19 results on '"Hanegbi U."'
Search Results
2. How Accurate is 68Ga PSMA PET/MRI in localizing primary prostate cancers compared to multiparametric MRI, Ga68 PSMA PET/CT and whole-mount histopathology?.
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Hanegbi U., Chen Z., Ferris N., McIntyre R., Bradley J., Egan G., Ryan A., Beech P., O'sullivan R., Pan Y., Kalapara A., Cheng J., Moon D., Landau A., Grummet J., Frydenberg M., Ramdave S., Tahayori B., Hanegbi U., Chen Z., Ferris N., McIntyre R., Bradley J., Egan G., Ryan A., Beech P., O'sullivan R., Pan Y., Kalapara A., Cheng J., Moon D., Landau A., Grummet J., Frydenberg M., Ramdave S., and Tahayori B.
- Abstract
Introduction and Objectives: Prostate specific membrane antigen (PSMA) ligands in positron emission tomography (PET) imaging have shown superior results when compared to traditional imaging in prostate cancer. Simultaneous PSMA PET/MRI is an emerging modality yielding promising results in detection and staging, although scant published evidence is available. We compared the diagnostic accuracy of multiparametric MRI, PSMA PET/MRI and PSMA PET/CT to wholemount histopathology for the localisation of primary prostate cancer. Method(s): A local prospective database for patients who underwent MRI was used. 13 patients underwent multiparametric MRI, transperineal prostate biopsy, PSMA PET/ CT, PSMA PET/MRI and subsequent radical prostatectomy with whole-mount histopathology. Imaging was reported with Prostate Imaging Reporting and Data System sector maps. These were individually evaluated by dividing the prostate into 12 sectors; apex/mid/base in the transverse plane, left/right in the sagittal plane, and anterior/posterior in the coronal plane. Result(s): Whole-mount histopathology revealed significant cancer in 13 patients, present in 59 of 156 sectors, with significant cancer defined as greater than or equal to Gleason 3 + 4 = 7 (Grade Group 2). MRI detected true positives in 31 of 36 MRI positive sectors and true negatives in 92 of 120 MRI negatives sectors, conferring a sensitivity and specificity of 51% and 95% respectively. PET/CT detected true positives in 25 of 32 PSMA avid sectors and true negatives in 90 of 124 PSMA non-avid sectors, conferring a sensitivity (Table pesented) and specificity of 42% and 93% respectively. PET/MRI detected true positives in 32 of 36 PSMA avid sectors and true negatives in 93 of 120 PSMA non-avid sectors, conferring a sensitivity and specificity of 54% and 96% respectively. The overall accuracy of all 3 modalities respectively were 78%, 74% and 80%. Conclusion(s): In this case-series involving highly selected patients undergoing pro
- Published
- 2019
3. What is the accuracy of 68Ga-PSMA PET/CT in detecting primary prostate cancers compared to multiparametric MRI?.
- Author
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Pan Y., Kalapara A., Cheng J., Moon D., Hanegbi U., Landau A., Snow R., O'sullivan R., Beech P., Ryan A., Frydenberg M., Grummet J., Pan Y., Kalapara A., Cheng J., Moon D., Hanegbi U., Landau A., Snow R., O'sullivan R., Beech P., Ryan A., Frydenberg M., and Grummet J.
