Urology Journal[JOURNAL]
Sun
200 papers
Prognostic Nomograms for Patients with Primary Sarcomatoid Carcinoma of The Urinary Bladder: Based on The SEER Database.
Xu C, Xiong B
Urol J · 2024 Mar · PMID 37245087 · Publisher ↗
PURPOSE: The present study aimed to develop nomograms based on the SEER database to predict the prognosis for patients with primary sarcomatoid carcinoma of the urinary bladder (SCUB). MATERIALS AND METHODS: Patients wit...
PURPOSE: The present study aimed to develop nomograms based on the SEER database to predict the prognosis for patients with primary sarcomatoid carcinoma of the urinary bladder (SCUB). MATERIALS AND METHODS: Patients with primary SCUB were identified in the Surveillance, Epidemiology, and End Results (SEER) database, between 1975 and 2017. Univariate and multivariable Cox analysis were conducted to identify the independent prognostic factors for developing the overall survival (OS) and cancer-specific survival (CSS) nomograms. Then, concordance index (C-index), receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the accuracy of the nomogram model. In addition, the model was further compared with TNM staging system. RESULTS: A total of 238 eligible patients with primary SCUB were selected from the SEER database. As suggested by Cox-analysis, age, sex, T stage, M stage, tumor size, and surgery type of primary site were identified as the independent factors for predicting both OS and CSS. We developed OS and CSS nomograms with a favorable C-index by using these prognostic factors. The C-indexes of the OS and CSS nomogram in the present study were 0.738 (0.701-0.775) and 0.763 (0.724-0.802), which were superior to those of the AJCC TNM staging with 0.621 (0.576-0.666) and 0.637 (0.588-0.686) respectively, showing better discriminatory ability. Subsequently, the ROC curves showed that the 1-, 3- and 5-year AUCs (area under the curve) of OS nomogram (i.e., 0.793, 0.807 and 0.793) were higher than those of the TNM stage((i.e., 0.659, 0.676, 0.659). Similarly, as for CSS model, them ((i.e., 0.823, 0.804 and 0.804) were aslo exceed those of TNM stage((i.e., 0.683, 0.682, 0.682). Furthermore, the calibration curves indicated a good consistency between the predictive survival and the actual survival. Finally, patients were stratified by risk, and Kaplan-Meier survival curve suggested that the prognosis of the low-risk group was significantly better than that of the high-risk group. CONCLUSION: We developed nomograms with the SEER database, which could help predict the prognosis of SCUB individuals more accurately.
Hydroalcoholic Extract of Ziziphus Jujuba Leaf to Prevent Ethylene Glycol and Ammonium Chloride-Induced Kidney Stones in Male Rat: Is it Effective?
Pourahmadi M, Fathi M, Rahimipour M … +2 more , Shaterian N, Kargar Jahromi H
Urol J · 2023 Dec · PMID 37245086 · Publisher ↗
PURPOSE: This study aimed to evaluate the effect of Ziziphus jujuba (Z. jujuba) leaf hydroalcoholic extract on the prevention/treatment of kidney stones. MATERIALS AND METHODS: Thirty-six male Wistar rats were randomly d...
PURPOSE: This study aimed to evaluate the effect of Ziziphus jujuba (Z. jujuba) leaf hydroalcoholic extract on the prevention/treatment of kidney stones. MATERIALS AND METHODS: Thirty-six male Wistar rats were randomly divided into six groups: control, Sham (kidney stone induction (KSI) by ethylene glycol 1% + ammonium chloride 0.25% through drinking water for 28 days), Prevention groups 1, 2 (KSI and Z. jujuba leaf (250 and 500 mg/kg, respectively) through gavage for 28 days), and Treatment groups 1, 2 (KSI and Z. jujuba leaf (250 and 500 mg/kg, respectively) from the 15th day). On the 29th day, the rats' 24-hour urine was assessed, the animals were weighed, and blood samples were taken. Finally, after nephrectomy and weighing the kidneys, tissue sections were prepared to examine the number of calcium oxalate crystals and tissue changes. RESULTS: The results indicated a significant increase in kidney weight and index, tissue changes, and the number of calcium oxalate crystals in the Sham group compared to the control; using Z. jujuba leaf considerably reduced them in experimental groups compared to the Sham. Body weight decreased in the Sham and experimental groups (except the prevention 2 group) compared to the control, while this observed reduction was lower in all experimental groups compared to the Sham. The mean urinary calcium, uric acid, creatinine, and serum creatinine in Sham and experimental groups (except the prevention 2 group) indicated a substantial increase compared to the control and decreased significantly in all experimental groups compared to the Sham. CONCLUSION: Hydroalcoholic extract of Z. jujuba leaf is effective in the reduction of calcium oxalate crystals forming, and its most effective dose was 500mg/kg.
An in-silico Approach for Recognition of Long non-coding RNA-Associated Competing Endogenous RNA Axes in Prostate Cancer.
