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The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies. 在经会阴前列腺活检中,对索引病灶进行映射靶向活检的有效性。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-05-01 DOI: 10.1590/S1677-5538.IBJU.2023.0558
Nahuel Paesano, Violeta Catalá, Larisa Tcholakian, Xavier Alomar, Miguel Barranco, Enric Trilla, Juan Morote

Purpose: To evaluate the effectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies.

Materials and methods: A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform. CsPCa was defined as International Society of Urological Pathology grade group ≥ 2.

Results: CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950).

Conclusions: This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly effective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases.

目的:评估在经会阴融合影像前列腺活组织检查中对指标病变进行映射靶向活组织检查(MTB)以检测有临床意义的前列腺癌(csPCa)的有效性:对309名疑似PCa的男性患者进行了回顾性分析,这些患者在西班牙巴塞罗那的Creu Blanca参考中心接受了前列腺活检。前列腺成像报告和数据系统(PI-RADS v.2.1)的磁共振成像(MRI)由放射科专家对活检前双参数磁共振成像进行重新分类,用于分割可疑病灶。使用 Artemis™ 平台对可疑病灶进行经会阴 MTB 和 12 核系统性活检。CsPCa的定义是国际泌尿病理学会分级组≥2:192名男性(62.1%)检出了CsPCa,其中PI-RADS 2的检出率为6.3%,PI-RADS 3的检出率为26.8%,PI-RADS 4的检出率为87.3%,PI-RADS 5的检出率为93.1%。指标病变的 MTB 发现了 185 个 csPCa(96.3%)。有 3 例病例(1.6%)仅在系统活检中发现了 csPCa,另有 4 例病例(2.1%)仅在第二个疑似病灶中发现了 csPCa。在指标病灶的 MTB 中建立了 csPCa 检测预测模型,其 AUC 为 0.918(95% CI 0.887-0.950):该模型有可能避免23.3%的前列腺活检,而不会漏掉额外的csPCa病例。在经会阴融合前列腺活检中,指标病灶的 MTB 对识别 csPCa 非常有效。所开发的预测模型成功减少了近四分之一的活组织检查需求,且不会遗漏csPCa病例。
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引用次数: 0
Ureteral access sheath. Does it improve the results of flexible ureteroscopy? A narrative review. 输尿管通路鞘。它能改善柔性输尿管镜检查的结果吗?综述。
IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-05-01 DOI: 10.1590/S1677-5538.IBJU.2024.9907
José Agustin Cabrera Santa Cruz, Alexandre Danilovic, Fabio Carvalho Vicentini, Artur Henrique Brito, Carlos Alfredo Batagello, Giovanni Scalla Marchini, Fabio César Miranda Torricelli, William Carlos Nahas, Eduardo Mazzucchi
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引用次数: 0
Outcomes of ablative therapy and radical treatment for prostate cancer: a systematic review and meta-analysis. 前列腺癌消融治疗和根治治疗的结果:系统回顾和荟萃分析。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-03 DOI: 10.1590/S1677-5538.IBJU.2023.0628
Guilherme Miranda Andrade, Felipe Giorgi Manente, Pedro José Damato Dias Barroso, Saulo Borborema Teles, Alexandre Dib Partezani, Willy Baccaglini, Rafael Sanchez-Salas, Ruben Olivares, Bruno Nahar, Gustavo Caserta Lemos, Bianca Bianco, Arie Carneiro

Purpose: To compare biochemical recurrence, sexual potency and urinary continence outcomes of ablative therapy and radical treatment (radical prostatectomy or radiotherapy with androgen deprivation therapy).

Material and methods: A systematic review and meta-analysis followed the PRISMA guidelines were performed. We searched MEDLINE/PubMed. Biochemical recurrence at three and five years; incontinence rate (patients who used one pad or more) and erectile dysfunction rate at 12 and 36 months (patients who did not have sufficient erection to achieve sexual intercourse) were evaluated. The Mantel-Haenszel method was applied to estimate the pooled risk difference (RD) in the individual studies for categorical variables. All results were presented as 95% confidence intervals (95%CI). Random effects models were used regardless of the level of heterogeneity (I²). (PROSPERO CRD42022296998).

Results: Eight studies comprising 2,677 men with prostate cancer were included. There was no difference in biochemical recurrence between ablative and radical treatments. We observed the same biochemical recurrence between ablative therapy and radical treatment within five years (19.3% vs. 16.8%, respectively; RD 0.07; 95%CI=-0.05, 0.19; I2=68.2%; P=0.08) and continence rate at 12 months (9.2% vs. 31.8%, respectively; RD -0.13; 95%CI, -0.27, 0.01; I2=89%; P=0.32). When focal treatment was analyzed alone, two studies with 582 patients found higher erectile function at 12 months in the ablative therapy group than in the radical treatment (88.9% vs. 30.8%, respectively; RD -0.45; 95%CI -0.84, -0.05; I2=93%; P=0.03).

Conclusion: Biochemical recurrence and urinary continence outcomes of ablative therapy and radical treatment were similar. Ablative therapy appears to have a high rate of sexual potency.

