ABSTRACT
BACKGROUND: There is a variability in the reported rate of post-prostate biopsy voiding inefficiency. The burden and potential predictors of this morbidity is not well studied in African patients. This study aimed to evaluate the incidence as well as the clinical and histological factors affecting voiding function in patients undergoing trans-rectal prostate biopsy in an African population. SUBJECTS, MATERIALS AND METHODS: An observational cohort study was carried out in 68 adult males, 40 years and above, scheduled for trans-rectal prostate biopsy for suspected prostate cancer. Those who could not void spontaneously, had either neurological conditions or were on drugs that could affect voiding, were excluded from the research. Data on demographic characteristics of the patients were collected. Uroflowmetry was done to obtain the peak urine flow rate of the patients at baseline and seven days after the procedure. The prostate volume was determined and the presence of other potential clinical and histological risk factors were recorded. The presence of other bleeding-related biopsy complications was also recorded. Statistical analysis was done using SPSS with a p-value of less than 0.05 reported as significant. RESULTS: Voiding inefficiency was recorded in 28 (41.2%) of the patients with majority, 21 (75.0%), experiencing a five to nine-point decrease in their seventh day peak flow rate values. Post-biopsy haematuria occurred in 37 (54.4%) of the population. The presence of haematuria with blood clots was associated with a 10.9 times increased risk of voiding inefficiency after the procedure (p = 0.006). CONCLUSION: About two in five patients developed post-prostate biopsy voiding inefficiency. Blood clot presence was independently. associated with the occurrence of this morbidity.
CONTEXTE: Le taux d'inefficacité mictionnelle après une biopsie de la prostate est variable l'inefficacité prostate. Le fardeau et les et les prédicteurs potentiels de cette morbidité ne sont pas bien étudiés chez les patients africains. Cette étude visait à évaluer l'incidence ainsi que les facteurs cliniques et histologiques affectant la fonction mictionnelle chez les patients subissant une biopsie transrectale de la prostate dans une population africaine. SUJETS, MATÉRIEL ET MÉTHODES: Une étude de cohorte observationnelle a été réalisée chez 68 adultes âgés de 40 ans et plus, programmés pour une biopsie transrectale de la prostate. Ceux qui ne pouvaient pas uriner spontanément, souffraient de troubles neurologiques ou etaient drogues qui peut agissaient la miction ont été exclus de la recherche. Les données sur les caractéristiques démographiques des patients ont été recueillies. Une uroflowmétrie a été fait pour obtenir le débit urinaire de pointe des patients au début de l'étude et sept jours après l'intervention. Le volume de la prostate a été déterminé et la présence d'autres facteurs de risque cliniques et facteurs de risque potentiels, cliniques et histologiques, ont été enregistrés. La présence d'autres complications de la biopsie liées au saignement a également été enregistrée. L'analyse statistique a été effectuée à l'aide du logiciel SPSS, une valeur p inférieure à 0,05 étant considérée comme significative. RÉSULTATS: L'insuffisance mictionnelle a été enregistrée chez 28 (41,2 %) des patients. La majorité d'entre eux, 21 (75,0 %), présentant une diminution de cinq à neuf points dans leurs valeurs de débit de pointe au septième jour. Une hématurie post-biopsie est survenue chez 37 (54,4 %) de la population. La présence d'une hématurie avec caillots sanguins était associée à un risque 10,9 fois plus élevé d'inefficacité mictionnelle après la procédure (p = 0,006). CONCLUSION: Environ deux patients sur cinq ont développé une insuffisance mictionnelle après une biopsie de la prostate. La présence de caillots sanguins était indépendamment associée à l'apparition de cette morbidité. Mots-clés: Symptômes du bas appareil urinaire, biopsie de la prostate, facteurs de risque, rétention urinaire.
