Purpose:To assess the public hospitalization rate due to stone disease in a large developing nation for a 15-year period and its association with socio-demographic data.Materials and Methods:A retrospective database analysis of hospitalization rates in the Brazilian public health system was performed, searching for records with a diagnosis code of renal/ureteral calculi at admission between 1998–2012. Patients managed in an outpatient basis or private care were excluded. Socio-demographic data was attained and a temporal trend analysis was performed.Results:The number of stone-related hospitalizations increased from 15.7%, although the population-adjusted hospitalization rate remained constant in 0.04%. Male:female proportion among hospitalized patients was stable (49.3%:50.7% in 1998; 49.2%:50.8% in 2012), though there was a significant reduction in the prevalence of male hospitalizations (−3.8%;p=0.041). In 2012, 38% of hospitalized patients due to stone disease had 40–59 years-old. The ≥80 years-old strata showed the most significant decrease (−43.44%;p=0.022), followed by the 20–39 (−23.17%;p<0.001) and 0–19 years-old cohorts (−16.73%;p=0.012). Overall, the lowest relative hospitalization rates were found for yellow and indigenous individuals. The number of overweight/obese individuals increased significantly (+20.6%), accompanied by a +43.6% augment in the per capita income. A significant correlation was found only between income and obesity (R=0.64;p=0.017).Conclusions:The prevalence of stone disease requiring hospitalization in Brazil remains stable, with a balanced proportion between males and females. There is trend for decreased hospitalization rates of male, <40 and ≥80 years-old individuals. Obesity and income have a more pronounced correlation with each other than with stone disease.
INTRODUCTION:
Chronic testicular pain remains an important challenge for urologists. Currently, the treatment plan is primarily empirical, with the first approach consisting of clinical measures. However, some patients remain in pain despite a conservative treatment protocol and, for them, it is possible to perform a surgical procedure that involves severing the scrotal and spermatic branches of the genitofemoral and ilioinguinal nerve fibers.
METHODS:
In our institution, 60 patients were evaluated and treated for idiopathic chronic testicular pain between January 2003 and July 2007. Priority was give to clinical treatment, which evolved from simple to more complex measures. Microsurgical treatment was performed on those who experienced no considerable pain relief (10 individuals in our study).
RESULTS:
Over a twenty-four-month follow-up period, 70% of patients showed complete remission and 20% exhibited partial relief from pain.
INTRODUCTION AND OBJECTIVES: To compare the rate of upper tract imaging abnormalities between recurrent UTI (RUTI) due to bacterial persistence or reinfection.METHODS: Following IRB approval, a prospectively maintained database of women with documented RUTIs (¼ 3 UTI/year) and extensive trigonitis was reviewed for demographic data (race, gravidity, parity, diabetes, immunosuppression, sexual activity), urine culture findings, and radiology-interpreted upper tract imaging study (renal ultrasound (US), CT scan, IVP) findings. Patients with irretrievable images, absent or incomplete urine culture results for review, no imaging study performed, an obvious source for RUTI (intermittent catheterization, indwelling catheter, > stage 2 anterior prolapse, neurogenic bladder), or history of pyelonephritis were excluded.1 RESULTS: From 2006 to 2014, 116 of 289 women with RUTIs met inclusion criteria. Mean age was 65.0AE14.4 with 95% being Caucasian and 81% post-menopausal. Nearly one-third were sexually active and none has prolapse >stage 2. Forty-one percent (48/116) had persistent and 59% (68/116) had reinfection RUTI. Imaging studies included US alone (52), CT alone (26), US and CT (31), and IVP with US/CT (7). Of total imaging findings (N¼58 in 55 women), 57/58 (98%) were noncontributory. All imaging findings were organized according to the urine culture findings (bacterial persistence or reinfection RUTI) (Table 1). One case (0.9%) of mild hydronephrosis was noted in the persistent RUTI group but not related to any clinical parameters. Escherichia coli was the dominant bacteria in both persistent (71%) and reinfection (47%) RUTI in most recently reported urine cultures.CONCLUSIONS: This study reaffirms that upper tract imaging is not indicated for RUTI secondary to reinfection,2 but also not for RUTI due to bacterial persistence, thus questioning the routine practice of upper tract studies in Caucasian post-menopausal women with RUTI.
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