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The Role of Artificial Intelligence in Patient Education: A Bladder Cancer Consultation with ChatGPT 人工智能在患者教育中的作用:使用 ChatGPT 进行膀胱癌咨询
Pub Date : 2024-06-14 DOI: 10.3390/siuj5030032
Allen Ao Guo, Basil Razi, Paul Kim, Ashan Canagasingham, Justin Vass, Venu Chalasani, Krishan Rasiah, Amanda Chung
Objectives: ChatGPT is a large language model that is able to generate human-like text. The aim of this study was to evaluate ChatGPT as a potential supplement to urological clinical practice by exploring its capacity, efficacy and accuracy when delivering information on frequently asked questions from patients with bladder cancer. Methods: We proposed 10 hypothetical questions to ChatGPT to simulate a doctor–patient consultation for patients recently diagnosed with bladder cancer. The responses were then assessed using two predefined scales of accuracy and completeness by Specialist Urologists. Results: ChatGPT provided coherent answers that were concise and easily comprehensible. Overall, mean accuracy scores for the 10 questions ranged from 3.7 to 6.0, with a median of 5.0. Mean completeness scores ranged from 1.3 to 2.3, with a median of 1.8. ChatGPT was also cognizant of its own limitations and recommended all patients should adhere closely to medical advice dispensed by their healthcare provider. Conclusions: This study provides further insight into the role of ChatGPT as an adjunct consultation tool for answering frequently asked questions from patients with bladder cancer diagnosis. Whilst it was able to provide information in a concise and coherent manner, there were concerns regarding the completeness of information conveyed. Further development and research into this rapidly evolving tool are required to ascertain the potential impacts of AI models such as ChatGPT in urology and the broader healthcare landscape.
目标ChatGPT 是一种大型语言模型,能够生成类人文本。本研究的目的是评估 ChatGPT 作为泌尿科临床实践潜在补充的能力,探索其在提供膀胱癌患者常见问题信息时的能力、功效和准确性。方法:我们向 ChatGPT 提出了 10 个假设性问题,以模拟医生与最近被诊断为膀胱癌的患者之间的问诊。然后由泌尿科专家使用两个预定义的准确性和完整性量表对回复进行评估。结果:ChatGPT 提供了简明易懂的连贯答案。总体而言,10 个问题的平均准确性得分在 3.7 到 6.0 之间,中位数为 5.0。完整度的平均分在 1.3 到 2.3 之间,中位数为 1.8。ChatGPT 也认识到自身的局限性,建议所有患者应严格遵守医疗保健提供者的医疗建议。结论本研究进一步揭示了 ChatGPT 作为辅助咨询工具在回答膀胱癌患者常见问题方面的作用。虽然它能以简洁连贯的方式提供信息,但所传达信息的完整性仍令人担忧。要确定 ChatGPT 等人工智能模型对泌尿外科和更广泛的医疗保健领域的潜在影响,还需要对这一快速发展的工具进行进一步的开发和研究。
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引用次数: 0
Perioperative Blood Transfusion Is Associated with Worse Survival in Patients Undergoing Radical Cystectomy after Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer 肌肉浸润性膀胱癌新辅助化疗后接受根治性膀胱切除术的患者围手术期输血与较差的存活率有关
Pub Date : 2024-06-14 DOI: 10.3390/siuj5030031
Tessa Ladner, Anna J. Black, Homayoun Zargar, Jonathan L. Wright, Andrew C. Thorpe, Todd M. Morgan, Jeffrey M. Holzbeierlein, M. S. Cookson, N. Jacobsen, A. Fairey, C. Dinney, M. Carmen Mir, Laura-Maria Krabbe, Jeffrey S. Montgomery, N. Vasdev, Evan Y. Yu, E. Xylinas, Andrew Stephenson, Jay B. Shah, S. Daneshmand, K. Zargar-Shoshtari, Philippe E. Spiess, Laura S. Mertens, B. V. van Rhijn, P. Grivas, W. Kassouf, M. Dall’Era, S. Sridhar, John S. McGrath, J. Aning, S. Shariat, T. Bivalacqua, Scott North, D. Barocas, Y. Lotan, Peter C. Black
Objectives: Perioperative blood transfusion (PBT) has been associated with worse survival after radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC). Here, we evaluated the association between PBT and survival after RC that was preceded by neoadjuvant chemotherapy (NAC). Methods: A retrospective analysis was performed on 949 patients with cT2-4aN0M0 bladder cancer who received NAC prior to RC between 2000 and 2013 at 19 centers. Kaplan–Meier estimates of overall survival (OS) were made. Presumed risk factors for OS were analyzed using Cox regression analysis. PBT was defined by the administration of any packed red blood cells during surgery or during the post-operative hospital stay. Results: A transfusion was given to 608 patients (64%). Transfused patients were more likely to have adverse clinical and pathologic parameters, including clinical stage and performance status. Transfused patients had worse OS (p = 0.01). On multivariable Cox regression, PBT was found to be independently associated with worse OS (HR 1.53 (95% CI 1.13–2.08), p = 0.007). Conclusions: PBT is common after NAC and RC, which may be linked, in part, to the anemia induced by NAC. PBT was associated with several adverse risk factors that correlate with poor outcomes after NAC and RC, and it was an independent predictor of adverse OS on multivariable analysis. Further study should determine if measures to avoid blood loss can reduce the need for PBT and thereby improve patient outcomes.
