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Methodological caveats in intradialytic hypotension prediction: BIA variability, low AUCs, and definition heterogeneity. 分析性低血压预测的方法学注意事项:BIA可变性、低auc和定义异质性。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-08-18 DOI: 10.1007/s11255-025-04743-4
Karan Chaman Lal, Ayesha Ubaid Ullah, Syeda Zainab Kazmi, Mishal Iqbal, Manisha Chamanlal
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引用次数: 0
Reassessing CKD staging in the elderly: methodological and clinical concerns. 重新评估老年人CKD分期:方法学和临床问题。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-08-13 DOI: 10.1007/s11255-025-04731-8
Bhoomeeka Jayramdass, Manohar Lal
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引用次数: 0
Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis of stone-free rates and complication profiles. 经皮肾镜取石术与逆行肾内手术:无结石率和并发症概况的系统回顾和荟萃分析。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-08-06 DOI: 10.1007/s11255-025-04707-8
Zunaira Naeem, Pakeezah Tabasum, Manahil Mustajab, Ahsan Abid, Muhammad Athar Khawaja, Hussain Ramzan, Yasmeen Sufi, Muhammad Talha, Nabeeha Noor, Imran Saeed, Muhammad Usman Hashmi
<p><strong>Background: </strong>Nephrolithiasis is a highly prevalent urological condition, necessitating effective and minimally invasive treatment strategies. Percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are commonly employed for managing renal calculi, but their comparative efficacy and safety remain subjects of ongoing debate. This meta-analysis aims to synthesize current evidence, providing a comprehensive assessment of surgical outcomes between PCNL and RIRS for renal stones under 2 cm and greater than 2 cm, reported across different study designs, various surgical techniques, and different geographical distributions to guide clinical decision-making.</p><p><strong>Methods: </strong>A systematic literature search was conducted across electronic databases, including PubMed, Embase, Scopus, Cochrane, and Clinicaltrials.gov, up to December 2024. Risk of Bias assessment was conducted using the Newcastle-Ottawa Scale for non-randomized cohort studies and the Cochrane Risk of Bias 2.0 (RoB 2.0) tool for RCTs. Data extraction focused on key outcomes such as stone-free rate, complications, operation time, hospital stay, and the need for blood transfusions. Statistical analysis utilized a random-effects model to pool data, with heterogeneity assessed using the I<sup>2</sup> statistic and publication bias evaluated via funnel plots.</p><p><strong>Results: </strong>The analysis of 62 studies (25 were RCTs and 37 were cohorts) with 7021 patients revealed a significantly higher stone-free rate in the PCNL group compared to RIRS (RR: 1.06, 95% CI [1.04, 1.09], p < 0.00001), indicating greater efficacy in stone clearance. However, PCNL was associated with a significantly higher risk of complications (RR: 1.49, 95% CI [1.25, 1.77], p < 0.00001) and a greater need for blood transfusions (RR: 3.20, 95% CI [1.70, 6.03], p = 0.0003), associated with increased risk. Post-operative hematuria was marginally higher in the PCNL group (RR: 2.06, 95% CI [1.01, 4.19], p = 0.05). Among the PCNL techniques, all PCNL techniques showed significantly higher Hb drop; micro-PCNL was associated with the smallest hemoglobin drop relative to RIRS (MD = 0.62, 95% CI 0.38 to 0.86), followed by mini-PCNL and standard-PCNL. Operation times were comparable between the two procedures, but PCNL resulted in a significantly longer hospital stay (MD: 1.73, 95% CI [1.35, 2.10], p < 0.00001).</p><p><strong>Conclusion: </strong>PCNL demonstrates a superior stone-free rate for renal stones under 2 cm and greater than 2 cm, but this is accompanied by a higher risk of complications and a longer hospital stay compared to RIRS. RIRS offers a safer alternative with fewer complications and shorter hospital stays, making it a viable option for at-risk patients. The use of miniaturized PCNL techniques appears to mitigate some of the complication risks associated with traditional PCNL, potentially offering a balance between efficacy and safety. Clinical decision-making
背景:肾结石是一种非常普遍的泌尿系统疾病,需要有效的微创治疗策略。经皮肾镜取石术(PCNL)和逆行肾内手术(RIRS)是治疗肾结石的常用方法,但其相对疗效和安全性仍存在争议。本荟萃分析旨在综合现有证据,全面评估PCNL和RIRS治疗2 cm以下和2 cm以上肾结石的手术结果,这些结果来自不同的研究设计、不同的手术技术和不同的地理分布,以指导临床决策。方法:系统检索截至2024年12月的PubMed、Embase、Scopus、Cochrane和Clinicaltrials.gov等电子数据库的文献。对非随机队列研究采用纽卡斯尔-渥太华量表进行偏倚风险评估,对随机对照试验采用Cochrane偏倚风险2.0 (RoB 2.0)工具。数据提取侧重于关键结果,如无结石率、并发症、手术时间、住院时间和输血需求。统计分析采用随机效应模型汇集数据,采用I2统计量评估异质性,通过漏斗图评估发表偏倚。结果:对62项研究(25项为随机对照试验,37项为队列研究)7021例患者的分析显示,与RIRS相比,PCNL组的结石无结石率显著高于RIRS (RR: 1.06, 95% CI [1.04, 1.09], p结论:PCNL对2厘米以下和大于2厘米的肾结石有更高的结石无结石率,但与RIRS相比,这伴随着更高的并发症风险和更长的住院时间。RIRS提供了一种更安全的替代方案,并发症更少,住院时间更短,使其成为高危患者的可行选择。小型化PCNL技术的使用似乎减轻了传统PCNL相关的一些并发症风险,在疗效和安全性之间提供了潜在的平衡。临床决策应个性化,考虑患者和结石的特点,外科医生的经验,以及先进的PCNL技术的可用性。
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引用次数: 0
Evaluating less-invasive strategies for localized prostate cancer: a comparative meta-analysis on high-intensity focused ultrasound versus radical prostatectomy. 评估局部前列腺癌的微创策略:高强度聚焦超声与根治性前列腺切除术的比较荟萃分析。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-31 DOI: 10.1007/s11255-025-04695-9
Henrique L Lepine, Fabio C Vicentini, Christiano Machado Filho, Guilherme Cavalcante, Fernanda M Llata, José Bessa Júnior, Leonardo O Reis, José Maurício Mota, William Carlos Nahas, Leopoldo Alves Ribeiro-Filho, Caio Vinícius Suartz

