Pub Date : 2024-08-08DOI: 10.1097/cu9.0000000000000254
Lin Wang, Wenxiong Song, Gongyi Chen, Zuowei Li, Rong Lyu, C. Jin, Xuxiao Ye, Yidong Liu, Yinglong Sa, Xiangguo Lyu
To evaluate the pubourethral stump angle (PUA) to determine the site of urethral transection during transperineal anastomotic urethroplasty (TAU). Patients diagnosed with pelvic fracture urethral distraction defect who underwent preoperative magnetic resonance (MR) urethrography and were treated with TAU between June 2019 and December 2021 were retrospectively reviewed. According to the site of urethral transection during TAU, patients were classified into proximal and distal groups receiving TAU with proximal and distal transection, respectively. The demographic and clinical data were recorded. The PUA was measured on sagittal T2-weighted MR urethrography. The relationship between the site of urethral transection and PUA was analyzed. Sixty-seven patients were included. Forty-one and 26 patients were included in the proximal and distal groups, respectively. Finally, the success rates in the proximal and distal groups were 95.1% and 92.3%, respectively. The PUAs were 123.7° ± 14.6° and 86.5° ± 9.8° (p = 0.005), respectively. The curves for the 2 groups intersected between 90° and 110°. The scribing effects at 90°, 100°, and 110° in the 2 groups were compared in detail. Compared with 90° and 110°, 100° had the highest sensitivity as the demarcation line. In the treatment of pelvic fracture urethral distraction defect, the PUA on MR urethrography is an objective and valid parameter for evaluating the site of urethral transection during TAU. A PUA >100° indicates that proximal transection should be preferentially attempted.
{"title":"Transperineal anastomotic urethroplasty with distal transection versus proximal transection: How to predict?","authors":"Lin Wang, Wenxiong Song, Gongyi Chen, Zuowei Li, Rong Lyu, C. Jin, Xuxiao Ye, Yidong Liu, Yinglong Sa, Xiangguo Lyu","doi":"10.1097/cu9.0000000000000254","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000254","url":null,"abstract":"\u0000 \u0000 \u0000 To evaluate the pubourethral stump angle (PUA) to determine the site of urethral transection during transperineal anastomotic urethroplasty (TAU).\u0000 \u0000 \u0000 \u0000 Patients diagnosed with pelvic fracture urethral distraction defect who underwent preoperative magnetic resonance (MR) urethrography and were treated with TAU between June 2019 and December 2021 were retrospectively reviewed. According to the site of urethral transection during TAU, patients were classified into proximal and distal groups receiving TAU with proximal and distal transection, respectively. The demographic and clinical data were recorded. The PUA was measured on sagittal T2-weighted MR urethrography. The relationship between the site of urethral transection and PUA was analyzed.\u0000 \u0000 \u0000 \u0000 Sixty-seven patients were included. Forty-one and 26 patients were included in the proximal and distal groups, respectively. Finally, the success rates in the proximal and distal groups were 95.1% and 92.3%, respectively. The PUAs were 123.7° ± 14.6° and 86.5° ± 9.8° (p = 0.005), respectively. The curves for the 2 groups intersected between 90° and 110°. The scribing effects at 90°, 100°, and 110° in the 2 groups were compared in detail. Compared with 90° and 110°, 100° had the highest sensitivity as the demarcation line.\u0000 \u0000 \u0000 \u0000 In the treatment of pelvic fracture urethral distraction defect, the PUA on MR urethrography is an objective and valid parameter for evaluating the site of urethral transection during TAU. A PUA >100° indicates that proximal transection should be preferentially attempted.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"15 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927649","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}
Pub Date : 2024-07-16DOI: 10.1097/cu9.0000000000000253
Lujie Xue, Lu Zhang, Chenyang Sun, Xiaomei Yang, Bin Li, Li Liu, Xiangyang Jiang, Lihong Chen
To develop an innovative and effective approach for cervical canal penetration in patients diagnosed with type II vaginal atresia with adequate uterine corpus development. Four patients underwent vaginal reconstruction surgery with laparoscopic and ultrasound-guided cervical canal penetration. The length and width of the neovagina were measured 0 and 6 months after surgery. Side effects were recorded during follow-up. The average age of the patients was 14.5 ± 3.3 years. After the surgical procedure, all patients had regular menstrual cycles. The average follow-up period was 32.3 ± 8.7 months. Laparoscopic and ultrasound-guided cervical canal penetration after vaginal reconstruction is feasible in patients with type II vaginal atresia and adequate uterine corpus development.
