Recent scoring systems predicting stone-free status after retrograde intrarenal surgery; a systematic review and meta-analysis

Introduction Several scoring systems and nomograms have been developed to predict the success of retrograde intrarenal surgery. But no meta-analysis for the performance of scoring systems has yet been performed. The aim of this study was to compare predictive ability of recent scoring systems for stone-free rate of retrograde intrarenal surgery. Materials and methods PubMed and Web of Science databases were searched systematically between April and May 2021. The scoring systems which were validated externally or studied at least by two different researcher groups were selected for further analysis. Of 59 records, 14 studies met the inclusion criteria (n = 4137). Area under curve (AUC) values of selected scoring systems were pooled in random or fixed effects. Thertest was used to quantify heterogeneity. Results Eight, 5, 8, 4 and 3 studies included in meta-analyses for the modified Seoul National University Renal Stone Complexity Score (S-ReSC), R.I.R.S., Resorlu-Unsal Score (RUS), S.T.O.N.E., and Ito's Nomogram, respectively. We found pooled AUC values 0.709 (95% CI 0.670-0.748), 0.704 (95% CI 0.668-0.739), 0.669 (95% CI 0.646 to 0.692), and 0.771 (95% CI 0.724 to 0.818), for first four of them, respectively. Heterogeneity was very high to pool AUC values for Ito's nomogram. Conclusions Although S.T.O.N.E. score showed higer pooled AUC value, this systematic review and meta-analysis has not revealed superiority of any scoring system. High heterogeneity between studies and dependencies between scoring systems make it difficult to design a comparative statistical model to generalize the findings. Also, limitations aside, neither scoring system has demonstrated good predictive/discriminative performance

Üreter taşı hastalarının kontrastsız spiral tomografi ile değerlendirilmesi

The aim of this study is to evaluate the patients that have 4-10 mm diameter ureteralstones detected during NCCT (helical noncontrast computed tomography) evaluation, and toshow the differences and similarities between the patients that have spontaneous stonepassage and the patients that need intervention.For this purpose, we evaluated 34 patients attended to Urology department ofPamukkale University Medical Hospital that have 4-10 mm diameter ureteral stone duringthe period December 2004- June 2005. We searched for the seconder findings caused by thestone, that can be detected with NCCT and can be helpful to determine the stones havespontan passage.Besides the axial diameter of the stone, we found that the cranio-caudal length and thevolume of the stone are important criterias for the spontan passage of the stone. In addition tothe size and localization of the stone, we found that the hydronephrosis degree, perinephricstranding and Tisue Rim Sign could have important roles in estimating the stone?sspontaneous passage. We found that little sized, distally localizated stones, and presence ofperinepric stranding, absence of hydronephrosis and Tisue Rim Sign are in favour ofspontaneous passage .As a result , we can detect the stones that don?t need surgical treatment by evaluatingthe ureteral stone and the secondary findings caused by the ureteral stone with NCCT inpatients that have renal colic caused by the ureteral stone.Bu çalışmanın amacı; KSBT incelemesinde 4-10 mm boyutlu taşı tespit edilenhastaları değerlendirmek, spontan taş pasajı olan hastalar ile müdahale gereken hastalararasındaki farkları ve benzerlikleri ortaya koymaktır.Bu amaçla; Aralık 2004- Haziran 2005 tarihleri arasında Pamukkale Üniversitesi TıpFakültesi Üroloji Anabilim Dalı'na başvuran, 4-10 mm çapında üreter taşı olan 34 hastaçalışmaya alındı. Spontan olarak düşebilecek taşları belirlemede yardımcı olabilecek, KSBTile belirlenebilen, üreter taşına bağlı olarak oluşan sekonder işaretler araştırıldı.Taşın aksial plandaki çapının yanı sıra, taşın kranio-kaudal uzunluğu ve taşın hacmininspontan pasaj için önemli kriterler olduğu bulundu. KSBT ile saptanabilen, taşın boyutu velokalizasyonuna ek olarak hidronefroz derecesi, perinefrik çizgilenme ve Tissue Rim Sign'ınspontan düşebilecek taşların tahmininde bize önemli yol göstereceği saptandı. Üretertaşlarının küçük boyutlu ve distalde olması, perinefrik çizgilenme varlığı, hidronefroz veTissue Rim Sign'ın olmaması spontan pasaj lehine olan bulgular olarak tespit edildi.Üreter taşına bağlı olarak renal kolikle başvuran hastalarda; KSBT ile üreter taşları veüreter taşına bağlı olarak oluşan sekonder işaretler değerlendirilerek müdahale gerekmeyeceküreter taşları belirlenebilir

