Research and Reports in Urology最新文献

Objective: To evaluate the clinical characteristics and treatment outcomes of ureteroscopic lithotripsy (URSL) in patients with ureteral duplication and urinary stones.

Methods: This retrospective study analyzed 18 patients with ureteral duplication and urolithiasis who underwent URSL between January 2020 and December 2024. A control group of 200 patients with normal urinary anatomy who underwent URSL during the same period was randomly selected. Demographic data, clinical features, stone size and location, comorbidities, and surgical outcomes (operative time, postoperative hospital stay, and complications) were collected and compared between groups.

Results: No significant differences were found in age, gender, or BMI between the two groups. The ureteral duplication group had a higher proportion of patients with a history of urinary stones. Stone location differed significantly, with fewer right-sided ureteral stones in the duplication group. Despite anatomical challenges, there were no significant differences in operative time, hospital stay, or complication rates between the groups.

Conclusion: URSL is a safe and effective treatment for patients with ureteral duplication and urinary stones. Surgical outcomes are comparable to those in patients with normal urinary anatomy. Further research with larger sample sizes and long-term follow-up is needed to optimize diagnostic and therapeutic strategies.

Background: Apatinib mesylate, a VEGFR2 tyrosine kinase inhibitor, is approved for advanced liver, esophageal, gastric and other malignant tumors, but its adverse effects require attention. We report a 79-year-old male with prostatic adenocarcinoma who developed superior mesenteric artery dissecting aneurysm after combined apatinib and chemotherapy. Apatinib, an anti-angiogenic agent, synergizes with chemotherapy. After informed consent, the combination regimen was initiated. Two cycles later, the patient had tolerable intermittent abdominal pain, and CT confirmed the aneurysm. Due to progressive tumor and poor physical status, no further treatment was given as the aneurysm did not affect the disease course. This case report aims to provide insights into the safe application of apatinib in clinical practice.

Materials and methods: The materials for the literature review were gathered through a comprehensive search conducted on PubMed. Which yielded VEGFR2 treated for prostate cancer.

Case report: In this case report, a 79-year-old male with a height of 172 cms and a weight of 67 kgs who had been diagnosed with prostate adenocarcinoma for over three years. MRI scan indicated that bone metastases increased and enlarged compared with prior test. No significant abnormalities were observed in both physical and blood examinations. The pelvic MRI scan showed a prostatectomy changes, multiple abnormal signals in the bilateral ilium, acetabulum, femur, ischiatic bone, pubis, sacral vertebrae, and part of the lumbar vertebrae.

Conclusion: Antiangiogenic agents are being increasingly utilized in clinical practice. As clinicians, it is imperative to remain vigilant against potential complications such as arterial dissection and aneurysm, while conducting meticulous evaluations of associated risks. Notably, this article serves solely as a reference and does not advocate for the adjustment of treatment protocols on this basis.

Background: Renal autotransplantation is a rare yet effective surgical strategy for managing complex ureteral injuries when conventional reconstructive options are not viable. We report an exceptional case of complete ureteral avulsion following a dilation and curettage (D&C) procedure, successfully treated with renal autotransplantation. This represents the first documented case of renal autotransplantation in Yemen, highlighting a successful organ-preserving approach in a resource-limited setting.

Case presentation: A 34-year-old female developed life-threatening complications following a D&C performed for retained products of conception. The procedure was complicated by uterine perforation and a complete avulsion of the left ureter, which was identified intraoperatively during emergent laparotomy. Initial management included pyelostomy, which failed, necessitating nephrostomy. Because to the absence of a viable ureteral stump, renal autotransplantation was performed. The kidney was reimplanted into the right iliac fossa, and urinary continuity was restored via a Boari flap. The patient had an uneventful postoperative course and demonstrated preserved renal function at two-month follow-up.

Conclusion: Complete ureteral avulsion is an exceedingly rare complication of D&C, often linked with uterine perforation. In cases where standard ureteral reconstruction is not feasible, renal autotransplantation provides a definitive, nephron-sparing solution. Early identification and referral to experienced centers are essential to optimizing outcomes.

