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Comparison of sperm retrieval rate between superficial and deep dissection during microscopic testicular sperm extraction. 显微镜下睾丸取精术中浅层和深层剥离取精率的比较。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_22_23
Hammam Mandourah, Mohammad Alghafees, Hamed Alali, Shaheed Alsuhaibani, Eyad Gutub, Lama Aldosari, Turki Alhumaid, Said Kattan, Naif Alhathal

Objective: The purpose of the study was to compare the outcome of microscopic testicular sperm extraction (micro-TESE) between superficial and deep dissection on the same testicle in terms of sperm retrieval rate (SRR).

Patients and methods: In a retrospective study from June 2019 to October 2021, 44 patients with nonobstructive azoospermia who underwent micro-TESE with positive results (mature sperm identified) were included. Eight patients were excluded from the study due to deficient documentation on superficial and deep dissection. A total of 36 patients were included; 60 testicles were examined for superficial and deep biopsies. Testicular histopathology was performed in all patients, and a hormonal evaluation was obtained before the micro-TESE attempt.

Results: Thirty-six patients and 60 testicles were included in the study. Of them, 47 (78.3%) testicles had positive results. Superficial TESE was positive in 38 (63.3%) testicles, and deep TESE was successful in 45 (75.0%) testicles. An improvement of 13.9% in the SRR was observed, following deep dissection. However, there was no statistically significant difference (P = 0.166). Rates of positive sperm retrieval (from any side) did not differ significantly based on patients' age, microdissection testicular sperm extraction sides, and hormonal concentrations; these differences were not apparent after superficial or deep TESE.

Conclusion: The presented findings suggest that although successful SRRs of deep TESE were higher than that of its superficial counterpart, there was no significant statistical difference. A larger body of evidence is needed to provide a higher grade of recommendation.

研究目的该研究旨在比较显微镜下睾丸取精术(micro-TESE)在同一睾丸上浅层和深层剥离的取精率(SRR)结果:在2019年6月至2021年10月的一项回顾性研究中,纳入了44名接受显微睾丸取精术(micro-TESE)并取得阳性结果(鉴定出成熟精子)的非梗阻性无精子症患者。由于浅层和深层解剖记录不全,8 名患者被排除在研究之外。研究共纳入 36 名患者,对 60 个睾丸进行了表层和深层活检。所有患者均进行了睾丸组织病理学检查,并在尝试显微 TESE 之前进行了激素评估:研究共纳入 36 名患者和 60 个睾丸。其中,47 个(78.3%)睾丸结果呈阳性。38个(63.3%)睾丸的表层TESE结果呈阳性,45个(75.0%)睾丸的深层TESE结果呈阳性。深部剥离后,SRR 提高了 13.9%。然而,两者之间并无统计学差异(P = 0.166)。根据患者的年龄、显微解剖睾丸取精侧和激素浓度,阳性取精率(从任何一侧取精)并无明显差异;这些差异在浅层或深层 TESE 之后并不明显:本文的研究结果表明,虽然深部TESE的成功率高于表层TESE,但两者并无显著的统计学差异。需要更多的证据来提供更高等级的建议。
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引用次数: 0
Prevalence of nocturnal enuresis among children of Aseer region in Saudi Arabia. 沙特阿拉伯 Aseer 地区儿童夜间遗尿症的发病率。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_90_23
Abdulaziz Alamri, Vinod Prem Singh, Mishari Hm Alshyarba, Alahmari Abdullah, Meshal Ogran, Abdullah Alsuayri, Amal Al-Amri, Tarique Hussain Ashraf, Fahad Alyami, Mohammed Sharaf Alshahrani

Introduction: Nocturnal enuresis (NE) in children is a very common problem managed in pediatric urology. In this study, we present the prevalence of NE in children in Aseer region in Saudi Arabia.

Methodology: This study was conducted as a descriptive cross-sectional survey to estimate the prevalence of NE among 555 Saudi children aged 5-15 years in Aseer region in Saudi Arabia. Data collection was done through a questionnaire, which included questions on sociodemographic data, personal knowledge, enuresis-related characteristics, risk factors, and management modalities.

Results: This study identified a prevalence of enuresis of 24% of the study population, most of whom were boys. The majority of the parents had a high educational level. Clinical characteristics of the study population showed: 9% have a family history of NE, 2.2% have a history of neurological disorder, 10.0% have a history of urinary tract infections, 66.8% have associated daytime urgency, 67% have urine-holding behavior, and 19.5% have associated daytime enuresis of the study population.

Conclusion: Our study found that 24% of children in the Aseer region in Saudi Arabia have NE. Our study finding helps us to understand the prevalence of NE in Aseer region in Saudi Arabia, and this can be applied to other regions in the kingdom. Furthermore, this finding helps us to understand the need to raise awareness in the community about NE and the need to educate the nonpediatric urologist health-care provider about the best management practice for NE.

