The acute phase management of traumatic spinal cord injury (tSCI) with polytrauma: A narrative review.

Introduction: Traumatic spinal cord injury (tSCI) is frequently observed in polytrauma patients.

Research Question: What is the optimal strategy to manage tSCI in the setting of polytrauma?

Material And Methods: This narrative review focuses on: 1) extraspinal damage control surgery and resuscitation, 2) the perioperative protection of the injured spine during emergency surgery, 3) imaging and timing of spinal surgery in polytrauma, 4) early interventions for skin, bowel and bladder, and 5) the multidisciplinary approach to tSCI polytrauma patients.

Results: Damage control resuscitation (DCR) and damage control surgery (DCS), aim to prevent/correct post-traumatic physiological derangements to minimize bleeding until definitive hemostasis is achieved.

Duraplasty promotes functional recovery by alleviating intraspinal pressure and edema following severe spinal cord compression injury in rabbits: Experimental studies.

Background: After acute traumatic spinal cord injury (tSCI), various surgical strategies have been developed to alleviate elevated intraspinal pressure (ISP) and secondary injury.

Purpose: Our study aimed to investigate the impacts of duraplasty and laminectomy on edema progression, perfusion and functional outcomes after severe balloon compression SCI.

Study Design: In vivo animal study.

Risk Factors for de Novo Postoperative Urinary Retention in Posterior Lumbar Spine Surgery.

Study Design: Retrospective cohort study.

Objective: De novo postoperative urinary retention (POUR) after lumbar posterior decompression surgery for lumbar spinal canal stenosis (LSCS) is a statistically known but uncommon complication for both patients and spine surgeons. The aim of this study is to review clinical data and imaging findings and identify preoperative predictors of de novo POUR.

Imaging of Urologic Trauma.

Urologic trauma encompassed a wide range of injuries affecting the urologic tract, resulting from various traumatic events or iatrogenic procedures. This review explores the clinical presentation, diagnostic strategies, and management approaches of urologic trauma, emphasizing the critical role of imaging, particularly computed tomography, in accurately assessing and guiding treatment decisions. Renal, ureteral, bladder, and urethral trauma are comprehensively discussed, including mechanisms of injury, classification systems, and therapeutic interventions.

Defining the potential for sexual structures-sparing for prostate cancer external beam radiotherapy: A dosimetric study.

Purpose: The purpose of the study was to evaluate the dosimetric impact of sexual-sparing radiotherapy for prostate cancer, with magnetic resonance-only treatment planning.

Material And Methods: Fifteen consecutive patients receiving prostate cancer radiotherapy were selected. A synthetic CT was generated with a deep learning method from each T2-weighted MRI performed at the time of treatment planning.

CBCT-based online adaptive radiotherapy of the prostate bed: first clinical experience and comparison to nonadaptive conventional IGRT.

Purpose: Conventional image-guided radiotherapy (IGRT) of the prostate bed is challenged by the varying anatomy due to dynamic changes of surrounding organs such as the bladder and rectum. This leads to changed dose coverage of target and surrounding tissue. The novel online adaptive radiotherapy (oART) aims to improve target coverage as well as reduce dose exposure to surrounding healthy tissues by daily reoptimization of treatment plans.

A case report on urethrovesical self-insertion of hand sewing needles over four years without symptoms: The hidden dangers of autoerotism.

Introduction And Clinical Importance: Inserting foreign bodies (FBs) into the lower genitourinary tract is an emergency and uncommon medical condition. The materials used for this purpose are batteries, telephone cables, wires and glass. This report highlights a rare case of urethrovesical FBs "hand sewing needles", emphasizing the limited literature on asymptomatic long-term retention and discussing removal strategies that include conservative care, endoscopic retrieval, and surgical intervention based on case complexity.

Imaging Findings Associated With Failure of Conservative Management After Blunt Extraperitoneal Bladder Injury.

Objective: To identify risk factors for failure of conservative management (CM) for uncomplicated extraperitoneal bladder injuries (EBI).

Methods: The trauma registry at a single Level 1 trauma center was queried for patients presenting with a blunt EBI between 2004 and 2022. Patients with CM and follow-up through at least 1 postoperative cystogram or catheter removal were included.

Light-Driven Green-Fabricated Artificial Intelligence-Enabled Micro/Nanorobots for Multimodal Phototherapeutic Management of Bladder Cancer.