Purpose: Prostate cancer is frequently managed with radical prostatectomy (RP), which can offer excellent oncological control but with significant genitourinary morbidity. High-intensity focused ultrasound (HIFU) has emerged as a less-invasive alternative. We performed a systematic review and meta-analysis to compare the oncological, functional, and safety outcomes of HIFU versus RP in men with localized prostate cancer.

Methods: Following PRISMA guidelines, we searched Medline, Embase, and Cochrane through December 2024 for comparative studies of HIFU and RP. Fourteen studies (including two randomized trials) met inclusion criteria. The primary endpoint was salvage therapy-free survival (STFS). Secondary outcomes included biochemical recurrence, metastasis-free survival, functional outcomes, and complications. Random-effect models were applied, and meta-regression explored sources of heterogeneity.

Results: Overall, HIFU was associated with lower STFS (odds ratio [OR]: 0.65, p = 0.02) although biochemical recurrence and metastasis-free survival did not differ significantly between treatments. Focal HIFU showed fewer major complications (OR: 0.36) and significantly better erectile function preservation (OR: 6.03), but minor complications were slightly more frequent. High heterogeneity was partly explained by study design and follow-up duration. Limitations include substantial heterogeneity, variable definitions of outcomes, and relatively short follow-ups in some studies.

Conclusion: For selected patients, biochemical recurrence and metastasis-free survival did not differ significantly between treatments although HIFU was associated with lower STFS. Particularly as focal therapy, it shows the potential to achieve oncologic outcomes comparable to radical prostatectomy while enhancing erectile function preservation, urinary continence, and reducing major complications. Further long-term prospective studies are warranted to solidify these findings.

