PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

Objectives: ：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods: ：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results: ：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions ：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Objectives: ：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods: ：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results: ：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions ：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

PURPOSE: There are few reports describing objective and subjective outcomes in aged patients undergoing distal urethral polypropylene sling (DUPS) and canal transobturator tape (canal TOT) placement, which make the submucosal mesh 'tension-free' state in the operating room. We evaluated surgical outcomes and subjective satisfaction in patients over 70 years of age who underwent DUPS and canal TOT for the treatment of stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 29 consecutive patients over 70 years of age who underwent DUPS and canal TOT for genuine SUI between January 2006 and April 2008. Surgical outcomes were determined on the basis of hemoglobin change, operative time, hospital stay, and complications. Subjective satisfaction was determined on the basis of disease-specific quality of life, measured via the Incontinence Impact Questionnaire-short form (IIQ-7) and the Urogenital Distress Inventory-short form (UDI-6). RESULTS: No intraoperative or major postoperative complications were reported. No concomitant procedures were performed, including cystocele repair (n=0) or rectocele repair (n=0). The mean IIQ-7 and UDI-6 scores both decreased significantly after DUPS and canal TOT. Moreover, 82% of patients reported no SUI symptoms under any circumstances, and 91% of patients reported being rarely or never bothered by SUI symptoms. CONCLUSIONS: The surgical outcomes and subjective satisfaction seen with DUPS and canal TOT in this study were superior to those seen in other studies. However, it is possible that this study overestimated the effects of DUPS and canal TOT in aged women because of the small study sample. Therefore, additional studies are needed.
Aged ; Cystocele ; Female ; Hemoglobins ; Humans ; Length of Stay ; Operating Rooms ; Operative Time ; Polypropylenes ; Postoperative Complications ; Quality of Life ; Rectocele ; Suburethral Slings ; Urinary Incontinence

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of urolithiasis since it was first introduced in 1980. ESWL is a well-established, safe and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. We present a case of a young female patient who developed a huge hepatic subcapsular hematoma accompanied by hypovolemic shock after ESWL for a 9 mm stone in the right kidney. The hematoma measured 13x6 cm. Conservative care with no surgical intervention was chosen because there was no evidence of active bleeding on the computed tomography. After conservative therapy, the hematoma was gradually absorbed and the patient was discharged.
Female ; Hematoma ; Hemorrhage ; Humans ; Kidney ; Lithotripsy ; Shock ; Urolithiasis

Purpose: This study aimed to develop and evaluate machine learning models, specifically CatBoost and extreme gradient boosting (XGBoost), for diagnosing lower urinary tract symptoms (LUTS) in male patients. The objective is to differentiate between bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using a comprehensive dataset that includes patient-reported outcomes, uroflowmetry measurements, and ultrasound-derived features. Methods: The dataset used in this study was collected from male patients aged 40 and older who presented with LUTS and sought treatment at the urology department of Samsung Medical Center. We developed and trained CatBoost and XGBoost models using this dataset. These models incorporated features like prostate size, voiding parameters, and responses from questionnaires. Their performance was assessed using standard metrics such as accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC). Results: The results indicated that the CatBoost models displayed greater sensitivity, rendering them effective for initial screenings by accurately identifying true positive cases. Conversely, the XGBoost models showed higher specificity and precision, making them more suitable for confirming diagnoses and reducing false positives. In terms of overall performance for both BOO and DUA, XGBoost surpassed CatBoost, achieving an AUROC of 0.826 and 0.819, respectively. Conclusions Integrating these machine learning models into the diagnostic workflow for LUTS can significantly enhance clinical decision-making by offering noninvasive, cost-effective, and patient-friendly diagnostic alternatives. The combined application of CatBoost and XGBoost models has the potential to improve diagnostic accuracy and provide customized treatment plans for patients, ultimately leading to better clinical outcomes.

