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European Journal of Surgical Oncology :... Nov 2014Groin dissection is commonly performed in patients with lower limb malignant conditions such as malignant melanoma, vulvar, penile, anal and scrotal carcinomas with an... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Groin dissection is commonly performed in patients with lower limb malignant conditions such as malignant melanoma, vulvar, penile, anal and scrotal carcinomas with an associated high complication rate. Numerous surgical strategies have been suggested to reduce morbidity. We aimed to systematically review one of those methods - fibrin sealant (FS) - in comparison to standard closure (SC) in reducing postoperative morbidity from groin dissection.
METHODS
A systematic search of the literature, study selection and data extraction using an independent screening process, assessment of risk of bias and statistical data analysis was performed. Only randomised controlled trials (RCTs) comparing fibrin sealant to standard care in patients with malignant disease undergoing groin dissection reporting at least one outcome measure relating to postoperative complications were included in the review.
RESULTS
A total of 6 RCTs were included. There were no statistically significant differences in postoperative surgical site infection (SSI) rates between FS and SC. The overall incidence of wound infection in the FS group was 32% (43/133) compared to 34% (45/132) in the SC group. (Pooled risk ratio = 0.0.94 [0.68, 1.32]; 95% CI; P = 0.74). The incidence of seroma for the FS group (30/133) and the SC group (30/132) did not differ (Pooled risk ratio = 1.03 [0.67, 1.58]; 95% CI; P value = 0.90). Complication rates were similar between groups.
CONCLUSION
Based on current evidence, fibrin sealant does not significantly reduce morbidity in patients undergoing groin dissection for the management of malignant disease when compared to standard closure techniques.
Topics: Fibrin Tissue Adhesive; Groin; Humans; Lymph Node Excision; Neoplasms; Postoperative Complications; Seroma; Surgical Wound Infection; Tissue Adhesives; Treatment Outcome; Wound Closure Techniques
PubMed: 25125341
DOI: 10.1016/j.ejso.2014.07.034 -
International Journal of Reproductive... Aug 2021In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for...
BACKGROUND
In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for better management.
OBJECTIVE
To determine the factors affecting male infertility in the Iranian male population.
MATERIALS AND METHODS
An online search was conducted in electronic databases including PubMed, Google Scholar, SID, and Scopus to identify articles on the factors associated with male infertility, published in English and Persian. The keywords used to perform the search included "factor", "epidemiology", "causes of infertility", and "male infertility". The search was conducted without a time restriction, up to April 2020.
RESULTS
The search resulted in a total number of 691 studies. After an assessment of the articles, finally 14 studies were included in this study with a total number of 26,324 infertile males. The factors associated with male infertility included semen abnormalities, varicocele and testis disorder, smoking, exposure to heat, obesity, anabolic steroids, vascular abnormalities, anti-spermatogenesis factors, antidepressants, taking ranitidine and cimetidine, penile discharge and genital ulcers, painful micturition, occupational factors, alcohol, chronic disease, sexual disorder, Surgical and urological diseases, genetic factors and herpes infection. Among these, the semen and varicocele disorders were common in most studies.
CONCLUSION
The present review suggests that the factors affecting male infertility in Iran are similar to those reported from other countries. The results of this study can be used in adopting appropriate strategies for infertility management in Iran.
PubMed: 34568728
DOI: 10.18502/ijrm.v19i8.9615 -
Medicine May 2019To compare the clinical feasibility and oncological outcomes of video endoscopic inguinal lymph node dissection (VE-ILND) and open inguinal lymph node dissection... (Comparative Study)
Comparative Study Meta-Analysis
Comparison of clinical feasibility and oncological outcomes between video endoscopic and open inguinal lymphadenectomy for penile cancer: A systematic review and meta-analysis.
BACKGROUND
To compare the clinical feasibility and oncological outcomes of video endoscopic inguinal lymph node dissection (VE-ILND) and open inguinal lymph node dissection (O-ILND) in the management of penile cancer.
METHODS
We searched published articles in the PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, and Wanfang databases. Data were extracted by 2 independent authors, and meta-analysis was performed by using Review Manager software version 5.3.
