Challenges facing the urologist in low- and middle-income countries.


PURPOSE:The challenges in providing urologic care across borders and in resource-constrained settings are poorly understood. We sought to better characterize the impediments to the delivery of urological care in low- and middle-income countries (LMICs) compared to high-income countries (HICs). METHODS:A 70 question online survey in RedCap™ was distributed to urologists who had practiced in countries outside of the United States and Europe categorized by World Bank income groups. RESULTS:114 urologists from 27 countries completed the survey; 35 (39%) practiced in HICs while 54 (61%) practiced in LMICs. Forty-three percent of urologists received training outside their home country. Most commonly treated conditions were urolithiasis (30%), BPH (15%) and prostate cancer (13%) which did not vary by group. Only 19% of urologists in LMICs reported sufficient urologists in their country. Patients in LMICs were less likely to get urgent drainage for infected obstructing kidney stones or endoscopic treatment for a painful kidney stone or obstructing prostate. Urologists visiting LMICs were more likely to cite deficits in knowledge, inadequate operative facilities and limited access to disposables as the major challenges whereas local LMIC urologists were more likely to cite financial challenges, limited access to diagnostics and support staff as the barriers to care. CONCLUSIONS:LMICs lack enough training opportunities and urologists to care for their population. There is disconnect between the needs identified by local and visiting urologists. International collaborations should target broader interventions in LMICs to address local priorities such as diagnostic studies, support staff and financial support.


World J Urol


World journal of urology


Metzler I,Bayne D,Chang H,Jalloh M,Sharlip I




Has Abstract


2020-11-01 00:00:00














  • Quality-of-life assessment in patients treated with lower-energy thermotherapy: Prostasoft 2.0.

    abstract::This study was designed to evaluate the impact of lower-energy transurethral microwave thermotherapy (TUMT) on quality of life (QoL) and quality of sexual function (QSF) in patients with benign prostatic hyperplasia (BPH). A total of 216 patients with BPH received lower-energy TUMT treatment (Prostasoft 2.0) and were ...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究


    authors: Francisca E,Blute M,de la Rosette J

    更新日期:1998-01-01 00:00:00

  • MRI-targeted biopsies: What's next?

    abstract:: ...

    journal_title:World journal of urology

    pub_type: 社论


    authors: Ploussard G,Briganti A

    更新日期:2019-02-01 00:00:00

  • Intra- and inter-resting-state networks abnormalities in overactive bladder syndrome patients: an independent component analysis of resting-state fMRI.

    abstract:PURPOSE:This study aims to determine whether intra-network and inter-network brain connectivities are altered using an independent component analysis (ICA). METHODS:Resting-state functional MRI (rs-fMRI) data were acquired from 26 patients with OAB and 28 healthy controls (HC). Eleven resting-state networks (RSNs) wer...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Zuo L,Chen J,Wang S,Zhou Y,Wang B,Gu H

    更新日期:2020-04-01 00:00:00

  • Quality of leadership in multidisciplinary cancer tumor boards: development and evaluation of a leadership assessment instrument (ATLAS).

    abstract:BACKGROUND:High-quality leadership and chairing skills are vital for good performance in multidisciplinary tumor boards (MTBs), but no instruments currently exist for assessing and improving these skills. OBJECTIVE:To construct and validate a robust instrument for assessment of MTB leading and chairing skills. DESIGN...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Jalil R,Soukup T,Akhter W,Sevdalis N,Green JSA

    更新日期:2018-07-01 00:00:00

  • Improved decision making in intermediate-risk prostate cancer: a multicenter study on pathologic and oncologic outcomes after radical prostatectomy.

    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


    authors: Beauval JB,Ploussard G,Cabarrou B,Roumiguié M,Ouzzane A,Gas J,Goujon A,Marcq G,Mathieu R,Vincendeau S,Cathelineau X,Mongiat-Artus P,Salomon L,Soulié M,Méjean A,de La Taille A,Rouprêt M,Rozet F,Committee of Cancerology

    更新日期:2017-08-01 00:00:00

  • Intratesticular varicocele: evaluation using grey scale and color Doppler ultrasound.

    abstract::Intratesticular varicocele is a rare condition with a variable clinical and ultrasound presentation. The purpose of this study was to evaluate the grey scale and color Doppler appearances of intratesticular varicocele (ITV). Herein we present seven new cases of intratesticular varicocele. From 2003 to 2005 we evaluate...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Bucci S,Liguori G,Amodeo A,Salamè L,Trombetta C,Belgrano E