- Abstract
Introduction and Objectives: PSMA PET/ CT has demonstrated superior sensitivity in detecting prostate cancer metastases compared to traditional staging modalities and seen a high degree of utilisation in the Australian setting. However, there is little data published on the role of PSMA PET/CT in detecting and diagnosing primary prostate cancer. We compared the accuracy of PSMA PET/CT to multiparametric MRI for (Table presented) the detection of clinically significant primary prostate cancer. Method(s): A local prospective database (REDCap-Monash) was maintained on patients who underwent MRI in our group urology practice from July 2013 to December 2017. All patients who had an MRI for diagnosis of prostate cancer, subsequent transperineal biopsy, and a PSMA PET/CT for initial staging were included, with significant cancer being defined as greater than or equal to Gleason 3 + 4 = 7 (ISUP Grade Group 2). Result(s): The database contained 2283 patients who underwent prostate MRI. 239 patients subsequently underwent both biopsy and PSMA PET/CT. 202 biopsies (84.5%) showed significant cancer. Of the non-significant cancer cases, 21 (8.8%) revealed Grade Group 1 lesions and 16 (6.7%) were benign. For significant cancers, 189 PSMA PET/CT scans demonstrated local PSMA avidity in the prostate, compared to 174 positive (PIRADS 4 or 5) MRI scans. MRI detected fewer insignificant cancers, but resulted in more false negatives. Overall, sensitivity and specificity for PSMA PET/CT and MRI respectively were 93.6%, 64.9% and 87.1%, 70.3%. Conclusion(s): In this highly-selected cohort of patients undergoing prostate MRI, transperineal biopsy and PSMA PET/CT for staging as part of clinical practice, PSMA PET/CT outperformed MRI in detecting clinically significant primary prostate cancer. It is proposed that PSMA PET may be used in both diagnosis of primary cancers and staging, although costeffectiveness in this dual role warrants further investigation. Higher sensitivity achieved by P
- Published
- 2019
4. What is the accuracy of Ga68 PSMA PET/CT in detecting primary prostate cancers compared to multiparametric MRI?.
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Moon D., Hanegbi U., Landau A., O'sullivan R., Beech P., Ryan A., Frydenberg M., Grummet J., Kalapara A.A., Pan Y.-C.H., Moon D., Hanegbi U., Landau A., O'sullivan R., Beech P., Ryan A., Frydenberg M., Grummet J., Kalapara A.A., and Pan Y.-C.H.
- Abstract
Introduction & Objective: PSMA PET/ CT demonstrates superior sensitivity in staging prostate cancer compared to traditional modalities and seen a high degree of utilisation in Australia1. However, there is little data published on the role of PSMA PET/CT in diagnosing primary prostate cancer. We compared the accuracy of PSMA PET/CT to multiparametric MRI for detecting clinically significant primary prostate cancer. Method(s): A local prospective database (REDCap-Monash) was maintained on patients who underwent MRI in our group urology practice from July-2013 to December- 2017. All patients who underwent MRI, subsequent transperineal biopsy, and PSMA PET/CT for initial staging were included, with significant cancer defined as greater than or equal to ISUP Grade Group 2. Result(s): 2,283 patients underwent prostate MRI. 239 patients subsequently underwent biopsy and PSMA PET/CT. 202 biopsies (84.5%) showed significant cancer. Of the non-significant cancers, 21 (8.8%) revealed Grade Group 1 lesions and 16 (6.7%) were benign. For significant cancers, 189 PSMA PET/CT scans demonstrated local prostate PSMA avidity, compared to 174 positive (PIRADS 4/5) MRI scans. MRI detected fewer insignificant cancers, but more false- negatives. Overall, sensitivity and specificity for PSMA PET/CT and MRI respectively were 93.6%, 18.9% and 86.1%, 70.3% (p < 0.05). Conclusion(s): In this highly-selected cohort of patients, PSMA PET/CT outperformed MRI in detecting clinically significant primary prostate cancer. This can enhance its uses, in detecting and staging primary cancers, although cost-effectiveness in this dual-role warrants further investigation. Higher sensitivity achieved by PET/CT comes at the expense of detecting clinically insignificant disease, evidenced by higher false-positive rates. Furthermore, soft-tissue resolution is inferior to MRI.
- Published
- 2018
5. What is the accuracy of Ga68 PSMA PET/CT in detecting primary prostate cancers compared to multi-parametric mri?.
- Author
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aO'Sullivan R., Ryan A., Beech P., Pan Y.-C.H., Kalapara A.A., Grummet J., Frydenberg M., Moon D., Hanegbi U., Landau A., aO'Sullivan R., Ryan A., Beech P., Pan Y.-C.H., Kalapara A.A., Grummet J., Frydenberg M., Moon D., Hanegbi U., and Landau A.
