Protective Effect of Intravesical Platelet-Rich Plasma on Cyclophosphamide-Induced Hemorrhagic Cystitis.

PURPOSE: Hemorrhagic cystitis (HC) is the most common urotoxic side effect of cyclophosphamide (CYP). Platelet rich plasma (PRP) plays an important role in wound healing and inflammatory responses. The aim of this study was to investigate the efficacy of intravesical PRP at treatment of interstitial cystitis (IC). MATERIAL-METHODS: Female rats (n=24) were used. IC was induced by intraperitoneal injection of cyclophosphamide (CYP). Rats were randomly allocated to one of four groups (n = 6 per group): a control group; a sham group with saline (75 mg/kg; i.p.) instead of CYP on day 1; a IC group, which was injected with CYP (150 mg/kg; i.p.) on day 1; and, a intravesical PRP­treated group which was injected with CYP (150 mg/kg; i.p.) on day 1. On day 2, the rats in each group were sacrificed under anesthesia. RESULTS: Histological evaluation showed that bladder inflammation in CYP­treated rats was not suppressed by PRP. CYP administration induced severe IC with marked edema, hemorrhage and inflammation in CYP and CYP+PRP groups, but PRP was not found to be effective to decrease these effects. CONCLUSION: The application of PRP could not reverse the histopathological changes in rats that had interstitial cystitis due to the cyclophosphamide injection.

Seguridad y eficacia de la cirugía retrógrada intrarrenal en pacientes de diferentes grupos de edad / Safety and efficacy of retrograde intrarenal surgery in patients of different age groups

Objetivos: Evaluar la eficacia y seguridad de la cirugía intrarrenal retrógrada (CIRR) para tratar los cálculos renales en pacientes de diferentes grupos de edad. Pacientes y métodos: Se realizó un análisis retrospectivo de 947 pacientes que se sometieron a CIRR para cálculos renales entre enero de 2008 y enero de 2014. La edad en la CIRR se analizó tanto como una variable continua como categórica, y los pacientes fueron clasificados en 3 grupos de edad; ≤ 15 años en la cirugía (grupo i, n = 51), 16-60 años (grupo ii, n = 726) y> 60 años (grupo iii, n = 170). Se compararon los 3 grupos con respecto a las características del cálculo, los parámetros operativos y los resultados postoperatorios. Resultados; La tasa de ausencia de cálculos fue del 78,4% en el grupo i, 77,5% en el grupo ii, y 81,1% en el grupo iii (p = 0,587). Un análisis de regresión logística multivariante mostró que solo el tamaño del cálculo y el número de cálculos tuvieron una influencia significativa en las tasas de ausencia de cálculos después de CIRR. Se produjo un 13,7% de complicaciones intraoperatorias en el grupo i, 5,6% en el grupo ii, y 7,6% en el grupo iii. Las tasas de complicación global en niños eran más altas que en pacientes adultos, pero las diferencias no fueron estadísticamente significativas. Se descubrió que solo el tiempo de operación esataba asociado con el aumento del riesgo de complicaciones intraoperatorias. Las complicaciones médicas perioperatorias se desarrollaron en 8 pacientes (0,8%) en el grupo ii y 2 pacientes (1,1%) en el grupo iii. Un hombre de 48 años de edad murió a causa de shock séptico 5 días después de la cirugía. Conclusiones; Se observó que la CIRR era un procedimiento seguro y eficaz en todos los grupos de edad de pacientes con cálculos, por lo tanto, la edad no debe ser considerada como un factor limitante