{"title":"An innovative and effective approach of cervical canal penetration in patients diagnosed with type II vaginal atresia with adequate uterine corpus development: a case series","authors":"Lujie Xue, Lu Zhang, Chenyang Sun, Xiaomei Yang, Bin Li, Li Liu, Xiangyang Jiang, Lihong Chen","doi":"10.1097/cu9.0000000000000253","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000253","url":null,"abstract":"\u0000 \u0000 \u0000 To develop an innovative and effective approach for cervical canal penetration in patients diagnosed with type II vaginal atresia with adequate uterine corpus development.\u0000 \u0000 \u0000 \u0000 Four patients underwent vaginal reconstruction surgery with laparoscopic and ultrasound-guided cervical canal penetration. The length and width of the neovagina were measured 0 and 6 months after surgery. Side effects were recorded during follow-up.\u0000 \u0000 \u0000 \u0000 The average age of the patients was 14.5 ± 3.3 years. After the surgical procedure, all patients had regular menstrual cycles. The average follow-up period was 32.3 ± 8.7 months.\u0000 \u0000 \u0000 \u0000 Laparoscopic and ultrasound-guided cervical canal penetration after vaginal reconstruction is feasible in patients with type II vaginal atresia and adequate uterine corpus development.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":" 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831942","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}
Pub Date : 2024-05-06DOI: 10.1097/cu9.0000000000000248
Marc Moulin, Erin D Lewis, David C. Crowley, Colleen E. May, Malkanthi Evans
Urinary incontinence (UI) is a debilitating and common condition that adversely affects quality of life. Prescriptive and surgical approaches for managing UI symptoms may result in undesirable risks and complications. This randomized, double-blind, placebo-controlled, parallel study investigated the efficacy of 2 nonsolvent flower pollen extracts on UI in healthy women. One-hundred and fourteen women aged 40–75 years who scored ≥5 on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) were randomized to receive either Graminex® RCT Fem™ UI, Graminex® PollenBerry®, or placebo for 24 weeks. The primary outcome was the change in the ICIQ-SF score between the trial and placebo groups after 24 weeks of supplementation. The secondary outcomes included changes in the frequency of nocturia (recorded in 3-day void diaries) and 24-hour leakage volume (assessed via pad weight) after 6, 12, 18, and 24 weeks of supplementation and changes in stress-induced urinary leakage volume (after completion of a provocative maneuver challenge) after 24 weeks of supplementation. All the groups demonstrated improvement in ICIQ-SF scores at week 24 (p < 0.001). The RCT Fem™ UI group had the greatest improvement in ICIQ-SF scores (−4.07 ± 3.4), followed by the PollenBerry® group (−3.34 ± 2.87) and placebo group (−2.61 ± 3.52). The RCT Fem™ UI group had corresponding improvements in 24-hour leakage volume (−17.68 ± 39.84 g) and frequency of nocturia (−0.52 ± 1.26) (p ≤ 0.05). PollenBerry® supplementation significantly improved stress-induced urinary leakage volume (−7.12 ± 15.64 g) at week 24. The study products demonstrated safe hematological and chemical profiles. RCT Fem™ UI supplementation resulted in significant and clinically meaningful reductions in UI severity, with corresponding improvements in daily urinary leakage volume and frequency of nocturia. PollenBerry® significantly improved stress-induced urinary leakage volume, suggesting that it may be efficacious in women who are prone to stress UI. The study products were safe and well tolerated in this population.
