Pub Date : 2023-01-01DOI: 10.4103/UROS.UROS_115_22
Yi-Jhou Chen, S. Lo, E. Meng, Jing-Dung Shen, E. Chou, S. Chen, Ming-Huei Lee, Chao-Yu Hsu, Hueih-Ling Ong, Jian-ting Chen, Sung-Lang Chen, Y. Tsai, C. Lin, Shuling Wu, B. Chiu, H. Kuo
This article presents the current evidence and expert opinions on the patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) for patients with chronic spinal cord injury (SCI) in Taiwan. This review article focuses on the pathophysiology, treatment strategies, and priorities of bladder management in patients with chronic SCI. The main problems of SCI-NLUTD are storage failure, voiding failure, and combined retention and voiding failure. The priorities in the management of SCI-NLUTD are as follows in order of importance: (1) preserving renal function, (2) preventing urinary tract infection, (3) achieving efficient bladder emptying, (4) avoiding indwelling catheter use, (5) obtaining patient agreement with management, and (6) avoiding medication after proper management. Management of NLUTD in SCI patients should be based on urodynamic study findings rather than inferences from neurologic evaluations. Conservative treatment and bladder management by clean intermittent catheterization should be the first-line option. When surgical intervention is necessary, less invasive types of surgery and reversible procedures should be considered first and any unnecessary surgery in the lower urinary tract should be avoided.
{"title":"Clinical guidelines of patient-centered bladder management of neurogenic lower urinary tract dysfunction due to chronic spinal cord injury-part 1: Pathophysiology, treatment strategy, and priority","authors":"Yi-Jhou Chen, S. Lo, E. Meng, Jing-Dung Shen, E. Chou, S. Chen, Ming-Huei Lee, Chao-Yu Hsu, Hueih-Ling Ong, Jian-ting Chen, Sung-Lang Chen, Y. Tsai, C. Lin, Shuling Wu, B. Chiu, H. Kuo","doi":"10.4103/UROS.UROS_115_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_115_22","url":null,"abstract":"This article presents the current evidence and expert opinions on the patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) for patients with chronic spinal cord injury (SCI) in Taiwan. This review article focuses on the pathophysiology, treatment strategies, and priorities of bladder management in patients with chronic SCI. The main problems of SCI-NLUTD are storage failure, voiding failure, and combined retention and voiding failure. The priorities in the management of SCI-NLUTD are as follows in order of importance: (1) preserving renal function, (2) preventing urinary tract infection, (3) achieving efficient bladder emptying, (4) avoiding indwelling catheter use, (5) obtaining patient agreement with management, and (6) avoiding medication after proper management. Management of NLUTD in SCI patients should be based on urodynamic study findings rather than inferences from neurologic evaluations. Conservative treatment and bladder management by clean intermittent catheterization should be the first-line option. When surgical intervention is necessary, less invasive types of surgery and reversible procedures should be considered first and any unnecessary surgery in the lower urinary tract should be avoided.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"3 - 9"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47612462","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}
M. Chaliy, Dmitri Ohobotov, N. Sorokin, A. Kadrev, L. Dyachuk, A. Strigunov, O. Nesterova, A. Mikhalchenko, R. Bogachev, S. Abbosov, A. Tivtikyan, A. Kamalov
Purpose: To determine the agreement between two erectile dysfunction (ED) diagnostic methods, International Index of Erectile Function-15 (IIEF-15) questionnaire and “Androscan MIT” night penile tumescence recorder. Materials and Methods: An assessment of ED in 40 patients (age, 25–60 years) was performed using the “Androscan MIT” device and IIEF-15 questionnaire (erectile domain). Cohen's kappa coefficient and receiver operating characteristic (ROC) analyses were used to examine the difference between “Androscan MIT” and IIEF-15 questionnaire results. During ROC-analyses “Androscan MIT” results were considered the gold standard for ED diagnosis. Results: “Androscan MIT” results had a significant but weak positive correlation with IIEF-15 questionnaire (kappa value = 0.333, P < 0.01). Based on the ROC-analyses, it was found that the sensitivity and specificity of the IIEF-15 questionnaire for severe ED according to “Androscan MIT” were 100% and 55.9%, respectively. The sensitivity and specificity of the IIEF-15 questionnaire for moderate ED according to “Androscan MIT” were 63.2% and 57.1%, and for mild ED, 23.1% and 33.3% respectively. The lowest accuracy of the IIEF-15 questionnaire was for patients with normal erectile function (sensitivity and specificity were 0% and 44.7%, respectively). Conclusion: The agreement between the objective and subjective diagnosis of ED remains low. At the same time, the lower severity of ED according to “Androscan MIT” is associated with less diagnostic value of IIEF-15.
