Perioperative complications and 90-day mortality of radical cystectomy in the elderly (75+): a retrospective, multicentre study.

Abstract:

OBJECTIVE:To assess perioperative complications and 90-day mortality of radical cystectomy (RC) in elderly patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS:This is a retrospective, multicentre (n = 11) study of a consecutive series of patients ≥75 years who underwent RC for MIBC between 2006 and 2010. Medical, surgical and wound complications were graded according to the modified Clavien-Dindo classification. RESULTS:A total of 256 patients with a mean age of 79.6 years (range 75.0-86.6) were analysed. Urinary diversion with the use of bowel was performed in 79.5% and ureterocutaneostomy in 20.5%, with a higher proportion in the ≥80 cohort (32.2 vs. 14%; p = 0.001). 41.4% of patients had an uneventful postoperative course (Clavien grade 0) and 26.6% developed severe complications (Clavien grade III-V). In a multivariable regression analysis, the Charlson comorbidity index (odds ratio 1.5 per unit increase; p < 0.001) and the body mass index (odds ratio 1.13 per kg/m(2) increase; p = 0.015) were predictors for the development of complications. The 90-day mortality rate was 9% and the independent correlates thereof were the development of severe medical complications (p = 0.004), the American Society of Anesthesiologists (ASA) score (p = 0.03) and age (p = 0.005). CONCLUSIONS:Morbidity and 90-day mortality of RC in the elderly remain substantial. The interrelation between comorbidity, complication rate and 90-day mortality underlines the need for a comprehensive geriatric assessment of elderly patients with MIBC in whom RC is indicated.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Berger I,Martini T,Wehrberger C,Comploj E,Ponholzer A,Wolfgang M,Breinl E,Dunzinger M,Hofbauer J,Höltl W,Jeschke K,Krause S,Kugler W,Pauer W,Rauchenwald M,Pycha A,Madersbacher S

doi

10.1159/000357127

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

296-302

issue

3

eissn

0042-1138

issn

1423-0399

pii

000357127

journal_volume

93

pub_type

杂志文章,多中心研究
  • Sacral Neuromodulation for Lower Urinary Tract Dysfunction in Spinal Cord Injury: A Systematic Review and Meta-Analysis.

    abstract:OBJECTIVE:To evaluate the intervention effect of sacral neuromodulation (SNM) in the treatment of lower urinary tract dysfunction after spinal cord injury (SCI). METHODS:We selected relevant studies published between January 1, 1971 and November 15, 2018 by searching the PubMed, EMBASE, Cochrane databases. The outcome...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,meta分析

    doi:10.1159/000501529

    authors: Hu M,Lai S,Zhang Y,Liu M,Wang J

    更新日期:2019-01-01 00:00:00

  • Stones and urinary tract infections.

    abstract::The term infection stones refers to calculi that occur following urinary tract infections (UTIs) caused by urease-producing gram-negative organisms. They consist of magnesium ammonium phosphate, carbonate apatite and monoammonium urate. Alkaline urine is most favorable to their formation. Urinary tract obstruction, ne...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000104439

    authors: Miano R,Germani S,Vespasiani G

    更新日期:2007-01-01 00:00:00

  • Novel Transparent Urinary Tract Simulator Improves Teaching of Urological Operation Skills at a Single Institution.

    abstract:OBJECTIVE:This randomized controlled study compared a novel transparent urinary tract simulator with the traditional opaque urinary tract simulator as an aid for efficiently teaching urological surgical procedures. METHODS:Senior medical students were tested on their understanding of urological theory before and after...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000375129

    authors: Zhong X,Wang P,Feng J,Hu W,Huang C

    更新日期:2015-01-01 00:00:00

  • Ipsilaterality of motor innervation of canine urethral sphincter.

    abstract::The functional activity of the sphincter muscle of the urethra is known to be controlled largely by the hypogastric and pudendal nerves. It remains unknown, however, whether innervation of the muscle by these peripheral nerves is ipsi- or bilateral. In an attempt to answer this question urethral closure pressure was d...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000281328

    authors: Morita T,Kizu N,Kondo S,Dohkita S,Tsuchida S

    更新日期:1988-01-01 00:00:00

  • Epididymo-orchitis due to brucellosis: not only to be considered in endemic areas. Two cases for the price of three patients.

    abstract::We report 2 patients with epididymo-orchitis, caused by Brucella melitensis, accompanied by severe delay of diagnosis. In 1 patient the correct diagnosis was only suspected after his wife had been diagnosed with brucellosis. Our cases illustrate that diagnosing brucellosis can be difficult in nonendemic areas, especia...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000218542

    authors: Moens AA,Vlaspolder F,Verlind J,Sepers JM,Stam F

    更新日期:2009-01-01 00:00:00

  • Is diabetic neuropathy responsible for diabetic impotence?

