Importance: The rate of genitourinary tract injury (GUTI) following pelvic organ prolapse (POP) surgery is presently ill-defined and based on relatively small trials with short follow-up time. Given the potential for higher risk of injury with POP, a better understanding of this type of injury is important for patient counseling.
Objectives: The objective of this study was to identify the incidence and risk factors of GUTI related to POP surgery.
Study Design: Women undergoing POP surgery between 2010 and 2019 were identified using Current Procedural Terminology codes in the Premier Healthcare Database. The primary outcome was GUTI, defined as bladder or ureteral injury, and vesicovaginal or ureterovaginal fistula within 1 year of surgery. Genitourinary tract injury was identified using International Classification of Diseases and Current Procedural Terminology codes. Patients were divided into those with and without GUTI. Differences between groups were evaluated using the Student t test, Wilcoxon rank-sum test, and Fisher exact test as appropriate. Multivariable logistic regression was used to evaluate the independent predictors of GUTI.
Results: One hundred thirty-nine thousand one hundred fifty-eight surgical procedures for POP were captured between 2010 and 2019. The rate of GUTI was 1.10%: 0.48% bladder, 0.64% ureteral injuries, and 0.01% fistulas. The most significant variables associated with any GUTI were as follows: adhesiolysis (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.07-6.51), blood transfusion (aOR, 3.67; 95% CI, 1.34-10.04), and low-volume surgeons (<12 cases per year) (aOR, 1.68; 95% CI, 1.60-1.77), nonurologic or gynecologic surgeon specialty (aOR, 1.62; 95% CI, 1.49-2.00), and uterosacral suspension (aOR, 1.30; 95% CI, 1.13-1.49).
Conclusions: The rate of GUTI following POP surgery is lower than has previously been reported. Surgeon experience and specialty and surgical approach may affect GUTI incidence.
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http://dx.doi.org/10.1097/SPV.0000000000001201 | DOI Listing |
Mucosal Immunol
December 2024
Kidney and Urinary Tract Center, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA; Division of Nephrology and Hypertension, Nationwide Children's Hospital, Columbus, OH 43215, USA. Electronic address:
The precise role of neutrophil-derived reactive oxygen species (ROS) in combating bacterial uropathogens during urinary tract infections (UTI) remains largely unexplored. In this study, we elucidate the antimicrobial significance of NADPH oxidase 2 (NOX2)-derived ROS, as opposed to mitochondrial ROS, in facilitating neutrophil-mediated eradication of uropathogenic Escherichia coli (UPEC), the primary causative agent of UTI. Furthermore, NOX2-derived ROS regulates NF-κB-mediated inflammatory responses in neutrophils against UPEC by inducing the release of nuclear factor erythroid 2-related factor 2 (Nrf2) from its inhibitor, Kelch-like ECH-associated protein 1 (Keap1).
View Article and Find Full Text PDFHinyokika Kiyo
November 2024
The Department of Urology and Renal Transplant Surgery, Faculty of Medicine, University of Nagasaki.
In 2021, Enfortumab Vedotin (EV) was approved for the treatment of locally advanced and metastatic urothelial carcinoma (UC) in Japan. Some patients require withdrawal or dose reduction due to cutaneous symptoms associated with EV treatment. Currently, the only reported associations of EV with cutaneous symptoms are pre-treatment performance status (PS) and body weight.
View Article and Find Full Text PDFBMC Bioinformatics
December 2024
Institute for the Advanced Study of Human Biology, Kyoto University Institute for Advanced Study, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
Background: Time-series scRNA-seq data have opened a door to elucidate cell differentiation, and in this context, the optimal transport theory has been attracting much attention. However, there remain critical issues in interpretability and computational cost.
Results: We present scEGOT, a comprehensive framework for single-cell trajectory inference, as a generative model with high interpretability and low computational cost.
BMC Urol
December 2024
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, 641-0012, Japan.
In calcium stone formers, most stones grow attached to Randall's plaque, which can be identified by measuring the computed tomography (CT) attenuation value of renal papilla. We hypothesized that the CT attenuation value of renal papilla can predict the severity (recurrent or multiple stone former) and recurrence of the stone disease. We retrospectively reviewed the charts of 180 calcium oxalate stone formers who underwent non-contrast CT and 24-hour urine chemistry in our hospital between September 2012 and November 2021.
View Article and Find Full Text PDFBackground: Optimizing outcomes of hospitalized patients anchors on standardizing processes in medical management, interventions to reduce the risk of decompensation, and prompt intervention when a patient decompensates.
Methods: A quality improvement initiative (optimized sepsis and respiratory compromise management, reducing health care-associated infection and medication risk, swift management of the deteriorating patient, feedback on performance, and accountability) was implemented in a multistate health system. The primary outcome was risk-adjusted in-hospital mortality.
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