Taheri M, Safarzadeh A, Ghafouri-Fard S … +1 more , Baniahmad A
Urol J · 2024 Feb · PMID 37245085 · Publisher ↗
PURPOSE: Prostate cancer is among the most central sources of cancer-related mortalities. In order to find novel candidates for therapeutic strategies in this kind of cancer, we developed an in-silico method for identifi...
PURPOSE: Prostate cancer is among the most central sources of cancer-related mortalities. In order to find novel candidates for therapeutic strategies in this kind of cancer, we developed an in-silico method for identification of competing endogenous RNA network. METHODS: According to the microarray data analyses between prostate tumor and normal specimens, we attained 1312 differentially expressed (DE)mRNAs, including 778 down-regulated DEmRNAs (such as CXCL13 and BMP5) and 584 up-regulated DEmRNAs (such as OR51E2 and LUZP2), 39 DElncRNAs, including 10 down-regulated DElncRNAs (such as UBXN10-AS1 and FENDRR) and 29 up-regulated DElncRNAs (such as PCA3 and LINC00992) and 10 DEmiRNAs, including 2 down-regulated DEmiRNAs (such as MIR675 and MIR1908) and 8 up-regulated DEmiRNAs (such as MIR6773 and MIR4683). RESULTS: We constructed the ceRNA network between these transcripts. We also evaluated the related signaling pathways and the significance of these RNAs in prediction of survival of patients with prostate cancer. CONCLUSION: This study provides novel candidates for construction of specific treatment routes for prostate cancer.
Perioperative Outcomes of Inguinal Hernioplasty along with Holmium Laser Enucleation of the Prostate (HoLEP).
Calvo de la Barra CI, Bravo Izurieta JC, Navarro Capone R … +3 more , Cañas Ramirez R, Pasten Alcaina F, San Francisco Reyes I
Urol J · 2023 May · PMID 37245078 · Publisher ↗
PURPOSE: Inguinal hernias and benign prostatic hyperplasia (BPH) can coexist in about one fifth of patients undergoing BPH surgery. There is scarce evidence about performing laser enucleation along with open inguinal her...
PURPOSE: Inguinal hernias and benign prostatic hyperplasia (BPH) can coexist in about one fifth of patients undergoing BPH surgery. There is scarce evidence about performing laser enucleation along with open inguinal hernia repair. Our goal is to describe the perioperative outcomes of performing both surgeries in the same operating session compared to doing HoLEP alone. MATERIALS AND METHODS: A retrospective analysis of patients undergoing HoLEP and hernioplasty with mesh in the same anesthetic time (group B) at an academic center was conducted. They were compared to a randomly picked control group of patients submitted to HoLEP alone (group A). Preoperative, operative and postoperative features were compared among both groups. RESULTS: 107 patients submitted to HoLEP alone were compared to 29 combined approach patients (HoLEP + hernia repair). Patients in group A were found to be older and had larger prostates. Group B showed a significant longer operative time. Length of stay and duration of catheter was comparable among groups. In multivariate analysis, the combined approach was not associated to a higher complication rate. CONCLUSION: Performing benign prostatic hyperplasia surgery with HoLEP in conjunction with open inguinal hernioplasty is not related to a higher length of stay or a significantly increased risk of morbidity.
Lowering the Dose of Corticosteroid Regimen in Kidney Transplantation: Is It Effective in Decreasing Post-operative Surgical Complications?
Simforoosh N, Nayebzade A, Dadpour M … +1 more , Eslami A
Urol J · 2023 Oct · PMID 37089059 · Publisher ↗
PURPOSE: To investigate the impact of reducing post-operative oral corticosteroid regimen on associated postoperative surgical complication rate, patient and graft survival in kidney transplant patients. MATERIALS AND ME...
PURPOSE: To investigate the impact of reducing post-operative oral corticosteroid regimen on associated postoperative surgical complication rate, patient and graft survival in kidney transplant patients. MATERIALS AND METHODS: In this retrospective cohort study, we enrolled patients who received a kidney transplant during two periods of distinct corticosteroid protocols. 592 patients in group 1 received prednisone 2 mg/kg (maximum dose 120 mg) on post-operative days (POD) 1, 2 and 3, 1mg/kg for a week, and tapered it to 10 mg by 3 months post-transplant and sustained the daily 10mg from 3 months post-transplant as maintenance therapy. 639 patients in group 2 received prednisone 50 mg on POD 1, 40mg on POD 2, 30mg on POD 3, 20mg on POD 4, 15mg on POD 5 and continued with 10mg daily from POD 6, as maintenance therapy. The two groups were similar in terms of other immunosuppression drug regimens. RESULTS: 75 (12.7%) patients in group 1 and 24 (3.4%) patients in group 2 developed corticosteroid-related postoperative surgical complications (P < .001). Wound infection (P = .035), incisional hernia (P = .003), infectious collection (P = .004), post-op hemorrhage (P = .005) and ureteral fistula (P = .076) occurred with lower frequency in group 2. Patient survival (1-year: 97.3% vs 97.1%, respectively; P = .85, 5-year: 89.9% vs 94.9%, respectively; P = .06) and graft survival (1-year: 94.6% vs 93.3%, respectively; P = .29, 5-year: 81.2% vs 85.1%, respectively; P = .39) were similar in both groups. CONCLUSION: Post-operative corticosteroid dosage decrement through our protocol would lessen the serious associated postoperative surgical complications, without negative impacts on overall patient and graft survival.