    abstract::It is well known that diabetes mellitus is accompanied by complications of sexual dysfunction and it is believed that diabetic neuropathy may cause impotence. In our study, we found that not all the patients who visited our center with the chief complaint of diabetic impotence were suffering from organic impotence, an...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282978

    authors: Takanami M,Nagao K,Ishii N,Miura K,Shirai M

    更新日期:1997-01-01 00:00:00

  • Prostate Volume Index Is Able to Differentiate between Prostatic Chronic Inflammation and Prostate Cancer in Patients with Normal Digital Rectal Examination and Prostate-Specific Antigen Values

    abstract:INTRODUCTION:To assess the association of prostate volume index (PVI), defined as the ratio of the central transition zone volume to the peripheral zone volume, and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA) risk in patients presenting with normal digital rectal exam and prostate-specif...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000502659

    authors: Porcaro AB,Tafuri A,Sebben M,Novella G,Processali T,Pirozzi M,Amigoni N,Rizzetto R,Shakir A,Panunzio A,De Michele M,Brunelli M,Cerruto MA,Migliorini F,Siracusano S,Artibani W

    更新日期:2019-01-01 00:00:00

  • Cumulative Sum Analysis of the Learning Curve for Modified Retroperitoneoscopic Living-Donor Nephrectomy.

    abstract:OBJECTIVES:To introduce our modified retroperitoneoscopic living-donor nephrectomy (RPLDN) techniques and estimate the learning curve. METHODS:We retrospectively evaluated 121 consecutive donors who underwent modified RPLDN performed by a single surgeon. While the surgeon controlled the renal vessels, one hand was ins...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000493765

    authors: Zhu D,Hong P,Zhu J,Ye X,Chen Y,Fan Y,Zhang Z,Shen C,Yu W,Jin J

    更新日期:2018-01-01 00:00:00

  • Clear cell adenocarcinoma of the bladder in a male patient: clinicopathologic analysis of a case.

    abstract::Clear cell adenocarcinoma arising in the lower urinary tract is unusual. We report a case of clear cell adenocarcinoma of the bladder in a 54-year-old male. Cystoscopic examination revealed a tumour arising from the dome of the urinary bladder. Histologically, the tumour was chiefly composed of tubulocystic and papill...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000071856

    authors: Signori G,Tonini G,Aulenti V,Taher B,Rad FK,Tosana M,Ungari M,Zorzi F

    更新日期:2003-01-01 00:00:00

  • Combination therapy of imipramine with oxybutynin in children with enuresis nocturna.

    abstract:PURPOSE:The treatment approach for enuresis is controversial due to the lack of consensus as to the exact causes of nocturnal enuresis. Despite various treatment modalities, pharmacotherapy still appears to be the common choice. The aim of this prospective study was the evaluation of the efficacy of combination therapy...

    journal_title:Urologia internationalis

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000064858

    authors: Tahmaz L,Kibar Y,Yildirim I,Ceylan S,Dayanç M

    更新日期:2000-01-01 00:00:00

  • Testicular sarcoid.

    abstract::Sarcoidosis occurs rarely in Caucasian males and seldom involves the testis. We report an unusual case of asymptomatic testicular sarcoid in a Caucasian man. ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000050958

    authors: Naseem S,Lindley R,Mufti GR

    更新日期:2001-01-01 00:00:00

  • Giant urethral diverticulum: unusual complication following ventral buccal mucosa onlay graft urethroplasty.

    abstract::During the past 10 years, buccal mucosa grafting for urethroplasty has gained widespread acceptance. In general the reported success rates are 80% and higher. Typical complications are recurrent strictures, fistula, and, especially when the technique of ventral onlay urethroplasty has been used, sacculations that are ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000096344

    authors: Miller J,Hauck EW,Rohde V,Weidner W

    更新日期:2006-01-01 00:00:00

  • Standard versus tubeless percutaneous nephrolithotomy: a systematic review.

    abstract:OBJECTIVE:This article systematically analyses comparative studies to evaluate the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL) versus standard PCNL. METHODS:The Medline, EMBASE, PsycINFO, Cochrane and DARE databases were searched from 1997 to February 2011. Comparative studies evaluating outcom...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000336145

    authors: Amer T,Ahmed K,Bultitude M,Khan S,Kumar P,De Rosa A,Khan MS,Hegarty N

    更新日期:2012-01-01 00:00:00

  • Renal cell carcinoma presenting as acute pancreatitis.

