Yangbing Wei, Chao Liu, Xiaoming Cao, Bo Wu, Liang Wei, Hua Yang, Chen Liu, Haifeng Hao, Qiang Jing, Fan Liu, Libing Sun, Nianzeng Xing, Xiaofeng Yang
Pelvic lymph node dissection (PLND) in radical cystectomy (RC) is of great significance, but the method and scope of PLND remain controversial. Based on the principle of indirect lymphadenography, we designed a method to localize the whole pelvic lymph nodes by intradermal injection of indocyanine green (ICG) through the lower limbs and perineum, and to evaluate the effectiveness of this method.In a single center, 54 bladder cancer patients who underwent RC and PLND participated in a prospective clinical trial, which began on February 28, 2022 and ended on December 30, 2022. ICG solution was injected subcutaneously at the medial malleolus of both lower extremities and at both sides of the midline of the perineum. The fluorescent laparoscopy was used to trace, locate, and remove the targeted areas under the image fusion mode. The consistency of lymph node resection was determined by histopathological diagnosis. The impact of ICG guidance on the surgical time of PLND was compared with that of 11 bladder cancer patients who underwent RC and PLND without ICG injection, serving as the control group.Perineal lower limb combined injection can provide comprehensive visualization of pelvic lymph nodes. This technique reduces PLND surgical time and increases the accuracy of PLND.Intracutaneous injection of ICG into the lower limbs and perineum can specifically mark pelvic lymph nodes. Intraoperative fluorescence imaging can accurately identify, locate, and resect lymph nodes in the pelvic region, reducing PLND surgical time and increasing the accuracy of PLND.
{"title":"Fluorescence imaging‐guided pelvic lymph node localization and resection of bladder cancer after intracutaneous injection of indocyanine green into the lower limbs and perineum","authors":"Yangbing Wei, Chao Liu, Xiaoming Cao, Bo Wu, Liang Wei, Hua Yang, Chen Liu, Haifeng Hao, Qiang Jing, Fan Liu, Libing Sun, Nianzeng Xing, Xiaofeng Yang","doi":"10.1002/uro2.70","DOIUrl":"https://doi.org/10.1002/uro2.70","url":null,"abstract":"Pelvic lymph node dissection (PLND) in radical cystectomy (RC) is of great significance, but the method and scope of PLND remain controversial. Based on the principle of indirect lymphadenography, we designed a method to localize the whole pelvic lymph nodes by intradermal injection of indocyanine green (ICG) through the lower limbs and perineum, and to evaluate the effectiveness of this method.In a single center, 54 bladder cancer patients who underwent RC and PLND participated in a prospective clinical trial, which began on February 28, 2022 and ended on December 30, 2022. ICG solution was injected subcutaneously at the medial malleolus of both lower extremities and at both sides of the midline of the perineum. The fluorescent laparoscopy was used to trace, locate, and remove the targeted areas under the image fusion mode. The consistency of lymph node resection was determined by histopathological diagnosis. The impact of ICG guidance on the surgical time of PLND was compared with that of 11 bladder cancer patients who underwent RC and PLND without ICG injection, serving as the control group.Perineal lower limb combined injection can provide comprehensive visualization of pelvic lymph nodes. This technique reduces PLND surgical time and increases the accuracy of PLND.Intracutaneous injection of ICG into the lower limbs and perineum can specifically mark pelvic lymph nodes. Intraoperative fluorescence imaging can accurately identify, locate, and resect lymph nodes in the pelvic region, reducing PLND surgical time and increasing the accuracy of PLND.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641743","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}
Thabata S. Freires, João Marco B. S. M. Pereira, Eder Roberto A. Capuzi, Otávio C. Coelho, Rodrigo D. B. Silva, Luiz Carlos Maciel
Pheochromocytomas are tumors originating from chromaffin cells and producing catecholamines. In 10%–20% of cases, these tumors act outside of the adrenal medulla, defining conglomerates named paragangliomas. Bladder paraganglioma is a rare tumor and accounts for less than 0.06% of all bladder neoplasms and less than 1% of all pheochromocytomas, with the first case described in 1953. The clinical procedure given by 47%–77% of the overall number of cases, consists of headache 48.1%, tachycardia 43.4%, hypertension 54.7%, hematuria 47.2%, and visual alterations.The article reports a case of a patient whose lesion was identified in the lateral wall of the bladder during a prostate ultrasonography exam, and was subsequently treated surgically with a partial cystectomy. The aim of this study is to detail the diagnosis and treatment of a patient with bladder paraganglioma.From the overall study conducted in this article, it is possible to conclude that paraganglioma requires adequate diagnostic and therapeutic methods. These methods include ultrasounds and computed tomography scans, followed by cystoscopy with visualization and biopsy of the lesion, and resection of the lesion.