Comparison of Early Inguinal Lymph Node Dissection and Neoadjuvant Chemotherapy in Penile Cancer Patient with Bulky Nodal Metastasis: A Cohort Study.
Warli SM, Ginting JT, Sihombing B … +2 more , Siregar GP, Prapiska FF
Urol J · 2024 Feb · PMID 37013859 · Publisher ↗
PURPOSE: Penile cancer is a rare malignancy, where extranodal extension in inguinal or pelvic lymph nodes is associated with decreased 5-year cancer-survival rate in this study, we try to assess survival and quality of l...
PURPOSE: Penile cancer is a rare malignancy, where extranodal extension in inguinal or pelvic lymph nodes is associated with decreased 5-year cancer-survival rate in this study, we try to assess survival and quality of life in a penile cancer patient with bulky lymph node. METHODS: We retrospectively reviewed data from penile cancer patients with bulky lymph nodes who underwent treatment between July 2016 and July 2021 at tertiary referral hospital care. The inclusion criteria (age >18 yr, histologically proven penile cancer, and completion of last treatment 6 months prior to this study) yielded a cohort of 20 eligible penile cancer patients with bulky lymph nodes (> 4 cm/bilateral mobile/unilateral fixed). Only patients who had completed therapy at least 6 months prior to the study were included. After obtaining consent, they were asked to complete the EORTC QLQ-C30 questionnaire to evaluate the patient's quality of life. RESULTS: Out of 20 patients, 5 patients underwent direct ILND and 15 patients underwent chemotherapy. Median follow-up after primary diagnosis was 114+32 months in patients with early ILND and 52+11 months in patients who underwent delayed lymph node dissection. Out of 5 patients who underwent early ILND, all of them survived during follow-up, and achieved cancer-free status without residual tumor and with excellent functional outcomes (Karnofsky 90). There was no significant difference in social function (p-value = 0.551), physical function (p-value = 0.272), role function (p-value = 0.546), emotional function (p-value = 0.551), cognitive function (p-value = 0.453), and global health status (p-value = 0.893) between patient which treated with early ILND and Neoadjuvant Chemotherapy. However, patients who underwent early ILND showed a relatively better clinical outcome. CONCLUSION: Early ILND followed by adjuvant chemotherapy for penile cancer with palpable lymph nodes is more favourable than neoadjuvant TIP chemotherapy.
Unroofing of Lower Pole Native Kidney Cysts in Patients with Autosomal Dominant Polycystic Kidneys at the Time of Kidney Transplantation.
Basiri A, Simforoosh N, Nayebzade A … +2 more , Marufi H, Kashi AH
Urol J · 2023 Jul · PMID 37013858 · Publisher ↗
To report our experience with unroofing of ipsilateral lower pole kidney cysts in five patients with adult-type polycystic kidneys [ADPKD] when free implantation of kidney allograft interfered with lower pole native kidn...
To report our experience with unroofing of ipsilateral lower pole kidney cysts in five patients with adult-type polycystic kidneys [ADPKD] when free implantation of kidney allograft interfered with lower pole native kidney cysts. In all of these patients, the native kidneys extended to the ipsilateral pelvis and bilateral ADPKD caused enlargement of the abdomen on gross examination. Unroofing of lower pole kidney cysts was performed during the same session of allograft transplantation. The decision to unroof lower pole cysts of the ipsilateral kidney was made after observing interference of lower pole cysts with free implantation of the allograft. In patient A, bilateral native nephrectomy was performed 6 weeks after kidney transplantation after consultation with the patient, when there was evidence of the good function of the allograft and the recipient was on a low dose of immunosuppressive medications. In other patients, no need for native nephrectomy observed. This experience suggests the possibility that when large ipsilateral kidney cysts interfere with safe implantation of the allograft, there is an option of performing cyst unroofing at the same session and proceeding with allograft implantation. In many patients, there would be no need for native nephrectomy and of deemed necessary, it will be performed later, when there is evidence of the good function of the allograft and the patient is on good kidney function with a low dose of immunosuppressive medications and a less risk profile for the operation. To our best knowledge, there is no prior such report in the literature.
Survival Differences in High-Risk Prostate Cancer by Age.
García Fuentes C, Guijarro A, Hernández V … +6 more , Gonzalo Á, Jiménez E, De la Peña E, Pérez E, Pérez E, Llorente C
Urol J · 2023 Jul · PMID 36932725 · Publisher ↗
PURPOSE: Age is an established determining factor in survival in low-risk prostate cancer (PC), being this evidence weaker in high-risk tumors. Our aim is to evaluate the survival of patients with high-risk PC treated wi...
