Is routine re-imaging for high-grade renal injury needed? Retrospective analysis of 1500 abdominal trauma patients from a tertiary care trauma center over 11 years.

INTRODUCTION AND AIM: The AUA and EAU guidelines recommend re-imaging in high-grade renal trauma, regardless of the clinical findings. The aim of this study was to assess the impact of re-imaging on the overall management and outcomes in these patients. METHODS: The trauma registry of our tertiary care Level-1 trauma center was reviewed from January 2007 till October 2018. Out of 1536 patients with abdominal trauma, 174 patients with isolated renal injury were identified. Renal injuries were classified based on the AAST classification. Variables retrieved were demographics, renal injury grade, presence of urinoma, repeated imaging findings, and intervention after initial and repeated imaging. RESULTS: Low-grade injury was found in 78.7% (137/174) compared to 21.3% (37/174) with high-grade injury. The majority (n = 136) of low-grade patients were managed conservatively except one patient with Grade III injury required angioembolization after initial imaging. Of the high-grade patients, 31/37 were treated conservatively except 6/37 patients required surgical intervention after initial imaging. Following re-imaging, only one patient required surgical intervention in the form of insertion of a drainage tube for a hematoma, which was possibly infected. The existence of urinoma (5 patients) or hematoma (47 patients) was not associated with significantly higher rate of intervention (p values: 0.717 and 0.138, respectively). No significant association was noted between hematoma size and rate of intervention (p value = 0.055). CONCLUSION: Re-imaging for high-grade renal injuries could be limited to the presence of urinary extravasation in initial imaging or the presence of clinical deterioration such as pain, fever or decrease in hemoglobin level.

Chronic pelvic pain syndrome symptoms significantly affect medical students' well-being.

Aims: This study aims to determine the prevalence of chronic pelvic pain syndrome (CPPS) symptoms among male-medical students in Riyadh, Saudi Arabia. Settings and Design: It is a cross-sectional study at King Saudi Bin Abdulaziz University for Health Sciences, College of Medicine at Riyadh, Saudi Arabia. Subjects and Methods: A total of 300 male medical students were given a hardcopy questionnaire to be filled anonymously that includes demographic characteristics, several questions regarding the health status, habits of the participants, and the National Institutes of Health Chronic Prostatitis Symptom Index for evaluating CPPS symptoms. Statistical Analysis Used: SPSS (v21) was used for the analysis. Qualitative data presented by frequencies and percentages and quantitative data presented by median and interquartile range (Q1 to Q3). The Chi-square test and binary logistic regression were used to assess the relationship between the outcome variables with demographical data. Results: In total 300 male medical students were surveyed, 245 medical students returned the questionnaire giving a response rate of 81.6%. The prevalence of CPPS symptoms among all participants was 57.9%. Majority of the participants does not have any associated medical/psychological conditions 152 (62%). Students with irritable bowel syndrome (IBS) or/and anxiety have statistically significant association with CPPS symptoms (P < 0.05). A total of 23% of students with CPPS reported being impaired with their quality of life (QOL), while 77% are satisfied. Conclusions: The prevalence of CPPS symptoms among male medical students is high. Anxiety, IBS, and lack of activity might be associated with CPPS symptoms, which have a significant negative impact on the QOL. For the future direction, a large-scale global study should be conducted to link the effects of CPPS symptoms on male medical students well-being.