{"title":"A comparison of the international index of erectile function and measurement of nocturnal penile tumescence using the Androscan MIT device","authors":"M. Chaliy, Dmitri Ohobotov, N. Sorokin, A. Kadrev, L. Dyachuk, A. Strigunov, O. Nesterova, A. Mikhalchenko, R. Bogachev, S. Abbosov, A. Tivtikyan, A. Kamalov","doi":"10.4103/UROS.UROS_13_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_13_22","url":null,"abstract":"Purpose: To determine the agreement between two erectile dysfunction (ED) diagnostic methods, International Index of Erectile Function-15 (IIEF-15) questionnaire and “Androscan MIT” night penile tumescence recorder. Materials and Methods: An assessment of ED in 40 patients (age, 25–60 years) was performed using the “Androscan MIT” device and IIEF-15 questionnaire (erectile domain). Cohen's kappa coefficient and receiver operating characteristic (ROC) analyses were used to examine the difference between “Androscan MIT” and IIEF-15 questionnaire results. During ROC-analyses “Androscan MIT” results were considered the gold standard for ED diagnosis. Results: “Androscan MIT” results had a significant but weak positive correlation with IIEF-15 questionnaire (kappa value = 0.333, P < 0.01). Based on the ROC-analyses, it was found that the sensitivity and specificity of the IIEF-15 questionnaire for severe ED according to “Androscan MIT” were 100% and 55.9%, respectively. The sensitivity and specificity of the IIEF-15 questionnaire for moderate ED according to “Androscan MIT” were 63.2% and 57.1%, and for mild ED, 23.1% and 33.3% respectively. The lowest accuracy of the IIEF-15 questionnaire was for patients with normal erectile function (sensitivity and specificity were 0% and 44.7%, respectively). Conclusion: The agreement between the objective and subjective diagnosis of ED remains low. At the same time, the lower severity of ED according to “Androscan MIT” is associated with less diagnostic value of IIEF-15.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"18 - 22"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46813410","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: Coronavirus disease 2019 (COVID-19) is a disease that can affect many of our organs, and its effects on the human body are still unknown. In this study, we aimed to find the answer to the question of whether erectile dysfunction (ED) develops in patients who had COVID-19. Materials and Methods: This is a prospective study of 459 patients. Married male patients aged between 25 and 70 years and who were hospitalized and treated for COVID-19 were included in the study. The patients were divided into three groups as mild, moderate, and severe cases, according to the extent of the disease. Each patient was asked to complete the International Index of Erectile Function (IIEF) upon admission and 45th and 90th days after discharge. Admission, 45th and 90th values of IIEF were compared within itself. Results: Statistically significant differences were observed in the IIEF evaluations on admission and 45th and 90th days of the patients in the three groups. IIEF values of three patient groups displayed a decrease on the 45th day with respect to admission, while the 90th day values were higher in comparison to 45th day, although still remained lower than the values of admission. Evaluation of the erectile function values of the patients revealed that IIEF values on admission decreased on 45th and 90th day values. Conclusions: We determined that COVID-19 affected IIEF values in male patients, which might cause ED by reducing erectile function values.