导言:儿童夜间遗尿(NE)是小儿泌尿科常见的问题。在本研究中,我们介绍了沙特阿拉伯 Aseer 地区儿童的 NE 患病率:本研究以描述性横断面调查的形式进行,旨在估算沙特阿拉伯 Aseer 地区 555 名 5-15 岁沙特儿童中 NE 的患病率。数据收集是通过问卷进行的,其中包括社会人口学数据、个人知识、遗尿症相关特征、风险因素和管理方式等问题:这项研究发现,24%的研究对象患有遗尿症,其中大部分是男孩。大多数家长具有较高的教育水平。研究人群的临床特征显示9%的研究对象有NE家族史,2.2%的研究对象有神经系统疾病史,10.0%的研究对象有尿路感染史,66.8%的研究对象伴有日间尿急,67%的研究对象有憋尿行为,19.5%的研究对象伴有日间遗尿:我们的研究发现,沙特阿拉伯 Aseer 地区有 24% 的儿童患有神经性尿失禁。我们的研究结果有助于我们了解近视在沙特阿拉伯 Aseer 地区的发病率,并可应用于沙特阿拉伯王国的其他地区。此外,这一发现还有助于我们了解提高社区对NE认识的必要性,以及教育非儿科泌尿科医护人员了解NE最佳治疗方法的必要性。
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引用次数: 0
The Saudi urological association guidelines on urolithiasis. 沙特泌尿外科协会尿石症指南。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_120_23
Wissam Kamal, Raed A Azhar, Saeed Bin Hamri, Abdulaziz H Alathal, Abdulaziz Alamri, Tarek Alzahrani, Hussain Abeery, Yasser A Noureldin, Mohammad Alomar, Abdulrahman Al Own, Mansour M Alnazari, Majid Alharthi, Mohannad A Awad, Abdulghafour Halawani, Hatem Hamed Althubiany, Abdulrahman Alruwaily, Phillipe Violette

Aims: The Saudi Urolithiasis Guidelines are a set of recommendations for diagnosing, evaluating, and treating urolithiasis in the Saudi population. These guidelines are based on the latest evidence and expert consensus to improve patient outcomes and optimize care delivery. They cover the various aspects of urolithiasis, including risk factors, diagnosis, medical and surgical treatments, and prevention strategies. By following these guidelines, health-care professionals can improve care quality for individuals with urolithiasis in Saudi Arabia.

Panel: The Saudi Urolithiasis Guidelines Panel consists of urologists specialized in endourology with expertise in urolithiasis and consultation with a guideline methodologist. All panelists involved in this document have submitted statements disclosing any potential conflicts of interest.

Methods: The Saudi Guidelines on Urolithiasis were developed by relying primarily on established international guidelines to adopt or adapt the most appropriate guidance for the Saudi context. When necessary, the panel modified the phrasing of recommendations from different sources to ensure consistency within the document. To address areas less well covered in existing guidelines, the panel conducted a directed literature search for high quality evidence published in English, including meta analyses, randomized controlled trials, and prospective nonrandomized comparative studies. The panel also searched for locally relevant studies containing information unique to the Saudi Arabian population. The recommendations are formulated with a direction and strength of recommendation based on GRADE terminology and interpretation while relying on existing summaries of evidence from the existing guidelines.

目的:《沙特泌尿系结石指南》是一套用于诊断、评估和治疗沙特人泌尿系结石的建议。这些指南以最新证据和专家共识为基础,旨在改善患者的治疗效果并优化护理服务。它们涵盖了尿路结石的各个方面,包括风险因素、诊断、内外科治疗和预防策略。通过遵循这些指南,医护人员可以提高沙特阿拉伯泌尿系结石患者的护理质量:沙特泌尿系结石指南专家小组由泌尿内科专家组成,他们拥有泌尿系结石方面的专业知识,并接受过指南方法论专家的咨询。所有参与本文件编写的专家均已提交声明,披露任何潜在的利益冲突:沙特泌尿系结石指南》的制定主要依据既有的国际指南,采用或调整最适合沙特国情的指南。必要时,专家小组修改了不同来源的建议措辞,以确保文件的一致性。针对现有指南中涵盖较少的领域,专家小组进行了有针对性的文献检索,寻找以英语发表的高质量证据,包括元分析、随机对照试验和前瞻性非随机比较研究。专家小组还搜索了包含沙特阿拉伯人口特有信息的本地相关研究。建议的方向和推荐强度是根据 GRADE 术语和解释制定的,同时依赖于现有指南中的证据摘要。
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引用次数: 0
Shock wave lithotripsy in the era of COVID-19. COVID-19 时代的冲击波碎石术。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_42_22
Rabie M Ibrahim, Faysal Elzawy, Ahmed Mohamed Ragheb, Akram A Elmarakbi, Osama Sayed, Amr M Lotfy, Ahmed Youssef, Hany F Badwy, Ahmed Gamal Mohamed

Objective: The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic.

Methods: Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m2 were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40-50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1st 300 shocks. Success rate and complications were recorded.

