Background: To evaluate the safety, efficacy, feasibility, stone-free rate, and complications of bilateral tubeless supine mini-percutaneous nephrolithotomy (M-PCNL) for bilateral multiple renal calculi with renal failure as a single-stage procedure. Materials and Methods: We conducted aretrospective study from January 2020 to March 2022 in adult patients with bilateral renal or proximal ureteric calculi with renal failure who were subjected to bilateral supine tubeless M-PCNL. Patients on regular hemodialysis before the procedure were excluded. Data regarding the demographic profile, stone characteristics on non-contrast computed tomography (NCCT), duration of surgery, complications, and auxiliary procedures were retrieved from clinical records. Residual stone fragments of≤4mm in NCCT were considered clinically insignificant. The Clinical Research Office of the Endourological Society validation ofClavien score for PCNL complications was used. Results: A total of twenty-seven patients with a mean age of 45.9years were included in this study. The mean size of stone diameter per renal unit was 2.4 ± 0.4 cm. The mean preoperative serum creatinine was 2.8 mg/dL. A total of 62 tracts and 27 sessions were required for complete treatment of all 54 renal units in the 27 successfully treated patients. The average operating time was 75 (52–122) min on both sides. Serum creatinine drop at onemonth postsurgery was statistically significant (p < 0.0001). Mean hospitalization time was 3.6 days [3–6 days]. The primary stone-free rate was 92.5%. Grade I, II, and IVA complications were recorded in three (11.1%), eight (29.6%), and two (7.4%) patients, respectively. Conclusion: Bilateral tubeless supine M-PCNL for bilateral renal calculi in selective patients with renal failure in a single session is a safe, feasible, and effective option which can be carried out without increased morbidity and can be attempted if the first-side M-PCNL has gone smoothly within a reasonable amount of time.
{"title":"Safety and Efficacy of Bilateral Tubeless Supine Mini-Percutaneous Nephrolithotomy for the Management of Bilateral Renal Calculi in Renal Failure Patients","authors":"Puvai Murugan Ponnuswamy, Bhalaguru Iyyan Arumugam, Shree Vishnu Siddarth Rajagopal, Krishna Mohan Boopathy Vijayaraghavan","doi":"10.3390/siuj5010011","DOIUrl":"https://doi.org/10.3390/siuj5010011","url":null,"abstract":"Background: To evaluate the safety, efficacy, feasibility, stone-free rate, and complications of bilateral tubeless supine mini-percutaneous nephrolithotomy (M-PCNL) for bilateral multiple renal calculi with renal failure as a single-stage procedure. Materials and Methods: We conducted aretrospective study from January 2020 to March 2022 in adult patients with bilateral renal or proximal ureteric calculi with renal failure who were subjected to bilateral supine tubeless M-PCNL. Patients on regular hemodialysis before the procedure were excluded. Data regarding the demographic profile, stone characteristics on non-contrast computed tomography (NCCT), duration of surgery, complications, and auxiliary procedures were retrieved from clinical records. Residual stone fragments of≤4mm in NCCT were considered clinically insignificant. The Clinical Research Office of the Endourological Society validation ofClavien score for PCNL complications was used. Results: A total of twenty-seven patients with a mean age of 45.9years were included in this study. The mean size of stone diameter per renal unit was 2.4 ± 0.4 cm. The mean preoperative serum creatinine was 2.8 mg/dL. A total of 62 tracts and 27 sessions were required for complete treatment of all 54 renal units in the 27 successfully treated patients. The average operating time was 75 (52–122) min on both sides. Serum creatinine drop at onemonth postsurgery was statistically significant (p < 0.0001). Mean hospitalization time was 3.6 days [3–6 days]. The primary stone-free rate was 92.5%. Grade I, II, and IVA complications were recorded in three (11.1%), eight (29.6%), and two (7.4%) patients, respectively. Conclusion: Bilateral tubeless supine M-PCNL for bilateral renal calculi in selective patients with renal failure in a single session is a safe, feasible, and effective option which can be carried out without increased morbidity and can be attempted if the first-side M-PCNL has gone smoothly within a reasonable amount of time.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452947","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}
Highlighting the restricted access to andrology medical devices in Arab Muslim countries, where unjust associations with sexual instruments lead to prohibitions, this commentary underscores the challenges in providing appropriate medical care for andrological conditions. Despite the crucial role of devices like penile extenders, vacuum devices, and vibrators in treating conditions such as Peyronie’s disease and erectile dysfunction, cultural and religious biases condemn them in certain regions. This lack of understanding deprives many patients of andrological treatments, limiting therapeutic options and equitable healthcare access. The commentary advocates for urology societies to raise awareness, engage policymakers, and use media to distinguish these devices from sex toys, emphasizing their medical nature for the benefit of patients.
