International Urology and Nephrology (INT UROL NEPHROL)

Publisher: Springer Verlag

Journal description

International Urology and Nephrology publishes original papers on a broad range of topics in urology nephrology and andrology. The journal integrates papers originating from clinical practice. In addition to the regular papers book reviews also form an essential feature of the journal. International Urology and Nephrology is published at bimonthly intervals.

Current impact factor: 1.52

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 1.519
2013 Impact Factor 1.293
2012 Impact Factor 1.325
2011 Impact Factor 1.471
2010 Impact Factor 1.567
2009 Impact Factor 1.053
2008 Impact Factor 0.912
2007 Impact Factor 0.482
2006 Impact Factor 0.53

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.39
Cited half-life 5.10
Immediacy index 0.28
Eigenfactor 0.01
Article influence 0.37
Website International Urology and Nephrology website
Other titles International urology and nephrology (Online)
ISSN 0301-1623
OCLC 45496589
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

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  • Classification
    green

Publications in this journal

  • Paula Loewe · Ioannis Stefanidis · Peter R. Mertens · Christos Chatzikyrkou
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    ABSTRACT: Background and objective: In diabetics genetic predisposition, poor glycemic control and arterial hypertension contribute to nephropathy development in patients affected by diabetes mellitus. We set up the hypothesis that diabetic nephropathy and incisional hernia formation may have in common alterations of collagen composition and tested whether the occurrence of diabetic nephropathy coincides with wound healing disturbance (incisional herniation) or connective tissue diseases (inguinal herniation, umbilical herniation, aortic aneurysm, varicose veins, disc herniation). Design: A questionnaire on surgical procedures, wound healing and connective tissue disorders was performed with 731 diabetics. Furthermore, test results for kidney function and damage (creatinine clearance, proteinuria) and blood sugar control (HbA1c) were recorded. Correlations between aforementioned connective tissue diseases and "advanced" diabetic nephropathy were calculated. "Advanced" diabetic nephropathy was assumed in patients with macroproteinuria, CKD stage 5 and/or end-stage renal disease. All diabetics with CKD stages 1 and 2 without proteinuria were included in the "control" group. A subgroup analysis on incisional hernia formation coinciding with diabetic nephropathy was performed in patients with previously performed abdominal surgery. Results: In patients with advanced nephropathy, some diseases with connective tissue alterations, such as inguinal herniation, aortic aneurysms and varicose veins, did not occur more frequently than in patients without nephropathy. In diabetics with nephropathy, umbilical herniation (3 vs. 8.2 %, p = 0.04) and disc herniation rates (5.7 vs. 16.1 %, p = 0.002) were significantly lower. Subgroup analysis of patients with previously performed abdominal surgery (n = 381) revealed significantly higher incisional herniation rates when "advanced" diabetic nephropathy was present (16 % compared to 5.7 % without nephropathy, p = 0.016). Conclusion: Our findings support the hypothesis that incisional hernia formation and diabetic nephropathy are positively correlated. Conversely, umbilical and disc herniation pathomechanisms are distinct, as these negatively correlate with the presence of advanced diabetic nephropathy.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose: Kidney fibrosis is the most common final stage of progressive renal disease. Bone morphogenetic protein-7 (BMP-7) has been shown to be important in both preservation of kidney function and resistance to injury. Recently, it has been realized that uterine sensitization-associated gene-1 (USAG-1) functions as a kidney-specific BMP antagonist. Because of the reported anti-fibrotic effects of artesunate (Art), this study was designed to investigate the effects of Art on renal fibrosis in unilateral ureteral obstruction (UUO) rats and to explore the underlying mechanisms. Methods: Thirty male Sprague-Dawley rats were randomly divided into five groups: Sham group, UUO group, low-dose Art-treated (Art-L), middle-dose Art-treated (Art-M), and high-dose Art-treated (Art-H) groups. The UUO rat model was established by ligating the left ureter. Fourteen days later, interstitial collagen deposition, expression of USAG-1, BMP-7, E-cadherin, α-smooth muscle actin (α-SMA), fibronectin (FN), collagen I, as well as the inflammatory infiltration levels in the kidneys were assessed. Results: Art treatment significantly attenuated the deposition of interstitial collagens in the UUO rats' kidneys and exhibited the ability to improve renal function, followed by the up-regulated expression of BMP-7 and E-cadherin and the down-regulated expression of USAG-1 and α-SMA. In addition, increased macrophages infiltration in the kidneys of the UUO rats were also attenuated by the administration of Art. Conclusions: These results indicate that Art is able to improve the renal function decline and renal fibrosis induced by UUO, which may be associated with the up-regulation of BMP-7 and down-regulation of USAG-1. Accordingly, Art may become a potential preventive or therapeutic agent for chronic kidney diseases.
