Abstract:
PURPOSE:Our objective was to determine the impact of preoperative frailty, as measured by validated Risk Analysis Index (RAI), on the occurrence of postoperative complications after urologic surgeries in a national database comprised of diverse practice groups and cases. STUDY DESIGN:The National Surgical Quality Improvement Program (NSQIP) database was queried from 2005 to 2011 for a list of abdominal, vaginal, transurethral and scrotal urological surgeries using Current Procedural Terminology codes. The study population was subdivided into two groups based on the nature of procedures performed: complex procedures (inpatient) and simple procedures (outpatient). Risk Analysis Index score was calculated using preoperative NSQIP variables to determine preoperative frailty. Major postoperative morbidities (pulmonary, cardiovascular, renal and infectious), mortality, return to operating room, discharge destination and readmission to the hospital were examined. RESULTS:The study identified 42,715 patients who underwent urological procedures, 25,693 complex and 17,022 simple procedures. Mean RAI score (range) was 7.75 (0-53). The majority of patients scored low on the RAI (90.57 % with RAI < 10). As the RAI score increased, there was a significant increase in postoperative complication and mortality rate (both p < 0.0001). Similarly, the rate of return to operating room and hospital readmission rate increased as RAI increased (both p < 0.0001). Additionally, rate of discharge to home decreased. Interestingly, mortality rate in patients with high RAI did not differ comparing simple to complex procedures (p = 0.90), whereas complications were significantly greater in the complex operation (p = 0.01). CONCLUSIONS:Increase in frailty, as measured by RAI score, is associated with increased postoperative complications and mortality. RAI may allow for rapid identification and counseling of patients who are at high risk of adverse perioperative outcomes.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Isharwal S,Johanning JM,Dwyer JG,Schimid KK,LaGrange CAdoi
10.1007/s00345-016-1845-zsubject
Has Abstractpub_date
2017-01-01 00:00:00pages
21-26issue
1eissn
0724-4983issn
1433-8726pii
10.1007/s00345-016-1845-zjournal_volume
35pub_type
杂志文章abstract:PURPOSE:To assess whether real-time elastography-targeted biopsy (RTE-bx) is superior to the standard systematic transrectal ultrasound (TRUS)-guided biopsy in predicting subsequent prostate cancer (PCa) rates in patients with initially negative biopsy and to specifically reveal differences in the occurrence of high-gr...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2178-x
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:Robotic radical cystectomy (RRC) has become a commonly utilised alternative to open radical cystectomy (ORC). We performed a systematic review and meta-analysis of RRC vs ORC focusing on perioperative outcomes and safety. METHODS:Medline, EMBASE and CENTRAL were searched from January 2000 to April 2020 followi...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-020-03385-8
更新日期:2020-07-30 00:00:00
abstract:PURPOSE:The aim of this study is to review the current literature that reports outcomes of Peyronie's disease (PD) reconstructive surgery using the collagen fleece TachoSil® (Baxter, CA, USA), a novel graft that has self-adhesive properties and gained popularity in recent years. METHODS:A literature review was perform...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-019-02792-w
更新日期:2020-02-01 00:00:00
abstract::This is the first reported use of low-angle X-ray scattering for the investigation of urinary calculi. Low-angle X-ray scattering (LAXS) measures the diffraction of a broad spectrum of X-rays at a single angle and uses a conventional diagnostic X-ray beam, and could thus be developed for use in vivo. A total of 45 cal...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/BF00182064
更新日期:1996-01-01 00:00:00
abstract::Urinary tract infection (UTI) remains the most common type of infection contracted by kidney transplant patients. UTI reduces both patient and graft survival. Understanding and managing UTI in transplant patients requires an appreciation of their unique anatomy and physiology. Both the transplant and native urinary sy...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-019-02742-6
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:To compare oncological, functional, and toxicity outcomes of patients with radiation-recurrent prostate cancer (PCa) after external beam radiation therapy (EBRT) or brachytherapy (BT) treated with salvage high-intensity focused ultrasound (S-HIFU) or salvage radical prostatectomy (S-RP). METHODS:This retrospec...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02640-x
