Urology Journal最新文献

Purpose: The exact molecular and cellular processes that cause benign urological diseases in the stromal and epithelial components of the urinary tract are yet unknown. Reviewing and analyzing the data linking microRNAs (miRNAs) expression in the pathophysiology of benign urological conditions, including overactive bladder (OAB), bladder outlet obstruction (BOO), bladder pain syndrome/interstitial cystitis (BPS/IC), and Lower urinary tract dysfunction (LUTD) is the objective of the current systematic review.

Materials and methods: Evidence including all case-control, cohort, and cross-sectional studies that measure participants' MicroRNA as a biomarker for benign urological diseases has been gathered in January 2024, through searching MEDLINE via PubMed, Scopus, Web of Science, Embase, and ProQuest databases. Studies considered eligible that present information on the reference Gene, profile type, and serum levels of microRNA from patients diagnosed with benign urological disease including benign prostate hyperplasia (BPH) or benign prostate enlargement (BPE), overactive bladder (OAB), and bladder outlet obstruction (BOO). These studies were appraised by the quality assessment checklist of Joanna Briggs Institute (JBI).

Results: A total of 4,587 records related to miRNAs in urological diseases were retrieved. Of these, we identified 28 records for our systematic study. The most frequently associated miRNA was 92a-3p identified which was found upregulated in OAB diagnosis. In BOO, miR-146a-5p was identified to be upregulated. miR-146a-5p was upregulated in BO, and for other benign conditions, different miRNAs were reported. 491-5p miRNAs were found deregulated in OAB-related studies. We expected other miRNAs to have the same trend in the OAB studies. InSUI miR-93 was the most frequent downregulated miRNA. The other reported miRNAs had similar frequencies.

Conclusion: When it comes to the early detection and treatment of benign urological conditions, 92a-3p, miR-21, miR-199a-5p, and miR-146a-5p, and 491-5p have the potential to be employed as both a biomarker and a therapeutic target. The creation of pre-RNA or anti-RNA molecules within carrier vehicles that may be safely administered to patients should be made possible by technological advancements.

Purpose: The primary outcome of this study is to compare the success rates of ONB techniques performed either with ultrasound guidance or with the blind technique. The second outcome is to compare the incidences of perioperative bleeding and the presence of recurrent tumors in the control cystoscopy performed in the 3rd postoperative month in both groups.

Materials and methods: The study was conducted in the urology operating room of Mugla Sitki Kocman Training and Research Hospital between December 2019 and March 2023. A total of 122 patients were included in the study: 22 females with a mean age of 56.63 ± 12.99 years and 100 males with a mean age of 63.18 ± 8.00 years. In one group (group 1), ONB was performed under ultrasound guidance by the same anesthesiologist, and in another group (group 2), ONB was performed blindly based on anatomical signs by the same urologist.

Results: Adductor muscle contraction was not observed in 53 patients (91.4%) in group 1 and in 49 patients (76.6%) in group 2 (p = 0.027).

Conclusion: The success rate of ONB was higher when using an ultrasound-guided technique than when using a blind technique.

Purpose: Chromosome 7 open reading frame 61 (C7orf 61) was a testis-specific gene, and may be involved in the process of spermatogenesis. This study aimed to investigate the expression of C7orf61 in the testis and determine its role in spermatogenesis.

Materials and methods: Reverse transcription-quantitative polymerase chain reaction, Western blot and immunofluorescence were performed to evaluate the expression characteristics of C7orf61 in mice and humans. In vitro fertilization assay was used to determine the role of the C7ORF61 protein in sperm-egg fusion.

Results: The results demonstrated that C7orf61 was a testis-specific gene; the C7ofr61 mRNA expression level sharply increased in the fourth postnatal week and gradually increased until the adult stage. The C7ORF61 protein was located throughout the subacrosomal area and close to the nucleus in both mouse and human sperm. The incubation with the C7ORF61 antibody significantly decreased the fertilization rate of mouse eggs.

Conclusion: The present findings suggested that the C7ORF61 protein might be involved in sperm-egg fusion, and could serve as a useful target for contraceptives. However, further research is still needed to know the detailed molecularmechanismofitsrole.

Purpose: To explore the efficacy and safety of a self-improved continuous bladder irrigation (CBI) sensor device after transurethral resection of the prostate (TURP).