Re: 'Association between exclusive maternal breastfeeding during the first 4 months of life and primary enuresis'

[No Abstract Available

Is it only a sleeping disorder or more? Restless legs syndrome and erectile function

Objective: Sexual dysfunction and restless legs syndrome (RLS) have similar pathophysiological properties. This study evaluated the presence of erectile dysfunction (ED) and premature ejaculation (PE) in patients with RLS. Materials and methods: Fifty patients in the RLS group and 50 in the control group were included in the study. The International Restless Legs Syndrome Study Group rating scale, the five-item International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool were used to define the RLS and erectile function of both the study and control groups. A stopwatch technique was used to evaluate the intravaginal ejaculatory latency time of patients in the study. Results: The mean age of patients in the RLS and control groups was 53.5 +/- 9.9 and 53.2 +/- 8.8 years, respectively (p = 0.527). None of the patients in either group had diabetes mellitus. There was no difference between the groups in terms of history of hypertension, body mass index and total testosterone level. There were 27 patients (54%) in the RLS group and 17 patients (34%) in the control group with PE (p = 0.008). There were 26 patients (52%) with ED in the RLS group and 17 (34%) in the control group (p = 0.069). The prevalence of moderate and severe ED was significantly higher in the RLS group (p = 0.045). Conclusions: PE was more prevalent in RLS than in control patients. On the other hand, the rate of ED did not differ between the groups. In addition to receiving a neurological evaluation, RLS patients must be evaluated for sexual function

The effectiveness of biofeedback therapy in children with monosymptomatic enuresis resistant to desmopressin treatment

Objective: To investigate the effect of biofeedback therapy on children with desmopressin-resistant primary monosymptomatic enuresis (MsE). Material and methods: The study comprised both retrospective and prospective sections. A total of 262 medical files of patients who were diagnosed as enuresis between November 2012 and January 2015 were retrospectively screened. Patients with neuropathic bladder, daytime voiding problems, anatomical pathology and enuresis-related diseases were excluded from the study. The demographic data and family characteristics of 29 children with desmopressin-resistant primary MsE were recorded. After biofeedback treatment patients whose frequency of enuretic episodes decrease by more than 50% were included in the successful biofeedback treatment group (SBTG), while other patients were categorized in the unsuccessful biofeedback treatment group (USGBT). The outcomes of uroflowmetry, voided volume, postvoiding residue (PVR) and total bladder volume/age-adjusted normal bladder capacity (TBV/NBC) were recorded before and at the sixth month of the treatment. Results: The mean age of 29 patients included in the study was 9.14 +/- 3.07 (6-15) years. Of patients, 16 were male (55.2%) and 13 were female (44.8%). Before biofeedback treatment the frequency of enuresis was 25.1 +/- 5.76 days/month, while after treatment this was calculated as 8.52 +/- 10.07 days/month. After treatment 8 patients (28.6%) achieved complete dryness. Twenty patients (69%), benefited from biofeedback (SBTG), while there were 9 patients (31%) in the USBTG group. There was no significant difference between the SBTG and USBTG groups in terms of age, body mass index and sex. The average bladder capacity of the patients increased from 215 mL to 257 mL after biofeedback treatment (p<0.001). The TBV/NBC value before treatment was 0.66, while after treatment it was 0.77 (p<0.001). There was a statistically significant difference between the SBTG and USBTG groups in terms of presence of MsE in mother, and both parents (p=0.001, p=0.016, respectively). Conclusion: Biofeedback therapy is a safe, simple, and minimally invasive treatment modality in children with MsE resistant to desmopressin treatment. This treatment, which was found to increase total bladder capacity, may be recommended for children with MsE when conventional desmopressin treatment fails

The effectiveness of biofeedback therapy in children with monosymptomatic enuresis resistant to desmopressin treatment