目的:前列腺癌通常采用根治性前列腺切除术(RP)治疗,它可以提供良好的肿瘤控制,但有显著的泌尿生殖系统发病率。高强度聚焦超声(HIFU)已成为一种侵入性较小的替代方法。我们进行了系统回顾和荟萃分析,比较HIFU和RP治疗局限性前列腺癌的肿瘤学、功能和安全性结果。方法:遵循PRISMA指南,我们检索了Medline, Embase和Cochrane,直到2024年12月进行HIFU和RP的比较研究。14项研究(包括2项随机试验)符合纳入标准。主要终点是挽救性无治疗生存期(STFS)。次要结局包括生化复发、无转移生存、功能结局和并发症。采用随机效应模型,meta回归探讨异质性的来源。结果:总体而言,HIFU与较低的STFS相关(优势比[OR]: 0.65, p = 0.02),尽管不同治疗间生化复发和无转移生存没有显著差异。局灶HIFU的主要并发症较少(OR: 0.36),勃起功能保存明显较好(OR: 6.03),但轻微并发症发生率略高。高异质性的部分原因是研究设计和随访时间。局限性包括实质性的异质性,结果的可变定义,以及一些研究的随访时间相对较短。结论:对于选定的患者,尽管HIFU与较低的STFS相关,但不同治疗之间的生化复发和无转移生存无显著差异。特别是作为局灶性治疗,它显示出实现与根治性前列腺切除术相当的肿瘤结果的潜力,同时增强了勃起功能的保留,尿失禁,并减少了主要并发症。需要进一步的长期前瞻性研究来巩固这些发现。
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引用次数: 0
Comparing complications of Rezum and Urolift for BPH/LUTS using the Accordion Severity Grading System. 用Accordion严重程度分级系统比较Rezum和Urolift治疗BPH/LUTS的并发症。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-29 DOI: 10.1007/s11255-025-04704-x
Kevin McVary, Bronwyn Long, Amandip Cheema, Larry E Miller

Purpose: To compare the short- and long-term complication profiles of Rezum and Urolift using standardized approaches.

Methods: We analyzed published data from the pivotal randomized trials of Rezum and Urolift. The severity of complications was independently graded by urologists using the Accordion Severity Grading System, developed by the American College of Surgeons National Surgical Quality Improvement Program. Short- (3 months) and long-term (5 years) complication rates were assessed. Long-term complications included medical retreatment, surgical retreatment, and surgical implant removal. We calculated the weighted postoperative morbidity index (PMI) values (0-1 scale) for each procedure and performed Monte Carlo simulations to account for uncertainty in complication rates and severities.

Results: Short-term PMI values were similar between the Rezum (0.091) and Urolift (0.092) groups, with dysuria, hematuria, pain, and urinary urgency most commonly reported. Over 5 years, the cumulative complication rates were 15.4% for Rezum and 33.6% for Urolift. The associated 5-year PMI was 0.055 for Rezum and 0.165 for Urolift, indicating a three-fold higher long-term severity-weighted complication burden with Urolift. Monte Carlo simulations confirmed the robustness of these findings.

Conclusions: This study identified significant differences in the long-term complication profiles of Rezum and Urolift when considering both the incidence and severity of postoperative complications. These findings may help guide clinical decision-making when selecting minimally invasive surgical options for BPH/LUTS treatment.

