积极监测与延迟干预复发低风险膀癌的延迟干预
Michael A Gorin1, Mark S Soloway2
1James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Urology practice
|August 10, 2023
概括
对低风险膀癌的积极监测是一种安全且具有成本效益的方法. 这一策略最大限度地减少了与反复出现的低等级Ta瘤的立即治疗相关的并发症和成本.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 医疗管理医疗管理
背景情况:
- 复发的低度Ta膀瘤往往需要管理.
- 立即治疗会带来并发症,不适和高成本的风险.
研究的目的:
- 审查支持积极监测低风险膀癌的数据.
- 评估延迟干预的安全性和成本效益.
主要方法:
- 对相关文献进行了全面的PubMed搜索.
- 审查了关于低风险膀癌的积极监测的英语出版物.
主要成果:
- 只有5-10%的患有低度乳头膀瘤的患者经历了进展.
- 积极监测可以减少患者的不适和治疗并发症.
- 这种方法为医疗保健系统提供了显著的成本节约.
结论:
- 带有延迟干预的积极监测是复发性低风险膀癌的安全策略.
- 这种管理方法对患者和医疗保健系统来说是具有成本效益的.
相关概念视频
Urinary Tract Infection IV: Nursing Management
25
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
25
Imaging Studies VI: Voiding Cystourethrography and Cystography
32
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...
32
Urinary Tract Calculi V: Nursing Management
14
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
14
Urinary Tract Calculi III: Medical Management
9
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)...
9
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
15
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
15
Urinary Tract Calculi VI: Surgical Management
10
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...
10