目的:围手术期输血(PBT)与肌浸润性膀胱癌(MIBC)患者根治性膀胱切除术(RC)后生存率下降有关。在此,我们评估了新辅助化疗(NAC)前根治性膀胱切除术后输血与生存率之间的关系。方法我们对 2000 年至 2013 年间在 19 个中心接受新辅助化疗的 949 例 cT2-4aN0M0 膀胱癌患者进行了回顾性分析。对总生存期(OS)进行了卡普兰-梅耶估计。采用 Cox 回归分析法对 OS 的假定风险因素进行了分析。PBT的定义是在手术期间或术后住院期间使用任何包装红细胞。结果:608名患者(64%)接受了输血。输血患者更有可能出现不良的临床和病理参数,包括临床分期和表现状态。输血患者的 OS 较差(P = 0.01)。多变量 Cox 回归发现,PBT 与较差的 OS 独立相关(HR 1.53(95% CI 1.13-2.08),P = 0.007)。结论PBT在NAC和RC后很常见,这可能部分与NAC引起的贫血有关。PBT 与几个与 NAC 和 RC 后不良预后相关的不良风险因素有关,并且是多变量分析中不良 OS 的独立预测因素。进一步的研究应确定避免失血的措施是否能减少对 PBT 的需求,从而改善患者的预后。
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引用次数: 0
RE: Prevalence of MRI Lesions in Men Responding to a GP-Led Invitation for a Prostate Health Check: A Prospective Cohort Study RE:响应全科医生前列腺健康检查邀请的男性 MRI 病变患病率:前瞻性队列研究
Pub Date : 2024-06-10 DOI: 10.3390/siuj5030030
Alice Thomson, Haidar Al Saffar, Marlon L Perera, Declan G. Murphy
Controversy surrounds population-based screening for prostate cancer, which has typically relied on PSA level for risk stratification. This commentary examines the recent prospective trial examining the use of biphasic prostate MRI scans as a screening tool for prostate cancer. Using a reliable test, such as MRI prostate, at an earlier point along the diagnostic pathway, the authors provide a novel solution to a difficult problem. Further research is warranted to assess how biphasic MRI might be feasible at a population level.