目的:比较标准化入路Rezum和Urolift的短期和长期并发症。方法:我们分析了Rezum和Urolift关键性随机试验的已发表数据。并发症的严重程度由泌尿科医生使用Accordion严重程度分级系统独立分级,该系统由美国外科医师学会国家手术质量改进计划开发。评估短期(3个月)和长期(5年)并发症发生率。长期并发症包括药物再治疗、手术再治疗和手术植入物移除。我们计算了每个手术的加权术后发病率指数(PMI)值(0-1级),并进行了蒙特卡罗模拟,以考虑并发症发生率和严重程度的不确定性。结果:短期PMI值在Rezum组(0.091)和Urolift组(0.092)之间相似,最常见的是排尿困难、血尿、疼痛和尿急。5年内,Rezum和Urolift的累计并发症发生率分别为15.4%和33.6%。Rezum的相关5年PMI为0.055,Urolift的相关5年PMI为0.165,表明Urolift的长期严重加权并发症负担高出3倍。蒙特卡罗模拟证实了这些发现的稳健性。结论:本研究发现,在考虑术后并发症的发生率和严重程度时,Rezum和Urolift的长期并发症情况存在显著差异。这些发现可能有助于指导临床决策选择微创手术治疗BPH/LUTS。
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引用次数: 0
Overnight-dwelled amino acid-based peritoneal dialysis solutions for malnutrition in CAPD: a prospective real-world study. 以氨基酸为基础的隔夜腹膜透析解决方案治疗CAPD中的营养不良:一项前瞻性现实世界研究。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-08-27 DOI: 10.1007/s11255-025-04749-y
Shanshan Deng, Huijie Xuan, Liling Chen, Xiaoyan Su, Yong Su, Yeming Lu, Mingsheng Zhu, Xiaoxia Yang, Chunmei Luo, Wei Shi

Purpose: To assess the efficacy and safety of amino acid peritoneal dialysis (AA-PD) in improving nutritional status among continuous ambulatory peritoneal dialysis (CAPD) patients with malnutrition in a real-world setting.

Methods: A prospective self-control study was conducted across five hospitals in China. Patients aged 18-75 years with malnutrition [serum albumin < 35 g/L, prealbumin < 300 mg/L, or Subjective Global Assessment (SGA) score > 7] were enrolled. Each patient used one bag of 2 L 1.1% AA-PD solution to replace the 1.5% dextrose solution for the overnight dwell. All patients received routine nutritional management at their respective centers. Primary outcomes were changes in serum albumin and prealbumin levels. Secondary outcomes included SGA, normalized protein nitrogen appearance (nPCR, as a protein intake indicator), hand grip strength, mid-arm muscle circumference (MAMC), and body mass index (BMI). Clinical symptoms and adverse events were also monitored.

Results: A total of 149 patients were enrolled, with 142 (95.3%) completing at least one efficacy assessment. After 6 months of AA-PD treatment, serum albumin increased from a baseline of 30.4-34.55 g/L (P < 0.001), and prealbumin increased from 302.8 to 348.7 mg/L (P < 0.001). SGA, nPCR, and hand grip strength improved significantly, while MAMC and BMI remained stable. The improvement in albumin level was independent of diet protein intake. Symptoms like anorexia, fatigue, and nausea decreased. A total of 53 patients (35.57%) experienced 56 treatment-emergent adverse events, of which only 3 mild events (2.01%) were considered related to AA-PD treatment. Additionally, 31 patients (20.81%) experienced a total of 31 serious adverse events, all of which were determined to be unrelated to AA-PD treatment. Although adverse events were generally mild with no AA-PD discontinuation, an acidosis tendency was noted.

Conclusion: AA-PD can improve serum levels of albumin and prealbumin, as well as clinical symptoms. However, relying solely on 6 months of AA-PD treatment is not sufficient to significantly improve medium- and long-term indicators. Treatment-related adverse reactions are generally mild, but acidosis still needs to be monitored.