PURPOSE: Age is an established determining factor in survival in low-risk prostate cancer (PC), being this evidence weaker in high-risk tumors. Our aim is to evaluate the survival of patients with high-risk PC treated with curative intent and to identify differences across ages at diagnosis. METHODS: We did a retrospective analysis of patients with high-risk PC treated with surgery (RP) or radiotherapy (RDT) excluding N+ patients. We divided patients by age groups: < 60, 60-70, and > 70 years. We performed a comparative survival analysis. A multivariate analysis adjusted for clinically relevant variables and initial treatment received was performed. RESULTS: Of a total of 2383 patients, 378 met the selection criteria with a median follow-up of 8.9 years: 38 (10.1%) < 60 years, 175 (46.3%) between 60-70 years, and 165 (43.6%) >70 years. Initial treatment with surgery was predominant in the younger group (RP:63.2%, RDT:36.8%), and with radiotherapy in the older group (RP:17%, RDT:83%) (p = 0.001). In the survival analysis, significant differences were observed in overall survival, with better results for the younger group. However, these results were reversed in biochemical recurrence-free survival, with patients < 60 years presenting a higher rate of biochemical recurrence at 10 years. In the multivariate analysis, age behaved as an independent risk variable only for overall survival, with a HR of 2.8 in the group >70 years (95%CI: 1.22-6.5; p = 0.015). CONCLUSION: In our series, age appeared to be an independent prognostic factor for overall survival, with no differences in the rest of the survival rates.
What is the Critical age for the Improvement of Parenchymal Thickness after Pyeloplasty?
Yayla D, Demirtas G, Karabulut B … +1 more , Tiryaki HT
Urol J · 2023 Oct · PMID 36932724 · Publisher ↗
PURPOSE: The most important point in cases of ureteropelvic junction obstruction (UPJO) is to decide on the need and timing of surgical treatment. Renal damage may become irreversible as the duration of the obstruction i...
PURPOSE: The most important point in cases of ureteropelvic junction obstruction (UPJO) is to decide on the need and timing of surgical treatment. Renal damage may become irreversible as the duration of the obstruction is prolonged. Worsening of hydronephrosis and decrease in renal parenchymal thickness after pyeloplasty may herald an irreversible renal damage. It is important to know at what age this damage begins. In this study, we aimed to determine the relationship between the age of the patients at the time of pyeloplasty performed for UPJO and parenchymal recovery. MATERIALS AND METHODS: In our study, 156 patients (mean age: 43.5 months) who underwent pyeloplasty with the diagnosis of UPJO between 2007 and 2019 were evaluated retrospectively. Demographic characteristics, ultrasonographic (USG) and nuclear renal scintigraphy findings, previous surgeries of the patients were recorded. RESULTS: Numerical variables were evaluated statistically, and the best cut-off point was determined. Parenchymal thickening was determined as the most important criterion in postoperative renal recovery which was more evident at early ages. Based on statistical assessments , the cut-off age for renal parenchymal recovery was determined as 38 months. While parenchymal recovery was inadequate after pyeloplasty performed in patients older than 38 months, the most significant improvement in renal functions was seen in children younger than 13 months of age. CONCLUSION: Pyeloplasty should be performed in patients with UPJO before development of severe renal damage. Statistically, the best parameter to evaluate the recovery after pyeloplasty is the change in parenchymal thickness. With advancing age, it is impossible to reverse the obstructive nephropathy.
Laparoscopic Simple Prostatectomy: A Single Center Experience with A Long-Term Follow Up.
Zeder R, Heidler S, Alber T … +1 more , Dalpiaz O
Urol J · 2023 May · PMID 36932461 · Publisher ↗
PURPOSE: The aim of this retrospective study is to assess the long-term outcomes and safety of laparoscopic simple prostatectomy. MATERIAL AND METHODS: Between 2012 and 2019 80 patients with prostates volumes ≥ 80 mL wer...
PURPOSE: The aim of this retrospective study is to assess the long-term outcomes and safety of laparoscopic simple prostatectomy. MATERIAL AND METHODS: Between 2012 and 2019 80 patients with prostates volumes ≥ 80 mL were treated with laparoscopic simple prostatectomy at our department. Uroflowmetry, post void residual volume and standardized questionnaires were assessed pre- and postoperatively. Perioperative complications were categorized using the Clavien-Dindo classification. RESULTS: The mean specimen weight was 83 grams, and the mean operation time was 156 minutes. At a mean follow-up time of 40 months patients showed a significant improvement of Qmax (P = .002), IPSS (P < .001) and QoL (P < .001). Post void residual volumes decreased significantly. Complications occurred in 11 patients (13.8%), nine had mild (grade 1 - 2) and two had severe (grade 3b - 4a) complications. One conversion to open surgery due to massive prostatic adherence from previous abscess formation was recorded and one patient needed blood transfusion intraoperatively. CONCLUSION: laparoscopic simple prostatectomy is an effective and safe procedure for large volume prostate glands with a significant and stable long term symptoms improvement.