Background: Acute scrotal pain is a urological emergency. Testicular torsion (TT) is a surgical emergency that compromises rapidly testicular viability. There is approximately a 4- to 8-hour window from the onset of torsion symptoms until surgical intervention is required to save the affected testis. Delays in care may necessitate orchiectomy, which has been associated with reduced fertility. It can occur at any age, with two peaks of frequency: during the first years of life and at puberty. The causes of testicular torsion are multiple and are related to a defect in the fixation system of the testicle.

Case presentation: Here we report an unusual situation of testicular torsion induced by a large epididymal cyst in a young adult. The cyst was excised as well as bilateral testicular fixation and the patient was discharged on the third day. Clinical examinations and Doppler ultrasound at the sixth and twelfth postoperative weeks were both normal.

Conclusion: This observation leads us to consider epididymal cysts as a risk factor for TT.

Purpose: Bladder cancer is one of the ten most common cancers in the world, with a high incidence rate and mortality, and therefore a major burden on the global health care system. PID1 (Phosphotyrosine Interaction Domain 1) functions as an intracellular receptor protein for LRP1. The purpose of this study was to explore the role of PID1 in bladder cancer.

Methods: RNA-seq data analysis was conducted on 404 BLCA specimens and 28 normal specimens to identify differentially expressed genes. The findings indicated a strong correlation between PID1 expression levels and bladder cancer. We constructed a bladder cancer cell line stably overexpressing PID1 and assessed its impact on cell proliferation and migration. Additionally, We used RT-112 cells to induce tumor formation in nude mice to study the function of the PID1 gene in vivo.

Results: PID1 expression was notably low in bladder cancer tissues. Compared to SV-HUC-1, RT-112, and SCaBER bladder cells exhibited significantly reduced PID1 expression. Overexpressing PID1 in cells led to the promotion of apoptosis in bladder cancer cells and suppressed cell proliferation and metastasis. In vivo, the overexpression of PID1 demonstrated a significant inhibitory effect on bladder cancer. Furthermore, it was capable of activating the AMPK-mTOR signaling pathway, thereby inhibiting tumor progression.

Conclusion: PID1 exhibits a potent inhibitory effect on bladder cancer and activates the AMPK-mTOR signaling pathway to hinder tumor growth.

[This corrects the article DOI: 10.2147/RRU.S271425.].

Background: Testicular cancer is a relatively rare malignancy, accounting for 1% of solid tumors in adult males and 5% of all urological tumors. Orchidopexy has been shown to lower the risk of testicular cancer, but it does not prevent it.

Case presentation: A 20-year-old adult male presented with a painful and palpable mass in his right testicle. The patient had orchidopexy at six months old but had been asymptomatic until his recent hospital visit. There was no previous history of cancer. Tumor markers including AFP and β-HCG were found to be elevated. Preoperative ultrasonograghy (USG) showed a solid and cystic mass of the right testis with increased vascularization. Following these findings, the patient underwent an orchidectomy. Histopathology examination revealed mixed type NSGCT of embryonal and choriocarcinoma. However, after completing four cycles of chemotherapy, a CT scan evaluation showed an enlarged mass in the abdomen, which was confirmed to be a mature teratoma.

Conclusion: In patients with a history of cryptorchidism, orchidopexy does not rule out the possibility of testicular cancer. Orchidopexy did reduce the risk of seminoma, but not nonseminomatous germ cell tumor, which in our case continued to develop a growing teratoma on the abdomen. It is essential to conduct long-term monitoring of patients who have undergone orchiopexy due to their risk of developing testicular cancer.