目的:评估氨基酸腹膜透析(AA-PD)在现实世界中改善持续动态腹膜透析(CAPD)患者营养状况的有效性和安全性。方法:在中国五家医院进行前瞻性自我控制研究。患者年龄18-75岁,伴有营养不良[血清白蛋白7]。每位患者使用1袋2 L 1.1% AA-PD溶液代替1.5%葡萄糖溶液过夜。所有患者在各自的中心接受常规营养管理。主要结果是血清白蛋白和前白蛋白水平的变化。次要结局包括SGA、标准化蛋白氮外观(nPCR,作为蛋白质摄入指标)、手部握力、手臂中肌围(MAMC)和体重指数(BMI)。同时监测临床症状和不良事件。结果:共有149例患者入组,其中142例(95.3%)完成了至少一项疗效评估。AA-PD治疗6个月后,血清白蛋白较基线30.4 ~ 34.55 g/L升高(P)。结论:AA-PD可改善血清白蛋白和前白蛋白水平,改善临床症状。然而,仅仅依靠6个月的AA-PD治疗不足以显著改善中长期指标。治疗相关的不良反应一般较轻,但酸中毒仍需监测。
{"title":"Overnight-dwelled amino acid-based peritoneal dialysis solutions for malnutrition in CAPD: a prospective real-world study.","authors":"Shanshan Deng, Huijie Xuan, Liling Chen, Xiaoyan Su, Yong Su, Yeming Lu, Mingsheng Zhu, Xiaoxia Yang, Chunmei Luo, Wei Shi","doi":"10.1007/s11255-025-04749-y","DOIUrl":"10.1007/s11255-025-04749-y","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of amino acid peritoneal dialysis (AA-PD) in improving nutritional status among continuous ambulatory peritoneal dialysis (CAPD) patients with malnutrition in a real-world setting.</p><p><strong>Methods: </strong>A prospective self-control study was conducted across five hospitals in China. Patients aged 18-75 years with malnutrition [serum albumin < 35 g/L, prealbumin < 300 mg/L, or Subjective Global Assessment (SGA) score > 7] were enrolled. Each patient used one bag of 2 L 1.1% AA-PD solution to replace the 1.5% dextrose solution for the overnight dwell. All patients received routine nutritional management at their respective centers. Primary outcomes were changes in serum albumin and prealbumin levels. Secondary outcomes included SGA, normalized protein nitrogen appearance (nPCR, as a protein intake indicator), hand grip strength, mid-arm muscle circumference (MAMC), and body mass index (BMI). Clinical symptoms and adverse events were also monitored.</p><p><strong>Results: </strong>A total of 149 patients were enrolled, with 142 (95.3%) completing at least one efficacy assessment. After 6 months of AA-PD treatment, serum albumin increased from a baseline of 30.4-34.55 g/L (P < 0.001), and prealbumin increased from 302.8 to 348.7 mg/L (P < 0.001). SGA, nPCR, and hand grip strength improved significantly, while MAMC and BMI remained stable. The improvement in albumin level was independent of diet protein intake. Symptoms like anorexia, fatigue, and nausea decreased. A total of 53 patients (35.57%) experienced 56 treatment-emergent adverse events, of which only 3 mild events (2.01%) were considered related to AA-PD treatment. Additionally, 31 patients (20.81%) experienced a total of 31 serious adverse events, all of which were determined to be unrelated to AA-PD treatment. Although adverse events were generally mild with no AA-PD discontinuation, an acidosis tendency was noted.</p><p><strong>Conclusion: </strong>AA-PD can improve serum levels of albumin and prealbumin, as well as clinical symptoms. However, relying solely on 6 months of AA-PD treatment is not sufficient to significantly improve medium- and long-term indicators. Treatment-related adverse reactions are generally mild, but acidosis still needs to be monitored.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"661-671"},"PeriodicalIF":1.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Comment on Yajima et al. (2025): "Association between initial intravenous fluid volume and the composite outcome of hemodialysis dependence or in-hospital mortality in inpatients with rhabdomyolysis". 更正:对Yajima等人(2025)的评论:“横纹肌溶解住院患者的初始静脉输液量与血液透析依赖或住院死亡率的综合结局之间的关系”。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 DOI: 10.1007/s11255-025-04621-z
Anfal Khan, Mohammad Idrees, Ameer Afzal Khan, Rahman Syed
{"title":"Correction: Comment on Yajima et al. (2025): \"Association between initial intravenous fluid volume and the composite outcome of hemodialysis dependence or in-hospital mortality in inpatients with rhabdomyolysis\".","authors":"Anfal Khan, Mohammad Idrees, Ameer Afzal Khan, Rahman Syed","doi":"10.1007/s11255-025-04621-z","DOIUrl":"10.1007/s11255-025-04621-z","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"737"},"PeriodicalIF":1.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Limitations of single-center retrospective studies in sepsis-associated AKI research: a call for broader, prospective approaches. 脓毒症相关AKI研究中单中心回顾性研究的局限性:呼吁采用更广泛、前瞻性的方法。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-29 DOI: 10.1007/s11255-025-04703-y
Adil Mushtaq, Nimrah Bhatti, Noor Un Nisa Irshad, Kamran Chatha, Nayyar Iqbal Tiwana, Nilay Bhatt
{"title":"Limitations of single-center retrospective studies in sepsis-associated AKI research: a call for broader, prospective approaches.","authors":"Adil Mushtaq, Nimrah Bhatti, Noor Un Nisa Irshad, Kamran Chatha, Nayyar Iqbal Tiwana, Nilay Bhatt","doi":"10.1007/s11255-025-04703-y","DOIUrl":"10.1007/s11255-025-04703-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"707-708"},"PeriodicalIF":1.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survivin and Ki-67 immunohistochemical expression in penile squamous cell carcinoma: clinicopathological features and overall survival. Survivin和Ki-67免疫组化在阴茎鳞状细胞癌中的表达:临床病理特征和总生存率。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-21 DOI: 10.1007/s11255-025-04672-2
Mateus W De Bacco, Iago Z Pires, Josenel M B Marçal, Mário B Wagner, André P Fay, Márcio A Averbeck, Gustavo F Carvalhal

