The impact of urinary drainage on the development of anastomotic stricture after radical retropubic prostatectomy

OBJECTIVES: Anastomotic stricture (AS) is a well-described complication of radical retropubic prostatectomy (RRP) despite all the refinements in surgical technique. We aimed to define and discuss the role of postoperative urinary drainage on AS development. PATIENTS AND METHODS: A total of 136 patients with localized prostate carcinoma underwent RRP. In all patients, urethral catheter was removed 3 weeks after RRP without a cystogram. We documented duration of drainage (<3 days, n = 86; 3-5 days, n = 36; and >5 days, n = 14), volume of drainage (<300 ml, n = 78; 300-500 ml, n = 27; and >500 ml, n = 31), and mean volume of drainage per day (<100 ml, n = 85 and >100 ml, n = 51), continence status, and clinical and histopathological characteristics of patients as risk factors related with AS. RESULTS: AS was diagnosed in 28.6% of patients. The rate was found to be 35.9%, 41%, and 23.1%, consistent with duration, and 38.4%, 15.4%, and 46.2% according to volume of drainage, respectively (P = 0.0001). AS occurred in 43.6% and 56.4% of patients concerning mean volume of drainage per day, respectively (P = 0.007). Analysis showed that AS was significantly associated with duration (>3 days), total volume (>500 ml), and the mean volume (>100 ml) of urinary drainage among the variables. The rates of urinary incontinence were 30.7% in patients with AS and 6.2% in patients without AS. CONCLUSIONS: Time and the amount of urinary drainage were significantly associated with stricture formation following RRP that might be caused by partial disruption of the anastomosis.     

Self‐reported quantity of daily water intake and urine output in healthy young

Water is an essential nutrient and adequate intake and output of water is required for health maintenance. Water homeostasis is vital for life and optimal function and considerable interest surrounds the issue of recommendations for water consumption in healthy individuals. Few studies are available about self‐reported water intake and urine output. The aim of this study was to assess the quantity of water intake and urine output in 24‐h period in healthy young individuals. This prospective study was carried out on 31 students aged 18–24 years undergoing nursing education in a University during January 2011 in Sakarya, Turkey. Healthy young individuals were recruited for determination of the quantity of water taken in and urine excretion along 24 h; they recorded fluid input and urine output. The students collected the data during weekend break. In our study, the total daily fluid intake (mL) for females was 2082·6 ± 687·1 and the total daily fluid intake (mL) for males was 2720·8 ± 717·4. The total daily quantity of urine (mL) for females was 1623·4 ± 602·4 and the total daily quantity of urine (mL) for males was 1818·3 ± 420·6. This research may be the source for similar studies that could include seasonal changes, climates, cultures and different age groups.     

Reversible nephrotoxicity after overdose of colloidal bismuth subcitrate

Although toxicity due to acute and chronic use of bismuth salts is well known, nephrotoxicity after ingestion of colloidal bismuth has been reported in few cases so far. Here we report the first case of acute renal failure (ARF) due to colloidal bismuth subcitrate overdosage in childhood. A 2-year-old boy was admitted to the hospital 6 h after ingestion of 28 De-Nol tablets (colloidal bismuth subcitrate 8.4 g). On admission, physical examination was unremarkable and he showed no signs of encephalopathy. Initially gastric lavage was performed then appropriate fluid therapy was started. ARF associated with uremia and oliguria developed on day 2 and peritoneal dialysis therapy was prescribed on day 4 for 10 days. Blood and urine bismuth levels were 739 μg/l and 693 μg/l, respectively, 10 days after the pills had been taken. His urine volume gradually increased and plasma BUN and creatinine levels decreased during peritoneal dialysis. On day 20 post-admission, plasma BUN and creatinine were 14 mg/dl and 0.7 mg/dl, respectively. Blood bismuth levels were 96 μg/l on day 60 and 12 μg/l on day 105. Now the patient is well and has no problem. This case suggests that ARF may develop in children following colloidal bismuth subcitrate overdosage; the prognosis is good, and peritoneal dialysis may be useful in these cases. Received: 25 February 2000 / Revised: 5 December 2000 / Accepted: 17 January 2001     

Intestinal Rotation Anomalies in Childhood: Review of 22 Years’ Experience

Purpose We review our experience of treating intestinal rotation anomalies in infants and children in the 22-year period between 1978 and 2000.Methods The type of operation performed, postoperative complications, and mortality were compared in three age groups. Group 1 consisted of neonates 1 month old, Group 2 consisted of infants aged 1 year old, and Group 3 consisted of children aged 1 year old.Results There were 101 infants and children, with a female:male ratio of 2:1. Of the 101 patients, 72 (71%) were neonates, with a mean age of 11.8 days (range 1–28 days); 20 (19.8%) were under the age of 1 year, with a mean age of 6.7 months (range 1–12 months); and 9 (8.9%) were 1 year of age, with a mean age of 6 years (range 1–9 years). Eighty-five (84%) patients underwent emergency procedures. Ladds operation was performed in all patients, with various additional procedures. The most frequent postoperative complications were adhesive intestinal obstruction, stoma necrosis, evisceration, and short bowel syndrome. The mortality rate was 36% in Group 1, 20% in Group 2, and 0% in Group 3.Conclusions In this series surgery was usually performed as an emergency procedure, with higher morbidity and mortality in newborns than in older infants and children.     

The evaluation of ozone and betahistine in the treatment of tinnitus

The aim of the study is to evaluate the effectiveness of ozone and betahistine treatments in the treatment of tinnitus. Sixty-eight patients were enrolled in this randomized, prospective controlled study. The ozone group consisted of 27, betahistine group consisted of 26 and control group consisted of 15 patients. The patients in ozone group received 10 sessions of ozone treatment via major autohemotherapy. Betahistine group received 48 mg/day betahistine tablets per oral for 3 months duration. The control group was followed up without any treatment given. The evaluation of tinnitus was made by tinnitus loudness and tinnitus handicap inventory (THI). The changes in findings from baseline to 3rd and 6th months were assessed, and the group results were compared. Comparison of the initial mean tinnitus loudness and 3 and 6 months after treatment in each of the three groups did not reveal a significant difference. The comparison between the groups in terms of the improvement of tinnitus loudness was not significant (p = 0.821). Comparison of the initial mean THI and 3 and 6 months after treatment revealed a significant difference in ozone and betahistine groups but not in the control group. When the delta (Δ) THI (the change of mean THI between the initial and 6th month) was compared between the groups, there was no significant difference. This randomized controlled study investigating the effects of ozone in tinnitus tries to shed light to a new method of treatment in tinnitus. The findings of the study does not provide enough evidence to support ozone and betahistine as a treatment for tinnitus and further research on the subject is necessary.