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:STAMPEDE arm H demonstrated a survival benefit for newly diagnosed prostate cancer (PCa) patients with low metastatic burden (LMB) who additionally received radiotherapy (RT) to the primary. However, it is unknown if radical prostatectomy (RP) may achieve equivalent results, since existing studies did neither i...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02950-0
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:To compare long-term functional outcomes after robotic vs. retropubic RP for patients with localized prostate cancer in routine care. METHODS:"HAROW" was a large German noninterventional health services research study that prospectively evaluated the treatment of patients with localized prostate cancer (≤ T2c)...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02956-8
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:To evaluate the role of adrenergic and nitrergic signaling on ureteric peristaltic frequency and contraction force in vivo using a large animal model. METHODS:Twelve female pigs (72 ± 4 kg) were chronically instrumented with an electronic pressure-monitoring catheter in the right ureter. Nephrostomy, cystostom...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1663-8
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:Several disease characteristics have been identified as potential predictors for pathological node involvement (pN+) following radical cystectomy (RC). However, these have not been assessed in patients treated with neoadjuvant chemotherapy (NAC). We endeavored to assess factors predicting adverse pathology in c...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-015-1667-4
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:Given that the tumor-promoting inflammation has been previously established in squamous cell carcinoma of the bladder but its contribution to development of urothelial carcinoma (UC) still remains elusive, our aim was to study changes in expression and activity of inflammation-mediating NF-κB and STAT3 transcri...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-014-1237-1
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:A paucity of data exists on the insignificant disease potentially suitable for active surveillance (AS) among men with intermediate-risk prostate cancer (PCa). We tried to identify pathologically insignificant disease and its preoperative predictors in men who underwent radical prostatectomy (RP) for intermedia...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-014-1413-3
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Recent studies demonstrated ongoing inverse stage migration in prostate cancer (PCa) patients towards more advanced and unfavorable tumors. The USPSTF grade D recommendation may impact this trend in North American patients. We assessed contemporary stage migration and treatment trends in a large North American ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2396-2
更新日期:2019-03-01 00:00:00
abstract::The present discussion on the natural history, growth rate pathophysiology, morbidity, and possible treatment of benign prostatic hyperplasia (BPH) reinforces the need to objectify mechanical BPH-induced obstruction with pressure-flow study. Different methods for the quantification of BPH-induced obstruction exist and...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/BF00182667
更新日期:1995-01-01 00:00:00
abstract::Sacral nerve modulation (SNM) is an effective way to treat non-neurogenic dysfunctions of pelvic organs. For over 20 years, this technique has been used for the treatment of overactive bladder, urinary retention, pelvic pain and even more recently, fecal incontinence and constipation. The objective of the study is to ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-007-0204-5
更新日期:2007-12-01 00:00:00
abstract::Candiduria is commonly seen in hospitalized patients and most of the patients are asymptomatic, but it may be due to cystitis, pyelonephritis, prostatitis, epididymo-orchitis or disseminated candidiasis. Major risk factors are diabetes mellitus, indwelling urinary catheters, use of broad-spectrum antibiotics, urinary ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02991-5
更新日期:2020-11-01 00:00:00
abstract:PURPOSE:We investigated hemodynamics in patients receiving delta-Aminolevulinic acid (delta-ALA) to visualize tumor margins prior to radical retro pubic prostatectomy. PATIENTS:Twenty patients undergoing elective open radical retro pubic prostatectomy (RRP). METHODS:Cohort observational study. Ten patients receiving ...