Background: The present study evaluated Survivin and Ki-67 immunohistochemical expression in squamous cell carcinoma of the penis and its association with clinicopathological features and outcomes.

Patients and methods: A retrospective cohort study, from 1998 to 2016, was conducted at a tertiary hospital in Brazil, utilizing a convenience sample. The study collected clinical characteristics, pathological features, and outcomes. Immunohistochemical expressions of Survivin and Ki-67 were performed on formalin-fixed paraffin-embedded specimens from patients with PSCC. Survivin positivity (Survivin +) was defined as any staining in more than 5% of tumor cells, while Ki-67 positivity was defined as any staining in more than 10%. The Mann-Whitney U test and Fisher's exact test were used to perform the associations. Kaplan-Meier curves with log-rank were used to estimate survival.

Results: Forty patients undergoing partial or total penectomy were selected, with five subsequently excluded. Among the remaining 35 patients, 15 (42.8%) were Ki-67 positive, and 9 (25.7%) were Survivin + . Ki-67 expression did not demonstrate association with higher tumor grade (73.3% for grades II and III vs. 55% for grade II in the Ki-67 < 10% group; p = 0.06), larger lesions (p = 0.05), or survival outcomes (HR 1.66; 95% CI 0.56-4.98; p = 0.36). Survivin + was more common in grade II and III than grade I (77.8% vs. 22.1; p = 0.027), and Survivin + patients were correlated with worse overall survival (HR 3.73; 95%CI 1.25-11.12; p = 0.01).

Conclusion: Ki-67 expression does not seem to have an impact on clinicopathological features and overall survival. The expression of survivin seems to be promising in detecting penile squamous cell carcinoma patients with a worse prognosis.