Results: Five hundred and ninety patients completed the study. The success rate after 1st session was 408/590 patients (69.15%) which was augmented by 2nd session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2).

Conclusions: SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic.

研究目的该研究旨在评估能够改善冲击波碎石术(SWL)效果的因素,以跟上COVID-19大流行的步伐:方法:2020 年 6 月至 2021 年 6 月期间,研究排除了放射性不透明或微弱放射性不透明上尿路结石、结石衰减值≤1200 HU 且结石大小为 11 cm、体重指数大于 30 kg/m2 的患者。在超声和荧光透视联合引导下,以 40-50 SWs/min 的速度对患者进行前瞻性 SWL 治疗,并在第 300 次冲击时将速度提升至高功率。成功率和并发症均有记录:共有 590 名患者完成了研究。第一次治疗后,成功率为 408/590 例患者(69.15%),第二次治疗后,成功率提高到 527/590 例患者(89.3%)。术后 3 个月的成功率为 96.2%。大多数并发症为轻微并发症(1 级或 2 级):在透视和超声联合引导下,从疗程一开始就使用慢速高功率,SWL 的效果有所改善。SWL可能是大流行期间的首选方案。
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引用次数: 0
Using machine learning models to predict synchronous genitourinary cancers among gastrointestinal stromal tumor patients. 利用机器学习模型预测胃肠道间质瘤患者的同步泌尿生殖系统癌症。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_32_23
Mohammad Alghafees, Raouf M Seyam, Turki Al-Hussain, Tarek Mahmoud Amin, Waleed Altaweel, Belal Nedal Sabbah, Ahmad Nedal Sabbah, Razan Almesned, Laila Alessa

Objectives: Gastrointestinal stromal tumors (GISTs) can occur synchronously with other neoplasms, including the genitourinary (GU) system. Machine learning (ML) may be a valuable tool in predicting synchronous GU tumors in GIST patients, and thus improving prognosis. This study aims to evaluate the use of ML algorithms to predict synchronous GU tumors among GIST patients in a specialist research center in Saudi Arabia.

Materials and methods: We analyzed data from all patients with histopathologically confirmed GIST at our facility from 2003 to 2020. Patient files were reviewed for the presence of renal cell carcinoma, adrenal tumors, or other GU cancers. Three supervised ML algorithms were used: logistic regression, XGBoost Regressor, and random forests (RFs). A set of variables, including independent attributes, was entered into the models.

Results: A total of 170 patients were included in the study, with 58.8% (n = 100) being male. The median age was 57 (range: 9-91) years. The majority of GISTs were gastric (60%, n = 102) with a spindle cell histology. The most common stage at diagnosis was T2 (27.6%, n = 47) and N0 (20%, n = 34). Six patients (3.5%) had synchronous GU tumors. The RF model achieved the highest accuracy with 97.1%.

Conclusion: Our study suggests that the RF model is an effective tool for predicting synchronous GU tumors in GIST patients. Larger multicenter studies, utilizing more powerful algorithms such as deep learning and other artificial intelligence subsets, are necessary to further refine and improve these predictions.

