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Imaging Studies IV: Magnetic Resonance Imaging01:27

Imaging Studies IV: Magnetic Resonance Imaging

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urodynamic Studies: Uroflowmetry01:19

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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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Climacturia After Radical Prostatectomy: MRI-Based Predictors.

John F Sullivan1, Yanira Ortega1, Kazuhito Matsushita1

  • 1Male Sexual and Reproductive Medicine Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

The Journal of Sexual Medicine
|July 23, 2020
PubMed
Summary
This summary is machine-generated.

Climacturia after radical prostatectomy may be predicted by urethral width on MRI scans. Wider urethral width on preoperative MRI is associated with a greater chance of experiencing climacturia post-surgery.

Keywords:
Magnetic Resonance ImagingOrgasm-Associated IncontinencePelvimetryProstatectomyProstatic Neoplasms

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Area of Science:

  • Urology
  • Radiology
  • Sexual Medicine

Background:

  • Climacturia, or orgasm-associated incontinence, is a common and distressing issue following radical prostatectomy (RP).
  • Predictive factors for climacturia post-RP have not been previously identified.

Purpose of the Study:

  • To identify associated pelvic magnetic resonance imaging (MRI) parameters that may predict climacturia after radical prostatectomy.
  • To explore potential preoperative risk factors for this condition.

Main Methods:

  • Retrospective review of 194 endorectal MRI studies from men who underwent radical prostatectomy.
  • Measurements of soft tissue and bony pelvic dimensions by blinded raters.
  • Statistical analysis including point-biserial correlations and logistic regression.

Main Results:

  • Urethral width and lower conjugate of the pelvis were associated with climacturia on univariate analysis.
  • On multivariable analysis, only urethral width remained significantly associated with climacturia (OR=1.23, P=0.04).
  • A wider urethral width on preoperative MRI correlated with an increased likelihood of experiencing climacturia.

Conclusions:

  • Preoperative urethral width, as measured by MRI, is a significant predictor of climacturia after radical prostatectomy.
  • Identifying these preoperative risk factors can improve understanding of the condition's pathophysiology.
  • This knowledge may enhance preoperative counseling for patients regarding potential postoperative outcomes.