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1.
C. J. O’Boyle O. E. O’Sullivan H. Shabana M. Boyce B. A. O’Reilly 《Obesity surgery》2016,26(7):1471-1478
Background
Little is known regarding the effect of bariatric surgery on urinary incontinence.Methods
Between September 2008 and November 2014, 240 female patients underwent bariatric surgery.Results
The prevalence of urinary incontinence preoperatively was 45 % (108). Eighty-two (76 %) completed urinary function questionnaires pre-operatively and post-operatively. Fifty-seven (70 %) underwent laparoscopic gastric bypass, twenty-four (29 %) underwent sleeve gastrectomy and one underwent a banding procedure. Thirty-one (38 %) reported leaking on sneezing or coughing—stress urinary incontinence (SUI). Thirteen (16 %) complained of leaking before reaching the toilet—overactive bladder syndrome (OAB). The remaining thirty-eight (46 %) reported mixed symptoms. The mean pre-operative weight and BMI were 133 (18)?kg and 50 (SD?=?6.2)?kg/m2 respectively. The mean post-operative BMI drop was 16 (SD?=?5.2)?kg/m2. Preoperatively, 61 (75 %) reported moderate to very severe urinary incontinence compared to 30 (37 %) post-operatively (χ 2?=?3.24.67, p?=?0.050). Twenty-seven (33 %) patients reported complete resolution of their urinary incontinence. Fifty-one (62 %) patients required incontinence pads on a daily basis pre-operatively, compared to 35 (43 %) post-operatively (χ 2?=?22.211.6, p?=?0.00). The mean International Consultation on Incontinence Questionnaire- Urinary Incontinence short form (ICIQ-UI SF) score was 9.3 (SD?=?4.4) pre-operatively compared to 4.9 (SD?=?5.3) post-operatively (t?=?7.2, p?=?0.000). The improvement score post-operatively was 8 (SD?=?3). A significant difference in the ICIQ-UI SF was identified between OAB and SUI groups when adjusting for age, number of children, type of delivery and pre-op BMI (t?=?1.98, p?=?0.05).Conclusion
Bariatric surgery results in a clinically significant improvement in urinary incontinence. However, this is not proportional to pre-operative BMI, weight loss, age, parity and mode of delivery.2.
Chanil D. Ekanayake Arunasalam Pathmeswaran Rasika P. Herath H. Suharshi S. Perera Malitha Patabendige Prasantha S. Wijesinghe 《International urogynecology journal》2017,28(12):1849-1855
Introduction
The multifaceted nature of pelvic floor disorders means that a systematic evaluation is required for optimal treatment outcome. It is also generally acknowledged that a valid tool is necessary to objectively assess symptoms reported by affected women.Methods
The International Consultation on Incontinence Questionnaire—Vaginal Symptoms (ICIQ-VS) questionnaire was translated to Sinhala and Tamil and a validation study carried out among women attending gynecology clinics at North Colombo Teaching Hospital, Ragama, and the district general hospitals Mannar and Vavuniya.Results
Content validity was assessed by the level of missing answers, which was < 4% and 2% for each item in Sinhala and Tamil, respectively. Construct validity was assessed by the ability of the questionnaire to differentiate between patients and controls. Both differentiated patients from controls on vaginal symptoms score (VSS) (p?<?0.001), sexual symptoms score (SSS) (p?<?0.01), and quality of life (QoL) (p?<?0.001). There was a strong positive correlation between Pelvic Organ Prolapse Quantification (POP-Q) scores and VSS (Sinhala r s ?=?0.64, p?<?0.001, Tamil r s ?=?0.65, p?<?0.001), and QoL (Sinhala r s ?=?0.49, p?<?0.001, Tamil r s ?=?0.60, p?<?0.001). Internal consistency as assessed using Cronbach’s coefficient alpha: 0.78 (0.76–0.78) and 0.83 (0.80–0.84) in Sinhala and Tamil, respectively. Test–retest reliability was assessed by weighted kappa scores (Sinhala 0.58–0.88 and Tamil 0.76–0.90). Both questionnaires were sensitive to change and showed that VSS and QoL improved following surgery (Wilcoxon matched-pairs signed-rank test p?<?0.001).Conclusion
The validated Sinhala and Tamil translations of ICIQ-VS will be useful for assessing vaginal and sexual symptoms among women speaking Sinhala and Tamil.3.