Outcomes of Artificial Urinary Sphincter Implantation in Patients with Detrusor Underactivity and Postprostatectomy Incontinence.
Han KH, Kim JC, Bae WJ … +3 more , Choi JB, Koh JS, Cho KJ
Urol J · 2023 Jul · PMID 36906798 · Publisher ↗
PURPOSE: There is insufficient evidence for postoperative outcomes of artificial urinary sphincter (AUS) implantation for postprostatectomy incontinence (PPI) with detrusor underactivity (DU). Thus, we assessed the impac...
PURPOSE: There is insufficient evidence for postoperative outcomes of artificial urinary sphincter (AUS) implantation for postprostatectomy incontinence (PPI) with detrusor underactivity (DU). Thus, we assessed the impact of preoperative DU on the outcomes of AUS implantation for PPI. MATERIALS AND METHODS: Medical records of men who underwent AUS implantation for PPI were reviewed. Patients who had bladder outlet obstruction surgery before radical prostatectomy or AUS-related complications that required revision of AUS within three months were excluded. Patients were divided into two groups based on the preoperative urodynamic study including pressure flow study, a DU group, and a non-DU group. DU was defined as a bladder contractility index less than 100. The primary outcome was postoperative postvoid residual urine volume (PVR). The secondary outcomes included maximum flow rate (Qmax), postoperative satisfaction, and international prostate symptom score (IPSS). RESULTS: A total of 78 patients with PPI were assessed. The DU group consisted of 55 patients (70.5%) and the non-DU group comprised 23 patients (29.5%). Qmax was lower in the DU group than in the non-DU group and PVR was higher in the DU group as per a urodynamic study before AUS implantation. There was no significant difference in postoperative PVR between the two groups, although the Qmax after AUS implantation was significantly lower in the DU group. While the DU group showed significant improvements in Qmax, PVR, IPSS total score, IPSS storage subscore, and IPSS quality of life (QoL) score after AUS implantation, the non-DU group showed postoperative improvement in IPSS QoL score. CONCLUSION: There was no clinically significant impact of preoperative DU on the outcome of AUS implantation for PPI; thus, surgery can be safely performed in patients with PPI and DU.
Upfront Androgen Receptor-Axis-Targeted Therapies in Men with De Novo High-Volume Metastatic Hormone-Sensitive Prostate Cancer.
Kimura N, Kaneko Y, Tetsuka T … +8 more , Takei A, Uchida T, Abe H, Amiya Y, Shima T, Suzuki N, Hayashi S, Nakatsu H
Urol J · 2023 Jul · PMID 36906797 · Publisher ↗
PURPOSE: The extent of effectiveness of upfront androgen receptor-axis-targeted therapies (ARAT) versus total androgen blockade (TAB) in improving prostate cancer-specific survival (CSS) and progression-free survival (PF...
PURPOSE: The extent of effectiveness of upfront androgen receptor-axis-targeted therapies (ARAT) versus total androgen blockade (TAB) in improving prostate cancer-specific survival (CSS) and progression-free survival (PFS) in a real-world sample of Japanese patients with high-volume mHSPC remains unclear. We, therefore, investigated the efficacy and safety of upfront ARAT versus bicalutamide for de novo high-volume mHSPC in Japanese patients. MATERIAL AND METHODS: This was a multicenter retrospective study that analyzed CSS, clinical PFS, and adverse events (AEs) in 170 patients with newly diagnosed high-volume mHSPC. Fifty-six patients were treated with upfront ARAT, and 114 of them were prescribed bicalutamide in addition to ADT between January 2018 and March 2021. The primary and secondary endpoints were CSS and PFS, respectively. A 1:1 nearest neighbor propensity score matching (PSM) with a caliper of 0.2 was performed to match the ARAT group to TAB patients. RESULTS: During the follow-up for a median of 21.5 months, the median CSS was not reached and 37 months in the upfront ARAT and total androgen blockade (TAB) groups, respectively (log-rank test: P = 0.006) by propensity score matching (PSM). Moreover, while the PFS of ARAT was unreached, the median PFS of TAB was 9 months (log-rank test: P < 0.001). Nine patients discontinued ARAT owing to grade ≥ 3 AEs; one patient who was treated with TAB had a grade 3 AE. CONCLUSION: Upfront ARAT significantly prolonged the CSS and PFS of patients with high-volume mHSPC better than TAB, although ARAT was associated with a higher rate of grade ≥ 3 AEs. Upfront ARAT can be more beneficial for patients with de novo high-volume mHSPC than TAB.
The Efficacy and Safety of Single-Incision Mini-Slings for Stress Urinary Incontinence: A Network Meta-Analysis.
Chen Y, Zhang J, Zeng Y … +5 more , Chen W, Liu F, Xing J, Zhang B, Chen Y
Urol J · 2023 Jul · PMID 36906796 · Publisher ↗
PURPOSE: To evaluate the efficacy and safety of single-incision mini-sling for stress urinary incontinence based on network Meta-analysis. MATERIALS AND METHODS: We searched PubMed, Embase, and Cochrane libraries from Au...
