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Influence of vascular endothelial growth factor inhibition on simple renal cysts in patients receiving bevacizumab-based chemotherapy 血管内皮生长因子抑制对接受贝伐单抗化疗患者单纯性肾囊肿的影响
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.791
T. Grenader, L. Shavit
Purpose Although angiogenesis has been implicated in the promotion of renal cyst growth in autosomal dominant polycystic kidney disease, no studies have investigated the role of angiogenesis in the growth of simple renal cysts. The aim of current study was to investigate the effect of chemotherapy with the antivascular endothelial growth factor antibody bevacizumab on renal cyst development and growth in cancer patients. Materials and Methods We retrospectively reviewed the medical records of 136 patients with a variety of cancers that were treated with bevacizumab-based chemotherapy for metastatic disease. The presence of and changes in renal cysts were evaluated by retrospective analysis of computed tomography scans performed for assessment of tumor response to bevacizumab-based therapy. Results The median age of the patients was 64 years. Renal cysts were identified in 66 patients, in whom 33 (50%) had a single cyst and the rest had 2 or more cysts. The average dose of bevacizumab was 2.68 mg/kg per week. Median duration of treatment was 33 weeks. Average cyst size was 1.9±2.4 cm at the beginning of the study and the majority of the cysts (54 patients, 84%) did not change in size or shape during bevacizumab treatment. No patients were identified with new cysts. Cyst size changed in 10 patients (16%): an increase of 15% to 40% from the baseline size in 5 patients and a decrease in size of 10% to 70% in another 5 patients. The duration of bevacizumab therapy was significantly longer in the subgroup of patients with diminished or increased cyst size than in the patients with stable cyst size: 62 weeks versus 29 weeks, respectively (p=0.0002). Conclusions Our data demonstrated that simple renal cysts were stable in size and number in the vast majority of cancer patients treated with bevacizumab.
虽然血管生成与常染色体显性多囊肾病肾囊肿生长的促进有关,但尚未有研究调查血管生成在单纯性肾囊肿生长中的作用。本研究的目的是探讨抗血管内皮生长因子抗体贝伐单抗化疗对癌症患者肾囊肿发展和生长的影响。材料和方法我们回顾性回顾了136例接受贝伐单抗为基础的化疗治疗转移性疾病的各种癌症患者的医疗记录。通过回顾性分析计算机断层扫描来评估肿瘤对贝伐单抗治疗的反应,评估肾囊肿的存在和变化。结果患者中位年龄64岁。66例患者发现肾囊肿,其中33例(50%)为单囊肿,其余为2个或更多囊肿。贝伐单抗的平均剂量为2.68 mg/kg /周。治疗中位持续时间为33周。在研究开始时,平均囊肿大小为1.9±2.4 cm,大多数囊肿(54例,84%)在贝伐单抗治疗期间没有改变大小或形状。没有患者被发现有新的囊肿。10例(16%)患者的囊肿大小发生变化:5例患者的囊肿大小较基线增大15%至40%,另外5例患者的囊肿大小减小10%至70%。在囊肿大小减小或增大的亚组患者中,贝伐单抗治疗的持续时间明显长于囊肿大小稳定的患者:分别为62周和29周(p=0.0002)。结论:我们的数据表明,在绝大多数接受贝伐单抗治疗的癌症患者中,单纯性肾囊肿的大小和数量是稳定的。
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引用次数: 2
The legend of the KJU KJU的传奇
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.789
Kwangsung Park