    更新日期:2008-02-01 00:00:00

  • 68Ga-labelled PSMA ligand HBED-CC PET/CT imaging in patients with recurrent prostate cancer.

    abstract:BACKGROUND:68Ga-PSMA Positron Emission Tomography/Computerized Tomography (PET/CT) has shown promising results for the detection of recurrent prostate cancer (RPCa). However, the diagnostic value of this method is yet to be validated. The aim of this study was to determine the influence of clinical and biochemical vari...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Akdemir EN,Tuncel M,Akyol F,Bilen CY,Baydar DE,Karabulut E,Ozen H,Caglar M

    更新日期:2019-05-01 00:00:00

  • A single mitochondrial DNA deletion accurately detects significant prostate cancer in men in the PSA 'grey zone'.

    abstract:PURPOSE:To determine the clinical performance of a blood-based test for clinically significant (CS) prostate cancer (PCa) (grade group ≥ 2) intended for use in men with prostate serum antigen levels in the 'grey zone' (PSA < 10 ng/ml). The test quantifies a previously described 3.4 kb mitochondrial DNA (mtDNA) deletion...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Creed J,Klotz L,Harbottle A,Maggrah A,Reguly B,George A,Gnanapragasm V

    更新日期:2018-03-01 00:00:00

  • Histologic characterization of the post-radiation urethral stenosis in men treated for prostate cancer.

    abstract:PURPOSE:To evaluate histological changes in stenotic urethral tissue post-radiation therapy. Treatment of prostate cancer by radiation therapy carries a risk of off-target injury to the membranous urethra causing urethral stenosis. Limited characterization of post-radiation urethral stenosis exists in the literature. W...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Hughes M,Caza T,Li G,Daugherty M,Blakley S,Nikolavsky D

    更新日期:2020-09-01 00:00:00

  • Long-term urinary adverse effects of pelvic radiotherapy.

    abstract:OBJECTIVE:Radiation for tumors arising in the pelvis has been utilized for over a 100 years. Adverse effects (AEs) of radiotherapy (RT) continue to accumulate with time and are reported to show decades after treatment. The benefit of RT for pelvic tumors is well described as is their acute AEs. Late AEs are less well d...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Elliott SP,Malaeb BS

    更新日期:2011-02-01 00:00:00

  • The electrified catheter. Role in sterilizing urine and decreasing bacteriuria.

    abstract::A catheter was designed to decrease the incidence of catheter-induced urinary infections. A randomized, controlled study was performed to assess its safety and efficacy. The study comprised 24 patients subjected to hemorrhoidectomy. The criteria for entry were a preoperative urinary pathogen count below 10(5) colony-f...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Shafik A

    更新日期:1993-01-01 00:00:00

  • Transrectal contrast enhanced ultrasound for diagnosis of prostate cancer.

    abstract::The diagnosis of prostate cancer is based on histology. Prostate biopsies are obtained based on the triad of prostate specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasound. Because prostate biopsies still have a large percentage of negative outcomes, patient selection and biopsy direction...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Wink MH,de la Rosette JJ,Grimbergen CA,Wijkstra H

    更新日期:2007-08-01 00:00:00

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    abstract:PURPOSE:In primary prostate cancer (PCa) patients, accurate staging and histologic grading are crucial to guide treatment decisions. 18F-DCFPyL (PSMA)-PET/CT has been successfully introduced for (re)staging PCa, showing high accuracy to localise PCa in lymph nodes and/or osseous structures. The diagnostic performance o...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Bodar YJL,Jansen BHE,van der Voorn JP,Zwezerijnen GJC,Meijer D,Nieuwenhuijzen JA,Boellaard R,Hendrikse NH,Hoekstra OS,van Moorselaar RJA,Oprea-Lager DE,Vis AN

    更新日期:2020-10-20 00:00:00

  • Comparison of suctioning and traditional ureteral access sheath during flexible ureteroscopy in the treatment of renal stones.

