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Efficacy of Palmitoylethanolamide, Epilobium and Calendula suppositories for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome type III. 棕榈酰乙醇酰胺、淫羊藿和金盏花栓剂治疗慢性前列腺炎/慢性盆腔疼痛综合征 III 型患者的疗效。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12582
Giuseppe Morgia, Arturo Lo Giudice, Maurizio Carrino, Salvatore Voce, Andrea Cocci, Giulio Reale, Andrea Minervini, Sebastiano Cimino, Giorgio Ivan Russo, Francesca Zingone

Objective: The management of chronic prostatitis/ chronic pelvic pain syndrome type III (CP/CPPS) has been always considered complex due to several biopsychological factors underlying the disease. In this clinical study, we aimed to evaluate the efficacy of the treatment with Palmitoylethanolamide, Epilobium and Calendula extract in patients with CP/CPPS III.

Materials and methods: From June 2023 to July 2023, we enrolled 45 consecutive patients affected by CP/CPPS type III in three different institution. We included patients aged between 18 and 75 years with symptoms of pelvic pain for 3 months or more before the study, a total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score ≥ 12 point and diagnosed with NIH category III, according to 4-glass test Meares-Stamey test. Patients were then allocated to receive rectal suppositories of PEA, Epilobium and Calendula, 1 suppository/ die for 1 month. All patients have been tested with standard urinalysis in order to assess urinary leukocytes (U-WBC). The primary endpoint of the study was the reduction of NIHCPSI. The secondary outcomes were the change of peak flow, post-void residual (PVR), IIEF-5, VAS score, PSA and decrease of U-WBC.

Results: A total of 45 patients concluded the study protocol. At baseline, the median age of all the patients included in the cohort was 49 years, the median PSA was 2.81 ng/ml, the median NIH-CPSI was 18.55, the median IIEF-5 was 18.27, the median U-WBC was 485.3/mmc, the median VAS score was 6.49, the median PVR was 26.5 ml and the median peak flow was 16.3 ml/s. After 1 month of therapy we observed a statistically significant improvement of NIH-CPSI, U-WBC, PSA, IIEF-5, peak flow, PVR and VAS.

Conclusions: In this observational study, we showed the clinical efficacy of the treatment with PEA, Epilobium and Calendula, 1 suppository/die for 1 month, in patients with CP/CPPS III. The benefits of this treatment could be related to the reduction of inflammatory cells in the urine that could imply a reduction of inflammatory cytokines. These results should be confirmed in further studies with greater sample size.

目的:慢性前列腺炎/慢性盆腔疼痛综合征 III 型(CP/CPPS)的治疗一直被认为是复杂的,因为该疾病的基础是多种生物心理因素。在这项临床研究中,我们旨在评估棕榈酰乙醇酰胺、淫羊藿和金盏花提取物对 CP/CPPS III 患者的治疗效果:2023 年 6 月至 2023 年 7 月,我们在三家不同的机构连续招募了 45 名 CP/CPPS III 型患者。我们纳入了年龄在 18 至 75 岁之间、研究前有 3 个月或更长时间盆腔疼痛症状、美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)总分≥ 12 分且根据 4 玻璃试验 Meares-Stamey 测试被诊断为 NIH III 类的患者。然后,患者被分配接受 PEA、淫羊藿和金盏花直肠栓剂,每次 1 粒,持续 1 个月。所有患者都接受了标准尿检,以评估尿白细胞(U-WBC)。研究的主要终点是降低 NIHCPSI。次要结果是峰值流量、排尿后残余物(PVR)、IIEF-5、VAS 评分、PSA 的变化以及尿白细胞的减少:共有 45 名患者完成了研究方案。所有患者的基线年龄中位数为 49 岁,PSA 中位数为 2.81 ng/ml,NIH-CPSI 中位数为 18.55,IIEF-5 中位数为 18.27,U-WBC 中位数为 485.3/mmc,VAS 评分中位数为 6.49,PVR 中位数为 26.5 ml,峰值流量中位数为 16.3 ml/s。治疗 1 个月后,我们观察到 NIH-CPSI、U-WBC、PSA、IIEF-5、峰值流量、PVR 和 VAS 均有明显改善:在这项观察性研究中,我们显示了使用 PEA、淫羊藿和金盏花治疗 CP/CPPS III 患者的临床疗效,1 颗/片,1 个月。这种治疗方法的益处可能与尿液中炎症细胞的减少有关,这可能意味着炎症细胞因子的减少。这些结果应在样本量更大的进一步研究中得到证实。
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引用次数: 0
Management of an elderly patient with retention of a steel nail in the scrotum: a case report. 阴囊内钢钉滞留老年患者的治疗:病例报告。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12363
Iacopo Meneghetti, Novella Cesta, Luca Mosillo, Simone Belli, Daniele Bianchi, Maurizio De Maria

Background: The retention of foreign bodies inside the body during ludic/sexual procedures or for traumatism represents one of the causes of visits to accident and emergency departments that often requires surgical removal of the foreign body. However, there are cases where the discovery of such foreign bodies takes place after many years, as in patients that are slightly compromised from a neuro-sociological point of view.