目的:比较消融治疗和根治治疗(根治性前列腺切除术或放射治疗加雄激素剥夺治疗)的生化复发、性功能和排尿功能:按照 PRISMA 指南进行了系统综述和荟萃分析。我们检索了 MEDLINE/PubMed。评估了3年和5年的生化复发率、尿失禁率(使用一个或多个尿垫的患者)以及12个月和36个月的勃起功能障碍率(勃起功能不足以实现性交的患者)。对于分类变量,采用曼特尔-海恩泽尔法估算各研究的汇总风险差异(RD)。所有结果均以 95% 置信区间 (95%CI) 表示。无论异质性水平(I²)如何,均采用随机效应模型。(PROSPERO CRD42022296998).Results:结果:共纳入八项研究,包括 2,677 名前列腺癌男性患者。消融治疗和根治治疗的生化复发率没有差异。我们观察到,消融治疗与根治治疗在五年内的生化复发率(分别为19.3% vs. 16.8%;RD 0.07;95%CI=-0.05,0.19;I2=68.2%;P=0.08)和12个月时的尿失禁率(分别为9.2% vs. 31.8%;RD -0.13;95%CI,-0.27,0.01;I2=89%;P=0.32)相同。当单独分析病灶治疗时,两项共 582 例患者的研究发现,消融治疗组患者在 12 个月后的勃起功能高于根治治疗组(分别为 88.9% 对 30.8%;RD -0.45;95%CI -0.84,-0.05;I2=93%;P=0.03):结论:消融治疗和根治治疗的生化复发和尿失禁结果相似。烧蚀疗法似乎具有较高的性功能恢复率。
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引用次数: 0
Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy. 确定体外尿路转流术和体外尿路转流术与机器人膀胱切除术围手术期结果的风险因素。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0477
Hangcheng Fu, Laura Davis, Venkat Ramakrishnan, Thomas Barefoot, Colleen Sholtes, Lifan Liang, Mohammed Said, Jamie Messer

Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches.

Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed.

Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate.

Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.

导言:体外尿路改道(ICUD)机器人辅助膀胱切除术尽管非常复杂,但其采用率却越来越高,这促使我们将其与体外尿路改道(ECUD)进行详细比较。我们在一家医疗机构进行的研究调查了围手术期的结果,并确定了影响这些手术方法成功的风险因素:在这项回顾性分析中,我们回顾了 2016 年 6 月至 2021 年 8 月期间在路易斯维尔大学接受机器人辅助膀胱切除术的 174 名患者。根据尿流改道方法将患者分为两组:30名患者接受了ECUD,144名患者接受了ICUD。对人口统计学、并发症发生率、住院时间和再入院率等数据进行了细致的收集和分析:ICUD组和ECUD组的手术时间相当。结果:ICUD 组和 ECUD 组的手术时间相当,但 ICUD 组的术中输血率明显更低(0.5 对 1.0,P=0.02),住院时间更短(7.8 对 12.3 天,P=0.01):与ECUD相比,ICUD机器人膀胱切除术的住院时间更短,术中输血率更低,但在手术时间、高级别术后并发症或再入院率方面没有差异。这些发现可为临床决策提供参考,在适当的情况下,ICUD可能是更有利的选择。
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引用次数: 0
Kidney collecting system anatomy applied to endourology - a narrative review. 肾收集系统解剖学应用于内窥镜 - 综述。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2024.9901
Ana Raquel M Morais, Luciano A Favorito, Francisco J B Sampaio

Objective: To evaluate the surgical anatomy of the kidney collecting system through a narrative review of the literature, highlighting its importance during diagnosis and its approach during surgical procedures for the treatment of renal stones.

Material and methods: We carried out a review about the anatomy of the kidney collecting system. We analyzed papers published in the past 40 years in the databases Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials and opinions of specialists.

Results: Renal collecting system could be divided in four groups: A1 - kidney midzone (KM), drained by minor calyx that are dependent on the superior or the inferior caliceal groups; A2 - KM drained by crossed calyx, one draining into the superior caliceal group and another draining into the inferior caliceal group; B1 - KM drained by a major caliceal group independent of both the superior and inferior groups; and B2 - KM drained by minor calyx entering directly into the renal pelvis. Some details and anatomic variations of the collecting system are related to clinical and radiological aspects, particularly perpendicular calyces, interpyelocalyx space, position of calyces in relation to renal border, classification of the renal collecting system, infundibular diameter and the angle between the lower infundibulum and renal pelvis.

Conclusion: The knowledge of intra-renal collecting system divisions and variations as the angle between the renal pelvis and lower infundibula, position of the calices in relationship with renal edge and the diameter and position of the calyces are important for the planning of minimally invasive renal surgeries.

