T. Takenaka

Preoperative positive urine cytology is a risk factor for subsequent development of bladder cancer after nephroureterectomy in patients with upper urinary tract urothelial carcinoma

PurposeTo determine the independent risk factors of bladder recurrence in patients with upper urinary tract urothelial carcinoma (UUT-UC).MethodsA total of 364 patients underwent nephroureterectomy (NUx) for UUT-UC between January 2005 and April 2009 in Okayama University and 17 affiliated hospitals. Patients with concomitant bladder cancer were excluded from the analysis. The clinicopathologic data for the remaining 288 patients with UUT-UC were retrospectively reviewed. Median follow-up after NUx was 20.2xa0months. The following variables were evaluated for any association with bladder recurrence: sex, age, tumor stage, tumor grade, venous invasion, lymphatic invasion, tumor location, multifocality, surgical modalities, time of ligation of the ureter, and preoperative urine cytology. The significance of each variable was tested univariately using the log-rank test. The simultaneous effects of multiple risk factors were estimated by multiple regression analysis using the Cox proportional hazards model.ResultsBladder recurrence occurred in 103 patients (35.8%). Median time to first bladder recurrence was 6.9xa0months. Significant risk factors for bladder recurrences on univariate analysis were tumor location (Pxa0=xa00.046) and preoperative positive urine cytology (Pxa0<xa00.001). Multivariate analysis revealed that preoperative urine cytology positive was significant for bladder recurrence (HR: 1.977; 95% CI: 1.310–2.983, Pxa0=xa00.001).ConclusionRisk factor for subsequent development of bladder cancer after NUx was preoperative positive urine cytology.

Impact of selective media for detecting fluoroquinolone-insusceptible/extended-spectrum beta-lactamase-producing Escherichia coli before transrectal prostate biopsy

To investigate the prevalence of fluoroquinolone‐insusceptible and/or extended‐spectrum beta‐lactamase‐producing Escherichia coli colonizing in the male rectum before transrectal prostate biopsy.

UROLOGIC DISEASES IN THE EMERGENCY DEPARTMENT

(Objectives) This paper aimed to report the clinical statistics on urologic diseases treated in the emergency department (ED). (Patients and methods) We retrospectively evaluated 1,480 patients diagnosed with urologic diseases in the ED between January 2013 and December 2014. We reviewed the patients sex, age, main complaints, emergency grade, care-seeking process, hospitalization, examination items, and diagnosis. We also reviewed the correct-diagnosis rates of patients who visited the ED for the first time and were followed up at the urology department. (Results) Of the patients, 2.6% were diagnosed as having a urologic disease, with a male-to-female ratio of 1.5:1. The age distribution ranged from 0 to 101 years, with a median age of 53 years. Patients who required hospitalization accounted for 17.8%. The diagnoses were urolithiasis (546 cases), cystitis (220 cases), and pyelonephritis (137 cases), in order of frequency. The correct-diagnosis rates of urolithiasis (91.2%), benign prostatic hyperplasia (75.0%), and pyelonephritis (71.9%) were high. However, those of testicular torsion (0%), urologic neoplasm (26.7%), prostatitis (35.7%), and epididymitis (35.7%) were low. (Conclusion) In the ED, 82.2% of cases of urologic diseases were mild and did not require hospitalization. The correct-diagnosis rate of acute scrotum was low, as it was difficult to diagnose and thus difficult to manage in the ED. Therefore, urologists should cooperate with ED staff and warn them that cases of acute scrotum should be subjected to emergency consultation.