    No preview · Article · Feb 2016 · International Urology and Nephrology

  • No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose: High fibroblast growth factor-23 (FGF-23) levels are associated with mortality and cardiovascular events in patients with chronic kidney disease. The aim of this cross-sectional study was to investigate the relationship between plasma FGF-23 levels and coronary artery calcification and carotid artery intima-media thickness (CA-IMT) in hemodialysis (HD) patients. Methods: In this cross-sectional study, plasma intact FGF-23 levels were measured in 229 patients who underwent coronary artery calcification scores (CACs) determined by multi-slice computerized tomography and CA-IMT assessed by using high-resolution color Doppler ultrasonography. Results: Median FGF-23 was 53.5 pg/ml (IQR 30.8-249.5). Median CACs was 98 (IQR 0-531), and the frequency of patients with severe calcification (CACs > 400) was 28.8 %; 27.5 % of cases had no calcification. Mean CA-IMT was 0.78 ± 0.20 mm, and the presence of carotid plaques was 51 % with a mean length 2.1 mm. FGF-23 level was positively correlated with serum calcium (r = 0.337, p < 0.001), phosphate (r = 0.397, p < 0.001) and CACs (r = 0.218, p = 0.001). Neither CA-IMT nor the presence of carotid artery plaques correlated with FGF-23 levels. In adjusted ordinal regression analysis, FGF-23 level was an independent predictor for severe CACs together with age, gender, presence of diabetes, time on dialysis and CA-IMT (model r (2) = 0.44, p < 0.001). As a novel finding, the mean CACs was markedly higher in patients with FGF-23 level above median regardless of phosphate levels (p = 0.03). Conclusions: In HD patients, plasma FGF-23 level is superior to phosphate in the prediction of coronary artery calcification. However, FGF-23 is not associated with carotid artery atherosclerosis in HD patients.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose: To analyse the mid-term oncological results and to asses predictive factors for recurrence and survival after nephron-sparing surgery (NSS) for renal cell carcinoma. Materials and methods: This is a retrospective study that includes 198 Partial Nephrectomies performed at our institution for malignant renal tumours. Demographic information and pathological characteristics were obtained, and completed statistical analysis was performed to assess predictors for overall survival (OS) and overall recurrence in our sample. Results: The presence of positive surgical margins (PSM) in the surgical specimen was reported in 13.6 %. At a median of follow-up of 56.1 months, the non-adjusted cancer-specific mortality, DSS and OS were 100, and 93.4 %, respectively. In the bivariate analysis regarding predictive factors for recurrence, bilaterality and NSS indication (elective or imperative) were statistically significant (p = 0.03 and p = 0.05 respectively). On multivariate analysis only bilaterality was a significant predictor of recurrence (p = 0.03), while high Fuhrman grade was for survival (p = 0.006). Conclusion: Our data suggest that patients with bilateral tumours have a higher incidence of local recurrence. Regarding overall survival, our data showed more risk of death at 5 years in those patients with high Fuhrman grade. No differences were found among PSM and negative surgical margins patients regarding oncological outcomes.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Background and objectives: Long noncoding RNAs (lncRNAs) play key roles in process of cancer cell growth and apoptosis and have received increasing attention. SChLAP1 is a novel lncRNA that is required for development and progression of prostate cancer. We hypothesized that SChLAP1 also has important biological functions in human bladder cancer which is another type of urological cancer. Methods: The expression of SChLAP1 in bladder cancer was determined using real-time qPCR. Bladder cancer T24 and 5637 cells were transfected with SChLAP1 siRNA or negative control siRNA. Cell proliferation, apoptosis and migration were determined using CCK-8 assay, flow cytometry analysis and wound healing assay, respectively. Results: SChLAP1 was overexpressed in bladder cancer tissues compared to paired normal bladder tissues. Cell growth arrest, apoptosis induction and migration inhibition were also observed in bladder cancer T24 and 5637 cells after transfection with SChLAP1 siRNA. Conclusions: Our data suggest that SChLAP1 plays oncogenic roles and can be used as a therapeutic target for treating human bladder cancer.