OBJECTIVE: To investigate the effect of biofeedback therapy on children with desmopressin- resistant primary monosymptomatic enuresis (MsE). MATERIAL AND METHODS: The study comprised both retrospective and prospective sections. A total of 262 medical files of patients who were diagnosed as enuresis between November 2012 and January 2015 were retrospectively screened. Patients with neuropathic bladder, daytime voiding problems, anatomical pathology and enuresis-related diseases were excluded from the study. The demographic data and family characteristics of 29 children with desmopressin- resistantprimary MsE were recorded. After biofeedback treatment patients whose frequency of enuretic episodes decrease by more than 50% were included in the successful biofeedback treatment group (SBTG), while other patients were categorized in the unsuccessful biofeedback treatment group (USGBT). The outcomes of uroflowmetry, voided volume, postvoiding residue (PVR) and total bladder volume/age-adjusted normal bladder capacity (TBV/NBC) were recorded before and at the sixth month of the treatment. RESULTS: The mean age of 29 patients included in the study was 9.14±3.07 (6–15) years. Of patients, 16 were male (55.2%) and 13 were female (44.8%). Before biofeedback treatment the frequency of enuresis was 25.1±5.76 days/month, while after treatment this was calculated as 8.52±10.07 days/month. After treatment 8 patients (28.6%) achieved complete dryness. Twenty patients (69%), benefited from biofeedback (SBTG), while there were 9 patients (31%) in the USBTG group. There was no significant difference between the SBTG and USBTG groups in terms of age, body mass index and sex. The average bladder capacity of the patients increased from 215 mL to 257 mL after biofeedback treatment (p<0.001). The TBV/NBC value before treatment was 0.66, while after treatment it was 0.77 (p<0.001). There was a statistically significant difference between the SBTG and USBTG groups in terms of presence of MsE in mother, and both parents (p=0.001, p=0.016, respectively). CONCLUSION: Biofeedback therapy is a safe, simple, and minimally invasive treatment modality in children with MsE resistant to desmopressin treatment. This treatment, which was found to increase total bladder capacity, may be recommended for children with MsE when conventional desmopressin treatment fails

Selim prostat hiperplazili olgularda ultrasonografi yardımıyla ölçülen mesane ağırlığının infravezikal obstrüksiyonu saptamadaki yeri

Çalışmamızda, infravezikal obstrüksiyonun tanısında noninvaziv bir yöntem olarak önerilen “ultrasonografi yardımıyla hesaplanan mesane ağırlığı”nın, klasik değerlendirme kriterleri olan semptomlar, serbest Qmax, rezidüel idrar ile prostat hacmi ve standart invaziv yöntem olarak bilinen “basınç–akım çalışmaları” ile karşılaştırmalı olarak değerlendirmeyi amaçladık. Çalışmaya alt üriner sistem yakınmasıyla polikliniğimize başvuran 49 erkek hasta alındı. Hastalarda fizik muayene, IPSS, tam idrar tahlili, PSA, böbrek fonksiyonların değerlendirilmesi, üroflowmetri, ultrasonografi ile mesane ağırlığı hesaplandıktan sonra standart sistometri ve sonrasında basınç akım çalışması yapıldı.Ürodinamik olarak obstrüktif ve nonobstrüktif olan hastaların mesane ağırlıkları birbiriyle karşılaştırıldığında aralarında istatistiksel bir farklılık vardı. Ultrasonografi yardımıyla hesaplanan mesane ağırlığı ile en büyük korelasyon sırasıyla A-G sayısı, Schafer derecesi, Pdet Qmax, detrüsör kontraksiyon gücü ve kontraktilite arasında bulundu. Mesane ağırlığı cut-off değeri 35 gr olarak alındığında sensitivitesi (duyarlılık) %93, spesifitesi (özgüllük) %55, pozitif prediktif değeri % 78, negatif prediktif değer %83 olarak bulundu. Bu sonuçlar ışığında ultrasonografi yardımıyla hesaplanan mesane ağırlığı noninvaziv bir yöntem olup infravezikal obstrüksiyonun değerlendirilmesinde değerli bir tanı yöntemi olabilir

Denizli ilinde ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansı ve risk faktörleri

