Journal of Yeungnam Medical Science

Original article

Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy: Seung Yun Yi, Dong Jin Park, Kyungchan Min, Jae-Wook Chung, Yun-Sok Ha, Bum Soo Kim, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo; Yeungnam Univ J Med. 2021;38(3):225-230. Published online April 20, 2021; DOI: https://doi.org/10.12701/yujm.2021.00955

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Background
We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS).
Methods
From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS.
Results
Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%).
Conclusion
This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

Citations

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An analysis of bacteriuria rates after endourological procedures
Nethravathy Billava Seenappa, Maneesh Sinha, Thyagaraj Krishna Prasad, Venkatesh Krishnamoorthy
International Journal of Urological Nursing.2023; 17(1): 45. CrossRef
Nutritional and Inflammatory Indices and the Risk of Surgical Site Infection After Fragility Hip Fractures: Can Routine Blood Test Point to Patients at Risk?
Tal Frenkel Rutenberg, Rana Gabarin, Vitali Kilimnik, Efrat Daglan, Moti Iflah, Shani Zach, Shai Shemesh
Surgical Infections.2023; 24(7): 645. CrossRef
Prognostic value of albumin-to-globulin ratio in COVID-19 patients: A systematic review and meta-analysis
Juan R. Ulloque-Badaracco, Melany D. Mosquera-Rojas, Enrique A. Hernandez-Bustamante, Esteban A. Alarcón-Braga, Percy Herrera-Añazco, Vicente A. Benites-Zapata
Heliyon.2022; 8(5): e09457. CrossRef

Case report

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures: Yeong Uk Kim, Jae Ho Cho, Phil Hyun Song; Yeungnam Univ J Med. 2020;37(4):337-340. Published online July 29, 2020; DOI: https://doi.org/10.12701/yujm.2020.00402

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Abstract PDF

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

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Ureterosciatic Hernia in Focus: A Narrative Review of the Literature
Mohamed Mustafa, Afiq Pouzi, Peter Senada, Lokesh Suraparaju, Suresh Gupta
Cureus.2023;[Epub] CrossRef
Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review
Kohei Kakimoto, Mayu Hikone, Ko Nagai, Jun Yamakawa, Kazuhiro Sugiyama, Yuichi Hamabe
International Journal of Emergency Medicine.2021;[Epub] CrossRef

Original Articles

Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length: Geon Woo Lim, Young Dong Yu, Kyung Hwa Choi, Seung Ryeol Rhee, Dong Soo Park, Young Kwon Hong; Yeungnam Univ J Med. 2018;35(2):179-186. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.179

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Abstract PDF

Background
To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.
Methods
A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.
Results
The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.
Conclusion
Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

Citations

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Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture
Bing Wang, Wenzhi Gao, Kunlin Yang, Honglei Liu, Yangjun Han, Mingxin Diao, Chao Zuo, Minghua Zhang, Yingzhi Diao, Zhihua Li, Xinfei Li, Gang Wang, Peng Zhang, Chunji Wang, Chunjuan Xiao, Chen Huang, Yaming Gu, Xuesong Li
Journal of Clinical Medicine.2023; 12(4): 1655. CrossRef
Mechanical characteristics of the ureter and clinical implications
Sorcha O’Meara, Eoghan M. Cunnane, Stefanie M. Croghan, Connor V. Cunnane, Michael T. Walsh, Fergal J. O’Brien, Niall F. Davis
Nature Reviews Urology.2023;[Epub] CrossRef
Left-sided flap transposition of the appendix for urethroplasty in oncourology
A. K. Nosov, D. I. Rumyantseva, E. M. Mamizhev, P. A. Lushina, N. A. Shchekuteev, M. V. Berkut
Cancer Urology.2022; 18(1): 127. CrossRef

Clinical Outcome of Ureteropelvic Junction Obstruction in the Pediatric and Adult Population.: Phill Hyun Song, Sang Taek Kwon, Ji Hyun Yeo, Yong Hoon Park, Ki Hak Moon; Yeungnam Univ J Med. 2004;21(1):67-73. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.67

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Abstract PDF: BACKGROUND
A ureteropelvic junction (UPJ) obstruction is a congenital anomaly commonly afflicting the pediatric population. However, it occurs more frequently in adults than is generally appreciated. To assess their characteristics, we have here compared and analyzed the clinical manifestations, causes, and outcomes of UPJ obstruction found in children and adults. MATERIALS AND METHODS: 102 patients (118 renal units) out of 182 patients (218 renal units), with diagnosed UPJ obstruction, were available for follow up. The follow-ups were retrospectively reviewed to determine the presenting symptoms, treatments, and clinical outcomes. Patients who were younger than 18 years of age were assigned to the pediatric group (44 patients), others the adult group (58 patents). RESULTS: The majority of the patients presented with flank pain (pediatric group: 68%, adult group: 76%). The majority of patients underwent a pyeloplasty (pediatric group: 50.9%, adult group: 62.3%). And the major cause of the UPJ obstruction was an intrinsic stenosis (pediatric group: 53%, adult group: 56%). CONCLUSION: The prevalence of bilateral UPJ obstruction in adults is evidently less prevalent than in pediatrics, and despite the late diagnosis, the surgical outcome is similar. A further investigation of UPJ obstruction will lead us to a more comprehensive understanding of the disease.

Clinical Experiences of the Ureteroscopic Management for the Lower Ureteral Stone.: Seong Jong Mo, Young Soo Kim, Jun Kyu Suh, Tong Choon Park; Yeungnam Univ J Med. 1990;7(2):97-102. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.97

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Abstract PDF

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.

Citations

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A Clinical Case Report of Severe Hematuria Patient after Ureterolith Lithotripsy
Sang Hyun Lee, Ju Yong Jeong, Myoung Rae Cho
Korean Journal of Acupuncture.2015; 32(3): 144. CrossRef

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