RESULTS
Ten studies were included. Compared with the O-ILND group, the VE-ILND group exhibited less intraoperative blood loss (standardized mean difference [SMD] = 3.12; 95% confidence intervals [95% CIs] [1.27, 4.98]; P = .001), shorter hospital stay (SMD = 1.77; 95% CIs [0.94, 2.60]; P < .001), shorter drainage time (SMD = 2.69; 95% CI [1.47, 3.91]; P < .001), reduced wound infection rate (odds ratio [OR] = 10.62; 95% CI [4.01, 28.10]; P < .001); reduced skin necrosis rate (OR = 7.48; 95% CI [2.79, 20.05]; P < .001), lower lymphedema rate (OR = 3.23; 95% CI [1.51, 6.88]; P = .002), equivalent lymphocele rate (OR = 0.83; 95% CI [0.31, 2.23]; P = .720), and parallel recurrence rate (OR = 1.54; 95% CI [0.41, 5.84]; P = 0.530). However, the number of dissected lymph nodes (OR = 0.25; 95% CI [0.03, 0.47]; P = .030) was slightly increased in the O-ILND group. GRADE recommendations of primary outcomes were shown in a summary of findings table.
CONCLUSIONS
For perioperative outcomes, VE-ILND is superior to O-ILND. For short-term oncological outcomes, VE-ILND is comparable to O-ILND. However, long-term oncological control still requires further verification.
Topics: Endoscopy; Feasibility Studies; Humans; Inguinal Canal; Length of Stay; Lymph Node Excision; Lymph Nodes; Male; Penile Neoplasms; Treatment Outcome; Video-Assisted Surgery
PubMed: 31145338
DOI: 10.1097/MD.0000000000015862 -
Urology Jun 2023To synthesize existing evidence to evaluate the outcomes of different urinary catheter removal timing (early vs late) after urethroplasty. (Review)
Review
OBJECTIVE
To synthesize existing evidence to evaluate the outcomes of different urinary catheter removal timing (early vs late) after urethroplasty.
METHODS
We performed a comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science from inception to August 7, 2022. Articles were initially screened by title, abstract, and subsequently by a full paper review before being included in the final analysis. All comparative studies that assessed the association between urethral catheterization duration and frequency of extravasation and recurrence rate in patients who underwent urethroplasty were included in the analysis. Exclusion criteria were case reports, case series, letters to editors, and non-English studies. The risk of bias was assessed using the Newcastle-Ottawa Scale.
RESULTS
Of the 439 relevant records in the literature databases, 5 studies involving 634 patients were included. In all 5 studies, the extravasation rate was not significantly different between the early and late catheter removal groups. Among the 3 studies that reported recurrence rates, the recurrence rate was low, with no statistically significant difference between the early and late catheter removal groups. Wound and urinary tract infections were among the most common complications, with a higher rate in patients with late catheter removal.
CONCLUSION
Early catheter removal following urethroplasty does not increase the rate of extravasation or recurrence during long-term follow-up. The existing evidence can serve as the foundation for additional research with a larger sample size.
Topics: Humans; Urinary Catheters; Urinary Catheterization; Urethra; Urinary Tract Infections; Device Removal
PubMed: 36963670
DOI: 10.1016/j.urology.2023.03.009 -
Neurourology and Urodynamics Aug 2021To perform a systematic review to assess and compare the efficacy and safety of all urethral bulking agents (UBAs) available for the treatment of stress urinary... (Review)
Review
AIMS
To perform a systematic review to assess and compare the efficacy and safety of all urethral bulking agents (UBAs) available for the treatment of stress urinary incontinence (SUI) in women.
METHODS
This systematic review was conducted in accordance with the PRISMA guideline. A systematic search was conducted using the Ovid Medline, Embase and PubMed databases. Studies were included if they involved women who underwent either Bulkamid®, Macroplastique®, Durasphere®, Coaptite®, or Urolastic® injections for the treatment of SUI. A total of 583 articles were screened with 56 articles included. A qualitative analysis was performed.
RESULTS
The newer synthetic UBAs are not inferior to Contigen®, with variable mean success rates of 30%-80% in the short-term. Better long-term success rates were found with Bulkamid® (42%-70%), Coaptite® (60%-75%), and Macroplastique® (21%-80%) on qualitative review. Urinary tract infection rates were similar between bulking agents (4%-10.6%) although temporary acute urinary retention was more commonly associated with Coaptite® (mean: 34.2%), and de novo urgency in Durasphere® (mean: 24.7%). Significant complications such as migration into lymph nodes was reported with Durasphere®. Erosion was reported with Macroplastique®, Coaptite®, and Urolastic®, with a rate as high as 24.6% in one study of Urolastic®.
CONCLUSION
Available data support the use of Bulkamid® and Macroplastique®, which has shown a short-term efficacy of 30%-90% and 40%-85% respectively, and long-term efficacy of 42%-70%, and 21%-80%, respectively. Bulkamid® appears to have a more favorable safety profile, with no cases of erosion or migration of product associated with its use. Direct comparisons of UBAs have not been performed.