Bhumy A. Davé Camaleigh Jaber Alix Leader-Cramer Nicole Higgins Margaret Mueller Christina Lewicky-Gaupp Kimberly Kenton 《International urogynecology journal》2016,27(9):1327-1332
Introduction and hypothesis
There is no consensus on the most appropriate type of anesthesia for placement of a midurethral sling. Our objective was to compare intra- and perioperative outcomes for this procedure performed under general anesthesia versus monitored anesthesia care.Methods
Retrospective cohort analysis of women undergoing outpatient placement of synthetic retropubic midurethral sling under general anesthesia (n?=?141) or monitored anesthesia care (n?=?84). Patients undergoing concomitant procedures were excluded. Primary outcome was operating room time. Secondary outcomes included surgical and recovery times, cost, discharge home with a catheter, and postoperative pain and/or nausea.Results
In the general anesthesia group, both operating room time (mean?±?SD, 67.6?±?13.3 min vs 56.9?±?11.8 min, p?<?0.001) and recovery room time (240.0?±?69.8 min vs 190.1?±?78.3 min, p?<?0.001) were longer, whereas there was no difference in surgical time (30.0?±?8.9 min vs 29.0?±?9.7 min, p?=?0.43). Cost was significantly higher in the general anesthesia group ($4,095?±?715 vs $3,877?±?777, p?=?0.03). There was no difference in rates of bladder perforation (6.4 % vs 11.9 %, p?=?0.33). Patients who underwent general anesthesia had higher rates of discharge with a catheter (27.0 % vs 15.8 %, p?=?0.04).Conclusion
Monitored anesthesia care may offer significant benefits over general anesthesia in women undergoing retropubic midurethral sling, including shorter operating room and recovery times, lower costs, and less voiding dysfunction in the immediate postoperative period.4.
Hong-xiang Lu Jian-hui Sun Da-lin Wen Juan Du Ling Zeng An-qiang Zhang Jian-xin Jiang 《World journal of emergency surgery : WJES》2018,13(1):52
Background
Previous study revealed that rs2232618 polymorphism (Phe436Leu) within LBP gene is a functional variant and associated with susceptibility of sepsis in traumatic patients. Our aim was to confirm the reported association by enlarging the population sample size and perform a meta-analysis to find additional evidence.Methods
Traumatic patients from Southwest (n?=?1296) and Southeast (n?=?445) of China were enrolled in our study. After genotyping, the relationship between rs2232618 and the risk of sepsis was analyzed. Furthermore, we proceeded with a comprehensive literature search and meta-analysis to determine whether the rs2232618 polymorphism conferred susceptibility to sepsis.Results
Significance correlation was observed between rs2232618 and risk of sepsis in Southwest patients (P?=?0.002 for the dominant model, P?=?0.006 for the recessive model). The association was confirmed in Southeast cohort (P?=?0.005 for the dominant model) and overall combined cohorts (P =?4.5?×?10?4, P?=?0.041 for the dominant and recessive model). Multiple logistical regression analyses suggested that rs2232618 polymorphism was related to higher risk of sepsis (OR?=?1.77, 95% CI?=?1.26–2.48, P?=?0.001 in Southwest patients; OR?=?2.11, 95% CI?=?1.24–3.58, P?=?0.006 in Southeast cohort; OR?=?1.54, 95% CI?=?1.34–2.08, P?=?0.006 in overall cohort). Furthermore, meta-analysis of four studies (including the present study) confirmed that rs2232618 within LBP increased the risk of sepsis (OR?=?1.75, P?<?0.001 for the dominant model; OR?=?6.08, P?=?0.003 for the recessive model; OR?=?2.72, P?<?0.001 for the allelic model).Conclusions
The results from our replication study and meta-analysis provided firm evidence that rs2232618T allele significantly increased the risk of sepsis.5.