The Korean Journal of Urology (KJU) will change its name starting in 2016. Recently, the editorial board of the KJU had a spirited discussion about whether to keep the original name or change it to attract more international authors and readers of our journal. In 2014, approximately 60% of the papers submitted to the KJU were from outside of Korea, and the number of countries represented by authorship totaled around 20, reflecting that the KJU has become an international journal [1,2]. Furthermore, the KJU is currently indexed in major international databases, such as MEDLINE, PubMed, PubMed Central, Web of Science, Scopus, Embase, and EBSCO. Therefore, the editorial board of the KJU and the council of the Korean Urological Association decided to open our gates internationally by changing the name of the journal in our 2015 Annual Meeting of the Korean Urological Association held in Seoul, Korea, on November 18th to 20th. Looking back at the history of the KJU, the official journal of the Korean Urological Association was first published as the 'Taehan Pinyogikwa Hakhoe chapchi' in 1960 and changed to 'Taehan Pinyogikwa Hakhoe chi' (ISSN 0494-4747) in 1979. It was renamed the 'Korean Journal of Urology' (print ISSN 2005-6737; online ISSN 2005-6745) in February 2009 to increase its exposure to a wider international audience. The cover design of the KJU has changed 3 times (Fig. 1). The journal title of the first and second edition of the KJU was in Chinese characters, which changed to Korean in the 3rd edition in 1998. However, the subtitles of the KJU were expressed as the Korean Journal of Urology in English from the 1st edition. In February 2009, the KJU changed its cover design and the title of the journal to English. Finally, the KJU became an English-language journal from the January issue of 2010. Fig. 1 The cover designs of the Korean Journal of Urology from the beginning to the current issues. In the age of high-speed internet and a rapidly changing world, we need to break down the walls of nationalities. Therefore, we found it a perfect time to change the name of the KJU. Even though the KJU will change its name starting in 2016, the editorial board and publisher will continue with the vision and volume number of the KJU. On behalf of the editorial board of the KJU, I would like to express my sincere thanks to the members of the Korean Urological Association and our international readers for their contributions to the KJU. We hope you continue to support and contribute to our journal. All the best!
韩国泌尿外科杂志(KJU)将从2016年开始更名。最近,为了吸引更多的国际作者和读者,韩国大学编辑委员会就是否保留原名称或更改名称进行了激烈的讨论。2014年,KJU投稿的论文中约有60%来自韩国以外的国家,作者代表的国家总数约为20个,反映出KJU已成为一份国际性期刊[1,2]。此外,KJU目前已被MEDLINE、PubMed、PubMed Central、Web of Science、Scopus、Embase和EBSCO等主要国际数据库收录。因此,在11月18日至20日在韩国首尔举行的2015年韩国泌尿外科学会年会上,韩国泌尿学会编委会和韩国泌尿外科学会理事会决定,通过更改期刊名称,向国际打开我们的大门。回顾韩国泌尿学会的历史,1960年大韩泌尿学会的正式期刊《大韩泌尿学会学刊》首次出版,1979年更名为《大韩泌尿学会学刊》(ISSN 0494-4747)。它被重新命名为“韩国泌尿学杂志”(印刷ISSN 2005-6737;在线ISSN 2005-6745),以增加其在更广泛的国际读者中的曝光率。《韩国大学》的封面设计经历了3次变化(图1)。《韩国大学》第1、2版的期刊名称是汉字,1998年第3版改为韩文。但是,从第1版开始,《韩国泌尿外科杂志》的英文字幕就变成了“Korean Journal of Urology”。2009年2月,韩国大学将杂志的封面设计和标题改为英文。最终,《韩国大学》从2010年1月开始成为英文期刊。图1《韩国泌尿学杂志》创刊号至当期封面设计。在高速互联网和快速变化的世界的时代,我们需要打破民族的围墙。因此,我们认为这是更改KJU名称的最佳时机。虽然将从2016年开始改名,但编委会和出版社将继续沿用韩国大学的宗旨和书号。我谨代表大韩泌尿学会编辑委员会,向大韩泌尿学会会员和我们的国际读者对大韩泌尿学会的贡献表示衷心的感谢。我们希望您继续支持和贡献我们的期刊。祝一切顺利!