目的通过文献综述评估肾集合系统的外科解剖学,强调其在诊断中的重要性以及在治疗肾结石的外科手术中的方法:我们对肾集合系统的解剖结构进行了综述。我们分析了Pubmed、Embase和Scielo数据库中过去40年发表的论文,只收录了英文论文,排除了病例报告、社论和专家意见:肾收集系统可分为四组:A1--肾中区(KM),由依附于上肾盏组或下肾盏组的小肾萼引流;A2--肾中区由交叉肾萼引流,一个肾萼引流至上肾盏组,另一个肾萼引流至下肾盏组;B1--肾中区由独立于上肾盏组和下肾盏组的大肾萼引流;B2--肾中区由直接进入肾盂的小肾萼引流。集尿系统的一些细节和解剖变异与临床和放射学方面有关,特别是垂直肾盏、肾盏间隙、肾盏与肾边界的位置、肾集尿系统分类、肾下盏直径以及肾下盏与肾盂之间的角度:结论:了解肾集合系统内部的划分和变化,如肾盂和下肾底之间的角度、肾盏与肾边缘的位置关系以及肾盏的直径和位置,对于制定微创肾脏手术计划非常重要。
{"title":"Kidney collecting system anatomy applied to endourology - a narrative review.","authors":"Ana Raquel M Morais, Luciano A Favorito, Francisco J B Sampaio","doi":"10.1590/S1677-5538.IBJU.2024.9901","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9901","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the surgical anatomy of the kidney collecting system through a narrative review of the literature, highlighting its importance during diagnosis and its approach during surgical procedures for the treatment of renal stones.</p><p><strong>Material and methods: </strong>We carried out a review about the anatomy of the kidney collecting system. We analyzed papers published in the past 40 years in the databases Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials and opinions of specialists.</p><p><strong>Results: </strong>Renal collecting system could be divided in four groups: A1 - kidney midzone (KM), drained by minor calyx that are dependent on the superior or the inferior caliceal groups; A2 - KM drained by crossed calyx, one draining into the superior caliceal group and another draining into the inferior caliceal group; B1 - KM drained by a major caliceal group independent of both the superior and inferior groups; and B2 - KM drained by minor calyx entering directly into the renal pelvis. Some details and anatomic variations of the collecting system are related to clinical and radiological aspects, particularly perpendicular calyces, interpyelocalyx space, position of calyces in relation to renal border, classification of the renal collecting system, infundibular diameter and the angle between the lower infundibulum and renal pelvis.</p><p><strong>Conclusion: </strong>The knowledge of intra-renal collecting system divisions and variations as the angle between the renal pelvis and lower infundibula, position of the calices in relationship with renal edge and the diameter and position of the calyces are important for the planning of minimally invasive renal surgeries.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"164-177"},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933777","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}
引用次数: 0
Postoperative antibiotic prophylaxis for percutaneous nephrolithotomy and risk of infection: a systematic review and meta-analysis. 经皮肾镜取石术的术后抗生素预防和感染风险:系统回顾和荟萃分析。
IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0626
Thalita Bento Talizin, Alexandre Danilovic, Fabio Cesar Miranda Torricelli, Giovanni S Marchini, Carlos Batagello, Fabio C Vicentini, William Carlos Nahas, Eduardo Mazzucchi

Purpose: The aim of this study is to perform a high-quality meta-analysis using only randomized controlled trials (RCT) to better define the role of postoperative antibiotics in patients undergoing percutaneous nephrolithotomy (PCNL).

Materials and methods: A literature search for RCTs in EMBASE, PubMed, and Web of Science up to May 2023 was conducted following the PICO framework: Population-adult patients who underwent PCNL; Intervention-postoperative antibiotic prophylaxis until nephrostomy tube withdrawal; Control-single dose of antibiotic during the induction of anesthesia; and Outcome-systemic inflammatory response syndrome (SIRS) or sepsis and fever after PCNL. The protocol was registered on the PROSPERO database (CRD42022361579). We calculated odds ratios (OR) and 95% confidence intervals (CI). A random-effects model was employed, and the alpha risk was defined as < 0.05.

Results: Seven articles, encompassing a total of 629 patients, were included in the analysis. The outcome of SIRS or sepsis was extracted from six of the included studies, while the outcome of postoperative fever was extracted from four studies. The analysis revealed no statistical association between the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal and the occurrence of SIRS/sepsis (OR 1.236, 95% CI 0.731 - 2.089, p=0.429) or fever (OR 2.049, 95% CI 0.790 - 5.316, p=0.140).

Conclusion: Our findings suggest that there is no benefit associated with the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal in patients undergoing percutaneous nephrolithotomy (PCNL). We recommend that antibiotic prophylaxis should be administered only until the induction of anesthesia in PCNL.