基于人群的前列腺癌筛查一直存在争议,因为这种筛查通常依赖于 PSA 水平来进行风险分层。这篇评论探讨了最近进行的一项前瞻性试验,该试验将双相前列腺核磁共振成像扫描用作前列腺癌筛查工具。作者在诊断路径的早期阶段使用前列腺核磁共振成像等可靠的检测方法,为这一难题提供了新颖的解决方案。我们有必要开展进一步研究,以评估双相核磁共振成像在人群中的可行性。
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引用次数: 0
A Quality and Completeness Assessment of Testicular Cancer Health Information on TikTok 嘀嗒网上睾丸癌健康信息的质量和完整性评估
Pub Date : 2024-06-05 DOI: 10.3390/siuj5030028
Hoi Pong Nicholas Wong, Lee Jing Yang, Vikneshwaren SO Senthamil Selvan, Jamie Yong Qi Lim, W. Z. So, V. Gauhar, Ho Yee Tiong
TikTok has become a hub for easily accessible medical information. However, the quality and completeness of this information for testicular cancer has not been examined. Our study aims to assess the quality and completeness of testicular cancer information on TikTok. A search was performed on TikTok using the search terms “Testicular Cancer” and “Testicle Cancer”. Inclusion criteria encompassed videos about testicular cancer in English. We excluded non-English videos, irrelevant videos, and videos without audio. We evaluated these videos using the DISCERN instrument and a completeness assessment. A total of 361 videos were considered for screening and 116 videos were included. Of these, 57 were created by healthcare professionals (HCPs). The median video length was 40 s (5–277 s), with >25 million cumulative views and a median of 446,400 views per video. The average DISCERN score was 29.0 ± 5.7, with HCPs providing higher-quality videos than non-HCPs (30.8 vs. 5.5, p < 0.05). HCPs also had more reliable videos (21.2 vs. 18.1, p < 0.05). Overall quality levels were mostly poor or very poor (97.4%), with none being good or excellent. Most HCP videos were poor (63.2%), whilst many non-HCP videos were very poor (61.0%). The most viewed video had 2,800,000 views but scored a 31 on the DISCERN tool and one on the completeness assessment. The highest DISCERN score had 11,700 views. HCP videos better defined the disease and were more complete (p < 0.05). Most videos discussed self-assessment but were lacking in definitions, risk factors, symptoms, evaluation, management, and outcomes. Most of TikTok’s testicular cancer information lacks quality and completeness, whilst higher-quality videos have limited reach.
TikTok 已成为轻松获取医疗信息的枢纽。然而,这些睾丸癌信息的质量和完整性尚未得到研究。我们的研究旨在评估 TikTok 上睾丸癌信息的质量和完整性。我们使用 "睾丸癌 "和 "睾丸癌 "这两个搜索词在 TikTok 上进行了搜索。纳入标准包括有关睾丸癌的英文视频。我们排除了非英语视频、无关视频和无音频视频。我们使用 DISCERN 工具和完整性评估对这些视频进行了评估。共有 361 部视频被考虑进行筛选,其中 116 部视频被纳入其中。其中,57 个视频由医疗保健专业人员 (HCP) 制作。视频长度的中位数为 40 秒(5-277 秒),累计观看次数超过 2,500 万次,每段视频的观看次数中位数为 446,400 次。DISCERN 的平均得分为 29.0 ± 5.7,HCP 提供的视频质量高于非 HCP(30.8 vs. 5.5,p < 0.05)。高级保健医生提供的视频也更可靠(21.2 对 18.1,p < 0.05)。总体质量水平大多较差或很差(97.4%),没有良好或优秀的。大多数卫生保健人员的视频质量较差(63.2%),而许多非卫生保健人员的视频质量很差(61.0%)。观看次数最多的视频有 280 万次观看,但在 DISCERN 工具中得了 31 分,在完整性评估中得了 1 分。DISCERN 评分最高的视频有 1.17 万次观看。保健医生视频对疾病的定义更明确,内容更完整(p < 0.05)。大多数视频讨论了自我评估,但缺乏定义、风险因素、症状、评估、管理和结果。TikTok上的大多数睾丸癌信息缺乏质量和完整性,而质量较高的视频影响力有限。
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引用次数: 0
Arteriovenous Malformation of the Prostate Vasculature as a Cause of Torrential Bleeding during Transurethral Resection of the Prostate 前列腺血管动静脉畸形是导致经尿道前列腺切除术中汹涌出血的原因之一
Pub Date : 2024-06-05 DOI: 10.3390/siuj5030026
Darshan Sitharthan, A. Katelaris, Gordon O’Neill
An 82-year-old male experienced severe bleeding during transurethral resection of the prostate (TURP) due to an undetected prostatic arteriovenous malformation (AVM). Initial management with a catheter was followed by successful transarterial embolisation. This case highlights the effectiveness of endovascular angioembolisation for unexpected prostatic AVMs.