    abstract::We present a 50-year-old male with renal cell carcinoma and hypercalcemia presenting as acute pancreatitis. The sudden onset of epigastralgia, acute pancreatitis and hypercalcemia with raised parathyroid-like peptide levels in this patient could not be explained except for renal cell carcinoma. This is the first repor...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000048452

    authors: Nabi G,Dogra PN,Chowdhary A

    更新日期:2002-01-01 00:00:00

  • Thyroid metastases from renal carcinoma.

    abstract::The identification and diagnosis of thyroid metastases from renal adenocarcinoma are rare in living patients, though more frequent during autopsy. A case is reported in which the identification of thyroid metastases indicated a clear-cell renal carcinoma in a kidney treated 12 years earlier for emptying of multiple cy...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000281389

    authors: Prati GF,Muolo A,Dean P,Ghimenton C

    更新日期:1988-01-01 00:00:00

  • The effect of sunitinib on immune subsets in metastatic clear cell renal cancer.

    abstract:BACKGROUND:Sunitinib is standard first-line therapy for metastatic clear cell renal cancer (MCRC). It is associated with leucopenia; however, its effects on specific immune cell subsets are unclear. Alterations in immune cell subsets may contribute to tumour progression. METHODS:Lymphocyte subsets (CD3, 4, 8, 19 and 5...

    journal_title:Urologia internationalis

    pub_type: 临床试验,杂志文章

    doi:10.1159/000319498

    authors: Powles T,Chowdhury S,Bower M,Saunders N,Lim L,Shamash J,Sarwar N,Sadev A,Peters J,Green J,Boleti K,Augwal S

    更新日期:2011-01-01 00:00:00

  • Intra- and perivesical tumor growth in preoperative staging of bladder cancer: the role of transrectal ultrasonography and high resolution magnetic resonance imaging.

    abstract::Bladder tumors were staged preoperatively before and/or after M-VEC poly-chemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%. Using thi...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282472

    authors: Ruether U,Guhl L,Schmidt A,Stilz S,Bader H,Nunnensiek C,Rassweiler J,Eisenberger F,Jipp P

    更新日期:1993-01-01 00:00:00

  • Copper, zinc, and Cu/Zn ratio in transitional cell carcinoma of the bladder.

    abstract:INTRODUCTION:Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, involvement of trace elements in the tumorigenesis of transitional cell carcinoma of the bladder has been poorly investigated. The aim of this study was to examine the rela...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000341976

    authors: Golabek T,Darewicz B,Borawska M,Socha K,Markiewicz R,Kudelski J

    更新日期:2012-01-01 00:00:00

  • Sonography of urethral calculi.

    abstract::We performed sonography in 7 males with membranous and posterior urethral calculi. Sonography demonstrated the urethral calculi in all 7 patients. These findings suggest that sonography is useful as a noninvasive screening technique for urethral calculi. ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282484

    authors: Koga S,Shiraishi K,Saito Y,Arakaki Y,Matsuoka M

    更新日期:1993-01-01 00:00:00

  • Intraurethral pressure response to the mucosal application of neuropharmacologic agent: an experiment study.

    abstract::In an experimental canine model, topical application of phenylephrine hydrochloride (Neo-Synephrine) to the urethral mucosa was demonstrated to cause a rise of intraurethral pressure which persisted for over 2 h without any rise of arterial pressure. There was no intraurethral pressure change after the topical applica...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000280047

    authors: Tulloch AG,Rossier AB

    更新日期:1976-01-01 00:00:00

  • Cytomegalovirus and Clostridium difficile ischemic colitis in a renal transplant recipient: a lethal complication of anti-rejection therapy?

    abstract::Intestinal ischemia is reported to be the most common gastrointestinal complication of renal transplantation and a potential cause of morbidity and mortality. The recent use of more potent immunosuppressive drug regimens has reduced the incidence of acute rejection, increasing the incidence of potentially fatal infect...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000106334

    authors: Veroux M,Puzzo L,Corona D,Buffone A,Tallarita T,Murabito P,Veroux P

    更新日期:2007-01-01 00:00:00

  • Chemodissolution of urinary uric acid stones by alkali therapy.

    abstract::Experience with chemodissolution of uric acid stones in 30 patients is presented. Chemodissolution was achieved either with infusion of 0.16 M i.v. lactate or oral sodium bicarbonate, in addition to liberal fluid intake and allopurinol wherever indicated. In some cases direct chemodissolution by in situ irrigation wit...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282302

    authors: Sharma SK,Indudhara R

    更新日期:1992-01-01 00:00:00

  • Renal Autotransplantation at Three Academic Institutions in Turkey.