目的:本研究旨在仅使用随机对照试验(RCT)进行高质量的荟萃分析,以更好地界定术后抗生素在经皮肾镜碎石术(PCNL)患者中的作用:按照 PICO 框架在 EMBASE、PubMed 和 Web of Science 中检索了截至 2023 年 5 月的 RCT 文献:人群--接受 PCNL 的成人患者;干预--术后预防使用抗生素直至拔除肾造瘘管;对照--麻醉诱导期间使用单剂量抗生素;结果--PCNL 后出现系统炎症反应综合征(SIRS)或败血症和发热。该方案已在 PROSPERO 数据库(CRD42022361579)中注册。我们计算了几率比(OR)和 95% 置信区间(CI)。采用随机效应模型,α风险定义为<0.05:共有七篇文章纳入分析,共涉及 629 名患者。其中 6 篇研究提取了 SIRS 或败血症的结果,4 篇研究提取了术后发热的结果。分析结果显示,在拔除肾造瘘管之前使用术后抗生素预防与 SIRS/败血症(OR 1.236,95% CI 0.731 - 2.089,P=0.429)或发热(OR 2.049,95% CI 0.790 - 5.316,P=0.140)的发生之间没有统计学关联:我们的研究结果表明,在接受经皮肾镜碎石术(PCNL)的患者拔除肾造瘘管之前,术后使用抗生素预防并无益处。我们建议,在 PCNL 手术中,抗生素预防性治疗只应在麻醉诱导前使用。
{"title":"Postoperative antibiotic prophylaxis for percutaneous nephrolithotomy and risk of infection: a systematic review and meta-analysis.","authors":"Thalita Bento Talizin, Alexandre Danilovic, Fabio Cesar Miranda Torricelli, Giovanni S Marchini, Carlos Batagello, Fabio C Vicentini, William Carlos Nahas, Eduardo Mazzucchi","doi":"10.1590/S1677-5538.IBJU.2023.0626","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0626","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to perform a high-quality meta-analysis using only randomized controlled trials (RCT) to better define the role of postoperative antibiotics in patients undergoing percutaneous nephrolithotomy (PCNL).</p><p><strong>Materials and methods: </strong>A literature search for RCTs in EMBASE, PubMed, and Web of Science up to May 2023 was conducted following the PICO framework: Population-adult patients who underwent PCNL; Intervention-postoperative antibiotic prophylaxis until nephrostomy tube withdrawal; Control-single dose of antibiotic during the induction of anesthesia; and Outcome-systemic inflammatory response syndrome (SIRS) or sepsis and fever after PCNL. The protocol was registered on the PROSPERO database (CRD42022361579). We calculated odds ratios (OR) and 95% confidence intervals (CI). A random-effects model was employed, and the alpha risk was defined as < 0.05.</p><p><strong>Results: </strong>Seven articles, encompassing a total of 629 patients, were included in the analysis. The outcome of SIRS or sepsis was extracted from six of the included studies, while the outcome of postoperative fever was extracted from four studies. The analysis revealed no statistical association between the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal and the occurrence of SIRS/sepsis (OR 1.236, 95% CI 0.731 - 2.089, p=0.429) or fever (OR 2.049, 95% CI 0.790 - 5.316, p=0.140).</p><p><strong>Conclusion: </strong>Our findings suggest that there is no benefit associated with the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal in patients undergoing percutaneous nephrolithotomy (PCNL). We recommend that antibiotic prophylaxis should be administered only until the induction of anesthesia in PCNL.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"152-163"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933778","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}
引用次数: 0
Smoking characteristics and years since quitting smoking of US adults diagnosed with lung and bladder cancer: A national health and nutrition examination survey analysis. 被诊断为肺癌和膀胱癌的美国成年人的吸烟特征和戒烟年数:全国健康与营养状况调查分析
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0625
Edoardo Beatrici, Muhieddine Labban, Dejan K Filipas, Benjamin V Stone, Leonardo O Reis, Filippo Dagnino, Giovanni Lughezzani, Nicolò M Buffi, Stuart R Lipsitz, Timothy N Clinton, Richard S Matulewicz, Quoc-Dien Trinh, Alexander P Cole

Purpose: Smoking is a recognized risk factor for bladder BC and lung cancer LC. We investigated the enduring risk of BC after smoking cessation using U.S. national survey data. Our analysis focused on comparing characteristics of LC and BC patients, emphasizing smoking status and the latency period from smoking cessation to cancer diagnosis in former smokers.

Materials and methods: We analyzed data from the National Health and Examination Survey (2003-2016), identifying adults with LC or BC history. Smoking status (never, active, former) and the interval between quitting smoking and cancer diagnosis for former smokers were assessed. We reported descriptive statistics using frequencies and percentages for categorical variables and median with interquartile ranges (IQR) for continuous variables.

Results: Among LC patients, 8.9% never smoked, 18.9% active smokers, and 72.2% former smokers. Former smokers had a median interval of 8 years (IQR 2-12) between quitting and LC diagnosis, with 88.3% quitting within 0-19 years before diagnosis. For BC patients, 26.8% never smoked, 22.4% were active smokers, and 50.8% former smokers. Former smokers had a median interval of 21 years (IQR 14-33) between quitting and BC diagnosis, with 49.3% quitting within 0-19 years before diagnosis.

Conclusions: BC patients exhibit a prolonged latency period between smoking cessation and cancer diagnosis compared to LC patients. Despite smoking status evaluation in microhematuria, current risk stratification models for urothelial cancer do not incorporate it. Our findings emphasize the significance of long-term post-smoking cessation surveillance and advocate for integrating smoking history into future risk stratification guidelines.