Case presentation: A 76-year-old male presented to an outpatient urological examination due to an increase in scrotal volume. At the ultrasound check, an acoustic interference from a solid object was detected, for which computed tomography was requested. The computed tomography scan revealed the presence of an elongated metal body in the perineum. The removal of the foreign body in the operating theatre was then scheduled. A 10 cm long stainless-steel nail located within an abscessed foreign body granuloma was identified and removed via a scrotal access. Four days later, a new surgical toilet was performed due to minimal necrosis of the skin flaps. The patient then performed three more dressings in the operating theatre during the following week. Healing took place by secondary intention until a perfect healing of the surgical wound was obtained.

Conclusions: Removal of foreign bodies from the perineum in case of infection can be challenging. Careful attention and postoperative dressings are crucial for the success of the case.

背景:在裸体/性爱过程中或外伤时异物在体内滞留是急诊室就诊的原因之一,通常需要通过手术取出异物。不过,也有一些病例是在多年后才发现异物的,比如从神经社会学的角度来看,患者的身体状况稍差:一名 76 岁的男性因阴囊体积增大到泌尿科门诊检查。在超声波检查中,发现了来自固体物体的声波干扰,因此要求进行计算机断层扫描。计算机断层扫描显示,会阴部有一个细长的金属异物。随后,手术室安排了异物取出手术。在脓肿异物肉芽肿内发现了一根 10 厘米长的不锈钢钉子,经阴囊入路将其取出。四天后,由于皮瓣的坏死程度极小,又进行了一次手术。随后一周,患者在手术室又进行了三次包扎。伤口通过继发意向愈合,直至完全愈合:结论:从会阴部清除感染异物是一项挑战。结论:在感染情况下从会阴部取出异物具有挑战性,仔细观察和术后包扎是手术成功的关键。
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引用次数: 0
Efficacy and safety of malleable penile prosthesis compared to inflatable penile prosthesis in erectile dysfunction patients. 可弯曲阴茎假体与充气阴茎假体在勃起功能障碍患者中的疗效和安全性比较。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12353
Handaru Satwikananda, Tetuka Bagus Laksita, Wahjoe Djatisoesanto, Doddy Moesbadianto Soebadi

Introduction: Erectile dysfunction can cause self-withdrawal and decreased quality of life. Patients who do not respond to pharmacological therapy and other conservative treatments are urged to undergo penile prosthesis implantation. Malleable penile prosthesis was the first prosthesis developed, but then inflatable penile prosthesis was developed to give a more natural erection. There is no meta-analysis comparing inflatable and malleable penile prostheses in terms of safety and efficacy. This study is conducted to evaluate patient and partner satisfaction, ease of use, mechanical failure, and infection rate in patients who underwent penile prosthesis implantation.

Method: This meta-analysis followed Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols. Five eligible studies were included from Pubmed, Scopus, ScienceDirect, and SemanticScholar databases.

Result: In this study, patient and partner satisfaction are significantly better (OR 3.39, 95% CI 1.66-6.93, p = 0.0008) (OR 2.32, 95% CI 1.75-3.08, p < 0.00001). Mechanical failure is also significantly higher in inflatable penile prostheses (OR 5.60, 95% CI 2.02-15.53, p = 0.0009). There is no significant difference in terms of ease of use and infection rate in inflatable or malleable penile prostheses.

Conclusions: This study concluded that inflatable penile prosthesis is better in terms of patient and partner satisfaction, but mechanical failures occur more frequently in this type of prosthesis.

简介勃起功能障碍会导致自我放弃和生活质量下降。对药物治疗和其他保守治疗无效的患者,应接受阴茎假体植入术。可塑性阴茎假体是最早开发的假体,但后来又开发了充气式阴茎假体,以提供更自然的勃起。目前还没有荟萃分析对充气式阴茎假体和可塑性阴茎假体的安全性和有效性进行比较。本研究旨在评估接受阴茎假体植入术的患者及其伴侣的满意度、易用性、机械故障和感染率:本荟萃分析遵循系统综述和荟萃分析首选报告项目(PRISMA)协议。从 Pubmed、Scopus、ScienceDirect 和 SemanticScholar 数据库中纳入了五项符合条件的研究:在这项研究中,患者和伴侣的满意度明显更高(OR 3.39,95% CI 1.66-6.93,p = 0.0008)(OR 2.32,95% CI 1.75-3.08,p < 0.00001)。充气式阴茎假体的机械故障发生率也明显更高(OR 5.60,95% CI 2.02-15.53,p = 0.0009)。在易用性和感染率方面,充气式和可弯曲式阴茎假体没有明显差异:本研究认为,充气式阴茎假体在患者和伴侣满意度方面更胜一筹,但这种假体的机械故障发生率更高。
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引用次数: 0
Exploring the potential of combined B-mode features and color Doppler ultrasound in the diagnosis of ureteric stone as an alternative to ionizing radiation exposure by computed tomography. 探索联合 B 型特征和彩色多普勒超声诊断输尿管结石的潜力,以替代计算机断层扫描的电离辐射暴露。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12523
Ahmed M Abdel Gawad, Bahaa-Eldin A Moustafa, Tamer A Abouelgreed, Esam A Elnady, Saed Khater, Mohamed Rehan, Mohamed F Elebiary, Basem A Fathy, Ahmed Shaalan, Nasser Ramadan, Mohamed Hindawy, Salma F Abdelkader

Objective: To assess the diagnostic efficacy of integrating B-mode and color Doppler capabilities of ultrasound (US) to establish a robust standalone diagnostic tool for the diagnosis of ureteric stones as an alternative to non-contrast-enhanced computed tomography (NCCT).