{"title":"Does erectile dysfunction develop following COVID-19 infection?","authors":"Mustafa Karabıçak, H. Türk","doi":"10.4103/uros.uros_18_22","DOIUrl":"https://doi.org/10.4103/uros.uros_18_22","url":null,"abstract":"Purpose: Coronavirus disease 2019 (COVID-19) is a disease that can affect many of our organs, and its effects on the human body are still unknown. In this study, we aimed to find the answer to the question of whether erectile dysfunction (ED) develops in patients who had COVID-19. Materials and Methods: This is a prospective study of 459 patients. Married male patients aged between 25 and 70 years and who were hospitalized and treated for COVID-19 were included in the study. The patients were divided into three groups as mild, moderate, and severe cases, according to the extent of the disease. Each patient was asked to complete the International Index of Erectile Function (IIEF) upon admission and 45th and 90th days after discharge. Admission, 45th and 90th values of IIEF were compared within itself. Results: Statistically significant differences were observed in the IIEF evaluations on admission and 45th and 90th days of the patients in the three groups. IIEF values of three patient groups displayed a decrease on the 45th day with respect to admission, while the 90th day values were higher in comparison to 45th day, although still remained lower than the values of admission. Evaluation of the erectile function values of the patients revealed that IIEF values on admission decreased on 45th and 90th day values. Conclusions: We determined that COVID-19 affected IIEF values in male patients, which might cause ED by reducing erectile function values.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"33 - 38"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44807455","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 : 2023-01-01DOI: 10.4103/uros.uros_133_22
Ping-Chia Chiang, P. Chiang, Hao-Lun Luo
{"title":"Comparison between En bloc Resection and conventional resection of bladder tumor in perioperative and oncological outcomes","authors":"Ping-Chia Chiang, P. Chiang, Hao-Lun Luo","doi":"10.4103/uros.uros_133_22","DOIUrl":"https://doi.org/10.4103/uros.uros_133_22","url":null,"abstract":"","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70853333","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: Metformin, an antidiabetic drug, has been proposed to play a possible protective role in cancer recurrence and patient mortality. However, the exact mechanism and efficacy of metformin in urothelial cancer, especially upper tract urothelial carcinoma (UTUC), remain unknown. In this study, we conducted a population-based analysis to investigate whether metformin could improve the survival rate of patients with UTUC. Materials and Methods: Males ≥40 years diagnosed with UTUC were included in this retrospective population-based longitudinal cohort study. Data were collected from the registry of the Taiwan National Health Insurance database for patients with UTUC and type 2 diabetes mellitus (T2DM). Patients who had received at least two prescriptions of metformin were included in the study cohort as ever-users, and patients who had never used metformin were included in the control cohort as never-users. The hazard ratios (HRs) were calculated using Cox regression for ever-users and never-users. Results: Among the 781 enrolled patients, 439 and 342 patients were included as ever-users and never-users, respectively. The median survival time was 3.95 years in the never-user cohort compared to 6.90 years in the ever-user cohort, which remained statistically significant in both univariate and multivariate analyses (HR = 0.63 and 0.72, P = 0.0001 and 0.011, respectively). Furthermore, subgroup analysis showed that continuous usage of metformin before and after the diagnosis of UTUC was associated with a better survival in patients with UTUC (adjusted HR = 0.72, 95% confidence interval: 0.55–0.93). Conclusion: This study shows a relationship between metformin usage and better survival outcome in patients with localized UTUC. The result may contribute a favorable anticancer role of metformin in localized UTUC and suggests that continuous metformin usage improves all-cause mortality in patients with localized UTUC and T2DM.
