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UP.29: Effect of Nutritional Status on Baseline Intravesical Pressure in Women
UNMODERATED POSTER SESSIONS
sues) are accompanied by an increase in the risk of blastomatous transformation.
UP.29 Effect of Nutritional Status on Baseline Intravesical Pressure in Women Salazar A1, Montiglio C1, Sarrat G2, Miranda A1, Schwarze E1 1 Department of Urology, Chilean Air Force Hospital, Santiago, Chile; 2Human Nutrition and Dietetics, Universidad Andre´s Bello, Santiago, Chile Introduction and Objectives: We have little information about the factors that can affect the intravesical pressure. To our knowledge, one of them is the patient’s weight, but there is not enough specific published data regarding this subject. The body mass index (BMI) is a good tool to evaluate the patient’s nutritional status, which is positively associated with the prevalence of urinary incontinence (UI), especially stress urinary incontinence is very common in obese patients. Overweight women have increased intra-abdominal pressures, which adversely stresses the pelvic floor and may contribute to the development of UI. Materials and Methods: We reviewed, retrospectively, the medical charts and UDS database of 355 consecutive women referred for the evaluation of lower urinary tract symptoms from January 2005 to December 2006 at our institution. Urodynamics were performed using a 6Fr double lumen transurethral catheter. Rectal pressure was measured using a 8Fr rectal catheter. Catheters were connected to the urodynamic machine (Dantec Menuet), the transducers were placed at the level of the upper edge of the symphysis and zeroed to atmosphere, and then baseline intravesical pressure was measured and recorded before to start the filling phase. Cystomanometry was performed in the standing position.To assess the frequency of different grades of nutritional status (normal weight, overweight, obesity, and thinness) we used four current definitions based on body mass index (BMI). Results: We identified 3 groups of patients according to the BMI, normal weight, overweight and obese patients. The ANOVA test shows that because of P⬍0.0001 there is a statistically significant difference in the baseline bladder pressure among these three groups of patients. Conclusions: Our findings suggest that female nutritional status impact directly on baseline intravesical pressure, so can impact in to select the different urodynamycs types of urinary incontinence.
Table, UP.29 Nutritional Status Normal Overweight Obesity TOTAL
Mean Age (years) 54.0 54.2 54.4 54.2
Patients (n) 111 168 76 355
UP.30 Nutrition Profile and Bone Loss in Prostate Cancer Patients Receiving Long-Term Androgen Deprivation Tobias-Machado M1,2,3, Maia P1,2,3, L Silva II J1, G Silva E1, L Wroclawski M1,2,3, R Wroclawski E1,2,3 1 ABC Medical School, Sao Paulo, Brazil; 2 Albert Einstein Jewish Hospital, Sao Paulo, Brazil; 3Brazilian Institute Of Cancer Control, Sao Paulo, Brazil Introduction and Objectives: The effects related to long-term androgen deprivation therapy (ADT) can have an impact on a prostate cancer (PC) patient’s quality of life. The aim of this study was to identify the relationship between the nutrition profile and bone loss in PC after ADT. Materials and Methods: A cross-sectional study was performed between April and September, 2007. All patients underwent ADT for at least one year and no one received calcium supplements or bisphosphonates. The nutritional status was evaluated by the body mass index (BMI). A food inventory was performed using a qualitative analysis for micronutrients, energy and calcium, meal times and inadequate food consistency. Yearly dual energy x-ray absorptimetry was applied to evaluate bone mineral density loss by World Health Organization criteria. The correlation between calcium intake, BMI, diet inventory and bone mass were analyzed. Results: Thirteen patients, average age of 77 (63-87), with a mean treatment period of 2.5 years (1-7) were enrolled. The most frequent nutrition diagnoses were eutrophy (62%), obesity (20%), overweight (16%), and malnutrition (2%). The feeding errors presented were qualitative (85%), inadequate meal time (68%) and quantitative (41.5%). The calcium intake was lower than 700mg/day in all patients (recommended⫽1200mg/day). Of these, 70% presented bone loss, either at the spine analysis (31% osteopenia, and 23% osteoporosis), or for the femur analysis(39% osteopenia, and 31% osteoporosis). There was a significant correlation between the low calcium intake and osteoporosis (p⫽0.03), but not between
