Abstract:
OBJECTIVES:To identify the rate of postoperative complications in patients who require surgical reconstruction for ketamine-induced urinary tract dysfunction and to identify any predictors for poor postoperative outcome with subsequent management strategies. PATIENTS AND METHODS:A retrospective review of data collected between 2007 and 2017 of all patients with ketamine-induced urinary tract disease was performed. Evaluation included computed tomography urogram, cystoscopy, and biopsy. Indications and outcomes for surgical intervention were assessed. RESULTS:In all, 44 patients were identified of which 68% were male. The mean (range) age at presentation was 31 (23-55) years. All bladder biopsies confirmed an eosinophilic inflammatory infiltrate. A significant proportion of patients (81.8%) were found to have reduced cystoscopic bladder capacity of <300 mL (mean 196, range 25-550 mL). In all, 29 patients were treated conservatively with a view to symptom resolution. Two patients underwent dilatation for urethral strictures. Four patients underwent repeated intra-detrusor onabotulinum toxin injection with minimal subjective symptom relief. Two of these patients proceeded to have major reconstruction. Indications for urinary tract reconstruction included intractable symptoms, high-pressure compliance loss with renal compromise and ureteric obstruction. Patients were advised to abstain from ketamine use for a minimum of 6 months prior to consideration of surgical intervention. A total of 14 patients underwent major reconstruction. Surgical intervention included ileal conduit urinary diversion, augmentation cystoplasty with or without Mitrofanoff channels, ureteric re-implantation, and cystectomy with neobladders. Complications included anastomotic leaks, ureteric strictures, adhesional small bowel obstruction, renal failure, and sepsis. Overall, complications occurred in 10/14 patients. CONCLUSION:In a tertiary high-volume reconstructive unit, ketamine patients were at high risk of significant perioperative complications. There did not appear to be any other common factor apart from their use of ketamine, and the significant inflammatory change associated with this. We recommend meticulous preoperative evaluation and multidisciplinary consultation for all patients to determine optimal treatment strategies.
journal_name
BJU Intjournal_title
BJU internationalauthors
Sihra N,Ockrim J,Wood Ddoi
10.1111/bju.14094subject
Has Abstractpub_date
2018-03-01 00:00:00pages
458-465issue
3eissn
1464-4096issn
1464-410Xjournal_volume
121pub_type
杂志文章abstract:OBJECTIVES:• To investigate whether cysteine-rich secretory protein 3 (CRISP-3) and/or β-microseminoprotein (β-MSP) expression in diagnostic prostate needle biopsies have predictive value for prostate cancer (PC) on radical prostatecomy (RP). • To evaluate their potential clinical implementation in a preoperative setti...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.10059.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:To examine patterns of care among women with urogenital fistula treated in the English National Health Service (NHS) between 2000 and 2009. To assess whether failure of repair was associated with hospital or surgeon workload. PATIENTS AND METHODS:We conducted a retrospective cohort study using data from Hos...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2012.11483.x
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To review the outcomes of all patients referred with vesico-vaginal (V VF) and urethro-vaginal (UVF) fistulae to a tertiary centre, and to investigate the patient, fistula and surgical factors relevant to success. PATIENTS AND METHODS:We reviewed retrospectively the case-notes of 41 consecutive patients (32 ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08237.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To compare in vivo the potency and bladder-vascular selectivity of ATP-sensitive potassium channel openers (KCOs) (-)-cromakalim, WAY-133537 and ZD6169 and a muscarinic antagonist, tolterodine in rats. MATERIALS AND METHODS:Bladder and arterial pressures were monitored simultaneously, before and after increa...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.03069.x
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To report the events during and after radical cystectomy and urinary diversion for bladder cancer, in terms of major and minor complications, comparing a minimal with an extended lymphadenectomy, as more lymph nodes obtained during radical cystectomy may improve staging and thus the outcome. PATIENTS AND MET...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410x.2004.04557.x
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:•To compare the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) and European Randomized Study of Screening for Prostate Cancer Risk Calculator (ERSPC-RC) in a single-institution Canadian cohort. PATIENTS AND METHODS:•At Princess Margaret Hospital, 982 consecutive patients with PCPT-RC and ERSPC-RC...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10207.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. PATIENTS AND METHODS:Patients managed with AS or RP who completed val...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12209
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To investigate the diagnostic performance of gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (68 Ga-PSMA PET/CT) in patients with recurrent prostate cancer with regard to the presence of lymph node metastases (LNM) and local recurrences after primary radiotherapy...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15135
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To retrospectively review hypogonadal men receiving testosterone replacement therapy (TRT), and evaluate the changes in prostate-specific antigen (PSA) levels over an extended period, and thus evaluate the occurrence of prostate cancer, as a primary concern in treating late-onset hypogonadism (LOH) is the po...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08240.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:• To determine (i) the presence of fatty acid amide hydrolase (FAAH) in the urinary bladder; (ii) whether or not endogenous fatty acid ethanolamides are synthesized by the bladder; (iii) the effects of FAAH inhibition on referred hyperalgesia associated with acute bladder inflammation in rats. MATERIALS AND ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09583.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To compare the effect of allowing patients to watch their cystoscopy on closed-circuit television and with an explanation during the procedure, with an explanation alone, as involving patients in the process of minimally invasive procedures like colonoscopy or colposcopy has been reported to alleviate pain an...
