Translational andrology and urology最新文献

Background: The impact of the interval between consecutive testicular sperm aspiration (TESA) procedures on pregnancy outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia (OA) remains controversial. This study aimed to evaluate the impact of the interval between consecutive TESA procedures on clinical pregnancy outcomes of ICSI in patients with OA.

Methods: We retrospectively analyzed 751 men with OA who underwent two consecutive TESA procedures at Reproduction Medical Center of West China Second University Hospital, Sichuan University between January 2015 and March 2023. The index outcome was clinical pregnancy in the ICSI cycle paired with the second (retrieval-day) TESA. Patients were divided into pregnancy and non-pregnancy groups. Group comparisons included TESA interval, patient age, hormone levels, and embryology outcomes.

Results: A total of 751 patients with OA were included, with an overall pregnancy rate of 51.7% (388/751). The short-interval group showed a higher pregnancy rate in one contrast (≤3 vs. >3 months, 56.0% vs. 47.9%, P=0.03), whereas the four-group comparison and the pregnant vs. non-pregnant mean interval comparison were not statistically significant. Exploratory stratified analyses were consistent with a short-interval advantage. Adjusted analyses yielded similar point estimates but results were not fully consistent across specifications. Same-side vs. opposite-side procedures had no significant impact on outcomes (50.8% vs. 54.9%, P=0.38).

Conclusions: In this retrospective cohort of men with OA undergoing ICSI, repeating TESA within 3 months did not compromise clinical pregnancy outcomes. Overall differences across interval definitions were small and inconsistent, supporting the practicality of proceeding to an ICSI cycle shortly after an outpatient TESA when clinically appropriate. Prospective studies are warranted.

Background: Bladder cancer (BC) screening contributes to better patient outcomes. However, existing diagnostic methods for BC are not suitable for large-scale screening. Serum microRNAs (miRNAs) are expected to be simple, cost-effective, and non-invasive screening tools for BC. This study aims to identify whether relevant serum miRNAs as diagnostic markers for BC.

Methods: This research covered 112 BCs and 112 healthy controls (HCs), utilizing quantitative reverse transcription polymerase chain reaction (RT-qPCR) to pinpoint miRNAs viable for diagnosing BC in serum across three phases. In addition, bioinformatics analyses were conducted to predict target genes and provide functional annotations.

Results: Six serum miRNAs showed significantly abnormal expression levels compared with the HC group. A highly efficient screening model, comprising four serum miRNAs (hsa-miR-107, hsa-miR-146a-5p, hsa-miR-15b-5p, and hsa-miR-218-5p) was developed, with an area under the receiver operating characteristic curve (AUC) value of 0.924, 95.24% sensitivity, and 78.57% specificity. The predicted target genes of these serum miRNAs, including ADAMTSL3, CACNB2, FOXP2 and GAS7, may play a role in the initiation and progression of BC.

Conclusions: A panel of four serum miRNAs (hsa-miR-107, hsa-miR-146a-5p, hsa-miR-15b-5p, and hsa-miR-218-5p) exhibits high specificity and sensitivity. It shows potential as an efficient, non-invasive, and cost-effective biomarker for BC screening.

Background: Overactive bladder (OAB) represents a frequent urological disorder with a multifaceted etiology, yet the implication of visceral adiposity in its pathogenesis remains underexplored. Our objective was to evaluate the connection between the metabolic score for visceral fat (METS-VF) and OAB risk in a nationally representative USA population, besides comparing METS-VF predictive utility against conventional adiposity indices.

Methods: This cross-sectional analysis utilized National Health and Nutrition Examination Survey (NHANES) data from 6,366 participants. Multivariable logistic regression (LR) analysis, subgroup analyses, and receiver operating characteristic (ROC) were employed to ascertain the interaction of METS-VF with OAB. Furthermore, ROC analysis was implemented to contrast METS-VF diagnostic capabilities against body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR).

Results: The analysis included 6,366 participants; of them, 4,536 were diagnosed with OAB, showing a significant link between METS-VF and OAB (P<0.001). Notably, OAB prevalence increased progressively across METS-VF quartiles (Q1: 52.20%, Q2: 64.76%, Q3: 74.56%, Q4: 85.19%). After full adjustment for covariates, METS-VF remained significantly related to OAB, revealing a positive association [odds ratio (OR) =1.38, 95% confidence interval (CI): 1.22-1.57]. Subgroup analyses consistently elucidated a significant interconnection between METS-VF and OAB across various demographics. The restricted cubic spline (RCS) analysis results demonstrated a significant non-linear association between METS-VF and OAB (P=0.004). Moreover, METS-VF displayed a superior predictive ability for OAB, unlike conventional indices, including BMI, WC, and WHtR.