journal_title:World journal of urology
pub_type: 临床试验,杂志文章
doi:10.1007/s00345-011-0788-7
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:To evaluate the feasibility of measuring the intrapelvic pressure (IPP) during f-URS with a wire including a pressure sensor and to assess IPP profiles during the procedure. METHODS:Patients undergoing f-URS for stone disease were recruited. A wire with pressure sensor was placed in the renal cavities to measu...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03216-w
更新日期:2020-05-07 00:00:00
abstract:PURPOSE:Because there is a lack of evidence, it is not generally recommended to use adjuvant radiotherapy plus chemotherapy to treat lymph node disease in penile cancer. The aim of this study was to determine the benefit of using adjuvant radiotherapy after inguinal surgery for penile cancer. METHODS:Multi-institution...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03179-y
更新日期:2020-04-17 00:00:00
abstract:PURPOSE:To assess the performance of EAU risk classification in PCa patients according to the biopsy pathway (standard versus MRI guided) and to develop a new, more accurate, targeted biopsy (TB)-based classification. MATERIALS AND METHODS:We included 1345 patients consecutively operated by radical prostatectomy (RP) ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-03053-6
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Erectile dysfunction (ED) and cardiovascular disease (CVD) share a great number of common risk factors. There is growing evidence that aldosterone, an independent CVD risk factor, is associated with ED. AIMS:The purpose of this study was to determine the relationship between plasma aldosterone and erectil...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1723-0
更新日期:2016-07-01 00:00:00
abstract::Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is more frequent in men than in women. We review the main established/proposed factors, both environmental and genetic, associated with bladder cancer etiology and prognosis. Data were extracted from previous reviews and original articles ident...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-007-0168-5
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:To evaluate the role of multiparametric magnetic resonance imaging (mpMRI) in Gleason score (GS) 3 + 4 prostate cancer (PCa) and evaluate independent factors in mpMRI that can predict GS upgrading, we compared the outcomes of GS upgrading group and GS non-upgrading group. PATIENTS AND METHODS:We analyzed th...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03421-7
更新日期:2020-08-31 00:00:00
abstract:OBJECTIVE:Robotic-assisted radical cystectomy (RARC) is a less invasive means of performing the radical cystectomy operation, which holds promise for improved patient morbidity. We review the history, technique and current literature pertaining to RARC and place the current results in context with the open procedure. ...
journal_title:World journal of urology
pub_type: 历史文章,杂志文章,评审
doi:10.1007/s00345-013-1053-z
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Prognoses for intermediate-risk prostate cancer (PCa) remain heterogeneous. Improved substratification could optimize treatment and monitoring strategies. The objective was to validate this subclassification in a radical prostatectomy (RP) series. METHODS:Between 2000 and 2011, 4038 patients who underwent R...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-016-1979-z
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy and safety of Adjustable Transobturator Male System (ATOMS) compared to male Readjustment Mechanical External (REMEEX) system for post-prostatectomy incontinence (PPI). MATERIAL AND METHODS:A systematic review and meta-analysis on adjustable device ATOMS compared to male REMEEX is pres...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-020-03300-1
更新日期:2020-06-11 00:00:00
abstract::Tissue engineering, long a matter of myth and dream throughout the history of medicine, is now a practical reality. A wide spectrum of biological materials are used in the field of urology to treat disease and to overcome human disabilities, including tissue grafts and organ transplantation. Laboratory-engineered biop...
journal_title:World journal of urology
pub_type: 历史文章,杂志文章
doi:10.1007/s003450050015
更新日期:2000-02-01 00:00:00
abstract::Although anejaculation is a relatively uncommon occurrence in the general population, over 12,000 new cases are reported annually. Anejaculation may result from spinal cord injury (SCI), retroperitoneal lymph node dissection (RPLND), diabetes mellitis, transverse myelitis, multiple sclerosis, or psychogenic disorders....
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/BF00182035
更新日期:1993-01-01 00:00:00
abstract::The effects of pelvic floor muscle contraction on rectal and vesical function were studied in 19 healthy volunteers with the aim of shedding light on some of the hitherto vague aspects of the mechanisms involved in micturition and defecation and their disorders. Rectal and vesical pressures were recorded during pubore...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s003450100218
更新日期:2001-08-01 00:00:00
abstract:PURPOSE:To evaluate the thermal effect of Ho:YAG laser lithotripsy in a standardized in vitro model via real-time temperature measurement. METHODS:Our model comprised a 20 ml test tube simulating the renal pelvis that was immersed in a 37 °C water bath. Two different laser fibers [FlexiFib (15-45 W), RigiFib 1000 (45-...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2303-x
更新日期:2018-09-01 00:00:00