Pub Date : 2023-07-01DOI: 10.4103/uros.uros_126_22
V. Venkatachalapathy, D. Palathullil, George Abraham
Purpose: Sequential ureteral dilatation facilitates placement of ureteral access sheath during retrograde intrarenal surgery. The authors adopted some improvisations in conventional sequential ureteral dilatation methods to achieve improved ureteral accommodation and prefer to call the sequential ureteral dilatation performed with these improvisations as “Rule of five” (ROF) ureteral dilatation. The objective of the article was to describe the “ROF” ureteral dilatation technique and share the preliminary experience with the technique. Materials and Methods: “ROF” ureteral dilatation involves repetitive dilatation of ureter for five times by 10 Fr ureteral dilator, with each dilatation lasting for 5 s. The technique was used in patients who underwent retrograde intrarenal surgery for renal calculi and in whom 12 Fr ureteral dilator passage and 9.5/11.5 Fr ureteral access sheath placement was not possible by conventional sequential ureteral dilatation methods. Preliminary efficacy and safety outcomes were reported. Results: “ROF” ureteral dilatation was performed in 14 renal units. Ureteral access sheath placement was successful in 10 renal units (71.4%) and unsuccessful in 4 renal units (28.6%). Ureteral access sheath associated low-grade ureteral wall injury was noted in 2 renal units (14.3%). None had new onset hydroureteronephrosis in follow-up ultrasonography and all patients were asymptomatic in the follow-up period. Conclusion: “ROF” ureteral dilatation is an improvisation of conventional sequential ureteral dilatation. It facilitates successful and safe ureteral access sheath placement in a proportion of patients undergoing sequential ureteral dilatation.
{"title":"“Rule of Five” in Ureteral Dilatation and its Role in Ureteral Access Sheath Placement during Retrograde Intrarenal Surgery","authors":"V. Venkatachalapathy, D. Palathullil, George Abraham","doi":"10.4103/uros.uros_126_22","DOIUrl":"https://doi.org/10.4103/uros.uros_126_22","url":null,"abstract":"Purpose: Sequential ureteral dilatation facilitates placement of ureteral access sheath during retrograde intrarenal surgery. The authors adopted some improvisations in conventional sequential ureteral dilatation methods to achieve improved ureteral accommodation and prefer to call the sequential ureteral dilatation performed with these improvisations as “Rule of five” (ROF) ureteral dilatation. The objective of the article was to describe the “ROF” ureteral dilatation technique and share the preliminary experience with the technique. Materials and Methods: “ROF” ureteral dilatation involves repetitive dilatation of ureter for five times by 10 Fr ureteral dilator, with each dilatation lasting for 5 s. The technique was used in patients who underwent retrograde intrarenal surgery for renal calculi and in whom 12 Fr ureteral dilator passage and 9.5/11.5 Fr ureteral access sheath placement was not possible by conventional sequential ureteral dilatation methods. Preliminary efficacy and safety outcomes were reported. Results: “ROF” ureteral dilatation was performed in 14 renal units. Ureteral access sheath placement was successful in 10 renal units (71.4%) and unsuccessful in 4 renal units (28.6%). Ureteral access sheath associated low-grade ureteral wall injury was noted in 2 renal units (14.3%). None had new onset hydroureteronephrosis in follow-up ultrasonography and all patients were asymptomatic in the follow-up period. Conclusion: “ROF” ureteral dilatation is an improvisation of conventional sequential ureteral dilatation. It facilitates successful and safe ureteral access sheath placement in a proportion of patients undergoing sequential ureteral dilatation.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"148 - 154"},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47411662","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}
Pub Date : 2023-07-01DOI: 10.4103/uros.uros_118_22
Yu-hua Lin, Yu-Hua Fan, Chun-Te Wu, Yuan-chi Shen, Ju-Chuan Hu, Shih-Wei Huang, P. Chow, Po-Chih Chang, C. Liao, Yu-Chen Chen, Victor Lin, C. Hsu, Shang-Jen Chang, Chung-Cheng Wang, W. Lin, C. Lin, Yuan-Hong Jiang, H. Kuo
This article reports the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) among chronic spinal cord injured (SCI) patients in Taiwan. The main problems with SCI-NLUTD are failure to store, empty, or both. The management of SCI-NLUTD should be prioritized as follows: (a) preservation of renal function, (b) freedom from urinary tract infection, (c) efficient bladder emptying, (d) freedom from indwelling catheters, (e) patient agreement with management, and (f) avoidance of medication after proper management. The management of NLUTD in SCI patients must be based on urodynamic findings rather than neurologic evaluation inferences. It is important to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-NLUTD. Urodynamic studies should be performed on patients with SCI on a regular basis, and any urological complications should be adequately treated. When surgery is required, less invasive and reversible procedures should be considered first, and any unnecessary surgery in the lower urinary tract should be avoided. The most important aspect of treatment is to improve the quality of life in SCI patients with NLUTD. Annual active surveillance of bladder and renal function is required to avoid renal function deterioration and urological complications, particularly in high-risk SCI patients.