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    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Zhu Z,Cui Y,Zeng F,Li Y,Chen Z,Hequn C

    更新日期:2019-05-01 00:00:00

  • Laparoscopic management of renal cystic disease.

    abstract::Renal cystic disease, ranging from simple cysts to autosomal dominant polycystic kidney disease (ADPKD), can lead to significant complications such as pain, hypertension, infection, upper urinary tract obstruction, and even renal failure. For patients with preserved renal function, laparoscopic ablation of renal cysts...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Dunn MD,Clayman RV

    更新日期:2000-09-01 00:00:00

  • The prognostic role of preoperative circulating neutrophil-lymphocyte ratio in primary bladder cancer patients undergoing radical cystectomy: a meta-analysis.

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    journal_title:World journal of urology

    pub_type: 杂志文章,meta分析


    authors: Hu G,Xu F,Zhong K,Wang S,Xu Q,Huang L,Cheng P

    更新日期:2019-09-01 00:00:00

  • Association between coronary artery disease severity and overactive bladder in geriatric patients.

    abstract:PURPOSE:To investigate the association between overactive bladder (OAB) and coronary artery disease (CAD) as demonstrated on coronary angiography in patients > 65 years. METHODS:The patients who were > 65 years completed an OAB-V8 form before undergoing coronary angiography at a tertiary care hospital. The presence of...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Kilinc MF,Yasar E,Aydin HI,Yildiz Y,Doluoglu OG

    更新日期:2018-01-01 00:00:00

  • Treatment of large impacted proximal ureteral stones: randomized comparison of minimally invasive percutaneous antegrade ureterolithotripsy versus retrograde ureterolithotripsy.

    abstract:OBJECTIVE:To provide appropriate evidence for treatment planning of patients with an impacted proximal ureteral stones ≥1.5 cm in size, by analyzing the therapeutic outcomes for those undergoing minimally invasive percutaneous antegrade ureterolithotripsy and retrograde ureterolithotripsy. PATIENTS AND METHODS:From Se...

    journal_title:World journal of urology

    pub_type: 杂志文章,随机对照试验


    authors: Gu XJ,Lu JL,Xu Y

    更新日期:2013-12-01 00:00:00

  • Salvage radical prostatectomy as management of locally recurrent prostate cancer: outcomes and complications.

    abstract:PURPOSE:Management of prostate cancer following radiation therapy remains challenging, especially for younger men or those with life expectancy greater than 10 years. We outline the efficacy, safety and adequacy of radical prostatectomy for the treatment of radiorecurrent localized prostate cancer. METHODS:A systemati...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Rosoff JS,Savage SJ,Prasad SM

    更新日期:2013-12-01 00:00:00

  • Central effects of sildenafil (Viagra) on auditory selective attention and verbal recognition memory in humans: a study with event-related brain potentials.

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    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Schultheiss D,Müller SV,Nager W,Stief CG,Schlote N,Jonas U,Asvestis C,Johannes S,Münte TF

    更新日期:2001-02-01 00:00:00

  • Evaluation of flexible ureteroscope with an omni-directional bending tip, using a JOYSTICK unit (URF-Y0016): an ex-vivo study.

    abstract:PURPOSE:To compare the range of reach of our newly designed omni-directional ureteroscope (URF-Y0016), compared to the commonly used URF-P6, FlexX2s, and LithoVue™ scopes, in the upper, middle, and lower calyces in an ex-vivo pyelocaliceal model. METHODS:We fabricated a three-dimensional pyelocaliceal model of the upp...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Inoue T,Okada S,Hamamoto S,Miura H,Matsuzaki J,Tambo M,Fukuhara H,Fujisawa M,Matsuda T,Nutahara K

    更新日期:2020-03-14 00:00:00

  • Effect of testosterone, raloxifene and estrogen replacement on the microstructure and biomechanics of metaphyseal osteoporotic bones in orchiectomized male rats.

    abstract:INTRODUCTION:Currently, osteoporosis research is rarely undertaken in males but an increase in male life expectancy in the company of hypogonadism suggests the necessity for potential therapeutic options. MATERIALS AND METHODS:In this study, the changes in bone structure under standardized testosterone- (T), raloxifen...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Stuermer EK,Sehmisch S,Tezval M,Tezval H,Rack T,Boekhoff J,Wuttke W,Herrmann TR,Seidlova-Wuttke D,Stuermer KM

    更新日期:2009-08-01 00:00:00

  • A prospective double-blind, randomized, placebo-controlled study to evaluate the efficacy of silodosin 8 mg as an on-demand, reversible, nonhormonal oral contraceptive for males: a pilot study.