目的:胃肠道间质瘤(GIST)可与包括泌尿生殖系统(GU)在内的其他肿瘤同步发生。机器学习(ML)可能是预测 GIST 患者同步泌尿生殖系统肿瘤的重要工具,从而改善预后。本研究旨在评估沙特阿拉伯一家专科研究中心使用 ML 算法预测 GIST 患者同步性 GU 肿瘤的情况:我们分析了 2003 年至 2020 年期间在本机构接受组织病理学确诊的所有 GIST 患者的数据。对患者档案进行了审查,以确定是否存在肾细胞癌、肾上腺肿瘤或其他 GU 癌。我们使用了三种有监督的 ML 算法:逻辑回归、XGBoost 回归和随机森林 (RF)。包括独立属性在内的一系列变量被输入到模型中:研究共纳入 170 名患者,其中 58.8%(n = 100)为男性。中位年龄为57岁(9-91岁)。大多数 GIST 为胃癌(60%,n = 102),组织学为纺锤形细胞。诊断时最常见的分期为T2(27.6%,n = 47)和N0(20%,n = 34)。6名患者(3.5%)患有同步GU肿瘤。RF模型的准确率最高,达到97.1%:我们的研究表明,RF模型是预测GIST患者同步性GU肿瘤的有效工具。有必要利用更强大的算法(如深度学习和其他人工智能子集)进行更大规模的多中心研究,以进一步完善和改进这些预测。
{"title":"Using machine learning models to predict synchronous genitourinary cancers among gastrointestinal stromal tumor patients.","authors":"Mohammad Alghafees, Raouf M Seyam, Turki Al-Hussain, Tarek Mahmoud Amin, Waleed Altaweel, Belal Nedal Sabbah, Ahmad Nedal Sabbah, Razan Almesned, Laila Alessa","doi":"10.4103/ua.ua_32_23","DOIUrl":"10.4103/ua.ua_32_23","url":null,"abstract":"<p><strong>Objectives: </strong>Gastrointestinal stromal tumors (GISTs) can occur synchronously with other neoplasms, including the genitourinary (GU) system. Machine learning (ML) may be a valuable tool in predicting synchronous GU tumors in GIST patients, and thus improving prognosis. This study aims to evaluate the use of ML algorithms to predict synchronous GU tumors among GIST patients in a specialist research center in Saudi Arabia.</p><p><strong>Materials and methods: </strong>We analyzed data from all patients with histopathologically confirmed GIST at our facility from 2003 to 2020. Patient files were reviewed for the presence of renal cell carcinoma, adrenal tumors, or other GU cancers. Three supervised ML algorithms were used: logistic regression, XGBoost Regressor, and random forests (RFs). A set of variables, including independent attributes, was entered into the models.</p><p><strong>Results: </strong>A total of 170 patients were included in the study, with 58.8% (<i>n</i> = 100) being male. The median age was 57 (range: 9-91) years. The majority of GISTs were gastric (60%, <i>n</i> = 102) with a spindle cell histology. The most common stage at diagnosis was T2 (27.6%, <i>n</i> = 47) and N0 (20%, <i>n</i> = 34). Six patients (3.5%) had synchronous GU tumors. The RF model achieved the highest accuracy with 97.1%.</p><p><strong>Conclusion: </strong>Our study suggests that the RF model is an effective tool for predicting synchronous GU tumors in GIST patients. Larger multicenter studies, utilizing more powerful algorithms such as deep learning and other artificial intelligence subsets, are necessary to further refine and improve these predictions.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"16 1","pages":"94-97"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delayed impacts of COVID-19 infection on unexplained male infertility: 2-year follow-up of normal sperm parameters in unexplained male infertility in KSA. COVID-19 感染对不明原因男性不育症的延迟影响:对阿联酋不明原因男性不育症患者正常精子参数的两年随访。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_154_22
Alsayed Saad Abdelaziz, Ayman Mohammed Ghoneem

Purpose: The current study aimed to assess the long-term effect of COVID-19 infection on unexplained male infertility.

Materials and methods: A retrospective comparative study of 134 men attending the infertility outpatient clinic of our institution before exposing to COVID-19 infection in KSA from January 2019 to July 2022. Medical recorded data of these patients who were investigated before COVID-19 infection were retrospectively collected using the hospital's electronic database, including semen analysis, sex hormonal, and ultrasound testicular size, and their data were compared prospectively to collected data after 2-year follow-up.

Results: One hundred and thirty-four infertile males who got COVID-19 infection in KSA (median age, 33 years) were assisted retrospectively preinfection and delayed 2 years postinfection (median of 23 months). Of the 134 men, 44 (32.83%) were asymptomatic positive COVID-19 (Group A), 68 (50.74%) had mild-to-moderate symptomatic positive COVID-19 (Group B), and 22 (16.41%) had severe symptomatic positive COVID-19 (Group C). There was no significant change between pre- and postinfections in sperm parameters, sex hormonal level, and testicular size. Subgroup analyses were performed for patients regarding the severity of infections. None of the evaluated parameters differed significantly after infections up to 2 years. Results of this study demonstrate that COVID-19 infection does not have significant changes in sperm parameters, sex hormonal level, and testicular size.

Conclusion: The long-term impact of COVID-19 infections has no significant effect on normal sperm parameters, sex hormones, and testicular size in male infertility in KSA.