{"title":"Accessibility to Andrology Medical Devices in Arab-Muslim Countries","authors":"Mounir Jamali","doi":"10.3390/siuj5010010","DOIUrl":"https://doi.org/10.3390/siuj5010010","url":null,"abstract":"Highlighting the restricted access to andrology medical devices in Arab Muslim countries, where unjust associations with sexual instruments lead to prohibitions, this commentary underscores the challenges in providing appropriate medical care for andrological conditions. Despite the crucial role of devices like penile extenders, vacuum devices, and vibrators in treating conditions such as Peyronie’s disease and erectile dysfunction, cultural and religious biases condemn them in certain regions. This lack of understanding deprives many patients of andrological treatments, limiting therapeutic options and equitable healthcare access. The commentary advocates for urology societies to raise awareness, engage policymakers, and use media to distinguish these devices from sex toys, emphasizing their medical nature for the benefit of patients.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140453535","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}
Darshan Sitharthan, Marco Rosario, Keeththana Thayanantharajah
The journey of organ transplantation in Australia has been marked with progressive milestones since the inaugural kidney transplant in 1965 [...]
自 1965 年首次肾脏移植以来，澳大利亚的器官移植历程不断取得重大进展 [...]
{"title":"Australian Kidney Transplantation in the Shadow of COVID-19: A Decade’s Insight","authors":"Darshan Sitharthan, Marco Rosario, Keeththana Thayanantharajah","doi":"10.3390/siuj5010009","DOIUrl":"https://doi.org/10.3390/siuj5010009","url":null,"abstract":"The journey of organ transplantation in Australia has been marked with progressive milestones since the inaugural kidney transplant in 1965 [...]","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454477","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}
C. Ayoub, Nassib F. Abou Heidar, A. Armache, E. Abou Chawareb, A. El Hajj
Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (p < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (p < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (p < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications.
{"title":"Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program","authors":"C. Ayoub, Nassib F. Abou Heidar, A. Armache, E. Abou Chawareb, A. El Hajj","doi":"10.3390/siuj5010008","DOIUrl":"https://doi.org/10.3390/siuj5010008","url":null,"abstract":"Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (p < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (p < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (p < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777940","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}
C. Ayoub, Nassib F. Abou Heidar, A. Armache, E. Abou Chawareb, A. El Hajj
Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (p < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (p < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (p < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications.
{"title":"Transfusion in Radical Cystectomy Increases Overall Morbidity and Mortality: A Retrospective Study Using Data from the American College of Surgeons—National Surgical Quality Improvement Program","authors":"C. Ayoub, Nassib F. Abou Heidar, A. Armache, E. Abou Chawareb, A. El Hajj","doi":"10.3390/siuj5010008","DOIUrl":"https://doi.org/10.3390/siuj5010008","url":null,"abstract":"Background: Radical cystectomy is a complex procedure imposing significant post-operation complications. Objective: Explore the impact of peri-operative pRBC transfusion on mortality and overall morbidity in a matched cohort. Methods: The American College of Surgeons—National Surgical Quality Improvement Program’s (ACS-NSQIP) dataset was used to select patients who underwent RC in 2008–2019. Patients who witnessed pre-operative transfusion and emergency cases were excluded. Peri-operative pRBC transfusion was defined as an intra-operative or up to 24-h post-operative pRBC transfusion. We matched patients who underwent peri-operative pRBC transfusion to patients who did not receive transfusion. Length of stay, mortality, and overall morbidity were compared between the two matched cohorts. Results: The match cohort was matched on all pre-operative demographics and medical history variables and yielded 3578 matched patients. Patients who underwent peri-operative pRBC transfusion had a longer length of hospital stay (9.3 days) as compared to patients who did not undergo transfusion (8.13 days) (p < 0.001). Furthermore, patients who underwent transfusion also had higher odds of mortality (OR = 1.934) and overall morbidity (OR = 1.443) (p < 0.03). Specifically, patients who underwent transfusion had higher odds of organ space SSI, pneumonia, unplanned intubation, pulmonary embolism, failure to wean off of ventilator, renal insufficiency, urinary tract infections, stroke, myocardial infarction, cardiac arrest requiring CPR, deep vein thrombosis, and septic shock (p < 0.047). Conclusion: Peri-operative pRBC transfusion in RC was associated with longer hospital stays, significant morbidity, and mortality. For this reason, pre-operative patient optimization and possible alternatives to common pRBC practices should be considered in RC to circumvent complications.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837793","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}