Karin Glavind Jonna Bjørk Sabrina Kousgaard 《International urogynecology journal》2016,27(12):1825-1829
Introduction and hypothesis
The aim of this study was to investigate patient-reported goals after a tension-free vaginal tape operation for stress urinary incontinence and the correlation with postoperative incontinence.Methods
A prospective study involving 70 women was carried out. Preoperatively, patients completed the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) and stated three goals for the operation. A telephone interview was performed 3 months postoperatively.Results
A Visual Analogue Scale (VAS) score from zero to ten estimated the extent to which goals were achieved. Goals were divided into five groups: 1, symptoms; 2, quality of life (physical); 3, quality of life (emotional); 4, sexual function; 5, avoidance. ICIQ-UI SF preoperative mean was 14.9 and postoperative mean was 1.5 (p?<?0.05). A total of 210 goals were stated. The majority of the goals (38 %) were in group 2 concerning quality of life in the physical domains. Mean VAS score for all goals was 9.1 (SD 2). Thirty-seven patients (53 %) fulfilled all their goals. Twenty-one patients (30 %) did not have a VAS score of 10, although continent with an ICIQ-UI SF score of zero. Reasons for not achieving a full VAS score were that some still used pads out of fear (n?=?10), that their mental focus was still on incontinence (n?=?7) or that they had not yet tried some of the physical aims (n?=?7).Conclusions
Most patients achieved their goals. The majority of the goals concerned quality of life in the physical domains.6.
7.
Magdalena Emilia Grzybowska Dariusz Grzegorz Wydra 《International urogynecology journal》2017,28(5):697-704
Introduction and hypothesis
To assess the impact of coital incontinence (CI) on health-related quality of life (HRQoL) and quality of sexual function (QSF) in women with urodynamic stress urinary incontinence (SUI).Methods
Women were recruited for this cross-sectional study from among 289 patients with lower urinary tract symptoms, underwent clinical and urodynamic evaluation. Of these 289 women, 127 sexually active women with SUI completed the King’s Health Questionnaire (KHQ) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ), of whom 97 were enrolled for the study. The study group comprised 53 women with CI occurring ‘sometimes’, ‘usually’ or ‘always’, and the control group comprised 44 women without CI. Total and individual domain scores were evaluated.Results
CI was reported by 65.35 % of the women. The frequency of CI was correlated with lower educational level and higher body mass index (r?=?0.22 and r?=?0.23, respectively; p?=?0.01). The KHQ results showed significantly lower HRQoL in women with CI in all domains (p?<?0.05) apart from Sleep/energy’ (p?=?0.054). PISQ revealed no significant differences in QSF in the Behavioral/emotive and Partner–related domains (34.3?±?10.0 vs. 33.0?±?12.2 and 18.0?±?2.9 vs. 18.2?±?3.6, respectively). Women with CI reported a significantly lower QSF in the Physical domain (29.1?±?6.6 vs. 35.0?±?4.6, p?=?0.001), and the total PISQ score was lower but the difference was not significant (81.4?±?14.3 vs. 86.2?±?16.5). Total PISQ score was correlated with age (r?=??0.28, p?=?0.001). Women with CI were significantly more likely to admit that fear of incontinence or fear of embarrassment restricted their sexual activity (p?<?0.001).Conclusions
A large percentage (65.35 %) of women with SUI reported CI, which had a negative impact on HRQoL and QSF in the Physical domain, but no significant impact on overall QSF.8.
Background
To study nocturia in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) after medical or placebo treatment.Methods
Patients with LUTS suggestive of BPH from several community clinics were included. Patients completed the International Prostate Symptom Score (I-PSS) questionnaire and a 3-day voiding diary. Urinalysis, prostate-specific antigen (PSA) measurement, and prostate ultrasonography were performed. Nocturnal polyuria (NP) was defined as a nocturnal urine fraction exceeding one third of the daily urine output in elderly men. A total of 148 outpatients were randomized to drug treatment (tamsulosin) or placebo treatment. After 8?weeks of treatment, they were re-evaluated using a 3-day voiding diary, PSA measurement, prostate volume (PV), I-PSS, etc.Results
The average I-PSS score was 20.3, storage symptom score was 11.7, voiding symptom score was 8.6, quality of life (QoL) score was 3.7, PV was 40.4?±?19.4?ml, and nocturnal urine volume (NUV) was 845.7?±?339.0?ml. The mean frequency of nocturia was 2.3?±?1.1 per day, and 94% of the patients had a nocturia frequency of more than two times per day. Of these patients, 76.5% had NP. A significant correlation was found between NUV and the amount of water intake at night and 4?h before sleep (r?=?0.419,P?=?0.002; r?=?0.302,P?=?0.031). Eighty patients were randomized to drug treatment (tamsulosin) and 68 patients were randomized to placebo treatment. The I-PSS score was 16.8?±?4.9 to 19.3?±?5.0 (p?=?0.002), the storage symptom score was 10.3?±?3.4 to 10.7?±?3.4 (p?=?0.007), and the voiding symptom score was 7.5?±?2.4 to 8.6?±?2.3 (p?=?0.003). The frequency of daytime urination was 7.5?±?2.6 to 8.1?±?2.6 (p?=?0.002), maximum urine volume (ml) was 372.8?±?103.3 to 302.8?±?119.3 (p?=?0.007), and morning urine volume (ml) was 280.5?±?111.7 to 259.5?±?100.7 (p?=?0.003). However, the frequency of nocturia score was 2.8?±?0.7 to 3.0?±?0.6 (p?=?0.306) and the nocturnal urine volume (ml) was 800.7?±?323.0 to 845.7?±?303.5 (p?=?0.056), which did not change significantly. There were significant differences between the NP and non-NP groups in the duration of LUTS, first voided urine volume, daytime urination frequency, and the amount of water intake at night and 4?h before sleep.Conclusions
Among the symptoms of LUTS, the improvement rates for nocturia were the lowest after medical treatment for BPH. The α-blockers did not improve nocturia, which was a common symptom accompanying LUTS suggestive of BPH. Our results showed that the prevalence of NP was 76.5% and that NP was significantly related to the amount of water intake during the evening and before sleep.Trial registration
ISRCTN registry, Trial registration number (TRN): ISRCTN85509614, Date of registration: 30/10/2018. This trial was registered retrospectively.9.