目的:吸烟是膀胱癌和肺癌 LC 的公认风险因素。我们利用美国全国调查数据研究了戒烟后膀胱癌的持久风险。我们的分析重点是比较 LC 和 BC 患者的特征,强调前吸烟者的吸烟状态以及从戒烟到癌症诊断的潜伏期:我们分析了全国健康与体检调查(2003-2016 年)的数据,确定了有 LC 或 BC 病史的成年人。我们评估了曾经吸烟者的吸烟状态(从不吸烟、积极吸烟、曾经吸烟)以及戒烟后到确诊癌症的间隔时间。我们使用频率和百分比对分类变量进行描述性统计,使用中位数和四分位数间距(IQR)对连续变量进行描述性统计:在 LC 患者中,8.9% 的人从不吸烟,18.9% 的人经常吸烟,72.2% 的人曾经吸烟。曾经吸烟者从戒烟到确诊为 LC 的中位间隔为 8 年(IQR 2-12),其中 88.3% 的人在确诊前 0-19 年内戒烟。在 BC 患者中,26.8% 从未吸烟,22.4% 是活跃吸烟者,50.8% 曾经吸烟。曾经吸烟者从戒烟到确诊为 BC 的中位间隔为 21 年(IQR 14-33),其中 49.3% 在确诊前 0-19 年内戒烟:结论:与 LC 患者相比,BC 患者从戒烟到确诊癌症的潜伏期较长。尽管在微血尿中对吸烟状况进行了评估,但目前的尿路癌风险分层模型并未将其纳入其中。我们的研究结果强调了长期戒烟后监测的重要性,并主张将吸烟史纳入未来的风险分层指南中。
{"title":"Smoking characteristics and years since quitting smoking of US adults diagnosed with lung and bladder cancer: A national health and nutrition examination survey analysis.","authors":"Edoardo Beatrici, Muhieddine Labban, Dejan K Filipas, Benjamin V Stone, Leonardo O Reis, Filippo Dagnino, Giovanni Lughezzani, Nicolò M Buffi, Stuart R Lipsitz, Timothy N Clinton, Richard S Matulewicz, Quoc-Dien Trinh, Alexander P Cole","doi":"10.1590/S1677-5538.IBJU.2023.0625","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0625","url":null,"abstract":"<p><strong>Purpose: </strong>Smoking is a recognized risk factor for bladder BC and lung cancer LC. We investigated the enduring risk of BC after smoking cessation using U.S. national survey data. Our analysis focused on comparing characteristics of LC and BC patients, emphasizing smoking status and the latency period from smoking cessation to cancer diagnosis in former smokers.</p><p><strong>Materials and methods: </strong>We analyzed data from the National Health and Examination Survey (2003-2016), identifying adults with LC or BC history. Smoking status (never, active, former) and the interval between quitting smoking and cancer diagnosis for former smokers were assessed. We reported descriptive statistics using frequencies and percentages for categorical variables and median with interquartile ranges (IQR) for continuous variables.</p><p><strong>Results: </strong>Among LC patients, 8.9% never smoked, 18.9% active smokers, and 72.2% former smokers. Former smokers had a median interval of 8 years (IQR 2-12) between quitting and LC diagnosis, with 88.3% quitting within 0-19 years before diagnosis. For BC patients, 26.8% never smoked, 22.4% were active smokers, and 50.8% former smokers. Former smokers had a median interval of 21 years (IQR 14-33) between quitting and BC diagnosis, with 49.3% quitting within 0-19 years before diagnosis.</p><p><strong>Conclusions: </strong>BC patients exhibit a prolonged latency period between smoking cessation and cancer diagnosis compared to LC patients. Despite smoking status evaluation in microhematuria, current risk stratification models for urothelial cancer do not incorporate it. Our findings emphasize the significance of long-term post-smoking cessation surveillance and advocate for integrating smoking history into future risk stratification guidelines.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"199-208"},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933813","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}
引用次数: 0
The effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of monosymptomatic enuresis in children and adolescents: a systematic review. 骶旁经皮神经电刺激治疗儿童和青少年单症状遗尿症的有效性:系统性综述。
IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0618
Melissa Faria Dutra, José de Bessa, Emerson Coelho Luiz de Almeida, Eleonora Moreira Lima, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad

Background: Parasacral Transcutaneous Electrical Nerve Stimulation (PTENS) is a treatment used in enuresis refractory to first-line treatment. This review aimed to evaluate the effectiveness of PTENS in treating monosymptomatic enuresis (MNE) in children and adolescents.

Methods: The study followed the Preferred Reporting Items for Systematic (PRISMA) guidelines. The search was carried out in the following databases: MEDLINE (via PubMed), Web of Science, SCOPUS, Central Cochrane Library and Physiotherapy Evidence Database (PEDro). The selected studies were randomized clinical trials (RCTs). The "Risk of Bias tool for randomized trials" and the "Risk of Bias VISualization" were used to analyze the risk of bias.

Results: Of the 624 studies selected, four RCTs were eligible. Three included 146 children and adolescents aged between six and 16.3 years and used similar PTENS protocols with a frequency of 10 Hz, pulse duration of 700 µs and 20 minutes three times/week. One study enrolled 52 patients aged seven to 14 years used PTENS at home, with a pulse duration of 200 µs and 20 to 60 minutes twice/day. Risk of bias was observed in three studies due to results' randomization and measurement. Two studies showed a partial response with a reduction in wet nights, one a complete response in 27% of patients, and one showed no improvement.