Matthew Yii, Chrisdan Gan, K. Qin, Damien Bolton, Gideon Blecher
Objectives and Methods: Penile fractures are a urologic emergency involving the rupture of the tunica albuginea of the corpora cavernosum. Geography is known to impact fracture aetiology, and higher impact aetiology is thought to predispose patients to complex trauma. To review long-term urinary and sexual outcomes following fracture repair in Australia, a retrospective analysis of data from three metropolitan hospital services over 10 years was performed. Only patients with intraoperatively confirmed fractures were included. Patients were contacted by clinicians to complete a survey, which utilised validated questionnaires, including the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). Perioperative data were analysed against survey responses. Results: We identified 55 confirmed penile fractures. Twenty-one patients completed questionnaire follow-ups, comprising the study cohort. The median age at the time of the injury was 44.8 years (range: 25–65). The median time from injury to questionnaire completion was 4.0 years (range: 1–10). Furthermore, 95.5% (20) of the injuries occurred during sexual intercourse. The median IIEF-5 score was 23 (range: 5–25); the median IPSS score was 5 (range: 0–22). Seven patients (33.3%) sustained a bilateral cavernosal injury, and eight (38.1%) sustained a urethral injury. Upon conducting a Mann–Whitney U test, no significant relationships were found between bilateral cavernosal injury and IIEF-5 scores (p = 0.7377) or urethral injury and IPSS scores (p = 0.5338). Conclusions: The Australian aetiology of penile fractures appears consistent with that of other Western countries, with subsequent high rates of bilateral cavernosal and urethral injuries. The long-term erectile and urinary function outcomes observed are promising. A larger prospective study would further illuminate the relationship between injury factors and outcomes, revealing information not presented herein due to study limitations relating to the cohort size and follow-up rates.
{"title":"A 10-Year Multicentre Experience of Australian Penile Fracture Repair Outcomes","authors":"Matthew Yii, Chrisdan Gan, K. Qin, Damien Bolton, Gideon Blecher","doi":"10.3390/siuj5010005","DOIUrl":"https://doi.org/10.3390/siuj5010005","url":null,"abstract":"Objectives and Methods: Penile fractures are a urologic emergency involving the rupture of the tunica albuginea of the corpora cavernosum. Geography is known to impact fracture aetiology, and higher impact aetiology is thought to predispose patients to complex trauma. To review long-term urinary and sexual outcomes following fracture repair in Australia, a retrospective analysis of data from three metropolitan hospital services over 10 years was performed. Only patients with intraoperatively confirmed fractures were included. Patients were contacted by clinicians to complete a survey, which utilised validated questionnaires, including the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). Perioperative data were analysed against survey responses. Results: We identified 55 confirmed penile fractures. Twenty-one patients completed questionnaire follow-ups, comprising the study cohort. The median age at the time of the injury was 44.8 years (range: 25–65). The median time from injury to questionnaire completion was 4.0 years (range: 1–10). Furthermore, 95.5% (20) of the injuries occurred during sexual intercourse. The median IIEF-5 score was 23 (range: 5–25); the median IPSS score was 5 (range: 0–22). Seven patients (33.3%) sustained a bilateral cavernosal injury, and eight (38.1%) sustained a urethral injury. Upon conducting a Mann–Whitney U test, no significant relationships were found between bilateral cavernosal injury and IIEF-5 scores (p = 0.7377) or urethral injury and IPSS scores (p = 0.5338). Conclusions: The Australian aetiology of penile fractures appears consistent with that of other Western countries, with subsequent high rates of bilateral cavernosal and urethral injuries. The long-term erectile and urinary function outcomes observed are promising. A larger prospective study would further illuminate the relationship between injury factors and outcomes, revealing information not presented herein due to study limitations relating to the cohort size and follow-up rates.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139841561","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}