Anant Dixit Frank S. Cautela Colin S. Cooper George A. Beyer James C. Messina Jeffrey E. Mait Neil V. Shah Bassel G. Diebo Carl B. Paulino William P. Urban 《Journal of orthopaedics and traumatology》2018,19(1):12
Background
Limited data exists in analyzing open reduction and internal fixation (ORIF) and arthroplasty in the management of open proximal humerus fractures. We analyzed differences in hospital course between these procedures, patient demographics, complication rate, length of stay, hospital charges, and mortality rate.Materials and methods
This is a retrospective review of the Nationwide Inpatient Sample database. ICD-9 codes identified patients hospitalized for open proximal humerus fractures from 1998 to 2013 who underwent ORIF or shoulder arthroplasty (hemi-, total, or reverse). Demographics and in-hospital complications were compared. Logistic regression controlling for age, gender, and Deyo index tested the impact of ORIF vs ARTH on any complications.Results
Seven hundred thirty patients were included (ORIF, n?=?662 vs ARTH, n?=?68). ORIF patients were younger (p?<?0.001), more likely to be males (p?<?0.001), and had a lower Deyo score (p?=?0.012). Both groups had comparable complication rates (21.4% vs 18.0%, p?=?0.535), lengths of stay (7.86 days vs 7.44 days, p?=?0.833), hospital charges ($76,998 vs $64,133, p?=?0.360), and mortality rates (0.2% vs 0%, p?=?0.761). Type of surgery was not a predictor of any complications (OR?=?0.67 [95% CI 0.33–1.35], p?=?0.266), extended length of stay (OR?=?1.01 [95% CI 0.58–1.78], p?=?0.967), or high hospital charges (OR?=?1.39 [95% CI 0.68–2.86], p?=?0.366).Conclusion
We revealed no differences in hospital course between ORIF and arthroplasty for management of open proximal humerus fractures. Although differences in demographics existed, no differences in complication rates, length of stay, hospital charges and mortality rates were noted. Future studies can evaluate the long-term outcomes of these procedures.Level of evidence
Level III.10.
Meng Gu Chong Liu Yan-bo Chen Huan Xu Shi Fu Qi Chen Zhong Wang 《International urology and nephrology》2018,50(5):819-823
Purpose
This study aimed to estimate the validity and applicability of Vela laser enucleation of the prostate (VoLEP) in the management of benign prostatic hyperplasia (BPH).Methods
A retrospective chart review of 112 patients with BPH who underwent VoLEP (n?=?60) or holmium laser enucleation of the prostate (HoLEP) (n?=?56) was conducted at our institution from January 2015 to June 2015. The general and perioperative characteristics of the patients were collected. The 12-month follow-up data, including the lower urinary tract symptom (LUTS) indexes (International Prostate Symptom Score [I-PSS], quality-of-life [QoL] score and maximum flow rate [Qmax]), as well as rates of perioperative and late complications, were analyzed.Results
No significant differences were observed in pre- and perioperative parameters, including operation time (58.05?±?10.14 vs. 60.14?±?12.30 min, P?=?0.44), serum sodium decrease (3.49?±?0.83 vs. 3.48?±?0.84 mmol/L, P?=?0.97), hemoglobin decrease (1.28?±?0.38 vs. 1.24?±?0.77 g/dL, P?=?0.71), catheterization time (3.63?±?1.10 vs. 3.89?±?1.11 days, P?=?0.21) and hospital stay (4.57?±?1.25 vs. 4.68?±?1.18 days, P?=?0.63) between the two groups of patients. Compared with the HoLEP group, the noise during operation was lower in VoLEP group (47.22?±?10.31 vs. 59.45?±?9.65 db, P?<?0.05). During 1, 6 and 12 months of follow-up visits, the LUTS indexes (I-PSS, QoL score and Qmax) were remarkably improved in both groups when comparing with the baseline values. Furthermore, LUTS indexes were comparable in both groups (P?>?0.05).Conclusion
Similarly as the holmium laser, the Vela laser is a potent, safe, efficient durable and surgical treatment option for minimally invasive surgery in patients with BPH-induced LUTS.11.