{"title":"Clinical guidelines of patient-centered bladder management of neurogenic lower urinary tract dysfunction due to chronic spinal cord injury – Part 3: Surgical treatment in chronic spinal cord injured patients","authors":"Yu-hua Lin, Yu-Hua Fan, Chun-Te Wu, Yuan-chi Shen, Ju-Chuan Hu, Shih-Wei Huang, P. Chow, Po-Chih Chang, C. Liao, Yu-Chen Chen, Victor Lin, C. Hsu, Shang-Jen Chang, Chung-Cheng Wang, W. Lin, C. Lin, Yuan-Hong Jiang, H. Kuo","doi":"10.4103/uros.uros_118_22","DOIUrl":"https://doi.org/10.4103/uros.uros_118_22","url":null,"abstract":"This article reports the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) among chronic spinal cord injured (SCI) patients in Taiwan. The main problems with SCI-NLUTD are failure to store, empty, or both. The management of SCI-NLUTD should be prioritized as follows: (a) preservation of renal function, (b) freedom from urinary tract infection, (c) efficient bladder emptying, (d) freedom from indwelling catheters, (e) patient agreement with management, and (f) avoidance of medication after proper management. The management of NLUTD in SCI patients must be based on urodynamic findings rather than neurologic evaluation inferences. It is important to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-NLUTD. Urodynamic studies should be performed on patients with SCI on a regular basis, and any urological complications should be adequately treated. When surgery is required, less invasive and reversible procedures should be considered first, and any unnecessary surgery in the lower urinary tract should be avoided. The most important aspect of treatment is to improve the quality of life in SCI patients with NLUTD. Annual active surveillance of bladder and renal function is required to avoid renal function deterioration and urological complications, particularly in high-risk SCI patients.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"109 - 116"},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43327271","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}
K. Movalled, Morteza Zavvar, H. Zafardoust, H. Salehi-pourmehr, S. Arlandis, Amirhossein Ghavidel-Sardsahra, S. Hajebrahimi
Purpose: This study aimed to review the functional urology guidelines, relate the level of evidence (LOE) of their recommendations and highlight the discrepancies between the LOE and grade of recommendation. Materials and Methods: The electronic search was conducted in May 2019 and updated in February 2021. Three researchers separately reviewed the extracted guidelines based on the Appraisal of Guidelines for Research and Evaluation II instrument. We extracted recommendations from each guideline and ranked them into three Grades of A, B, and C; and their evidence into four levels of I to IV. Results: Among the published functional urology guidelines, 18 guidelines were published between 2014 and 2020. Overall, 592 recommendations were abstracted. Of these, 121 recommendations were related to evaluation or diagnosis, and the others (n = 471) on the disease management. These recommendations were in the field of urinary incontinence (UI) (n = 216), overactive bladder (OAB) (n = 172), lower urinary tract symptoms (LUTS) (n = 126), and neurogenic bladder (NGB) (n = 78). Subgroup analysis showed that most of the recommendations in relation to UI were Grade A (n = 111; 51.4%), and one-third were Grade C (n = 83; 38.4%). The remaining 22 recommendations were Grade B (10.2%). In OAB, most of the recommendations were Grade B (n = 67, 39.0%), 55 of them were Grade A (32.0%) and the rest were Grade C (n = 50, 29.1%). Among UI guidelines, 51 (45.9%) Grade A recommendations were supported by LOE I evidence, and 39 (47.0%) Grade C recommendations were supported by LOE IV evidence. Across OAB guidelines, 43 (78.2%) Grade A recommendations were supported by LOE I evidence, and 20 (40.0%) Grade C recommendations were supported by LOE IV evidence. Across LUTS guidelines, 34 (61.8%) Grade A recommendations were supported by LOE I evidence, and 14 (23.3%) Grade C recommendations were supported by LOE IV evidence. Among NGB guidelines, 21 Grade A recommendations were supported by LOE I evidence, and 9 Grade C recommendations were supported by LOE IV evidence. Conclusion: Most of the recommendations in the field of functional urology are not based on the systematic review and meta-analysis of randomized controlled trials (RCTs) and high quality RCTs; which indicates that more attention is still needed in making decisions based on the certainty and grade of recommendations.
