Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.10.001
Xueying Li , Yepeng Guo , Antonio Augusto Ornellas , Jiun-Hung Geng , Yonghong Li , Wayne Lam , Yabing Cao , Zhuowei Liu , Hui Han , Fangjian Zhou , Zaishang Li
Objective
The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer (AJCC) anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.
Methods
The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups. Kaplan–Meier plots were used to estimate the disease-specific survival (DSS) of the patients. The accuracy of the staging systems was investigated using the Harrell's concordance index (C-index).
Results
According to the 8th AJCC anatomic and prognostic stage groups, the 5-year DSS rates for patients with stages 0is/a, I, IIA, IIB, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 81%, 66%, 34%, and 23%, respectively (p0is/a–I=0.8, pI–IIA<0.001, pIIA–IIB=0.5, pIIB–IIIA<0.001, pIIIA–IIIB<0.001, pIIIB–IV=0.004, and pTotal<0.001). According to the modified model 1 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 88%, 66%, 34%, and 23%, respectively (p0is/a–I=0.8, pI–II<0.001, pII–IIIA=0.002, pIIIA–IIIB<0.001, pIIIB–IV=0.004, and pTotal<0.001). Similarly, according to the modified model 2 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 66%, 34%, and 23%, respectively (p0is/a–I=0.8, pI–II<0.001, pII–IIIA=0.008, pIIIA–IIIB<0.001, pIIIB–IV=0.004, and pTotal<0.001). The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups. These results were confirmed by the bootstrap internal validation.
Conclusion
There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups. The improved models, which are more concise and convenient, have similar prediction accuracy.
{"title":"The prognostic value of the 8th American Joint Committee on cancer anatomic and prognostic stage groups for penile cancer: A multicenter collaboration study","authors":"Xueying Li , Yepeng Guo , Antonio Augusto Ornellas , Jiun-Hung Geng , Yonghong Li , Wayne Lam , Yabing Cao , Zhuowei Liu , Hui Han , Fangjian Zhou , Zaishang Li","doi":"10.1016/j.ajur.2024.10.001","DOIUrl":"10.1016/j.ajur.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer (AJCC) anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.</div></div><div><h3>Methods</h3><div>The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups. Kaplan–Meier plots were used to estimate the disease-specific survival (DSS) of the patients. The accuracy of the staging systems was investigated using the Harrell's concordance index (C-index).</div></div><div><h3>Results</h3><div>According to the 8th AJCC anatomic and prognostic stage groups, the 5-year DSS rates for patients with stages 0is/a, I, IIA, IIB, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 81%, 66%, 34%, and 23%, respectively (<em>p</em><sub>0is/a–I</sub>=0.8, <em>p</em><sub>I–IIA</sub><0.001, <em>p</em><sub>IIA–IIB</sub>=0.5, <em>p</em><sub>IIB–IIIA</sub><0.001, <em>p</em><sub>IIIA–IIIB</sub><0.001, <em>p</em><sub>IIIB–IV</sub>=0.004, and <em>p</em><sub>Total</sub><0.001). According to the modified model 1 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 88%, 66%, 34%, and 23%, respectively (<em>p</em><sub>0is/a–I</sub>=0.8, <em>p</em><sub>I–II</sub><0.001, <em>p</em><sub>II–IIIA</sub>=0.002, <em>p</em><sub>IIIA–IIIB</sub><0.001, <em>p</em><sub>IIIB–IV</sub>=0.004, and <em>p</em><sub>Total</sub><0.001). Similarly, according to the modified model 2 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 66%, 34%, and 23%, respectively (<em>p</em><sub>0is/a–I</sub>=0.8, <em>p</em><sub>I–II</sub><0.001, <em>p</em><sub>II–IIIA</sub>=0.008, <em>p</em><sub>IIIA–IIIB</sub><0.001, <em>p</em><sub>IIIB–IV</sub>=0.004, and <em>p</em><sub>Total</sub><0.001). The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups. These results were confirmed by the bootstrap internal validation.</div></div><div><h3>Conclusion</h3><div>There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups. The improved models, which are more concise and convenient, have similar prediction accuracy.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 100-105"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.06.004