Arthur Yim, Matthew Alberto, Marco Herold, Dixon Woon, J. Ischia, Damien Bolton
Introduction: Urological cancers account for a significant portion of cancer diagnoses and mortality rates worldwide. The traditional treatment options of surgery and chemoradiation can have significant morbidity and become ineffective in refractory disease. The discovery of the CRISPR system has opened up new avenues for cancer research by targeting specific genes or mutations that play a role in cancer development and progression. In this review, we summarise the current state of research on CRISPR in urology and discuss its potential for improving the diagnosis and treatment of urological cancers. Methods: A comprehensive literature search was conducted on databases including PubMed, Embase, and Cochrane Library. The keywords included CRISPR and urology OR prostate OR renal OR bladder OR testicular cancer. Results: CRISPR has been used extensively in a preclinical setting to identify and target genes in prostate cancer, including AR, NANOG, ERβ, TP53, PTEN, and PD-1. Targeting PRRX2 and PTEN has also been shown to overcome enzalutamide and docetaxel resistance in vitro. In bladder cancer, CBP, p300, hTERT, lncRNA SNGH3, SMAD7e, and FOXA1 have been targeted, with HNRNPU knockout demonstrating tumour inhibition, increased apoptosis and enhanced cisplatin sensitivity both in vitro and in vivo. Renal cancer has seen CRISPR target VHL, TWIST1, PTEN, and CD70, with the first in-human clinical trial of Anti-CD70 CAR T cell therapy showing an excellent safety profile and durable oncological results. Lastly, testicular cancer modelling has utilised CRISPR to knockout FLNA, ASH2L, HMGB4, CD24, and VIRMA, with NAE1 found to be over-expressed in cisplatin-resistant germ cell colonies. Conclusions: CRISPR is a cutting-edge technology that has been used extensively in the pre-clinical setting to identify new genetic targets, enhance drug sensitivity, and inhibit cancer progression in animal models. Although CAR T cell therapy has shown promising results in RCC, CRISPR-based therapeutics are far from mainstream, with further studies needed across all urological malignancies.
{"title":"“Pass the Genetic Scalpel”: A Comprehensive Review of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) in Urological Cancers","authors":"Arthur Yim, Matthew Alberto, Marco Herold, Dixon Woon, J. Ischia, Damien Bolton","doi":"10.3390/siuj5010006","DOIUrl":"https://doi.org/10.3390/siuj5010006","url":null,"abstract":"Introduction: Urological cancers account for a significant portion of cancer diagnoses and mortality rates worldwide. The traditional treatment options of surgery and chemoradiation can have significant morbidity and become ineffective in refractory disease. The discovery of the CRISPR system has opened up new avenues for cancer research by targeting specific genes or mutations that play a role in cancer development and progression. In this review, we summarise the current state of research on CRISPR in urology and discuss its potential for improving the diagnosis and treatment of urological cancers. Methods: A comprehensive literature search was conducted on databases including PubMed, Embase, and Cochrane Library. The keywords included CRISPR and urology OR prostate OR renal OR bladder OR testicular cancer. Results: CRISPR has been used extensively in a preclinical setting to identify and target genes in prostate cancer, including AR, NANOG, ERβ, TP53, PTEN, and PD-1. Targeting PRRX2 and PTEN has also been shown to overcome enzalutamide and docetaxel resistance in vitro. In bladder cancer, CBP, p300, hTERT, lncRNA SNGH3, SMAD7e, and FOXA1 have been targeted, with HNRNPU knockout demonstrating tumour inhibition, increased apoptosis and enhanced cisplatin sensitivity both in vitro and in vivo. Renal cancer has seen CRISPR target VHL, TWIST1, PTEN, and CD70, with the first in-human clinical trial of Anti-CD70 CAR T cell therapy showing an excellent safety profile and durable oncological results. Lastly, testicular cancer modelling has utilised CRISPR to knockout FLNA, ASH2L, HMGB4, CD24, and VIRMA, with NAE1 found to be over-expressed in cisplatin-resistant germ cell colonies. Conclusions: CRISPR is a cutting-edge technology that has been used extensively in the pre-clinical setting to identify new genetic targets, enhance drug sensitivity, and inhibit cancer progression in animal models. Although CAR T cell therapy has shown promising results in RCC, CRISPR-based therapeutics are far from mainstream, with further studies needed across all urological malignancies.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139779731","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}
Matthew Yii, Chrisdan Gan, K. Qin, Damien Bolton, Gideon Blecher