- Abstract
Objective: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has demonstrated superior sensitivity in detecting prostate cancer metastases compared to traditional staging modalities and seen a high degree of utilisation in the Australian setting.1 However, there is little data published on the role of PSMA PET/CT in diagnosing primary prostate cancer. We compared the accuracy of PSMA PET/CT to multi-parametric MRI for the detection of clinically significant primary prostate cancer. Method(s): A local prospective database (REDCap-Monash) was maintained on patients who underwent MRI in our group urology practice from July 2013 to December 2017. All patients who had an MRI for diagnosis of prostate cancer, subsequent transperineal biopsy and a PSMA PET/CT for initial staging were included, with significant cancer being defined as greater than or equal to Gleason 3+4=7 (ISUP Grade Group 2). Result(s): The database contained 2283 patients who underwent prostate MRI. Two-hundred thirty-nine patients subsequently underwent both biopsy and PSMA PET/CT. Two hundred biopsies (84.5%) showed significant cancer. Of the non-significant cancer cases, 21 (8.8%) revealed Grade Group 1 lesions and 16 (6.7%) were benign. For significant cancers, 189 PSMA PET/CT scans demonstrated local PSMA avidity in the prostate, compared to 174 positive (PIRADS 4 or 5) MRI scans. MRI detected fewer insignificant cancers, but resulted in more false negatives. Overall, sensitivity and specificity for PSMA PET/CT and MRI, respectively, were 93.6%, 18.9% and 86.1%, 70.3% (P < 0.05). Conclusion(s): In this highly selected cohort of patients undergoing prostate MRI, transperineal biopsy and PSMA PET/CT as part of clinical practice, PSMA PET/CT outperformed MRI in detecting clinically significant primary prostate cancer. This can enhance its uses, in detecting and staging primary cancers, although cost-effectiveness in this dual role warrants further inves
- Published
- 2018
6. How accurate is Ga68 PSMA PET/ MR in localizing primary prostate cancers compared to multiparametric MRI, Ga68 PSMA PET/CT and whole-mount histopathology-A case series.
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Frydenberg M., Moon D., Hanegbi U., Landau A., O'sullivan R., Beech P., Ryan A., Pan Y.-C.H., Kalapara A.A., Grummet J., Frydenberg M., Moon D., Hanegbi U., Landau A., O'sullivan R., Beech P., Ryan A., Pan Y.-C.H., Kalapara A.A., and Grummet J.
- Abstract
Objective: Prostate specific membrane antigen ligands in PET imaging show superior results compared to traditional prostate cancer imaging techniques1. Simultaneous PSMA PET/MR is an emerging modality yielding promising results. We compared the diagnostic accuracy of multiparametric MRI, PSMA PET/ MR and PSMA PET/CT to whole-mount histopathology for localization of primary prostate cancer. Method(s): A prospective database (REDCap-Monash) for patients who underwent MRI in our group urology practice since 2013 was used. 8 patients underwent MRI, PSMA PET/CT, PSMA PET/MR and subsequent radical prostatectomy with whole-mount histopathology. Imaging was reported based on PIRADS Sector Maps, with results analysed by dividing the prostate into 12 sectors; apex/ mid/base in the transverse plane, left/right in the sagittal plane, and anterior/posterior in the coronal plane. Result(s): Whole-mount histopathology revealed significant cancer in 8 patients, with tumour foci detected in 46/96 sectors, with significant cancer defined as greater than or equal to Gleason 3 + 4 = 7. MRI detected lesions in 20 sectors (19 involving tumour foci), no lesion in 76 sectors (27 involving tumour foci). PET/CT demonstrated avidity in 32 sectors (21 involving tumour foci), no avidity in 64 sectors (25 involving tumour foci). PET/MR demonstrated avidity in 22 sectors (all involving tumour foci), no avidity in 74 sectors (24 involving tumour foci). The overall accuracies were 71%, 63% and 75% respectively. Conclusion(s): In this case-series involving highly selected patients, PET/MR outperformed both MRI and PET/CT in accurately detecting significant primary prostate cancer. As a diagnostic technique, pelvic PET/MR is an emerging modality, and as such requires further investigation and cost-effectiveness analysis.