Ciro Esposito, Claudia Di Mento, Annalisa Chiodi, Giovanni Esposito, Luisa Florio, Maria Escolino
{"title":"An unusual case of blood dripping following robotic-assisted laparoscopic varicocelectomy","authors":"Ciro Esposito, Claudia Di Mento, Annalisa Chiodi, Giovanni Esposito, Luisa Florio, Maria Escolino","doi":"10.1016/j.ajur.2024.06.004","DOIUrl":"10.1016/j.ajur.2024.06.004","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 127-128"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.07.001
Siyang Ma , Jianxuan Sun , Jinzhou Xu, Ye An, Mengyao Xu, Chenqian Liu, Sihan Zhang, Lintao Miao, Xingyu Zhong, Na Zeng, Haodong He, Shaogang Wang, Qidong Xia
Objective
Almost 15% of prostate cancer (PCa) patients were found to have lymph node metastases (LNMs), which are associated with higher risk of biochemical recurrence. Using indocyanine green (ICG) for the sentinel node biopsy (SNB) before surgery was proposed to detect LNMs in PCa patients. However, its diagnostic performance still remains controversial. This study aimed to investigate the diagnostic performance of ICG for the SNB in PCa.
Methods
This systematic review and meta-analysis has been reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The protocol has been registered in the International Prospective Register of Systematic Reviews database, and the register number is CRD42023421911. Four bibliographic databases were searched, i.e., PubMed, EMBASE, Cochrane Library, and Web of Science, to retrieve articles studying the diagnostic performance of ICG for the SNB in PCa from the inception to Sep 9, 2023. We calculated the pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios and their 95% confidence intervals (CIs). Subgroup analyses and meta-regression analyses were also conducted.
Results
A total of 17 articles from databases are enrolled in this study. Using lymph node-based data, our results showed that the pooled sensitivity and specificity of applying ICG alone in PCa were 71% (95% CI 52%–85%) and 68% (95% CI 64%–72%), respectively. The pooled sensitivity and specificity of applying ICG-technetium-99m-nanocolloid in PCa were 49% (95% CI 39%–59%) and 69% (95% CI 67%–71%), respectively.
Conclusion
The efficacy of using ICG or ICG-technetium-99m-nanocolloid for the SNB in PCa is relatively unsatisfactory. ICG cannot yet substitute extended pelvic lymph node dissection for detecting LNMs accurately. More research or novel tracers are needed to achieve the goal of precise surgery.
目的近15%的前列腺癌（PCa）患者存在淋巴结转移（LNMs），淋巴结转移具有较高的生化复发风险。建议术前采用吲哚菁绿（ICG）进行前哨淋巴结活检（SNB）检测PCa患者的LNMs。然而，其诊断性能仍存在争议。本研究旨在探讨ICG对前列腺癌中SNB的诊断价值。方法本系统评价和荟萃分析按照系统评价和荟萃分析指南的首选报告项目进行报道。该方案已在国际前瞻性系统评价注册数据库中注册，注册号为CRD42023421911。检索PubMed、EMBASE、Cochrane Library和Web of Science四个文献数据库，检索自PCa成立至2023年9月9日有关ICG对SNB诊断性能的文章。我们计算了合并的敏感性、特异性、似然比、诊断优势比及其95%置信区间（ci）。并进行亚组分析和meta回归分析。结果本研究共纳入数据库中的17篇文章。使用基于淋巴结的数据，我们的结果显示单独应用ICG治疗PCa的敏感性和特异性分别为71% （95% CI 52%-85%）和68% （95% CI 64%-72%）。在PCa中应用icg -锝-99m纳米胶体的总敏感性和特异性分别为49% （95% CI 39%-59%）和69% （95% CI 67%-71%）。结论应用ICG或ICG-tech -99m纳米胶体治疗前列腺癌的SNB疗效较差。ICG尚不能代替盆腔淋巴结清扫术准确检测LNMs。需要更多的研究或新的示踪剂来实现精确手术的目标。