Holly Kramer Gina Kuffel Krystal Thomas-White Alan J. Wolfe Kavitha Vellanki David J. Leehey Vinod K. Bansal Linda Brubaker Robert Flanigan Julia Koval Anuradha Wadhwa Michael J. Zilliox 《International urology and nephrology》2018,50(6):1123-1130
Purpose
To examine the characteristics of the midstream urine microbiome in adults with stage 3–5 non-dialysis-dependent chronic kidney disease (CKD).Methods
Patients with non-dialysis-dependent CKD (estimated glomerular filtration rate [eGFR]?<?60 ml/min/1.73 m2) and diuretic use were recruited from outpatient nephrology clinics. Midstream voided urine specimens were collected using the clean-catch method. The bacterial composition was determined by sequencing the hypervariable (V4) region of the bacterial 16S ribosomal RNA gene. Extraction negative controls (no urine) were included to assess the contribution of extraneous DNA from possible sources of contamination. Midstream urine microbiome diversity was assessed with the inverse Simpson, Chao and Shannon indices. The diversity measures were further examined by demographic characteristics and by comorbidities.Results
The cohort of 41 women and 36 men with detectable bacterial DNA in their urine samples had a mean age of 71.5 years (standard deviation [SD] 7.9) years (range 60–91 years). The majority were white (68.0%) and a substantial minority were African-American (29.3%) The mean eGFR was 27.2 (SD 13.6) ml/min/1.73 m2. Most men (72.2%) were circumcised and 16.6% reported a remote history of prostate cancer. Many midstream voided urine specimens were dominated (>?50% reads) by the genera Corynebacterium (n?=?11), Staphylococcus (n?=?9), Streptococcus (n?=?7), Lactobacillus (n?=?7), Gardnerella (n?=?7), Prevotella (n?=?4), Escherichia_Shigella (n?=?3), and Enterobacteriaceae (n?=?2); the rest lacked a dominant genus. The samples had high levels of diversity, as measured by the inverse Simpson [7.24 (95% CI 6.76, 7.81)], Chao [558.24 (95% CI 381.70, 879.35)], and Shannon indices [2.60 (95% CI 2.51, 2.69)]. Diversity measures were generally higher in participants with urgency urinary incontinence and higher estimated glomerular filtration rate (eGFR). After controlling for demographics and diabetes status, microbiome diversity was significantly associated with estimated eGFR (P?<?0.05).Conclusions
The midstream voided urine microbiome of older adults with stage 3–5 non-dialysis-dependent CKD is diverse. Greater microbiome diversity is associated with higher eGFR.12.
Sushil Kumar Sharma Arvind Kohli Eshan Chopra 《Indian Journal of Thoracic and Cardiovascular Surgery》2016,32(2):120-125
Background
Peripheral arterial disease is associated with high cardiovascular morbidity and mortality. The objective of this study was to identify unrecognized patients with peripheral arterial disease using ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherosclerosis.Material and methods
One hundred fifty-four patients with 94 males and 60 females underwent assessment of peripheral arterial disease using ankle-brachial index by pulse Doppler. Correlation between peripheral arterial disease and various variables (history of cardiovascular disease or various risk factors for atherosclerosis) was established using Pearson coefficient correlation test and linear-by-linear association.Results
Peripheral arterial disease was present in 24.03 % (n?=?37) of patients in the study population. A total of 22.08 % (n?=?34) patients in study population had ankle-brachial index between 0.41 and 0.90, i.e., mild to moderate peripheral arterial disease, and 1.95 % (n?=?3) had ankle-brachial index between 0.00 and 0.40, indicating severe peripheral arterial disease. Advancing age (p?<?0.001; linear-by-linear association?=?24.448), smoking (p?<?0.001), diabetes (p?=?0.005), hypertension (p?=?0.008), hyperlipidemia (p?<?0.001), cardiovascular disease (p?=?0.003), and number of risk factors (p?<?0.001; linear-by-linear association?=?50.099) showed a statistically significant correlation with peripheral arterial disease. No significant difference was found between men and women (59.46 vs. 40.54 %, respectively, p?=?0.051) in terms of peripheral arterial disease.Conclusion
Peripheral arterial disease is highly prevalent in patients with established cardiovascular disease or who have at least one risk factor for atherosclerosis. Screening of patients for peripheral arterial disease by pulse Doppler (which is cheap, rapid, and precise method to detect peripheral arterial disease) would allow identification of high-risk patients who could benefit from an appropriate treatment strategy.13.