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose: The role of cytoreductive nephrectomy (CN) has been controversial with the advent of targeted therapy. Our study was to identify the prognostic value of CN combined with targeted therapy for treatment of metastatic renal cell carcinoma (mRCC) by conducting a meta-analysis based on the existing population-based studies. Methods: Research articles published up to September 2015 were searched through PubMed and Embase. A meta-analysis was performed to assess the overall survival (OS) and progression-free survival (PFS) of patients with mRCC undergoing CN combined with targeted therapy compared with targeted therapy alone. Furthermore, analysis was made to evaluate some potential prognostic factors predicting survival. Results: Eight studies were included in our analysis with 2688 mRCC patients. A fixed-effect model was performed and found the pooled HR of OS was 0.60 (95 % CI 0.53-0.67, p < 0.0001). Furthermore, the pooled median survival ratio was elevated (HR 2.11, 95 % CI 1.78-2.49, p < 0.0001), indicating that patients who received CN combined with targeted therapy yielded a more than twofold prolonged OS compared with those who received targeted therapy alone. Moreover, no significant difference was observed in PFS in the patients undergoing CN combined with targeted therapy (HR 0.82, 95 % CI 0.57-1.19, p = 0.30). Conclusions: Current evidence suggests that CN combined with targeted therapy has a significant OS advantage in patients with mRCC. However, the results should be evaluated in the context of the potential selection biases of the existing evidence. Large prospective cohort studies are required to confirm these findings.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose: Hippocampus plays an important role in spatial learning and memory. Ghrelin, a brain-gut peptide, participates in the mnestic functions of hippocampus through its receptor growth hormone secretagogue receptor (GHS-R) distributed in hippocampus. This study was to investigate whether there was a correlation between the changes of ghrelin system in hippocampus and the spatial cognitive impairment caused by chronic renal failure (CRF). Methods: Sprague-Dawley rats (male, 180 ± 10 g, 7-8 weeks old) were randomly classified into CRF group and control group (n = 18 per group). The CRF model was constructed by 5/6 nephrectomy and the controls treated with sham operation. By the 8th week after the surgery, the spatial cognitive function of rats was assessed by Morris water-maze test (MWM), the protein expression of ghrelin and GHS-R in the hippocampus by immunohistochemistry, and the mRNA expression by real-time PCR. Statistical analysis was performed using ANOVA, Student-Newman-Keuls-q test and Pearson correlation analysis, and P < 0.05 was considered significant. Results: Compared with the controls, the time spent in "platform" quadrant (TSPQ) of rats with CRF was decreased, but the escape latency (EL) was increased significantly in MWM, and meanwhile the protein and mRNA expression of ghrelin and GHS-R in hippocampus was also increased significantly (P < 0.05 or P < 0.01). Correlation analysis suggested that the TSPQ was negatively but the EL was positively correlated with the mRNA expression of ghrelin and GHS-R (P < 0.01). Conclusion: The CRF-caused changes of ghrelin system in hippocampus might be correlated with the CRF-caused cognitive function impairment.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To investigate the effect of rapamycin on TGFβ1 and MMP1 expression in a rabbit model of urethral stricture. Methods Twenty-four adult New Zealand male rabbits underwent an electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Then rabbits were randomly divided into three groups: (1) normal control group: normal saline (NS), (2) the vehicle control group: dimethyl sulfoxide (DMSO), and (3) the treatment group: effective-dose rapamycin in DMSO (Ra), with 12, 6, and 6 rabbits in each group, respectively. Drugs were given by urethral irrigation daily for 4 weeks. Urethral tissue was harvested for histological and molecular analyses. TGFβ1 and MMP1 expression levels were evaluated by real-time quantitative PCR and immunohistochemistry. Results Ten, six, and