PURPOSE: To evaluate the efficacy and safety of single-incision mini-sling for stress urinary incontinence based on network Meta-analysis. MATERIALS AND METHODS: We searched PubMed, Embase, and Cochrane libraries from August 2008 to August 2019. Randomized controlled trials comparing two or more indicators of Miniarc (Single Incision Mini-slings), Ajust (Adjustable Single-Incision Sling), C-NDL (Contasure-Needleless), TFS (Tissue Fixation System), Ophria (Transobturator Vaginal Tap), TVT-O (Transobturator Vaginal Tape), and TOT (Trans-obturatortape) in treating female stress urinary incontinence were collected. RESULTS: Totally, 3,428 patients from 21 studies were included. Ajust had the highest subjective cure rate (Rank=0.52), while Ophira had the worst (Rank=0.67). TFS had the highest objective cure rate, and the worst was found in Ophira. TFS required the shortest operating time (Rank=0.40), while TVT-O required the longest operating time (Rank=0.47). Miniarc had the least bleeding (Rank=0.47), while TVT-O had the most bleeding (Rank=0.37). C-NDL had the shortest postoperative hospital stay (Rank=0.77), while Ajust had the longest postoperative hospital stay (Rank=0.36). For postoperative complications, TFS performed best in groin pain (Rank=0.84), urinary retention (Rank=0.78), and repeat surgery (Rank=0.45). TVT-O performed worst in groin pain (Rank=0.36), and urinary retention (Rank=0.58). Miniarc had the highest repeat surgery rate (Rank=0.35). Ajust had the lowest probability of tap erosion (Rank=0.30), while Ophira had the highest tap erosion level (Rank=0.45). Miniarc showed the greatest advantage in urinary tract infections (Rank=0.84) and de novo urgency (Rank=0.60), while C-NDL had the highest incidence of urethral infections (Rank=0.51). Ophira performed worst in de novo urgency (Rank=0.60). C-NDL performed the best in sexual intercourse pain (Rank=0.79) while Ajust was the worst (Rank=0.49). CONCLUSIONS: In view of comprehensive efficacy and safety, we recommend that TFS or Ajust should be selected first for single-incision sling and the application of Ophria should be minimized.
Clinical Study of Modified Devine's Surgical Technique in the Treatment of Concealed Penis.
Zhang Z, Wu H, Mao W … +3 more , Gao SL, Zuo L, Zhang LF
Urol J · 2023 Jul · PMID 36906795 · Publisher ↗
PURPOSE: This study aimed to observe the clinical effect of modified Devine's surgical technique in the treatment of concealed penis. MATERIALS AND METHODS: From July 2015 to September 2020, fifty-six children with conce...
PURPOSE: This study aimed to observe the clinical effect of modified Devine's surgical technique in the treatment of concealed penis. MATERIALS AND METHODS: From July 2015 to September 2020, fifty-six children with concealed penis were treated with modified Devine's technique. Recorded the penile length and the satisfaction score preoperatively and postoperatively to confirm the effect of the surgery. Followed up the penis for bleeding, infection and edema one week and four weeks after the operation. Twelve weeks after the operation, we measured the length of the penis and observed whether there was a retraction. RESULTS: The length of the penis has been effectively lengthened(P < 0.001). There was significant improvement in parents' satisfaction grades (P < 0.001). All the patients had different degrees of penile edema after the operation. Most of the penile edema subsided about four weeks after the operation. No other complications occurred. No obvious penile retraction was found twelve weeks postoperative. CONCLUSION: The modified Devine's technique was safe and effective. As a treatment for concealed penis, it is worthy of wide clinical application.
Effects of an Initial Single Dose of Intravenous Antibiotics on Emergency Department Revisits Among Elderly Patients with Urinary Tract Infections.
Chung HS, Bae SJ, Namgung M … +3 more , Choi YH, Choi JY, Lee DH
Urol J · 2023 Feb · PMID 36840477 · Publisher ↗
PURPOSE: Urinary tract infection (UTI) is the second most common infectious disease among older adults. It is important that the treatment strategy used for older patients with UTIs in the emergency department (ED) be ad...
PURPOSE: Urinary tract infection (UTI) is the second most common infectious disease among older adults. It is important that the treatment strategy used for older patients with UTIs in the emergency department (ED) be adequate. The effectiveness of an initial single dose of intravenous antibiotics in the ED for treating UTIs has not been extensively studied. Therefore, we investigated the clinical outcomes of single-dose intravenous antibiotic administration before discharge from the ED in elderly patients with UTIs. MATERIALS AND METHODS: This retrospective study was conducted among patients who visited two academic tertiary hospitals in Seoul, South Korea. We included all patients older than 65 years of age with UTI who visited the ED and were directly discharged between 1 January and 31 December 2019 (n = 429). The patients were divided into two groups according to whether they received a single dose of intravenous antibiotics before ED discharge. RESULTS: Patients who received intravenous antibiotics had a higher 72-hour revisit rate (43 [15.4%] vs 10 [6.7%], p = .009) and a longer mean duration of therapy (total days of antibiotics use) (11 [4.00 - 15.00] vs 5 [3.00 - 11.00], p < .001) than patients who received only oral antibiotics. However, the rate of admission after revisits did not differ significantly between the groups (27 [62.8%] vs 5 [50.0%], p = .492). CONCLUSION: Older patients with severe UTIs were prescribed intravenous antibiotics in the ED. Decisions on admission or discharge should be made carefully for older patients with UTIs who are prescribed intravenous antibiotics in the ED.