{"title":"Paraganglioma in the bladder wall: A case report","authors":"Thabata S. Freires, João Marco B. S. M. Pereira, Eder Roberto A. Capuzi, Otávio C. Coelho, Rodrigo D. B. Silva, Luiz Carlos Maciel","doi":"10.1002/uro2.71","DOIUrl":"https://doi.org/10.1002/uro2.71","url":null,"abstract":"Pheochromocytomas are tumors originating from chromaffin cells and producing catecholamines. In 10%–20% of cases, these tumors act outside of the adrenal medulla, defining conglomerates named paragangliomas. Bladder paraganglioma is a rare tumor and accounts for less than 0.06% of all bladder neoplasms and less than 1% of all pheochromocytomas, with the first case described in 1953. The clinical procedure given by 47%–77% of the overall number of cases, consists of headache 48.1%, tachycardia 43.4%, hypertension 54.7%, hematuria 47.2%, and visual alterations.The article reports a case of a patient whose lesion was identified in the lateral wall of the bladder during a prostate ultrasonography exam, and was subsequently treated surgically with a partial cystectomy. The aim of this study is to detail the diagnosis and treatment of a patient with bladder paraganglioma.From the overall study conducted in this article, it is possible to conclude that paraganglioma requires adequate diagnostic and therapeutic methods. These methods include ultrasounds and computed tomography scans, followed by cystoscopy with visualization and biopsy of the lesion, and resection of the lesion.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"118 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667529","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}
Adrian M Fernandez, Behzad Abbasi, A. Sudhakar, Christine Shieh, Lindsay A. Hampson, Jason L. Lui, Umar Ghaffar, Hiren V. Patel, Nathan M. Shaw, Benjamin N. Breyer
Though urinary incontinence (UI) after prostate treatment often contributes to emotional distress and significantly impacts quality of life, many patients do not discuss this condition with their physicians. We analyzed the patient perspective by examining online support group posts to gain insight into specific challenges associated with different UI management methods.We examined discussion board threads from multiple patient‐focused forums on experiences of UI due to prostate treatment (threads from January 2016 to January 2022). Principles of grounded theory in thematic analysis were used to analyze the threads.Three hundred and eighteen posts from 84 unique users were analyzed. Among users, 47 (56%) reported UI following radical prostatectomy (RP), 5 (6%) secondary to radiation therapy (RT), 12 (14%) after a combination of RP and RT, and 20 (24%) were ambiguous. UI management methods included pads/diapers/liners, condom catheters/external clamps, Kegels/pelvic floor physiotherapy, and surgical treatment (artificial urinary sphincter or sling placement). We identified challenges common to all management methods: “requires trial and error,” “physical discomfort,” and “difficult to be in public.” Factors influencing management choices included the ability to “feel normal” and the development of a management routine.The current study identifies opportunities for improved expectation‐setting and education regarding post‐procedural UI and its management. These findings can serve as a guide for providers to counsel patients on the advantages and disadvantages of UI management devices.