Methods: A total of 140 consecutive patients diagnosed with ureteric stones using NCCT were enrolled. On the same day, US in both B-mode and Color Doppler was performed by an experienced radiologist who was blinded to the NCCT scan results. The diagnostic rate of US for stone detection was recorded. Additionally, baseline patient and stone characteristics were analyzed for their association with the accuracy of stone detection using US.

Results: US exhibited a high sensitivity of 91.43%, detecting 128 out of 140 stone foci. Notably, ureteric stones in the proximal and uretero-vesical junction (UVJ) segments were readily identifiable compared to those in the pelvic region (p = 0.0003). Additionally, hydronephrosis enhanced the US's ability to detect stones (p < 0.0001). Conversely, abdominal gases and obesity adversely affected US capabilities (p < 0.0001 and p = 0.009, respectively). Stone side, size, and density showed no statistically significant impact (p > 0.05).

Conclusions: US with its color Doppler capabilities could serve as a reliable and safe alternative imaging modality in the diagnostic work up of patients with ureterolithiasis. Factors including stone location, Hydronephrosis, weight and abdominal gases significantly influenced its accuracy.

目的评估将超声波(US)的B型和彩色多普勒功能整合到输尿管结石诊断中,作为非对比度增强计算机断层扫描(NCCT)的替代诊断工具的诊断效果:方法:共招募了140名连续使用NCCT诊断出输尿管结石的患者。同一天,由一名经验丰富的放射科医生进行 B 型和彩色多普勒超声检查,该医生对 NCCT 扫描结果保密。记录了 US 对结石检测的诊断率。此外,还分析了患者和结石的基线特征与使用 US 检测结石准确率的关系:结果:US 的灵敏度高达 91.43%,在 140 个结石灶中检测出 128 个。值得注意的是,与盆腔区域的结石相比,近端和输尿管-膀胱交界处(UVJ)区域的输尿管结石更容易识别(p = 0.0003)。此外,肾积水也增强了 US 检测结石的能力(p < 0.0001)。相反,腹腔气体和肥胖则会对 US 的能力产生不利影响(p < 0.0001 和 p = 0.009)。结石的侧面、大小和密度在统计学上没有明显影响(p > 0.05):结论:在输尿管结石患者的诊断工作中,具有彩色多普勒功能的 US 可作为一种可靠、安全的替代成像方式。结石位置、肾积水、体重和腹腔气体等因素对其准确性有显著影响。
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引用次数: 0
Negative biopsy histology in men with PI-RADS score 5: is it useful PSMA PET/CT evaluation? PI-RADS 评分为 5 分的男性活检组织学阴性:PSMA PET/CT 评估有用吗?
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12358
Pietro Pepe, Ludovica Pepe, Michele Pennisi

Introduction: To evaluate the accuracy of PSMA PET/CT in men with mpMRI PI-RADS score 5 negative biopsy histology.

Materials and methods: From January 2011 to January 2023, 180 men with PI-RADS score 5 underwent systematic plus mpMRI/TRUS biopsy; 25/180 (13.9%) patients had absence of cancer and six months from biopsy were submitted to: digital rectal examination, PSA and PSA density exams, mpMRI and 68GaPSMA PET/CT evaluation (standardized uptake value "SUVmax" was reported).

Results: In 24/25 (96%) patients PSA and PSA density significantly decreased, moreover, the PI-RADS score was downgraded resulting < 3; in addition, median SUVmax was 7.5. Only 1/25 (4%) man had an increased PSA value (from 10.5 to 31 ng/ml) with a confirmed PI-RADS score 5, SUVmax of 32 and repeated prostate biopsy demonstrating a Gleason score 9/ISUP Grade Group 5 PCa.

Conclusions: The strict follow up of men with PI-RADS score 5 and negative histology reduce the risk of missing csPCa especially if PSMA PET/CT evaluation is in agreement with downgrading of mpMRI (PI-RADS score < 3).