- Published
- 2018
7. Comparison of perioperative, renal and oncologic outcomes in robotic-assisted versus open partial nephrectomy
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Tan, J-L, Frydenberg, M, Grummet, J, Hanegbi, U, Snow, R, Mann, S, Begashaw, K, Moon, D, Tan, J-L, Frydenberg, M, Grummet, J, Hanegbi, U, Snow, R, Mann, S, Begashaw, K, and Moon, D
- Abstract
BACKGROUND: To compare perioperative, renal and oncological outcomes after robotic-assisted partial nephrectomy (RAPN) versus open partial nephrectomy (OPN) for the treatment of renal tumours. METHODS: All partial nephrectomies performed at a Metropolitan Urology Centre between 2010 and 2016 were analysed. Baseline data was collected for patient demographics, tumour characteristics (tumour size, laterality and polarity, RENAL scores), and perioperative variables (e.g. warm ischaemic time, operation time, estimated blood loss (EBL), length of stay). Tumour characteristics included malignancy, clinical stage, Fuhrman nuclear grade and surgical margin status. Day-1 post-operative serum creatinine, estimated glomerular filtration rate (eGFR) and 6-month eGFR stage were used for assessing renal function. RESULTS: Two hundred patients underwent partial nephrectomy between 2010 and 2016 (n = 200; 55 OPN versus 145 RAPN). Baseline data was similar between groups, except for lower age (P = 0.0001) and higher RENAL scores (P = 0.001) in the RAPN group. RAPN demonstrated significantly lower complication rates (P = 0.015), lesser EBL (P = <0.0001), shorter hospital stays (P = <0.001) and reduced positive tumour resection margins (P = 0.039). There was no significant difference in mean operation time between RAPN and OPN (137.2 (±48.0) OPN versus 146.07 (±35.91) RAPN; P = 0.16). No statistical difference was shown for post-operative eGFR stage between groups at Day-1 and 6-month post-surgery (P = 0.15 and P = 0.861, respectively). CONCLUSION: We present the largest reported Australian series on partial nephrectomy, confirming that a robotic-assisted approach is equivalent to OPN, with reduced complications, EBL, length of hospital stays and fewer positive margins, even when resecting more complex tumours.
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- 2018
8. Biparametric MRI: Could it reduce the cost of MRI while maintaining diagnostic accuracy for prostate cancer?
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Grummet, J., primary, Pepdjonovic, L., additional, Huang, S., additional, Dat, A., additional, Miller, R., additional, Begashaw, K., additional, Kalapara, A., additional, Mann, S., additional, Ryan, A., additional, O’Sullivan, R., additional, Moon, D., additional, Landau, A., additional, Snow, R., additional, Hanegbi, U., additional, and Frydenberg, M., additional
- Published
- 2018
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9. 620 - Biparametric MRI: Could it reduce the cost of MRI while maintaining diagnostic accuracy for prostate cancer?
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Grummet, J., Pepdjonovic, L., Huang, S., Dat, A., Miller, R., Begashaw, K., Kalapara, A., Mann, S., Ryan, A., O’Sullivan, R., Moon, D., Landau, A., Snow, R., Hanegbi, U., and Frydenberg, M.
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- 2018
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10. ALK-rearranged renal cell carcinoma with TPM3::ALK gene fusion and review of the literature.
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Galea LA, Hildebrand MS, Witkowski T, Joy C, McEvoy CR, Hanegbi U, and Aga A
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- Female, Humans, Gene Fusion, Gene Rearrangement, Immunohistochemistry, In Situ Hybridization, Fluorescence, Tropomyosin genetics, Aged, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology
- Abstract
ALK-rearranged renal cell carcinoma (ALK-RCC) is a very rare novel molecularly defined entity in the recently published fifth edition of the World Health Organization classification of tumours. We describe a case of ALK-RCC in a 76-year-old female. The tumour was composed of discohesive rhabdoid cells and pleomorphic, multinucleated cells (equivalent to ISUP/WHO grade 4). The tumour showed expression with PAX8, Keratin 7 and alpha methylacyl CoA racemase. ALK (D5F3 clone) was strongly and diffusely positive. ALK-FISH showed significant split signals of ALK, confirming the diagnosis. RNA sequencing showed TPM3::ALK rearrangement. Including the current case, there are 14 reported ALK-RCC cases with the same TPM3 fusion partner gene. Review of these published cases highlights their morphological heterogeneity and stresses the importance of running ALK immunohistochemistry on difficult cases to classify renal tumours. This is important while identification of ALK-RCC has clinical significance due to the availability of targeted therapy with ALK inhibitors., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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11. The Detection of Prostate Cancer with Magnetic Resonance Imaging-Targeted Prostate Biopsies is Superior with the Transperineal vs the Transrectal Approach. A European Association of Urology-Young Academic Urologists Prostate Cancer Working Group Multi-Institutional Study.