Conclusions: The METS-VF, an innovative composite indicator of visceral adiposity and metabolic dysfunction, serves as a robust and reliable predictor of OAB risk among adults in the USA. Its enhanced predictive capacity relative to traditional adiposity metrics highlights its potential application in clinical risk assessment and public health strategies aimed at mitigating visceral obesity-related urological conditions.

Background: Clear cell renal cell carcinoma (ccRCC) is a common and aggressive malignant tumor of the kidney, with a complex pathogenesis involving abnormal expression of multiple genes and signaling pathways. In recent years, the nucleoside diphosphate kinase 4 (NME4) gene has garnered increasing attention due to its critical role in cell proliferation, differentiation, and migration. This study aims to investigate the role of NME4 in ccRCC and its potential as a biomarker and therapeutic target.

Methods: In this study, we knocked down the NME4 gene and observed its effects on 786-O cells (a ccRCC cell line). We assessed cell proliferation and migration capacity using clonogenic assays, Ki67 immunofluorescence staining, and cell scratch assays. Additionally, we systematically analyzed the relationship between NME4 expression levels and clinical characteristics and prognosis in ccRCC patients using multiple large-scale public databases and explored its potential mechanisms in tumor immune regulation.

Results: Experimental results showed that NME4 knockdown significantly reduced the clonogenic capacity of 786-O cells, with a marked decrease in both the average number and size of clones. Ki67 immunofluorescence staining results further confirmed that NME4 knockdown inhibited the proliferation capacity of ccRCC cells. Cell scratch assay results showed that the wound healing rate of 786-O cells with NME4 knockdown was significantly reduced, indicating that NME4 also plays an important role in cell migration. Multi-database joint analysis results showed that high NME4 expression is closely associated with poor prognosis in ccRCC patients. In immune cell infiltration and signaling pathway enrichment analysis, high NME4 expression was significantly correlated with multiple immune cell infiltration levels and may promote tumorigenesis and progression by enhancing the activity of multiple signaling pathways.

Conclusions: NME4 is highly expressed in ccRCC, and its expression levels are significantly associated with patients' clinical characteristics and survival prognosis. Meanwhile, experimental results indicate its important role in tumorigenesis and progression. NME4 has the potential to serve as a biomarker and therapeutic target for ccRCC.

Background: The Advanced Prostate Cancer Consensus Conference (APCCC) is a forum for discussing and debating current questions regarding the clinical management of patients with advanced prostate cancer, with a particular focus on these controversies. The aim of this study is to summarize and discuss the results of APCCC-JAPAN 2025 and APCCC 2024 to elucidate the current consensus for advanced prostate cancer in Japan.

Methods: A total of 183 topics on advanced prostate cancer with substantial effects on daily practice but insufficient high-level evidence were addressed at APCCC 2024. From these, 16 questions were selected and presented by a panel of six prostate cancer experts at APCCC-JAPAN 2025 during the 112^th Annual Meeting of the Japanese Urological Association. Japanese urologists attending the symposium cast their votes on questions on their smartphones using a web-based tool. The results were compared with those obtained at APCCC 2024.

Results: Differences in voting results were observed between APCCC-JAPAN 2025 and APCCC 2024, particularly regarding treatment strategies for localized high-risk prostate cancer and metastatic hormone-sensitive prostate cancer.

Conclusions: The APCCC-JAPAN 2025 highlighted critical aspects of the current issues surrounding the management of advanced prostate cancer in Japan. Both similarities and differences were observed in the treatment approaches employed by Japanese urologists and global prostate cancer experts.

Background: Previous studies on penile color Doppler ultrasound (CDU) examination after intracavernosal injection (ICI) have included a small number of patients and rarely focused on the effects of intracavernous communicating branches and persistent rigid erection. This study aimed to explore these issues using a large institutional database of erectile dysfunction (ED) patients.

Methods: We conducted a retrospective study of 9,109 ED patients who underwent CDU examination after ICI with prostaglandin E1 (PGE1) at our Department of Andrology.