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引用次数: 1
Analysis of voiding dysfunction after transobturator tape procedure for stress urinary incontinence 压力性尿失禁经通气带术后排尿功能障碍分析
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.823
Chang Ahn, J. Bae, K. Lee, Hae Won Lee
Purpose The definition of posttransobturator tape procedure (post-TOT) voiding dysfunction (VD) is inconsistent in the literature. In this study, we retrospectively investigated the risk factors for post-TOT VD by applying various definitions in one cohort. Materials and Methods The medical records of 449 patients were evaluated postoperatively. Acute urinary retention requiring catheterization, subjective feeling of voiding difficulty during follow-up, and postoperative postvoid residual (PVR) greater than 100 mL or PVR greater than 50% of voided volume (significant PVR) were adopted for the definition of VD. With these categories, multivariate analysis was performed for risk factors of postoperative VD. Results Ten patients (2.2%) required catheterization, 47 (10.5%) experienced postoperative voiding difficulty, and 63 (14.7%) showed significant PVR. In the multivariate logistic analysis, independent risk factors for postoperative retention requiring catheterization were previous retention history (p=0.06) and preoperative history of hysterectomy. Risk factors for subjective postoperative voiding difficulty were underactive detrusor (p=0.04) and preoperative obstructive voiding symptoms (p<0.01). Previous urinary retention history (p<0.01)) was an independent risk factor for concomitant postoperative voiding difficulty and significant PVR. Spinal anesthesia (p=0.02) and previous urinary retention history (p=0.02) were independent risk factors for significant postoperative PVR. Conclusions With the use of several definitions of VD after the midurethral sling procedure, postoperative peak flow rate and PVR were significantly different between groups. Although there were no independent risk factors consistent with various definitions of VD, preoperative obstructive voiding symptoms and objective parameters suggesting impaired detrusor tend to have predictive power for post-TOT VD.
目的:文献中对经通气后带式手术(post-TOT)的定义不一致。在这项研究中,我们回顾性地研究了在同一队列中应用不同定义的tot后VD的危险因素。材料与方法对449例患者的术后病历进行回顾性分析。采用需要导尿的急性尿潴留、随访时主观感觉排尿困难、术后空后残留(PVR)大于100 mL或PVR大于排尿量的50%(显著性PVR)作为VD的定义。通过这些分类,对术后VD的危险因素进行多因素分析。结果需置管10例(2.2%),术后排尿困难47例(10.5%),明显PVR 63例(14.7%)。在多因素logistic分析中,术后需要留置导管的独立危险因素是既往留置史(p=0.06)和术前子宫切除术史。术后主观排尿困难的危险因素为逼尿肌活动不足(p=0.04)和术前排尿梗阻性症状(p<0.01)。既往尿潴留史(p<0.01)是术后并发排尿困难和显著PVR的独立危险因素。脊髓麻醉(p=0.02)和既往尿潴留史(p=0.02)是术后明显PVR的独立危险因素。结论在不同的VD定义下,两组间尿流峰率和PVR有显著性差异。尽管没有与各种VD定义一致的独立危险因素,但术前排尿障碍症状和提示逼尿肌受损的客观参数往往对tot后VD具有预测作用。
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引用次数: 9
Semen parameters from 2002 to 2013 in Korea young population: A preliminary report 2002 - 2013年韩国年轻人群精液参数初步报告
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.831
S. Kim, Y. Kim, I. Cho, S. Min
Purpose To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013. Materials and Methods A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH. Results A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially. Conclusions There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.