{"title":"Qualitative analysis of online discussion boards for male urinary incontinence after prostate treatment","authors":"Adrian M Fernandez, Behzad Abbasi, A. Sudhakar, Christine Shieh, Lindsay A. Hampson, Jason L. Lui, Umar Ghaffar, Hiren V. Patel, Nathan M. Shaw, Benjamin N. Breyer","doi":"10.1002/uro2.57","DOIUrl":"https://doi.org/10.1002/uro2.57","url":null,"abstract":"Though urinary incontinence (UI) after prostate treatment often contributes to emotional distress and significantly impacts quality of life, many patients do not discuss this condition with their physicians. We analyzed the patient perspective by examining online support group posts to gain insight into specific challenges associated with different UI management methods.We examined discussion board threads from multiple patient‐focused forums on experiences of UI due to prostate treatment (threads from January 2016 to January 2022). Principles of grounded theory in thematic analysis were used to analyze the threads.Three hundred and eighteen posts from 84 unique users were analyzed. Among users, 47 (56%) reported UI following radical prostatectomy (RP), 5 (6%) secondary to radiation therapy (RT), 12 (14%) after a combination of RP and RT, and 20 (24%) were ambiguous. UI management methods included pads/diapers/liners, condom catheters/external clamps, Kegels/pelvic floor physiotherapy, and surgical treatment (artificial urinary sphincter or sling placement). We identified challenges common to all management methods: “requires trial and error,” “physical discomfort,” and “difficult to be in public.” Factors influencing management choices included the ability to “feel normal” and the development of a management routine.The current study identifies opportunities for improved expectation‐setting and education regarding post‐procedural UI and its management. These findings can serve as a guide for providers to counsel patients on the advantages and disadvantages of UI management devices.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"44 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141355021","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}
Mohammed Mahdi, Shannon Leung, Curtis Pettaway, Run Wang
Erectile dysfunction is a common consequence following radical cystectomy (RC), with inflatable penile prostheses (IPPs) placement considered as the gold standard for refractory cases. Urethral recurrence post‐RC necessitates urethrectomy, which poses challenges for patients with an IPP in place. The thinning of the ventral tunica albuginea during urethrectomy may increase the risk of corporal disruption and IPP cylinder aneurysm, affecting device functionality. This case report introduces a novel surgical technique using Tutoplast, a human‐derived pericardium allograft, for corporal reinforcement during urethrectomy in the presence of an in‐situ IPP.A 74‐year‐old male, with a history of robotic‐assisted RC and IPP presented with recurrent bleeding per urethra. Imaging revealed urethral masses. The patient underwent total urethrectomy which resulted in significant thinning of the ventral tunica albuginea. To prevent device aneurysm or mechanical failure, a Tutoplast graft was used intraoperatively to reinforce the thinned tunica. Patient was followed up six months postoperatively.Final pathology showed urethral high‐grade papillary urothelial carcinoma. Postoperatively, the patient exhibited smooth recovery, with normal IPP functionality up to the 6‐month follow‐up period. While Tutoplast has been used in other settings, its application in preventing IPP malfunction posturethrectomy is a unique contribution.Corporal reinforcement using Tutoplast during urethrectomy in patients with an existing IPP presents a simple and cost‐effective solution to mitigate the risks of corporal disruption and IPP cylinder aneurysms. The positive outcomes demonstrated in this case report warrant further studies on larger patient populations and longer follow‐up periods to assess the long‐term outcomes of this technique.