{"title":"Efficacy of nonsolvent flower pollen extracts in healthy women with urinary incontinence: A randomized, double-blind, placebo-controlled, parallel study","authors":"Marc Moulin, Erin D Lewis, David C. Crowley, Colleen E. May, Malkanthi Evans","doi":"10.1097/cu9.0000000000000248","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000248","url":null,"abstract":"\u0000 \u0000 \u0000 Urinary incontinence (UI) is a debilitating and common condition that adversely affects quality of life. Prescriptive and surgical approaches for managing UI symptoms may result in undesirable risks and complications. This randomized, double-blind, placebo-controlled, parallel study investigated the efficacy of 2 nonsolvent flower pollen extracts on UI in healthy women.\u0000 \u0000 \u0000 \u0000 One-hundred and fourteen women aged 40–75 years who scored ≥5 on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) were randomized to receive either Graminex® RCT Fem™ UI, Graminex® PollenBerry®, or placebo for 24 weeks. The primary outcome was the change in the ICIQ-SF score between the trial and placebo groups after 24 weeks of supplementation. The secondary outcomes included changes in the frequency of nocturia (recorded in 3-day void diaries) and 24-hour leakage volume (assessed via pad weight) after 6, 12, 18, and 24 weeks of supplementation and changes in stress-induced urinary leakage volume (after completion of a provocative maneuver challenge) after 24 weeks of supplementation.\u0000 \u0000 \u0000 \u0000 All the groups demonstrated improvement in ICIQ-SF scores at week 24 (p < 0.001). The RCT Fem™ UI group had the greatest improvement in ICIQ-SF scores (−4.07 ± 3.4), followed by the PollenBerry® group (−3.34 ± 2.87) and placebo group (−2.61 ± 3.52). The RCT Fem™ UI group had corresponding improvements in 24-hour leakage volume (−17.68 ± 39.84 g) and frequency of nocturia (−0.52 ± 1.26) (p ≤ 0.05). PollenBerry® supplementation significantly improved stress-induced urinary leakage volume (−7.12 ± 15.64 g) at week 24. The study products demonstrated safe hematological and chemical profiles.\u0000 \u0000 \u0000 \u0000 RCT Fem™ UI supplementation resulted in significant and clinically meaningful reductions in UI severity, with corresponding improvements in daily urinary leakage volume and frequency of nocturia. PollenBerry® significantly improved stress-induced urinary leakage volume, suggesting that it may be efficacious in women who are prone to stress UI. The study products were safe and well tolerated in this population.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"36 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007770","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}
We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP). Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels. Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I 2 = 92%), 3 months (MD, 2.78, 95% CI, 0.53 to 5.02, p = 0.02, I 2 = 89%), 6 months (MD, 2.13, 95% CI, 1.11 to 3.15, p < 0.0001, I 2 = 87%), and 12 months (MD, 3.98, 95% CI, 2.06 to 5.89, p < 0.0001, I 2 = 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005). Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.