{"title":"Metformin is associated with better survival rate of localized upper tract urothelial carcinoma patients with type 2 diabetes","authors":"Chung-Yu Lin, Chien-Sheng Wang, Jhen-Hao Jhan, Hsiang-Ying Lee, Yi-Hsin Yang, Che-Wei Chang, Hung-Lung Ke, Ching-Chia Li, Yung-Chin Lee","doi":"10.4103/uros.uros_60_22","DOIUrl":"https://doi.org/10.4103/uros.uros_60_22","url":null,"abstract":"Purpose: Metformin, an antidiabetic drug, has been proposed to play a possible protective role in cancer recurrence and patient mortality. However, the exact mechanism and efficacy of metformin in urothelial cancer, especially upper tract urothelial carcinoma (UTUC), remain unknown. In this study, we conducted a population-based analysis to investigate whether metformin could improve the survival rate of patients with UTUC. Materials and Methods: Males ≥40 years diagnosed with UTUC were included in this retrospective population-based longitudinal cohort study. Data were collected from the registry of the Taiwan National Health Insurance database for patients with UTUC and type 2 diabetes mellitus (T2DM). Patients who had received at least two prescriptions of metformin were included in the study cohort as ever-users, and patients who had never used metformin were included in the control cohort as never-users. The hazard ratios (HRs) were calculated using Cox regression for ever-users and never-users. Results: Among the 781 enrolled patients, 439 and 342 patients were included as ever-users and never-users, respectively. The median survival time was 3.95 years in the never-user cohort compared to 6.90 years in the ever-user cohort, which remained statistically significant in both univariate and multivariate analyses (HR = 0.63 and 0.72, P = 0.0001 and 0.011, respectively). Furthermore, subgroup analysis showed that continuous usage of metformin before and after the diagnosis of UTUC was associated with a better survival in patients with UTUC (adjusted HR = 0.72, 95% confidence interval: 0.55–0.93). Conclusion: This study shows a relationship between metformin usage and better survival outcome in patients with localized UTUC. The result may contribute a favorable anticancer role of metformin in localized UTUC and suggests that continuous metformin usage improves all-cause mortality in patients with localized UTUC and T2DM.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135838779","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}
Yi-Hsuan Chen, Y. Juan, Wei Wei, J. Geng, K. Chueh, Hsiang-Ying Lee
Purpose: Postprostate surgeries urinary incontinence (UI) is one of the common bothersome complications of prostate surgery. Pelvic floor muscle exercises (PFME) have been reported to have benefits in shortening postoperative recovery time of UI. The aim of our study is to evaluate the efficacy of intensive schedule of PFME and pelvic muscle electrical stimulation in improving the recovery of postoperative UI. Materials and Methods: We prospectively enrolled 72 patients (63 Benign prostate hyperplasia [BPH] and 9 prostate cancer [PC]) who received transurethral resection of the prostate (TURP), anatomical endoscopic enucleation of the prostate (AEEP), Radical prostatectomy (RP) from January 2019 to December 2020. Twenty-seven patients who are unable to remove Foley catheter before discharge or loss follow-up were excluded. Finally, we enrolled 44 patients (35 BPH and 9 PC). All patients were assessed using the pad test, International Prostate Symptom Score, and Overactive Bladder Symptom Score. Abdominal ultrasonography or transrectal ultrasound of prostate was used to measure prostate volume and the postvoid residual urine volume. Results: The rate of UI was 60% and 88.9% immediately after removing the Foley catheter in TURP/AEEP and RP groups respectively. The incontinence rates in TURP/AEEP were 34.2%, 20%, and 3% after 2 weeks, 1 month, and 3 months' postoperation. In the RP group, the incontinence rate was 55.6%, 44.4% after 2 weeks, and 1 month postoperation. The pad amount was 63.11 ± 52.9 g, 37.89 ± 52.99 g, and 13.22 ± 18.48 g after 2 weeks, 1 month, and 3 months' postoperation. Conclusion: We demonstrated early intensive PFME program can shorten the recovery time of UI after prostate surgery.
{"title":"Effects of early pelvic floor muscle training on early recovery of urinary incontinence after prostate surgery","authors":"Yi-Hsuan Chen, Y. Juan, Wei Wei, J. Geng, K. Chueh, Hsiang-Ying Lee","doi":"10.4103/uros.uros_59_22","DOIUrl":"https://doi.org/10.4103/uros.uros_59_22","url":null,"abstract":"Purpose: Postprostate surgeries urinary incontinence (UI) is one of the common bothersome complications of prostate surgery. Pelvic floor muscle exercises (PFME) have been reported to have benefits in shortening postoperative recovery time of UI. The aim of our study is to evaluate the efficacy of intensive schedule of PFME and pelvic muscle electrical stimulation in improving the recovery of postoperative UI. Materials and Methods: We prospectively enrolled 72 patients (63 Benign prostate hyperplasia [BPH] and 9 prostate cancer [PC]) who received transurethral resection of the prostate (TURP), anatomical endoscopic enucleation of the prostate (AEEP), Radical prostatectomy (RP) from January 2019 to December 2020. Twenty-seven patients who are unable to remove Foley catheter before discharge or loss follow-up were excluded. Finally, we enrolled 44 patients (35 BPH and 9 PC). All patients were assessed using the pad test, International Prostate Symptom Score, and Overactive Bladder Symptom Score. Abdominal ultrasonography or transrectal ultrasound of prostate was used to measure prostate volume and the postvoid residual urine volume. Results: The rate of UI was 60% and 88.9% immediately after removing the Foley catheter in TURP/AEEP and RP groups respectively. The incontinence rates in TURP/AEEP were 34.2%, 20%, and 3% after 2 weeks, 1 month, and 3 months' postoperation. In the RP group, the incontinence rate was 55.6%, 44.4% after 2 weeks, and 1 month postoperation. The pad amount was 63.11 ± 52.9 g, 37.89 ± 52.99 g, and 13.22 ± 18.48 g after 2 weeks, 1 month, and 3 months' postoperation. Conclusion: We demonstrated early intensive PFME program can shorten the recovery time of UI after prostate surgery.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"39 - 45"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44803274","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}
{"title":"A comparative study of the efficacy of thulium fiber laser enucleation and transurethral resection for medium- to large-size prostate","authors":"Abhay Mahajan, S. Mahajan","doi":"10.4103/uros.uros_92_22","DOIUrl":"https://doi.org/10.4103/uros.uros_92_22","url":null,"abstract":"","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70854045","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}
Small renal masses (SRM) are defined as contrast-enhancing solid masses detected on diagnostic imaging, with a size of less than or equal to 4cm, corresponding to renal cell carcinoma stage T1a. These tumours are mainly benign, with an indolent nature and rare metastatic potential. Given the size and nature of these tumours, there has been a significant evolution and in management modalities of these tumours. These range from conventional radical approaches such as radical nephrectomy, partial nephrectomy, to more conservative approaches such as active surveillance, and some novel emerging management strategies such as various thermal ablation techniques. The treatment decision depends on patient factors such as age and co-morbidity, and tumour factor on radiological imaging, such as tumour size, location, growth rate and biopsy result. In this review, we aim to provide the latest updates on approaching SRM and various management modalities.
{"title":"Small renal masses","authors":"Homayoun Zargar, Mandana Gholami, Jihad Kaouk","doi":"10.4103/uros.uros_31_23","DOIUrl":"https://doi.org/10.4103/uros.uros_31_23","url":null,"abstract":"Small renal masses (SRM) are defined as contrast-enhancing solid masses detected on diagnostic imaging, with a size of less than or equal to 4cm, corresponding to renal cell carcinoma stage T1a. These tumours are mainly benign, with an indolent nature and rare metastatic potential. Given the size and nature of these tumours, there has been a significant evolution and in management modalities of these tumours. These range from conventional radical approaches such as radical nephrectomy, partial nephrectomy, to more conservative approaches such as active surveillance, and some novel emerging management strategies such as various thermal ablation techniques. The treatment decision depends on patient factors such as age and co-morbidity, and tumour factor on radiological imaging, such as tumour size, location, growth rate and biopsy result. In this review, we aim to provide the latest updates on approaching SRM and various management modalities.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"490 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135838782","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}
Upper urinary tract urothelial carcinomas (UTUCs) are rare diseases, accounting for only 5%–10% of all urothelial cancers. Radical nephroureterectomy (RNU) with bladder cuff excision remains the standard care modality of UTUCs. However, the prognosis is poor and the recurrence is high in patients with advanced UTUC treated with RNU currently. Therefore, identifying cancer behavior for UTUC is an important guide for clinical practice. Herein, we provide an overview of cancer behavior of UTUCs, including prognostic factors and clinical cancer courses. We also discuss the appropriate management of patients with UTUC, such as diagnosis, surgical management, and systemic therapies. Due to the rarity of UTUC, strong evidence of management is often lacking. Therefore, further prospective trials are needed, and regular follow-up after interventions is mandatory.