一名 82 岁的男性在经尿道前列腺切除术(TURP)中因未发现前列腺动静脉畸形(AVM)而大出血。最初使用导管进行处理,随后成功进行了经动脉栓塞。该病例凸显了血管内栓塞治疗意外前列腺动静脉畸形的有效性。
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引用次数: 0
Prevalence of Genetic Mutations in Patients with Metastatic Prostate Cancer in a Cohort of Mexican Patients 墨西哥患者队列中转移性前列腺癌患者基因突变的发生率
Pub Date : 2024-06-05 DOI: 10.3390/siuj5030027
Orión Erenhú Rodríguez González, Edgar Iván Bravo Castro, Jesus Eduardo Osorio, Habiram Pacheco Guerrero, Brenda Suaste Carmona, Luis David Arreola Peralta, Noe Esaul Martinez Juárez, Juan Samuel Izquierdo Luna, José de Jesús Oswaldo Islas García, Omar Dimas Victorio Vargas, Rafael Alberto Valdez Flores, Jesús Javier Torres Gómez, José Gadú Campos Salcedo
Background: Prostate cancer is a malignant neoplasm of the male genitourinary system with the highest incidence worldwide. Susceptibility genes related to aggressiveness and prognosis, such as BRCA1/2, ATM, PTEN, have been identified. Currently, reports related to germline mutations in patients with prostate cancer in Latin American populations are very limited or absent. In the Mexican population, reports are also limited, especially in the context of metastatic prostate cancer. Determining the prevalence of these mutations is relevant to predict the potential aggressiveness of tumors and allow the use of targeted therapies, such as PARPi inhibitors. Objective: Determine the prevalence of germline mutations in patients with metastatic prostate cancer and establish their clinical characteristics at diagnosis. Material and Methods: Sixty-nine patients with metastatic PCa underwent testing and genetic analysis using the Comprehensive Multi-Cancer Hereditary Cancer Panel. The prevalence of germline mutations was assessed, and the cohort was divided into two groups for the evaluation and analysis of clinical characteristics between the mutated and non-mutated populations. Results: We identified mutations in 15 out of 69 patients (21.73%), while 54 patients (78.26%) had no mutations. Pathogenic mutations were observed in 15.9% of patients, Variants of Uncertain Significance (VUS) in 34.78%, and 5.79% had both. The most frequent mutations included ATM (11.54%), BRCA1 (11.54%), BRCA2 (7.69%), FANCA (7.69%), and FANCM (7.69%). No statistically significant differences were found in PSA levels, age at diagnosis, and resistance to castration between the two groups. Conclusions: Our study unveiled a mutation rate of 21.73%, marked by a significant prevalence of ATM, FANCA, FANCM, and Variants of Uncertain Significance (VUS). This pattern deviates from findings in other series, underscoring the necessity for improved access to clinical genetic testing in our population.
背景:前列腺癌是全球发病率最高的男性泌尿生殖系统恶性肿瘤:前列腺癌是全球发病率最高的男性泌尿生殖系统恶性肿瘤。与侵袭性和预后有关的易感基因,如 BRCA1/2、ATM、PTEN 等已被确定。目前,有关拉丁美洲人群前列腺癌患者种系突变的报告非常有限或根本没有。在墨西哥人群中,特别是在转移性前列腺癌方面的报告也很有限。确定这些基因突变的发生率对预测肿瘤的潜在侵袭性和使用 PARPi 抑制剂等靶向治疗具有重要意义。目标:确定这些突变的发生率确定转移性前列腺癌患者种系突变的发生率,并确定其诊断时的临床特征。材料与方法:69名转移性前列腺癌患者接受了使用多癌症遗传性癌症综合面板进行的检测和基因分析。评估种系突变的发生率,并将患者分为两组,以评估和分析突变人群和非突变人群的临床特征。结果在 69 名患者中,我们发现 15 名患者(21.73%)存在基因突变,54 名患者(78.26%)没有基因突变。15.9%的患者出现致病突变,34.78%的患者出现意义不明的变异(VUS),5.79%的患者同时出现致病突变和意义不明的变异。最常见的突变包括 ATM(11.54%)、BRCA1(11.54%)、BRCA2(7.69%)、FANCA(7.69%)和 FANCM(7.69%)。两组患者的 PSA 水平、确诊年龄和对阉割的耐受性在统计学上无明显差异。结论我们的研究揭示了21.73%的突变率,其中ATM、FANCA、FANCM和意义不明变异体(VUS)的突变率较高。这种模式与其他系列研究的结果不同,突出表明有必要改善我国人群的临床基因检测。
{"title":"Prevalence of Genetic Mutations in Patients with Metastatic Prostate Cancer in a Cohort of Mexican Patients","authors":"Orión Erenhú Rodríguez González, Edgar Iván Bravo Castro, Jesus Eduardo Osorio, Habiram Pacheco Guerrero, Brenda Suaste Carmona, Luis David Arreola Peralta, Noe Esaul Martinez Juárez, Juan Samuel Izquierdo Luna, José de Jesús Oswaldo Islas García, Omar Dimas Victorio Vargas, Rafael Alberto Valdez Flores, Jesús Javier Torres Gómez, José Gadú Campos Salcedo","doi":"10.3390/siuj5030027","DOIUrl":"https://doi.org/10.3390/siuj5030027","url":null,"abstract":"Background: Prostate cancer is a malignant neoplasm of the male genitourinary system with the highest incidence