Materials and methods: A total of 160 patients with benign prostatic hyperplasia who received TURP from June 2021 to May 2022 were selected. According to the envelope randomization method, patients were divided into a control group (80 cases) and study group (80 cases). In the control group, the speed of bladder flushing fluid was adjusted according to the clinical experience of nurses. On the basis of the control group, the self-improved CBI sensor device was used in the study group to observe the postoperative comfort and complication rate in the two groups.

Results: The comfort of patients in the study group was significantly higher than that of patients in the control group (97.50% vs. 88.75%, P = .023), and the number of postoperative complications in the control group was significantly higher than that in the study group (8.75% vs. 1.25%, P = .021). Meanwhile, the average amount of irrigation fluid in the study group was obviously lower than that in the control group (26.4 L vs. 27.8 L, P = .011). In addition, patients in the study group had a significantly shorter hospital stay than the controls (3.3 days vs. 3.6 days, P = .005).

Conclusion: Implementation of the new self-improved CBI sensor device for patients after TURP can improve their awareness regarding disease-related knowledge, alleviate their fear and anxiety, improve their compliance and comfort with treatment and nursing, and reduce the incidence of complications.

Purpose: Platelet-rich plasma (PRP) is enriched with active biological components which showed proliferative and cytoprotective properties in healing different injuries in medicinal fields. This study was designed to assess the cryoprotective effects of autologous PRP on the quality of oligoasthenoteratospermia (OAT) samples during freezing and thawing procedure.

Materials and methods: The present study is an experimental research. Twenty OAT semen samples were obtained from individuals and prepared by discontinuous density - gradients technique DGC). The control group is sperm samples after DGC. After the procedure, the specimen was divided into four groups. The Freeze group which has no additive and the other three groups were cryopreserved with different concentrations of PRP (1×105/ μL, 0.5×105/μL and 0.25×105/μL). Autologous PRP was provided by each participant. After thawing, sperm parameters, DNA fragmentation by sperm chromatin dispersion test (SCD), protamine deficiency by (Chromomycin A3) CMA3 staining, acrosome integrity and malondialdehyde (MDA) level were evaluated.

Results: Cryopreservation resulted in a significant decrease in all factors compared to the control group. There were no significant changes in sperm count, morphology, non-progressive motility and acrosome reaction by adding PRP as a cryoprotectant in comparison with the freeze group. PRP at all three concentrations showed a significant increase in progressive motility (3.05 ± 2.01 vs. 14.05 ± 4.13, 12.35 ± 4.90 and 12.15 ± 9.65, P < 0.001) and viability (36.85 ± 10.25 vs. 47.85 ± 5.86, 51.30 ± 5.54 and 50.05 ± 5.67, P < 0.001) compared to the sperm samples without PRP. The percentage of immotile sperms decreased at all PRP concentrations compared to the freeze group. Moreover, PRP at 1×105/μL concentration showed cryoprotective effects on DNA fragmentation, protamine deficiency and MDA level compared to the other three concentrations.

Conclusion: Cryopreservation and thawing procedures may exert adverse effects on biological factors of sperm samples. Therefore, adding PRP as cryoprotectant at all three concentrations especially 1×105/μL can be promising strategy to reduce adverse effects of cryopreservation on OAT samples.

Purpose: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA).

Materials and methods: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound.

Results: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased.

Conclusion: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

Purpose: The incidence of ureteral injury is increasing due to extensive application of the endourological procedures. In the present study, we evaluated the accuracy of imaging studies in predicting length of defect in patients with ureteral injury.

Methods: We reviewed data of all consecutive patients who underwent endourological management for ureteral injury in our institution from Jan 2020 to Jan 2023, to assess the accuracy of radiological evaluations in determining the length of ureteral defect. We compared the radiological imaging results with intraoperative findings to determine its diagnostic accuracy.

Results: We report data on accuracy of preoperative imaging and outcomes of endourological management in 5 patients who presented with apparently long ureteral defects in preoperative radiological evaluations following ureteral injury. The mean age was 42[30.5-42.5]. three of five were male. The mean time from injury to ureteroscopic management was 12.5±7.5 days. The mean follow up time was 7.3±2.2 months.  Our experience showed that radiological evaluations have the potential to overestimate the length of defect.

Conclusion: Radiological evaluations following ureteral injury have the potential to overestimate the length of defect and therefore endoscopic evaluations and intraoperative imaging studies are necessary to accurately determine the length of defect and appropriate management. However, endourological management is safe and efficient in treating patients with short segment ureteral defect/injury.