Purpose: This study aimed to develop and evaluate machine learning models, specifically CatBoost and extreme gradient boosting (XGBoost), for diagnosing lower urinary tract symptoms (LUTS) in male patients. The objective is to differentiate between bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using a comprehensive dataset that includes patient-reported outcomes, uroflowmetry measurements, and ultrasound-derived features. Methods: The dataset used in this study was collected from male patients aged 40 and older who presented with LUTS and sought treatment at the urology department of Samsung Medical Center. We developed and trained CatBoost and XGBoost models using this dataset. These models incorporated features like prostate size, voiding parameters, and responses from questionnaires. Their performance was assessed using standard metrics such as accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC). Results: The results indicated that the CatBoost models displayed greater sensitivity, rendering them effective for initial screenings by accurately identifying true positive cases. Conversely, the XGBoost models showed higher specificity and precision, making them more suitable for confirming diagnoses and reducing false positives. In terms of overall performance for both BOO and DUA, XGBoost surpassed CatBoost, achieving an AUROC of 0.826 and 0.819, respectively. Conclusions Integrating these machine learning models into the diagnostic workflow for LUTS can significantly enhance clinical decision-making by offering noninvasive, cost-effective, and patient-friendly diagnostic alternatives. The combined application of CatBoost and XGBoost models has the potential to improve diagnostic accuracy and provide customized treatment plans for patients, ultimately leading to better clinical outcomes.

Purpose: This study aimed to develop and evaluate machine learning models, specifically CatBoost and extreme gradient boosting (XGBoost), for diagnosing lower urinary tract symptoms (LUTS) in male patients. The objective is to differentiate between bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using a comprehensive dataset that includes patient-reported outcomes, uroflowmetry measurements, and ultrasound-derived features. Methods: The dataset used in this study was collected from male patients aged 40 and older who presented with LUTS and sought treatment at the urology department of Samsung Medical Center. We developed and trained CatBoost and XGBoost models using this dataset. These models incorporated features like prostate size, voiding parameters, and responses from questionnaires. Their performance was assessed using standard metrics such as accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC). Results: The results indicated that the CatBoost models displayed greater sensitivity, rendering them effective for initial screenings by accurately identifying true positive cases. Conversely, the XGBoost models showed higher specificity and precision, making them more suitable for confirming diagnoses and reducing false positives. In terms of overall performance for both BOO and DUA, XGBoost surpassed CatBoost, achieving an AUROC of 0.826 and 0.819, respectively. Conclusions Integrating these machine learning models into the diagnostic workflow for LUTS can significantly enhance clinical decision-making by offering noninvasive, cost-effective, and patient-friendly diagnostic alternatives. The combined application of CatBoost and XGBoost models has the potential to improve diagnostic accuracy and provide customized treatment plans for patients, ultimately leading to better clinical outcomes.

PURPOSE: The prevalence of vesicoureteral reflux (VUR) in prepuberty children with urinary tract infection (UTI) varies among the different racial groups. The purpose of this study was to determine if the incidence of VUR is associated with age, gender and the clinical indications for the prepuberty children with UTI in Daegu city and the Gyeongbuk area, and we wanted to compare our findings to those reported findings for the other racial groups. MATERIALS AND METHODS: The medical records of all 2,474 prepuberty children who underwent a voiding cystourethrogram (VCUG) or radionuclide cystogram (RNC) between 1998 and 2003 were retrospectively reviewed. Age, gender and the clinical indications were recorded for the first VCUG or RNC. For the children with UTI, the highest grade of VUR and the number of UTIs were also examined. We analyzed the data by using chi square test and calculating the odds ratio with using SAS version 8.12. RESULTS: There were 2,037 prepuberty children with UTI (82.5%) among the 2,474 total subjects. Among the participants, 718 (35.2%) were female and 1,306 (64.1%) were male, and 13 were missing data. The overall rate of VUR was 21.2% (432/2,037) with a rate of 22.6% (162/718) for the females and 20.4% (267/1,306) for the males, respectively. With respect to the age distribution, none were younger than 1, 1 was younger than 2, the 2-6 year-olds were 17.3% (257/1,485), and the 7-12 year olds were 35.9% (103/287). Referring to the frequency of UTI, the patients experiencing their first, second. third, fourth, and over five episodes were 16.8%, 34.2%, 36.7%, 42.9% and 56.1%, respectively. As the patients got older, the first VCUG was done for recurrent UTI (p<0.05). CONCLUSIONS: We investigated the rate of VUR based on the clinical indications, age and gender among Korean preadolescents. The rate of reflux was 21.2% for the patients suffering with UTI. The female had VUD 1.1 times more frequent than did the males. The older patient had a higher reflux rate, which suggested that prepuberty children over 1 year of age with recurrent UTI should undergo their first VCUG or RNC.
Age Distribution ; Child ; Daegu* ; Female ; Gyeongsangbuk-do* ; Humans ; Incidence* ; Male ; Medical Records ; Odds Ratio ; Prevalence ; Radionuclide Imaging ; Retrospective Studies ; Urinary Tract Infections ; Vesico-Ureteral Reflux*