{"title":"A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization","authors":"Zhichao Wang, Zicheng Tan, Mengzhen Qiu, Longyang Zhang","doi":"10.1097/cu9.0000000000000247","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000247","url":null,"abstract":"\u0000 \u0000 \u0000 We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP).\u0000 \u0000 \u0000 \u0000 Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels.\u0000 \u0000 \u0000 \u0000 Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I\u0000 2 = 92%), 3 months (MD, 2.78, 95% CI, 0.53 to 5.02, p = 0.02, I\u0000 2 = 89%), 6 months (MD, 2.13, 95% CI, 1.11 to 3.15, p < 0.0001, I\u0000 2 = 87%), and 12 months (MD, 3.98, 95% CI, 2.06 to 5.89, p < 0.0001, I\u0000 2 = 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005).\u0000 \u0000 \u0000 \u0000 Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"52 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701414","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}
Pub Date : 2024-04-15DOI: 10.1097/cu9.0000000000000246
G. Mazzon, S. Ferretti, E. Serafin, Francesco Claps, Pietro Acquati, Davide Brusa, F. Germinale, G. Celentano, Andrea Pescuma, A. Fugini, D. Campobasso, U. Maestroni, G. Costa, T. Morena, Flavia Di Marco, A. Baudo, M. Creta, Nicola Pavan, M. Ticonosco, Angelo Peroni, D. Collura, M. Cerruto, Alessandro Antonelli, L. Carmignani, Salvatore Micali, Carlo Trombetta, G. Muto, A. Celia
The coronavirus disease (COVID-19) pandemic has posed challenges to the global health care community, affecting the management of upper urinary tract stones. This retrospective study involved 9 Italian centers. We compared the 12-month period prior to COVID-19 (March 1, 2019, to February 28, 2020; Period A) with the COVID-19 period (March 1, 2020, to February 28, 2021, Period B). This study aimed to compare outcomes during Periods A and B, specifically focusing on the overall number of treatments, rate of urgent/elective cases, and operational complexity. A total of 4018 procedures were collected, comprising 2176 procedures during Period A and 1842 during Period B, indicating a loss of 15.35% (p < 0.001). In the elective cases, 1622 procedures were conducted in Period A, compared with 1280 in Period B, representing a 21.09% reduction in cases (p = 0.001). All types of stone treatments were affected: extracorporeal shock wave lithotripsy (−29.37%, p = 0.001), percutaneous nephrolithotomy (−26.47%, p = 0.008), retrograde surgeries for renal stones (−10.63%, p = 0.008), and semirigid ureterolithotripsy (−24.86%, p = 0.008). Waiting lists experienced significant delays during Period B. The waiting time for elective procedures increased during Period B (p < 0.001). For ureteral stones, the mean waiting time in Period A was 61.44 days compared with 86.56 days in Period B (p = 0.008). The waiting time for renal stones increased from 64.96 days in Period A to 85.66 days in Period B for retrograde intrarenal surgery (p = 0.008) and from 96.9 days to 1103.9 days (p = 0.035) for percutaneous nephrolithotomy procedures. Our study demonstrates that COVID-19 significantly disrupted endourological services across the country. Our data underline how patients received treatment over a prolonged period, potentially increasing the risk of stone-related complications and patient discomfort.
{"title":"COVID-19 outbreak impact on urolithiasis treatments: A multicenter retrospective study across 9 urological centers","authors":"G. Mazzon, S. Ferretti, E. Serafin, Francesco Claps, Pietro Acquati, Davide Brusa, F. Germinale, G. Celentano, Andrea Pescuma, A. Fugini, D. Campobasso, U. Maestroni, G. Costa, T. Morena, Flavia Di Marco, A. Baudo, M. Creta, Nicola Pavan, M. Ticonosco, Angelo Peroni, D. Collura, M. Cerruto, Alessandro Antonelli, L. Carmignani, Salvatore Micali, Carlo Trombetta, G. Muto, A. Celia","doi":"10.1097/cu9.0000000000000246","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000246","url":null,"abstract":"\u0000 \u0000 \u0000 The coronavirus disease (COVID-19) pandemic has posed challenges to the global health care community, affecting the management of upper urinary tract stones.\u0000 \u0000 \u0000 \u0000 This retrospective study involved 9 Italian centers. We compared the 12-month period prior to COVID-19 (March 1, 2019, to February 28, 2020; Period A) with the COVID-19 period (March 1, 2020, to February 28, 2021, Period B). This study aimed to compare outcomes during Periods A and B, specifically focusing on the overall number of treatments, rate of urgent/elective cases, and operational complexity.