背景:本研究评估了Survivin和Ki-67在阴茎鳞状细胞癌中的免疫组织化学表达及其与临床病理特征和预后的关系。患者和方法:1998年至2016年,在巴西一家三级医院进行了一项回顾性队列研究,采用方便样本。该研究收集了临床特征、病理特征和结果。对PSCC患者经福尔马林固定石蜡包埋的标本进行Survivin和Ki-67的免疫组化表达。Survivin阳性(Survivin +)定义为超过5%的肿瘤细胞染色,Ki-67阳性定义为超过10%的肿瘤细胞染色。使用Mann-Whitney U检验和Fisher精确检验来执行关联。用log-rank Kaplan-Meier曲线估计生存率。结果:40例患者接受部分或全部阴茎切除术,5例随后被排除。其余35例患者中Ki-67阳性15例(42.8%),Survivin + 9例(25.7%)。Ki-67的表达与较高的肿瘤分级没有相关性(II级和III级为73.3%,II级为55%)。结论:Ki-67的表达似乎对临床病理特征和总生存率没有影响。survivin的表达在检测预后较差的阴茎鳞状细胞癌患者中具有较好的应用前景。
{"title":"Survivin and Ki-67 immunohistochemical expression in penile squamous cell carcinoma: clinicopathological features and overall survival.","authors":"Mateus W De Bacco, Iago Z Pires, Josenel M B Marçal, Mário B Wagner, André P Fay, Márcio A Averbeck, Gustavo F Carvalhal","doi":"10.1007/s11255-025-04672-2","DOIUrl":"10.1007/s11255-025-04672-2","url":null,"abstract":"<p><strong>Background: </strong>The present study evaluated Survivin and Ki-67 immunohistochemical expression in squamous cell carcinoma of the penis and its association with clinicopathological features and outcomes.</p><p><strong>Patients and methods: </strong>A retrospective cohort study, from 1998 to 2016, was conducted at a tertiary hospital in Brazil, utilizing a convenience sample. The study collected clinical characteristics, pathological features, and outcomes. Immunohistochemical expressions of Survivin and Ki-67 were performed on formalin-fixed paraffin-embedded specimens from patients with PSCC. Survivin positivity (Survivin +) was defined as any staining in more than 5% of tumor cells, while Ki-67 positivity was defined as any staining in more than 10%. The Mann-Whitney U test and Fisher's exact test were used to perform the associations. Kaplan-Meier curves with log-rank were used to estimate survival.</p><p><strong>Results: </strong>Forty patients undergoing partial or total penectomy were selected, with five subsequently excluded. Among the remaining 35 patients, 15 (42.8%) were Ki-67 positive, and 9 (25.7%) were Survivin + . Ki-67 expression did not demonstrate association with higher tumor grade (73.3% for grades II and III vs. 55% for grade II in the Ki-67 < 10% group; p = 0.06), larger lesions (p = 0.05), or survival outcomes (HR 1.66; 95% CI 0.56-4.98; p = 0.36). Survivin + was more common in grade II and III than grade I (77.8% vs. 22.1; p = 0.027), and Survivin + patients were correlated with worse overall survival (HR 3.73; 95%CI 1.25-11.12; p = 0.01).</p><p><strong>Conclusion: </strong>Ki-67 expression does not seem to have an impact on clinicopathological features and overall survival. The expression of survivin seems to be promising in detecting penile squamous cell carcinoma patients with a worse prognosis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"467-475"},"PeriodicalIF":1.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperbaric oxygen therapy in a rat model of cyclophosphamide-induced hemorrhagic cystitis. 高压氧治疗对环磷酰胺致出血性膀胱炎大鼠模型的影响。
IF 1.9 4区 医学 Q3 UROLOGY & NEPHROLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-17 DOI: 10.1007/s11255-025-04650-8
Cagri Can Makar, Elif Sanli, Gizem Koral, Ozge Hurdogan, Ahmet Veysel Gumus, Mehmet Guven Gunver, Yasemin Ozluk, Samil Aktas

Objective: To evaluate the effects of hyperbaric oxygen therapy (HBOT) on inflammation, oxidative stress, and bladder damage in a cyclophosphamide (CP)-induced hemorrhagic cystitis (HC) rat model.

Methods: Forty male Wistar albino rats received a single intraperitoneal dose of 200 mg/kg CP to induce HC. Rats were assigned to either the HBOT or control groups and sacrificed on days 3, 7, and 14. The HBOT group received 6, 14, or 28 sessions of 100% oxygen at 2.4 ATA for 90 min. Outcomes included mortality, weight loss, bladder weight, macroscopic edema and hemorrhage scores, histopathology, Ki-67 immunostaining, and levels of cytokines (IL-1β, IL-4, IL-6, MCP-1, TNF-α) and malondialdehyde in bladder tissue, serum, and urine. Cytokines were quantified using the Luminex assay and malondialdehyde by ELISA.

