Prevention and Management Following Complications from Endourology Procedures

Cornu, Jean Nicolas; Herrmann, Thomas; Traxer, Olivier; Matlaga, Brian R.

doi:10.1016/j.euf.2016.03.014

Cited by 32 publications

(23 citation statements)

References 79 publications

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“…A PubMed search of “transurethral resection” (of) “bladder” and “morbidity” or “complication”, or “mortality” or “death” yielded 585, 664, 9 and 95 articles, respectively. Of these, 89 articles relevant to the process of defining complexity were analysed, obtaining 36 articles ( Table S1 ) which were instrumental in highlighting adequacy, operative time and morbidity as the three drivers that characterize a complex surgery, as opposed to an uneventful procedure [ 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Roumiguié¹,

Xylinas

Brisuda

et al. 2020

Cancers

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Ten senior urologists were interrogated to develop a predictive model based on factors from which they could anticipate complex transurethral resection of bladder tumours (TURBT). Complexity was defined by consensus. Panel members then used a five-point Likert scale to grade those factors that, in their opinion, drove complexity. Consensual factors were highlighted through two Delphi rounds. Respective contributions to complexity were quantitated by the median values of their scores. Multivariate analysis with complexity as a dependent variable tested their independence in clinical scenarios obtained by random allocation of the factors. The consensus definition of complexity was “any TURBT/En-bloc dissection that results in incomplete resection and/or prolonged surgery (>1 hour) and/or significant (Clavien-Dindo ≥ 3) perioperative complications”. Logistic regression highlighted five domains as independent predictors: patient’s history, tumour number, location, and size and access to the bladder. Receiver operating characteristic (ROC) analysis confirmed good discrimination (AUC = 0.92). The sum of the scores of the five domains adjusted to their regression coefficients or Bladder Complexity Score yielded comparable performance (AUC = 0.91, C-statistics, p = 0.94) and good calibration. As a whole, preoperative factors identified by expert judgement were organized to quantitate the risk of a complex TURBT, a crucial requisite to personalise patient information, adapt human and technical resources to individual situations and address TURBT variability in clinical trials.

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Section: Resultsmentioning

confidence: 99%

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Roumiguié¹,

Xylinas

Brisuda

et al. 2020

Cancers

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“…40 While urinary tract infections are potentially the most serious and sometimes fatal, urological nurses must be expert to recognize sign and symptoms of infections using "quick SOFA" score particular on which potentially lead to a fatality. 43 For those having risk of bleeding, it is recommended to use laser therapy to minimize the blood loss. 42 In addition to this, any medications (ie, blood thinners and nonprescription pain relievers) increasing the risk of excessive blood loss during TURP need to be discontinued.…”

Section: Historical Overview Of Hrqol and Its Implication On Turpmentioning

confidence: 99%

“…42 In addition to this, any medications (ie, blood thinners and nonprescription pain relievers) increasing the risk of excessive blood loss during TURP need to be discontinued. 43 For those having risk of bleeding, it is recommended to use laser therapy to minimize the blood loss. 44 Urological nurses need to be considered the prostate gland size larger than 45 g requiring a longer resection time which may possibly call for higher levels of bleeding.…”

Section: Characteristics Of the Environmentsmentioning

confidence: 99%

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

Subrata

2019

Int J of Uro Nursing

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How can the deterioration of the health-related quality of life (HRQoL) in patients undergoing transurethral resection of the prostate (TURP) be prevented by urological nurses? The intention of this study is to examine the relevant literature regarding HRQoL among those undergoing TURP. Transurethral resection of the prostate is fully considered as a historical reference-standard procedure for treating benign prostatic hyperplasia. Even though this method is highly effective and offers significant progress in urinary functioning, it is related to a risk of complications recognized as TURP syndrome which may impact patients' HRQoL. Several studies have discussed the management of TURP syndrome; however, they did not clearly elucidate the comprehensive aspect of HRQoL pertaining to physiological and psychological elements. As a consequence, this clinical condition may cause unpromising outcomes in regard to residual physical and psychological symptoms after TURP. Wilson and Cleary's model of HRQOL was thoughtfully chosen to guide this study. Several themes of the model were discussed as follows: biological and physiological factors, symptoms and general health perceptions, functional status, patient preferences, emotional and psychological factors, and overall quality of life. We generated a model of HRQoL along with nursing care with respect to the patients undergoing TURP.The findings of this study will render a positive contribution to improving TURP outcomes as well as preventing deterioration of patients' HRQoL. K E Y W O R D Sadvanced nursing practice, benign prostate disease, evidence-based practice, models of nursing, quality of life, TUR syndrome

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“…Percutaneous and reconstructive procedures are performed in 5.2-15% of the cases [10,38] . Ureteral anastomosis, ureterovesical reimplantation in distal lesions, Boari flap ureteroneocystostomy, ileoplasty and self-transplantation are surgery techniques used for the reconstruction of perforated ureters [46] . Nephrectomy remains as the procedure of last choice.…”

Section: Treatment Of Perforations and Their Complicationsmentioning

confidence: 99%

Complications of Endourologic Procedures: A Review on Iatrogenic Ureteral Perforation

Cruz¹,

Morcillo²,

Folkersma³

et al. 2017

ARC Journal of Urology

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The aim of this study is to describe ureteral perforation as a complication of endourologic procedures; its incidence, risk factors, complications and treatment. Ureteral perforation is an injury that involves the entire thickness of the ureteral wall; whose incidence rate is less than 2%. It is related to the caliber of the equipment, the duration of the intervention, the surgeon's experience, the characteristics and location of the stones and the condition of the ureter prior to the intervention. Late diagnosis or inadequate management may lead to more serious complications such as urinoma, fever, and long-term stricture and obstructive uropathy. The treatment of this complication in the majority of cases consists in Double-Jstenting with a success rate over 80%; when this treatment fails, the following therapeutic options are Percutaneous Nephrostomy and reconstructive surgery.

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Prevention and Management Following Complications from Endourology Procedures

Cited by 32 publications

References 79 publications

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

Complications of Endourologic Procedures: A Review on Iatrogenic Ureteral Perforation

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