
The first uretero-arterial fistula (UAF) was reported in 1908 by Moschcowitz. In 2009, a systematic review identified 139 cases. Since then a further 23 cases were described with 19 cases originating from a single center. It has been recognized as a very rare condition in the past. However, more recently, the increasing incidence of UAF has led us to believe that this condition is more frequent than previously described. Aging population, improved cancer survival and extensive multimodal pelvic cancer treatments have been recognized as culprits for the increased incidence of UAFs. We have reviewed literature on UAFs, identified risk factors, patho-physiology and treatment options. Also, we present a case of fistulous communication between the internal iliac artery and ureter in a patient with a potential risk factor previously not described in the literature.
iGFR measurement is recommended following ileal conduit urinary diversion if early signs of renal function loss are to be detected. eGFR overestimates GFR in critically relevant ranges and fails to detect loss in a clinically significant proportion of patients.
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