Detrusor wall thickness compared to other non-invasive methods in diagnosing men with bladder outlet obstruction: A prospective controlled study

AbstractIntroductionThe current study aims to compare the diagnostic accuracy of detrusor wall thickness to other noninvasive, tools, using pressure flow studies as a reference, in the assessment of bladder outlet, obstruction among men presenting with lower urinary tract symptoms.Patients and MethodsMen aged 50 or older presenting with lower urinary tract symptoms were evaluated for bladder outlet, obstruction using detrusor wall thickness (measured by a transabdominal 7.5MHz ultrasound) and, other non-invasive tools (namely uroflowmetry, post-void residual, and prostate volume), and the results were compared to pressure flow study.ResultsDetrusor wall thickness ranged from 0.7mm to 7mm (mean±SD of 2.39±1.64mm), and 21 patients, were classified as obstructed (thickness≥2mm). Based on pressure flow study 23 patients had, bladder outlet obstruction. Detrusor wall thickness had the highest accuracy (88.0%), the highest, specificity (92.6%) and the highest positive predictive value (90.5%) among the non-invasive tests.ConclusionsDetrusor wall thickness measurement can be used to diagnose and quantify bladder outlet obstruction, non-invasively in men with lower urinary tract symptoms, with an accuracy approaching that of the standard pressure flow studies

Numerical Solution to a One-Dimensional, Nonlinear Problem of Thermoelasticity with Volume Force and Heat Supply in a Slab

A numerical solution is presented for a one-dimensional, nonlinear boundary-value problem of thermoelasticity with variable volume force and heat supply in a slab. One surface of the body is subjected to a given periodic displacement and Robin thermal condition, while the other is kept fixed and at zero temperature. Other conditions may be equally treated as well. The volume force and bulk heating simulate the effect of a beam of hot particles infiltrating the medium. The present study is a continuation of previous work by the same authors for the half-space [1]. The presented Figures display the process of propagation and reflection of the coupled nonlinear thermoelastic waves in the slab. They also show the effects of volume force and heat supply on the distributions of the mechanical displacements and temperature inside the medium. The propagation of beats provides evidence for sufficiently large time values

Retroperitoneal lymph node dissection (RPLND) for malignant phenotype Leydig cell tumours of the testis: a 10-year experience.

Retroperitoneal lymph node dissection (RPLND) is a prognostic, palliative, and potentially therapeutic procedure for patients with malignant phenotype Leydig cell tumours of the testis. We reviewed the records of patients diagnosed with malignant phenotype Leydig cell tumours of the testis treated by RPLND. Modified template dissection was performed in all cases with extra-template excision of tumour mass in Stage II disease. Routine clinico-radiological follow-up was performed. Six open RPLNDs (1 re-do procedure) were performed on 5 patients diagnosed with Stage I (n = 3) and Stage II (n = 2) malignant phenotype Leydig cell tumour of the testis. Median age = 63 years (range = 55-72). Median peri-operative blood loss = 1500 ml (range = 500-1500 ml). Median operating time = 6 h (range = 4.5-6.5). Two patients with Stage II disease developed post-operative complications of acute kidney injury (n = 1) and pneumonia (n = 1). Median length of stay was 8 days (range = 6-11). RPLND specimens from patients with Stage I were tumour-free, whilst patients with Stage II disease had evidence of metastatic tumour. At latest follow-up (median = 13 months, range = 7-22), no patient with Stage I disease had radiological evidence of recurrence, however the two patients with Stage II disease had died due to tumour recurrence at 13 months and 36 months. RPLND for malignant phenotype Leydig cell testicular tumours appears to be well tolerated. Despite surgery, overall outcomes for Stage II appear to be poor due to the disease phenotype. Larger prospective multi-centre studies are required to determine the definitive criteria for surgery in Stage I disease

Making the headlines: EU Immigration to the UK and the wave of new racism after Brexit

This chapter explores the immigration-related topics in the news media during the EU referendum campaign in the UK (April–June 2016) and after (July–September 2016). The chapter argues that attitudes anti-EU immigration are a wave of “new(s)” racism (van Dijk 2000) in the UK and EU immigration is frequently used as an umbrella term for Eastern European immigration being often mixed with non-EU immigration and the refugee crisis. The data shows that the prevalence of negative news stories has led to a distinctive immigration-narrative, confirming the claim of Hoffner and Cohen (2013) that members of minority groups are almost always associated with violent and threatening media content

Editorial: African Journal of Urology:Continuing progress

No Abstract

Conservative management of colonic injury during percutaneous nephrolithotomy

Objectives: Colonic injury is a rare but serious complication of percutaneous renal surgery. Its clinical course may be elusive and an awareness of the various presentations is of great importance. We describe how early diagnosis and a diligent conservative approach have resulted in a favorable outcome in our series. Patients and methods: From 2005 to 2015, 2150 percutaneous nephrolithotomy (PNL) procedures were performed in our center. Patients’ records were searched for the occurrence of colonic injury. Records were reviewed and we report on the preoperative data, the clinical presentation and the management approach in these cases. Results: Three patients (0.14%) were identified with colonic injury following PNL, the three injuries were in male patients with a median age of 36.6 (range 28–45 years). Two injuries were on the left side and one on the right. Two of our patients had a low BMI. The renal puncture was in the lower posterior calyx in two and in the middle calyx in one. The diagnosis was established postoperatively in all and confirmed using antegrade or retrograde pyelography. All patients were managed conservatively with a favorable outcome. Conclusion: An approach combining a high degree of suspicion for early diagnosis and a diligent conservative management results in a favorable outcome in patients with colonic injury during PNL