worldwide. Susceptibility genes related to aggressiveness and prognosis, such as BRCA1/2, ATM, PTEN, have been identified. Currently, reports related to germline mutations in patients with prostate cancer in Latin American populations are very limited or absent. In the Mexican population, reports are also limited, especially in the context of metastatic prostate cancer. Determining the prevalence of these mutations is relevant to predict the potential aggressiveness of tumors and allow the use of targeted therapies, such as PARPi inhibitors. Objective: Determine the prevalence of germline mutations in patients with metastatic prostate cancer and establish their clinical characteristics at diagnosis. Material and Methods: Sixty-nine patients with metastatic PCa underwent testing and genetic analysis using the Comprehensive Multi-Cancer Hereditary Cancer Panel. The prevalence of germline mutations was assessed, and the cohort was divided into two groups for the evaluation and analysis of clinical characteristics between the mutated and non-mutated populations. Results: We identified mutations in 15 out of 69 patients (21.73%), while 54 patients (78.26%) had no mutations. Pathogenic mutations were observed in 15.9% of patients, Variants of Uncertain Significance (VUS) in 34.78%, and 5.79% had both. The most frequent mutations included ATM (11.54%), BRCA1 (11.54%), BRCA2 (7.69%), FANCA (7.69%), and FANCM (7.69%). No statistically significant differences were found in PSA levels, age at diagnosis, and resistance to castration between the two groups. Conclusions: Our study unveiled a mutation rate of 21.73%, marked by a significant prevalence of ATM, FANCA, FANCM, and Variants of Uncertain Significance (VUS). This pattern deviates from findings in other series, underscoring the necessity for improved access to clinical genetic testing in our population.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"303 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386295","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: 0
Quality and Readability of Google Search Information on HoLEP for Benign Prostate Hyperplasia 谷歌搜索有关 HoLEP 治疗良性前列腺增生的信息的质量和可读性
Pub Date : 2024-06-05 DOI: 10.3390/siuj5030029
Yam Ting Ho, J. Saad, Femi E. Ayeni, S. Ranasinghe, M. Arianayagam, B. Canagasingham, A. Goolam, Nicola Jeffery, Mohamed Khadra, Raymond Ko, Nicholas Mehan, C. Varol, Jonathan Kam, Isaac A. Thangasamy
Objective: To assess the quality and readability of online information on holmium laser enucleation of the prostate in managing benign prostate hyperplasia using the most-used search engine worldwide, Google. Methods: Google search terms “Holmium laser surgery” and “enlarged prostate” were used to generate 150 search results. Two independent authors (i) excluded any paywall, scientific literature, or advertisement and (ii) conducted an independent assessment on information quality, which was based on DISCERN, QUEST, and JAMA criteria, and readability, which was based on the FKG, GFI, SMOG, and FRE scores on qualified webpages. A third author was involved if there were any discrepancies between the assessments. Results: 107 qualified webpages were included in the data analysis. The median DISCERN score was 42 out of 80 (IQR 35–49). The median JAMA score was 0 out of 4 (IQR 0–1). The median QUEST score was 9 out of 28 (IQR 9–12). Using the non-parametric ANOVA and post hoc Games–Howell test, significant differences were identified between rankings of webpages. Sponsorship had no influence on the quality of webpages. The overall readability level required a minimum reading level of grade 11. Linear regression analysis showed that a higher ranked webpage is a positive predictor for all three quality assessment tools. Conclusions: The overall quality of online information on HoLEP is poor. We identify that the top-ranked google searches have a higher DISCERN score and are a positive predictor for DISCERN/QUEST/JAMA. Quality online information can benefit patients but should be used in conjunction with professional medical consultation.
