Introduction and hypothesis
The objective was to evaluate the safety and efficacy of robotic-assisted sacrocolpo(hystero)pexy in elderly patients with symptomatic apical pelvic organ prolapse and to ...compare the outcomes of open abdominal and robotic-assisted sacrocolpo(hystero)pexy in geriatric patients.
Methods
Elderly patients (≥65 years of age) who underwent open abdominal or robotic-assisted sacrocolpo(hystero)pexy for treatment of symptomatic grade 3 and 4 apical pelvic organ prolapse between November 2015 and May 2019 were evaluated retrospectively. The success rates of the procedures, the surgical outcomes, and the perioperative adverse events of both groups were compared. Perioperative adverse events were categorized according to the Clavien–Dindo classification.
Results
Forty-four patients underwent open abdominal sacrocolpo(hystero)pexy and 30 patients underwent robotic-assisted sacrocolpo(hystero)pexy. The mean age in the open abdominal sacrocolpo(hystero)pexy group was 68.4 ± 3.4 years and in the robotic-assisted sacrocolpo(hystero)pexy group it was 69.7 ± 4.1 years. The success rates in the open abdominal sacrocolpo(hystero)pexy and robotic-assisted sacrocolpo(hystero)pexy groups were 59% and 57% at median follow-up time of 28 months and 24 months respectively. Although the mean dosage of the analgesic (10.1 mg/24 h) and the mean length of hospital stay (2.1 days) were significantly lower and shorter for the robotic-assisted sacrocolpopexy group, the mean duration of operation was considerably longer (141.2 min). The rate of grade 2 or higher complications for open abdominal sacrocolpopexy was 16% (7 out of 44) and for robotic-assisted sacrocolpopexy it was 17% (5 out of 30).
Conclusions
Anatomical outcomes and adverse events are similar in elderly patients undergoing open sacrocolpo(hystero)pexy and robotic-assisted sacrocolpo(hystero)pexy.
Circumcision is a surgical operation that is frequently performed throughout the world due to religious, cultural, and medical reasons. The best age for circumcision is still debatable, with ...different procedures depending on geography, culture, and surgeon preference.
This study aims to immunohistochemical examination using S100 staining and histologically evaluate the neurovascular structures in foreskin samples obtained from children aged 0–3 years and 6–11 years. The goal is to provide guidance in determining an appropriate age for circumcision based on these data.
Concerns regarding potential effects on glans sensitivity and sexual function led to the investigation and comparison of sensory innervation in the foreskin of children aged 0–3 and 6–11 years, a total 54 samples, divided into pre-phallic (0–3 years) and post-phallic (6–11 years) groups, were examined. The mean number of Meissner and Pacinian corpuscles, Ruffini endings, free nerve endings and the diameters of arteries were investigated.
Our findings show that compared to the 6–11 age group, the 0–3 age group had considerably lower sensory innervation in terms of, Meissner's corpuscles, Pacinian corpuscles, Ruffini endings and free nerve endings. Additionally, the diameter of arteries was noticeably smaller in the 0–3 age group.
In conclusion, this study supports the idea that circumcision performed in the early years of life may be associated with less adverse effects on neurovascular structures.Summary tableComparison of the outcome of neurovascular structures in the foreskin at two different age groups.Summary tableThe samples characteristicsAge Groupsp value0-3 ages (n = 27)6-11 ages (n = 27)-Mean value of Pacinian corpuscles1.33 (1-2)2.74 (1–5)p < 0.0001-Mean value of Meissner corpuscles3.814.78 (2–6)8.9610.3 (6–12)p < 0.0001-Mean value of Ruffini endings10.65 (6–15)18.58 (11–28)p < 0.0001-Mean value of free nerve endings5.44 (3–9)11.19 (8–14)p < 0.0001-Mean value of artery diameters (μm)56.9 (24–214)133.5 (469–43)p < 0.0001
This study investigated the effect of the discontinuation of vitamin D supplementation on kidney stone formation in children under 2 years of age.
This study involved a retrospective analysis of two ...patient groups. The first group comprised postoperative patients who were stone-free, while the second group consisted of asymptomatic patients with kidney stones. The patients who discontinued vitamin D supplementation and those who continued were compared in terms of stone formation and stone size progression. The data collected included patient characteristics, stone size measurements, and laboratory results.