    abstract:PURPOSE:As silodosin 8 mg, used for treating BPH, is known to cause absence of sperms in the ejaculate, its potential as an on-demand, reversible, nonhormonal oral contraceptive for males was assessed in this pilot study. METHODS:In this randomized, double-blind, placebo-controlled pilot study, healthy, sexually activ...

    journal_title:World journal of urology

    pub_type: 杂志文章,随机对照试验


    authors: Bhat GS,Shastry A

    更新日期:2020-03-01 00:00:00

  • Mechanisms of tumor invasion and metastasis.

    abstract::Metastasis is the cascade of events involved in the transition of a malignancy from a localized tumor to the establishment of a distant foci. In this review we define the known stages and the factors involved. The multiplicity of steps involved allows many opportunities for therapeutic intervention. Current research h...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Lawrence JA,Steeg PS

    更新日期:1996-01-01 00:00:00

  • Obstructive sleep apnea and Fuhrman grade in patients with clear cell renal cell carcinoma treated surgically.

    abstract:PURPOSE:To assess the association between obstructive sleep apnea (OSA) and Fuhrman grade in patients with clear cell renal cell carcinoma (ccRCC). As secondary endpoints, we studied its association with tumor size, metastasis-free survival (MFS) and cancer-specific survival (CSS). METHODS:We reviewed the databases of...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Vilaseca A,Nguyen DP,Vertosick EA,Corradi RB,Musquera M,Pérez M,Fossati N,Sjoberg DD,Farré R,Almendros I,Montserrat JM,Benfante NE,Hakimi AA,Skanderup AJ,Russo P,Alcaraz A,Touijer KA

    更新日期:2017-01-01 00:00:00

  • Circulating sex steroids and prostate cancer: introducing the time-dependency theory.

    abstract:PURPOSE:We sought whether serum total testosterone (tT), estradiol (E2), tT/E2 ratio, and sex hormone-binding globulin (SHBG) significantly fluctuate throughout time in men with prostate cancer (PCa). METHODS:Circulating hormones were measured in a cohort of 631 candidates for radical prostatectomy. Hormone levels wer...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Salonia A,Abdollah F,Capitanio U,Suardi N,Gallina A,Castagna G,Clementi MC,Briganti A,Rigatti P,Montorsi F

    更新日期:2013-04-01 00:00:00

  • Involvement of renin-angiotensin-aldosterone system in calcium oxalate crystal induced activation of NADPH oxidase and renal cell injury.

    abstract:INTRODUCTION AND OBJECTIVES:Reactive oxygen species (ROS) are produced during the interaction between oxalate/calcium oxalate monohydrate (COM) crystals and renal epithelial cells and are responsible for the various cellular responses through the activation of NADPH oxidase (Nox). Ox and COM also activate the renin-ang...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Tsuji H,Wang W,Sunil J,Shimizu N,Yoshimura K,Uemura H,Peck AB,Khan SR

    更新日期:2016-01-01 00:00:00

  • Factors that influence lower urinary tract symptom (LUTS)-related quality of life (QoL) in a healthy population.

    abstract:OBJECTIVES:The aim of this study was to evaluate the factors affecting the lower urinary tract symptoms (LUTS) related quality of life (QoL) score. METHODS:This retrospective study analyzed 29,123 men who underwent health check-ups from January 2007 to July 2011 at a single institution. Those patients who completed th...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Choi WS,Heo NJ,Lee YJ,Son H

    更新日期:2017-11-01 00:00:00

  • The selenium and vitamin E cancer prevention trial.

    abstract:BACKGROUND:Evidence suggests that both selenium and vitamin E reduce the risk of prostate cancer. The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is a randomized, prospective, double-blind study designed to determine whether selenium and vitamin E alone and in combination can reduce the risk of prostate can...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Klein EA,Lippman SM,Thompson IM,Goodman PJ,Albanes D,Taylor PR,Coltman C

    更新日期:2003-05-01 00:00:00

  • Role of urinary tract infection in bladder cancer: a systematic review and meta-analysis.

    abstract:PURPOSE:We sought to examine the literature reporting the effect of urinary tract infection (UTI) on non-schistosomiasis-related UBC (UBCNS) through a systematic review and meta-analysis. METHODS:A predefined study protocol was developed according to PRISMA. Medline and Scopus were searched for all studies investigati...

    journal_title:World journal of urology

    pub_type: 杂志文章,meta分析


    authors: Bayne CE,Farah D,Herbst KW,Hsieh MH

    更新日期:2018-08-01 00:00:00