简介:目的评估PSMA PET/CT在mpMRI PI-RADS评分5分活检组织学阴性男性中的准确性:2011年1月至2023年1月,180名PI-RADS评分为5分的男性接受了系统加mpMRI/TRUS活检;25/180(13.9%)名患者无癌症,在活检后6个月接受了数字直肠检查、PSA和PSA密度检查、mpMRI和68GaPSMA PET/CT评估(报告标准化摄取值 "SUVmax"):结果:24/25(96%)名患者的 PSA 和 PSA 密度明显降低,PI-RADS 评分下降,结果小于 3;此外,中位 SUVmax 为 7.5。只有1/25(4%)的患者PSA值升高(从10.5到31纳克/毫升),PI-RADS评分确认为5分,SUVmax为32,重复前列腺活检显示为格里森评分9分/ISUP分级5级PCa:对 PI-RADS 评分为 5 分且组织学检查为阴性的男性进行严格随访可降低漏诊 csPCa 的风险,尤其是在 PSMA PET/CT 评估与 mpMRI 降级(PI-RADS 评分 < 3 分)一致的情况下。
{"title":"Negative biopsy histology in men with PI-RADS score 5: is it useful PSMA PET/CT evaluation?","authors":"Pietro Pepe, Ludovica Pepe, Michele Pennisi","doi":"10.4081/aiua.2024.12358","DOIUrl":"10.4081/aiua.2024.12358","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the accuracy of PSMA PET/CT in men with mpMRI PI-RADS score 5 negative biopsy histology.</p><p><strong>Materials and methods: </strong>From January 2011 to January 2023, 180 men with PI-RADS score 5 underwent systematic plus mpMRI/TRUS biopsy; 25/180 (13.9%) patients had absence of cancer and six months from biopsy were submitted to: digital rectal examination, PSA and PSA density exams, mpMRI and 68GaPSMA PET/CT evaluation (standardized uptake value \"SUVmax\" was reported).</p><p><strong>Results: </strong>In 24/25 (96%) patients PSA and PSA density significantly decreased, moreover, the PI-RADS score was downgraded resulting < 3; in addition, median SUVmax was 7.5. Only 1/25 (4%) man had an increased PSA value (from 10.5 to 31 ng/ml) with a confirmed PI-RADS score 5, SUVmax of 32 and repeated prostate biopsy demonstrating a Gleason score 9/ISUP Grade Group 5 PCa.</p><p><strong>Conclusions: </strong>The strict follow up of men with PI-RADS score 5 and negative histology reduce the risk of missing csPCa especially if PSMA PET/CT evaluation is in agreement with downgrading of mpMRI (PI-RADS score < 3).</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459871","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
Pentoxifylline treatment as a safe method for selecting viable testicular spermatozoa before cryopreservation of a small numbers of spermatozoa in azoospermia individuals. 在对无精子症患者的少量精子进行冷冻保存之前,将五氧化锡治疗作为一种安全的方法来选择有活力的睾丸精子。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-06-27 DOI: 10.4081/aiua.2024.12525
Keivan Lorian, Serajoddin Vahidi, Fatemeh Dehghanpour, Fatemeh Anbari, Azam Agha-Rahimi

Background: Single sperm cryopreservation (SSC) is a specific technique especially used in individuals with small numbers of sperm who suffered from non-obstructive azoospermia (NOA). Testicular specimens possess poor motility and low population of viable spermatozoa. Therefore, sperm selection methods such as applying pentoxifylline (PTX) may improve motility in these cases. The main aim of this study was to evaluate the protective effects of PTX on testicular spermatozoa before and after performing SSC.

Methods: Thirty testicular samples were obtained from men with azoospermia. This study was conducted in two phases. Phase 1 evaluated the effect of PTX for sperm selection before SSC. Twenty testicular samples were divided to two experimental groups: SSC without (I) and with PTX treatment (II). For PTX treatment spermatozoa were incubated with PTX at 37°C for 30 min and only motile spermatozoa were selected for SSC. In phase 2, ten testicular samples were cryopreserved with SSC and warming procedure was carried out in droplet with and without PTX. Motility and viability rates, morphology by motile sperm organelle morphology examination (MSOME), DNA fragmentation by sperm chromatin dispersion test (SCD) and mitochondrial membrane potential (MMP) were evaluated.

Results: In phase 1, post warm motility rate was higher in PTX exposed group compared to the unexposed group (25.6 ± 8.13 vs. 0.85 ± 2.1) (p > 0.00). Recovery rate, viability and morphology were not significantly different between groups. DNA integrity and MMP were also similar between both groups. In phase 2 although motility increased in PTX group compared to without PTX group (29.30 ± 12.73 vs. 1.90 ± 2.64) (p > 0.00), the viability rate was not different (70.40 ± 12.12 vs. 65.30 ± 11.87). All above mentioned parameters were similar between the two SSC groups.

Conclusions: Supplementation of testicular spermatozoa with PTX before cryopreservation increases motility and did not have adverse effects on viability, morphology, DNA integrity and MMP. PTX could be used as sperm selection method before single sperm cryopreservation, but PTX could not maintain motile the most of viable testicular sperms.