The findings showed that the discontinuation of vitamin D supplementation was not associated with kidney stone formation or the progression of stone size in either group. For patients who were stone-free on ultrasonography 1 month after the operation, according to the 12-month ultrasonography evaluation, in the group that discontinued vitamin D, 42 (78%) patients had no stones, 6 (11%) patients had stones larger than 3 mm, and 6 (11%) patients had microlithiasis. However, in the group that continued vitamin D, 49 (72%) patients were stone-free, 10 (15%) patients had stones larger than 3 mm, and 9 (13%) patients had microlithiasis. There was no difference between the groups in terms of stone status at 12 months (p = 0.76). For patients with asymptomatic kidney stones, the initial stone sizes were similar between the groups (p = 0.74). During the 6th month of ultrasound, the changes in stone size were 1.76 ± 1.81 mm and 1.79 ± 1.75 mm for the two groups, respectively (p = 0.9). During the 12-month ultrasound measurement, the changes in stone size were 1.98 ± 2.93 mm and 2.60 ± 2.48 mm for the two groups, respectively (p = 0.09).
We believe that more research is needed to make definitive recommendations regarding vitamin D prophylaxis in infants with kidney stones. Although the first objective of our study is not conclusively proven with the current findings, we recommend continued vitamin D prophylaxis in infants with urolithiasis.Summary tablePatient demographic characteristics and ultrasonography results at 12 months.Summary table(n)Stone-free After Surgery (122)Vitamin D Discontinuation Group (54)Vitamin D Group (68)Age (months mean ± SD)13.19 ± 4.0811.57 ± 4.59GenderBoy 39 (72%)Girl 15 (28%)Boy 47 (69%)Girl 21 (31%)12th month ultrasound imaging42 (78%)Stone-free6 (11%)Stone larger than 3 mm6 (11%) microlithiasis49 (72%)Stone-free10 (15%)Stone larger than 3 mm9 (13%) microlithiasisAsymptomatic Patients (228)Vitamin D Discontinuation Group (101)Vitamin D Group (127)Age (months mean ± SD)11.89 ± 4.2411.54 ± 4.52GenderBoy 71 (70%)Girl 30 (30%)Boy 83 (65%)Girl 44 (35%)12th month ultrasound imaging1.98 ± 2.93 mm (stone size change)2.60 ± 2.48 mm (stone size change)
Objective We aimed to evaluate the efficacy and safety of mirabegron monotherapy in very older (>80 years) women with overactive bladder (OAB) who were discontinued anticholinergic drugs by the other ...departments. Material and methods The present retrospective study evaluated very older (>80 years) women with OAB who were discontinued anticholinergic drugs by the other departments between May 2018 and January 2021. Efficacy assessments were performed using Overactive Bladder-Validated Eight-Question (OAB-V8) scores before and after mirabegron monotherapy (12 weeks). Safety was evaluated based on adverse events (hypertension, nasopharyngitis, and urinary tract infection), electrocardiography, hypertension measure, uroflowmetry (UFM), and post-voiding. Patient data including demographic characteristics, diagnoses, values before and after mirabegron monotherapy, and adverse events were evaluated. Results A total of 42 very older (>80 years) women with OAB who used mirabegron monotherapy (50 mg per day) were included in this study. Frequency, nocturia, urgency, and total OAB-V8 scores were significantly lower after mirabegron monotherapy than before mirabegron monotherapy (p < 0.05, p < 0.05, p < 0.05, and p < 0.05, respectively). There was no significant difference between systolic-diastolic blood pressure and heart rate before and after mirabegron monotherapy treatment. Conclusion Mirabegron monotherapy is an effective and safe therapy in very older (>80 years) women with OAB.
To evaluate the consistency of the urinalysis results performed with the ORUBA INALYS device, (Oruba, Ankara, Turkey) which can perform urinalysis and uroflowmetry simultaneously, with the analysis ...results performed with the SYSMEX UC3500 automated urine chemistry analyzer (Sysmex, Kobe, Japan).
In this prospective study, urinalysis of 50 male patients with lower urinary tract symptoms were evaluated. The parameters of glucose, pH, urobilinogen, bilirubin and ketone, leukocyte, protein, and blood were measured with ORUBA INALYS, and the same urine specimens collected from ORUBA INALYS by a special setup were sent to the laboratory for urinalysis with Sysmex UC-3500 to assess the concordance of the results between two devices.
Urinalysis results in ORUBA INALYS device in terms of glucose, pH, urobilinogen, bilirubin, and ketone parameters were shown to achieve 100% agreement within ±1 category with SYSMEX UC3500 whereas these values were slightly decreased to 88%, 96%, and 98% for leukocyte, protein, and blood, respectively. Among the calculable weighted kappa values for the test parameters, the highest value was found for glucose and followed by blood, pH, leukocyte, and specific gravity respectively.
Significant consistency of the urinalysis results obtained from ORUBA INALYS with those obtained from device SYSMEX UC3500 shows the reliability of the urinalysis performed with ORUBA INALYS. ORUBA INALYS could minimize costs and workload, provide time save and reduce plastic waste.
PDF
