Uro, Volume 1, Issue 2 (June 2021) – 2 articles

(1) Background: The Adjustable Transobturator Male System (ATOMS) device is increasingly used to treat post-prostatectomy incontinence as it enhances residual urinary sphincteric function and allows continence recovery or improvement by dorsal compression of the bulbar urethra through a fixed transobturator mesh passage. The mode of action and the profile of the patients with best results are not totally understood. (2) Methods: Intraoperative urethral pressure measurements at different filling levels of the ATOMS device show increased urethral resistance and enhanced residual sphincteric activity. We evaluated whether the pattern of urethral pressure change secondary to serial progressive intraoperative filling of the cushion can predict postoperative results after ATOMS placement. (3) Results: The regression analysis showed a significant direct relationship between cushion volume and intraurethral pressure (p = 0.000). The median intraurethral pressure at atmospheric pressure was 51 ± 22.7 cm H2O, and at atmospheric pressure plus 4 mL was 80 ± 23.1 cm H2O). Cluster analyses defined a group of patients (n = 6) formed by patients with a distensible urethra and 100% continence after adjustment in contrast to another group (n = 3) with rigid urethras and 33% continence after adjustment. (4) Conclusions: As a part of its continence mechanism, the ATOMS device leads to continence by increasing intraurethral pressure owing to the stretching effect on the urethral wall caused by cushion filling that increases urethral resistance. Full article

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma. Full article