Lizz van der Heijden Sheila R. Piner Michiel Adrianus Josephus van de Sande 《International orthopaedics》2016,40(12):2459-2468
Purpose
We aimed to ascertain the feasibility of crowdsourcing via Facebook for medical research purposes; by investigating surgical, oncological and functional outcome and quality-of-life (QOL) in patients with pigmented villonodular synovitis (PVNS) enrolled in a Facebook community (1112 members).Methods
Patients completed online open surveys on demographics, surgery and clinical outcomes (group 1); and patient-reported outcome measures (PROMs) including knee-injury osteoarthritis outcome score (KOOS), hip-disability osteoarthritis outcome score (HOOS), Toronto extremity salvage score (TESS) and SF-36 (group 2). Mean follow-up was 70 months (12–374). Consistency checks were performed with Cohen’s kappa statistic for intra-rater agreement.Results
The first survey was completed by 272 patients (group 1) and 72 patients completed the second (group 2). In group 1, recurrence-rate was 58 % (69/118) after arthroscopic, 36 % (35/97) after open and 50 % (5/10) after combined synovectomy (p?=?0.003). In group 2, recurrence-rate was 67 % (26/39) after arthroscopic and 51 % (17/33) after open synovectomy (p?=?0.19). Recurrence-risk was increased for diffuse disease (OR?=?16; 95%CI?=?3.2–85; p?<?0.001). Mean function and QOL did not differ after arthroscopic or open synovectomy: KOOS 49 vs. 58 (p?=?0.24), HOOS 62 vs. 53 (p?=?0.56), TESS 78 vs. 82 (p?=?0.86), SF-36 61 vs. 66 (p?=?0.41). Cohen’s kappa statistic for intra-rater agreement was good to outstanding (κ?=?0.68–0.95; p?<?0.001).Conclusion
Local recurrence-risk was higher for diffuse-type disease and arthroscopic synovectomy. Functional outcome and QOL were comparable for both types of surgery. Gathering data via crowdsourcing seems a promising and innovative way of evaluating rare diseases including PVNS.14.
Background
Bibliometric and Altmetric analyses highlight key publications, which have been considered to be the most influential in their field. The hypothesis was that highly cited articles would correlate positively with levels of evidence and Altmetric scores (AS) and rank.Methods
Surgery as a search term was entered into Thomson Reuter’s Web of Science database to identify all English-language full articles. The 100 most cited articles were analysed by topic, journal, author, year, institution, and AS.Results
By bibliometric criteria, eligible articles numbered 286,122 and the median (range) citation number was 574 (446–5746). The most cited article (Dindo et al.) classified surgical complications by severity score (5746 citations). Annals of Surgery published most articles and received most citations (26,457). The country and year with most publications were the USA (n?=?50) and 1999 (n?=?11). By Altmetric criteria, the article with the highest AS was by Bigelow et al. (AS?=?53, hypothermia’s role in cardiac surgery); Annals of Surgery published most articles, and the country and year with most publications were USA (n?=?4) and 2007 (n?=?3). Level-1-evidence articles numbered 13, but no correlation was found between evidence level and citation number (SCC 0.094, p?=?0.352) or AS (SCC?=?0.149, p?=?0.244). Median AS was 0 (0–53), and in articles published after the year 2000, AS was associated with citation number (r?=?0.461, p?=?0.001) and citation rate index (r?=?0.455, p?=?0.002). AS was not associated with journal impact factor (r?=?0.160, p?=?0.118).Conclusion
Bibliometric and Altmetric analyses provide important but different perspectives regarding article impact, which are unrelated to evidence level.15.