UROLOGY 72 (Supplement 5A), November 2008
% 31.268 47.324 21.408 100
Mean Baseline p. ves (cm H2O) 29.76 33.66 38.26 33,42
S.D. 5.24 5.90 6.03 11.5
BMI and bone mass. No bone fracture event was identified. Conclusions: Diet orientation with regard to increased calcium intake is recommended as an adjuvant care in PC patients under ADT. If earlier nutritional intervention could minimize the bone loss related to ADT in these patients is completely unknown. UP.31 Robotic Assisted Radical Prostatectomy in the Renal Allograft Recipient Jhaveri J, Tan G, Scherr D, Vaughan Jr. E, Tewari A Brady Department of Urology, Weill Medical College of Cornell University, New York, USA Introduction and Objectives: Since the advent of immunosuppressive therapy, patients have been able to lead longer lives as transplant recipients. We report the first case of robotic assisted laparoscopic prostatectomy in the renal allograft recipient. Materials and Methods: A 54-year old male presented with Gleason 3⫹3 localized prostate cancer with PSA of 8.5ng/ml. He had a previous history of end-stage renal failure secondary to fulminant acute pyelonephritis requiring bilateral nephrectomy. Renal allograft transplant in the right iliac fossa was performed in 1981, with adequate renal function while continuing his immunosuppressant regime. The patient also had previous left inguinal herniorrhaphy. Modifications to our surgical approach include placement of a bariatric port superior-laterally to the standard port site; siting the left port inferio-laterally to provide adequate access for pelvic lymph node dissection; and developing the retropubic space largely from the contralateral side to avoid allograft injury. Extensive adhesiolysis was also required. Following negative urethral margin on frozen section, vesicourethral anastomosis was fashioned using our Cornell bladder neck anatomic reconstruction technique. Results: The patient required a post-operative transfusion of one unit of blood and discharged on post-operative day 2 after recommencement of immunosuppression. Final pathology revealed pT2c Gleason 7
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sues) are accompanied by an increase in the risk of blastomatous transformation.
UP.29 Effect of Nutritional Status on Baseline Intravesical Pressure in Women Salazar A1, Montiglio C1, Sarrat G2, Miranda A1, Schwarze E1 1 Department of Urology, Chilean Air Force Hospital, Santiago, Chile; 2Human Nutrition and Dietetics, Universidad Andre´s Bello, Santiago, Chile Introduction and Objectives: We have little information about the factors that can affect the intravesical pressure. To our knowledge, one of them is the patient’s weight, but there is not enough specific published data regarding this subject. The body mass index (BMI) is a good tool to evaluate the patient’s nutritional status, which is positively associated with the prevalence of urinary incontinence (UI), especially stress urinary incontinence is very common in obese patients. Overweight women have increased intra-abdominal pressures, which adversely stresses the pelvic floor and may contribute to the development of UI. Materials and Methods: We reviewed, retrospectively, the medical charts and UDS database of 355 consecutive women referred for the evaluation of lower urinary tract symptoms from January 2005 to December 2006 at our institution. Urodynamics were performed using a 6Fr double lumen transurethral catheter. Rectal pressure was measured using a 8Fr rectal catheter. Catheters were connected to the urodynamic machine (Dantec Menuet), the transducers were placed at the level of the upper edge of the symphysis and zeroed to atmosphere, and then baseline intravesical pressure was measured and recorded before to start the filling phase. Cystomanometry was performed in the standing position.To assess the frequency of different grades of nutritional status (normal weight, overweight, obesity, and thinness) we used four current definitions based on body mass index (BMI). Results: We identified 3 groups of patients according to the BMI, normal weight, overweight and obese patients. The ANOVA test shows that because of P⬍0.0001 there is a statistically significant difference in the baseline bladder pressure among these three groups of patients. Conclusions: Our findings suggest that female nutritional status impact directly on baseline intravesical pressure, so can impact in to select the different urodynamycs types of urinary incontinence.