Conclusion: PTENS reduces wet nights' frequency but does not cure them, except in 27% of patients in one study. Limited RCTs and data heterogeneity are limitations.

背景:骶旁经皮神经电刺激(PTENS)是一种用于治疗一线治疗难治性遗尿症的疗法。本综述旨在评估经皮神经电刺激治疗儿童和青少年无症状性遗尿症(MNE)的有效性:研究遵循系统性报告首选项目(PRISMA)指南。在以下数据库中进行了检索:MEDLINE(通过 PubMed)、Web of Science、SCOPUS、Cochrane 中央图书馆和物理治疗证据数据库 (PEDro)。所选研究均为随机临床试验(RCT)。使用 "随机试验偏倚风险工具 "和 "偏倚风险可视化 "分析偏倚风险:在所选的 624 项研究中,有四项研究符合条件。其中三项研究纳入了 146 名年龄在 6 至 16.3 岁之间的儿童和青少年,并采用了类似的 PTENS 方案,频率为 10 赫兹,脉冲持续时间为 700 微秒,每次 20 分钟,每周三次。一项研究招募了 52 名 7 至 14 岁的患者,他们在家中使用 PTENS,脉冲持续时间为 200 µs,20 至 60 分钟/天,2 次/天。有三项研究因结果的随机化和测量而存在偏倚风险。两项研究显示,部分患者的夜尿次数有所减少,一项研究显示,27% 的患者有完全反应,一项研究显示没有改善:结论:PTENS 可减少夜尿次数,但不能治愈夜尿,只有一项研究中 27% 的患者例外。有限的 RCT 和数据异质性是其局限性。
{"title":"The effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of monosymptomatic enuresis in children and adolescents: a systematic review.","authors":"Melissa Faria Dutra, José de Bessa, Emerson Coelho Luiz de Almeida, Eleonora Moreira Lima, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad","doi":"10.1590/S1677-5538.IBJU.2023.0618","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0618","url":null,"abstract":"<p><strong>Background: </strong>Parasacral Transcutaneous Electrical Nerve Stimulation (PTENS) is a treatment used in enuresis refractory to first-line treatment. This review aimed to evaluate the effectiveness of PTENS in treating monosymptomatic enuresis (MNE) in children and adolescents.</p><p><strong>Methods: </strong>The study followed the Preferred Reporting Items for Systematic (PRISMA) guidelines. The search was carried out in the following databases: MEDLINE (via PubMed), Web of Science, SCOPUS, Central Cochrane Library and Physiotherapy Evidence Database (PEDro). The selected studies were randomized clinical trials (RCTs). The \"Risk of Bias tool for randomized trials\" and the \"Risk of Bias VISualization\" were used to analyze the risk of bias.</p><p><strong>Results: </strong>Of the 624 studies selected, four RCTs were eligible. Three included 146 children and adolescents aged between six and 16.3 years and used similar PTENS protocols with a frequency of 10 Hz, pulse duration of 700 µs and 20 minutes three times/week. One study enrolled 52 patients aged seven to 14 years used PTENS at home, with a pulse duration of 200 µs and 20 to 60 minutes twice/day. Risk of bias was observed in three studies due to results' randomization and measurement. Two studies showed a partial response with a reduction in wet nights, one a complete response in 27% of patients, and one showed no improvement.</p><p><strong>Conclusion: </strong>PTENS reduces wet nights' frequency but does not cure them, except in 27% of patients in one study. Limited RCTs and data heterogeneity are limitations.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"136-151"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933814","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}
引用次数: 0
Do statins decrease testosterone in men? Systematic review and meta-analysis. 他汀类药物会降低男性睾酮吗?系统回顾和荟萃分析。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0578
Felipe Placco Araujo Glina, Leonardo Lopes, Rodrigo Spinola E Silva, Eduardo Augusto Correa Barros, Bruno Biselli, Sidney Glina

Purpose: Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the use of statin could cause a reduction in testosterone levels. The objective was to evaluate whether the continued use of statins in patients with hypercholesterolemia causes a deficiency in testosterone and other sex hormones.

Materials and methods: Systematic Review with Meta-analysis, performed in Embase, Medline and Cochrane databases, until May 2023; PROSPERO CRD42021270424protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement. There were selected comparative studies, prospective cohorts (CP), randomized clinical trials (RCT) and cross-sectional studies (CSS) with comparison of testosterone levels before and after statin administration and between groups. Bias analysis were evaluated with Cochrane Tool, The Newcastle-Ottawa Scale (NOS), and using the Assess the Quality of Cross-sectional studies (AXIS) tool.

Results: There were found on MedLine, Embase and Cochrane, after selected comparative studies, 10CP and 6RCT and 6CSS for the meta-analysis. In the Forrest plot with 6CSS, a correlation between patients with continuous use of statins and a reduction in total testosterone was evidenced with a statistically significant reduction of 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p<0.00001).In the analysis with 5RCT, a reduction in the mean total testosterone in patients who started continuous statin use was evidenced, with a statistical significance of 13.12ng/dL (95%CI=[1.16,25.08],I²=0%,p=0.03). Furthermore, the analysis of all prospective studies with 15 articles showed a statistically significant reduction in the mean total testosterone of 9.11 ng/dL (95%CI=[0.16,18.06],I²=37%,p=0.04). A reduction in total testosterone has been shown in most studies and in its accumulated analysis after statin use. However, this decrease was not enough to reach levels below normal.