Objectives and Methods: Penile fractures are a urologic emergency involving the rupture of the tunica albuginea of the corpora cavernosum. Geography is known to impact fracture aetiology, and higher impact aetiology is thought to predispose patients to complex trauma. To review long-term urinary and sexual outcomes following fracture repair in Australia, a retrospective analysis of data from three metropolitan hospital services over 10 years was performed. Only patients with intraoperatively confirmed fractures were included. Patients were contacted by clinicians to complete a survey, which utilised validated questionnaires, including the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). Perioperative data were analysed against survey responses. Results: We identified 55 confirmed penile fractures. Twenty-one patients completed questionnaire follow-ups, comprising the study cohort. The median age at the time of the injury was 44.8 years (range: 25–65). The median time from injury to questionnaire completion was 4.0 years (range: 1–10). Furthermore, 95.5% (20) of the injuries occurred during sexual intercourse. The median IIEF-5 score was 23 (range: 5–25); the median IPSS score was 5 (range: 0–22). Seven patients (33.3%) sustained a bilateral cavernosal injury, and eight (38.1%) sustained a urethral injury. Upon conducting a Mann–Whitney U test, no significant relationships were found between bilateral cavernosal injury and IIEF-5 scores (p = 0.7377) or urethral injury and IPSS scores (p = 0.5338). Conclusions: The Australian aetiology of penile fractures appears consistent with that of other Western countries, with subsequent high rates of bilateral cavernosal and urethral injuries. The long-term erectile and urinary function outcomes observed are promising. A larger prospective study would further illuminate the relationship between injury factors and outcomes, revealing information not presented herein due to study limitations relating to the cohort size and follow-up rates.
{"title":"A 10-Year Multicentre Experience of Australian Penile Fracture Repair Outcomes","authors":"Matthew Yii, Chrisdan Gan, K. Qin, Damien Bolton, Gideon Blecher","doi":"10.3390/siuj5010005","DOIUrl":"https://doi.org/10.3390/siuj5010005","url":null,"abstract":"Objectives and Methods: Penile fractures are a urologic emergency involving the rupture of the tunica albuginea of the corpora cavernosum. Geography is known to impact fracture aetiology, and higher impact aetiology is thought to predispose patients to complex trauma. To review long-term urinary and sexual outcomes following fracture repair in Australia, a retrospective analysis of data from three metropolitan hospital services over 10 years was performed. Only patients with intraoperatively confirmed fractures were included. Patients were contacted by clinicians to complete a survey, which utilised validated questionnaires, including the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). Perioperative data were analysed against survey responses. Results: We identified 55 confirmed penile fractures. Twenty-one patients completed questionnaire follow-ups, comprising the study cohort. The median age at the time of the injury was 44.8 years (range: 25–65). The median time from injury to questionnaire completion was 4.0 years (range: 1–10). Furthermore, 95.5% (20) of the injuries occurred during sexual intercourse. The median IIEF-5 score was 23 (range: 5–25); the median IPSS score was 5 (range: 0–22). Seven patients (33.3%) sustained a bilateral cavernosal injury, and eight (38.1%) sustained a urethral injury. Upon conducting a Mann–Whitney U test, no significant relationships were found between bilateral cavernosal injury and IIEF-5 scores (p = 0.7377) or urethral injury and IPSS scores (p = 0.5338). Conclusions: The Australian aetiology of penile fractures appears consistent with that of other Western countries, with subsequent high rates of bilateral cavernosal and urethral injuries. The long-term erectile and urinary function outcomes observed are promising. A larger prospective study would further illuminate the relationship between injury factors and outcomes, revealing information not presented herein due to study limitations relating to the cohort size and follow-up rates.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139781621","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}
H. Kamran, Nooshin Tafazoli, S. Eftekharzadeh, P. Hekmati, H. Arshadi, Abdolmohamad Kajbafzadeh