{"title":"Ventral corporal reinforcement using a pericardium allograft (Tutoplast®) in a patient undergoing urethrectomy procedure with an inflatable penile prosthesis in place: A case report","authors":"Mohammed Mahdi, Shannon Leung, Curtis Pettaway, Run Wang","doi":"10.1002/uro2.62","DOIUrl":"https://doi.org/10.1002/uro2.62","url":null,"abstract":"Erectile dysfunction is a common consequence following radical cystectomy (RC), with inflatable penile prostheses (IPPs) placement considered as the gold standard for refractory cases. Urethral recurrence post‐RC necessitates urethrectomy, which poses challenges for patients with an IPP in place. The thinning of the ventral tunica albuginea during urethrectomy may increase the risk of corporal disruption and IPP cylinder aneurysm, affecting device functionality. This case report introduces a novel surgical technique using Tutoplast, a human‐derived pericardium allograft, for corporal reinforcement during urethrectomy in the presence of an in‐situ IPP.A 74‐year‐old male, with a history of robotic‐assisted RC and IPP presented with recurrent bleeding per urethra. Imaging revealed urethral masses. The patient underwent total urethrectomy which resulted in significant thinning of the ventral tunica albuginea. To prevent device aneurysm or mechanical failure, a Tutoplast graft was used intraoperatively to reinforce the thinned tunica. Patient was followed up six months postoperatively.Final pathology showed urethral high‐grade papillary urothelial carcinoma. Postoperatively, the patient exhibited smooth recovery, with normal IPP functionality up to the 6‐month follow‐up period. While Tutoplast has been used in other settings, its application in preventing IPP malfunction posturethrectomy is a unique contribution.Corporal reinforcement using Tutoplast during urethrectomy in patients with an existing IPP presents a simple and cost‐effective solution to mitigate the risks of corporal disruption and IPP cylinder aneurysms. The positive outcomes demonstrated in this case report warrant further studies on larger patient populations and longer follow‐up periods to assess the long‐term outcomes of this technique.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141356482","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}
A. M. Mukendi, Emelia K. C. de Heer‐Menlah Phaladi, Charles E. Mathye
Renal cysts are common in clinical practice, but some may harbor rare pathological entities such as mixed epithelial and stromal tumors (MEST). Imaging studies are crucial for accurate diagnosis. While laparoscopic deroofing is an established approach for symptomatic renal cysts, encountering MEST within a cyst is uncommon.We present the case of a 37‐year‐old female who presented with persistent left flank pain. Imaging revealed a large renal cyst in the lower pole of the left kidney, classified as Bosniak 2. Despite analgesia, the patient's symptoms persisted, leading to a laparoscopic deroofing procedure. Histopathological examination postprocedure revealed a MEST. The patient reported complete resolution of symptoms at the 3‐month follow‐up.This unique case presents the successful identification and surgical management of a MEST masquerading as a lower pole renal cyst through laparoscopic deroofing. It also contributes to the existing literature by highlighting the importance of considering rare pathological entities in the evaluation of renal cysts and the value of laparoscopic techniques in their management.
肾囊肿在临床上很常见，但有些囊肿可能隐藏着罕见的病理实体，如上皮和间质混合瘤（MEST）。影像学检查对准确诊断至关重要。虽然腹腔镜切除术是治疗无症状肾囊肿的成熟方法，但在囊肿内发现 MEST 的情况并不常见。影像学检查显示，左肾下极有一个巨大的肾囊肿，分类为波什尼亚克 2 型。尽管采取了镇痛措施，但患者的症状仍持续存在，因此接受了腹腔镜下肾脏切除术。术后的组织病理学检查显示患者患有 MEST。这个独特的病例展示了通过腹腔镜切除术成功识别并手术治疗了伪装成下极肾囊肿的 MEST。这例独特的病例介绍了通过腹腔镜切除术成功鉴别并手术治疗了伪装成下极肾囊肿的 MEST，同时还强调了在评估肾囊肿时考虑罕见病理实体的重要性以及腹腔镜技术在治疗中的价值，为现有文献做出了贡献。
{"title":"Successful management of a mixed epithelial and stromal renal tumor masquerading as lower pole renal cyst: A laparoscopic deroofing approach","authors":"A. M. Mukendi, Emelia K. C. de Heer‐Menlah Phaladi, Charles E. Mathye","doi":"10.1002/uro2.39","DOIUrl":"https://doi.org/10.1002/uro2.39","url":null,"abstract":"Renal cysts are common in clinical practice, but some may harbor rare pathological entities such as mixed epithelial and stromal tumors (MEST). Imaging studies are crucial for accurate diagnosis. While laparoscopic deroofing is an established approach for symptomatic renal cysts, encountering MEST within a cyst is uncommon.We present the case of a 37‐year‐old female who presented with persistent left flank pain. Imaging revealed a large renal cyst in the lower pole of the left kidney, classified as Bosniak 2. Despite analgesia, the patient's symptoms persisted, leading to a laparoscopic deroofing procedure. Histopathological examination postprocedure revealed a MEST. The patient reported complete resolution of symptoms at the 3‐month follow‐up.This unique case presents the successful identification and surgical management of a MEST masquerading as a lower pole renal cyst through laparoscopic deroofing. It also contributes to the existing literature by highlighting the importance of considering rare pathological entities in the evaluation of renal cysts and the value of laparoscopic techniques in their management.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"121 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378860","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}