Prostate cancer (PCa) is a major global health concern. It ranks as the fifth leading cause of cancer-related mortality worldwide. While localized PCa is often indolent, with a nearly 100% five-year survival rate, prognosis worsens significantly in metastatic disease, where survival drops to approximately 30%. Androgen deprivation therapy (ADT) is initially effective in suppressing tumor growth. However, resistance eventually develops, resulting in castration-resistant prostate cancer (CRPC). The androgen receptor (AR) plays a central role in both PCa progression and treatment resistance. It promotes tumor growth by mediating the effects of testosterone and 5α-dihydrotestosterone (DHT). Several mechanisms contribute to resistance. These include AR gene mutations that reduce ligand specificity or convert antagonists into agonists. AR overexpression can maintain activity even at low androgen levels. Splice variants such as AR-V7 can activate AR signaling despite androgen depletion. AR transcriptional activity is also modulated by coregulators. Coactivators (such as the SRC family) and corepressors (such as NCOR1/2) contribute to the persistence of AR signaling. Beyond AR-dependent mechanisms, CRPC may develop through AR-independent pathways. These include glucocorticoid receptor (GR) bypass signaling and lineage plasticity leading to neuroendocrine prostate cancer (NEPC). In addition, intratumoral steroidogenesis sustains AR activation despite systemic suppression of androgens. Together, these resistance mechanisms underscore the biological complexity of CRPC. They also highlight the urgent need for innovative therapeutic approaches. This manuscript reviews emerging molecular targets and resistance pathways to inform the development of next-generation treatments.

Localized prostate cancer (PCa) remains the most common noncutaneous cancer in men, with numerous management options tailored to individual patient needs. This review examines the role of patient-reported outcomes (PROs) in guiding the management of localized PCa, focusing on the impact of various treatments on long-term quality of life. Standard therapies, including radical prostatectomy, radiotherapy, and active surveillance, are discussed alongside emerging focal therapies. Each treatment modality presents distinct risks, notably urinary incontinence, erectile dysfunction, bowel issues, and cancer recurrence. Understanding these adverse effects in terms of PROs is critical for patients and healthcare providers to engage in shared decision-making, enabling personalized treatment plans based on clinical outcomes and patient values. The incorporation of PROs into treatment selection emphasizes the significance of balancing oncologic control with functional outcomes, such as sexual, bowel, and urinary health. The importance of patient counseling is underscored, ensuring patients are fully informed about potential complications and long-term implications. This review advocates for personalized, evidence-based management strategies that align therapeutic decisions with individual patient preferences, optimizing both survival and quality of life. Enhanced communication between patients and clinicians, informed by PROs, is critical for minimizing decisional regret and maximizing satisfaction in the management of localized PCa.

Introduction: We aimed to assess the role of major perioperative risk factors (age, preoperative PSA values, body mass index, pathologic T-stage, resection status, and ISUP grade) in predicting biochemical recurrence (BCR) and survival after radical prostatectomy (RP) for prostate cancer (PC).

Methods: An analysis of the prospective cohort of patients undergoing RP from 2013 to 2023 at our center was performed. Patients who received neoadjuvant or adjuvant therapies for PC or those with PSA persistence after RP were excluded. A Cox regression analysis was undertaken to evaluate the effect of major perioperative risk factors on the time to BCR. The role of the EAU BCR risk stratification on survival was also assessed. For all analyses, hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) were estimated.

Results: A total of 1539 patients underwent RP for localized PC. At a median follow-up of 39 months (IQR: 25-60) from RP, 393 (26%) patients developed BCR. Of them, 266 (68%) were classified as EAU BCR high risk and 127 (32%) as EAU BCR low risk. In the multivariate Cox regression analysis, locally advanced PC (HR: 1.5, 95% CI: 1.2-1.9, p<0.001), positive surgical margins (HR: 1.4, 95% CI: 1.1-1.7, p=0.01), as well as ISUP grade 3 (HR: 2.4, 95% CI: 1.5-3.6, p<0.001) and 4 (HR: 2.4, 95% CI: 1.5-3.7, p<0.001) were associated with worse time to BCR. Overall, 16 (1%) patients died. Of them, 13 (81%) were classified as EAU BCR high risk and 3 (19%) as EAU BCR low risk (p<0.001). In the univariate Cox regression analysis, patients with EAU BCR high risk presented worse overall survival (HR: 4.9, 95% CI: 1.4-17, p=0.014).

Conclusion: Locally advanced PC, positive surgical margins, and worse ISUP grade are independent risk factors for BCR. Accordingly, patients at BCR high-risk based on the EAU risk stratification present worse overall survival.