{"title":"Level of scientific evidence underlying recommendations arising from the functional urology guidelines","authors":"K. Movalled, Morteza Zavvar, H. Zafardoust, H. Salehi-pourmehr, S. Arlandis, Amirhossein Ghavidel-Sardsahra, S. Hajebrahimi","doi":"10.4103/uros.uros_82_22","DOIUrl":"https://doi.org/10.4103/uros.uros_82_22","url":null,"abstract":"Purpose: This study aimed to review the functional urology guidelines, relate the level of evidence (LOE) of their recommendations and highlight the discrepancies between the LOE and grade of recommendation. Materials and Methods: The electronic search was conducted in May 2019 and updated in February 2021. Three researchers separately reviewed the extracted guidelines based on the Appraisal of Guidelines for Research and Evaluation II instrument. We extracted recommendations from each guideline and ranked them into three Grades of A, B, and C; and their evidence into four levels of I to IV. Results: Among the published functional urology guidelines, 18 guidelines were published between 2014 and 2020. Overall, 592 recommendations were abstracted. Of these, 121 recommendations were related to evaluation or diagnosis, and the others (n = 471) on the disease management. These recommendations were in the field of urinary incontinence (UI) (n = 216), overactive bladder (OAB) (n = 172), lower urinary tract symptoms (LUTS) (n = 126), and neurogenic bladder (NGB) (n = 78). Subgroup analysis showed that most of the recommendations in relation to UI were Grade A (n = 111; 51.4%), and one-third were Grade C (n = 83; 38.4%). The remaining 22 recommendations were Grade B (10.2%). In OAB, most of the recommendations were Grade B (n = 67, 39.0%), 55 of them were Grade A (32.0%) and the rest were Grade C (n = 50, 29.1%). Among UI guidelines, 51 (45.9%) Grade A recommendations were supported by LOE I evidence, and 39 (47.0%) Grade C recommendations were supported by LOE IV evidence. Across OAB guidelines, 43 (78.2%) Grade A recommendations were supported by LOE I evidence, and 20 (40.0%) Grade C recommendations were supported by LOE IV evidence. Across LUTS guidelines, 34 (61.8%) Grade A recommendations were supported by LOE I evidence, and 14 (23.3%) Grade C recommendations were supported by LOE IV evidence. Among NGB guidelines, 21 Grade A recommendations were supported by LOE I evidence, and 9 Grade C recommendations were supported by LOE IV evidence. Conclusion: Most of the recommendations in the field of functional urology are not based on the systematic review and meta-analysis of randomized controlled trials (RCTs) and high quality RCTs; which indicates that more attention is still needed in making decisions based on the certainty and grade of recommendations.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"142 - 147"},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48768709","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}
A. Cheriyan, R. Mukha, S. Balakumar, N. John, Santosh Kumar
Purpose: Collecting duct carcinoma of the kidney (CDC) is an aggressive subtype of renal cell carcinoma with a dismal prognosis. The available knowledge concerning optimal management is still unclear. We report the largest single-institutional experience in the management of CDC. Materials and Methods: All the cases of CDC which were diagnosed at our center following a radical or partial nephrectomy in the past 15 years were included. Treatment details, radiological features, and histological features were reviewed. Descriptive statistics were used to show the clinicopathological profile and management of these patients, and Kaplan–Meier overall survival (OS) estimate was calculated. Results: Eighteen patients who were diagnosed and underwent the primary intervention at our center were included. The median age of patients was 40 years, with a male-to-female ratio of 5:1. Typical histopathological features included high-grade nuclear features, stromal desmoplasia, and tubular architecture. Surgery was the primary modality of treatment. Five (28%) patients who had metastases received adjuvant therapy, three received interferon-alpha therapy, and two received adjuvant chemotherapy with gemcitabine and cisplatin. The median follow-up was 19 months (range: 3–46 months). Kaplan–Meier OS estimate was 68% at 1 year and 48% at 3 years. Conclusion: CDC of the kidney often presents at an advanced stage, and has a poor prognosis. Survival remains poor despite surgery and adjuvant therapy.
