Clinical analysis of human acellular allogeneic dermis in the repair of urinary fistula / 现代泌尿外科杂志

【Objective】 To investigate the clinical efficacy of human acellular allogeneic dermis (HADM) in the repair of urinary fistula. 【Methods】 The clinical data of 12 female patients with complex vesicovaginal fistula treated during Jun.2021 and Nov.2022 were retrospectively analyzed. The patients’ average age was 47.3 years, ranging from 38 to 56 years. The body mass index (BMI) ranged from 16.6 to 25.2, with an average of 21.3. HADM was inserted between vagina and bladder wall fistula to repair fistula in all 12 patients. 【Results】 All operations were successful. After the operation, the vaginal urine leakage stopped and the urinary tube was retained for 2 weeks. During the postoperative follow-up of 1 to 16 months, no recurrence or complication were observed. 【Conclusion】 Transvaginal HDMA is an ideal surgical method in the treatment of complex vesicovaginal fistula, which has advantages of small trauma, fast recovery and high success rate.

Application of ureteral stent in kidney transplantation / 器官移植

Ureteral stricture, urine leakage and other urinary complications are likely to occur after kidney transplantation, which severely affect the function of renal allograft and even lead to renal allograft loss. Ureteral stent plays a critical role in kidney transplantation, which could promote the urine flow from kidney to bladder after kidney transplantation, lower the pressure within the ureter and reduce the risk of early urinary complications. However, it may also cause urinary tract infection, stent-related complications and BK virus infection, etc. Therefore, clinicians should flexibly grasp the indications for ureteral stent removal. In this article, the application, potential adverse reactions and the timing of removal of ureteral stent in the field of kidney transplantation were reviewed, aiming to provide reference for clinical decision-making related to ureteral stent after kidney transplantation.

Therapeutic Evaluation of Acupuncture for Female Stress Urinary Incontinence / 上海针灸杂志

Objective Taking sham electroacupuncture as control, to observe the clinical efficacy of electroacupuncture in treating female stress urinary incontinence (SUI). Method By using central random design, the eligible subjects were randomized into an electroacupuncture group of 42 cases [electroacupuncture at Zhongliao (BL33) and Huiyang (BL35)] and a sham group of 42 cases [sham electroacupuncture at points beside Zhongliao and Huiyang]. The therapeutic efficacy was evaluated by observing the urine leakage volume in the 1-h pad test and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Result In the electroacupuncture group, the urine leakage volumes in the 4th, 6th, 20th, and 32nd treatment week were significantly lower than that before treatment (P<0.05);the decreases of urine leakage volume in the electroacupuncture group were more significant than that in the sham group in the 4th, 6th, 20th, and 32nd treatment week (P<0.05). In the electroacupuncture group, the ICIQ-SF scores in the 4th, 6th, 20th, and 32nd treatment week were significantly lower than that before treatment (P<0.05); the ICIQ-SF scores were significantly lower in the electroacupuncture group than in the sham group in the 4th, 6th, 20th, and 32nd treatment week (P<0.05). Conclusion Electroacupuncture can effectively improve urine leakage and other urinary symptoms in SUI.

The Significance of Estimation of Urine Leakage on Fluoroscopic Cystourethrography in Female Stress Urinary Incontinence: Correlation with Subjective Degree and Valsalva Leak Point Pressure

PURPOSE: To compare the estimated degree of urine leakage during straining on standing cystourethrography(CUG) under fluoroscopy with subjective degree and Valsalva leak point pressure(VLPP), and to determine it's clinical significance. MATERIALS AND METHODS: 157 consecutive women who presented with stress urinary incontinence with a mean age of 47 years were included in this study. Standing CUG was performed in the state of urethral catheter insertion and removal. Degree of urine leakage was determined on the fluoroscopy during standing CUG by one urologist, and VLPP was determined by another observer. Each of subjective degree, leakage amount and VLPP was classified into 3 grade and compared it's results to each other. RESULTS: High correlation was present between the leakage amount and VLPP(p<0.05), and the subjective degree and VLPP(p<0.001), but subjective degree was not highly correlated with leakage amount. Among the clinical parameters, urge syndrome and urge incontinence only had the positive effect to urine leakage. CONCLUSIONS: Estimation of leakage amount during standing CUG on fluoroscopy seems to be a simple and useful method in the objective evaluation of urine leakage, but it should be considered to be the possibility of over-estimation in the cases of associated urge syndrome and urge incontinence.

Clinical Consideration of Ureterolithotomy without Closure of the Ureter / 대한비뇨기과학회지

The clinical observation of ureterolithotomy without closure of the ureter was done in 57 patients during the period from Sep., 1970 to Aug., 1974 in the Department of Urology. Daegu Presbyterian Medical Center. The results are as follows. 1) Incidence of ureteral stones is higher in male than in female, ratio M:F=1.6:1 and the most common age group is from 30 to 39 years with 54.3% of the total cases. 2) Locational distribution of ureteral stone; 27 cases in the upper, 5 in the middle and 25 in the lower ureter. 3) The size of ureteral stone is from 0.3 x O.4cm to 1.4x 2.2cm. The average size is 0.48x 0.80cm. 4) The druation of post-operative urine drainage was 7.4 days in the upper ureter, 4.4 days in the mid ureter and 7.6 days in the lower ureter. 5) Post-operative complications: Persistent urine leakage requiring retrograde catheterization; 1 case. Pyelonephritis : 2 cases. 6) Change of post-operative I. V. P. findings; Improved in 50 cases, not changed in 3 cases and deteriorated in 4 cases. 7) Post operative hospital stay; 10. 5 days in the upper, 8.4 days in the mid and 11.3 days in the lower ureter.