目的分析2002 - 2013年韩国青年人群精液参数的差异。材料与方法从2002年1月- 2003年12月、2007年1月- 2008年12月、2012年1月- 2013年12月三个时期,从韩国男性中采集了516份精液样本,其中包括不孕、精索静脉曲张或其他感染问题。采用世界卫生组织精液分析标准程序,评估精液浓度、体积、活力、形态和ph值。结果2002 - 2003年、2007 - 2008年和2012 - 2013年,共有160、162和194名男性构成研究人群。精子总体参数结果显示,2002 - 2003年和2012 - 2013年除ph值外,其他指标差异均有统计学意义。但考虑到2007 - 2008年的数据,精液总体参数无变化趋势。除ph外,所有患者的精液参数均与年龄呈负相关。此外,从2002年到2013年,精液体积、活力和形态与年龄呈负相关。结论2002 - 2013年韩国男性精液参数无明显变化。此外,2002 - 2013年,精液体积、活力和形态与年龄呈负相关。
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引用次数: 2
The authors reply: Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia 作者回复:代谢综合征对良性前列腺增生药物治疗反应的影响
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.847
A. Kabir, A. Cyrus
To the editor: We express our special thanks for these nice comments on our published paper in your journal [1]. Our study was done before the release of the mentioned new guidelines in 2015 [2]. Moreover, there are studies that have also studied different outcomes (effect) of different durations of these medications on benign prostatic hyperplasia [3,4,5]. We were not able to study the maximal effect for more than 3 months. Because of the lack of previous studies with our design, we preferred to run a study with a shorter duration. In addition, our study was a cohort based on the present data and not a clinical trial with an arbitrary duration of study. Our treatment regimen contained both medications and we did not have a cohort of persons receiving only one of these medications. Perhaps in a factorial clinical trial with different groups consisting of only one of these medications, their combination and placebo could be useful for evaluation of the effect of each regimen. Surely, our results cannot be assumed to refer to only one of these medications but to their combination. In response to the comment, "In addition, the clinical effects of 5ARIs are seen after a minimum treatment duration of at least 6 to 12 months," we should note that in our study, the effects of combination therapy had been observed with a shorter duration. It may be that combination therapy is more effective with a shorter duration and that the effect of combination therapy with both finasteride and prazosin is different from their single treatment effect. Finally, our study was a clinical study and not a basic evaluation of the hormones. Accordingly, we prefer to not discuss these issues, even though the authors' opinions about hormonal pathways and changes seem logical. We think that these issues need a separate study evaluating the effect of all single or combination therapies on biochemical, hormonal, and enzymatic changes.
致编辑:我们特别感谢您在您的期刊上对我们发表的论文的好评[1]。我们的研究是在2015年上述新指南发布之前完成的[2]。此外,也有研究研究了这些药物不同用药时间对前列腺增生的不同结局(效果)[3,4,5]。我们无法研究超过3个月的最大效果。由于缺乏与我们设计相关的既往研究,我们倾向于进行一项持续时间较短的研究。此外,我们的研究是基于现有数据的队列研究,而不是具有任意研究时间的临床试验。我们的治疗方案包含这两种药物,我们没有只接受其中一种药物的人群。也许在仅由这些药物中的一种组成的不同组的析因临床试验中,它们的组合和安慰剂可以用于评估每种方案的效果。当然,我们的研究结果不能只适用于其中一种药物,而是它们的组合。针对“另外,5ARIs的临床效果需要至少6 - 12个月的最短治疗时间才能看到”的评论,我们应该注意到,在我们的研究中,联合治疗的效果是在更短的时间内观察到的。可能是联合治疗更有效,持续时间更短,非那雄胺和普唑嗪联合治疗的效果不同于它们单独治疗的效果。最后,我们的研究是临床研究,而不是对激素的基本评估。因此,我们宁愿不讨论这些问题,即使作者关于激素途径和变化的观点似乎合乎逻辑。我们认为这些问题需要一项单独的研究来评估所有单一或联合治疗对生化、激素和酶变化的影响。
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引用次数: 1
Letter to the editor: Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia 致编辑的信:代谢综合征对良性前列腺增生药物治疗反应的影响
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.845
M. Kadıhasanoğlu, E. Ozbek