six rabbits were evaluated finally in Ra, DMSO, and NS group, respectively. Histological examination revealed the distribution of fibrosis and the degree of collagen deposition in the Ra group were smaller and slighter than the two control groups. Collagen content was significantly less in the Ra group than in the DMSO group (P < 0.001) and the NS group (P < 0.001). qRT-PCR analysis showed a higher expression of MMP1 mRNA in the Ra group than in the DMSO group (P < 0.001) and the NS group (P < 0.001). Immunohistochemistry showed the protein levels of MMP1 in the Ra group were significantly increased when compared with the DMSO group (P < 0.01) and the NS group (P < 0.01). On the other hand, no statistical difference could be found between every two groups in both mRNA and protein levels of TGFβ1. Conclusions Rapamycin enhances the expression of MMP1 in a rabbit model of urethral stricture, but has no direct effect on the expression of TGFβ1.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose Sodium restriction is important for the management of chronic kidney disease (CKD). The present study evaluated the factors impacting dietary sodium restriction in a cohort of Chinese patients with CKD. Methods A questionnaire on dietary sodium restriction was administered to patients with non-dialysis CKD who visited our CKD clinic from September 2014 to March 2015. Twenty-four-hour urinary sodium excretion (24-h UNa) was measured. Logistic regression was performed to examine the association between patient characteristics and sodium restriction. Results Two hundred and twenty-nine patients were included in the final analysis. Most of the patients (97.7 %) declared their awareness of the necessity of sodium restriction, but 27.3 % of them chose an incorrect sodium restriction limit. Most of the patients (85.2 %) also reported that they had taken actions to reduce their sodium consumption, with intolerance of sodium restriction as the most common reason for taking no actions. Only 42 patients (18.3 %) had a 24-h UNa of <100 mmol. Multivariable logistic regression showed that age and the use of condiments were independently associated with successful sodium restriction [odds ratio (95 % confidence interval) 1.04 (1.01–1.07), p = 0.006 and 0.38 (0.16–0.88), p = 0.023, respectively]. Most of the patients (83.0 %) did not know how to estimate their sodium intake from condiments. Conclusions This study indicates that there is much room for improvement in dietary sodium restriction in Chinese patients with CKD. Condiments as a hidden source of sodium intake should be stressed in the education of these patients.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose CXCL3 and its receptor CXCR2 were considered to play particularly important roles in the progression of malignancies. However, the investigations about CXCL3/CXCR2 axis in prostate cancer have been poorly involved. Herein we firstly reported our studies on the expression and biological roles of CXCL3 and CXCR2 in prostate cancer. Methods Expression levels of CXCL3 and CXCR2 in prostate cancer cell lines (PC-3, DU145 and LNCaP), immortalized prostate stromal cell line (WPMY-1) and immortalized prostate epithelial cell line (RWPE-1) were investigated by RT-PCR, ELISA and western blot, whereas expression levels of CXCL3 in a prostate tissue microarray were detected by immunohistochemistry. Cell counting kit-8 and transwell assays were, respectively, utilized to determine the effects of exogenous CXCL3 on the cell proliferation and migration. We further examined whether CXCL3 could regulate the expression of genes correlated with prostate tumorigenesis by RT- PCR. Results Elevated expression of CXCR2 was detected in DU145, LNCaP and RWPE-1. Moreover, high-level CXCL3 can be secreted by PC-3 and RWPE-1, and CXCL3 protein expression level in tissue microarray is concordant with prostate cancer metastasis. Exogenous CXCL3 does not contribute to proliferation, but has a significant effect on migration of prostate cancer cells and RWPE-1. Finally, our data showed that exogenous CXCL3 can regulate the expression of genes including ERK, TP73, NUMB, BAX and NDRG3. Conclusion Our findings suggest that CXCL3 and its receptor CXCR2 are overexpressed in prostate cancer cells, prostate epithelial cells and prostate cancer tissues, which may play multiple roles in prostate cancer progression and metastasis.
