ABSTRACT
AIMS: This study is to investigate whether a repetitive education program for behavioral modification is necessary for the patients with nocturnal polyuria (NPU). MATERIALS AND METHODS: A prospective single-arm study was carried out and 82 patients with NPU were analyzed. We developed a 30-min systematized behavioral modification program (SBMP), which consisted of (1) watching videos about normal physiology of storing and emptying function of urine, (2) regulation of fluid intake, (3) explanation by giving specific examples, and (4) discussion with a specialized nurse practitioner. Patients received reinforcement SBMP if they still had NPU after the first SBMP. RESULTS: Mean age was 66 ± 8.3 years. Sixty-three males (77%) and 19 females (23%) were included. The results of all questionnaires showed significant improvement of nocturia after the first SBMP. Nocturnal voids, quality of life scores, nocturia index, and nocturnal bladder capacity index were significantly improved and the decrease of nocturnal urine volume was borderline significant. No additional significant improvement was demonstrated after the second SBMP. Overall, 62 patients (78.5%) were satisfied with the first SBMP and 6 patients (7.6%) became satisfied after reinforcement SBMP. Eleven patients (13.9%) were eventually dissatisfied with SBMP. CONCLUSIONS: A single SBMP was sufficient for treating most of the patients with NPU and reinforcement SBMP was effective in some patients. Moving from two to one rises at night may significantly reduce bother and this may explain quality of life improvements rather than any decrease in amount voided.
Subject(s)
Behavior Therapy/methods , Nocturia/physiopathology , Nocturia/therapy , Patient Education as Topic/methods , Adult , Aged , Aged, 80 and over , Drinking Behavior/physiology , Female , Humans , Male , Middle Aged , Nurse Practitioners , Prospective Studies , Quality of Life , Treatment Outcome , Urinary Bladder/physiology , Urodynamics/physiologyABSTRACT
PURPOSE: We performed laparoendoscopic single-site (LESS) partial nephrectomy in a porcine model with the objectives of overcoming the technical challenges of this surgery and exploring its feasibility. MATERIALS AND METHODS: Six partial nephrectomies were performed on a pig aged 5 months, three cases on each kidney, by four surgeons: two urologists with much experience in laparoscopic surgery (E1, E2) and two less-experienced urologists (B1, B2). While under general anesthesia, the swine was placed in a lateral flank position. Umbilical placement of an Octoport was done with a 2.5 cm incision. After dissection of the renal hilum and Gerota's fascia, a bulldog clamp was applied on the renal artery and parenchymal resection was done. Renorrhaphy was then performed with interrupted sutures with the use of a sliding knot technique. RESULTS: All six partial nephrectomies were performed successfully after repair of the vascular and collecting system at the resection margin and renorrhaphy without the need to introduce any additional ports. There were no noticeable intra- or postoperative complications. The mean warm ischemic time was 42 minutes (range, 30-60 minutes). The shortest warm ischemic time, 30 minutes, was achieved by using the early unclamping technique during renorrhaphy. The longest warm ischemic time was 60 minutes. The average number of renorrhaphy stitches was 3.2 (range, 2-5). CONCLUSIONS: LESS partial nephrectomy was successfully performed in a porcine model but resulted in a longer ischemic time than that of conventional laparoscopic surgeries. Therefore, further laboratory disciplinary efforts are needed to decrease the warm ischemic time and to improve this surgical technique.
ABSTRACT
We present an unusual case of concurrent occurrence of a multilocular cystic renal cell carcinoma and a leiomyoma in the same kidney of a patient with no evident clinical symptoms. A 38-year-old man was found incidentally to have a cystic right renal mass on computed tomography. Laparoscopic radical nephrectomy was performed under a preoperative diagnosis of cystic renal cell carcinoma. Histology revealed a multilocular cystic renal cell carcinoma and a leiomyoma. This is the first report of this kind of presentation.