therapy with an α-blocker and 5α-reductase inhibitor (5ARI) after a 3-month period of therapy. Although the mean prostate volume of the patients with MetS was significantly higher than that that of the controls, significant differences in the International Prostate Symptom Score and its components were shown between patients with and without MetS. The authors suggested with this finding that MetS negatively affected the clinical response of BPH to medical treatment. Hyperinsulinemia in patients with BPH might have increased sympathetic nervous system activity, which contributes to an increase of prostate smooth muscle tone [2]. Selective α1-blockers reduce urethral closure resistance and inhibit smooth muscle tone in the prostate and are the firstline medical treatment option for men with BPH. 5ARIs block the conversion of testosterone to dihydrotestosterone and are approved for the treatment of BPH. The duration of treatment with finasteride in the study was 3 months. In the European Association of Urology Guidelines, which include benign prostatic obstruction, it
治疗3个月后给予α-阻滞剂和5α-还原酶抑制剂(5ARI)治疗。虽然met患者的平均前列腺体积明显高于对照组,但国际前列腺症状评分及其组成在有无met患者之间存在显著差异。作者认为,这一发现对BPH对药物治疗的临床反应有负面影响。BPH患者的高胰岛素血症可能使交感神经系统活动增加,从而导致前列腺平滑肌张力增加[2]。选择性α1受体阻滞剂可降低尿道关闭阻力,抑制前列腺平滑肌张力,是前列腺增生男性的一线药物治疗选择。5ARIs阻断睾酮向二氢睾酮的转化,被批准用于治疗前列腺增生。非那雄胺治疗的持续时间为3个月。在欧洲泌尿外科协会指南中,包括良性前列腺阻塞,它
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引用次数: 1
Simultaneous treatment of anterior vaginal wall prolapse and stress urinary incontinence by using transobturator four arms polypropylene mesh 经通气四臂聚丙烯网片同时治疗阴道前壁脱垂和压力性尿失禁
Pub Date : 2015-12-01 DOI: 10.4111/kju.2015.56.12.811
F. Sharifiaghdas, A. Daneshpajooh, M. Mirzaei
Purpose To evaluate the medium-term efficacy and safety of transobturator four-arm polypropylene mesh in the treatment of high-stage anterior vaginal wall prolapse and concomitant stress urinary incontinence (SUI). Materials and Methods Between September 2010 and August 2013, a prospective single-center trial was performed to evaluate women with stage≥3 anterior vaginal wall prolapse with or without SUI who presented to Labbafinejad Hospital, Teheran, Iran, and underwent anterior vaginal wall repair with polypropylene mesh. Pre- and postoperative evaluation included history; physical examination using the Pelvic Organ Prolapse Quantification system and cough stress test, both before and after reduction of prolapsed structures; Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ); urinalysis and culture; and a postvoid residual assessment. Complications were reported at a mean of 2 years of follow-up. Results A total of 71 patients underwent cystocele repair with the transobturator four-arm polypropylene mesh. Seven of the patients were lost to follow-up. There were no perioperative complications. The anatomical success rate was 87.5%. The subjective success rate was 92.1%. The PFDI and PFIQ were significantly improved after surgery (p<0.001). Among those with the simultaneous complaint of SUI, 82% were cured without any additional procedure. Three patients (4.6%) experienced vaginal mesh extrusion. Two patients (3.1%) reported worsening of dyspareunia after surgery. Conclusions The four arms polypropylene mesh is an effective device for simultaneous correction of anterior vaginal wall prolapse and SUI with a low complication rate at a medium-term follow-up. The majority of the subgroup with concomitant SUI were cured without a second simultaneous procedure.