目的:利用全球最常用的搜索引擎谷歌,评估有关前列腺钬激光去核术治疗良性前列腺增生的在线信息的质量和可读性。搜索方法使用谷歌搜索关键词 "钬激光手术 "和 "前列腺增生",共产生 150 条搜索结果。两位独立作者(i)排除了任何付费墙、科学文献或广告,(ii)对信息质量(基于 DISCERN、QUEST 和 JAMA 标准)和可读性(基于合格网页的 FKG、GFI、SMOG 和 FRE 分数)进行了独立评估。如果评估之间存在任何差异,第三位作者也会参与其中。结果共有 107 个合格网页被纳入数据分析。DISCERN 评分的中位数为 42 分(满分 80 分,IQR 为 35-49)。JAMA 评分中位数为 0 分(满分 4 分,IQR 0-1)。QUEST 评分中位数为 9 分(28 分)(IQR 9-12)。通过非参数方差分析和事后Games-Howell检验,发现网页排名之间存在显著差异。赞助对网页质量没有影响。总体可读性要求至少达到 11 年级的阅读水平。线性回归分析表明,排名较高的网页对所有三种质量评估工具都有积极的预测作用。结论关于 HoLEP 的在线信息总体质量较差。我们发现,排名靠前的谷歌搜索具有较高的 DISCERN 分数,并且对 DISCERN/QUEST/JAMA 具有积极的预测作用。高质量的在线信息可使患者受益,但应与专业医疗咨询结合使用。
{"title":"Quality and Readability of Google Search Information on HoLEP for Benign Prostate Hyperplasia","authors":"Yam Ting Ho, J. Saad, Femi E. Ayeni, S. Ranasinghe, M. Arianayagam, B. Canagasingham, A. Goolam, Nicola Jeffery, Mohamed Khadra, Raymond Ko, Nicholas Mehan, C. Varol, Jonathan Kam, Isaac A. Thangasamy","doi":"10.3390/siuj5030029","DOIUrl":"https://doi.org/10.3390/siuj5030029","url":null,"abstract":"Objective: To assess the quality and readability of online information on holmium laser enucleation of the prostate in managing benign prostate hyperplasia using the most-used search engine worldwide, Google. Methods: Google search terms “Holmium laser surgery” and “enlarged prostate” were used to generate 150 search results. Two independent authors (i) excluded any paywall, scientific literature, or advertisement and (ii) conducted an independent assessment on information quality, which was based on DISCERN, QUEST, and JAMA criteria, and readability, which was based on the FKG, GFI, SMOG, and FRE scores on qualified webpages. A third author was involved if there were any discrepancies between the assessments. Results: 107 qualified webpages were included in the data analysis. The median DISCERN score was 42 out of 80 (IQR 35–49). The median JAMA score was 0 out of 4 (IQR 0–1). The median QUEST score was 9 out of 28 (IQR 9–12). Using the non-parametric ANOVA and post hoc Games–Howell test, significant differences were identified between rankings of webpages. Sponsorship had no influence on the quality of webpages. The overall readability level required a minimum reading level of grade 11. Linear regression analysis showed that a higher ranked webpage is a positive predictor for all three quality assessment tools. Conclusions: The overall quality of online information on HoLEP is poor. We identify that the top-ranked google searches have a higher DISCERN score and are a positive predictor for DISCERN/QUEST/JAMA. Quality online information can benefit patients but should be used in conjunction with professional medical consultation.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"49 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381785","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: 0
Early Results after Thulium Laser Enucleation of the Prostate in Patients with Urodynamically Proven Detrusor Underactivity 铥激光前列腺去核术对经尿路动力学证实的逼尿肌活动不足患者的早期疗效
Pub Date : 2024-06-03 DOI: 10.3390/siuj5030025
P. Trotsenko, C. Wetterauer, Martin Haydter, Lukas Lusuardi, Thomas R. W. Herrmann
Objectives: Benign prostatic hyperplasia is one of the most common urological diseases. Among these patients, the presence of detrusor underactivity or acontractility represents a challenging condition since no medical treatment is available. Our objective is to evaluate early term outcomes following transurethral anatomical enucleation of the prostate with Tm:YAG support. Methods: In a retrospective analysis of 115 patients who underwent this procedure between January 2019 and March 2022 due to lower urinary tract symptoms, 8 patients with urodynamic evidence of detrusor underactivity secondary to a non-neurogenic aetiology were identified. Detrusor underactivity was defined as a bladder contractility index of <100. Results: Median age, prostate volume and bladder contractility index were 73.2 years, 78.5 cm3 and 63.9, respectively. Median International Prostate Symptom Score/quality of life, Qmax and post-void residual volume were 15/3.5 points, 4.4 mL/s and 189 mL, respectively. Postoperatively, immediate catheter-removal success rate was 87.5% (7/8), at 2 months all patients were catheter-free and remained so at 1-year follow-up. Significant improvements for quality of life, Qmax and post-void residual volume were detected. Median postoperative International Prostate Symptom Score/Quality of life, Qmax and post-void residual volume were 7/2, 21.6 mL/s and 0 mL, respectively. Conclusions: This surgical approach offers high catheter-free rates, significantly improves functional voiding parameters and increases patient satisfaction in patients with benign prostatic hyperplasia and concomitant detrusor underactivity. Therefore, it can be regarded as an effective approach for such patients.