Laparoscopic versus Conventional Open Peritoneal Dialysis Catheter Insertion in China: A Meta-Analysis.
Lu M, Cheng C, Zhang Y
Urol J · 2023 Feb · PMID 36840476 · Publisher ↗
PURPOSE: To compare the risk of complications between laparoscopic peritoneal dialysis (PD) catheter placement and open PD catheter placement. METHODS: We searched numerous databases, including SinoMed, CNKI, cqVIP, WanF...
PURPOSE: To compare the risk of complications between laparoscopic peritoneal dialysis (PD) catheter placement and open PD catheter placement. METHODS: We searched numerous databases, including SinoMed, CNKI, cqVIP, WanFang, Pubmed, Web of Science, OVID, Cochrane and Scopus, for published randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) . RESULTS: Ten studies were included(n=1341). The overall statistical results showed that patients receiving laparoscopic insertion of the PD catheter had a lower risk of catheter migration, inadequate drainage and blockage. The risk of leakage was higher in the laparoscopic group in studies performed prior to 2015; in studies performed after 2015, the risk of leakage was lower than in the conventional open-placement group. For the risk of developing pain, the risk was lower in the subgroup of laparoscopic patients starting PD within 1 day after catheter insertion; however, there was no significant difference between the subgroups starting PD 1 week or 2 weeks after catheter insertion. The risk outcome for abdominal bleeding was similar to that for pain, with a lower risk in the subgroup of laparoscopic patients starting PD within 1 day. The overall research quality was moderate. CONCLUSION: Laparoscopic placement of the PD catheter has unique advantages over conventional open surgical placement, especially in special conditions such as emergency initiation. In addition, we found that some factors that were previously considered irrelevant may have an impact on the results for Asians. However, this conclusion still needs to be substantiated by further large samples in multicenter, high quality Randomized Controlled Trials (RCTs).
Discriminant Efficacy of mpMRI for Variant Pathology Associated with Prostate Adenocarcinoma.
Köseoğlu H, Çevik Cenkeri H, Eroğlu T … +1 more , Yalçın B
Urol J · 2023 May · PMID 36840448 · Publisher ↗
Purpose - Implementation of multiparametric magnetic resonance imaging (mpMRI) for prostate adenocarcinoma's variant pathology requires awareness. The aim of this retrospective study was to investigate the discriminant...
Purpose - Implementation of multiparametric magnetic resonance imaging (mpMRI) for prostate adenocarcinoma's variant pathology requires awareness. The aim of this retrospective study was to investigate the discriminant efficacy of multiparametric magnetic resonance imaging modality for variant pathology associated with prostate adenocarcinoma. Methods - Consecutive 247 prostate cancer patients who underwent radical prostatectomy in our university-based hospital between October 2014 and October 2019, were retrospectively reviewed. Data of mpMRI-associated contrast enhancements, T2 signals, apparent diffusion coefficients (ADC), ages and PSA values were compared. Clinical and demographic data of patients were noted including associated variant pathologies and reports of preoperative mpMRI images. Results - Among the patients, 63 (26%) had variant pathology and 14 (22%) had mpMRI before primary prostate biopsy. The group with variant pathology and the control group had similar perfusion curves and increased contrast when compared for mpMRI parameters, but different ADC values for each of the adjusted b-values for 400, 800 and 1400. Conclusion - Our study demonstrates that mpMRI appears to have no role in distinguishing rare variant pathologies associated with prostate adenocarcinoma despite different ADC values.
A Novel Computed Tomography-Ultrasound Image Fusion Technique for Guiding the Percutaneous Kidney Access.
Shen X, Li K, Wu Z … +6 more , Lu C, Yu H, Lai C, Tang Z, Li K, Xu K
Urol J · 2023 Jul · PMID 36840447 · Publisher ↗
PURPOSE: To describe the feasibility of computed tomography (CT)-ultrasound image fusion technique on guiding percutaneous kidney access in vitro and vivo. MATERIALS AND METHODS: we compare CT-ultrasound image fusion tec...