目的评价经通气四臂聚丙烯网片治疗高位阴道前壁脱垂合并应激性尿失禁(SUI)的中期疗效和安全性。材料和方法2010年9月至2013年8月,一项前瞻性单中心试验评估了在伊朗德黑兰Labbafinejad医院接受聚丙烯补片阴道前壁修复的伴有或不伴有SUI的≥3期阴道前壁脱垂的妇女。术前和术后评估包括病史;使用盆腔器官脱垂量化系统和咳嗽压力测试进行脱垂结构复位前后的体格检查;盆底痛苦量表(PFDI)和盆底影响问卷(PFIQ);尿液分析和培养;还有一个失效后的剩余评估。在平均2年的随访中报告了并发症。结果71例患者采用经通气四臂聚丙烯网片进行了胆囊膨出修复。其中7例患者未能随访。无围手术期并发症。解剖成功率为87.5%。主观成功率为92.1%。术后PFDI和PFIQ明显改善(p<0.001)。在同时主诉SUI的患者中,82%的患者在没有任何额外手术的情况下治愈。3例(4.6%)患者出现阴道补片挤压。2例患者(3.1%)报告术后性交困难加重。结论四臂聚丙烯补片是同时矫正阴道前壁脱垂和SUI的有效器械,中期随访并发症发生率低。大多数合并SUI的亚组不需第二次同时手术即可治愈。
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引用次数: 15
Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy 高级别前列腺上皮内瘤变的多个核心和首次活检时的任何非典型性核心是重复活检时癌症检测的重要预测因子
Pub Date : 2015-11-26 DOI: 10.4111/kju.2015.56.12.796
Tae Sun Kim, K. Ko, S. Shin, H. Ryoo, W. Song, H. Sung, D. Han, B. Jeong, S. Seo, S. Jeon, Kyu-Sung Lee, S. W. Lee, H. Lee, H. Choi, H. Jeon
Purpose To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy. Materials and Methods We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). We compared the cancer detection rate and Gleason scores on second biopsy and the unfavorable disease rate after radical prostatectomy among the three groups. Results A total of 214 patients (16.2%) were diagnosed with prostate cancer on a second biopsy. The rate of cancer detection was 14.6% in the benign diagnosis group, 22.1% in the HGPIN group, and 32.1% in the ASAP group, respectively (p<0.001). When patients were divided into subgroups according to the number of positive cores, the rate of cancer detection was 16.7%, 30.5%, 31.0%, and 36.4% in patients with a single core of HGPIN, more than one core of HGPIN, a single core of ASAP, and more than one core of ASAP, respectively. There were no significant differences in Gleason scores on second biopsy (p=0.324) or in the unfavorable disease rate after radical prostatectomy among the three groups (benign diagnosis vs. HGPIN, p=0.857, and benign diagnosis vs. ASAP, p=0.957, respectively). Conclusions Patients with multiple cores of HGPIN or any core number of ASAP on a first biopsy had a significantly higher cancer detection rate on a second biopsy. Repeat biopsy should be considered and not be delayed in those patients.
目的探讨第二次前列腺活检诊断为良性、高级别前列腺上皮内瘤变(HGPIN)和非典型小腺泡增生(ASAP)的肿瘤检出率和病理表现的差异。材料和方法我们回顾性回顾了1995年3月至2012年11月期间接受第二次前列腺活检的1323例患者的记录。根据首次活检病理结果(良性诊断、HGPIN、ASAP)将患者分为三组。比较三组患者的肿瘤检出率、第二次活检Gleason评分及根治性前列腺切除术后的不良发病率。结果214例患者(16.2%)在第二次活检中被诊断为前列腺癌。良性诊断组的肿瘤检出率为14.6%,HGPIN组为22.1%,ASAP组为32.1% (p<0.001)。按阳性核数分组时,HGPIN单核、HGPIN多核、ASAP单核、ASAP多核患者的癌症检出率分别为16.7%、30.5%、31.0%、36.4%。三组患者第二次活检Gleason评分(p=0.324)和根治性前列腺切除术后的不良发病率(良性诊断vs. HGPIN, p=0.857,良性诊断vs. ASAP, p=0.957)差异均无统计学意义。结论HGPIN多核或任何核数的患者在第一次活检时的癌症检出率明显高于第二次活检。这些患者应考虑重复活检,而不是延迟。
{"title":"Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy","authors":"Tae Sun Kim, K. Ko, S. Shin, H. Ryoo, W. Song, H. Sung, D. Han, B. Jeong, S. Seo, S. Jeon, Kyu-Sung Lee, S. W. Lee, H. Lee, H. Choi, H. Jeon","doi":"10.4111/kju.2015.56.12.796","DOIUrl":"https://doi.org/10.4111/kju.2015.56.12.796","url":null,"abstract":"Purpose To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy. Materials and Methods We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). We compared the cancer detection rate and Gleason scores on second biopsy and the unfavorable disease rate after radical prostatectomy among the three groups. Results