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Zattoni F, Marra G, Kasivisvanathan V, Grummet J, Nandurkar R, Ploussard G, Olivier J, Chiu PK, Valerio M, Gontero P, Guo H, Zhuang J, Barletta F, Leni R, Frydenberg M, Moon D, Hanegbi U, Landaumailto A, Snow R, Apfelbeck M, Kretschmer A, van den Bergh R, Novara G, Briganti A, Dal Moro F, and Gandaglia G
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- Humans, Image-Guided Biopsy, Magnetic Resonance Imaging, Male, Prostate diagnostic imaging, Prostate pathology, Retrospective Studies, Urologists, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology, Urology
- Abstract
Purpose: Our aim was to evaluate whether transperineal (TP) MRI-targeted prostate biopsy (TBx) may improve the detection of clinically significant prostate cancer (csPCa), defined as International Society of Urological Pathology ≥2, in comparison to transrectal (TR) TBx., Materials and Methods: A multicenter retrospective cohort study comprising patients who underwent MRI-guided prostate biopsy was conducted. To address possible benefits of TP-TBx in the detection of prostate cancer (PCa) and csPCa, a cohort of patients undergoing TP-TBx were compared to patients undergoing TR-TBx. Multivariable logistic regression analyses were performed to assess predictors of PCa and csPCa detection., Results: Overall, 1,936 and 3,305 patients who underwent TR-TBx vs TP-TBx at 10 referral centers were enrolled. The rate of PCa and csPCa diagnosed was higher for TP-TBx vs TR-TBx (64.0% vs 50%, p <0.01 and 49% vs 35%, p <0.01). At multivariable analysis adjusted for age, biopsy naïve/repeated biopsy, cT stage, Prostate Imaging-Reporting and Data System®, prostate volume, PSA, and number of biopsy cores targeted, TP-TBx was an independent predictor of PCa (odds ratio [OR] 1.37, 95% CI 1.08-1.72) and csPCa (1.19, 95% CI 1.12-1.50). When considering the approach according to the site of the index lesion, TP-TBx had a significantly higher likelihood than TR-TBx to detect csPCa in the apex (OR 4.81, 95% CI 1.03-6.27), transition/central zone (OR 2.67, 95% CI 1.42-5.00), and anterior zone (OR 5.62, 95% CI 1.74-8.13)., Conclusions: The use of TP-TBx allows a better cancer grade definition and PCa risk assessment. This has important implication in the decision-making process and in patient counseling for further therapies.
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- 2022
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12. Ductal variant prostate carcinoma is associated with a significantly shorter metastasis-free survival.
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Chow K, Bedő J, Ryan A, Agarwal D, Bolton D, Chan Y, Dundee P, Frydenberg M, Furrer MA, Goad J, Gyomber D, Hanegbi U, Harewood L, King D, Lamb AD, Lawrentschuk N, Liodakis P, Moon D, Murphy DG, Peters JS, Ruljancich P, Verrill CL, Webb D, Wong LM, Zargar H, Costello AJ, Papenfuss AT, Hovens CM, and Corcoran NM
- Subjects
- Adenocarcinoma secondary, Adenocarcinoma surgery, Aged, Carcinoma, Ductal secondary, Carcinoma, Ductal surgery, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Retrospective Studies, Survival Rate, Adenocarcinoma mortality, Carcinoma, Ductal mortality, Prostatectomy mortality, Prostatic Neoplasms mortality
- Abstract
Background: Ductal adenocarcinoma is an uncommon prostate cancer variant. Previous studies suggest that ductal variant histology may be associated with worse clinical outcomes, but these are difficult to interpret. To address this, we performed an international, multi-institutional study to describe the characteristics of ductal adenocarcinoma, particularly focussing on the effect of presence of ductal variant cancer on metastasis-free survival., Methods: Patients with ductal variant histology from two institutional databases who underwent radical prostatectomies were identified and compared with an independent acinar adenocarcinoma cohort. After propensity score matching, the effect of the presence of ductal adenocarcinoma on time to biochemical recurrence, initiation of salvage therapy and the development of metastatic disease was determined. Deep whole-exome sequencing was performed for selected cases (n = 8)., Results: A total of 202 ductal adenocarcinoma and 2037 acinar adenocarcinoma cases were analysed. Survival analysis after matching demonstrated that patients with ductal variant histology had shorter salvage-free survival (8.1 versus 22.0 months, p = 0.03) and metastasis-free survival (6.7 versus 78.6 months, p < 0.0001). Ductal variant histology was consistently associated with RB1 loss, as well as copy number gains in TAP1, SLC4A2 and EHHADH., Conclusions: The presence of any ductal variant adenocarcinoma at the time of prostatectomy portends a worse clinical outcome than pure acinar cancers, with significantly shorter times to initiation of salvage therapies and the onset of metastatic disease. These features appear to be driven by uncoupling of chromosomal duplication from cell division, resulting in widespread copy number aberration with specific gain of genes implicated in treatment resistance., Competing Interests: Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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13. Recurrent UTIs and cystitis symptoms in women.
