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IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-07-01 DOI: 10.4103/uros.uros_160_21
Y. Chuang
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引用次数: 0
Comparison of trimodal therapy versus radical cystectomy for each stage of muscle-invasive bladder cancer 三模式治疗与根治性膀胱切除术治疗癌症各期肌肉浸润性膀胱癌的比较
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-07-01 DOI: 10.4103/uros.uros_8_21
Wen-Hsin Tseng, Steven Y Huang, Chien-Liang Liu, J. Kuo, Shun-Hsing Hun, Chun-Hao Chen, C. Su, Jhih-Cheng Wang, Kau-Han Lee, K. Hsieh, A. Chiu
Purpose: Radical cystectomy (RC) has long been the standard of care for the management of muscle-invasive bladder cancer (MIBC). However, an increasing trend of bladder-sparing trimodal therapy (TMT) using maximal transurethral resection of bladder tumor, followed by radiation therapy (RT) with concomitant radiosensitizing chemotherapy, has been advocated. We compared the differences regarding long-term oncological outcomes between patients who accepted RC or TMT for MIBC. Materials and Methods: Between January 2012 and December 2018, 207 patients were diagnosed with MIBC at our center. We excluded patients with metastasis disease, received other treatments, and lost to follow-up. The patients were categorized into Group 1 (TMT) and Group 2 (RC). Both the groups with each tumor stage were compared for disease-free survival (DFS) and overall survival (OS) rates, and the risk factors for recurrence and survival were assessed. Results: In total, 58 (48.7%) patients in Group 1 underwent TMT and 61 (51.3%) patients in Group 2 underwent RC. The mean follow-up was 39.8 months. The 3-year DFS rates were 44.1% and 69.7% for Groups 1 and 2, respectively (P = 0.003). The 3-year OS rates were 61.7% and 72.5% for Groups 1 and 2, respectively (P = 0.226). We also analyzed the DFS with each stage, and the results showed a lower DFS rate for T2 and N0 stages. Conclusion: There was no significant survival benefit for MIBC with either RC or TMT. However, RC is associated with better outcome of DFS rate, especially for patients with early stages of MIBC in stages T2 and N0.
目的:根治性膀胱切除术(RC)长期以来一直是治疗肌肉浸润性膀胱癌(MIBC)的标准治疗方法。然而,越来越多的人提倡保留膀胱的三模式治疗(TMT),即经尿道最大限度切除膀胱肿瘤,然后进行放射治疗(RT),同时进行放射增敏化疗。我们比较了接受RC或TMT治疗MIBC患者长期肿瘤预后的差异。材料与方法:2012年1月至2018年12月,我们中心有207例确诊为MIBC的患者。我们排除了转移性疾病的患者,接受了其他治疗,失去了随访。患者分为1组(TMT)和2组(RC)。比较两组各肿瘤分期的无病生存(DFS)和总生存(OS)率,并评估复发和生存的危险因素。结果:1组58例(48.7%)患者行TMT, 2组61例(51.3%)患者行RC。平均随访39.8个月。第1组和第2组3年DFS分别为44.1%和69.7% (P = 0.003)。第1组和第2组3年生存率分别为61.7%和72.5% (P = 0.226)。我们还分析了各分期的DFS,结果显示T2和N0分期的DFS率较低。结论:无论是RC还是TMT,对MIBC患者都没有明显的生存益处。然而,RC与更好的DFS率相关,特别是对于T2期和N0期的早期MIBC患者。
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引用次数: 0
A short term follow up for intracavernosal injection of platelet rich plasma for the treatment of erectile dysfunction 海绵体内注射富血小板血浆治疗勃起功能障碍的短期随访
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-07-01 DOI: 10.4103/uros.uros_22_21
Shin-Mei Wong, B. Chiang, Hui-Chun Chen, Yi-No Wu, Yingtao Lin, C. Liao
Purpose: The objective of this study was to investigate the safety and efficacy of intracavernosal platelet-rich plasma (PRP) injection in patients with erectile dysfunction (ED). Materials and Methods: Between September 2018 and September 2020, thirty participants with ED were enrolled in this prospective single-arm study. All participants received three sessions of intracavernosal PRP injection. Oral phosphodiesterase type 5 (PDE5) inhibitors or testosterone replacement therapy (TRT) without a change in dosing was permitted during the treatment period. Efficacy was assessed using the International Index of Erectile Function-5 (IIEF-5), Erectile Hardness Score (EHS), Sexual Encounter Profile (SEP) 2 and 3, and Global Assessment Question, every 2 weeks after each treatment session. Any adverse events were recorded. Results: The mean age of participants was 54.93 years. Oral PDE5 inhibitors were prescribed to 76.7% of participants (n = 23), and 50% of participants (n = 15) received concurrent TRT. A significant improvement in erectile function was measured by an average of 4.556 points in IIEF-5 (P < 0.001) and 0.72 points in EHS (P < 0.001). In total, 4 (13.3%) and 15 (50%) participants reported “no” to “yes” in SEP2 and SEP3 questions after therapy, respectively. Overall, 82.8% of participants agreed that the study therapy improved erectile function. No significant adverse events were reported. Conclusion: This single-arm prospective study revealed that preliminary experience with penile PRP significantly improves erectile function without obvious adverse events.