{"title":"The diagnostic performance of indocyanine green for the sentinel node biopsy in prostate cancer: A systematic review and meta-analysis","authors":"Siyang Ma , Jianxuan Sun , Jinzhou Xu, Ye An, Mengyao Xu, Chenqian Liu, Sihan Zhang, Lintao Miao, Xingyu Zhong, Na Zeng, Haodong He, Shaogang Wang, Qidong Xia","doi":"10.1016/j.ajur.2024.07.001","DOIUrl":"10.1016/j.ajur.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>Almost 15% of prostate cancer (PCa) patients were found to have lymph node metastases (LNMs), which are associated with higher risk of biochemical recurrence. Using indocyanine green (ICG) for the sentinel node biopsy (SNB) before surgery was proposed to detect LNMs in PCa patients. However, its diagnostic performance still remains controversial. This study aimed to investigate the diagnostic performance of ICG for the SNB in PCa.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis has been reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The protocol has been registered in the International Prospective Register of Systematic Reviews database, and the register number is CRD42023421911. Four bibliographic databases were searched, <em>i.e.</em>, PubMed, EMBASE, Cochrane Library, and Web of Science, to retrieve articles studying the diagnostic performance of ICG for the SNB in PCa from the inception to Sep 9, 2023. We calculated the pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios and their 95% confidence intervals (CIs). Subgroup analyses and meta-regression analyses were also conducted.</div></div><div><h3>Results</h3><div>A total of 17 articles from databases are enrolled in this study. Using lymph node-based data, our results showed that the pooled sensitivity and specificity of applying ICG alone in PCa were 71% (95% CI 52%–85%) and 68% (95% CI 64%–72%), respectively. The pooled sensitivity and specificity of applying ICG-technetium-99m-nanocolloid in PCa were 49% (95% CI 39%–59%) and 69% (95% CI 67%–71%), respectively.</div></div><div><h3>Conclusion</h3><div>The efficacy of using ICG or ICG-technetium-99m-nanocolloid for the SNB in PCa is relatively unsatisfactory. ICG cannot yet substitute extended pelvic lymph node dissection for detecting LNMs accurately. More research or novel tracers are needed to achieve the goal of precise surgery.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 1-14"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.02.004
Otaš Durutovic , Guohua Zeng , Bhaskar Somani , Simon Choong , Giorgio Mazzon , Di Gu , Zeeshan Hameed , TP Rajeev , Bogomir Milojevic , Davide Brusa , Tiago Ribeiro Oliveira , Sergio Pereira , Nariman Gadzhiev , Ali Serdar Gozen , Evangelos Liatsikos , Panagiotis Kallidonis , Uros Bumbasirevic , Andreas Skolarikos
Objective
This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.
Methods
We conducted an anonymous internet-based survey addressed to the EAU Section of Uro-Technology and the International Alliance of Urolithiasis members with particular interest in the stone treatment at all levels of expertise. The final version of the questionnaire included 31 questions, evaluated the level of knowledge on X-ray utilization and exposure, and identified correlations between geographic areas, levels of seniority, surgical volumes, and awareness on radiation protection.
Results
In total, 586 respondents were included. Knowledge of fluoroscopy settings appeared low, particularly among trainees (up to 87.5% were uninformed, p=0.008). Precautions to reduce exposure appeared poorly followed as up to 25.4% of respondents used regularly continuous fluoroscopy, and up to 20.5% used regularly high-frequency setting and this trend was more obvious among senior specialists (6.2% of trainees used high-frequency settings vs. 21.3% of consultants, p<0.05). Additionally, only 24.9% of respondents would provide X-ray protection to patients too.