目的:本研究旨在评估 COVID-19 感染对不明原因男性不育的长期影响:对2019年1月至2022年7月期间在KSA感染COVID-19之前在本机构不孕不育门诊就诊的134名男性进行回顾性比较研究。利用医院电子数据库回顾性收集了这些在感染COVID-19前接受检查的患者的医疗记录数据,包括精液分析、性激素、超声睾丸大小等,并将其数据与2年随访后收集的数据进行前瞻性比较:对 134 名在 KSA 感染 COVID-19(中位年龄 33 岁)的不育男性进行了感染前和感染后 2 年(中位 23 个月)的回顾性辅助检查。在 134 名男性中,44 人(32.83%)为 COVID-19 无症状阳性(A 组),68 人(50.74%)为 COVID-19 轻度至中度症状阳性(B 组),22 人(16.41%)为 COVID-19 严重症状阳性(C 组)。感染前后,精子参数、性激素水平和睾丸大小均无明显变化。对感染严重程度不同的患者进行了分组分析。感染长达两年后,所有评估参数均无明显差异。本研究结果表明,COVID-19感染不会对精子参数、性激素水平和睾丸大小产生显著变化:COVID-19的长期感染对沙特男性不育症患者的正常精子参数、性激素水平和睾丸大小没有明显影响。
{"title":"Delayed impacts of COVID-19 infection on unexplained male infertility: 2-year follow-up of normal sperm parameters in unexplained male infertility in KSA.","authors":"Alsayed Saad Abdelaziz, Ayman Mohammed Ghoneem","doi":"10.4103/ua.ua_154_22","DOIUrl":"10.4103/ua.ua_154_22","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aimed to assess the long-term effect of COVID-19 infection on unexplained male infertility.</p><p><strong>Materials and methods: </strong>A retrospective comparative study of 134 men attending the infertility outpatient clinic of our institution before exposing to COVID-19 infection in KSA from January 2019 to July 2022. Medical recorded data of these patients who were investigated before COVID-19 infection were retrospectively collected using the hospital's electronic database, including semen analysis, sex hormonal, and ultrasound testicular size, and their data were compared prospectively to collected data after 2-year follow-up.</p><p><strong>Results: </strong>One hundred and thirty-four infertile males who got COVID-19 infection in KSA (median age, 33 years) were assisted retrospectively preinfection and delayed 2 years postinfection (median of 23 months). Of the 134 men, 44 (32.83%) were asymptomatic positive COVID-19 (Group A), 68 (50.74%) had mild-to-moderate symptomatic positive COVID-19 (Group B), and 22 (16.41%) had severe symptomatic positive COVID-19 (Group C). There was no significant change between pre- and postinfections in sperm parameters, sex hormonal level, and testicular size. Subgroup analyses were performed for patients regarding the severity of infections. None of the evaluated parameters differed significantly after infections up to 2 years. Results of this study demonstrate that COVID-19 infection does not have significant changes in sperm parameters, sex hormonal level, and testicular size.</p><p><strong>Conclusion: </strong>The long-term impact of COVID-19 infections has no significant effect on normal sperm parameters, sex hormones, and testicular size in male infertility in KSA.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"16 1","pages":"75-80"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of nephrolithiasis in the Middle East over a recent decade: A systematic review. 近十年来中东地区的肾炎治疗情况:系统回顾。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_111_23
Ehab Mahmoud Ahmed

Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis.