Subject(s)
Prostate , Adult , Biopsy , Cohort Studies , Humans , Male , Prospective Studies , Risk FactorsABSTRACT
BACKGROUND: Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound-guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, affordable, and not associated with radiation exposure. We present our experience with ultrasound-guided PCN. PATIENTS AND METHODS: We studied all patients who had ultrasound-guided PCN in our center between January 2013 and January 2017. Information obtained included the patients' demographics, clinical details, primary pathology, indications, outcome, and complications within 30 days. Relevant data were extracted and analyzed using descriptive statistics. RESULTS: A total number of 35 PCNs were performed in 26 patients within the period of study. The median age was 44.5 years. There were 17 females and 9 males. About 88.2% of the females had ureteric obstruction from advanced carcinoma of the cervix while the predominant cause of obstruction in the males was advanced carcinoma of the bladder. Kidney access under ultrasound guidance required well dilated collecting systems for success and ease of puncture. The most common complication was hematuria, which resolved within 24-48 h in all patients uneventfully. CONCLUSION: PCN is an important and common procedure for temporary relief of upper urinary tract obstruction. While fluoroscopic guidance provides superior image guidance, ultrasound guidance is comparatively reliable, albeit with a longer learning curve. Adequate training, careful patients selection, and patience are key to success.
Subject(s)
Kidney/diagnostic imaging , Nephrostomy, Percutaneous/methods , Ultrasonography, Interventional/methods , Ureteral Obstruction/etiology , Ureteral Obstruction/surgery , Adult , Aged , Catheterization , Drainage/adverse effects , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Nephrostomy, Percutaneous/instrumentation , Nigeria , Punctures , Ureteral Obstruction/diagnostic imagingABSTRACT
We carried out a prospective study of consecutive patients who presented with chronic urinary retention over a period of 2 years in order to determine the safety and effectiveness of rapid and complete decompression of chronic urinary retention. A total of 22 patients met the inclusion criteria. Although slow decompression is thought to reduce complications, it harbours the disadvantages of impracticability, time and labour demands and an increased risk of infection. Post-obstructive diuresis, haematuria and hypotension are relatively frequent in rapid and complete decompression of chronic urinary retention. However, they are mild, transient and clinically insignificant. Rapid and complete decompression of the chronically obstructed urinary bladder not only saves time, it is safe and effective and should be adopted as the standard practice.
Subject(s)
Decompression , Drainage , Urinary Retention/therapy , Adult , Aged , Decompression/adverse effects , Hematuria/etiology , Humans , Male , Middle Aged , Prospective Studies , Urinary Retention/etiology , Young AdultABSTRACT
The development of two phosphate biosensors is described and compared for potentiometric detection of phosphate. Purine nucleoside phosphorylase (PNP) and xanthine oxidase (XOD) were co-immobilised by chemical cross-linking with glutaraldehyde (GLA) and bovine serum albumin (BSA), and via entrapment into polypyrrole (PPy) films by galvanostatic polymerisation. The BSA-GLA film was made with 4.5% v/v GLA and 6.8% w/v BSA with a drying time of 30 min, while polypyrrole entrapment was achieved with 0.5M pyrrole by using a polymerisation time of 200s. A mole ratio of 1:8 (6.2U/mL XOD: 49.6 U/mL PNP) was used for both methods of enzyme immobilisation. Sensitive potentiometric measurements obtained for phosphate with the BSA-GLA-PNP-XOD biosensor were compared with those of PPy-PNP-XOD-Fe(CN)(6)(4-) biosensor. A minimum detectable concentration of 0.1mg/L phosphate and a linear concentration range of 0.5-2.5mg/L were achieved with the PPy-PNP-XOD-Fe(CN)(6)(4-) biosensor. In comparison, a minimum detectable concentration of 2mg/L and a linear concentration range of 4-12 mg/L were achieved with the BSA-GLA immobilisation. The presence of uric and ascorbic acids had the least effect on the performance of the PPy-PNP-XOD-Fe(CN)(6)(4-) biosensor, but will not have any effect on phosphate measurement with both biosensors at levels normally present in water.