Results: Obvious communicating branches between the bilateral cavernous arteries were observed in 200 patients, and the blood flow of the main trunk of the cavernous artery was significantly better than that of the main branch. Another 19 patients remained in a phase of persistent rigid erection and showed no obvious blood flow in at least one cavernous artery. Based on the peak systolic velocity (PSV) and end diastolic velocity (EDV), the remaining 8,890 patients were allocated to non-vascular, arterial, and venous ED groups. Based on the erection duration, the patients in the non-vascular ED group were allocated to persistent erection and non-persistent erection subgroups. The data of each group were standardized and statistically analyzed according to the age gradient. The PSV of the persistent erection, arterial ED, and venous ED groups showed a negative correlation with age, while the EDV of the arterial ED and venous ED groups showed a positive correlation with age.

Conclusions: The CDU parameters were found to be correlated with age. Additionally, the communicating branches between bilateral cavernous arteries and persistent rigid erection significantly affected the CDU results.

Background: This study explores the clinicopathological features, diagnostic criteria, treatments, and prognosis of mixed epithelial and stromal tumor of the kidney (MESTK), with a focus on atypical cases (males and young females)-filling the gap in the perception that "only perimenopausal women are susceptible" in MESTK epidemiological data.

Case description: A retrospective analysis of 4 MESTK patients (admitted between January 2019 and December 2024) was conducted, including epidemiological data, imaging findings, pathology, immunohistochemistry (IHC), treatments, and follow-up outcomes. This analysis was combined with a literature review to summarize diagnostic and treatment patterns. Among the 4 patients, 3 were male (21, 29, and 54 years old) and 1 was female (22 years old). All were asymptomatic except 1, who reported occasional low back pain; the tumors were detected incidentally in all cases. Imaging showed cystic or cystic-solid masses (3 classified as Bosniak IIF; 1 with fat density). Pathologically, all tumors exhibited biphasic epithelial-stromal differentiation. Immunohistochemically, epithelial components expressed paired box gene 8 (Pax-8) and cytokeratin 7 (CK7); stromal components expressed estrogen receptor (ER) and progesterone receptor (PR). All patients underwent robot-assisted laparoscopic partial nephrectomy; postoperatively, physician assessment showed no significant decline in renal function, and patients reported no discomfort such as low back pain, with uneventful follow-ups.

Conclusions: MESTK presents diverse clinical features, and male or young patients are not rare. Diagnosis requires integration of non-specific imaging findings with pathological and immunohistochemical examination (positive biphasic markers). Robot-assisted partial nephrectomy is effective, and benign cases have a good prognosis. This study enriches MESTK clinical data, aiding in the differentiation of atypical cases and providing clinical evidence for standardized diagnosis and minimally invasive treatment of such cases.

Background: Central obesity represents a well-established risk factor for stress urinary incontinence (SUI), with sagittal abdominal diameter-to-height ratio (SADHtR) recognized as a superior anthropometric indicator of visceral adiposity. However, the evidence between the SADHtR and SUI remains scarce. This study aimed to elucidate the association between SADHtR and SUI of adult women.

Methods: This cross-sectional study incorporated 4,846 women ≥20 years from the 2011-2016 cycles of the National Health and Nutrition Examination Survey (NHANES). Multivariable-adjusted logistic and linear regression models were used to investigate the relationship between SADHtR and the prevalence and severity of SUI. Smooth curve fitting methods and a two-piecewise linear regression model were employed to examine potential nonlinear relationships. Subgroup analyses and interaction tests were performed to identify potential effect modifiers. Propensity score matching (PSM) was employed to balance confounders, strengthening the robustness of the findings.

Results: A positive association was observed between SADHtR and both the prevalence and severity of SUI after adjusted for potential confounders [odds ratio (OR) =3.59; 95% confidence interval (CI): 2.75-4.69; P<0.001] (β=0.71; 95% CI: 0.23-1.19; P=0.004). The relationship between SADHtR and the prevalence of SUI exhibited non-linear dose-response, with an inflection point at SADHtR =0.14. Subgroup analyses demonstrated consistent associations across all examined cohorts and showed that the positive relationship was more pronounced among young women.

Conclusions: This study demonstrated a nonlinear positive association between SADHtR and SUI risk. Our findings establish SADHtR as a valuable anthropometric measure for SUI risk evaluation.