Free interactive counselling program in a mobile communication application for improving health education on indwelling ureteric stents after ureterorenoscopic lithotripsy: An observational study.

Objective: This study examines the potential benefit of an interactive counselling program via a mobile application (app), which can instantly provide patients with the necessary information and correct response regarding their condition. Methods: We designed a free 'Ureteric Stent Interactive Program' for patients receiving ureterorenoscopic lithotripsy and provided the program to interested patients. Patient data were collected from medical records and depending on whether patients used our program, they were divided into two groups: 'program-user' and 'non-user'. The differences between the groups were analysed using Fisher's exact tests. Results: Of the 70 patients, 50 elected to use the program. The program-user group was significantly younger (<60 years: 74% vs 15%, P<0.001) and had higher education levels (40% vs 5%, P = 0.004). All 50 patients in the program-user group reported being satisfied (32%) or very satisfied (68%) with the program. Patients over 60 years were significantly more satisfied with program (35.5% vs 6.3%, P = 0.04). Conclusions: Younger patients with high education levels were more likely to use the app and improve their health knowledge. Using the program resulted in high satisfaction, especially among older patients. This study demonstrates the benefits of interactive application for educating patients regarding their health.

Efficacy of intravenous hydration during extracorporeal shock wave lithotripsy in improving ureteral stone treatment success rate.

OBJECTIVE: The treatment efficacy of extracorporeal shock wave lithotripsy for urolithiasis depends on several factors. We aimed to evaluate the impact of intravenous hydration during shock wave lithotripsy on stone treatment success rate in patients with ureteral stones. METHODS: We retrospectively evaluated patients with ureteral stones <2 cm in diameter treated with extracorporeal shock wave lithotripsy at two sites. Patients from one of the sites received intravenous hydration with 500 mL of 0.9% NaCl. Stone treatment success status was defined as stone-free or residual ureteral stones <0.4 cm in diameter 1 month after the procedure. Predictive factors associated with treatment success were evaluated using univariate and multivariate logistic regression. RESULTS: Overall, 146 consecutive patients with ureteral stones were included. Eighty (54.8%) patients received intravenous hydration. The overall stone treatment success rate was 66.4%. Those with intravenous hydration during the shock wave lithotripsy had significantly smaller stone size, lower serum creatinine levels, lower rate of alpha-blockers use, and higher rate of nonsteroidal anti-inflammatory drug use. Upon multivariate analysis, stone treatment success status postprocedure was significantly associated with stone size (odds ratio 4.118, 95% confidence interval 1.920-8.832, P < 0.0001) and intravenous hydration during the procedure (odds ratio 2.475, 95% confidence interval 1.176-5.208, P = 0.017). CONCLUSION: Besides small ureteral stone size, concomitant intravenous hydration with 500 mL of normal saline during extracorporeal shock wave lithotripsy was significantly associated with subsequent stone passage. Administering 0.9% NaCl may be a simple and effective measure to improve the treatment efficacy of extracorporeal shock wave lithotripsy.

Prevalence and clinical characteristics of simple renal cyst.

BACKGROUND: We investigated simple renal cysts to understand the prevalence in healthy individuals and evaluate their clinical characteristics to determine whether or not there are any risk factors associated with simple renal cysts. METHODS: Abdominal sonography was performed in 577 individuals (317 men, 260 women; mean age, 48.84 years; age range, 20-94 years) who received health check-up in January to February 2005. Data including age, sex, renal sonographic findings (cyst number, site, diameter, renal stones), values of serum cholesterol, glucose and creatinine, urine analysis (proteinuria, hematuria, pyuria), and smoking habit were analyzed. RESULTS: The overall prevalence of simple renal cysts was 10.7%, ranging from 2.38% in the 2nd to 35.29% in the 7th or later decade of life. The prevalence increased with age (p<0.001). The mean age of individuals with cysts was significantly older than those without cysts (57.65+/-13.35 vs. 47.78+/-12.40 years; p<0.001). Male-to-female ratio was 2.81 (15.14% vs. 5.38%; p<0.001). The majority of cysts were solitary (82.3%). Mean largest diameter of cysts was 20.89+/-12.62 mm. The mean size of cysts in every age group was not statistically different. Factors significantly associated with simple renal cysts were age (odds ratio [OR], 4.37; p<0.001), sex (OR, 0.32; p<0.001), serum creatinine (OR, 11.77; p=0.001), proteinuria (OR, 3.11; p=0.004), renal stone (OR, 2.47; p=0.006), and smoking (OR, 2.80; p<0.001). However, in multivariate analysis, except proteinuria, all of the above factors were significantly related to the occurrence of simple renal cysts. CONCLUSION: The overall prevalence of simple renal cysts in healthy individuals was 10.7%. Age, sex, renal stone, serum creatinine, and smoking were found to be risk factors for the presence of simple renal cysts.

Transurethral prostatic resection for acute urinary retention in patients with prostate cancer.

BACKGROUND: Few studies have focused on clinical findings in prostate cancer patients receiving transurethral resection of the prostate (TURP) for acute urinary retention (AUR). We compared the clinical findings (preoperative characteristics, operative morbidities, and pathology results) of patients with diagnosed prostate cancer undergoing palliative TURP for AUR with those of patients undergoing TURP for AUR who were diagnosed with prostate cancer postoperatively. METHODS: The charts of 25 patients with prostate cancer undergoing TURP for AUR between 1986 and 2003 were retrospectively reviewed. Fourteen patients underwent palliative TURP (group A) and the other 11 patients with newly diagnosed prostate cancer received TURP (group B). The data, including preoperative characteristics, operative morbidities, and pathology results were analyzed. RESULTS: There were no significant differences between the 2 groups in parameters such as age at diagnosis and operation, operative time, hospitalization, and catheter duration. However, the Gleason score was higher in group A (7.6 +/- 1.7) than in group B (5.4 +/- 1.8) (p < 0.005). The mean resected weight was lower in group A (19.9 g) than in group B (39.5 g). Group A was more likely to receive recatheterization (33.3% vs 0%, p = 0.058) and repeat operation (28.6%), although the difference was not statistically significant. There were no complications such as transurethral resection syndrome or perioperative death in either group. CONCLUSION: TURP can be performed safely for relief of AUR in patients with prostate cancer, no matter if the cancer was diagnosed before or after surgery. The higher Gleason score and more advanced cancer stage, as found in group A, may correlate to high recatheterization and reoperation rates due to preexisting tumor progression.