Pelvic floor muscle exercise with biofeedback helps regain urinary continence after robot-assisted radical prostatectomy / 영남의대학술지

Background@#To determine the benefit of pelvic floor muscle exercise with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy. @*Methods@#Of the 83 patients enrolled, 41 consecutive patients completed pelvic floor muscle exercise (the exercise group), and the other 42 consecutive patients just before the pelvic floor muscle exercise program commenced (the control group). The primary outcome was whether pelvic floor muscle exercise engagement was associated with zero pad continence restoration within 3 months of surgery. @*Results@#Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p70 years old (p=0.002) benefited significantly. @*Conclusion@#This study suggests that postoperative engagement in pelvic floor muscle exercise with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo robot-assisted radical prostatectomy.

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures / 영남의대학술지

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy

PURPOSE: Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy. MATERIALS AND METHODS: Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position. RESULTS: No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (beta=-0.772, p=0.003) and diabetes mellitus (beta=-0.803, p=0.033). CONCLUSIONS: We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.