Conclusion
Although high and routinary utilization of X-rays, the level of awareness and adhesion to “as low as reasonably achievable” principles among endourologists seems suboptimal in 65.0% of all respondents. Highest volume surgeons, inevitably at higher risk, do not seem to adopt more precautions. More efforts should be addressed to improve these results, reducing the risk related to excessive radiation exposure for both surgical staff and patients in order to minimize health related issues.
{"title":"Worldwide variations in the knowledge and use of fluoroscopy during percutaneous nephrolithotomy—should we do better? A survey by the European Association of Urology Section for Uro-Technology and the International Alliance of Urolithiasis","authors":"Otaš Durutovic , Guohua Zeng , Bhaskar Somani , Simon Choong , Giorgio Mazzon , Di Gu , Zeeshan Hameed , TP Rajeev , Bogomir Milojevic , Davide Brusa , Tiago Ribeiro Oliveira , Sergio Pereira , Nariman Gadzhiev , Ali Serdar Gozen , Evangelos Liatsikos , Panagiotis Kallidonis , Uros Bumbasirevic , Andreas Skolarikos","doi":"10.1016/j.ajur.2024.02.004","DOIUrl":"10.1016/j.ajur.2024.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.</div></div><div><h3>Methods</h3><div>We conducted an anonymous internet-based survey addressed to the EAU Section of Uro-Technology and the International Alliance of Urolithiasis members with particular interest in the stone treatment at all levels of expertise. The final version of the questionnaire included 31 questions, evaluated the level of knowledge on X-ray utilization and exposure, and identified correlations between geographic areas, levels of seniority, surgical volumes, and awareness on radiation protection.</div></div><div><h3>Results</h3><div>In total, 586 respondents were included. Knowledge of fluoroscopy settings appeared low, particularly among trainees (up to 87.5% were uninformed, <em>p</em>=0.008). Precautions to reduce exposure appeared poorly followed as up to 25.4% of respondents used regularly continuous fluoroscopy, and up to 20.5% used regularly high-frequency setting and this trend was more obvious among senior specialists (6.2% of trainees used high-frequency settings <em>vs.</em> 21.3% of consultants, <em>p</em><0.05). Additionally, only 24.9% of respondents would provide X-ray protection to patients too.</div></div><div><h3>Conclusion</h3><div>Although high and routinary utilization of X-rays, the level of awareness and adhesion to “as low as reasonably achievable” principles among endourologists seems suboptimal in 65.0% of all respondents. Highest volume surgeons, inevitably at higher risk, do not seem to adopt more precautions. More efforts should be addressed to improve these results, reducing the risk related to excessive radiation exposure for both surgical staff and patients in order to minimize health related issues.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 51-58"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.05.004
Zhihuan Zheng , Zhongyi Li , Jiazhe Yuan , Feng Han , Li Huang , Zhao Wang
Objective
To review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.
Methods
A literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.
Results
A total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.
Conclusion
Ketamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.
{"title":"Ketamine-associated upper urinary tract dysfunction: What we know from current literature","authors":"Zhihuan Zheng , Zhongyi Li , Jiazhe Yuan , Feng Han , Li Huang , Zhao Wang","doi":"10.1016/j.ajur.2024.05.004","DOIUrl":"10.1016/j.ajur.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>To review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.</div></div><div><h3>Results</h3><div>A total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.</div></div><div><h3>Conclusion</h3><div>Ketamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 33-42"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.
Methods
We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021. The primary outcome was a stone-free rate with one session within 30 days, defined as no residual stones without auxiliary treatment. The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success. Furthermore, we compared the outcomes using propensity score matching.
