Introduction: Percutaneous nephrolithotomy (PCNL) is a standard management for complex renal stone disease. However, the implications of delays in PCNL are under-explored. We hypothesized that increased time prior to intervention in a county hospital system would be associated with higher hospital charges, increased clinic and hospital visits, and increased procedural interventions.
Methods: A single-center retrospective chart review of 132 adult patients undergoing PCNL at a county hospital from April 2019 to December 2022 was performed. Groups were organized based on time from diagnosis to surgery (<4 months, 4–6 months, >6 months). Key outcomes included hospital charges, insurance types, ureteral stent versus nephrostomy decompression, presence of stent encrustation, and number of preoperative computed tomography (CT) scans, emergency department (ED) visits, and interventions. Kruskal–Wallis ANOVA was used for determining group differences between continuous variables, and χ2 was used for categorical variables.
Results: A total of 132 PCNLs were analyzed with a median diagnosis-to-operating room (OR) period of 135 days. Compared to patients with diagnosis-to-OR period less than 4 months, those with PCNL performed in 4–6 months and over 6 months had 7% and 36% higher hospital charges respectively ($27 607 vs. $29 416 vs. $37 622, p = 0.018). Delays to PCNL surgery resulted in more CT scans (p = 0.019), clinic visits (p < 0.001), and interventions (p = 0.003).
Conclusion: Our study showed that in a medically underserved population, increased diagnosis-to-OR period led to increased healthcare utilization, additional procedures, and hospital charges. Changes aimed at reducing the time from diagnosis to surgery could reduce the financial burden for both patients and the healthcare system.
Background: Ureteral stents are used as temporary or permanent drainage measures for intrinsic or extrinsic occlusions of the upper urinary tract. Their use can cause complications such as urinary symptoms, which consequently impact the quality of life. Therefore, the aim of this study was to analyze the symptoms and level of satisfaction of patients who used the double-J ureteral stent.
Methods: This article is a cross-sectional study involving 40 volunteers who had previously undergone a urological procedure that required the insertion of a double-J ureteral stent. Subsequently, they consulted the urology outpatient clinic and answered a questionnaire designed by the authors.
Results: According to the results, the average age of the patients was 43 years old, 75% were female, and 42.5% reported comorbidities, with hypertension being the most prevalent. The wired double-J ureteral stent was used in 72.5% of patients, and the average length of stay was 6 days. 95% of the patients had complaints related to the use of the double-J ureteral stent, with colicky abdominal pain being the most frequent symptom (77.5%) and hematuria being the most common urinary symptom (65%), followed by dysuria (62.5%) and urgency (52.5%). Analysis of the level of satisfaction showed that 55% of patients were satisfied and 22.5% were dissatisfied. No statistical significance was found between the incidence of symptoms related to the double-J ureteral stent and the groups analyzed.
Conclusion: This study was able to highlight important features of the symptomatology of patients using the double-J ureteral stent and the repercussions on satisfaction with its use. Furthermore, it was possible to concluded that the experience of using the double-J ureteral stent was satisfactory for 55% of the patients.
Background: Pheochromocytomas are tumors originating from chromaffin cells and producing catecholamines. In 10%-20% of cases, these tumors act outside of the adrenal medulla, defining conglomerates named paragangliomas. Bladder paraganglioma is a rare tumor and accounts for less than 0.06% of all bladder neoplasms and less than 1% of all pheochromocytomas, with the first case described in 1953. The clinical procedure given by 47%-77% of the overall number of cases, consists of headache 48.1%, tachycardia 43.4%, hypertension 54.7%, hematuria 47.2%, and visual alterations.
Case Presentation: The article reports a case of a patient whose lesion was identified in the lateral wall of the bladder during a prostate ultrasonography exam, and was subsequently treated surgically with a partial cystectomy. The aim of this study is to detail the diagnosis and treatment of a patient with bladder paraganglioma.
Conclusion: From the overall study conducted in this article, it is possible to conclude that paraganglioma requires adequate diagnostic and therapeutic methods. These methods include ultrasounds and computed tomography scans, followed by cystoscopy with visualization and biopsy of the lesion, and resection of the lesion.
Prostate cancer is one of the most common solid tumors in men, and its incidence continues to rise in China. Several guidelines have been developed and published to facilitate the standardization of diagnosis and treatment of prostate cancer. However, there are still many challenges and issues in clinical practice that lack high-level evidence. A panel of recognized domestic experts including urologists, medical oncologists, and radiologists was organized and invited to discuss and vote on the key issues of lacking high-level evidence and unified guideline recommendations questions. Following careful selection and voting processes, 19 questions were identified, leading to the establishment of a consensus based on collective agreement regarding these hot issues. The aim of this consensus is to provide a reference for managing the whole patient journey of prostate cancer for Chinese clinicians.
Background: A ureterocele is a cystic dilation of the distal ureter, most commonly presenting as a congenital abnormality that may be associated with other renal anomalies. Ureteroceles present in a variety of manifestations in both children and adults, from asymptomatic to significant flank pain with urolithiasis or recurrent urinary tract infections (UTIs) that often mimic other more common renal pathologies, owing to its challenging clinical diagnosis.
Case Presentation: We report the case of a 78-year-old female patient who presented with recurrent UTIs and failure to thrive, complicated by a large stone that first presented in the bladder on computed tomography scan and was later found in the distal right ureter.
Conclusion: This case underscores the varied and often deceptive clinical presentation of ureterocele, stressing the importance of timely diagnosis to prevent secondary complications.