目的:本研究的目的是探讨海绵体内富血小板血浆(PRP)注射治疗勃起功能障碍(ED)的安全性和有效性。材料和方法:在2018年9月至2020年9月期间,30名ED患者入组了这项前瞻性单臂研究。所有参与者均接受三次海海绵内PRP注射。在治疗期间,允许口服磷酸二酯酶5型(PDE5)抑制剂或睾酮替代疗法(TRT)而不改变剂量。每次治疗后每2周使用国际勃起功能指数-5 (IIEF-5)、勃起硬度评分(EHS)、性接触概况(SEP) 2和3以及全球评估问题对疗效进行评估。记录任何不良事件。结果:参与者平均年龄54.93岁。76.7%的参与者(n = 23)口服PDE5抑制剂,50%的参与者(n = 15)同时接受TRT治疗。勃起功能显著改善,IIEF-5评分平均为4.556分(P < 0.001), EHS评分平均为0.72分(P < 0.001)。总共有4名(13.3%)和15名(50%)参与者在治疗后的SEP2和SEP3问题中分别报告“否”到“是”。总体而言,82.8%的参与者认为研究疗法改善了勃起功能。无明显不良事件报道。结论:这项单臂前瞻性研究显示,阴茎PRP的初步经验可显著改善勃起功能,且无明显不良事件。
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引用次数: 2
Mitochondrial dysfunction in patients with urogenital disease 泌尿生殖系统疾病患者的线粒体功能障碍
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-07-01 DOI: 10.4103/uros.uros_47_21
Tzu-Yu Chuang, Te-Wei Chang, Shiou-Sheng Chen, Chang-Chi Chang, W. Cheng, Yau-Huei Wei
Mitochondria are intracellular organelles responsible for the production of the majority of adenosine triphosphate (ATP). In addition to energy production, mitochondria also contribute to cellular apoptosis, the regulation of intracellular Ca2+ homeostasis, signaling through reactive oxygen species (ROS), and the coordination of the cell cycle. The prevalence rate of primary mitochondrial disease was estimated at nearly 1:5000. In this review, we have integrated recent evidence to discuss new insights into how mitochondrial dysregulation plays a role in bladder dysfunction, reproductive disorder and the correlation between mtDNA mutation and bladder cancer.