肾结石是全球普遍存在的问题,尤其是在沙特阿拉伯等气候炎热的地区。这项分析的目的是研究沙特阿拉伯东部地区肾结石的特点,并提供以下研究结果:尿石组成、性别和年龄分布、结石形成的季节性变化、与结石形成有关的并存疾病以及尿石发病率。通过与欧美人群的比较,本系统综述和荟萃分析将确定亚洲人群肾结石的主要风险因素。我们通过 PubMed、ScienceDirect 和 ResearchGate 进行了全面的文献检索,按照系统综述和荟萃分析的首选报告项目标准,综合了 13 项地域不同的研究数据。通过阐明寻求医疗保健行为的差异和获得医疗保健机会的差距,突出了专门公共卫生计划的潜在目标。这项系统分析的结果让医生、研究人员和政策制定者对当今沙特阿拉伯的肾炎治疗状况有了全面的了解。此外,为了最大限度地改善这一特殊群体的肾炎护理,本综述还指出了信息差距,并强调了针对具体情况制定指导方针和未来研究计划的必要性。综上所述,本系统性综述探讨了沙特阿拉伯医疗保健领域存在的独特可能性和问题,同时也为世界范围内有关肾炎的讨论增添了新的内容。
{"title":"Management of nephrolithiasis in the Middle East over a recent decade: A systematic review.","authors":"Ehab Mahmoud Ahmed","doi":"10.4103/ua.ua_111_23","DOIUrl":"10.4103/ua.ua_111_23","url":null,"abstract":"<p><p>Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"16 1","pages":"36-42"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bladder perivascular epithelioid cell neoplasm: Review on clinical features of this rare tumor. 膀胱血管周围上皮样细胞瘤:关于这种罕见肿瘤临床特征的综述。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_40_23
Zeno Adriaenssens, Robby Peter Anna Lamoury, Sam Tilborghs, Stefan De Wachter, Tim Brits
<p><p>Perivascular epithelioid cell neoplasm (PEComa) is a rare mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They can arise in various localizations such as the bladder. A total of 36 case reports regarding bladder PEComa have been described in the literature. Eleven reviews regarding this tumor have been published in literature so far primarily focusing on anatomic pathology. Through these reviews, it is known that in bladder PEComa, the melanocytic marker Human Melanoma Black-45 is expressed in 100% of cases whereas variable expression can be seen in multiple other melanocytic and myoid markers such as smooth muscle actin, <i>Melan-A, CD117, S100, CD31</i>, and CD34. Since current reviews mainly emphasize anatomic pathology, we perform a review focusing on the clinical aspects of PEComa at the level of the clinician. A manual electronic search of the PubMed/Medline and Web of Science Core Collection databases was conducted. Search was done on (perivascular epithelioid cell neoplasms [MeSH terms]) AND (Bladder). All case reports and reviews were encompassed until March 15, 2023, to identify studies that assessed bladder PEComa. The age of presentation is relatively low with a median age of 37 years. There is a female predominance with a female/male ratio of 1.5. The tumor shows no preference in anatomical localization within the bladder. Even involvement of the bladder neck, proximal urethra, and distal ureter has been described. The clinical presentation consists in the majority of patients of symptoms related to the urinary tract such as hematuria, dysuria, passage of urine sediment, frequency, and urgency. Other symptoms include abdominal discomfort and dysmenorrhea. In clinical examination, an abdominal mass can be found based on the size and location of the tumor. Further examination usually encompasses cystoscopy due to the hematuria and radiological investigations such as ultrasound (US), computed tomography, and magnetic resonance imaging. These radiological investigations reveal a heterogeneous solid mass with clear borders. In our center, we performed a transvaginal US additionally in a patient with bladder PEComa, which was the only investigation in our patient that concluded the mass was located in the Retzius space. For treatment, transurethral resection of the bladder tumor and partial cystectomy were both described in equal numbers. The choice of treatment depends on the localization and size of the tumor. Follow-up consists of imaging, but clear guidelines on this matter are lacking. Bladder PEComa is a rare condition and usually presents itself with nonspecific symptoms. Radiological investigations will reveal the tumor, but the final diagnosis is based on cytological and immunohistochemical features. Since bladder PEComa is an entity with uncertain malignant potential, it is important to include this entity in the differential diagnosis when a patient present
血管周围上皮样细胞瘤(PEComa)是一种罕见的间质肿瘤,由组织学和免疫组织化学上独特的血管周围上皮样细胞组成。它们可发生在不同部位,如膀胱。文献中共有 36 篇关于膀胱上皮细胞瘤的病例报告。迄今为止,文献中已发表了 11 篇有关该肿瘤的综述,主要集中在解剖病理学方面。通过这些综述可知,在膀胱PEC瘤中,黑色素细胞标记物人类黑色素瘤黑-45在100%的病例中都有表达,而其他多种黑色素细胞和肌层标记物,如平滑肌肌动蛋白、Melan-A、CD117、S100、CD31和CD34,则有不同程度的表达。由于目前的综述主要强调解剖病理学,因此我们从临床医生的角度出发,对多发性黑素瘤的临床方面进行了综述。我们对 PubMed/Medline 和 Web of Science Core Collection 数据库进行了人工电子检索。搜索关键词为(血管周围上皮样细胞瘤[MeSH术语])和(膀胱)。截至 2023 年 3 月 15 日,所有病例报告和综述均被囊括在内,以确定对膀胱上皮细胞瘤进行评估的研究。发病年龄相对较低,中位年龄为 37 岁。女性占多数,男女比例为 1.5。肿瘤在膀胱内的解剖定位没有偏好。甚至膀胱颈、尿道近端和输尿管远端也有受累的描述。大多数患者的临床表现为血尿、排尿困难、尿沉渣排出、尿频和尿急等与泌尿道有关的症状。其他症状还包括腹部不适和痛经。在临床检查中,可根据肿瘤的大小和位置发现腹部肿块。进一步检查通常包括因血尿而进行的膀胱镜检查,以及超声波(US)、计算机断层扫描和磁共振成像等放射学检查。这些放射检查会发现边界清晰的异质实性肿块。在我们的中心,我们对一名膀胱PEComa患者额外进行了经阴道超声检查,这是唯一一次对患者进行的检查,其结论是肿块位于Retzius间隙。在治疗方面,经尿道膀胱肿瘤切除术和膀胱部分切除术的患者人数相当。治疗方法的选择取决于肿瘤的位置和大小。随访包括影像学检查,但目前还缺乏这方面的明确指南。膀胱前列腺癌是一种罕见病,通常表现为非特异性症状。放射学检查可发现肿瘤,但最终诊断要依据细胞学和免疫组化特征。由于膀胱前列腺癌是一种恶性可能性不确定的实体瘤,因此当患者出现下腹部不适和下尿路症状并伴有盆腔肿块时,将其纳入鉴别诊断非常重要。