Results: Mortality and weight loss were similar between groups. On day 3, the HBOT group showed significantly lower bladder weights and hemorrhage scores (p < 0.01), with no significant differences in edema. On day 7, IL-1β and MCP-1 levels were higher in the HBOT group (p = 0.02). Malondialdehyde levels were significantly elevated in the control group on day 3. Histopathological and other cytokine findings showed no significant differences.

Conclusions: HBOT may provide early but transient benefits in alleviating HC based on macroscopic findings; however, these effects were not supported by sustained histopathological or molecular improvements. The high-dose CP model may have masked the potential therapeutic effects of HBOT. Further studies using lower or fractionated CP dosing and extended observation periods are warranted to better evaluate the therapeutic potential of HBOT.

目的:探讨高压氧治疗(HBOT)对环磷酰胺(CP)致出血性膀胱炎(HC)大鼠模型炎症、氧化应激及膀胱损伤的影响。方法:40只雄性Wistar白化大鼠单次腹腔注射200 mg/kg CP诱导HC。将大鼠分为HBOT组和对照组,并于第3、7和14天处死。HBOT组接受6、14或28次100%氧气,2.4 ATA,持续90分钟。结果包括死亡率、体重减轻、膀胱重量、宏观水肿和出血评分、组织病理学、Ki-67免疫染色、膀胱组织、血清和尿液中细胞因子(IL-1β、IL-4、IL-6、MCP-1、TNF-α)和丙二醛水平。采用Luminex法定量细胞因子,ELISA法定量丙二醛。结果:两组间死亡率和体重减轻相似。在第3天,HBOT组膀胱重量和出血评分显著降低(p)。结论:基于宏观结果,HBOT可能在缓解HC方面提供早期但短暂的益处;然而,这些效果并没有得到持续的组织病理学或分子改善的支持。高剂量CP模型可能掩盖了HBOT潜在的治疗作用。为了更好地评估HBOT的治疗潜力,有必要进一步研究使用较低或分次的CP剂量和延长观察期。
{"title":"Hyperbaric oxygen therapy in a rat model of cyclophosphamide-induced hemorrhagic cystitis.","authors":"Cagri Can Makar, Elif Sanli, Gizem Koral, Ozge Hurdogan, Ahmet Veysel Gumus, Mehmet Guven Gunver, Yasemin Ozluk, Samil Aktas","doi":"10.1007/s11255-025-04650-8","DOIUrl":"10.1007/s11255-025-04650-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of hyperbaric oxygen therapy (HBOT) on inflammation, oxidative stress, and bladder damage in a cyclophosphamide (CP)-induced hemorrhagic cystitis (HC) rat model.</p><p><strong>Methods: </strong>Forty male Wistar albino rats received a single intraperitoneal dose of 200 mg/kg CP to induce HC. Rats were assigned to either the HBOT or control groups and sacrificed on days 3, 7, and 14. The HBOT group received 6, 14, or 28 sessions of 100% oxygen at 2.4 ATA for 90 min. Outcomes included mortality, weight loss, bladder weight, macroscopic edema and hemorrhage scores, histopathology, Ki-67 immunostaining, and levels of cytokines (IL-1β, IL-4, IL-6, MCP-1, TNF-α) and malondialdehyde in bladder tissue, serum, and urine. Cytokines were quantified using the Luminex assay and malondialdehyde by ELISA.</p><p><strong>Results: </strong>Mortality and weight loss were similar between groups. On day 3, the HBOT group showed significantly lower bladder weights and hemorrhage scores (p < 0.01), with no significant differences in edema. On day 7, IL-1β and MCP-1 levels were higher in the HBOT group (p = 0.02). Malondialdehyde levels were significantly elevated in the control group on day 3. Histopathological and other cytokine findings showed no significant differences.</p><p><strong>Conclusions: </strong>HBOT may provide early but transient benefits in alleviating HC based on macroscopic findings; however, these effects were not supported by sustained histopathological or molecular improvements. The high-dose CP model may have masked the potential therapeutic effects of HBOT. Further studies using lower or fractionated CP dosing and extended observation periods are warranted to better evaluate the therapeutic potential of HBOT.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"459-466"},"PeriodicalIF":1.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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International Urology and Nephrology
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