Conclusion: Statins use causes a decrease in total testosterone, not enough to cause a drop below the normal range and also determines increase in FSH levels. No differences were found in LH, Estradiol, SHBG and Free Testosterone analysis.

目的:他汀类药物是全球治疗高胆固醇血症和血脂异常的处方药之一。通过降低胆固醇水平,他汀类药物的使用可能会导致睾酮水平下降。本研究旨在评估高胆固醇血症患者持续使用他汀类药物是否会导致睾酮和其他性激素的缺乏:在 Embase、Medline 和 Cochrane 数据库中进行系统综述和 Meta 分析,直至 2023 年 5 月;PROSPERO CRD42021270424protocol。由两位独立作者进行筛选,随后分阶段召开会议。方法基于 PRISMA 声明。选择了比较性研究、前瞻性队列研究(CP)、随机临床试验(RCT)和横断面研究(CSS),对他汀类药物用药前后和组间的睾酮水平进行了比较。偏倚分析采用 Cochrane 工具、纽卡斯尔-渥太华量表(NOS)以及横断面研究质量评估(AXIS)工具进行评估:在 MedLine、Embase 和 Cochrane 上找到了 10CP 和 6RCT 以及 6CSS 进行荟萃分析。在 6CSS 的福雷斯特图中,连续使用他汀类药物的患者与总睾酮下降之间存在相关性,总睾酮下降了 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p),具有显著的统计学意义:使用他汀类药物会导致总睾酮下降,但不足以使其降至正常范围以下,同时也会决定前列腺素水平的升高。在LH、雌二醇、SHBG和游离睾酮分析中未发现差异。
{"title":"Do statins decrease testosterone in men? Systematic review and meta-analysis.","authors":"Felipe Placco Araujo Glina, Leonardo Lopes, Rodrigo Spinola E Silva, Eduardo Augusto Correa Barros, Bruno Biselli, Sidney Glina","doi":"10.1590/S1677-5538.IBJU.2023.0578","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0578","url":null,"abstract":"<p><strong>Purpose: </strong>Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the use of statin could cause a reduction in testosterone levels. The objective was to evaluate whether the continued use of statins in patients with hypercholesterolemia causes a deficiency in testosterone and other sex hormones.</p><p><strong>Materials and methods: </strong>Systematic Review with Meta-analysis, performed in Embase, Medline and Cochrane databases, until May 2023; PROSPERO CRD42021270424protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement. There were selected comparative studies, prospective cohorts (CP), randomized clinical trials (RCT) and cross-sectional studies (CSS) with comparison of testosterone levels before and after statin administration and between groups. Bias analysis were evaluated with Cochrane Tool, The Newcastle-Ottawa Scale (NOS), and using the Assess the Quality of Cross-sectional studies (AXIS) tool.</p><p><strong>Results: </strong>There were found on MedLine, Embase and Cochrane, after selected comparative studies, 10CP and 6RCT and 6CSS for the meta-analysis. In the Forrest plot with 6CSS, a correlation between patients with continuous use of statins and a reduction in total testosterone was evidenced with a statistically significant reduction of 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p<0.00001).In the analysis with 5RCT, a reduction in the mean total testosterone in patients who started continuous statin use was evidenced, with a statistical significance of 13.12ng/dL (95%CI=[1.16,25.08],I²=0%,p=0.03). Furthermore, the analysis of all prospective studies with 15 articles showed a statistically significant reduction in the mean total testosterone of 9.11 ng/dL (95%CI=[0.16,18.06],I²=37%,p=0.04). A reduction in total testosterone has been shown in most studies and in its accumulated analysis after statin use. However, this decrease was not enough to reach levels below normal.</p><p><strong>Conclusion: </strong>Statins use causes a decrease in total testosterone, not enough to cause a drop below the normal range and also determines increase in FSH levels. No differences were found in LH, Estradiol, SHBG and Free Testosterone analysis.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"119-135"},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933773","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}
引用次数: 0
Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia. 机器人辅助膀胱切除术和体外尿流改道术在右肾盂异位患者中的适用性和可行性。
IF 3.7 3区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-03-01 DOI: 10.1590/S1677-5538.IBJU.2023.0608
Stefano Puliatti, Stefania Ferretti, Natali Rodriguez Peñaranda, Ahmed Eissa, Marco Ticonosco, Andrea De Faveri, Cosimo De Carne, Pawel Wisz, Riccardo Ferrari, Greta Tosi, Filippo Annino, Giampaolo Bianchi, Salvatore Micali

Background: The ectopic pelvic kidney, a common renal anomaly, is often smaller and malformed, with a shorter and sometimes tortuous ureter (1). Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases (2), mandates radical cystectomy with a 50% 5-year survival rate (2). Despite the growing use of robot-assisted radical cystectomy (RARC) (3, 4), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported (5), in contrast to numerous open radical cystectomies (1, 6) involving an ectopic kidney.