    abstract:OBJECTIVE:The objective of this study is to present the experience of 3 institutions performing renal autotransplantation (RAT) and to discuss surgical techniques employed and the results in the light of the medical literature. MATERIALS AND METHODS:A total of 14 patients (11 male and 3 female) with a mean age of 47 ±...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000448482

    authors: Yakupoglu YK,Aki FT,Kordan Y,Ozden E,Tonyali S,Bostanci Y,Vuruskan H,Bilen CY,Sarikaya S

    更新日期:2016-01-01 00:00:00

  • Effect of urinary tract infection on disintegration of calcium-containing stones.

    abstract::To evaluate the possible effect of urinary tract infection (UTI) on the fragility of calcium-containing stones (calcium-oxalate, calcium-phosphate), the results of extracorporeal shock wave lithotripsy (ESWL) therapy in 81 patients with UTI and 30 patients with no sign of UTI were comparatively evaluated. ESWL paramet...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282908

    authors: Sarica K,Küpeli B,Soygür T,Türkölmez K,Göğüş O

    更新日期:1996-01-01 00:00:00

  • Bilateral percutaneous nephrolithotomy in a patient with hemophilia A disorder.

    abstract::A 50-year-old man with hemophilia A presented with recurrent hematuria due to renal stone disease. He was receiving approximately 50,000 units of recombinant factor (rF) VIII concentrate every year due to hematuria. Between 1996 and 2002, his serum creatinine level increased from 0.7 to 1.2 ng/ml. In an effort to reso...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000100846

    authors: Kural AR,Demirkesen O,Alici B,Obek C,Tunc B,Ozkan B

    更新日期:2007-01-01 00:00:00

  • Negotiating ureteral stenoses and kinks with a hydrophilic wire.

    abstract::Negotiating a tortuous or obstructed ureter with a wire can be time-consuming and sometimes tiring. The principle of using a slippery floppy wire and then replacing it with a stiff wire through a 5-french open-ended ureteral catheter yields a high success rate. The ureteral catheter can be used for a radiocontrast stu...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282713

    authors: Hofmann R,Pickl U,Hartung R

    更新日期:1995-01-01 00:00:00

  • Primary repair of colorenocutaneous fistula in patients with genitourinary tuberculosis.

    abstract::Two cases of colorenocutaneous fistula due to genitourinary tuberculosis are presented. They were successfully managed by single-stage surgery (nephroureterectomy, fistulectomy, and primary repair of the colon) and antitubercular treatment. The literature is briefly reviewed. ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000282568

    authors: Hemal AK,Gupta NP,Wadhwa SN,Songra MC,Batura D,Bhuyan UN

    更新日期:1994-01-01 00:00:00

  • Meatal Occlusive Disease in Adult Males: Are There Any Clinical Variations?

    abstract:OBJECTIVE:The study aimed to document the types of meatal occlusive disease (MOD) in adult males in terms of its clinical presentation, management and prognosis. MATERIAL AND METHODS:Eighty-six adult males with MOD were assessed during the study period. The patients were divided into Group 1, having meatal opening tha...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000446221

    authors: Dalela D,Gupta P,Dalela D,Bansal A,Govil T,Goel A,Sankhwar SN

    更新日期:2016-01-01 00:00:00

  • Long-term follow-up after clam ileocystoplasty. Complications and results including some quality-of-life parameters for 32 patients treated for neuropathic and nonneuropathic bladder disease.

    abstract::The results of clam ileocystoplasty in 32 patients were evaluated. Nineteen patients had a neuropathic (group N) and 13 a nonneuropathic disease (group NN). Mean follow-up was 75 months; 62 months for group N and 95 months for group NN. Mean age was 38 years. Postoperative complications and some quality-of-life parame...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282577

    authors: Geertsen U,Mommsen S

    更新日期:1994-01-01 00:00:00

  • The impact of prior TURP on radical prostatectomy surgical margins: a multicenter analysis.

    abstract:OBJECTIVE:To analyze positive surgical margins (PSM) after radical prostatectomy (RP) in the overall population and in patients previously treated with transurethral resection of the prostate (TURP). MATERIALS AND METHODS:2,408 patients treated with RP for clinically localized prostate cancer (PCa) were consecutively ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000346748

    authors: Gacci M,Simonato A,Lanciotti M,Ennas M,Varca V,Maffezzini M,Imbimbo C,Gontero P,Schiavina R,Carini M,Martorana G,Nicita G,Mirone V,Carmignani G

    更新日期:2013-01-01 00:00:00