Table, UP.29 Nutritional Status Normal Overweight Obesity TOTAL
Mean Age (years) 54.0 54.2 54.4 54.2
Patients (n) 111 168 76 355
UP.30 Nutrition Profile and Bone Loss in Prostate Cancer Patients Receiving Long-Term Androgen Deprivation Tobias-Machado M1,2,3, Maia P1,2,3, L Silva II J1, G Silva E1, L Wroclawski M1,2,3, R Wroclawski E1,2,3 1 ABC Medical School, Sao Paulo, Brazil; 2 Albert Einstein Jewish Hospital, Sao Paulo, Brazil; 3Brazilian Institute Of Cancer Control, Sao Paulo, Brazil Introduction and Objectives: The effects related to long-term androgen deprivation therapy (ADT) can have an impact on a prostate cancer (PC) patient’s quality of life. The aim of this study was to identify the relationship between the nutrition profile and bone loss in PC after ADT. Materials and Methods: A cross-sectional study was performed between April and September, 2007. All patients underwent ADT for at least one year and no one received calcium supplements or bisphosphonates. The nutritional status was evaluated by the body mass index (BMI). A food inventory was performed using a qualitative analysis for micronutrients, energy and calcium, meal times and inadequate food consistency. Yearly dual energy x-ray absorptimetry was applied to evaluate bone mineral density loss by World Health Organization criteria. The correlation between calcium intake, BMI, diet inventory and bone mass were analyzed. Results: Thirteen patients, average age of 77 (63-87), with a mean treatment period of 2.5 years (1-7) were enrolled. The most frequent nutrition diagnoses were eutrophy (62%), obesity (20%), overweight (16%), and malnutrition (2%). The feeding errors presented were qualitative (85%), inadequate meal time (68%) and quantitative (41.5%). The calcium intake was lower than 700mg/day in all patients (recommended⫽1200mg/day). Of these, 70% presented bone loss, either at the spine analysis (31% osteopenia, and 23% osteoporosis), or for the femur analysis(39% osteopenia, and 31% osteoporosis). There was a significant correlation between the low calcium intake and osteoporosis (p⫽0.03), but not between
UROLOGY 72 (Supplement 5A), November 2008
% 31.268 47.324 21.408 100
Mean Baseline p. ves (cm H2O) 29.76 33.66 38.26 33,42
S.D. 5.24 5.90 6.03 11.5
BMI and bone mass. No bone fracture event was identified. Conclusions: Diet orientation with regard to increased calcium intake is recommended as an adjuvant care in PC patients under ADT. If earlier nutritional intervention could minimize the bone loss related to ADT in these patients is completely unknown. UP.31 Robotic Assisted Radical Prostatectomy in the Renal Allograft Recipient Jhaveri J, Tan G, Scherr D, Vaughan Jr. E, Tewari A Brady Department of Urology, Weill Medical College of Cornell University, New York, USA Introduction and Objectives: Since the advent of immunosuppressive therapy, patients have been able to lead longer lives as transplant recipients. We report the first case of robotic assisted laparoscopic prostatectomy in the renal allograft recipient. Materials and Methods: A 54-year old male presented with Gleason 3⫹3 localized prostate cancer with PSA of 8.5ng/ml. He had a previous history of end-stage renal failure secondary to fulminant acute pyelonephritis requiring bilateral nephrectomy. Renal allograft transplant in the right iliac fossa was performed in 1981, with adequate renal function while continuing his immunosuppressant regime. The patient also had previous left inguinal herniorrhaphy. Modifications to our surgical approach include placement of a bariatric port superior-laterally to the standard port site; siting the left port inferio-laterally to provide adequate access for pelvic lymph node dissection; and developing the retropubic space largely from the contralateral side to avoid allograft injury. Extensive adhesiolysis was also required. Following negative urethral margin on frozen section, vesicourethral anastomosis was fashioned using our Cornell bladder neck anatomic reconstruction technique. Results: The patient required a post-operative transfusion of one unit of blood and discharged on post-operative day 2 after recommencement of immunosuppression. Final pathology revealed pT2c Gleason 7
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