Patient and methods: After being diagnosed with T2 high-grade urothelial carcinoma, the 66-year-old patient, previously treated with multiple transurethral resections and adjuvant BCG therapy, received neoadjuvant chemotherapy. Preoperative staging CT revealed a 2.6 x 2.2 cm bladder neoformation and an ectopic right pelvic kidney.

Results: Using the da Vinci Surgical System, radical cystectomy with ileal conduit (sec Wallace II) and lymphadenectomy were performed. During the demolition phase, the shorter right ureter was dissected with care to avoid damage to the renal pedicle. The reconstructive phase included intracorporeal urinary diversion (ICUD) and uretero-ileal anastomosis, facilitated by the favorable position of the kidney. The 8-hour console surgery resulted in minimal blood loss. Discharged on day 16 due to COVID-19, the patient exhibited positive outcomes. A 2-month CT follow-up revealed no cancer recurrence, metastasis, hydronephrosis, and complete regression of the lymphocele. Imaging follow-up continues without postoperative adjuvant chemotherapy.

Conclusion: Robotic surgery with intracorporeal urinary diversion holds potential for right-sided pelvic kidney cases, but additional studies are necessary for validation.

背景:异位肾盂肾是一种常见的肾脏畸形,通常体积较小且畸形,输尿管较短,有时迂曲(1)。肌肉浸润性膀胱癌(MIBC)占膀胱癌病例的 15-25%(2),必须进行根治性膀胱切除术,5 年生存率为 50%(2)。尽管机器人辅助根治性膀胱切除术(RARC)的应用越来越广泛(3、4),但其在异位肾中的应用数据却很有限。目前仅有一例 RARC 病例的报道(5),而涉及异位肾脏的开放根治性膀胱切除术(1、6)则不胜枚举:这名 66 岁的患者曾接受过多次经尿道切除术和卡介苗辅助治疗,确诊为 T2 高级尿路上皮癌后接受了新辅助化疗。术前分期 CT 显示有一个 2.6 x 2.2 厘米的膀胱新造瘘和一个异位的右侧盆腔肾脏:使用达芬奇手术系统,进行了带回肠导管的根治性膀胱切除术(sec Wallace II)和淋巴结切除术。在切除阶段,对较短的右输尿管进行了解剖,并注意避免损伤肾蒂。重建阶段包括体外尿路转流(ICUD)和输尿管-回肠吻合术,肾脏的有利位置为手术提供了便利。8 小时的控制台手术失血量极少。患者因COVID-19于第16天出院,术后效果良好。2 个月的 CT 随访显示没有癌症复发、转移和肾积水,淋巴结也完全消退。影像学随访仍在继续,术后未进行辅助化疗:结论:体外尿路转流机器人手术在右侧盆肾病例中具有潜力,但还需要更多的研究来验证。
{"title":"Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia.","authors":"Stefano Puliatti, Stefania Ferretti, Natali Rodriguez Peñaranda, Ahmed Eissa, Marco Ticonosco, Andrea De Faveri, Cosimo De Carne, Pawel Wisz, Riccardo Ferrari, Greta Tosi, Filippo Annino, Giampaolo Bianchi, Salvatore Micali","doi":"10.1590/S1677-5538.IBJU.2023.0608","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0608","url":null,"abstract":"<p><strong>Background: </strong>The ectopic pelvic kidney, a common renal anomaly, is often smaller and malformed, with a shorter and sometimes tortuous ureter (1). Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases (2), mandates radical cystectomy with a 50% 5-year survival rate (2). Despite the growing use of robot-assisted radical cystectomy (RARC) (3, 4), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported (5), in contrast to numerous open radical cystectomies (1, 6) involving an ectopic kidney.</p><p><strong>Patient and methods: </strong>After being diagnosed with T2 high-grade urothelial carcinoma, the 66-year-old patient, previously treated with multiple transurethral resections and adjuvant BCG therapy, received neoadjuvant chemotherapy. Preoperative staging CT revealed a 2.6 x 2.2 cm bladder neoformation and an ectopic right pelvic kidney.</p><p><strong>Results: </strong>Using the da Vinci Surgical System, radical cystectomy with ileal conduit (sec Wallace II) and lymphadenectomy were performed. During the demolition phase, the shorter right ureter was dissected with care to avoid damage to the renal pedicle. The reconstructive phase included intracorporeal urinary diversion (ICUD) and uretero-ileal anastomosis, facilitated by the favorable position of the kidney. The 8-hour console surgery resulted in minimal blood loss. Discharged on day 16 due to COVID-19, the patient exhibited positive outcomes. A 2-month CT follow-up revealed no cancer recurrence, metastasis, hydronephrosis, and complete regression of the lymphocele. Imaging follow-up continues without postoperative adjuvant chemotherapy.</p><p><strong>Conclusion: </strong>Robotic surgery with intracorporeal urinary diversion holds potential for right-sided pelvic kidney cases, but additional studies are necessary for validation.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 2","pages":"227-228"},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933772","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}
引用次数: 0
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International Braz J Urol
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