    No preview · Article · Feb 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To investigate the incidence of isolated hematuria and its relationship to the glomerular filtration rate (GFR). Methods Data from the Korean National Health and Nutrition Examination Survey V were used. A stratified, three-stage, clustered probability design was used to collect representative data on the Korean population. Ultimately, 18,587 participants were included. The incidence of isolated dipstick hematuria and its relationship with the GFR (estimated by the Chronic Kidney Disease Epidemiology Collaboration equation) were evaluated. Results The analysis showed that 31.8 % of the population had isolated hematuria, the incidence of which significantly increased with age (P trend < 0.001). As the severity of hematuria increased, the ratio of GFR < 60 ml/min/1.73 m2 and 60 ml/min/1.73 m2 ≤ GFR < 90 ml/min/1.73 m2 was significantly increased (P trend < 0.001). After adjusting for the confounders, the mean GFR of the grade 3+ (grades 3, 4, 5) hematuria group was significantly reduced compared to that of the negative, grade 1, and grade 2 hematuria groups (with an adjusted mean ± standard error of 94.0 ± 0.8 vs. 97.2 ± 0.3 ml/min/1.73 m2, P < 0.001). Additionally, the odds ratio of the grade 3+ hematuria group for a GFR < 60 ml/min/1.73 m2 was significantly increased compared to that of the negative, grade 1, and grade 2 hematuria groups after adjusting for the confounders (adjusted odds ratio 1.468, 95 % confidence interval 1.049–2.054, P = 0.025). Conclusion An effective health policy for hematuria screening is needed for older age groups. A strategy of careful checkups and counseling regarding renal function is necessary for patients with isolated hematuria.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose The diagnosis of Gleason score (GS) ≥7 with distinction from GS < 7 remains a difficult problem instructing clinical decisions. Moreover, the present wide application of prostate biopsy to increase prostate cancer detection rate might cause unnecessary and excessive examination or treatment. Therefore, a risk assessment model for forecasting GS ≥ 7 in potential prostate cancer patients was established to reduce unnecessary prostate biopsies. Methods Patients (n = 981; September 2009 to January 2013) who underwent trans-rectal ultrasound (TRUS)-guided core prostate biopsy were retrospectively evaluated in the first stage of the study. Age, prostate-specific antigen (PSA), free PSA (fPSA), the free/total PSA ratio (f/t), prostate volume (PV), PSA density (PSAD), digital rectal examination (DRE) findings (texture, nodules) and B-ultrasound detection results (normal or abnormal, presence of hypoechoic mass or microcalcification) were considered as potential predictive factors. After multiple logistic regression analysis, independent variables used to build a nomogram were selected using a backward elimination selection procedure. Then, a model to forecast GS ≥ 7 was designed for potential prostate cancer patients. In the second stage of the study, 410 cases (January 2013 to March 2015) were subsequently evaluated using our model for prostate biopsies, and the outcomes of biopsies were compared between the two stages. Results PSA, DRE texture, DRE nodules and B-ultrasound results were finally brought into our nomogram; a obviously greater area under the receiver operating characteristic (ROC) curve was obtained for the model than utilizing PSA, fPSA or PSAD alone (0.831 vs. 0.803, 0.770, 0.780 separately). We thereafter sought the best cutoff value in the ROC curve at 0.87, which provided sensitivity as high as 90 %. Meanwhile, the specificity was 45.8 %, which was much higher than the specificity of PSA, fPSA and PSAD at the same sensitivity level (37.7, 24.6 and 35.2 %, respectively). In the first stage, the detection rate of GS ≥ 7 in the high-risk group was significantly higher than in the low-risk group (80.3 vs. 35.0 %, p < 0.001). Furthermore, in the second stage, with the application of the new model associated with our former models, the rate of GS ≥ 7 was improved from 71.0 (697/981) to 79.2 % (267/337) (p = 0.003). Conclusions The model for forecasting GS ≥ 7 is effective, which could reduce unnecessary prostate biopsies without delaying patients’ diagnoses and treatments.