线粒体是负责产生大部分三磷酸腺苷(ATP)的细胞内细胞器。除了能量产生外,线粒体还参与细胞凋亡、细胞内Ca2+稳态的调节、通过活性氧(ROS)发出信号以及细胞周期的协调。原发性线粒体疾病的患病率估计接近1:5000。在这篇综述中,我们整合了最近的证据,以讨论线粒体失调如何在膀胱功能障碍、生殖障碍中发挥作用,以及mtDNA突变与膀胱癌症之间的相关性。
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引用次数: 3
An observational study on the efficacy of mirabegron in medical expulsive therapy of the lower ureteric calculus mirabegron药物排尿治疗输尿管下段结石疗效观察
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_19_21
S. Chatterjee, V. Jalan, D. Pal
Purpose: Medical expulsive therapy (MET) is used in lower ureteric calculus to reduce symptoms, to facilitate passage, and to decrease the requirement of endourological surgical interventions. Alpha-blockers, spasmolytics, and calcium channel blockers have been shown to be effective in clinical trials. Beta-3 receptor stimulation in the ureter has been shown to decrease the intraluminal pressure. Thus, Mirabegron, beta 3 receptor agonist, can be thought as alternative MET agent. Materials and Methods: We have done prospective observational study to see the efficacy of mirabegron for MET of lower ureteric calculus ≤10 mm in size. Patients were divided into two groups: Group A (n = 50) received diclofenac 50 mg twice daily for 5 days then on demand for 4 weeks and Group B (n = 50) received diclofenac 50 mg twice daily for 5 days than on demand and mirabegron 50 mg daily for 4 weeks. Patients were followed up weekly with clinical examination, ultrasound screening of kidney, ureter, and bladder (KUB) and noncontrast computed tomography scan KUB after the 28th day of therapy. Results: We found that the passage of stone is significantly higher in mirabegron group (Group A: 68% and Group B: 92%; P < 0.05), and this effect is also statistically significant for stones <7 mm size (Group A: 73.91%, Group B: 96.96%, P = 0.01026). Duration of stone expulsion in Group A: 20.29 ± 5.512 days and Group B: 10.65 ± 4.294 days (P = 0.00001) and the relief of storage symptoms are earlier in mirabegron group (Group A: 16.28 ± 5.65 days and Group B: 6.2 ± 2.58 days, P = 0.00001). Conclusion: Our study reveals that Mirabegron is effective for the treatment of lower ureteric stones ≤10 mm size, especially for stone of size <7 mm and it improves the storage symptoms in these patients.
目的:药物推进治疗(MET)用于治疗下输尿管结石,以减轻症状,促进通道,并降低泌尿外科手术干预的要求。α受体阻滞剂、解痉药和钙通道阻滞剂已在临床试验中被证明是有效的。刺激输尿管中的Beta-3受体已被证明可以降低管腔内压力。因此,β3受体激动剂Mirabegron可以被认为是MET的替代剂。材料和方法:我们进行了前瞻性观察研究,以观察米拉贝隆治疗大小≤10mm的下输尿管结石MET的疗效。患者被分为两组:A组(n=50)接受双氯芬酸50 mg,每日两次,持续5天,然后按需接受4周;B组(n=5)接受双氯芬酸50 mg/d,每日两次于按需接受5天,米拉贝隆50 mg/d。每周对患者进行随访,在治疗第28天后进行临床检查、肾脏、输尿管和膀胱(KUB)超声筛查以及非扫描计算机断层扫描。结果:mirabegron组结石通过率明显高于对照组(A组68%,B组92%,对于小于7mm大小的结石,这种效果也具有统计学意义(A组:73.91%,B组:96.96%,P=0.01026)。A组排石时间为20.29±5.512天,B组为10.65±4.294天(P=0.0001),mirabegron组储存症状缓解较早(A组为16.28±5.65天,B队为6.2±2.58天,P=0.0001)Mirabegron对大小≤10mm的下输尿管结石有效,尤其是对大小<7mm的结石有效,并改善了这些患者的储存症状。
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引用次数: 1
Effect of short-term preoperative dutasteride and finasteride on bleeding after transurethral resection of the prostate: A prospective randomized study 术前短期使用杜他雄胺和非那雄胺对经尿道前列腺电切术后出血的影响:一项前瞻性随机研究
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_2_21
Nitesh Kumar, Sunil Palve, Karthik Marripeddi, Sanath Thantla
Purpose: Transurethral resection of the prostate (TURP) is the standard surgical treatment for patients with benign prostatic hyperplasia (BPH). Among the many complications of TURP, the most prevalent and serious complication is hemorrhage. The aim of the study was to compare the effect of short-term (2–4 weeks) pretreatment of BPH with dutasteride and finasteride on bleeding after TURP. Methods: A prospective randomized double-blinded study was conducted in Osmania General Hospital, a tertiary care center for a period of 2 years. Two hundred and forty patients who were planned for TURP were included and randomized into four groups; D2: 2 weeks of dutasteride, F2: 2 weeks of finasteride, P2: 2 weeks of placebo, and D4: 4 weeks of dutasteride. The primary outcome was to evaluate the volume of blood loss. Results: The baseline variables were comparable among the groups. Statistically significant differences were seen in total volume of blood loss (183.4 vs. 172.7 vs. 288.5 vs. 173.2 ml, P = 0.01), blood loss per minute of operating time (3.80 vs. 3.65 vs. 5.71 vs. 3.61 ml/min, P = 0.02), and blood loss per gram of resected prostatic tissue (7.61 vs. 7.43 vs. 11.57 vs. 7.21 ml/g, P = 0.008). Blood transfusion requirement was significantly more in the placebo group (11.8%) compared to other groups (P = 0.02). Conclusion: Short-term preoperative dutasteride and finasteride for 2 weeks are equally effective, and they significantly reduce the perioperative blood loss during TURP. Four weeks of dutasteride has no significant advantage when compared to its 2-week course.