Results
Ninety-eight patients underwent the intravenous urography use protocol (Group I), and the remaining 636 patients underwent the non-intravenous urography protocol (Group N). Stone-free rates with one session within 30 days were 38% and 32% in groups I and N, respectively (p=0.3). No statistical differences were observed in the conversion rate to ureteroscopy (p=0.3) or complication rate (p=0.7) between Group I and Group N. One patient who developed skin redness was considered a complication of the contrast medium. Propensity score matching examined 88 matched pairs. Treatment success was obtained in 31 (35%) patients in Group I and 33 (38%) patients in Group N (p=0.9) within 30 days with one session.
Conclusion
Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.
{"title":"Clinical outcomes of intravenous urography-assisted shockwave lithotripsy for radiolucent ureteral stones","authors":"Shinya Somiya , Shigeki Koterazawa , Katsuhiro Ito , Takao Haitani , Yuki Makino , Ryuichiro Arakaki , Norio Kawase , Yoshihito Higashi , Hitoshi Yamada , Toru Kanno","doi":"10.1016/j.ajur.2024.03.002","DOIUrl":"10.1016/j.ajur.2024.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021. The primary outcome was a stone-free rate with one session within 30 days, defined as no residual stones without auxiliary treatment. The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success. Furthermore, we compared the outcomes using propensity score matching.</div></div><div><h3>Results</h3><div>Ninety-eight patients underwent the intravenous urography use protocol (Group I), and the remaining 636 patients underwent the non-intravenous urography protocol (Group N). Stone-free rates with one session within 30 days were 38% and 32% in groups I and N, respectively (<em>p</em>=0.3). No statistical differences were observed in the conversion rate to ureteroscopy (<em>p</em>=0.3) or complication rate (<em>p</em>=0.7) between Group I and Group N. One patient who developed skin redness was considered a complication of the contrast medium. Propensity score matching examined 88 matched pairs. Treatment success was obtained in 31 (35%) patients in Group I and 33 (38%) patients in Group N (<em>p</em>=0.9) within 30 days with one session.</div></div><div><h3>Conclusion</h3><div>Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 66-71"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.06.001
Hasan Gungor , Ahmet Camtosun , Ibrahim Topcu , Leyla Karaca
Objective
This study aimed to assess the local staging of bladder tumors in patients utilizing preoperative multiparametric MRI (mpMRI) and to demonstrate the clinical efficacy of this method through a comparative analysis with corresponding histopathological findings.
Methods
Between November 2020 and April 2022, 63 patients with a planned cystoscopy and a preliminary or previous diagnosis of bladder tumor were included. All participants underwent mpMRI, and Vesical Imaging Reporting and Data System (VI-RADS) criteria were applied to assess the recorded images. Subsequently, obtained biopsies were histopathologically examined and compared with radiological findings.
Results
Of the 63 participants, 60 were male, and three were female. Categorizing tumors with a VI-RADS score of >3 as muscle invasive, 84% were radiologically classified as having an invasive bladder tumor. However, histopathological results indicated invasive bladder tumors in 52% of cases. Sensitivity of the VI-RADS score was 100%; specificity was 23%; the negative predictive value was 100%; and the positive predictive value was 62%.
Conclusion
The scoring system obtained through mpMRI, VI-RADS, proves to be a successful method, particularly in determining the absence of muscle invasion in bladder cancer. Its efficacy in detecting muscle invasion in bladder tumors could be further enhanced with additional studies, suggesting potential for increased diagnostic efficiency through ongoing research. The VI-RADS could enhance the selection of patients eligible for accurate diagnosis and treatment.