背景:单精子冷冻保存(SSC)是一种特殊技术,特别适用于精子数量少的非梗阻性无精子症(NOA)患者。睾丸标本运动能力差,存活精子数量少。因此,精子选择方法(如使用戊氧去氧肾上腺素(PTX))可提高这些病例的精子活力。本研究的主要目的是评估 PTX 在进行 SSC 前后对睾丸精子的保护作用:从患有无精子症的男性体内获取了 30 份睾丸样本。本研究分两个阶段进行。第一阶段评估了PTX在SSC前对精子选择的影响。20 个睾丸样本被分为两个实验组:不进行 SSC 的实验组(I)和进行 PTX 治疗的实验组(II)。在 PTX 处理组中,精子与 PTX 在 37°C 孵育 30 分钟,只有运动精子才会被选入 SSC。在第二阶段,用 SSC 对 10 个睾丸样本进行冷冻保存,并在含有或不含 PTX 的液滴中进行升温。对精子的运动能力和存活率、运动精子细胞器形态检查(MSOME)结果、精子染色质分散试验(SCD)结果和线粒体膜电位(MMP)结果进行了评估:在第一阶段,与未暴露组相比,暴露 PTX 组的温育后运动率更高(25.6 ± 8.13 vs. 0.85 ± 2.1)(P > 0.00)。各组之间的恢复率、存活率和形态无明显差异。两组的 DNA 完整性和 MMP 也相似。在第二阶段,虽然 PTX 组的运动能力比无 PTX 组有所提高(29.30 ± 12.73 vs. 1.90 ± 2.64)(p > 0.00),但存活率没有差异(70.40 ± 12.12 vs. 65.30 ± 11.87)。上述所有参数在两组 SSC 之间均相似:结论:冷冻保存前用PTX补充睾丸精子可提高精子活力,对精子存活率、形态、DNA完整性和MMP没有不良影响。PTX可作为单精子冷冻保存前的精子选择方法,但PTX不能保持大多数有活力睾丸精子的活力。
{"title":"Pentoxifylline treatment as a safe method for selecting viable testicular spermatozoa before cryopreservation of a small numbers of spermatozoa in azoospermia individuals.","authors":"Keivan Lorian, Serajoddin Vahidi, Fatemeh Dehghanpour, Fatemeh Anbari, Azam Agha-Rahimi","doi":"10.4081/aiua.2024.12525","DOIUrl":"https://doi.org/10.4081/aiua.2024.12525","url":null,"abstract":"<p><strong>Background: </strong>Single sperm cryopreservation (SSC) is a specific technique especially used in individuals with small numbers of sperm who suffered from non-obstructive azoospermia (NOA). Testicular specimens possess poor motility and low population of viable spermatozoa. Therefore, sperm selection methods such as applying pentoxifylline (PTX) may improve motility in these cases. The main aim of this study was to evaluate the protective effects of PTX on testicular spermatozoa before and after performing SSC.</p><p><strong>Methods: </strong>Thirty testicular samples were obtained from men with azoospermia. This study was conducted in two phases. Phase 1 evaluated the effect of PTX for sperm selection before SSC. Twenty testicular samples were divided to two experimental groups: SSC without (I) and with PTX treatment (II). For PTX treatment spermatozoa were incubated with PTX at 37°C for 30 min and only motile spermatozoa were selected for SSC. In phase 2, ten testicular samples were cryopreserved with SSC and warming procedure was carried out in droplet with and without PTX. Motility and viability rates, morphology by motile sperm organelle morphology examination (MSOME), DNA fragmentation by sperm chromatin dispersion test (SCD) and mitochondrial membrane potential (MMP) were evaluated.</p><p><strong>Results: </strong>In phase 1, post warm motility rate was higher in PTX exposed group compared to the unexposed group (25.6 ± 8.13 vs. 0.85 ± 2.1) (p > 0.00). Recovery rate, viability and morphology were not significantly different between groups. DNA integrity and MMP were also similar between both groups. In phase 2 although motility increased in PTX group compared to without PTX group (29.30 ± 12.73 vs. 1.90 ± 2.64) (p > 0.00), the viability rate was not different (70.40 ± 12.12 vs. 65.30 ± 11.87). All above mentioned parameters were similar between the two SSC groups.</p><p><strong>Conclusions: </strong>Supplementation of testicular spermatozoa with PTX before cryopreservation increases motility and did not have adverse effects on viability, morphology, DNA integrity and MMP. PTX could be used as sperm selection method before single sperm cryopreservation, but PTX could not maintain motile the most of viable testicular sperms.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459872","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
Evaluating prognostic indicators for in-hospital mortality in Fournier's gangrene: a 7-year study in a tertiary hospital. 评估 Fournier 坏疽患者院内死亡率的预后指标:在一家三级医院进行的为期 7 年的研究。
IF 1.4 Q3 Medicine Pub Date : 2024-05-30 DOI: 10.4081/aiua.2024.12387
Soetojo Wirjopranoto, Mohammad Reza Affandi, Faisal Yusuf Ashari, Yufi Aulia Azmi, Kevin Muliawan Soetanto

Background: Fournier's Gangrene Scoring Index (FGSI), Simplified FGSI (SFGSI), Uludag FGSI (UFGSI), Laboratory Risk Indicator for Necrotizing (LRINEC), Neutrophil-Lymphocyte ratio (NLR), and Platelet-lymphocyte ratio (PLR) have been devised to assess the risk of mortality in Fournier's Gangrene (FG) patients. However, the effectiveness of these indicators in predicting mortality at the time of admission remains uncertain. The aim of this study is to assess the prognostic efficacy of FG's various indicators on in-hospital mortality.

Methods: This study analyzed 123 patients from Dr. Soetomo General Hospital's emergency department in Indonesia from 2014 to 2020. Data included demographics, wound cultures, and parameters like FGSI, UFGSI, SFGSI, NLR, PLR, and LRINEC. In-hospital mortality status was also recorded. The data was subjected to comparative, sensitivity, specificity and regression analyses.

Results: In our study of 123 patients, the median age was 52, with a mortality rate of 17.9%. The majority of patients were male (91.1%) and the most common location was scrotal (54.5%). Non-survivors had a shorter median stay (6.5 days) compared to survivors (14 days). Diabetes was the most prevalent comorbidity (61.8%). The highest sensitivity and specificity were found in FGSI and UFGSI indicators. Multivariate logistic regression identified LoS and FGSI as independent predictors of mortality.