目的:良性前列腺增生症是最常见的泌尿科疾病之一。在这些患者中,由于没有药物治疗,存在逼尿肌活动减退或收缩功能障碍是一种具有挑战性的情况。我们的目标是评估在 Tm:YAG 支持下经尿道解剖性前列腺去核术后的早期疗效。方法:在对2019年1月至2022年3月期间因下尿路症状接受该手术的115名患者进行的回顾性分析中,确定了8名非神经源病因导致的尿动力学证据显示有逼尿肌活动不足的患者。膀胱收缩力指数小于 100 即为逼尿肌活动不足。结果中位年龄、前列腺体积和膀胱收缩力指数分别为 73.2 岁、78.5 立方厘米和 63.9。国际前列腺症状评分/生活质量、Qmax和排尿后残余尿量的中位数分别为15/3.5分、4.4毫升/秒和189毫升。术后,立即拔除导尿管的成功率为 87.5%(7/8),2 个月后,所有患者都不再使用导尿管,随访 1 年后仍是如此。患者的生活质量、Qmax 和排尿后残余尿量均有明显改善。术后国际前列腺症状评分/生活质量、Qmax和排尿后残余尿量的中位数分别为7/2、21.6 mL/s和0 mL。结论对于良性前列腺增生并伴有逼尿肌功能减退的患者,这种手术方法可提供较高的无导管率,显著改善排尿功能参数,并提高患者满意度。因此,它可被视为治疗此类患者的有效方法。
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引用次数: 0
Protocol for the RoboSling Trial: A Randomised Study Assessing Urinary Continence Following Robotic Radical Prostatectomy with or without an Intraoperative Retropubic Vascularised Fascial Sling (RoboSling) RoboSling 试验协议:一项随机研究,评估机器人根治性前列腺切除术后是否使用术中耻骨后血管筋膜吊带(RoboSling)的排尿连续性
Pub Date : 2024-04-17 DOI: 10.3390/siuj5020024
Amandeep Virk, P. Treacy, Wenjie Zhong, Stuart Robert Jackson, Nariman Ahmadi, Nicola Jeffery, Lewis Chan, Paul Sved, Arthur Vasilaras, R. Thanigasalam, Scott Leslie
Objectives: To determine if early (three months) and late (one year) post-operative continence is improved by performing a novel retropubic vascularised fascial sling (RoboSling) procedure concurrently with robot-assisted radical prostatectomy in men undergoing treatment for localised prostate cancer. To additionally assess surgical outcomes, quality of life and health economic outcomes in patients undergoing the novel RoboSling technique. Methods: This study aims to recruit 120 consecutive patients with clinically localised prostate cancer who have chosen to undergo robot-assisted radical prostatectomy in the Sydney Local Health District, Australia. A prospective assessment of early and late post-operative continence following robot-assisted radical prostatectomy with and without a RoboSling procedure will be performed in a two-group, 1:1, parallel, randomized controlled trial. Four surgeons will take part in the study, all of whom are beyond their learning curve. Patients will be blinded as to whether the RoboSling procedure is performed for them, as will be the research officers collecting the post-operative data on urinary function. Trial Registration: ACTRN12618002058257. Results: The trial is currently underway. Conclusions: The RoboSling technique is unique in that the sling is vascularised and has a broad surface area compared to previously described slings in the literature. If a clinically significant improvement in post-operative continence is established with the RoboSling, then, we can in turn expect improvements in quality of life for men undergoing this technique with radical prostatectomy.