{"title":"Evaluating the concordance between Vesical Imaging Reporting and Data System scores and bladder tumor histopathology","authors":"Hasan Gungor , Ahmet Camtosun , Ibrahim Topcu , Leyla Karaca","doi":"10.1016/j.ajur.2024.06.001","DOIUrl":"10.1016/j.ajur.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the local staging of bladder tumors in patients utilizing preoperative multiparametric MRI (mpMRI) and to demonstrate the clinical efficacy of this method through a comparative analysis with corresponding histopathological findings.</div></div><div><h3>Methods</h3><div>Between November 2020 and April 2022, 63 patients with a planned cystoscopy and a preliminary or previous diagnosis of bladder tumor were included. All participants underwent mpMRI, and Vesical Imaging Reporting and Data System (VI-RADS) criteria were applied to assess the recorded images. Subsequently, obtained biopsies were histopathologically examined and compared with radiological findings.</div></div><div><h3>Results</h3><div>Of the 63 participants, 60 were male, and three were female. Categorizing tumors with a VI-RADS score of >3 as muscle invasive, 84% were radiologically classified as having an invasive bladder tumor. However, histopathological results indicated invasive bladder tumors in 52% of cases. Sensitivity of the VI-RADS score was 100%; specificity was 23%; the negative predictive value was 100%; and the positive predictive value was 62%.</div></div><div><h3>Conclusion</h3><div>The scoring system obtained through mpMRI, VI-RADS, proves to be a successful method, particularly in determining the absence of muscle invasion in bladder cancer. Its efficacy in detecting muscle invasion in bladder tumors could be further enhanced with additional studies, suggesting potential for increased diagnostic efficiency through ongoing research. The VI-RADS could enhance the selection of patients eligible for accurate diagnosis and treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 87-92"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.02.010
Murat Olukman , Cenk Can , Sibel Ülker , Yiğit Uyanikgil , Türker Çavuşoğlu , Neslihan Düzenli , Deniz Coşkunsever , Fatma G. Kozcu
Objective
This study aimed to investigate the effects of treatment with palosuran, a urotensin receptor blocker, on molecular changes in the corpora cavernosa (CC) in diabetic rats.
Methods
Streptozotocin-induced diabetic rats were treated with palosuran 300 mg/kg per day for 6 weeks. Contraction of CC induced by potassium chloride, phenylephrine, and NG-nitro-L-arginine methyl ester and relaxation of CC induced by electrical field stimulation (EFS) and sodium nitroprusside (SNP) (endothelium-dependent and endothelium-independent stimuli, respectively), and Y-27632 (Rho-kinase inhibitor) were examined in organ baths. Direct contraction or relaxation induced by palosuran and urotensin-II (U-II) were also evaluated. The expression levels of nitric oxide synthetases (NOSs), RhoA, oxidative stress regulators, and U-II were analyzed by Western blotting or immunohistochemistry.
Results
Induction of diabetes in rats resulted in the decreased relaxant response to SNP, decreased pD2 value of SNP, attenuated relaxant response to Y-27632 as well as the decreased RhoA expression in CC. Palosuran treatment of diabetic rats reversed all of these parameters; however, it further impaired the already weakened relaxation of diabetic CC in response to EFS. Although induction of diabetes did not change U-II expression in CC significantly, palosuran treatment reduced U-II expression in diabetic CC. The expression level of nNOS was lowered in diabetic CC; however, palosuran treatment did not change the decreased the neuronal NOS expression. In vitro exposure of diabetic CC strips to palosuran produced a direct relaxant response.
Conclusion
Palosuran treatment did not affect the expression of NOSs or reduce nitrergic conduction induced by EFS stimulation in diabetic CC. However, while directly triggering a relaxant response, it did not induce a prominent contraction either by decreasing U-II expression, or increasing the sensitivity of CC to nitric oxide which suggested that palosuran has the potential to support erectile function. Further and comprehensive studies are required to clarify this issue.