Objective: Penile torsion is a counterclockwise rotational anomaly of the penile shaft or glans. We aimed to evaluate the results of dorsal dartos flap rotation technique in children with isolated penile torsion.

Materials and methods: 5470 boys who applied to our clinic between 2012 and 2022 for circumcision were evaluated for congenital isolated penile torsion. They were classified according to the degree and direction of torsion and clinical findings were analyzed.  According to the degree of torsion, penile degloving or dorsal dartos flap rotation technique with circumcision was performed. Patients whose torsion corrected after penile degloving were excluded from the study. The results of dorsal dartos flap rotation technique were evaluated.  Results: Congenital isolated penile torsion ≥60° was identified in 1.04 % (n=57) of the children. Eight patients whose torsion corrected after penile degloving were excluded from the study. 49 patients who underwent dorsal dartos flap rotation had a mean age of 4.94 years (1-9) and a mean operation time of 29.9 min (20-40). The mean degree of torsion was 77.6° (60-110). The mean operation times in the < 90° and ≥ 90° dorsal dartos flap groups were statistically significant (p<0.05).  Residual torsion was statistically significant in the < 90° and ≥ 90° dorsal dartos flap groups (p<0.05).  At the postoperative 1st and 6th month follow-ups, torsion less than 10 degrees was observed in 3 patients who underwent dorsal dartos flap rotation technique. No residual torsion was observed in other patients.

Conclusion: Isolated penile torsion cases should not be overlooked during circumcision.  It seems possible to obtain successful results with dorsal dartos flap rotation in moderate and severe torsions.

Purpose: Prostate cancer (PCA) is the second most common malignancy in Western countries. Long non-coding RNAs are new markers in disease diagnosis. Our aim of this study was to investigate liquid biopsy biomarkers with high specificity and sensitivity for early diagnosis of PCA patients in Iran.

Materials and methods: Blood specimens were collected from 29 PCA, 32 benign prostate hyperplasia (BPH), and 29 control (CTRL) individuals. Real-time PCR analyzed expression amounts of PSA, ARLNC1, UCA1, and PCA3. The ROC curve (receiver operating characteristic curve) analysis evaluated the diagnostic power of the examined molecules for PCA.

Results: There was a significant upregulation of PCA3 in PCA and BPH groups compared to the controls (p values for PCA3=< 0.001 and BPH vs. CTRL = 0.0015) while there was no significant difference between PCA and BPH individuals. A significant upregulation of ARLNC1 was seen in BPH group compared to the controls (p value=0.0042). Also, PCA3 expression level showed a significant relationship with prostate volume. There was no significant difference in UCA1 and PSA expression levels among the three groups (>0.05). The PCA3/PSA ratio was significantly increased in PCA and BPH individuals vs. the CTRL group with high sensitivity and specificity. The gene expression of PCA3 and ARLNC1 in the BPH group showed a significant relationship with age.

Conclusion: Our findings showed that in the diagnosis of prostate cancer, measuring the expression of PCA3, PSA, and ARLNC1 genes is necessary to determine the health, benign, or cancerous status of patients' prostate. Also, selecting the PCA3/PSA ratio provides a new approach for diagnosing this cancer if confirmed in a larger clinical sample size and functional studies.

Purpose: Estrogen receptor (ER) genes play key roles in male and female reproduction. Non-obstructive azoospermia (NOA) and severe secretory oligozoospermia (SOL) are the most severe and complex conditions impacting male fertility. This meta-analysis aimed to study the association between PvuII ( rs2234693, 397T>C ), XbaI ( rs9340799, 351G>A ), AluI (1730G>A, rs4986938), and RsaI (1082G>A, rs1256049) polymorphisms and spermatogenic failure.

Materials and methods: The literature in PubMed, Medline, Embase, Web of Science, Cochrane Library, China Science and Technology Journal Database, WanFang data, and China National Knowledge Infrastructure databases were systematically searched, and a meta-analysis was conducted to investigate the association between polymorphism in estrogen receptors and spermatogenic failure. According to a set criterion, 10 studies were included for analyses.

Results: ER α XbaI polymorphism was a decreased risk of NOA. The ER α PvuII polymorphisms does not associate with NOA and SOL. ER β AluI polymorphism increased the risk of NOA in Caucasian population. ER β RsaI polymorphism was a decreased risk of NOA and SOL in Caucasian males.

Conclusion: The ER α XbaI and ER β RsaI polymorphisms are associated with the risk of NOA and SOL.