{"title":"The cancer behavior and current treatment strategy for upper urinary tract cancer","authors":"Hao-Lun Luo, T. Chen, Wen-Jeng Wu","doi":"10.4103/uros.uros_58_22","DOIUrl":"https://doi.org/10.4103/uros.uros_58_22","url":null,"abstract":"Upper urinary tract urothelial carcinomas (UTUCs) are rare diseases, accounting for only 5%–10% of all urothelial cancers. Radical nephroureterectomy (RNU) with bladder cuff excision remains the standard care modality of UTUCs. However, the prognosis is poor and the recurrence is high in patients with advanced UTUC treated with RNU currently. Therefore, identifying cancer behavior for UTUC is an important guide for clinical practice. Herein, we provide an overview of cancer behavior of UTUCs, including prognostic factors and clinical cancer courses. We also discuss the appropriate management of patients with UTUC, such as diagnosis, surgical management, and systemic therapies. Due to the rarity of UTUC, strong evidence of management is often lacking. Therefore, further prospective trials are needed, and regular follow-up after interventions is mandatory.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"161 - 169"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49005617","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}
M. Chancellor, L. Lamb, E. Ward, S. Bartolone, Alexander L. Carabulea, Prasun Sharma, Joseph J. Janicki, Christopher Smith, M. Laudano, N. Abraham, Bernadette M. Zwaans
Purpose: We sought to determine if urinary cytokine concentration profiles were different between various bladder conditions. Materials and Methods: Participants at three clinical sites completed a demographics survey and provided a urine sample in a collection cup containing a room-temperature urine preservative. Participants were divided into the following categories based on physician-documented diagnosis: asymptomatic control, nonulcerative interstitial cystitis (IC), overactive bladder with incontinence (OAB wet), urinary tract infection (UTI), and bladder cancer. Urinary cytokines were measured through Luminex multiplex assay. Results: Two hundred and seventy-seven urine samples were collected from three clinical sites. Urinary pro-inflammatory cytokines had an increasing trend in bladder disease versus control, with a significant increase for chemokine (C-X-C) ligand 1 growth-regulated protein alpha CXCL1 (GRO). Further analyses demonstrated that patients with UTI had significantly higher levels of GRO and interleukin-8 (IL-8) in comparison to control, nonulcerative IC, OAB wet, and bladder cancer. Both are chemokines that stimulate chemotaxis resulting in the rapid accumulation of immune cells such as neutrophils. IL-6 levels overall were at the lower limit of assay range but were significantly increased in urine of UTI patients versus IC patients. MCP-1 (CCL2) had the least separation among the control group and the various bladder diseases. Conclusion: Urinary concentrations of GRO were higher in disease state compared to control. Specifically, levels of GRO and IL-8 were higher in urine samples from patients with UTI compared to controls and other bladder conditions. Comparing and contrasting urinary cytokines may help improve our understanding of these important bladder diseases with great unmet needs.
{"title":"Comparing concentration of urinary inflammatory cytokines in interstitial cystitis, overactive bladder, urinary tract infection, and bladder cancer","authors":"M. Chancellor, L. Lamb, E. Ward, S. Bartolone, Alexander L. Carabulea, Prasun Sharma, Joseph J. Janicki, Christopher Smith, M. Laudano, N. Abraham, Bernadette M. Zwaans","doi":"10.4103/UROS.UROS_26_22","DOIUrl":"https://doi.org/10.4103/UROS.UROS_26_22","url":null,"abstract":"Purpose: We sought to determine if urinary cytokine concentration profiles were different between various bladder conditions. Materials and Methods: Participants at three clinical sites completed a demographics survey and provided a urine sample in a collection cup containing a room-temperature urine preservative. Participants were divided into the following categories based on physician-documented diagnosis: asymptomatic control, nonulcerative interstitial cystitis (IC), overactive bladder with incontinence (OAB wet), urinary tract infection (UTI), and bladder cancer. Urinary cytokines were measured through Luminex multiplex assay. Results: Two hundred and seventy-seven urine samples were collected from three clinical sites. Urinary pro-inflammatory cytokines had an increasing trend in bladder disease versus control, with a significant increase for chemokine (C-X-C) ligand 1 growth-regulated protein alpha CXCL1 (GRO). Further analyses demonstrated that patients with UTI had significantly higher levels of GRO and interleukin-8 (IL-8) in comparison to control, nonulcerative IC, OAB wet, and bladder cancer. Both are chemokines that stimulate chemotaxis resulting in the rapid accumulation of immune cells such as neutrophils. IL-6 levels overall were at the lower limit of assay range but were significantly increased in urine of UTI patients versus IC patients. MCP-1 (CCL2) had the least separation among the control group and the various bladder diseases. Conclusion: Urinary concentrations of GRO were higher in disease state compared to control. Specifically, levels of GRO and IL-8 were higher in urine samples from patients with UTI compared to controls and other bladder conditions. Comparing and contrasting urinary cytokines may help improve our understanding of these important bladder diseases with great unmet needs.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"33 1","pages":"199 - 204"},"PeriodicalIF":0.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44928909","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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