Combination therapy based on precise phototherapies combined with immune modulation provides successful antitumor effects. In this study, a combination therapy is designed based on phototactic, photosynthetic, and phototherapeutic Chlamydomonas Reinhardtii (CHL)-glycol chitosan (GCS)-polypyrrole (PPy) nanoparticle (NP)-enhanced immunity combined with the tumor microenvironment turnover of cytotoxic T cells and M1/M2 macrophages, which is based on photothermal GCS-PPy NPs decorated onto the phototactic and photosynthetic CHL. Phototherapy based on CHL-GCS-PPy NPs alleviates hypoxia and modulates the tumor immune microenvironment, which induces tumor cell death.

Urinoma: A Rare but Potential Differential of Acute Abdomen.

Urinoma is an encapsulated collection of extravasated urine in the retroperitoneal space. This rare and potentially dangerous event can occur spontaneously or iatrogenically varying from asymptomatic cases to acute abdomen. The initial diagnostic modality is ultrasound.

Nonoperative Management of a Spontaneous Perforation of Neobladder Secondary to Blackout From Solitary Binge Drinking: A Case Report and Current Literature Review.

The orthotopic ileal neobladder is becoming a popular technique of urinary diversion after radical cystectomy (RC) for localized muscle-invasive bladder cancer (MIBC), allowing patient continence, with a more desirable body image and good quality of life. Minimally invasive robot-assisted RC and neobladder have the potential to minimize physical and psychological trauma and are increasingly being adopted for patients with MIBC worldwide. Spontaneous perforation of orthotopic neobladder is uncommon;however, it represents serious complications.

Comparison prediction models of bladder toxicity based on radiomic features of CT and MRI in patients with prostate cancer undergoing radiotherapy.

Purpose: This study aimed to assess the radiomic features of computed tomography (CT) and magnetic resonance imaging (MRI) of the bladder wall before radiotherapy using machine learning (ML) methods to predict bladder radiotoxicity in patients with prostate cancer.

Methods: This study enrolled 70 patients with pathologically confirmed prostate cancer who were candidates for radiation therapy (RT). CT and MRI of the bladder wall before radiotherapy were used to extract radiomic features.

Polypyrrole/iron-glycol chitosan nanozymes mediate M1 macrophages to enhance the X-ray-triggered photodynamic therapy for bladder cancer by promoting antitumor immunity.

X-ray Photodynamic Therapy (XPDT) is an emerging, deeply penetrating, and non-invasive tumor treatment that stimulates robust antitumor immune responses. However, its efficacy is often limited by low therapeutic delivery and immunosuppressant within the tumor microenvironment. This challenge can potentially be addressed by utilizing X-ray responsive iron-glycol chitosan-polypyrrole nanozymes (GCS-I-PPy NZs), which activate M1 macrophages.

Retrograde Ejaculation Due to Posterior Urethral Stricture: A Rare Case Report.

Pelvic fracture is a serious injury, which has a profound impact on sexual function due to concurrent nervous and urethral injuries. In this case report, we describe a 29-year-old single man who had retrograde ejaculation as a result of a pelvic fracture-related posterior urethral stricture. The patient wanted to improve his ejaculatory ability after experiencing urethral stricture for 8 years and retrograde ejaculation for 3 years following the pelvic fracture.

The effect of distal ureteral lateralization angle on ureteral trauma avoidance and successful ureteral access sheath placement.

Background: The use of ureteral access sheaths (UAS), which offer advantages in flexible ureteroscopic lithotripsy (fURL), may lead to undesirable conditions such as ureteral injury, ischemia, and prolonged ureteral stenosis. The aim of this study was to investigate the effect of the distal ureteral lateralization angle on successful UAS placement.

Methods: We analyzed the data of patients who underwent fURL for kidney and/or proximal ureteral stones retrospectively.

A Vesicocutaneous Fistula Treated With Urinary Diversion, Negative Pressure Wound Therapy, and Time.

A 38-year-old motor vehicle accident victim presented for acute urinary retention due to a clogged Foley catheter, which was inserted two weeks prior during surgery for pelvic and spine fixation and extra-peritoneal bladder rupture. Imaging studies revealed persistent bladder leaks despite primary and, later, secondary surgical repair. A combination of novel non-surgical techniques, that is, urinary diversion, negative pressure dressings, and waiting proved beneficial in our case, and led ultimately to complete clinical and radiological resolution of the fistula.