Özet Amaç: Bu çalışmada Denizli ilinde ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansını ve bu durumla ilişkili risk faktörlerini araştırmak amaçlanmıştır. Gereç ve yöntem: Çalışma için Denizli İl Milli Eğitim Müdürlüğünün 30/03/2005 tarihli ve 8820 sayılı onayı alınmıştır. Denizli il merkezinden 8, ilçelerinden 6 ilköğretim okulu randomize olarak seçildi. Ailenin sosyodemografik özelliklerini, çocuğun tıbbi özgeçmişini içeren sorgulama formu ile beraber işeme alışkanlıklarını sorgulayan İşeme Bozuklukları Semptom Skoru Anketi yaşları 7-14 arasında olan 2353 ilköğretim öğrencisi çocuğun ebeveynleri tarafından dolduruldu. Bilinen nörolojik ya da ürolojik hastalık öyküsü olan çocuklar araştırma dışı bırakıldı. İstatistiksel yöntemler olarak tanımlayıcı, analitik ve lojistik regresyon analizi kullanıldı. Bulgular: Araştırmaya katılım hızı %91,9du (2164 kişi). Nokturnal enürezis toplam prevalansı %19,2 olmakla birlikte bu oran ilerleyen yaşla beraber düşme eğilimindeydi. Çocuğun okul başarısı, ailenin sosyoekonomik seviyesi, ebeveynlerin eğitim düzeyi, babanın mesleği, pozitif aile öyküsü, gündüz idrar kaçırma, geçirilmiş idrar yolu enfeksiyonu öyküsü, kabızlık ve disfonksiyonel işeme semptomları nokturnal enürezis ile istatistiksel olarak anlamlı ilişki göstermekteydi (p0.05). Erkek cinsiyet, erken yaş, annenin düşük eğitim seviyesi ve pozitif aile öyküsü nokturnal enürezis için bağımsız risk faktörlerini oluşturmaktaydı. Sonuç: Nokturnal enürezis, ilköğretim çağındaki çocuklarda sık görülen önemli bir sağlık sorunudur. Enüretik çocukların tedavileri planlanırken bu durumla ilişkili risk faktörleri göz önünde bulundurulmalıdır. Bu çalışma, Türkçe validasyonu yapılmış bir semptom skoru ile, Türkiyedeki ilköğretim çağındaki çocuklarda nokturnal enürezis prevalansını değerlendiren ilk kesitsel çalışmadır

The time of spontaneous resolution of monosymptomatic nocturnal enuresis (MNE) is familial

Sarikaya, Selcuk/0000-0001-6426-1398; Aykac, Aykut/0000-0001-7078-0135WOS: 000355885000014PubMed: 25661820Purpose: To investigate whether or not the age of spontaneous resolution of monosymptomatic nocturnal enuresis (MNE) was familial. Patients and Methods: A questionnaire was administered to more than 1,500 people, and 100 appropriate participants were identified from four referral hospitals. We included the participants who had MNE and whose parents also had MNE with spontaneous resolution. Then the association between the spontaneous resolution time of MNE in parents and that in their children was investigated. Results:The mean ages of spontaneous resolution were 10.7 (10-30 years), 9.4 (6-17 years) and 10.9 (6-18 years) in participants, their mothers and their fathers, respectively. According to the statistical analysis, there was a positive correlation between participants and both their mothers and fathers (p 0.05). Conclusion: As a conclusion, the age of spontaneous resolution of MNE is familial. Although the exact reasons of spontaneous resolution still remain a mystery; further genetic investigations may be able to resolve this mystery. (C) 2015 S. Karger AG, Base

External validation of Modified Seoul National University Renal Stone Complexity Score to predict outcome and complications of retrograde intrarenal surgery: a RIRSearch Group study

Introduction: The Modified Seoul National University Renal Stone Complexity Score (S-ReSC) is a simple model based solely on stone location regardless of stone burden. The aims of this study were to validate S-ReSC for outcomes and complications of retrograde intrarenal surgery (RIRS) and to evaluate its predictive power against the stone burden. Material and methods: Data of 1007 patients with kidney stones who had undergone RIRS were collected from our RIRSearch database. Linear-by-linear association, logistic regression, ANOVA/post hoc analysis and ROC curve (with Hanley and McNeil’s test) were used for evaluation. The main outcomes were stone-free status and complications of RIRS. Results: The overall stone-free rate was 76.8% (773/1007). Higher S-ReSC scores were related to lower stone-free rates and higher total, perioperative and postoperative complication rates (p<.001, p<.001, p=.008 and p<.001, respectively). S-ReSC score (p=.02) and stone burden (p<.001) were independent predictors of stone-free status. But stone burden (AUC = 0.718) had a more powerful discriminating ability than the S-ReSC score (AUC = 0.618). Conclusions: The S-ReSC score is able to predict not only stone-free status but also complications of RIRS. Although this location-only based scoring system has a fair discriminative ability, stone burden is a more powerful predictor of stone-free status after RIRS. An ideal scoring system aiming to predict outcomes of RIRS must include stone burden as a parameter. © 2022 Society of Medical Innovation and Technology