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To investigate the impact of preoperative anemia (PA) on oncologic outcomes among patients who underwent radical cystectomy (RC) for bladder cancer. Methods We reviewed the records of 200 patients undergoing RC between October 2003 and December 2014. Patients were categorized according to PA status. We performed multivariable Cox regression analyses to assess the impact of PA on oncological outcomes. Results Among 200 patients, 81 patients (40.5 %) had PA according to definition of the WHO classification. Fifty-two (26 %) of 200, 12 (6 %) of 200 and 61 (30.5 %) of 200 patients experienced the disease recurrence (DR), cancer-specific mortality (CSM) and all-cause mortality (ACM), respectively. In Kaplan–Meier analysis, the non-PA group showed a significantly higher 5-year DR-free survival than PA group (log-rank test: p = 0.018). The non-PA group showed a similar pattern of CSM and ACM (p = 0.004 and p = 0.037, respectively). In multivariable Cox proportional hazards analysis, PA was significantly associated with DR (HR 1.86, 95 % CI, p = 0.04) and ACM (HR 2.13, 95 % CI, p = 0.006) after adjusting other factors. Conclusions The preoperative anemic bladder cancer patients who underwent RC had worse oncological outcomes than non-anemic bladder cancer patients.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Objective To describe a novel transurethral front-firing Greenlight bladder autoaugmentation for the treatment of bladder contracture and report initial clinical outcomes. Methods Between April 2014 and August 2015, five patients diagnosed with contracted bladder were all refractory to conservative treatment and received novel transurethral autoaugmentation. CT scan and urodynamics examination were conducted before operation for disease assessment. Mucosal and muscular layers of bladder wall in fundus were incised vertically and horizontally with front-firing Greenlight laser to enlarge bladder capacity in the operation. Imaging examination and periodical urodynamics study were performed to evaluate the clinical outcomes of the procedure in postoperative follow-up. Results Transurethral front-firing Greenlight bladder autoaugmentation was performed successfully on all the patients. The mean operative time was 59 min (range 52–65 min) with no significant blood loss. Urodynamic parameters of these patients after operation improved significantly compared with those before operation. Average maximum cystometric capacity (V max) increased from 91.2 to 333 ml (p < 0.01), average maximum flow rate (Q max) ascended from 12.6 to 18.62 ml/min (p < 0.01), and average flow rate (Q ave) also increased from 5.74 to 13.18 ml/min (p < 0.01). At the last follow-up, all the patients could void spontaneously with good bladder emptying and their symptoms improved significantly. Conclusion Our novel transurethral front-firing Greenlight bladder autoaugmentation is a safe and effective treatment for contracted bladders. Future studies with larger sample size and long-term follow-up are needed to confirm our findings.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To compare the surgical effects and postoperative complications and patient experience of two circumcision methods (novel disposable suture device and conventional suture approach) in Chinese excess foreskin or phimosis patients performed in our Andrology centre in a prospective non-randomized controlled study. Methods A total of 520 cases of excess foreskin and 62 phimosis patients that underwent circumcision between June 2014 and June 2015 in a single center using novel disposable device (n = 295; mean age 30.4 years, range 18–44 years) and conventional suture approach (n = 287; mean age 28.6 years, range 16–41 years) were documented. The main surgical outcomes (surgical time, intraoperative blood loss, incision healing time) and postoperative complications and patient experience (postoperative pain score, satisfaction rate of postoperative penile cosmetic appearance, recovery duration) were collected and analyzed. A multivariate logistic regression with likelihood ratio test was also used to observe the possible determinants of edema occurrence postoperatively. Results The novel disposable suture device group had shorter operation time, lower pain score and rapid recovery and a higher satisfaction rate of penile cosmetic appearance when compared to the conventional circumcision group. Besides, the incidence of complications (hematoma and incision bleeding and infection) was significantly lower in the novel disposable suture device group. A multivariate logistic regression with likelihood ratio test revealed that phimosis was the significant predictor of edema occurrence postoperatively (Chi square of likelihood ratio = 9.88, df = 1, p = 0.025). Conclusions Circumcision using this novel disposable suture device is associated with short operative time, rapid recovery, less pain experience, less complications (hematoma and incision bleeding and infection) and high satisfaction rate of penile appearance. This new approach should be of value for future application. Phimosis patients should be notified that they had a great possibility to develop edema postoperatively regardless of the surgical options.