目的确定接受局部前列腺癌治疗的男性在接受机器人辅助根治性前列腺切除术的同时接受新型耻骨后血管筋膜吊带术(RoboSling)是否能改善术后早期(三个月)和晚期(一年)的尿失禁情况。此外,还将评估接受新型 RoboSling 技术的患者的手术效果、生活质量和医疗经济效益。研究方法本研究旨在招募120名连续的临床局部前列腺癌患者,这些患者选择在澳大利亚悉尼地方卫生区接受机器人辅助前列腺癌根治术。在一项两组、1:1、平行、随机对照试验中,将对机器人辅助根治性前列腺切除术术后早期和晚期的尿失禁情况进行前瞻性评估。将有四名外科医生参与这项研究,他们都已过了学习曲线期。患者是否使用 RoboSling 手术将是双盲的,收集术后排尿功能数据的研究人员也是双盲的。试验注册:ACTRN12618002058257。试验结果试验目前正在进行中。结论与之前文献中描述的吊衣相比,RoboSling 技术的独特之处在于吊衣血管化且表面积大。如果使用 RoboSling 能够在临床上明显改善术后尿失禁的情况,那么我们就可以期待使用这种技术进行根治性前列腺切除术的男性的生活质量得到改善。
{"title":"Protocol for the RoboSling Trial: A Randomised Study Assessing Urinary Continence Following Robotic Radical Prostatectomy with or without an Intraoperative Retropubic Vascularised Fascial Sling (RoboSling)","authors":"Amandeep Virk, P. Treacy, Wenjie Zhong, Stuart Robert Jackson, Nariman Ahmadi, Nicola Jeffery, Lewis Chan, Paul Sved, Arthur Vasilaras, R. Thanigasalam, Scott Leslie","doi":"10.3390/siuj5020024","DOIUrl":"https://doi.org/10.3390/siuj5020024","url":null,"abstract":"Objectives: To determine if early (three months) and late (one year) post-operative continence is improved by performing a novel retropubic vascularised fascial sling (RoboSling) procedure concurrently with robot-assisted radical prostatectomy in men undergoing treatment for localised prostate cancer. To additionally assess surgical outcomes, quality of life and health economic outcomes in patients undergoing the novel RoboSling technique. Methods: This study aims to recruit 120 consecutive patients with clinically localised prostate cancer who have chosen to undergo robot-assisted radical prostatectomy in the Sydney Local Health District, Australia. A prospective assessment of early and late post-operative continence following robot-assisted radical prostatectomy with and without a RoboSling procedure will be performed in a two-group, 1:1, parallel, randomized controlled trial. Four surgeons will take part in the study, all of whom are beyond their learning curve. Patients will be blinded as to whether the RoboSling procedure is performed for them, as will be the research officers collecting the post-operative data on urinary function. Trial Registration: ACTRN12618002058257. Results: The trial is currently underway. Conclusions: The RoboSling technique is unique in that the sling is vascularised and has a broad surface area compared to previously described slings in the literature. If a clinically significant improvement in post-operative continence is established with the RoboSling, then, we can in turn expect improvements in quality of life for men undergoing this technique with radical prostatectomy.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693381","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: 0
Robot-Assisted Surgery in Poland: The Past, the Present, and the Perspectives for the Future 波兰的机器人辅助手术:过去、现在和未来展望
Pub Date : 2024-04-16 DOI: 10.3390/siuj5020023
Roman Sosnowski, Krzysztof Jakubiak, H. Kamecki, Grzegorz Kade, Tomasz Drewa, T. Szydełko, Piotr Chłosta, Piotr Kania, Piotr Jarzemski
In recent decades, we have been witnessing a technological revolution in the area of minimally invasive urologic surgery, with robot-assisted surgery being one of the most game-changing inventions [...]
近几十年来,我们见证了泌尿外科微创手术领域的技术革命,其中机器人辅助手术是最能改变游戏规则的发明之一 [...] 。
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Société Internationale d’Urologie Journal
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