The increase in the retrograde intrarenal surgery (RIRS) has been accompanied by the increase in complications. This study identified the factors that affected the severity of the complications using the modified Clavien classification system (MCCS). Three hundred and twenty-two consecutive RIRS performed by a single surgeon were analyzed. Data collection included demographics, clinical parameters, and perioperative and postoperative complications. The rate of adverse events for each of the Clavien grades was calculated, and statistical comparisons were made. The impact of each of the factors on the severity of the complications, based on the MCCS, was investigated using the univariate and multivariate analyses. The total complication rate was 26.1% (MCCS: I = 67.7%, II = 22.7%, IIIb = 7.2%, IVb = 2.4%). On the univariate analyses, the following factors affected complication: positive preoperative urine culture, operative time, irrigation rate, and stone burden. Multivariate logistic regression analysis demonstrated that positive preoperative urine culture, irrigation rate, and operative time were the significant factors affecting the complications. Most of the RIRS complications were in the lower Clavien grades and major complications were uncommon. Positive preoperative urine culture, irrigation rate, and operative time were the factors that affected complications.
64-MDCT urethrography is a promising tool as an alternative to traditional radiographic methods for defining male urethral strictures. It has the advantage of examining patients only in one position, without distortion, and by generating three-dimensional images; it can accurately measure the stricture length, aid in the diagnosis of some associated pathological conditions, such as urethrorectal fistula, and does not expose the physician to radiation.
LIM kinases modulate multiple aspects of cancer development, including cell proliferation and survival. As the mechanisms of LIMK-associated tumorigenesis are still unclear, we analyzed the tumorigenic functions of LIM kinase 2 (LIMK2) in human bladder cancer (BC) and explored whether the newly identified LIMK2 3´-UTR SNP rs2073859 (G-to-A allele) is correlated with clinical features. Expression levels of LIMK2 in 38 human BC tissues and eight cell lines were examined using quantitative real-time PCR and immunohistochemistry. LIMK2 was overexpressed in most BC tissues (27/38, 71%) and BC-derived cell lines (6/8), and was more frequently overexpessed in high-grade than low-grade BC (80% vs. 47%). The effects of LIMK2 on BC cell proliferation, survival and migration, were studied by overexpression and RNA interference approaches in vitro and in vivo. LIMK2 overexpression promoted proliferation, migration and invasion of BC cells, while LIMK2 depletion inhibited cell invasion and viability and induced growth arrest in vitro and in vivo. PCR-Restriction Fragment Length Polymorphism (RFLP) was used to genotype LIMK2 SNP rs2073859 and multivariate logistic regression applied to assess the relationship between allele frequency and clinical features in 139 BC patients. Functional analyses localized SNP rs2073859 within the microRNA-135a seed-binding region and revealed significantly lower LIMK2 G allele expression. The frequency of A genotypes (AG + AA) was higher in the BC group than normal controls and correlated with risks of high-grade and high-stage BC. In conclusion, LIMK2 may function as an oncogene in human BC, while allele-specific regulation by microRNA-135a may influence disease risk.
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