Study Type – Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? At present, many studies have been executed to identify predictors for chronic kidney disease or renal insufficiency after radical nephrectomy or partial nephrectomy. We examined whether preoperative kidney volume is a predictor for renal function after radical or partial nephrectomies in RCC patients. To our knowledge, this is the first study to report on the relationship between preoperative kidney volume and changes in renal function in RCC patients who underwent radical nephrectomy or partial nephrectomy performed by one surgeon. OBJECTIVE: To investigate whether preoperative kidney volume is a prognostic factor for predicting the postoperative glomerular filtration rate (GFR) in renal cell carcinoma (RCC) patients. PATIENTS AND METHODS: We included 133 patients who underwent radical ( n = 83) or partial ( n = 50) nephrectomy for RCC. Kidney parenchymal volume was measured using personal computer‐based software and GFR was estimated before and after surgery at 6 and 12 months. We evaluated the change in kidney volume after radical and partial nephrectomy and used regression analysis to identify predictors of lower post‐surgical GFR at 12 months. RESULTS: The mean volume of the normal side kidney for the radical nephrectomy group increased from 142.4 mL to 166.0 mL (17.2%) and 171.5 mL (21.2%) after surgery at 6 and 12 months, respectively. In the partial nephrectomy group, the volume of the normal side kidney increased from 127.2 mL to 138.8 mL (9.1%) and 140.6 mL (10.9%) after surgery at 6 and 12 months, respectively. The volume of the operated side kidney decreased from 128.5 mL to 102.3 mL (20.1%) and 101.8 (20.6%) after surgery at 6 and 12 months, respectively. In the radical nephrectomy group, older age ( P < 0.001), preoperative volume of the normal kidney ( P = 0.022) and preoperative GFR for the normal side kidney ( P = 0.045) were significant predictors of lower post‐surgical GFR at 12 months. In the partial nephrectomy group, older age ( P = 0.001) and preoperative volume for both kidneys ( P = 0.037) were significant predictors of lower post‐surgical GFR at 12 months. CONCLUSION: Preoperative kidney volume is an independent predictor of GFR in RCC patients who underwent radical or partial nephrectomy.

Park DS, et al. Yonsei Med J. 2006 Oct;47(5):706-714. http://dx.doi.org/10.3349/ymj.2006.47.5.706

Choi CI, et al. Chonnam Med J. 2016 May;52(2):123-127. http://dx.doi.org/10.4068/cmj.2016.52.2.123

Purpose. To determine the effect of simple use of suppository povidone-iodine on infectious complications after transrectal ultrasonography-guided biopsy of the prostate.Methods. All 481 patients are included and received antibiotic prophylaxis. Among them, 360 patients received povidone-iodine suppository (Gynobetadine; 200 mg) immediately prior to biopsy and 121 patients did not. Infectious complications were classified. To evaluate bactericidal effects, we counted bacterial colonies in the rectum, harvested from a rectal swab before insertion of the suppository and after biopsy. Aliquots of the suspended bacterial strains were added to Mueller-Hinton agar medium for incubation. Colony counts were determined.Results. Infectious complications developed in 1 case (0.3%) in the rectal preparation group (Group 1) and in 8 cases (6.6%) in the nonrectal preparation group (Group 2). One in Group 1 had a fever without sepsis. Two patients had sepsis and six had fever without sepsis in Group 2. Rectal preparation was a statistically significant risk factor influencing the development of infectious complications. In vitro experiments, the mean number of colony-forming units decreased 99.9% after the rectal povidone-iodine preparation.Conclusions. All through the biopsy, povidone-iodine melted into the rectum and decreased the bacterial colony count. Simple use of povidone-iodine suppository before prostate biopsy minimizes the risk of infectious complications.

We present five cases of bilateral extrinsic ureteral obstruction in advanced nongenitourinary abdominal malignancy. They show the superiority of percutaneous nephrostomy to indwelling ureteral stents in providing diversion. We suggest that percutaneous nephrostomy drainage should be the management of choice in extrinsic obstruction by advanced abdominal malignancies.

Yoon YE, et al. World J Mens Health. 2019 Jan;37:e3. https://doi.org/10.5534/wjmh.180095