{"title":"Bladder perivascular epithelioid cell neoplasm: Review on clinical features of this rare tumor.","authors":"Zeno Adriaenssens, Robby Peter Anna Lamoury, Sam Tilborghs, Stefan De Wachter, Tim Brits","doi":"10.4103/ua.ua_40_23","DOIUrl":"10.4103/ua.ua_40_23","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Perivascular epithelioid cell neoplasm (PEComa) is a rare mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They can arise in various localizations such as the bladder. A total of 36 case reports regarding bladder PEComa have been described in the literature. Eleven reviews regarding this tumor have been published in literature so far primarily focusing on anatomic pathology. Through these reviews, it is known that in bladder PEComa, the melanocytic marker Human Melanoma Black-45 is expressed in 100% of cases whereas variable expression can be seen in multiple other melanocytic and myoid markers such as smooth muscle actin, &lt;i&gt;Melan-A, CD117, S100, CD31&lt;/i&gt;, and CD34. Since current reviews mainly emphasize anatomic pathology, we perform a review focusing on the clinical aspects of PEComa at the level of the clinician. A manual electronic search of the PubMed/Medline and Web of Science Core Collection databases was conducted. Search was done on (perivascular epithelioid cell neoplasms [MeSH terms]) AND (Bladder). All case reports and reviews were encompassed until March 15, 2023, to identify studies that assessed bladder PEComa. The age of presentation is relatively low with a median age of 37 years. There is a female predominance with a female/male ratio of 1.5. The tumor shows no preference in anatomical localization within the bladder. Even involvement of the bladder neck, proximal urethra, and distal ureter has been described. The clinical presentation consists in the majority of patients of symptoms related to the urinary tract such as hematuria, dysuria, passage of urine sediment, frequency, and urgency. Other symptoms include abdominal discomfort and dysmenorrhea. In clinical examination, an abdominal mass can be found based on the size and location of the tumor. Further examination usually encompasses cystoscopy due to the hematuria and radiological investigations such as ultrasound (US), computed tomography, and magnetic resonance imaging. These radiological investigations reveal a heterogeneous solid mass with clear borders. In our center, we performed a transvaginal US additionally in a patient with bladder PEComa, which was the only investigation in our patient that concluded the mass was located in the Retzius space. For treatment, transurethral resection of the bladder tumor and partial cystectomy were both described in equal numbers. The choice of treatment depends on the localization and size of the tumor. Follow-up consists of imaging, but clear guidelines on this matter are lacking. Bladder PEComa is a rare condition and usually presents itself with nonspecific symptoms. Radiological investigations will reveal the tumor, but the final diagnosis is based on cytological and immunohistochemical features. Since bladder PEComa is an entity with uncertain malignant potential, it is important to include this entity in the differential diagnosis when a patient present","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"16 1","pages":"28-35"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Grossing to reporting of Wilms tumor with emphasis on proper sampling in treatment-naive and postchemotherapy specimens and their clinicopathological correlation with outcome. 从粗略检查到报告 Wilms 肿瘤,重点关注治疗无效标本和化疗后标本的正确取样及其与预后的临床病理学相关性。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_60_23
Mohan Krishna Pasam, B Vishal Rao, Sai Kiran Chaganty, Rakesh Manilal Sharma, Veerendra Patil, Suseela Kodandapani, Sundaram Challa, Subramanyeshwar Rao Thammineedi
<p><strong>Context: </strong>Emphasis on grossing to reporting for the assessment of histopathological parameters predicting outcomes in Wilms tumor.</p><p><strong>Aims: </strong>To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens.</p><p><strong>Settings and design: </strong>This was a retrospective observational study.</p><p><strong>Subjects and methods: </strong>All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children's Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed.</p><p><strong>Statistical analysis used: </strong>Chi-square and Fisher's exact tests were used for statistical analysis.</p><p><strong>Results: </strong>A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (<i>n</i> = 10) we mixed histological type followed by blastemal type constituting (32%, <i>n</i> = 8). Regressive and epithelial histological types constituted 16% (<i>n</i> = 4) and 12% (<i>n</i> = 3), respectively. In the SIOP group 72% (<i>n</i> = 19) had no anaplasia and 28% (<i>n</i> = 7) had anaplasia. Fifty seven percent (<i>n</i> = 15) cases were Stage I, followed by 26.9% <i>n</i> = 7) and 11.5% (<i>n</i> = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission.</p><p><strong>Conclusions: </strong>Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor
背景:目的:分析影响未接受治疗和化疗后Wilms肿瘤标本预后的各种临床病理参数:这是一项回顾性观察研究:将纳入 2012 年至 2018 年期间在我院确诊的所有 Wilms 肿瘤患者,并提供其临床结果、实验室报告和放射学结果。根据所使用的治疗方案(儿科肿瘤学会(SIOP)或国家威尔姆斯肿瘤研究组/儿童肿瘤学组(COG)指南),将患者分为两组。将分析治疗前和治疗后标本的毛细和报告方案的细节。将对截至 2020 年 12 月的随访情况进行分析:统计分析采用卡方检验和费雪精确检验:本研究共纳入 36 名确诊为 Wilms 肿瘤的患者。平均发病年龄为(3.9±0.7)岁,男性多于女性。大多数患者表现为腹部肿块,少数患者伴有孤立性血尿。26例(72%)患者按照SIOP方案接受了术前新辅助化疗。10名患者按照COG方案进行了前期手术。SIOP 组患者的平均肿瘤大小为 9.3 厘米。40%的患者(10 人)为混合组织学类型,其次是胚芽组织类型(32%,8 人)。退行性和上皮性组织学类型分别占 16%(4 人)和 12%(3 人)。在 SIOP 组中,72%(n = 19)无增生,28%(n = 7)有增生。57%(n = 15)的病例为Ⅰ期,26.9%(n = 7)和11.5%(n = 3)的病例分别为Ⅱ期和Ⅲ期。10名患者按照COG方案接受了前期手术。这组患者的肿瘤平均大小为 8 厘米,从 7 厘米到 11 厘米不等。其中八例(80%)的组织学状况良好,两例出现局灶性增生。3例(70%)出现异源分化。在 10 例病例中,1 例为Ⅰ期,6 例为Ⅱ期,1 例为Ⅲ期,2 例为临床Ⅳ期。无一例出现血管或淋巴结转移。所有患者在手术后都接受了辅助化疗,并随访至 2020 年 12 月(至少 3 年)。在 SIOP 组的 25 名患者中,18 人(72%)的病情完全缓解,且没有残留疾病的放射学证据。在COG组的10名患者中,6名(70%)完全缓解:Wilms肿瘤的组织病理学评估是治疗Wilms肿瘤的关键环节,因为在SIOP和COG方案下治疗的肿瘤特征不同,这将最终影响预后风险分层。因此,有必要了解这两种方案下这些肿瘤的重要大体检查和报告方法。
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引用次数: 0
Thermoexpandable Memokath stent: Usage and efficacy in ureteral and urethral strictures in Saudi Arabia. 热膨胀 Memokath 支架:沙特阿拉伯输尿管和尿道狭窄患者的使用情况和疗效。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4103/ua.ua_160_22
Omar Buksh, Anfar Jar, Ahmad Khogeer, Hani Alzahrani, Rabea Akram, Mohammad Taher, Mahmoud Al Akra'a, Adel Alammari, Islam Junaid