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To evaluate the accuracy of estimated glomerular filtration rate (eGFR) against the reference standard of isotopic GFR (iGFR) in monitoring renal function during follow-up after cystectomy and urinary diversion. Methods Patients who had undergone cystectomy and ileal conduit urinary diversion at two centres between August 2001 and August 2006 were identified. eGFR calculated using the MDRD formula was compared to 51Cr EDTA measured iGFR values measured at similar time-points during follow-up. Results Six hundred and fourteen paired iGFR and eGFR results were analysed from 166 patients (18 % female, median age 70 years). There was a significant difference between paired iGFR and eGFR measurements (p < 0.0001) with a mean bias of +1.8 mls/min/1.73m2 (SD 18.0) and a 95 % limit of agreement of −33.5 to 37.2 mls/min/1.73m2. iGFR and eGFR values converged at a GFR of approximately 45 mls/min/1.73m2. 70.6 % of patients experienced a loss of renal function greater than expected (>0.58 mls/min/1.73m2/year). In 22.4 % of these patients, a decline of greater than 10 % in iGFR occurred that was undetected by eGFR measurements, which overestimated GFR. There was no significant relationship between patient height, weight or body mass index and the accuracy of eGFR measurements. Conclusions 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.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose The changes in redox status characterise physiological platelet activation. Increased oxidative stress in chronic kidney disease (CKD) associated with uremic toxicity and procedures of renal replacement therapy leads to the impairment of antioxidant properties of platelets. It may contribute to thrombosis and cardiovascular complications increasing morbidity and mortality among the CKD patients. The object of the research was to assess the influence of conservative treatment, peritoneal dialysis and haemodialysis on platelet prooxidative-antioxidative balance. Methods The examined group consisted of 122 patients: 37 on regular haemodialysis (HD), 23 on peritoneal dialysis (PD) and 62 on conservative treatment with CKD stages 3–5 (CKD3–5). The activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione transpherase (GST) in platelets were obtained using kinetic methods. The spectrophotometric method established the concentrations of reduced glutathione (GSH). Results SOD activity in PD differs significantly from CKD3–5 (4.96 vs 1.66; p < 0.0001). CAT activity assessed in PD and CKD3–5 was significantly different from HD (0.82 and 0.8 vs 0.52 before and 0.35 after HD, respectively). GST activity reached the highest value in PD (1.62), and it was significantly different from CKD3–5 (0.23) and HD before haemodialysis (0.11). During haemodialysis therapy, there was a considerable increase in GST activity (0.11 vs 0.3; p = 0.02) and decrease in SOD activity (from 3.41 to 2.27; p = 0.01). The highest GSH concentrations were obtained in CKD3–5 and differ significantly from HD (4.12 vs 2.01; p = 0.02). Conclusions The type of treatment, age and duration of renal replacement therapy determined significant changes in platelet antioxidative enzymes activities and concentration of GSH, which may enhance the thrombotic complications. PD is associated with lower platelet oxidative stress.
    No preview · Article · Jan 2016 · International Urology and Nephrology
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    ABSTRACT: Purpose To compare the characteristics of primary tumors, sites distribution of metastases and the metastasis-free interval (MFI) between metastatic upper tract urothelial carcinoma (UTUC) and urothelial bladder cancer (UBC), and evaluate the clinicopathological factors associated with MFI. Methods We retrospectively reviewed 153 metastatic urothelial carcinoma patients consecutively registered at our hospital from 1997 to 2015, including 71 UTUC and 82 UBC, with a median follow-up of 18.3 months. MFI indicators were assessed by univariate and multivariate logistic regression analysis. Results There were significant differences in median age at metastatic disease (p = 0.016), gender (p = 0.018), primary tumor size (p = 0.003), growth pattern (p < 0.001), grade (p < 0.001) and stage (p < 0.001) between metastatic UTUC and UBC. The median MFI of UTUC was dramatically shorter than that of UBC (6.1 vs. 17.4 months, p < 0.001). Univariate analysis revealed pathological stage was the only factor associated with the MFI of UTUC. Multivariate analysis showed that primary tumor grade was an independent inferior predictor for the MFI of UBC (HR 6.384, 95 % CI 3.21–12.69, p < 0.001), while recurrence was an independent favorable factor for the MFI of UBC (HR 0.384, 95 % CI 0.18–0.82, p = 0.014). Conclusions Compared to metastatic UBC, the primary tumors of metastatic UTUC were more invasive and the MFI was significantly shorter. Pathological stage was the only factor associated with the MFI in UTUC, while primary tumor grade and recurrence were independent factors for the MFI of UBC.
    No preview · Article · Jan 2016 · International Urology and Nephrology