A total of 214 patients (16.2%) were diagnosed with prostate cancer on a second biopsy. The rate of cancer detection was 14.6% in the benign diagnosis group, 22.1% in the HGPIN group, and 32.1% in the ASAP group, respectively (p<0.001). When patients were divided into subgroups according to the number of positive cores, the rate of cancer detection was 16.7%, 30.5%, 31.0%, and 36.4% in patients with a single core of HGPIN, more than one core of HGPIN, a single core of ASAP, and more than one core of ASAP, respectively. There were no significant differences in Gleason scores on second biopsy (p=0.324) or in the unfavorable disease rate after radical prostatectomy among the three groups (benign diagnosis vs. HGPIN, p=0.857, and benign diagnosis vs. ASAP, p=0.957, respectively). Conclusions Patients with multiple cores of HGPIN or any core number of ASAP on a first biopsy had a significantly higher cancer detection rate on a second biopsy. Repeat biopsy should be considered and not be delayed in those patients.","PeriodicalId":17819,"journal":{"name":"Korean Journal of Urology","volume":"1 1","pages":"796 - 802"},"PeriodicalIF":0.0,"publicationDate":"2015-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80152617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 16
Urodynamic assessment of bladder and urethral function among men with lower urinary tract symptoms after radical prostatectomy: A comparison between men with and without urinary incontinence 根治性前列腺切除术后出现下尿路症状的男性膀胱和尿道功能的尿动力学评估:有尿失禁和没有尿失禁的男性的比较
Pub Date : 2015-11-26 DOI: 10.4111/kju.2015.56.12.803
Hansol Lee, Ki Bom Kim, Sangchul Lee, Sang Wook Lee, Myong Kim, S. Cho, Seung-June Oh, S. Jeong
Purpose We compared bladder and urethral functions following radical prostatectomy (RP) between men with and without urinary incontinence (UI), using a large-scale database from SNU-experts-of-urodynamics-leading (SEOUL) Study Group. Materials and Methods Since July 2004, we have prospectively collected data on urodynamics from 303 patients with lower urinary tract symptoms (LUTS) following RP at three affiliated hospitals of SEOUL Study Group. After excluding 35 patients with neurogenic abnormality, pelvic irradiation after surgery, or a history of surgery on the lower urinary tract, 268 men were evaluated. We compared the urodynamic findings between men who had LUTS with UI (postprostatectomy incontinence [PPI] group) and those who had LUTS without UI (non-PPI group). Results The mean age at an urodynamic study was 68.2 years. Overall, a reduced bladder compliance (≤20 mL/cmH2O) was shown in 27.2% of patients; and 31.3% patients had idiopathic detrusor overactivity. The patients in the PPI group were older (p=0.001) at an urodynamic study and had a lower maximum urethral closure pressure (MUCP) (p<0.001), as compared with those in the non-PPI group. Bladder capacity and detrusor pressure during voiding were also significantly lower in the PPI group. In the logistic regression, only MUCP and maximum cystometric capacity were identified as the related factor with the presence of PPI. Conclusions In our study, significant number of patients with LUTS following RP showed a reduced bladder compliance and detrusor overactivity. PPI is associated with both impairment of the urethral closuring mechanism and bladder storage dysfunction.