Xiying Dong, Gang Song, Kaopeng Guan, Tie Wang, Xiaoli Feng, Yulin Liu, Min Liu, Zhigang Ji, Xiao Li, Jiongming Li, Yong Zhang, Fangjian Zhou, Aiping Zhou, Wanhai Xu, Tao Xu, Xianshu Gao, Qing Zhai, Qiang Wei, Nianzeng Xing
Bladder cancer (BC) is an increasingly common malignancy in China, with an incidence rate of 5.80 per 100 000 in 2015, making it the thirteenth most common cancer in the country. This trend underscores the urgent need for standardized diagnosis and treatment protocols. In terms of treatment, approaches for bladder cancer vary based on the cancer's stage and pathology, as well as the patient's overall health. Notably, non‐muscle‐invasive BC (NMIBC) confined to the mucosa (Ta) and lamina propria (T1) without invading the muscle represents about 75% of all BC cases. Succeeding the first part of the guideline, this part of the clinical practice guideline focuses on NMIBC. It details risk classifications and treatment options, including both surgical procedures and posttransurethral resection of the bladder tumor intravesical instillations. Special attention is given to the treatment strategies for carcinoma in situ. The guideline also covers the recommended follow‐up procedures for patients with NMIBC, underscoring the need for thorough and continuous care management.
{"title":"Clinical practice guideline on bladder cancer (Part II)","authors":"Xiying Dong, Gang Song, Kaopeng Guan, Tie Wang, Xiaoli Feng, Yulin Liu, Min Liu, Zhigang Ji, Xiao Li, Jiongming Li, Yong Zhang, Fangjian Zhou, Aiping Zhou, Wanhai Xu, Tao Xu, Xianshu Gao, Qing Zhai, Qiang Wei, Nianzeng Xing","doi":"10.1002/uro2.35","DOIUrl":"https://doi.org/10.1002/uro2.35","url":null,"abstract":"Bladder cancer (BC) is an increasingly common malignancy in China, with an incidence rate of 5.80 per 100 000 in 2015, making it the thirteenth most common cancer in the country. This trend underscores the urgent need for standardized diagnosis and treatment protocols. In terms of treatment, approaches for bladder cancer vary based on the cancer's stage and pathology, as well as the patient's overall health. Notably, non‐muscle‐invasive BC (NMIBC) confined to the mucosa (Ta) and lamina propria (T1) without invading the muscle represents about 75% of all BC cases. Succeeding the first part of the guideline, this part of the clinical practice guideline focuses on NMIBC. It details risk classifications and treatment options, including both surgical procedures and posttransurethral resection of the bladder tumor intravesical instillations. Special attention is given to the treatment strategies for carcinoma in situ. The guideline also covers the recommended follow‐up procedures for patients with NMIBC, underscoring the need for thorough and continuous care management.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"117 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090648","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}
Wei Wang, Kai Zhang, Hongbo Li, Lihua Yuan, Yan Hou, Derek A. O'Reilly, Gang Zhu
Radical prostatectomy (RP) and radical cystectomy (RC) with concurrent pelvic lymph node dissection (PLND) are considered as the curative surgical treatment options for localized prostate cancer (PC) or muscle‐invasive bladder cancer (BC). Regarding lymphatic leakage management after PLND, there is no standard of care, with different therapeutic approaches having been reported with varying success rates.Seventy patients underwent pelvic lymphadenectomy during robotic RP and RC with postoperative pelvic drainage volume more than 50 mL/day before the removal of drainage tube, were retrospectively evaluated in this study between August 2015 and June 2023. If the pelvic drainage volume on postoperative Day 2 was more than 50 mL/day, a drainage fluid creatinine was routinely tested to rule out urine leakage. We removed the drainage if the patient had no significant abdominal free fluid collection, no abdominal distension or pain, no fever, and no abdominal tenderness. After 1‐day observation of the vital signs and abdominal symptoms, the patient was discharged and followed‐up in clinic for 2 weeks after surgery.Forty‐one cases underwent the early drainage removal even if the pelvic drainage volume was more than 50 mL/day. Among these forty‐one cases, twenty‐five drainage tubes were removed when drainage volume was more than 100 mL/day. All the forty‐one cases with pelvic drainage volume greater than 50 mL/day were successfully managed with the early drainage removal. No paracentesis or drainage placement was required. No re‐admission occured during the follow‐up period.It is safe to manage the high‐volume pelvic lymphatic leakage by early clamping of the drainage tube, ultrasonography assessment of no significant residual fluid in the abdominal and pelvic cavity, and then the early removal of the drainage tube.