Erin A Brennand Selphee Tang Colin Birch Magnus Murphy Sue Ross Magali Robert for the Calgary Women’s Pelvic Health Research Group 《International urogynecology journal》2017,28(4):621-628
Introduction and hypothesis
The objective was to evaluate the impact of preoperative body mass index ≥30 on objective and subjective cure rates 5 years after midurethral sling surgery.Methods
Secondary analysis of the 5-year results of a randomized clinical trial evaluating tension-free vaginal tape vs transobturator tape surgery. Women (n?=?176) were classified as obese or non-obese based on preoperative height and weight. Women self-reported symptoms and quality of life, and underwent standardized physical examinations and pad-testing. Categorical data were analyzed using Chi-squared or Fisher’s exact tests, continuous data by Mann–Whitney U test. Primary outcome was objective cure defined as <1 g urine lost on pad-test at 5 years post-surgery. Secondary outcomes were subjective cure of incontinence, urinary urge incontinence symptoms, and quality of life scores.Results
Non-obese women had a higher rate of objective cure, 87.4 % (n?=?83 out of 95) compared with 65.9 % (n?=?29 out of 44) in the obese group (P?=?0.003, risk difference [RD] 21.5 %, 95 % CI 5.9–37.0 %). Subjectively, non-obese women also reported higher rates of cure, 76.7 % (n?=?89 out of 116) compared with 53.6 % (n?=?30 out of 56) of obese women (P?=?0.002, RD 23.2 %, 95 % CI 8.0–38.3 %). Overall rates of urge incontinence symptoms were similar in the two groups, but rates of bothersome symptoms were higher for obese women (58.9 % vs 42.1 %, P?=?0.039, RD 16.8 % 95 % CI 1.1–32.6).Conclusions
Five years after surgery, obese women continued to experience lower rates of cure compared with non-obese women.16.
S. Mohammad Jafri Laura N. Nguyen Larry T. Sirls 《International urology and nephrology》2018,50(12):2187-2191
Introduction
Robotic-assisted laparoscopic prostatectomy (RALP) has largely replaced open radical prostatectomy in many centers. Radical perineal prostatectomy (RPP) is another less invasive approach that has not been widely adopted. RPP offers excellent exposure of the urinary sphincter and bladder neck that may provide good urinary function outcomes. We evaluate urinary function after RALP and RPP.Methods
Retrospective review of a prospective radical prostatectomy database was performed. Urinary modules from the Expanded Prostate Cancer Index Composite—Urinary Function (EPIC-UF) questionnaire were used to determine urinary symptoms at baseline and at 6, 12, 18, and 24 months after surgery.Results
753 men underwent RALP (n?=?623) or RPP (n?=?130). Of these, 558 had complete data and were included in our study (RALP: n?=?458, RPP: n?=?100). A higher number of patients undergoing RALP than RPP had pelvic lymph node dissection (20.2% vs. 0%, p?<?0.0001) and cavernosal neurovascular bundle sparing (79.2% vs. 68.4%, p?<?0.0001). 558 patients had complete EPIC-UF data. Overall urinary recovery was greater for RALP than RPP at 6 months (p?=?0.028). Urinary incontinence and function were also more improved after RALP compared to RPP at 6 months (p?=?0.021, p?=?0.006). However, no differences in overall, urinary incontinence, or urinary function scores were seen at 12, 18, or 24 months. There was no difference between groups in urinary bother or irritative/obstructive symptoms at any time point.Conclusions
RALP had more rapid recovery of urinary function at 6 months vs. RPP; at 12–24 months, however, RALP and RPP had similar urinary function recovery in all urinary subdomains.17.
