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  • Mahler Burke posted an update 3 weeks, 5 days ago

    The patients’ answers revealed that UI was only brought up by doctors in 6% of cases, whereas the patient was the first to bring it up in 55%, primarily with their general practitioner (80%). Thus, in 4 out of 10 cases, the issue was not addressed; 49% of patients stated they did not discuss their condition with their partner and 33% did not discuss it with anybody.

    UI is still a major taboo and we have a long way to go to change attitudes.

    3.

    3.

    The complications of stoma and peristomal are encountered by nearly 80% of patients within two years of surgery. The objective of this study was to evaluate the practical modalities of daily management of stoma and possible skin complications in a series of patients with non-continent urinary stoma.

    Monocentric study by questionnaires including all patients with non-continent urinary stoma between 2007 and 2019 in a French university center. The STOMA-QOL and a self-report questionnaire with 15 specific questions were used.

    Among the 87 patients included in the analysis whose median age was 71 years, 57.5% used a 2-piece system, 69% used leg or thigh pockets, 74.7% were self-sufficient in emptying their stoma pockets. Autonomy on cutaneous support change was 38%. 62.1% of patients reported a peristomal skin event and 74.7% reported leaking stoma. In multivariate analysis, BMI>30, the presence of leaks and physical activity were significantly associated with the onset of peristomal skin events.

    This study sheds light on the practical modalities of management of urinary stoma and the occurrence of skin complications related to stoma in terms of frequency and predisposing factors. The results obtained are likely to guide practitioners in the information of future operations and in the management of complications of urinary stoma.

    III.

    III.

    The emergence of new communication media such as digital contents are progressively replacing more traditional medias in the field of educational programs. Our purpose was to assess urologist in training aspirations regarding urological education.

    Members of a national urologist in training association were sent an anonymous online questionnaire regarding their medical formation in the field of urology. Responders interest for urological sub-specialty or education support (new tools and traditional support) were evaluated through a 5-point Likert scale.

    Overall, 109 young urologists (26%) responded to the survey. Most of the respondents worked during their training in an academic hospital (n=89, 82%). The three favorite tools for training chosen by the responders were videos, workshop or masterclass, and podcasts (responders very interested were respectively n=64 (58.7%), n=50 (45.9%), and n=49 (45%)). E-mail newsletters were reported as the less useful educational tool by participants (n=38, 34.9%). Participants were very interested in improving their surgical skills and their radiological knowledge. Responders who were the most attracted by PCa were much more looking to improve their systemic treatment and radiological knowledges.

    Urologic-oncology was a priority regarding education for urologists in training. A majority of participants expressed a lack in their surgical education, revealing a reduced OR access and underlining utilization of new tools such as simulation. New digital contents such as social media or podcast achieved high interest for the participants, instead of more traditional media. There is a need that educational content evolve and uses new digital media.

    3.

    3.

    No recent national guidelines exist regarding the management of urinary tract infections (UTIs) in the presence of ureteral stent. This situation could lead to discrepancies in clinical management and less opportunity for a favorable patient’s outcome.

    All available data published on Medline® between 1998 and 2018 were systematically searched and reviewed. All papers assessing adult patients carrying ureteral stent were included for analysis. After studies critical analysis, national guidelines for clinical management were elaborated in order to answer clinical questions.

    A total of 451 articles were identified, of which 58 have been included. The prevalence of urinary tract infections in the presence of ureteral stent remains unknown. After 3 months, all endo-ureteral devices were colonized on microbiological study. These patients also presented a positive urine culture in 25 to 70% of the cases, often polymicrobial. Staphylococci, E.coli, Klebsiella, Pseudomonas, Enterococcus and Candida were the commonest micro-organisms responsible for urinary colonization or infection. The risk of UTI on endo-ureteral devices seemed higher the longer it stayed implanted. There is no justification in the literature to recommend a systematic change of endo-ureteral devices following a urinary tract infection.

    The existing literature is rich but of poor methodological quality, and therefore does not allow to draw robust conclusions. The greatest difficulty faced in this work was to accurately differentiate urinary colonizations from true infections, including clinical symptoms and not only microbiological results.

    These guidelines propose a standardized management of such common clinical situations. Well-designed studies are needed to upgrade the level of evidence of these guidelines.

    These guidelines propose a standardized management of such common clinical situations. Well-designed studies are needed to upgrade the level of evidence of these guidelines.

    High-intensity focused ultrasound (HIFU) has proved to be effective in the treatment of localized prostate cancer. this website The aim of this prospective study is to assess their first oncological and functional results in an Afro-Caribbean population.

    From May 2018 to January 2020, 77 patients issued from French West Indies were included. Several treatments were carried out whole-gland treatment hemi or focal ablation; in a primary setting (group I) or a salvage therapy (group II). PSA level was assessed at 2, 6, 9 and 12 months. MpMRI and post HIFU biopsy were performed between 6 and 9 months postoperatively. Continence, urinary end erectile functions were assessed by ICS, IPSS and IIEF scores.

    Groupe I included 71.2% patients, group II, 28.8%. The median age was 75.4 years [IQR 69.6-79.4]. The median follow-up was 8.3 months [IQR 3.5-12.25]. At inclusion, PSA was 7.7ng/ml [IQR 5.5-11.2] in group I, and 5.9ng/ml [IQR 4.4-7.9] in group II. In the whole population, there was 73.5% negative biopsies; 14.7% of the biopsies were positive in treated zone and 11.

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