目的:经尿道前列腺切除术(TURP)是治疗良性前列腺增生症(BPH)的标准手术方法。在TURP的众多并发症中,出血是最常见和最严重的并发症。本研究的目的是比较短期(2-4周)预处理前列腺增生与杜他司胺和非那雄胺对经尿道前列腺电切术后出血的影响。方法:在Osmania综合医院三级护理中心进行为期2年的前瞻性随机双盲研究。纳入240名计划进行TURP的患者,并将其随机分为四组;D2:2周的杜他司胺,F2:2周的非那雄胺,P2:2周的安慰剂,D4:4周的杜特司胺。主要结果是评估失血量。结果:基线变量在各组之间具有可比性。在总失血量(183.4 vs.172.7 vs.288.5 vs.173.2 ml,P=0.01)、每分钟手术时间失血量(3.80 vs.3.65 vs.5.71 vs.3.61 ml/min,P=0.02)、,以及每克切除前列腺组织的失血量(7.61 vs.7.43 vs.11.57 vs.7.21 ml/g,P=0.008)。与其他组相比,安慰剂组的输血需求显著增加(11.8%)(P=0.02)。与2周疗程相比,4周的杜他司胺没有显著优势。
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引用次数: 0
“True gold fears no fire” – High-quality videourodynamic studies make possible precision diagnosis of lower urinary tract symptoms in women “真金不怕火炼”——高质量的视频尿动力学研究使女性下尿路症状的精确诊断成为可能
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_126_21
E. Chou
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引用次数: 0
Feasibility and safety of retrograde radical cystectomy under combined spinal and epidural anesthesia in high-risk and elderly patients. A single surgeon experience 脊髓硬膜外联合麻醉下逆行膀胱根治术治疗高危老年患者的可行性及安全性。一个外科医生的经历
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_156_20
A. Khawaja, Y. Dar, M. Suhail, K. Sofi, Prince Muzaffar, Sajad A Parra, S. Malik, A. Bhat, M. Wani
Purpose: The purpose of the study is to study feasibility and safety of retrograde radical cystectomy (RC) under regional anesthesia (RA) in high-risk and elderly patients of muscle invasive bladder carcinoma. Materials and Methods: This study was an observational study, conducted in the department of urology, SKIMS, Kashmir, India, from 2012 to 2020. All patients underwent retrograde RC under RA. Results: Thirty-seven patients were operated with median follow-up period of 32 months and included 30 male and 7 female patients with median age of 74.5 years (70–83 years). The American Society of Anesthesiologists score was II in 20 patients, III in 15 patients, and IV in 2 patients. All the patients included in study had significant comorbidities. All patients were anemic and required preoperative blood transfusions for optimization. Total blood loss ranged from 200 to 900 ml (mean: 400 ml). Bilateral internal iliac artery was ligated preemptively in all patients. Total transfusion required ranged from one to six units (mean: 2 units). Number of lymph nodes removed ranged from 15 to 35 (mean: 20). Total peritoneal exposure time ranged from 0 to 70 min (mean: 50 min). None of the patient needed intensive care postoperatively. Gastrointestinal tract (GIT) recovery time ranged from 1 to 4 days (mean of 1.5 days). Total hospital stay ranged from 7 to 15 days (mean: 9 days). On follow-up, one patient had stent (feeding tube) fracture, and the residual fragment was managed by antegrade approach. One patient had ureteroileal anastomotic stricture which was managed by refashioning of the anastomosis (Bricker to Wallace). One patient had stomal stenosis with features of recurrent urinary tract infections and underwent refashioning of stoma with stabilization of renal function. Conclusion: To circumvent the need of postoperative ventilation, intensive care unit admission, and prolonged hospital stay, we advocate retrograde extraperitoneal RC under combined RA (CRA) as preferred approach of surgical intervention in high-risk and elderly patients with little abdominal organ disturbance and early bowel recovery.