Topics: Female; Humans; Injections; Male; Treatment Outcome; Urethra; Urinary Incontinence, Stress
PubMed: 34015151
DOI: 10.1002/nau.24696 -
Journal of the European Academy of... May 2002Patients with chronic prostatitis/pelvic pain syndrome typically report genital or pelvic pain (in or around the penis, perineum, scrotum) lasting > 3 months. Whereas... (Review)
Review
Patients with chronic prostatitis/pelvic pain syndrome typically report genital or pelvic pain (in or around the penis, perineum, scrotum) lasting > 3 months. Whereas true chronic bacterial prostatitis is an uncommon condition characterised by recurrent prostatic and urinary infection, chronic pelvic pain syndrome (CPPS) is a common condition in which no infection is found. Recent surveys suggest a prevalence of 2.5-3% for CPPS. The four-glass test, traditionally used to distinguish inflammatory and inflammatory forms of CPPS, has not been adequately validated; whether the distinction is clinically meaningful is increasingly questioned. The aetiology of CPPS is not known; urodynamic studies imply a neuromuscular origin. More recent work supports a role for proinflammatory cytokines in the pathogenesis. In the management of chronic bacterial prostatitis, trials support the use of quinolone antibiotics as first-line treatment. In contrast, the management of CPPS is generally unsatisfactory, as no reliable treatment has been identified. Treatments commonly tried include antibiotics (notably tetracyclines, quinolones and macrolides), anti-inflammatory agents, and alpha blockers. Newer approaches include trials of finasteride, quercetin and rofecoxib. A recent systematic review demonstrated that none of the current diagnostic and treatment methods for CPPS is supported by a robust evidence base.
Topics: Adrenergic alpha-Antagonists; Anti-Bacterial Agents; Chronic Disease; Diagnosis, Differential; Enzyme Inhibitors; Finasteride; Humans; Male; Pelvic Pain; Prostatitis; Quercetin; Syndrome
PubMed: 12195565
DOI: 10.1046/j.1468-3083.2002.00481.x -
Clinical Anatomy (New York, N.Y.) Mar 2018Gender-affirmation surgery is often the final gender-confirming medical intervention sought by those patients suffering from gender dysphoria. In the male-to-female... (Meta-Analysis)
Meta-Analysis Review
Gender-affirmation surgery is often the final gender-confirming medical intervention sought by those patients suffering from gender dysphoria. In the male-to-female (MtF) transgendered patient, the creation of esthetic and functional external female genitalia with a functional vaginal channel is of the utmost importance. The aim of this review and meta-analysis is to evaluate the epidemiology, presentation, management, and outcomes of neovaginal complications in the MtF transgender reassignment surgery patients. PUBMED was searched in accordance with PRISMA guidelines for relevant articles (n = 125). Ineligible articles were excluded and articles meeting all inclusion criteria went on to review and analysis (n = 13). Ultimately, studies reported on 1,684 patients with an overall complication rate of 32.5% and a reoperation rate of 21.7% for non-esthetic reasons. The most common complication was stenosis of the neo-meatus (14.4%). Wound infection was associated with an increased risk of all tissue-healing complications. Use of sacrospinous ligament fixation (SSL) was associated with a significantly decreased risk of prolapse of the neovagina. Gender-affirmation surgery is important in the treatment of gender dysphoric patients, but there is a high complication rate in the reported literature. Variability in technique and complication reporting standards makes it difficult to assess the accurately the current state of MtF gender reassignment surgery. Further research and implementation of standards is necessary to improve patient outcomes. Clin. Anat. 31:191-199, 2018. © 2017 Wiley Periodicals, Inc.
Topics: Female; Humans; Male; Penis; Postoperative Complications; Reoperation; Sex Reassignment Surgery; Treatment Outcome; Vagina
PubMed: 29057562
DOI: 10.1002/ca.23001 -
World Journal of Urology Sep 2016To evaluate the efficacy and safety of transurethral enucleation of the prostate (TUEP) versus transvesical open prostatectomy (OP) for the management of large benign... (Comparative Study)
Comparative Study Meta-Analysis Review
Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials.
PURPOSE
To evaluate the efficacy and safety of transurethral enucleation of the prostate (TUEP) versus transvesical open prostatectomy (OP) for the management of large benign prostatic hyperplasia (BPH).
METHODS
Randomized controlled trials (RCTs) comparing TUEP and OP were identified from PubMed, Embase and Web of Science up to February 28, 2015. A meta-analysis was conducted with the STATA 12.0 software.