{"title":"Collecting duct carcinoma of the kidney: Clinicopathological profile and outcomes","authors":"A. Cheriyan, R. Mukha, S. Balakumar, N. John, Santosh Kumar","doi":"10.4103/uros.uros_63_22","DOIUrl":"https://doi.org/10.4103/uros.uros_63_22","url":null,"abstract":"Purpose: Collecting duct carcinoma of the kidney (CDC) is an aggressive subtype of renal cell carcinoma with a dismal prognosis. The available knowledge concerning optimal management is still unclear. We report the largest single-institutional experience in the management of CDC. Materials and Methods: All the cases of CDC which were diagnosed at our center following a radical or partial nephrectomy in the past 15 years were included. Treatment details, radiological features, and histological features were reviewed. Descriptive statistics were used to show the clinicopathological profile and management of these patients, and Kaplan–Meier overall survival (OS) estimate was calculated. Results: Eighteen patients who were diagnosed and underwent the primary intervention at our center were included. The median age of patients was 40 years, with a male-to-female ratio of 5:1. Typical histopathological features included high-grade nuclear features, stromal desmoplasia, and tubular architecture. Surgery was the primary modality of treatment. Five (28%) patients who had metastases received adjuvant therapy, three received interferon-alpha therapy, and two received adjuvant chemotherapy with gemcitabine and cisplatin. The median follow-up was 19 months (range: 3–46 months). Kaplan–Meier OS estimate was 68% at 1 year and 48% at 3 years. Conclusion: CDC of the kidney often presents at an advanced stage, and has a poor prognosis. Survival remains poor despite surgery and adjuvant therapy.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"131 - 135"},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47211476","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}
Pub Date : 2023-07-01DOI: 10.4103/uros.uros_100_22
S. Pramod, and Yuananda, Ferry Safriadi, B. Hernowo
Purpose: This study aimed to determine survival rate and clinical characteristics of testicular tumor patients with a history of scrotal violation. Materials and Methods: This study was a retrospective cohort; we reviewed medical records from 2017 to 2021 with testicular tumors who had a history of scrotal violation. We evaluate clinical characteristics and survival up to 5 years. We used the KaplanMeier survival analysis and log-rank test. Results: There are 27 patients with testicular tumor who had a history of scrotal violation. Based on histopathological findings, the most common type was seminoma testis. While based on TNMS staging of the testicular tumor, the most common presentation is T2; Nx; Mx; and S3. Furthermore, based on the prognostic group for testicular tumor we found 5 patients with stage IB, 15 patients with stage IS, 2 patients with stage II, and 5 patients with stage III. Clinical manifestations of scrotal violation were residual tumor found in scrotal region in 2 patients, inguinal and abdominal region in 3 patients. Using the Kaplan-Meier survival curve, the 5-year survival rate was 44% from Statistical test in log-rank test, a significant result is obtained. Conclusion: Survival rate of testicular tumors who had a history of scrotal violation were lower and influenced by ECOG Performance Status Scale. Prognosis of a scrotal breach in the late stage may have a higher mortality rate. In contrast, there was a significant difference in outcome if the scrotal violation had been known at the early stages.
{"title":"Testicular tumor patients presented with scrotal violation-nonstandard surgical approach and its survival rate","authors":"S. Pramod, and Yuananda, Ferry Safriadi, B. Hernowo","doi":"10.4103/uros.uros_100_22","DOIUrl":"https://doi.org/10.4103/uros.uros_100_22","url":null,"abstract":"Purpose: This study aimed to determine survival rate and clinical characteristics of testicular tumor patients with a history of scrotal violation. Materials and Methods: This study was a retrospective cohort; we reviewed medical records from 2017 to 2021 with testicular tumors who had a history of scrotal violation. We evaluate clinical characteristics and survival up to 5 years. We used the KaplanMeier survival analysis and log-rank test. Results: There are 27 patients with testicular tumor who had a history of scrotal violation. Based on histopathological findings, the most common type was seminoma testis. While based on TNMS staging of the testicular tumor, the most common presentation is T2; Nx; Mx; and S3. Furthermore, based on the prognostic group for testicular tumor we found 5 patients with stage IB, 15 patients with stage IS, 2 patients with stage II, and 5 patients with stage III. Clinical manifestations of scrotal violation were residual tumor found in scrotal region in 2 patients, inguinal and abdominal region in 3 patients. Using the Kaplan-Meier survival curve, the 5-year survival rate was 44% from Statistical test in log-rank test, a significant result is obtained. Conclusion: Survival rate of testicular tumors who had a history of scrotal violation were lower and influenced by ECOG Performance Status Scale. Prognosis of a scrotal breach in the late stage may have a higher mortality rate. In contrast, there was a significant difference in outcome if the scrotal violation had been known at the early stages.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"136 - 141"},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48552842","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}