journal_title:BJU international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1464-410x.2003.04477.x
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To determine the neurophysiological and vascular factors in diabetic impotence, particularly the role of autonomic neuropathy on venous leakage and erectile impotence. PATIENTS AND METHODS:Thirty-four diabetic men with impotence were investigated using various neurophysiological and radiological methods. The...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00916.x
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To assess the rate of prostate-specific antigen (PSA) testing for prostate cancer in general practice in asymptomatic and symptomatic patients. SUBJECTS AND METHODS:The cross-sectional study took place in England and Wales, was population-based and covered 469 159 men aged 45-84 years. Pathology data on PSA ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-4096.2004.04832.x
更新日期:2004-07-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? Acute urinary retention (AUR) and catheterization for AUR (AURC) or drainage of the urine is a well established cause of bladder dysfunction. Previously, we reported that the induction of AURC significantly reduced contractile responses to both carbac...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.10965.x
更新日期:2012-09-01 00:00:00
abstract:UNLABELLED:Study Type--Therapy (cohort) Level of Evidence 2a. What's known on the subject? and What does the study add? Despite expanding treatment options for castration-resistant prostate cancer (CRPC), therapies with long response duration remain intangible due to prostate cancer cells' natural ability to develop it...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11456.x
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To determine the effect of combined finasteride and flutamide therapy on haemoglobin and haematocrit values in men with advanced prostate cancer. PATIENTS AND METHODS:Nineteen men, previously untreated by hormone therapy, with histologically confirmed adenocarcinoma of the prostate and clinical evidence of a...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00844.x
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the diffusion of nephron-sparing modalities (NSM) for the treatment of renal neoplasms in the USA over the last decade and to identify the factors associated with renal procedure selection. PATIENTS AND METHODS:The Nationwide Inpatient Sample was utlized to identify patients undergoing cryo/radio...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11497.x
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To determine whether conformity to standard recommendations of retroperitoneal lymph node dissection (RPLND) after chemotherapy for testicular and primary retroperitoneal nonseminomatous germ cell tumours (NSGCT) and completeness of surgical excision have an effect on oncological outcome. PATIENTS AND METHOD...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.09175.x
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To prospectively investigate the presentation of germ cell tumours (GCTs) of the testis in terms of stage or histology, as the incidence of this disease in increasing. PATIENTS AND METHODS:Patients diagnosed with GCT of the testis between 1983 and 2002 were categorised into three periods depending on the dat...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2005.05504.x
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To determine whether the temperature of 2% lignocaine hydrochloride gel affects the initial discomfort during instillation into the male urethra. PATIENTS AND METHODS:Sixty consenting men were randomized to receive 11 mL of 2% lignocaine hydrochloride gel (Instillagel, Farco-Pharma GmbH, Cologne, Germany) at...
journal_title:BJU international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1464-410x.1999.00346.x
更新日期:1999-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12770
更新日期:2015-01-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? Recent studies have indicated that high mobility group box 1 (HMGB1) is related to the development and progression of human carcinomas. However, further studies were required to confirm the roles played by HMGB1 in clinical prostate cancer treatment. ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11277.x
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To investigate the feasibility and clinical outcome of extracorporeal shock-wave therapy (ESWT) for patients suffering from chronic pelvic pain syndrome (CPPS). PATIENTS AND METHODS:The study included 34 patients who had had CPPS for >or=3 months, who were investigated in two subsequent studies. ESWT was adm...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07742.x
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:To determine if baseline characteristics, treatment efficacy, psychosocial outcomes or tolerability were associated with patient preference for sildenafil citrate (sildenafil) or tadalafil for treating erectile dysfunction (ED) in men naive to phosphodiesterase 5 inhibitor therapy. PATIENTS AND METHODS:In a...
journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1464-410X.2007.06916.x
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To explore whether a panel of kallikrein markers in blood: total, free and intact prostate-specific antigen (PSA) and kallikrein-related peptidase 2, could be used as a non-invasive alternative for predicting prostate cancer on biopsy in a screening setting. SUBJECTS AND METHODS:The study cohort comprised pr...
journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1464-410X.2012.11690.x
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To characterise the incidence, onset, management, predictors, and clinical impact of mammalian target of rapamycin (mTOR) inhibitor-associated non-infectious pneumonitis (NIP) on patients with metastatic renal cell carcinoma (mRCC). PATIENTS AND METHODS:Retrospective review of 310 patients with mRCC who rece...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12420
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To assess the changing distribution of stage in seminoma and nonseminomatous germ cell tumours (NSGCTs), as recent reports contained no detailed information on pT stage and vascular invasion, important factors in the decision for further treatment. PATIENTS AND METHODS:Histopathological reports from 1976 to ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06424.x
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To evaluate if moderate chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 ] is associated with high rates of non-muscle-invasive bladder cancer (NMIBC) recurrence or progression. PATIENTS AND METHODS:A multi-institutional database identified patients with serum creat...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.13904
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:• To investigate the relationship between pretreatment testosterone levels and pathological specimen characteristics, by prospectively examining serum androgen concentrations in a well-studied cohort of patients who underwent radical prostatectomy (RP) for localized prostate cancer. PATIENTS AND METHODS:• A ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09816.x
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To systematically review and create nomograms of flaccid and erect penile size measurements. METHODS:Study key eligibility criteria: measurement of penis size by a health professional using a standard procedure; a minimum of 50 participants per sample. EXCLUSION CRITERIA:samples with a congenital or acquire...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/bju.13010
更新日期:2015-06-01 00:00:00