{"title":"Early drainage removal in the management of lymphatic leakage after robotic pelvic lymph node dissection","authors":"Wei Wang, Kai Zhang, Hongbo Li, Lihua Yuan, Yan Hou, Derek A. O'Reilly, Gang Zhu","doi":"10.1002/uro2.33","DOIUrl":"https://doi.org/10.1002/uro2.33","url":null,"abstract":"Radical prostatectomy (RP) and radical cystectomy (RC) with concurrent pelvic lymph node dissection (PLND) are considered as the curative surgical treatment options for localized prostate cancer (PC) or muscle‐invasive bladder cancer (BC). Regarding lymphatic leakage management after PLND, there is no standard of care, with different therapeutic approaches having been reported with varying success rates.Seventy patients underwent pelvic lymphadenectomy during robotic RP and RC with postoperative pelvic drainage volume more than 50 mL/day before the removal of drainage tube, were retrospectively evaluated in this study between August 2015 and June 2023. If the pelvic drainage volume on postoperative Day 2 was more than 50 mL/day, a drainage fluid creatinine was routinely tested to rule out urine leakage. We removed the drainage if the patient had no significant abdominal free fluid collection, no abdominal distension or pain, no fever, and no abdominal tenderness. After 1‐day observation of the vital signs and abdominal symptoms, the patient was discharged and followed‐up in clinic for 2 weeks after surgery.Forty‐one cases underwent the early drainage removal even if the pelvic drainage volume was more than 50 mL/day. Among these forty‐one cases, twenty‐five drainage tubes were removed when drainage volume was more than 100 mL/day. All the forty‐one cases with pelvic drainage volume greater than 50 mL/day were successfully managed with the early drainage removal. No paracentesis or drainage placement was required. No re‐admission occured during the follow‐up period.It is safe to manage the high‐volume pelvic lymphatic leakage by early clamping of the drainage tube, ultrasonography assessment of no significant residual fluid in the abdominal and pelvic cavity, and then the early removal of the drainage tube.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"29 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425031","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}
As one of the most common diseases in urology, a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).In this study, we systematically evaluated the current status of preclinical research on CP/CPPS through bibliometrics analysis using VOSviewer and Citespace. Characteristics of publication such as year, country/region, institution, author, journal, citation, and keywords were analyzed. Based on the bibliometrics analysis results of keywords, we summarized the possible mechanisms and promising treatments for CP/CPPS narratively.According to the results of this study, the most common mechanisms involved in CP/CPPS were as follows: disturbed immune and inflammation mediators, immune cell dysfunction, oxidative stress, dysregulated signaling pathways, apoptosis, gut microbiota, and testosterone metabolism. Chinese Traditional Medicine and extracorporeal shock wave therapy have important potential in the treatment of CP/CPPS.Further translational studies targeting the above mechanisms and validating the objective efficacy of potential treatments indicated by preclinical studies in clinical patients are needed in the future.