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McKertich K and Hanegbi U
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- Anti-Bacterial Agents therapeutic use, Female, Humans, Recurrence, Urinalysis, Cystitis diagnosis, Cystitis drug therapy, Urinary Tract Infections diagnosis, Urinary Tract Infections drug therapy
- Abstract
Background: Recurrent urinary tract infections (rUTIs) and recurrent cystitis symptoms without infection occur commonly in women and present frequently in general practice., Objective: The aim of this article is to provide a management approach to the assessment and treatment of recurrent cystitis symptoms in women with rUTIs as well as women who have negative urine cultures., Discussion: Five common clinical scenarios are discussed with different approaches to treatment: true rUTIs with positive urine cultures, women with variable urine cultures (some positive and some negative), women with negative urine cultures who have pyuria +/- haematuria, women with completely normal urine cultures and women with ongoing symptoms after a definite UTI. Red flags signalling the need for early referral to a urologist for further assessment are discussed. Both non-antibiotic and antibiotic-related strategies to treat women with rUTIs are available.
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- 2021
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14. Predictors of erectile dysfunction after transperineal template prostate biopsy.
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Tan JL, Papa N, Hanegbi U, Snow R, Grummet J, Mann S, Cuthbertson A, Frydenberg M, and Moon D
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- Aged, Biopsy adverse effects, Biopsy methods, Humans, Incidence, Male, Middle Aged, Perineum, Prognosis, Prospective Studies, Self Report, Erectile Dysfunction epidemiology, Erectile Dysfunction etiology, Postoperative Complications epidemiology, Postoperative Complications etiology, Prostate pathology
- Abstract
Purpose: To investigate the incidence and possible contributing factors of erectile dysfunction (ED) after transperineal template prostate biopsy (TTPB)., Materials and Methods: Males undergoing TTPB were prospectively administered a Sexual Health Inventory for Men (SHIM) questionnaire before biopsy and one month after. SHIM questionnaires were repeated at 3- and 9-months for males not receiving interventional treatment. Sexually inactive males were excluded. Interval change in SHIM categories based upon baseline characteristics were evaluated. Multivariable logistic regression models were used to evaluate predictors of change in SHIM score category., Results: A total of 576 males were included in our sample. Of these, 450 (78%) males underwent their first biopsy. A decline in SHIM category within the immediate 4-weeks post-biopsy was reported by 167 males (31% of total eligible sample). Age was the strongest predictor of decline in SHIM category, the predicted probability of a decline in SHIM at age 50 was 10% (95% confidence interval [CI], 1%-19%), 32% at age 60 (95% CI, 25%-40%) and 36% at age 70 (95% CI, 29%-44%). For new onset ED, the predicted probability of ED within 4-weeks post-TTPB were 6.7% at age 50 (95% CI, 0%-15%), 26% at age 60 (95% CI, 17%-34%) and 31% at age 70 (95% CI, 21%-40%)., Conclusions: Older age at biopsy is an independent predictor of immediate ED after TTPB in sexually active males. This association was observed in the subgroup with no pre-existing ED. These findings provide useful information when counselling males undergoing TTPB., Competing Interests: The authors have nothing to disclose., (© The Korean Urological Association, 2021.)