Hayser Medina Lucena Harnek Rai Chrysostomos Siozos Douglas G. Tincello Sambita Basak Ilias Giarenis 《International urogynecology journal》2016,27(10):1529-1533
Introduction and hypothesis
A significant proportion of patients develop voiding dysfunction after midurethral tape (MUT) insertion, which reduces patient satisfaction. The study’s purpose was to identify predictive factors of voiding dysfunction after a retropubic MUT procedure.Methods
This was a retrospective study of 100 patients who underwent only a retropubic MUT procedure between January 2010 and December 2011. Early voiding dysfunction was defined when patients required a Foley catheter within 48 h. Data including demographic information, urogenital symptoms, previous surgery, preoperative uroflowmetry and urodynamic parameters were analysed using SPSS v22. Univariate analysis of all demographic variables was performed; those significant at 10 % were entered into a multivariate logistic regression.Results
Fourteen patients required Foley catheter insertion, with a median age of 58 years (26–83 years), median BMI 28 kg/m2 (20–48 kg/m2), and median parity 2 (0–4). Univariate analysis revealed peak flow rate <15 ml/s (OR 3.79; 1.07, 13.4; p?=?0.046), bladder capacity (p?=?0.044), stress incontinence versus mixed or urge incontinence (p?=?0.064) and previous surgery (OR 4.39; 1.34, 14.41; p?=?0.015) to be associated with voiding dysfunction. Multivariate analysis showed only previous pelvic floor surgery to be independently associated (OR 3.76; 1.14, 12.23, p?=?0.029).Conclusions
Only previous pelvic-floor surgery was found to be a strong predictive factor of voiding dysfunction. The rate of voiding dysfunction was similar to those of published data. Previous studies revealed different predictive factors. A larger cohort is needed to provide a definite answer. Those with previous surgery appear to be those most at risk and pre-surgical counselling for these women could be suggested.18.
Kamal K. Mahawar Abdelrahman Nimeri Marco Adamo Cynthia-Michelle Borg Rishi Singhal Omar Khan Peter K. Small 《Obesity surgery》2018,28(9):2650-2660
Background
There is currently little evidence available on various aspects of Revisional Bariatric Surgery (RBS) and no published consensus amongst experts. The purpose of this study was to understand variation in practices concerning RBS.Methods
Bariatric surgeons from around the world who perform RBS were invited to participate in a questionnaire-based survey on SurveyMonkey®.Results
A total of 460 respondents from 62 countries took the survey. For revision after gastric banding, Roux-en-Y gastric bypass (RYGB) (75.5%, n?=?345) emerged as the commonest choice followed by sleeve gastrectomy (SG) (56.9%, n?=?260) and one anastomosis gastric bypass (OAGB) (37.2%, n?=?170). For revision after SG, RYGB (77.7%, n?=?355) was the commonest option followed by OAGB (42.45%, n?=?194) and re-sleeve (22.32%, n?=?102). For revision after RYGB, surgical pouch reduction (49.1%, n?=?223), prolongation of bilio-pancreatic limb (30.0%, n?=?136), and surgical stoma size reduction (26.43%, n?=?120) were the most preferred options. Approximately 90.0% of respondents (n?=?406/454) routinely perform an upper gastrointestinal endoscopy before an RBS, and 85.6% (n?=?388/453) routinely perform a contrast study. Ninety percent (n?=?403/445) reported that the demand for RBS was usually patient-driven, and there was wide variation in criteria used to define successful response, non-responders, and significant weight regain.Conclusions
This survey is the first attempt to understand various aspects of RBS. The findings will help in identifying areas for research and allow consensus building amongst experts.19.
Background
Most of the cases of PHPT in developing countries present in symptomatic stage, some even in very advanced stage but in recent years the trend seems to be changing. This has been corroborated from few recently published literature from developing countries. The scope of this study is to further carry out an in-depth analysis of various clinical and biochemical parameters of PHPT patients at a tertiary care center of northern India.Methods
In this retrospective analysis, a total of 333 patients with PHPT from the year 1990 to 2016 were studied. The study population was divided into three subgroups based on the time span; 1990–1999 (n?=?34), 2000–2009 (n?=?112), 2010–2016 (n?=?187), and clinical and biochemical parameters were compared.Results
The clinical presentation has evolved progressively with increase in older age group (35 vs 39 vs 43.85, p?<?0.001), less patients with musculoskeletal symptoms (85.3 vs 76.8 vs 61%, p?=?0.002) and less patients with severe bone disease (29.4 vs 10.7 vs 10.7%, p?=?0.088). Biochemical parameters also showed a changing trend with significant decrease in mean S. Alkaline phosphatase (1393 vs 965 vs 414.8 IU/L, p?<?0.001) and S. iPTH (837.52 vs 812.89 vs 635.74 pg/mL, p?=?0.02). Vitamin D nutrition status is still suboptimal but shows improvement, and more patients are insufficient as compared to previous deficient state (mean S. Vitamin D—10.31 vs 16.16 vs 25.30 ng/mL, p?<?0.001).Conclusions
Our study reveals a change in trend in PHPT which is similar to evolution of this disease in western population and positively corroborated with observations from China, Hong Kong and Turkey.20.