Purpose: Because bacterial motility has been implicated as a potential virulence factor, we compared the motile and nonmotile properties of bacteria isolated from urine cultures in women with recurrent urinary tract infections (RUTI) to test if such motility properties are linked to the extent of bladder wall infection on cystoscopy. Materials and Methods: After IRB approval, a retrospective review of women with antibiotic-recalcitrant symptomatic RUTI (≥3 Urinary tract infections/year) who underwent electrofulguration (EF) for cystitis was conducted. Pre-operative office cystoscopy staged cystitis as stage 1: trigone (trigonitis), stage 2: stage 1 and bladder base, stage 3: stage 2 and one or both lateral walls, and stage 4: the whole bladder (pancystitis). Positive urine cultures before EF for the type of bacteria (motile vs. non-motile) were compared among stages. Results: From 2006 to 2020, 139 women with RUTI met the study criteria. The median age was 67 with 95% Caucasian. Those with stage 4 cystitis were older (P = 0.0009) and less sexually active (P = 0.038). Patients with a higher stage were associated with a higher number of motile organisms (P = 0.0056), with an increased presence of non-E. Coli motile organisms (P < 0.0001) such as Proteus (P = 0.0024), Pseudomonas (P = 0.0062), Enterobacter (P = 0.020) and Citrobacter (P = 0.0067). Conclusion: The comparison of bacterial motility in women with RUTI at four different stages of bladder surface involvement identified unique characteristics and bacterial strains associated with each stage. RUTI women with higher stages of cystitis had more unique types of motile urinary bacterial strains, possibly suggesting a role in the spread of cystitis beyond the trigone.
{"title":"Does bacterial motility influence the extent of bladder wall involvement in women with recurrent urinary tract infections?","authors":"Rahul Patel, A. Christie, P. Zimmern","doi":"10.4103/uros.uros_74_22","DOIUrl":"https://doi.org/10.4103/uros.uros_74_22","url":null,"abstract":"Purpose: Because bacterial motility has been implicated as a potential virulence factor, we compared the motile and nonmotile properties of bacteria isolated from urine cultures in women with recurrent urinary tract infections (RUTI) to test if such motility properties are linked to the extent of bladder wall infection on cystoscopy. Materials and Methods: After IRB approval, a retrospective review of women with antibiotic-recalcitrant symptomatic RUTI (≥3 Urinary tract infections/year) who underwent electrofulguration (EF) for cystitis was conducted. Pre-operative office cystoscopy staged cystitis as stage 1: trigone (trigonitis), stage 2: stage 1 and bladder base, stage 3: stage 2 and one or both lateral walls, and stage 4: the whole bladder (pancystitis). Positive urine cultures before EF for the type of bacteria (motile vs. non-motile) were compared among stages. Results: From 2006 to 2020, 139 women with RUTI met the study criteria. The median age was 67 with 95% Caucasian. Those with stage 4 cystitis were older (P = 0.0009) and less sexually active (P = 0.038). Patients with a higher stage were associated with a higher number of motile organisms (P = 0.0056), with an increased presence of non-E. Coli motile organisms (P < 0.0001) such as Proteus (P = 0.0024), Pseudomonas (P = 0.0062), Enterobacter (P = 0.020) and Citrobacter (P = 0.0067). Conclusion: The comparison of bacterial motility in women with RUTI at four different stages of bladder surface involvement identified unique characteristics and bacterial strains associated with each stage. RUTI women with higher stages of cystitis had more unique types of motile urinary bacterial strains, possibly suggesting a role in the spread of cystitis beyond the trigone.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"93 - 98"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43592404","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}
An-Chen Chang, Po-Chun Chen, Hung-En Chen, T. Tsai, K. Chou, C. Ho, T. Hwang
Purpose: Although intravesical chemotherapy has several antitumoral benefits, it can also have severe side effects. The development of novel therapeutic approaches for bladder cancer (BC) is thus warranted. Hyperthermia (HT) is a widely applicable adjuvant therapy in various cancers. Therefore, this study investigated the effect of HT on improving the chemosensitivity of BC. Materials and Methods: The BC cell lines 5637 and T24 were cultured and treated with HT (43°C) for 24 h. Then, cell viability and survival were assessed using resazurin reagent and colony formation assay, respectively. Western blot assay was used to analyze the levels of Bax, Bcl-2, cleaved caspase-3, and cleaved poly (ADP-ribose) polymerase (PARP) protein expression. Mitochondria degradation was observed by MitoTracker Green staining. Results: In BC cells, HT co-administered with various concentrations of doxorubicin significantly inhibited cell viability and survival. Moreover, HT combined with doxorubicin promoted mitochondrial apoptosis, which caused Bax upregulation and Bcl-2 downregulation. Levels of cleaved caspase-3 and PARP protein expression were also elevated after co-treatment. Conclusion: Taken together, HT improved the chemosensitivity of BC cells to doxorubicin. HT combined with chemotherapy further activated mitochondrial apoptosis in BC cells. The findings suggested that HT may serve as a potential adjunctive treatment for BC that is ready to be applied clinically.