Objectives: To assess the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in different age groups of patients. Patients and methods: We performed a retrospective analysis of 947 patients who underwent RIRS for renal calculi between January 2008 and January 2014. Age at RIRS was analysed both as a continuous and categorical variable and patients were categorized into three age groups; aged ≤ 15 years at surgery (group i, n = 51), 16 - 60 years (group Ii, n = 726) and > 60 years (group iii, n = 170). We compared the 3 groups with the regard to stone characteristics, operative parameters and postoperative outcomes. Results: The stone-free rate was 78.4% in group i, 77.5% in group ii, and 81.1% in group iii (P = .587). A multivariate logistic regression analysis showed that only stone size and stone number had significant influence on the stone-free rates after RIRS. Intraoperative complications occurred 13.7% in group i, 5.6% group ii, and 7.6% in group iii. Overall complication rates in children were higher than adult patients but the differences were not statistically significant. We found that only operation time was associated with the increased risk of intraoperative complications. Peroperative medical complications developed in 8 patients (.8%) in group ii and 2 patients (1.1%) in group iii. A 48-year-old man died from septic shock 5 days after the surgery. Conclusions: RIRS was observed to be a safe and effective procedure in all age groups of patients with stone disease, therefore age should not be considered as a limiting factor

Safety and efficacy of retrograde intrarenal surgery in patients of different age groups.

OBJECTIVES: To assess the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in different age groups of patients. PATIENTS AND METHODS: We performed a retrospective analysis of 947 patients who underwent RIRS for renal calculi between January 2008 and January 2014. Age at RIRS was analysed both as a continuous and categorical variable and patients were categorized into three age groups; aged ≤ 15 years at surgery (group i, n=51), 16 - 60 years (group Ii, n=726) and>60 years (group iii, n=170). We compared the 3 groups with the regard to stone characteristics, operative parameters and postoperative outcomes. RESULTS: The stone-free rate was 78.4% in group i, 77.5% in group ii, and 81.1% in group iii (P=.587). A multivariate logistic regression analysis showed that only stone size and stone number had significant influence on the stone-free rates after RIRS. Intraoperative complications occurred 13.7% in group i, 5.6% group ii, and 7.6% in group iii. Overall complication rates in children were higher than adult patients but the differences were not statistically significant. We found that only operation time was associated with the increased risk of intraoperative complications. Peroperative medical complications developed in 8 patients (.8%) in group ii and 2 patients (1.1%) in group iii. A 48-year-old man died from septic shock 5 days after the surgery. CONCLUSIONS: RIRS was observed to be a safe and effective procedure in all age groups of patients with stone disease, therefore age should not be considered as a limiting factor.

Percutaneous nephrolithotomy in hypertensive patients with different sizes of instruments.

OBJECTIVES: The risk of major complications, especially hemorrhage, is significantly elevated during surgery in hypertensive patients. To determine whether percutaneous nephrolithotomy (PCNL) can be safely performed in the hypertensive patients using different sized instruments. METHODS: We reviewed the records of 602 patients undergoing PCNL at our institution and identified 53 who were on antihypertensive therapy at the time of surgery. Patients were categorized into three groups according to size of devices used in surgery : those 24 F percutaneous tract with 22 F nephroscope (Group 1, n = 12 [22.7%]; 26 F percutaneous tract with 24 F nephroscope (Group 2, n = 19 [35.8%]) and 30 F percutaneous tract with 26 F nephroscope (Group 3, n = 22 [41.5%]). We compared the groups with regard to baseline characteristics, intraoperative parameters, stone-free and complication rates, and the length of hospitalization. RESULTS: There were no differences between the three groups in age, gender, weight and stone laterality. Fluoroscopy time, access to the collecting system and mean operative time for per cm2 stone did not differ between the groups. Hemoglobin decrease, postoperative hospital stay and blood transfusion rate was higher in group 3. Stones were completely cleared in 83.3%, 84.2% and 81.3% of patients, which increased to 91.6%, 89.5%, and 90.1% with adjunctive therapy in the group 1,2 and 3, respectively. CONCLUSIONS: PCNL with smaller devices is a safe and effective method in hypertensive patients. It has significantly a shorter hospital stay and less bleeding rates compared to classical PCNL.