目的探讨尿紧张素受体阻滞剂palosuran对糖尿病大鼠海绵体（CC）分子变化的影响。方法采用帕洛舒兰300 mg/kg / d治疗链脲佐菌素诱导的糖尿病大鼠，连续6周。在器官浴中检测了氯化钾、苯肾上腺素和ng -硝基- l -精氨酸甲酯诱导的CC收缩和电场刺激（EFS）、硝普钠（SNP）（分别为内皮依赖性和内皮非依赖性刺激）和Y-27632 （rho激酶抑制剂）诱导的CC松弛。palosuran和urotensin-II （U-II）诱导的直接收缩或松弛也进行了评估。采用Western blotting或免疫组织化学方法分析一氧化氮合成酶（nos）、RhoA、氧化应激调节因子和U-II的表达水平。结果糖尿病诱导大鼠对SNP的舒张反应减弱，SNP的pD2值降低，Y-27632的舒张反应减弱，CC中RhoA的表达降低，而糖尿病大鼠给予帕洛舒兰治疗后这些参数均逆转；然而，它进一步损害了已经减弱的糖尿病CC对EFS的松弛。虽然诱导糖尿病没有显著改变CC中U-II的表达，但palosuran治疗降低了糖尿病CC中U-II的表达，降低了糖尿病CC中nNOS的表达水平；然而，帕络舒兰治疗未改变神经元NOS表达降低的情况。糖尿病CC条在体外暴露于palosuran产生直接松弛反应。结论palosuran治疗不影响糖尿病CC中NOSs的表达，也不降低EFS刺激引起的氮能传导，但直接引发松弛反应，但未通过降低U-II表达或增加CC对一氧化氮的敏感性引起明显收缩，提示palosuran具有支持勃起功能的潜力。需要进一步和全面的研究来澄清这个问题。
{"title":"The effects of the urotensin-II receptor antagonist palosuran treatment on the corpora cavernosa of streptozotocin-induced diabetic rats","authors":"Murat Olukman , Cenk Can , Sibel Ülker , Yiğit Uyanikgil , Türker Çavuşoğlu , Neslihan Düzenli , Deniz Coşkunsever , Fatma G. Kozcu","doi":"10.1016/j.ajur.2024.02.010","DOIUrl":"10.1016/j.ajur.2024.02.010","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the effects of treatment with palosuran, a urotensin receptor blocker, on molecular changes in the corpora cavernosa (CC) in diabetic rats.</div></div><div><h3>Methods</h3><div>Streptozotocin-induced diabetic rats were treated with palosuran 300 mg/kg per day for 6 weeks. Contraction of CC induced by potassium chloride, phenylephrine, and NG-nitro-<em>L</em>-arginine methyl ester and relaxation of CC induced by electrical field stimulation (EFS) and sodium nitroprusside (SNP) (endothelium-dependent and endothelium-independent stimuli, respectively), and Y-27632 (Rho-kinase inhibitor) were examined in organ baths. Direct contraction or relaxation induced by palosuran and urotensin-II (U-II) were also evaluated. The expression levels of nitric oxide synthetases (NOSs), RhoA, oxidative stress regulators, and U-II were analyzed by Western blotting or immunohistochemistry.</div></div><div><h3>Results</h3><div>Induction of diabetes in rats resulted in the decreased relaxant response to SNP, decreased pD<sub>2</sub> value of SNP, attenuated relaxant response to Y-27632 as well as the decreased RhoA expression in CC. Palosuran treatment of diabetic rats reversed all of these parameters; however, it further impaired the already weakened relaxation of diabetic CC in response to EFS. Although induction of diabetes did not change U-II expression in CC significantly, palosuran treatment reduced U-II expression in diabetic CC. The expression level of nNOS was lowered in diabetic CC; however, palosuran treatment did not change the decreased the neuronal NOS expression. <em>In vitro</em> exposure of diabetic CC strips to palosuran produced a direct relaxant response.</div></div><div><h3>Conclusion</h3><div>Palosuran treatment did not affect the expression of NOSs or reduce nitrergic conduction induced by EFS stimulation in diabetic CC. However, while directly triggering a relaxant response, it did not induce a prominent contraction either by decreasing U-II expression, or increasing the sensitivity of CC to nitric oxide which suggested that palosuran has the potential to support erectile function. Further and comprehensive studies are required to clarify this issue.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 116-126"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.04.008
Usama Al-Jumaily , Hamid D. Habeeb Rjeib , Mohammed Fawzi Alqanbar , Safa Faraj , Dheyaa Aldeen Al-Khateeb
Objective
The treatment of Wilms’ tumor (WT) in children largely relies on a multidisciplinary strategy. In the absence of an appropriate multidisciplinary team, we reviewed the data of children with WT to determine their outcomes. The primary goal of the study was to highlight the role that a pediatric oncologist plays in the management of WT in low- and middle-income countries, taking into account the variety of initial treatments available, the lack of multidisciplinary care, and management strategies to overcome obstacles.