PURPOSE: To describe the feasibility of computed tomography (CT)-ultrasound image fusion technique on guiding percutaneous kidney access in vitro and vivo. MATERIALS AND METHODS: we compare CT-ultrasound image fusion technique and ultrasound for percutaneous kidney puncture guidance by using an in vitro pig kidney model. The fusion method, fusion time, ultrasound screening time, and success rate of puncture were compared between the groups. Next, patients with kidney stones in our hospital were randomized in the study of simulated puncture guidance. The general condition of patients, fusion method, fusion time, and ultrasound screening time were compared between the groups. RESULTS: A total of 45 pig models were established, including 23 in the CT-ultrasound group and 22 in the ultrasound group. The ultrasound screening time in the CT-ultrasound group was significantly shorter than that in the ultrasound group (P < .001). In addition, the success rate of puncture in the CT-ultrasound group was significantly higher than that in the ultrasound group (P =.015). Furthermore, in the simulated PCNL puncture study, baseline data including age, BMI, and S.T.O.N.E score between the two groups showed no statistical difference. The ultrasound screening time of the two groups was (2.60 ± 0.33) min and (3.37 ± 0.51) min respectively, and the difference was statistically significant (P < .001). CONCLUSION: Our research revealed that the CT-ultrasound image fusion technique was a feasible and safe method to guide PCNL puncture. Compared with traditional ultrasound guidance, the CT-ultrasound image fusion technique can shorten the learning curve of PCNL puncture, improve the success rate of puncture, and shorten the ultrasound screening time.
The Rate of Phosphatase and Tensin (PTEN) Gene Expression Loss in Prostate Cancer and its Link to Tumor Upgrading.
Gharib A, Aziminejad A, Pourmotahari F … +2 more , Kazeminejad B, Soleimani M
Urol J · 2023 Dec · PMID 36840446 · Publisher ↗
PURPOSE: Recent studies have provided reliable evidence for a relationship between loss of PTEN gene expression and prognosis in patients suffering from prostate cancer, although the results have been somewhat diverse in...
PURPOSE: Recent studies have provided reliable evidence for a relationship between loss of PTEN gene expression and prognosis in patients suffering from prostate cancer, although the results have been somewhat diverse in different populations. We aimed to assess PTEN gene expression loss by immunohistochemistry in prostate cancer and also its link to tumor upgrading in a group of affected patients undergoing radical prostatectomy. MATERIALS AND METHODS: This cross-sectional study was performed on 58 tissue samples sourced from the patients with prostate cancer and undergoing radical prostatectomy. TRUS-guided needle biopsies of the cancer tissue samples with histological grade groups of I to IV (the Gleason scores of 6 to 8) were prepared as the study samples. 29 patients with Gleason score (6 to 8) whose tumors on needle biopsy upgraded to Gleason score 7, 8 or 9 at prostatectomy (cases) were compared with 29 patients with Gleason scores of 6, 7 or 8 on both biopsy and prostatectomy samples (controls). Immunohistochemistry (IHC) technique was employed to determine PTEN gene expression status. RESULTS: Loss of PTEN gene expression was found in 62.1% of upgraded cases compared with 27.6% of controls, indicating a statistically significant difference, revealing a meaningful association between the loss of PTEN gene expression and tumor upgrading. Furthermore, we demonstrated that deletions of PTEN gene expression and increased Gleason score in control and upgraded case groups, did not reach statistical significance. CONCLUSION: A high rate of PTEN gene expression loss can be detected in prostate cancer tumor tissue, and this loss of gene expression is associated with tumor upgrading.
Analysis of The Curative Effect of Tubularized Incised Plate Urethroplasty for Distal Hypospadias With The Dysplastic Corpus Spongiosum Covering Technique.
Ji L, Chen S, Chen Y … +4 more , Zhao J, Yin Q, Xian H, Ge W
Urol J · 2023 May · PMID 36811181 · Publisher ↗
PURPOSE: To investigate the use of tubularized incised plate (TIP) urethroplasty for distal second- and third-degree hypospadias to free the dysplastic forked corpus spongiosum and Buck's fascia, which are used as a cove...
PURPOSE: To investigate the use of tubularized incised plate (TIP) urethroplasty for distal second- and third-degree hypospadias to free the dysplastic forked corpus spongiosum and Buck's fascia, which are used as a covering material for the new urethra, thereby reducing the incidence of urinary fistula and other complications in the coronal sulcus. MATERIALS AND METHODS: Clinical data of 113 patients with distal hypospadias treated with TIP urethroplasty from January 2017 to December 2020 were retrospectively analyzed. The study group comprised 58 patients (use of dysplastic corpus spongiosum and Buck's fascia to cover the new urethra), and the control group comprised 55 patients (use of dorsal Dartos fascia to cover the new urethra). RESULTS: All children were followed up for more than 12 months. In the study group, 4 patients developed urinary fistulas, 4 developed a urethral stricture, and no case developed glans fissure. In the control group, 11 patients developed urinary fistulas, 2 developed a urethral stricture, 3 developed a glans cracking. CONCLUSION: Using the dysplastic corpus spongiosum to cover the new urethra increases the amount of tissue in the coronal sulcus and reduces the incidence of urethral fistula, but it may increase the incidence of urethral stricture.
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