Objectives: Double J (DJ) stent is widely used in cases of ureteric strictures as a temporary solution; however, it has certain limitations, such as the need for frequent exchange. Alternatively, a long-lasting thermoexpandable stent (Memokath™ 051) has been used to relieve ureteral obstructions in comorbid patients with multiple reported advantages, such as longer durability which avoids the need of frequent exchanges. In addition, it can be used in certain cases of urethral strictures. Our study is the first in the region to report the experience and outcome of Memokath stent with ureteral and urethral strictures.

Materials and methods: After local IRB approval, we retrospectively reviewed records of 21 patients who underwent insertion of Memokath 051 stent in the ureter and Memokath 045 in the urethra between 2013 and 2021. Indications of insertion, indwelling duration, and causes of removal were collected and analyzed by SPSS.

Results: Twenty-one patients received 21 Memokath stents for 11 ureteral strictures and 10 urethral strictures. Fifty-five percent of ureteral strictures were malignant, and 27.3% of the benign ureteric strictures were transplant ureters. Ureteric memokath stents remained functioning for a mean of 16.1 months. Mean indwelling time for transplant ureteric memokath stents was 24.3 months. Total 4 ureteric stents had migrated, 4 stents blocked, and 2 stents were removed as planned and 1 stent removed due to febrile urinary tract infection (UTI). Ten urethral stents remained in place for mean of 14 months. Three stents were removed as planned with resolution of stricture, two were removed due to blockage, three stents had UTI, one was removed due to pain, and one stent remained functioning until the patient expired.

Conclusion: Our outcome is comparable to other published studies, suggesting that ureteric Memokath stent is a better option with adequate indwelling time, especially in transplant ureters, in comparison with DJ stents. In addition, Memokath stents can be used in selected recurrent urethral strictures where surgical reconstruction is not feasible.

目的:双 J(Double J,DJ)支架作为一种临时解决方案被广泛应用于输尿管狭窄的病例中,但它也有一定的局限性,例如需要频繁更换。另外,一种长效热膨胀支架(Memokath™ 051)已被用于缓解合并症患者的输尿管梗阻,据报道这种支架具有多种优点,如使用寿命长,无需频繁更换。此外,它还可用于某些尿道狭窄病例。我们的研究是该地区首次报告 Memokath 支架治疗输尿管和尿道狭窄的经验和结果:经当地国际注册研究委员会批准后,我们回顾性审查了 2013 年至 2021 年期间在输尿管插入 Memokath 051 支架和在尿道插入 Memokath 045 支架的 21 例患者的记录。收集了插入指征、留置时间和移除原因,并用 SPSS 进行了分析:21名患者接受了21枚Memokath支架,用于治疗11处输尿管狭窄和10处尿道狭窄。55%的输尿管狭窄为恶性,27.3%的良性输尿管狭窄为移植性输尿管。输尿管membokath支架的平均使用寿命为16.1个月。移植输尿管membokath支架的平均留置时间为24.3个月。共有 4 个输尿管支架移位,4 个支架堵塞,2 个支架按计划移除,1 个支架因发热性尿路感染(UTI)而移除。10 个尿道支架平均放置了 14 个月。3个支架按计划取出,狭窄得到缓解,2个支架因堵塞而取出,3个支架发生UTI,1个支架因疼痛而取出,1个支架在患者去世前仍在发挥作用:结论:我们的研究结果与其他已发表的研究结果相当,表明与 DJ 支架相比,输尿管 Memokath 支架是一种具有足够留置时间的更好选择,尤其是在移植输尿管中。此外,Memokath 支架还可用于无法进行手术重建的复发性尿道狭窄。
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引用次数: 0
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Urology Annals
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