Methods
Retrospective recruitment was used to identify patients, aged 18 years or under, with WT diagnosis, in a major tertiary hospital in Iraq between January 2014 and December 2021. Initially, patients were treated with a pretreatment biopsy, preoperative chemotherapy, or upfront nephrectomy.
Results
In this study, 54 patients were enrolled. The median age was 3.3 years. The numbers of patients with stages I and III are 24 (44%) and 12 (22%), respectively. Seven patients had pretreatment biopsies. In 23 patients, upfront nephrectomy was performed. The histology of only two patients was unfavorable. In 20 patients, intraoperative complications were not disclosed. The mean 3-year estimated event-free survival was 64% (standard deviation 6.6%) and the mean overall survival was 76% (standard deviation 6.8%). There was a significant statistical difference according to stages of disease (p<0.001). Compared with the extended study until December 2021, the overall survival of the previous study from January 2014 to December 2017 was only 40%.
Conclusion
Promising results for pediatric WT can be attained in low- and middle-income nations. Acquiring an evidence-based strategy tailored to a low- and middle-income country and a multidisciplinary approach may escalate the outcome.
{"title":"Improved outcomes of children with Wilms’ tumor in a low-middle-income nation: The contribution of a pediatric oncologist to successful management","authors":"Usama Al-Jumaily , Hamid D. Habeeb Rjeib , Mohammed Fawzi Alqanbar , Safa Faraj , Dheyaa Aldeen Al-Khateeb","doi":"10.1016/j.ajur.2024.04.008","DOIUrl":"10.1016/j.ajur.2024.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>The treatment of Wilms’ tumor (WT) in children largely relies on a multidisciplinary strategy. In the absence of an appropriate multidisciplinary team, we reviewed the data of children with WT to determine their outcomes. The primary goal of the study was to highlight the role that a pediatric oncologist plays in the management of WT in low- and middle-income countries, taking into account the variety of initial treatments available, the lack of multidisciplinary care, and management strategies to overcome obstacles.</div></div><div><h3>Methods</h3><div>Retrospective recruitment was used to identify patients, aged 18 years or under, with WT diagnosis, in a major tertiary hospital in Iraq between January 2014 and December 2021. Initially, patients were treated with a pretreatment biopsy, preoperative chemotherapy, or upfront nephrectomy.</div></div><div><h3>Results</h3><div>In this study, 54 patients were enrolled. The median age was 3.3 years. The numbers of patients with stages I and III are 24 (44%) and 12 (22%), respectively. Seven patients had pretreatment biopsies. In 23 patients, upfront nephrectomy was performed. The histology of only two patients was unfavorable. In 20 patients, intraoperative complications were not disclosed. The mean 3-year estimated event-free survival was 64% (standard deviation 6.6%) and the mean overall survival was 76% (standard deviation 6.8%). There was a significant statistical difference according to stages of disease (<em>p</em><0.001). Compared with the extended study until December 2021, the overall survival of the previous study from January 2014 to December 2017 was only 40%.</div></div><div><h3>Conclusion</h3><div>Promising results for pediatric WT can be attained in low- and middle-income nations. Acquiring an evidence-based strategy tailored to a low- and middle-income country and a multidisciplinary approach may escalate the outcome.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 93-99"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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