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Reproductive system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
If the cause of LUTS is thought clinically to be a urethral stricture, ultrasound will be very helpful if local expertise is available, but retrograde urethrography with dynamic studies remains the most widely used diagnostic test.
Prostate cancer high dose-rate brachytherapy: review of evidence and current perspectives
Published in Expert Review of Medical Devices, 2018
Sunil W. Dutta, Clayton E. Alonso, Bruce Libby, Timothy N. Showalter
HDR monotherapy carries a low rate of adverse events, as shown in Table 1 [22–26]. Hauswald et al. observed no late grade 3–4 rectal toxicities, and 4.9% late GU toxicities of 448 patients who received HDR monotherapy [27]. One concern of HDR brachytherapy is urethral stricture due to potentially high dose to the urethra; however, the incidence has been shown to be low. Zamboglou et al. noted a urethral stricture incidence of 1.8%, Rogers et al. 0%, and Martinez et al. 4% [22,23,26]. Short-term urinary toxicities such a frequency or urgency occurred in around 10% of 298 patients (42 Gy in 6 fractions) reported by Demanes et al., but typically resolved in 3–18 months [35]. While minimizing the number of fractions improves patient convenience and potentially takes advantage of prostate tumor alpha/beta ratio, there is concern for increased late GU toxicity. However, Morton et al. recently reported toxicity outcomes from a phase II trial comparing single (19 Gy in 1 fraction) to two fraction (13.5 Gy in 2 fractions) HDR monotherapy, and found increased rates of erectile dysfunction in the two fraction arm (29% versus 11.5%, p = 0.0249), as well as higher IPSS scores and lower EPIC urinary scores in the two fraction arm [36]. In somewhat conflicting results, Hoskin et al. found higher requirement for catheter use with two fractions (13 Gy in 2 fractions) versus single fraction (19–20 Gy in 1 fraction) [37].
High-intensity focused ultrasound for prostate cancer
Published in Expert Review of Medical Devices, 2020
Alessandro Napoli, Giulia Alfieri, Roberto Scipione, Andrea Leonardi, Davide Fierro, Valeria Panebianco, Cosimo De Nunzio, Costantino Leonardo, Carlo Catalano
In this category of patients, the reported rate of side events is variable among the different reports, ranging 3.7–46% for urinary incontinence, 3–54% of bladder neck contracture/urethral stricture, and 0–16% of rectal fistula. However, compared to salvage cryotherapy, HIFU seems to have a better safety profile, with lower rates of both mild-to-moderate urinary incontinence and urinary retention [74].
An update on research and outcomes in surgical management of vaginal mesh complications
Published in Expert Review of Medical Devices, 2019
Dominic Lee, Philippe E. Zimmern
Specific complications following MUS removal include persistent or recurrent incontinence, urethral stricture, persistent pain or dyspareunia, de novo pain, bladder neck injury, urethral injury requiring immediate or delayed repair, urethrovaginal fistula and need for repeat surgery.