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- 2021
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15. Lower risk of pelvic metalware infection with operative repair of concurrent bladder rupture.
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Yao HH, Esser M, Grummet J, Atkins C, Royce P, and Hanegbi U
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- Adult, Cohort Studies, Conservative Treatment methods, Cystoscopy methods, Female, Fracture Fixation, Internal adverse effects, Fractures, Bone diagnostic imaging, Fractures, Bone surgery, Humans, Incidence, Internal Fixators microbiology, Male, Middle Aged, Monitoring, Intraoperative methods, Multiple Trauma diagnostic imaging, Multiple Trauma surgery, Pelvic Bones surgery, Predictive Value of Tests, Prognosis, Prosthesis-Related Infections prevention & control, Retrospective Studies, Risk Assessment, Rupture diagnostic imaging, Statistics, Nonparametric, Tomography, X-Ray Computed methods, Trauma Centers, Treatment Outcome, Urinary Bladder surgery, Fracture Fixation, Internal methods, Internal Fixators adverse effects, Pelvic Bones injuries, Prosthesis-Related Infections epidemiology, Rupture surgery, Urinary Bladder injuries
- Abstract
Background: Patients with traumatic bladder rupture frequently have associated pelvic fracture. With increasing numbers of pelvic fractures fixed internally, there are concerns that conservative management of bladder rupture may increase the risk of pelvic metalware infection. This study aims to determine if operative repair of bladder rupture in comparison to conservative management with catheter drainage alone is associated with a lower rate of infection of internal fixation device for concurrent pelvic fracture., Methods: This is a retrospective cohort study of level IV evidence. From July 2001 through June 2013, 45 multi-trauma patients at a level 1 trauma centre were identified to have sustained bladder rupture with concurrent pelvic fracture requiring internal fixation. Clinicopathological data were extracted from the TraumaNET database, medical records and health-coding database. Patients were stratified into two retrospective cohorts, management with surgical repair and management with catheter drainage alone. Fischer's exact test was used to determine whether the rate of pelvic metalware infection was different in the two cohorts., Results: Of the 45 patients, 13 had intraperitoneal bladder rupture, 28 had extraperitoneal bladder rupture and four had combined intra-extraperitoneal bladder rupture. The median age for this cohort was 31. Bladder rupture was surgically repaired in 36 patients and managed conservatively with catheter drainage in nine patients. The rate of pelvic internal fixation device infection was lower in patients managed with surgical repair compared with conservative management (5.6% versus 33.3%, P = 0.047)., Conclusion: Operative repair of bladder rupture is associated with a lower rate of pelvic orthopaedic hardware infection in the presence of concurrent pelvic fracture requiring internal fixation., (© 2017 Royal Australasian College of Surgeons.)
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- 2018
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16. Comparison of perioperative, renal and oncologic outcomes in robotic-assisted versus open partial nephrectomy.