Conclusions: FGSI and UFGSI, upon admission, demonstrated the highest sensitivity and specificity, with hospital stay duration and FGSI as key mortality determinants.

背景:福尼尔坏疽评分指数(Fournier's Gangrene Scoring Index,FGSI)、简化福尼尔坏疽评分指数(Simplified FGSI,SFGSI)、乌鲁达格福尼尔坏疽评分指数(Uludag FGSI,UFGSI)、坏死性实验室风险指标(Laboratory Risk Indicator for Necrotizing,LRINEC)、中性粒细胞-淋巴细胞比值(Nutrophil-Lymphocyte ratio,NLR)和血小板-淋巴细胞比值(Plate-lymphocyte ratio,PLR)已被设计用于评估福尼尔坏疽(FG)患者的死亡风险。然而,这些指标在预测入院时死亡率方面的有效性仍不确定。本研究旨在评估 FG 各项指标对院内死亡率的预后效果:本研究分析了 2014 年至 2020 年印度尼西亚苏托莫博士综合医院急诊科的 123 名患者。数据包括人口统计学、伤口培养以及 FGSI、UFGSI、SFGSI、NLR、PLR 和 LRINEC 等参数。此外,还记录了院内死亡率情况。对数据进行了比较、敏感性、特异性和回归分析:在我们的研究中,123 名患者的中位年龄为 52 岁,死亡率为 17.9%。大多数患者为男性(91.1%),最常见的位置是阴囊(54.5%)。非幸存者的中位住院时间(6.5 天)短于幸存者(14 天)。糖尿病是最常见的合并症(61.8%)。FGSI和UFGSI指标的敏感性和特异性最高。多变量逻辑回归确定 LoS 和 FGSI 是死亡率的独立预测因素:结论:入院时的 FGSI 和 UFGSI 显示出最高的灵敏度和特异性,住院时间和 FGSI 是决定死亡率的关键因素。
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引用次数: 0
The role of immunotherapy in urological cancers. 免疫疗法在泌尿系统癌症中的作用。
IF 1.4 Q3 Medicine Pub Date : 2024-05-30 DOI: 10.4081/aiua.2024.12307
Efe Bosnali, Enes Malik Akdas, Engin Telli, Kerem Teke, Onder Kara

Immunotherapy is defined as a therapeutic approach that targets or manipulates the immune system. A deeper understanding of the cellular and molecular composition of the tumour environment, as well as the mechanisms controlling the immune system, has made possible the development and clinical investigation of many innovative cancer therapies. Historically, immunotherapy has played an essential role in treating urologic malignancies, while in the modern era, the development of immune checkpoint inhibitors (ICIs) has been critical to urology. Urothelial carcinoma is a common type of cancer in the genitourinary system, and treatment strategies in this area are constantly evolving. Intravesical and systemic immunotherapeutic agents have begun to be used increasingly frequently in treating urothelial carcinoma. These agents increase the anti-tumour response by affecting the body's defence mechanisms. Immunotherapeutic agents used in urothelial carcinoma include various options such as BCG, interferon, anti-PD-1 (pembrolizumab, nivolumab) and anti-PD-L1 (atezolizumab, avelumab, durvalumab). Renal cell carcinoma (RCC) has been known for many years as a tumour with unique sensitivity to immunotherapies. The recent emergence of ICIs that block PD-1/PD-L1 (pembrolizumab, nivolumab, atezolizumab) or CTLA4 (ipilimumab) signalling pathways has reestablished systemic immunotherapy as central to the treatment of advanced RCC. In light of randomized clinical trials conducted with increasing interest in the application of immunotherapies in the adjuvant setting, combination therapies (nivolumab/ipilimumab, nivolumab/cabozantinib, pembrolizumab/ axitinib, pembrolizumab/lenvantinib) have become the standard first-line treatment of metastatic RCC. Prostate cancer is in the immunologically "cold" tumour category; on the contrary, in recent years, immunotherapeutic agents have come to the fore as an essential area in the treatment of this disease. Especially in the treatment of castration-resistant prostate cancer, immunotherapeutic agents constitute an alternative treatment method besides androgen deprivation therapy and chemotherapy. Ipilimumab, nivolumab, pembrolizumab, atezolizumab, and Sipuleucel T (Vaccine-based) are promising alternative treatment options. Considering ongoing randomized clinical trials, immunotherapeutic agents promise to transform the uro-oncology field significantly. In this review, we aimed to summarize the role of immunotherapy in urothelial, renal and prostate cancer in the light of randomized clinical trials.