{"title":"Molecular mechanism and promising treatments of chronic prostatitis/chronic pelvic pain syndrome: An exploratory bibliometric analysis and literature review of preclinical studies","authors":"Yongfeng Lao, Xin Guan, Jian Wang, Yanan Bai, Zewen Li, Zhiping Wang, Zhilong Dong","doi":"10.1002/uro2.34","DOIUrl":"https://doi.org/10.1002/uro2.34","url":null,"abstract":"As one of the most common diseases in urology, a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).In this study, we systematically evaluated the current status of preclinical research on CP/CPPS through bibliometrics analysis using VOSviewer and Citespace. Characteristics of publication such as year, country/region, institution, author, journal, citation, and keywords were analyzed. Based on the bibliometrics analysis results of keywords, we summarized the possible mechanisms and promising treatments for CP/CPPS narratively.According to the results of this study, the most common mechanisms involved in CP/CPPS were as follows: disturbed immune and inflammation mediators, immune cell dysfunction, oxidative stress, dysregulated signaling pathways, apoptosis, gut microbiota, and testosterone metabolism. Chinese Traditional Medicine and extracorporeal shock wave therapy have important potential in the treatment of CP/CPPS.Further translational studies targeting the above mechanisms and validating the objective efficacy of potential treatments indicated by preclinical studies in clinical patients are needed in the future.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139800224","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}
Prostate cancer is a heterogeneous disease process with a wide spectrum of clinicopathologic variables that impact diagnosis, risk stratification, and management. To improve diagnostic accuracy and to better inform clinical decision making, the development of molecular biomarkers has undergone considerable discovery and clinical validation in the past decade. Prostate cancer is no longer seen as a single disease entity but one with considerable heterogeneity existing between tumors and between patients. Biomarkers now allow for more personalized and precision‐based approaches to management that otherwise would have depended on applying clinical algorithms alone. The aim of this review is to discuss and evaluate prostate cancer tissue‐based biomarkers that have been developed to aid diagnosis, improve risk stratification, and management.
{"title":"Current and emerging tissue‐based molecular biomarkers for prostate cancer management: A narrative review","authors":"Jas Singh","doi":"10.1002/uro2.32","DOIUrl":"https://doi.org/10.1002/uro2.32","url":null,"abstract":"Prostate cancer is a heterogeneous disease process with a wide spectrum of clinicopathologic variables that impact diagnosis, risk stratification, and management. To improve diagnostic accuracy and to better inform clinical decision making, the development of molecular biomarkers has undergone considerable discovery and clinical validation in the past decade. Prostate cancer is no longer seen as a single disease entity but one with considerable heterogeneity existing between tumors and between patients. Biomarkers now allow for more personalized and precision‐based approaches to management that otherwise would have depended on applying clinical algorithms alone. The aim of this review is to discuss and evaluate prostate cancer tissue‐based biomarkers that have been developed to aid diagnosis, improve risk stratification, and management.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"54 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801057","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}
Prostate cancer is a heterogeneous disease process with a wide spectrum of clinicopathologic variables that impact diagnosis, risk stratification, and management. To improve diagnostic accuracy and to better inform clinical decision making, the development of molecular biomarkers has undergone considerable discovery and clinical validation in the past decade. Prostate cancer is no longer seen as a single disease entity but one with considerable heterogeneity existing between tumors and between patients. Biomarkers now allow for more personalized and precision‐based approaches to management that otherwise would have depended on applying clinical algorithms alone. The aim of this review is to discuss and evaluate prostate cancer tissue‐based biomarkers that have been developed to aid diagnosis, improve risk stratification, and management.
{"title":"Current and emerging tissue‐based molecular biomarkers for prostate cancer management: A narrative review","authors":"Jas Singh","doi":"10.1002/uro2.32","DOIUrl":"https://doi.org/10.1002/uro2.32","url":null,"abstract":"Prostate cancer is a heterogeneous disease process with a wide spectrum of clinicopathologic variables that impact diagnosis, risk stratification, and management. To improve diagnostic accuracy and to better inform clinical decision making, the development of molecular biomarkers has undergone considerable discovery and clinical validation in the past decade. Prostate cancer is no longer seen as a single disease entity but one with considerable heterogeneity existing between tumors and between patients. Biomarkers now allow for more personalized and precision‐based approaches to management that otherwise would have depended on applying clinical algorithms alone. The aim of this review is to discuss and evaluate prostate cancer tissue‐based biomarkers that have been developed to aid diagnosis, improve risk stratification, and management.","PeriodicalId":478044,"journal":{"name":"UroPrecision","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139861006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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