In compliant patients desmopressin lyophilisate and enuretic alarm provided equivalent success at the end of treatment and after extended followup. Alarm therapy had a high rate of early withdrawal from therapy and consequently lower rates of success on intention to treat analyses. Severe enuresis (more than 5 wet nights weekly) is an important predictive factor for cure after first-line treatment.
Objective: In this study, we evaluated the predictive value of R.E.N.A.L. Nephrometry Score (RNS), a system to standardize the renal tumors according to size, location, and depth, for surgical outcomes of robotic partial nephrectomy.
Materials and methods:Twenty-nine cases who underwent robotic partial nephrectomy in two institutions between 2008 and 2010 were included in the study. RNS was calculated from preoperative computed tomography and/or magnetic resonance images by considering tumor size, exophytic/endophytic properties, distance to the collecting system, anterior or posterior location, and distance to the polar lines. Total RNS less than 7 was considered as low and ≥7 as high complexity lesions. Operative time, estimated blood loss, warm ischemia time, and positive surgical margin were analyzed.Results: There were 14 low complexity tumors with a mean RNS of 5 and 15 high complexity tumors with a mean RNS of 7.9. The mean warm ischemia time was 18.6 min in low complexity tumors and 29.8 min in high complexity tumors (p=0.01). There was a strong positive correlation between RNS and warm ischemia time (r=0.57, p=0.002). The difference between low and high complexity tumors was not statistically significant in terms of operative time, estimated blood loss, length of hospital stay, and positive surgical margins.
Conclusion:Preoperative RNS can predict the warm ischemia time in robotic assisted partial nephrectomy. High RNS results in longer warm ischemia time. RNS may be useful in determining surgical approach to preserve renal function in high-risk patients.
The objective of this study is to evaluate the average radiation exposure in children with renal stones before SWL treatment. Mean radiation exposure values were evaluated in 110 children before SWL treatment. While some children referred to the emergency department (ED) with colic pain, remaining cases referred to outpatient department (OD). Although low-dose NCCT was performed in ED; KUB and abdominal sonography were first performed in other cases referring to OD where CT has been applied if needed. The type of imaging modality used and the mean radiation exposure were evaluated and comparatively evaluated with respect to the department referred, patient as well as stone related parameters. 49 children referred to ED and 61 children referred to OD. Mean stone size was 7.24 ± 0.29 mm. 62 cases had opaque stones. Mean radiation exposure values were higher in children referring to ED than the other cases. However, there was no significant difference between the two groups regarding the mean number of KUB, IVU and sonographic evaluation performed prior to SWL management. There was a significant correlation between the mean radiation exposure and the stone size as well degree of hydonephrosis in a positive manner. Although a significant correlation was present between the mean radiation exposure and stone opacity in a negative manner; there was no correlation with respect to the other related parameters. Unnecessary use of X-ray based imaging modalities in children could be effectively avoided using KUB and US combination beginning from the diagnostic phase of stone disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.