目的:我们使用首尔大学泌尿动力学专家研究组的大型数据库,比较了有和没有尿失禁(UI)的男性在根治性前列腺切除术(RP)后的膀胱和尿道功能。材料和方法自2004年7月以来,我们前瞻性地收集了来自首尔研究组三家附属医院的303例RP后下尿路症状(LUTS)患者的尿动力学数据。在排除35例神经源性异常、术后盆腔照射或下尿路手术史的患者后,对268名男性进行了评估。我们比较了伴有尿失禁的LUTS(前列腺切除术后尿失禁[PPI]组)和没有尿失禁的LUTS(非PPI组)的尿动力学结果。结果尿动力学研究的平均年龄为68.2岁。总体而言,27.2%的患者膀胱顺应性降低(≤20 mL/cmH2O);31.3%的患者有特发性逼尿肌过度活动。尿动力学研究显示,与非PPI组相比,PPI组患者年龄更大(p=0.001),最大尿道闭合压力(MUCP)更低(p<0.001)。PPI组排尿时膀胱容量和逼尿肌压力也明显降低。在logistic回归中,只有MUCP和最大膀胱容量被确定为与PPI存在相关的因素。结论:在我们的研究中,大量RP后LUTS患者表现出膀胱顺应性降低和逼尿肌过度活动。PPI与尿道关闭机制的损害和膀胱储存功能障碍有关。
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引用次数: 19
Characteristics of urinary retention in female inpatients managed with medical treatments 内科治疗女性住院患者尿潴留的特点
Pub Date : 2015-11-26 DOI: 10.4111/kju.2015.56.12.817
Chang-Yong Lee, C. Kim, W. J. Cho
Purpose We aimed to analyze the characteristics of urinary retention (UR) in female inpatients managed with medical treatments. Materials and Methods We retrospectively analyzed the medical records of female inpatients referred to the department of urology for UR at our institution from January 2009, to December 2014. UR was defined as a difficulty in self-voiding despite a sufficient urine volume or >300-mL postvoid residual. The data included patients' age, body mass index (BMI), ambulatory status, medical and surgical history, classes of taking drugs, and urinary tract infection. Results A total of 182 women were included as retention group, mean age of 72.64±12.94 years and BMI of 22.94±3.10 kg/m2. In the chi-square analysis, cardiovascular disorders (p=0.000), diabetes mellitus (p=0.008), metastatic malignancy (p=0.008), chronic renal disorders (p=0.028) were found significantly. In the multiple logistic regression analysis, cardiovascular disorders (p=0.002; odds ratio [OR], 0.491), metastatic malignancy (p=0.013; OR, 2.616) were found to increase the risk of UR. The most common surgical history was anti-incontinence surgery (7.2%). In term of medication use, the most prescribed agents were nonsteroidal anti-inflammatory drugs (NSAIDs) (53.8%). The patients taking multiple drugs with antimuscarinic effects except of NSAIDs, narcotics and diuretics were 48 (26.4%). Urinary tract infection was identified in 43 patients (23.6%). Conclusions UR in females managed with medical treatments could be occurred occasionally. We think that thorough attentions are needed for UR to patients with cardiovascular disorders including diabetes mellitus, metastatic malignancy, chronic renal disorders urinary tract infection, and more careful interests when managing with drugs with antimuscarinic effects.
目的分析内科住院女性患者尿潴留(UR)的特点。材料与方法回顾性分析我院2009年1月至2014年12月泌尿外科收治的泌尿外科住院女性患者的病历。尿潴留被定义为尽管尿量充足或排尿后残余量>300毫升,但仍存在排尿困难。这些数据包括患者的年龄、身体质量指数(BMI)、门诊状态、病史和手术史、用药类别和尿路感染。结果留置组182例,平均年龄72.64±12.94岁,BMI 22.94±3.10 kg/m2。在卡方分析中,心血管疾病(p=0.000)、糖尿病(p=0.008)、转移性恶性肿瘤(p=0.008)、慢性肾脏疾病(p=0.028)有显著性差异。在多元logistic回归分析中,心血管疾病(p=0.002;优势比[OR], 0.491),转移性恶性肿瘤(p=0.013;OR为2.616)会增加尿路风险。最常见的手术史是防尿失禁手术(7.2%)。用药方面,处方用药最多的是非甾体类抗炎药(NSAIDs)(53.8%)。除非甾体抗炎药、麻醉药、利尿剂外,同时使用多种抗毒药物的患者48例(26.4%)。尿路感染43例(23.6%)。结论经药物治疗的女性尿路时有发生。我们认为,对于合并心血管疾病(包括糖尿病、转移性恶性肿瘤、慢性肾脏疾病、尿路感染)的患者,需要给予充分的关注,并且在使用具有抗毒蕈碱作用的药物时需要更加谨慎。
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引用次数: 4
期刊
Korean Journal of Urology
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