免疫疗法的定义是以免疫系统为靶点或操纵免疫系统的治疗方法。随着对肿瘤环境的细胞和分子组成以及控制免疫系统的机制有了更深入的了解,许多创新癌症疗法的开发和临床研究成为可能。从历史上看,免疫疗法在治疗泌尿系统恶性肿瘤中发挥了至关重要的作用,而在现代,免疫检查点抑制剂(ICIs)的开发对泌尿外科至关重要。尿路上皮癌是泌尿生殖系统常见的癌症类型,该领域的治疗策略也在不断发展。膀胱内和全身免疫治疗药物已开始越来越多地用于治疗尿路上皮癌。这些药物通过影响机体的防御机制来增强抗肿瘤反应。用于治疗尿路癌的免疫治疗药物包括卡介苗、干扰素、抗PD-1(pembrolizumab、nivolumab)和抗PD-L1(atezolizumab、avelumab、durvalumab)等多种选择。多年来,人们一直认为肾细胞癌(RCC)是一种对免疫疗法具有独特敏感性的肿瘤。最近出现的阻断 PD-1/PD-L1(pembrolizumab、nivolumab、atezolizumab)或 CTLA4(ipilimumab)信号通路的 ICIs 重新确立了全身免疫疗法在晚期 RCC 治疗中的核心地位。随着随机临床试验的开展,人们对免疫疗法在辅助治疗中的应用越来越感兴趣,联合疗法(nivolumab/ipilimumab、nivolumab/cabozantinib、pembrolizumab/axitinib、pembrolizumab/lenvantinib)已成为转移性 RCC 的标准一线疗法。前列腺癌在免疫学上属于 "冷门 "肿瘤;相反,近年来,免疫治疗药物已成为治疗这种疾病的重要领域。特别是在治疗对阉割有抵抗力的前列腺癌时,免疫治疗药物是除雄激素剥夺疗法和化疗之外的另一种治疗方法。Ipilimumab、nivolumab、pembrolizumab、atezolizumab和Sipuleucel T(疫苗型)都是很有前景的替代治疗方案。考虑到正在进行的随机临床试验,免疫治疗药物有望极大地改变泌尿肿瘤学领域。在这篇综述中,我们旨在根据随机临床试验总结免疫疗法在尿路肿瘤、肾癌和前列腺癌中的作用。
{"title":"The role of immunotherapy in urological cancers.","authors":"Efe Bosnali, Enes Malik Akdas, Engin Telli, Kerem Teke, Onder Kara","doi":"10.4081/aiua.2024.12307","DOIUrl":"10.4081/aiua.2024.12307","url":null,"abstract":"<p><p>Immunotherapy is defined as a therapeutic approach that targets or manipulates the immune system. A deeper understanding of the cellular and molecular composition of the tumour environment, as well as the mechanisms controlling the immune system, has made possible the development and clinical investigation of many innovative cancer therapies. Historically, immunotherapy has played an essential role in treating urologic malignancies, while in the modern era, the development of immune checkpoint inhibitors (ICIs) has been critical to urology. Urothelial carcinoma is a common type of cancer in the genitourinary system, and treatment strategies in this area are constantly evolving. Intravesical and systemic immunotherapeutic agents have begun to be used increasingly frequently in treating urothelial carcinoma. These agents increase the anti-tumour response by affecting the body's defence mechanisms. Immunotherapeutic agents used in urothelial carcinoma include various options such as BCG, interferon, anti-PD-1 (pembrolizumab, nivolumab) and anti-PD-L1 (atezolizumab, avelumab, durvalumab). Renal cell carcinoma (RCC) has been known for many years as a tumour with unique sensitivity to immunotherapies. The recent emergence of ICIs that block PD-1/PD-L1 (pembrolizumab, nivolumab, atezolizumab) or CTLA4 (ipilimumab) signalling pathways has reestablished systemic immunotherapy as central to the treatment of advanced RCC. In light of randomized clinical trials conducted with increasing interest in the application of immunotherapies in the adjuvant setting, combination therapies (nivolumab/ipilimumab, nivolumab/cabozantinib, pembrolizumab/ axitinib, pembrolizumab/lenvantinib) have become the standard first-line treatment of metastatic RCC. Prostate cancer is in the immunologically \"cold\" tumour category; on the contrary, in recent years, immunotherapeutic agents have come to the fore as an essential area in the treatment of this disease. Especially in the treatment of castration-resistant prostate cancer, immunotherapeutic agents constitute an alternative treatment method besides androgen deprivation therapy and chemotherapy. Ipilimumab, nivolumab, pembrolizumab, atezolizumab, and Sipuleucel T (Vaccine-based) are promising alternative treatment options. Considering ongoing randomized clinical trials, immunotherapeutic agents promise to transform the uro-oncology field significantly. In this review, we aimed to summarize the role of immunotherapy in urothelial, renal and prostate cancer in the light of randomized clinical trials.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180906","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
Pediatric renal transplantation: a single center experience. 小儿肾移植:单中心经验。
IF 1.4 Q3 Medicine Pub Date : 2024-05-20 DOI: 10.4081/aiua.2024.12389
Shakhawan Hama Amin Said, Saiwan Hayas Agha, Goran Fryad Abdulla, Mzhda Sahib Jaafar, Rawa Bapir, Nali H Hama, Ismaeel Aghaways, Aso Omer Rashid, Berun A Abdalla, Fahmi H Kakamad

Introduction: The rising prevalence of global end-stage renal disease (ESRD) is a significant health concern, especially among children. Although renal replacement therapy is available, children with ESRD are at an increased risk of mortality. Kidney transplantation is the preferred modality of treatment and surpasses renal replacement therapy in terms of survival. However, pediatric renal transplantation could prove difficult due to factors like smaller recipients and donor-recipient mismatches leading to higher complications.

Materials and methods: A retrospective single-group case series study was conducted on children with ESRD who were planned to undergo kidney transplantation from living donors between 2015 and 2021. The data was collected from two centers in the city of Sulaymaniyah.