{"title":"Hyperthermia improves doxorubicin-based chemotherapy by activating mitochondrial apoptosis in bladder cancer","authors":"An-Chen Chang, Po-Chun Chen, Hung-En Chen, T. Tsai, K. Chou, C. Ho, T. Hwang","doi":"10.4103/UROS.UROS_6_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_6_22","url":null,"abstract":"Purpose: Although intravesical chemotherapy has several antitumoral benefits, it can also have severe side effects. The development of novel therapeutic approaches for bladder cancer (BC) is thus warranted. Hyperthermia (HT) is a widely applicable adjuvant therapy in various cancers. Therefore, this study investigated the effect of HT on improving the chemosensitivity of BC. Materials and Methods: The BC cell lines 5637 and T24 were cultured and treated with HT (43°C) for 24 h. Then, cell viability and survival were assessed using resazurin reagent and colony formation assay, respectively. Western blot assay was used to analyze the levels of Bax, Bcl-2, cleaved caspase-3, and cleaved poly (ADP-ribose) polymerase (PARP) protein expression. Mitochondria degradation was observed by MitoTracker Green staining. Results: In BC cells, HT co-administered with various concentrations of doxorubicin significantly inhibited cell viability and survival. Moreover, HT combined with doxorubicin promoted mitochondrial apoptosis, which caused Bax upregulation and Bcl-2 downregulation. Levels of cleaved caspase-3 and PARP protein expression were also elevated after co-treatment. Conclusion: Taken together, HT improved the chemosensitivity of BC cells to doxorubicin. HT combined with chemotherapy further activated mitochondrial apoptosis in BC cells. The findings suggested that HT may serve as a potential adjunctive treatment for BC that is ready to be applied clinically.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"64 - 69"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46692049","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}
Shin-Mei Wong, C. Tseng, Jian-Hua Hong, Kuo-How Huang, I. Chiang
Purpose: The five-grade international scale for vesicoureteral reflux (VUR) has been the mainstay for describing VUR severity. The concept of the distal ureteral diameter to the L1–L3 vertebral body distance ratio has been validated. We validated the ureteral diameter ratio (UDR) for predicting VUR outcomes and determined the cutoff value for spontaneous resolution. Materials and Methods: This retrospective review included children with primary VUR and detailed serial voiding cystourethrograms (VCUGs) between March 2005 and December 2016. Patient characteristics, VUR grade, laterality, UDR, laboratory data, and follow-up results were collected. UDR was estimated as the largest distal ureteral diameter within the pelvis divided by the distance of the L1–L3 vertebral bodies. The primary outcome was the prediction of spontaneous VUR resolution. The secondary outcome was the determination of the cutoff value of UDR in the present cohort. Results: We recruited 101 children (59 boys and 42 girls) diagnosed as having primary VUR based on VCUGs at a mean age of 23.48 months. VUR resolved spontaneously in 31 (30.7%) children, 40 (39.6%) children had persistent disease, and 30 (29.7%) received surgical correction. In univariate analysis, laterality, VUR grade, and UDR were significantly associated with spontaneous resolution (P = 0.017, P = 0.026, and P = 0.001, respectively). Multivariate analysis revealed UDR as the prognostic factor for spontaneous VUR resolution (odds ratio, 4.167; P = 0.023). The area under the curve of UDR indicates that the prediction accuracy was 0.74. The optimal cutoff value for UDR in this study was 0.264 (sensitivity, 0.81 and specificity, 0.63). Conclusion: UDR is superior to the VUR grade for predicting spontaneous VUR resolution. Our findings add significant prognostic value for children with primary VUR. A cutoff value of 0.264 may assist with clinical assessment and future management.
