Purpose Of Review: This article reviews the mechanisms, risk factors, evaluation and current management options for iatrogenic lower urinary tract stenosis, including urethral stricture and bladder neck contracture, caused by surgery for benign prostatic hyperplasia (BPH).
Recent Findings: The incidence of iatrogenic stenosis following endoscopic BPH surgery ranges from 0 to 9.7%. New endoscopic techniques and technologies for treating BPH do not appear to substantially mitigate this risk. However, new advances in our understanding of urethral sphincter anatomy combined with both innovative open urethroplasty techniques and utilization of robotic surgery for bladder neck reconstruction, offer promise in improving treatment outcomes for this patient population. Treating patient with stenosis following BPH-related surgery can be challenging, especially in patients with recurrent disease. Optimizing outcomes and patient satisfaction relies on performing a thorough work-up and openly discussing treatment choices, risks and postoperative expectations with patients. Future research and emerging technology in both endoscopic BPH treatment surgical options and management of postoperative stenosis is critical to continuing to improve patient care.
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http://dx.doi.org/10.1007/s11934-021-01070-w | DOI Listing |
Front Surg
December 2024
Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
Objectives: To present our initial experience of robotic ureteroplasty with lower-lip mucosal graft (LLMG) for treating ureteral stenosis longer than 2 cm and evaluate its feasibility and efficacy.
Materials And Methods: A total of thirteen patients with ureteral stenosis who underwent robotic ureteroplasty with LLMG were retrospectively analyzed. After identification and dissection of the ureteral stenosis segment, the segment was incised longitudinally.
Adv Lab Med
December 2024
Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy.
Objectives: Urinalysis is widely used and is also frequently requested in emergency situations for screening hypovolemia, urinary tract infections, diabetes, ketoacidosis and hematuria. Our aim was to evaluate the impact of reporting urinary sediment in emergency department specimens with the Sysmex UN system.
Methods: We evaluated urinalyses requested by the emergency department over a three-month period and examined red blood cell count interference, compared leukocyte esterase dipsticks to cytofluorimetric leukocyte count and nitrites to cytofluorimetric bacterial count.
J Pharm Technol
December 2024
Division of Outcomes and Practice Advancement, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA.
Expansion of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use in chronic kidney disease (CKD) prompted a pragmatic study of their safety and effectiveness in patients with type 2 diabetes mellitus (T2DM) and late-stage CKD. The primary clinical endpoint was change in HbA. Secondary clinical endpoints included change in body weight and blood pressure.
View Article and Find Full Text PDFCureus
November 2024
Department of Clinical Infectious Diseases, Tokoname City Hospital, Tokoname, JPN.
This report presents a patient with pneumonia (LP), initially presented with fever and mild hypoxemia, with subsequent progression to severe pneumonia during hospitalization. Despite multiple negative urinary antigen tests using Ribotest , the diagnosis was confirmed via the loop-mediated isothermal amplification method of lower respiratory tract secretions. This case highlights the diagnostic limitations of Ribotest and emphasizes the importance of a comprehensive diagnostic strategy, incorporating nucleic acid amplification tests or culture in suspected patients with LP.
View Article and Find Full Text PDFBioelectricity
December 2024
Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
Objective: To determine whether adjuvant transforming growth factor-β (TGF-β) inhibition with pirfenidone (PFD) can mitigate ureteral wall scarring and related complications in a rat model of upper urinary tract ablation with irreversible electroporation (IRE).
Methods: Transmural ablation of the ureter was performed with IRE in 24 rats. Post-IRE, animals were randomly assigned to receive PFD or no drug, followed by euthanasia at 2-, 5-, or 10-days.
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