Results: The study comprised a predominantly male patient population, with a total of 39 individuals (n = 39) and 13 female patients. The donors were mostly males between 25-40 years old. The majority of participants were 15-18 years old. In majority of the patients Thymoglobulin was the immunosuppressive agent used in induction. The most common etiology for renal failure was reflux nephropathy and artery anastomosis was performed to the external iliac artery in the majority of patients. Only 9 patients had complications following the transplantation and 3 patients had an episode of acute rejection.

Conclusions: Renal transplantation is the preferred treatment of renal failure in pediatric patients in the city of Sulaymaniyah. The most common etiology for pediatric renal failure was reflux nephropathy which was different from the findings of North American Pediatric Renal Trials and Collaborative Studies.

导言:全球终末期肾病(ESRD)发病率的上升是一个重大的健康问题,尤其是在儿童中。虽然可以使用肾替代疗法,但患有终末期肾病的儿童死亡风险增加。肾移植是首选的治疗方式,在存活率方面超过了肾替代疗法。然而,由于受体较小、供体与受体不匹配等因素导致并发症较多,儿科肾移植可能会很困难:对计划在 2015 年至 2021 年期间接受活体肾移植的 ESRD 儿童进行了一项回顾性单组病例系列研究。数据来自苏莱曼尼亚市的两个中心:研究对象主要为男性患者,共有 39 人(n = 39)和 13 名女性患者。捐献者多为 25-40 岁的男性。大多数参与者的年龄在 15-18 岁之间。大多数患者在诱导过程中使用胸腺球蛋白作为免疫抑制剂。肾功能衰竭最常见的病因是反流性肾病,大多数患者的动脉吻合术是在髂外动脉上进行的。只有9名患者在移植后出现并发症,3名患者出现急性排斥反应:结论:在苏莱曼尼亚市,肾移植是治疗儿童肾功能衰竭的首选方法。小儿肾功能衰竭最常见的病因是反流性肾病,这与北美小儿肾脏试验和合作研究的结果不同。
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引用次数: 0
Factors associated to hemoglobin decrease after percutaneous nephrolithotomy: a retrospective study. 经皮肾镜碎石术后血红蛋白下降的相关因素:一项回顾性研究。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2024-05-20 DOI: 10.4081/aiua.2024.12382
Syarif Syarif, Abdul Azis, Saidah Rahmat A, Ahmad Taufik Fadillah Zainal, Ade Nusraya

Objective: This study aims to determine the preoperative and perioperative risk parameters associated with a decrease in hemoglobin (Hb) in patients undergoing percutaneous nephrolithotomy (PCNL).

Methods: We collected prospective data of consecutive patients who underwent PCNL from January 2018 to December 2022. The median decrease in post-operative hemoglobin levels compared to pre-operative was found to be 1.5 g/dl. This value was the cut-off value that divided the sample into two groups. Group 1 has a decrease in Hb levels that is higher or equal to the cutoff, group 2 has a decrease in Hb levels that is lower than the cut-off. All preoperative, stone characteristics and perioperative factors were recorded.

Results: A total of 273 patients were included in the study, 141 in Group 1 and 132 in Group 2. The mean age of Group 1 was significantly higher (55.48 ± 8.73 vs 45.9 ± 10.75 years, p < 0.05). The mean bleeding of Group 1 was significantly higher (285.85 ± 113.68 vs 135 ± 77.54 ml, p < 0.05). There was a significant difference in mean operation time between groups (86.35 ± 32.05 vs 64.89 ± 27.83 min, p < 0.05). Multivariate analysis showed that the variables age, comorbid diabetes mellitus, intraoperative bleeding amount, and operation time had a significant relationship with Hb reduction in patients undergoing PCNL (p < 0.05).

Conclusions: Older age, comorbid diabetes mellitus, large amounts of intraoperative bleeding, and longer operating time are factors associated with PCNL-related postoperative hemoglobin decrease.

研究目的本研究旨在确定经皮肾镜取石术(PCNL)患者术前和围手术期与血红蛋白(Hb)下降相关的风险参数:我们收集了2018年1月至2022年12月期间接受PCNL手术的连续患者的前瞻性数据。结果发现,与术前相比,术后血红蛋白水平下降的中位数为 1.5 g/dl。这一数值是将样本分为两组的临界值。第一组的血红蛋白水平降幅高于或等于临界值,第二组的血红蛋白水平降幅低于临界值。所有术前、结石特征和围手术期因素均记录在案:第一组患者的平均年龄明显更高(55.48±8.73 岁 vs 45.9±10.75岁,P <0.05)。第 1 组的平均出血量明显更高(285.85 ± 113.68 对 135 ± 77.54 毫升,P < 0.05)。两组的平均手术时间有明显差异(86.35 ± 32.05 vs 64.89 ± 27.83 分钟,P < 0.05)。多变量分析显示,年龄、合并糖尿病、术中出血量和手术时间等变量与 PCNL 患者的血红蛋白降低有显著关系(P < 0.05):结论:高龄、合并糖尿病、术中出血量大和手术时间长是与 PCNL 相关的术后血红蛋白下降的相关因素。
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引用次数: 0
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Archivio Italiano di Urologia e Andrologia
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