RESULTS
Nine RCTs including 758 patients were enrolled in our meta-analysis. There were no significant differences between the two groups in the maximum urinary flow rate at 1, 3, 6 months, 1 and 2 years: postvoiding residual urinary volume, prostate-specific antigen, international prostate symptom score and quality of life score at 1, 3, 6 months and 1 year; or international index of erectile function at 3, 6 months and 1 year. Perioperative outcomes including hemoglobin level drop, catheter period, irrigation length and hospital stay favored TUEP, while operative time and resected prostate weight favored OP. There was significantly less blood transfusion with TUEP, but no significant differences were found in other complications such as recatheterization, urinary tract infection, reintervention for clots and bleeding control, incidence of pneumonia and infarction, transient incontinence, bladder neck contracture, urethral stricture and recurrent adenoma.
CONCLUSIONS
TUEP can be performed effectively and safely with functional outcomes and complications similar to OP for large BPH, whereas it has the advantages of a shorter catheter period, shorter hospital stays and less blood transfusion. These findings seem to support TUEP as the next-generation "gold standard" of surgery for large BPH.
Topics: Humans; Male; Prostatectomy; Prostatic Hyperplasia; Randomized Controlled Trials as Topic; Urethra; Urinary Bladder
PubMed: 26699627
DOI: 10.1007/s00345-015-1735-9 -
Pathogens and Disease Sep 2017A reliable overview of data on the prevalence of Chlamydia trachomatis (CT) in Russia is lacking and needed. All the available data on CT prevalence were analyzed in a... (Review)
Review
A reliable overview of data on the prevalence of Chlamydia trachomatis (CT) in Russia is lacking and needed. All the available data on CT prevalence were analyzed in a systematic literature review on CT prevalence in Russia, strengthened with data from the multicenter study among 1263 people in the second-largest Russian megalopolis, St. Petersburg, testing for CT DNA in urethral, anal, cervical and prostate samples. A total of 10 articles met the inclusion criteria. The overall average prevalence of genital CT infections in Russian populations ranged from 2.9% to 33%. Risk factors included being symptomatic (P = 0.004; in men P < 0.001), being younger than 30 years (P = 0.001) and being a man who has sex with men (MSM) (P = 0.0084). Main limitations included the lack of studies in MSM. CT prevalence was higher in the groups where urethral and prostate secretion samples were pooled (5.2%-7.3% vs 3.2% in the urethra only). The data on CT prevalence in a range of Russian populations are analyzed and reported. Prostate secretions represent an additional sampling material for the study of CT infection in men. CT detection in some settings in St. Petersburg yielded levels of reliability comparable with internationally available tests. The initiation of screening programs for Chlamydia infections in Russia should be considered.
Topics: Adult; Age Factors; Anal Canal; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Female; Homosexuality, Male; Humans; Male; Prevalence; Prostate; Risk Factors; Russia; Urethra
PubMed: 28830072
DOI: 10.1093/femspd/ftx081 -
Sexual Health Feb 2016The primary mode of human papillomavirus (HPV) transmission is through penetrative sex; however, there is evidence of other modes of transmission. No systematic review... (Review)
Review
The primary mode of human papillomavirus (HPV) transmission is through penetrative sex; however, there is evidence of other modes of transmission. No systematic review was found that focussed on HPV horizontal transmission that is not penocentric. A systematic review of the literature by searching Medline (Ovid), PubMed (NLM) and Embase (Ovid) was conducted to retrieve articles published from 1946 to March 2014. Studies that suggested evidence of non-sexual or non-penetrative sexual transmission of α-HPV genotypes were included. After review of 2061 titles and abstracts, 51 studies were abstracted. Fifteen studies examined HPV fomites from medical settings or public environments, and 36 examined HPV in humans. Human papillomavirus DNA was detected in the genital tract of female virgins, with prevalence estimates ranging from 0% to 51.1%. HPV transmission from hands to genitals or genitals to hands was reported for both sexes and heterosexual couples. Other studies commonly found HPV on surfaces in medical settings and public environments. Further studies on non-sexual and non-penetrative sexual transmission are needed to understand the complexity of HPV transmission. Health-care policies may need to be reassessed/established to ensure the safety of medical instruments and to reduce the risk of HPV nosocomial infection.
Topics: Cross Infection; DNA, Viral; Disease Transmission, Infectious; Female; Genitalia, Female; Heterosexuality; Humans; Male; Papillomaviridae; Papillomavirus Infections; Prevalence; Sexual Behavior
PubMed: 26433493
DOI: 10.1071/SH15089