{"title":"Cutoff value of ureteral diameter ratio for predicting spontaneous resolution of vesicoureteral reflux","authors":"Shin-Mei Wong, C. Tseng, Jian-Hua Hong, Kuo-How Huang, I. Chiang","doi":"10.4103/UROS.UROS_30_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_30_22","url":null,"abstract":"Purpose: The five-grade international scale for vesicoureteral reflux (VUR) has been the mainstay for describing VUR severity. The concept of the distal ureteral diameter to the L1–L3 vertebral body distance ratio has been validated. We validated the ureteral diameter ratio (UDR) for predicting VUR outcomes and determined the cutoff value for spontaneous resolution. Materials and Methods: This retrospective review included children with primary VUR and detailed serial voiding cystourethrograms (VCUGs) between March 2005 and December 2016. Patient characteristics, VUR grade, laterality, UDR, laboratory data, and follow-up results were collected. UDR was estimated as the largest distal ureteral diameter within the pelvis divided by the distance of the L1–L3 vertebral bodies. The primary outcome was the prediction of spontaneous VUR resolution. The secondary outcome was the determination of the cutoff value of UDR in the present cohort. Results: We recruited 101 children (59 boys and 42 girls) diagnosed as having primary VUR based on VCUGs at a mean age of 23.48 months. VUR resolved spontaneously in 31 (30.7%) children, 40 (39.6%) children had persistent disease, and 30 (29.7%) received surgical correction. In univariate analysis, laterality, VUR grade, and UDR were significantly associated with spontaneous resolution (P = 0.017, P = 0.026, and P = 0.001, respectively). Multivariate analysis revealed UDR as the prognostic factor for spontaneous VUR resolution (odds ratio, 4.167; P = 0.023). The area under the curve of UDR indicates that the prediction accuracy was 0.74. The optimal cutoff value for UDR in this study was 0.264 (sensitivity, 0.81 and specificity, 0.63). Conclusion: UDR is superior to the VUR grade for predicting spontaneous VUR resolution. Our findings add significant prognostic value for children with primary VUR. A cutoff value of 0.264 may assist with clinical assessment and future management.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"75 - 79"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49278264","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}
B. Reddy, M. Kulshreshtha, S. Reddy, S. Pillai, A. Chawla, M. Shah, B. Somani, Sanket Kankaria
Purpose: To assess the safety and efficacy of self-removing antegrade tethered stents after percutaneous nephrolithotomy (PNL) during the COVID-19 pandemic. Materials and Methods: Instead of routine placement of double-J stent which requires endoscopic removal, a tethered antegrade stent after tubeless PNL as an exit strategy followed by self-removal can obviate the need of early postoperative revisit. A prospective observational study in a university teaching hospital was conducted during the lockdown period from May 2021–June 2021 with the use of antegrade tethered stent in 30 patients and we studied the complications associated with it. Results: The average stone size among the patients was 2.4 cm (1.2–4.9). Postoperative visual analog scale (VAS) till the time of stent removal was 30.8 + 4.4 mm while the VAS at stent removal was 26.6 + 3.8 mm. None of the patients had urine leak or hemorrhage from the site of percutaneous access after self-removal of stent. Two (6.66 percent) patients had grade I and grade II modified Clavien–Dindo complication. The mean score of satisfaction with life scale (SWLS) Questionnaire was 31 (34–27). The present study demonstrates that tubeless PNL with antegrade tethered stent has the advantages of avoiding hospital visits for stent removal during COVID-19. Conclusion: The use of an antegrade threaded stent is safe, culminating in minimal morbidity and patient distress, and greater overall patient satisfaction.