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Tan JL, Frydenberg M, Grummet J, Hanegbi U, Snow R, Mann S, Begashaw K, and Moon D
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- Aged, Australia, Blood Loss, Surgical, Carcinoma pathology, Female, Humans, Kidney Neoplasms pathology, Length of Stay, Male, Margins of Excision, Middle Aged, Neoplasm Staging, Operative Time, Retrospective Studies, Treatment Outcome, Warm Ischemia, Carcinoma surgery, Kidney Neoplasms surgery, Nephrectomy adverse effects, Postoperative Complications epidemiology, Robotic Surgical Procedures adverse effects
- Abstract
Background: To compare perioperative, renal and oncological outcomes after robotic-assisted partial nephrectomy (RAPN) versus open partial nephrectomy (OPN) for the treatment of renal tumours., Methods: All partial nephrectomies performed at a Metropolitan Urology Centre between 2010 and 2016 were analysed. Baseline data was collected for patient demographics, tumour characteristics (tumour size, laterality and polarity, RENAL scores), and perioperative variables (e.g. warm ischaemic time, operation time, estimated blood loss (EBL), length of stay). Tumour characteristics included malignancy, clinical stage, Fuhrman nuclear grade and surgical margin status. Day-1 post-operative serum creatinine, estimated glomerular filtration rate (eGFR) and 6-month eGFR stage were used for assessing renal function., Results: Two hundred patients underwent partial nephrectomy between 2010 and 2016 (n = 200; 55 OPN versus 145 RAPN). Baseline data was similar between groups, except for lower age (P = 0.0001) and higher RENAL scores (P = 0.001) in the RAPN group. RAPN demonstrated significantly lower complication rates (P = 0.015), lesser EBL (P = <0.0001), shorter hospital stays (P = <0.001) and reduced positive tumour resection margins (P = 0.039). There was no significant difference in mean operation time between RAPN and OPN (137.2 (±48.0) OPN versus 146.07 (±35.91) RAPN; P = 0.16). No statistical difference was shown for post-operative eGFR stage between groups at Day-1 and 6-month post-surgery (P = 0.15 and P = 0.861, respectively)., Conclusion: We present the largest reported Australian series on partial nephrectomy, confirming that a robotic-assisted approach is equivalent to OPN, with reduced complications, EBL, length of hospital stays and fewer positive margins, even when resecting more complex tumours., (© 2017 Royal Australasian College of Surgeons.)
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- 2018
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17. Zero hospital admissions for infection after 577 transperineal prostate biopsies using single-dose cephazolin prophylaxis.
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Pepdjonovic L, Tan GH, Huang S, Mann S, Frydenberg M, Moon D, Hanegbi U, Landau A, Snow R, and Grummet J
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- Adult, Aged, Aged, 80 and over, Antibiotic Prophylaxis methods, Biopsy, Large-Core Needle methods, Databases, Factual, Humans, Male, Middle Aged, Patient Readmission statistics & numerical data, Perineum, Prostatic Neoplasms diagnosis, Surgical Wound Infection epidemiology, Anti-Bacterial Agents therapeutic use, Cefazolin therapeutic use, Hospitalization statistics & numerical data, Postoperative Complications epidemiology, Prostate pathology, Prostatic Neoplasms pathology, Sepsis epidemiology
- Abstract
Purpose: To determine the rate of hospital admissions for infection after transperineal biopsy of prostate (TPB) with single-dose cephazolin prophylaxis using a prospective database., Method: Between April 2013 and February 2016, 577 patients undergoing TPB had 2 g of cephazolin given intravenously at induction of anaesthesia. Data collected from these patients included age, PSA, prostate volume, number of cores taken and post-operative complications., Results: No patients were readmitted to hospital with infection post-TPB. Seven patients developed acute urinary retention, and one patient developed clinical prostatitis that was treated with oral antibiotics in the community., Conclusion: It is safe to use single-dose cephazolin only as antibiotic prophylaxis prior to TPB, negating the need for quinolones. This study supports Australia's current Therapeutic Guidelines recommendation for TPB prophylaxis and the existing evidence that sepsis post-TPB is a rare complication. Whether any antibiotic prophylaxis is needed at all for TPB is the subject of a future study.
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- 2017
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18. Beware of the 'Ascites' Patient: Delayed Presentation of Traumatic Intraperitoneal Bladder Rupture.
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Dat A, Yip CL, and Hanegbi U
- Abstract
Delayed diagnosis of an intraperitoneal bladder rupture is rare in the post CT era. We present a case of a middle aged male with a delayed presentation of a traumatic intraperitoneal bladder rupture. He initially presented with an acute distended abdomen and acute kidney injury after an alleged assault. He was initially admitted for investigation of his 'ascites.' This case to our knowledge is the longest delay to diagnosis (>2 weeks) for an intraperitoneal bladder rupture in the post computed tomography era and should serve as a learning point in the workup of the patient with suspected blunt bladder injury.
- Published
- 2015
- Full Text
- View/download PDF
19. Systemic amyloidosis presenting with lower urinary tract symptoms.
- Author
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Davis P, Corcoran N, Hanegbi U, and Bultitude M
- Subjects
- Aged, Amyloidosis diagnosis, Humans, Male, Amyloidosis complications, Urinary Bladder Diseases etiology
- Published
- 2010
- Full Text
- View/download PDF
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