Objectives: It has been shown that concomitant autologous blood and dextranomer/hyaluronic acid (Deflux®) injection, hydrodistension autologous blood injection technique (HABIT), had a better mound preservation and treatment success compared to the hydrodistension injection technique (HIT) in vesicoureteral reflux (VUR) correction. In this study, we aimed to show microscopically whether the concomitant injection of autologous blood decreases the leakage of Deflux® particles. Methods: Children with VUR who underwent HIT or HABIT between March 2020 and January 2023 were enrolled. Following the completion of the procedure on each ureter, the bladder was irrigated for 3 to 5 min, and the retrieved sample of irrigation fluid was evaluated for dextranomer particle count as “immediate leakage”. A foley catheter was placed, and a urine sample after 12 h was collected as “early leakage”. Results: A total of 86 children with a median age of 3.0 years (interquartile range = 4.6) were included. Overall, 66 patients underwent HABIT, and 20 children underwent HIT. Rupture was observed in five patients during the procedure, and re-injection was conducted successfully in these cases. Immediate, early, and total particle leakage in the first 12 h of the injection were significantly less in the HABIT group compared to the HIT group. In the regression analysis, only the injection technique (HIT/HABIT) and rupture were significantly associated with the total particle leakage in the first 12 h. Conclusions: Immediate injection of autologous blood into the mound following an endoscopic correction of VUR in children is associated with significantly less Deflux® particle leakage from the injection site regardless of the VUR grade. We hypothesize that a concomitant blood injection into the Deflux® mound will create a blood clot while the needle is kept in situ and help to stabilize the mound and decrease treatment failure by minimizing particle leakage from the injection site.
{"title":"Does Autologous Blood Injection Following Dextranomer/Hyaluronic Acid Copolymer Implantation in Treating Vesicoureteral Reflux Affect the Microsphere Particle Leakage?","authors":"H. Kamran, Nooshin Tafazoli, S. Eftekharzadeh, P. Hekmati, H. Arshadi, Abdolmohamad Kajbafzadeh","doi":"10.3390/siuj5010007","DOIUrl":"https://doi.org/10.3390/siuj5010007","url":null,"abstract":"Objectives: It has been shown that concomitant autologous blood and dextranomer/hyaluronic acid (Deflux®) injection, hydrodistension autologous blood injection technique (HABIT), had a better mound preservation and treatment success compared to the hydrodistension injection technique (HIT) in vesicoureteral reflux (VUR) correction. In this study, we aimed to show microscopically whether the concomitant injection of autologous blood decreases the leakage of Deflux® particles. Methods: Children with VUR who underwent HIT or HABIT between March 2020 and January 2023 were enrolled. Following the completion of the procedure on each ureter, the bladder was irrigated for 3 to 5 min, and the retrieved sample of irrigation fluid was evaluated for dextranomer particle count as “immediate leakage”. A foley catheter was placed, and a urine sample after 12 h was collected as “early leakage”. Results: A total of 86 children with a median age of 3.0 years (interquartile range = 4.6) were included. Overall, 66 patients underwent HABIT, and 20 children underwent HIT. Rupture was observed in five patients during the procedure, and re-injection was conducted successfully in these cases. Immediate, early, and total particle leakage in the first 12 h of the injection were significantly less in the HABIT group compared to the HIT group. In the regression analysis, only the injection technique (HIT/HABIT) and rupture were significantly associated with the total particle leakage in the first 12 h. Conclusions: Immediate injection of autologous blood into the mound following an endoscopic correction of VUR in children is associated with significantly less Deflux® particle leakage from the injection site regardless of the VUR grade. We hypothesize that a concomitant blood injection into the Deflux® mound will create a blood clot while the needle is kept in situ and help to stabilize the mound and decrease treatment failure by minimizing particle leakage from the injection site.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139780098","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}
We present a case of supernumerary kidney with fusion of all three kidney units with five pelvicalyceal system (bilateral bifid PCS and PCS of supernumerary kidney). This is probably the first such case reported in literature.
{"title":"Triple Fused Supernumerary Kidneys with Five Pelvicalyceal Systems","authors":"Naveen Kumar, Srishti Sharma, Kashif Rizwi","doi":"10.3390/siuj5010004","DOIUrl":"https://doi.org/10.3390/siuj5010004","url":null,"abstract":"We present a case of supernumerary kidney with fusion of all three kidney units with five pelvicalyceal system (bilateral bifid PCS and PCS of supernumerary kidney). This is probably the first such case reported in literature.","PeriodicalId":21961,"journal":{"name":"Société Internationale d’Urologie Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139781724","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}
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