目的:研究区域麻醉(RA)下逆行膀胱根治术(RC)治疗高龄及高危肌肉浸润性膀胱癌的可行性和安全性。材料与方法:本研究是一项观察性研究,于2012年至2020年在印度克什米尔SKIMS泌尿科进行。所有患者在RA下行逆行RC。结果:手术37例,中位随访期32个月,其中男30例,女7例,中位年龄74.5岁(70 ~ 83岁)。美国麻醉医师学会评分:20例为II, 15例为III, 2例为IV。所有纳入研究的患者均有显著的合并症。所有患者均为贫血,术前需输血优化。总失血量为200 ~ 900毫升(平均400毫升)。所有患者均预先结扎双侧髂内动脉。总输血需求从1到6个单位不等(平均:2个单位)。淋巴结切除数15 ~ 35个(平均20个)。总腹膜暴露时间为0 ~ 70分钟(平均50分钟)。所有患者均无需术后重症监护。胃肠道(GIT)恢复时间1 ~ 4天,平均1.5天。总住院时间为7至15天(平均9天)。随访中,1例患者发生支架(饲管)骨折,剩余碎片行顺行入路处理。1例输尿管输尿管吻合口狭窄,行吻合口重塑术(Bricker to Wallace)。1例患者因造口狭窄伴反复尿路感染,行造口重塑术,肾功能稳定。结论:为避免术后需要通气、入住重症监护病房和延长住院时间,我们建议在联合RA (CRA)下逆行腹膜外RC作为手术干预的首选方法,适用于腹部脏器功能障碍小、肠道恢复早的高危老年患者。
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引用次数: 0
Videourodynamic precision diagnosis and treatment of lower urinary tract symptoms in women 女性下尿路症状的影像尿动力学精确诊断和治疗
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_46_21
H. Kuo
Lower urinary tract symptoms (LUTSs) in women are common in urological practice but are usually uninformative for diagnosing the underlying lower urinary tract dysfunction. To obtain a precise diagnosis and devise a precise treatment strategy, a videourodynamic study (VUDS) is an essential tool for investigating the bladder and bladder outlet dysfunction, especially when LUTS cannot be relieved after initial medical treatment. An accurate VUDS diagnosis can guide effective treatment and prevent unnecessary or incorrect surgical intervention. This article reviews updated applications of VUDS in the diagnosis and treatment of LUTS in women.
女性下尿路症状(LUTs)在泌尿外科实践中很常见,但通常对诊断潜在的下尿路功能障碍没有信息。为了获得精确的诊断和制定精确的治疗策略,视频尿动力学研究(VUDS)是研究膀胱和膀胱出口功能障碍的重要工具,尤其是在初次药物治疗后LUTS无法缓解时。准确的VUDS诊断可以指导有效的治疗,并防止不必要或不正确的手术干预。本文综述了VUDS在妇女LUTS诊断和治疗中的最新应用。
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引用次数: 5
Editorial 社论
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2021-05-01 DOI: 10.4103/UROS.UROS_121_21
Y. Chuang
{"title":"Editorial","authors":"Y. Chuang","doi":"10.4103/UROS.UROS_121_21","DOIUrl":"https://doi.org/10.4103/UROS.UROS_121_21","url":null,"abstract":"","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"32 1","pages":"93 - 93"},"PeriodicalIF":0.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42453145","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}
引用次数: 0
期刊
Urological Science
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