{"title":"Self-removing antegrade tethered ureteric stents after tubeless percutaneous nephrolithotomy in the COVID-19 era: A prospective study from a university teaching hospital","authors":"B. Reddy, M. Kulshreshtha, S. Reddy, S. Pillai, A. Chawla, M. Shah, B. Somani, Sanket Kankaria","doi":"10.4103/UROS.UROS_46_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_46_22","url":null,"abstract":"Purpose: To assess the safety and efficacy of self-removing antegrade tethered stents after percutaneous nephrolithotomy (PNL) during the COVID-19 pandemic. Materials and Methods: Instead of routine placement of double-J stent which requires endoscopic removal, a tethered antegrade stent after tubeless PNL as an exit strategy followed by self-removal can obviate the need of early postoperative revisit. A prospective observational study in a university teaching hospital was conducted during the lockdown period from May 2021–June 2021 with the use of antegrade tethered stent in 30 patients and we studied the complications associated with it. Results: The average stone size among the patients was 2.4 cm (1.2–4.9). Postoperative visual analog scale (VAS) till the time of stent removal was 30.8 + 4.4 mm while the VAS at stent removal was 26.6 + 3.8 mm. None of the patients had urine leak or hemorrhage from the site of percutaneous access after self-removal of stent. Two (6.66 percent) patients had grade I and grade II modified Clavien–Dindo complication. The mean score of satisfaction with life scale (SWLS) Questionnaire was 31 (34–27). The present study demonstrates that tubeless PNL with antegrade tethered stent has the advantages of avoiding hospital visits for stent removal during COVID-19. Conclusion: The use of an antegrade threaded stent is safe, culminating in minimal morbidity and patient distress, and greater overall patient satisfaction.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"70 - 74"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45151156","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}
Sih-Han Chen, Chun-Hsien Wu, R. Wu, Hsing-Chia Mai, V. Lin
Purpose: The gold standard for treatment of urothelial carcinoma (UC) of the ureter is radical nephroureterectomy (RNU) with bladder cuff excision. However, segmental ureterectomy (SU) can be considered in specific cases, such as serious renal insufficiency or solitary kidney. This study evaluated oncologic and renal function outcomes of SU compared with RNU for treatment of UC of the ureter. Materials and Methods: This single-center retrospective study assessed 99 patients who underwent SU or RNU for UC of the ureter from October 2005 to May 2021. Exclusion criteria were end-stage renal disease managed with regular hemodialysis (10 patients) and previous or concurrent radical cystectomy due to muscle-invasive bladder cancer (20 patients). The study enrolled 69 patients, with 39 in the RNU group and 30 in the SU group, to compare perioperative outcomes and renal function outcomes between the groups. Kaplan–Meier analysis and the log-rank test were performed to compare overall survival (OS), cancer-specific survival (CSS), intravesical recurrence-free survival (IVRFS), and disease-free survival (DFS) between the groups. Results: The mean age was 67.5 years in the RNU group and 68.3 years in the SU group. The median tumor length was 3.2 cm in the RNU group and 2.4 cm in the SU group. Patients who underwent RNU had a significantly decreased estimated glomerular filtration rate at 3 months postoperatively (−6.4 vs. 3.5 mL/min/1.73 m2; P = 0.001). No significant differences were found for OS, CSS, and IVRFS between the groups. However, the SU group had shorter DFS (P = 0.029). Conclusion: Results showed that SU may preserve better renal function. The OS and CSS were comparable between the groups; however, the SU group had shorter DFS. When preservation of renal function is warranted, SU may be considered for patients with UC of the ureter.
{"title":"Oncologic and renal function outcomes of segmental ureterectomy versus radical nephroureterectomy for urothelial carcinoma of the ureter","authors":"Sih-Han Chen, Chun-Hsien Wu, R. Wu, Hsing-Chia Mai, V. Lin","doi":"10.4103/UROS.UROS_54_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_54_22","url":null,"abstract":"Purpose: The gold standard for treatment of urothelial carcinoma (UC) of the ureter is radical nephroureterectomy (RNU) with bladder cuff excision. However, segmental ureterectomy (SU) can be considered in specific cases, such as serious renal insufficiency or solitary kidney. This study evaluated oncologic and renal function outcomes of SU compared with RNU for treatment of UC of the ureter. Materials and Methods: This single-center retrospective study assessed 99 patients who underwent SU or RNU for UC of the ureter from October 2005 to May 2021. Exclusion criteria were end-stage renal disease managed with regular hemodialysis (10 patients) and previous or concurrent radical cystectomy due to muscle-invasive bladder cancer (20 patients). The study enrolled 69 patients, with 39 in the RNU group and 30 in the SU group, to compare perioperative outcomes and renal function outcomes between the groups. Kaplan–Meier analysis and the log-rank test were performed to compare overall survival (OS), cancer-specific survival (CSS), intravesical recurrence-free survival (IVRFS), and disease-free survival (DFS) between the groups. Results: The mean age was 67.5 years in the RNU group and 68.3 years in the SU group. The median tumor length was 3.2 cm in the RNU group and 2.4 cm in the SU group. Patients who underwent RNU had a significantly decreased estimated glomerular filtration rate at 3 months postoperatively (−6.4 vs. 3.5 mL/min/1.73 m2; P = 0.001). No significant differences were found for OS, CSS, and IVRFS between the groups. However, the SU group had shorter DFS (P = 0.029). Conclusion: Results showed that SU may preserve better renal function. The OS and CSS were comparable between the groups; however, the SU group had shorter DFS. When preservation of renal function is warranted, SU may be considered for patients with UC of the ureter.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"80 - 85"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49230042","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：