\u0000 \u0000 \u0000 \u0000 A total of 4018 procedures were collected, comprising 2176 procedures during Period A and 1842 during Period B, indicating a loss of 15.35% (p < 0.001). In the elective cases, 1622 procedures were conducted in Period A, compared with 1280 in Period B, representing a 21.09% reduction in cases (p = 0.001). All types of stone treatments were affected: extracorporeal shock wave lithotripsy (−29.37%, p = 0.001), percutaneous nephrolithotomy (−26.47%, p = 0.008), retrograde surgeries for renal stones (−10.63%, p = 0.008), and semirigid ureterolithotripsy (−24.86%, p = 0.008). Waiting lists experienced significant delays during Period B. The waiting time for elective procedures increased during Period B (p < 0.001). For ureteral stones, the mean waiting time in Period A was 61.44 days compared with 86.56 days in Period B (p = 0.008). The waiting time for renal stones increased from 64.96 days in Period A to 85.66 days in Period B for retrograde intrarenal surgery (p = 0.008) and from 96.9 days to 1103.9 days (p = 0.035) for percutaneous nephrolithotomy procedures.\u0000 \u0000 \u0000 \u0000 Our study demonstrates that COVID-19 significantly disrupted endourological services across the country. Our data underline how patients received treatment over a prolonged period, potentially increasing the risk of stone-related complications and patient discomfort.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"69 s99","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699859","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}
Pub Date : 2024-04-12DOI: 10.1097/cu9.0000000000000240
Sergey Kravchick, S. Parekattil, Gennady Bratslavsky, M. Beamer, Robert Moldwin, Daniel Shulman, J. Nickel
Chronic scrotal content pain (CSCP) is a devastating condition characterized by localized scrotal pain that persists for ≥3 months and interferes with daily activities. Approximately 2.5% of all urology outpatient visits are associated with CSCP. General urologists may have difficulty treating these patients because of uncertainties regarding the etiology and pathophysiology of CSCP. Therefore, we aimed to provide a simplified diagnostic and treatment approach for CSCP by subdividing it into distinct categories. We systematically reviewed the published literature in the PubMed, MEDLINE, and Cochrane databases for all reports on CSCP diagnosis and treatment using the keywords “chronic scrotal content pain,” “testicular pain,” “orchialgia,” “testicular pain syndrome,” “microdenervation of the spermatic cord,” “post-vasectomy pain syndrome,” “post-inguinal hernia repair pain,” “testialgia,” and “pudendal neuralgia.” This review included only CSCP-related articles published in English language. We subdivided CSCP syndrome into 5 clinical presentation types, including hyperactive cremasteric reflex, pain localized in the testicles, pain in the testis, spermatic cord, and groin, pain localized in the testicles, spermatic cord, groin, and pubis, and pain in the testicles, spermatic cord/groin, and penis/pelvis. Treatments were adjusted stepwise for each type and section. We included more information regarding the role of pudendal neuroglia in CSCP syndrome and discussed more options for nerve blocks for CSCP. For microsurgical spermatic cord denervation failure, we included treatment options for salvage ultrasound-guided targeted cryoablation, Botox injections, and posterior-inferior scrotal denervation. Different CSCP subtypes could help general urologists assess the appropriate diagnostic and treatment approaches for scrotal pain management in daily practice.
{"title":"A simplified treatment algorithm for chronic scrotal content pain syndrome","authors":"Sergey Kravchick, S. Parekattil, Gennady Bratslavsky, M. Beamer, Robert Moldwin, Daniel Shulman, J. Nickel","doi":"10.1097/cu9.0000000000000240","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000240","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic scrotal content pain (CSCP) is a devastating condition characterized by localized scrotal pain that persists for ≥3 months and interferes with daily activities. Approximately 2.5% of all urology outpatient visits are associated with CSCP. General urologists may have difficulty treating these patients because of uncertainties regarding the etiology and pathophysiology of CSCP. Therefore, we aimed to provide a simplified diagnostic and treatment approach for CSCP by subdividing it into distinct categories.\u0000 \u0000 \u0000 \u0000 We systematically reviewed the published literature in the PubMed, MEDLINE, and Cochrane databases for all reports on CSCP diagnosis and treatment using the keywords “chronic scrotal content pain,” “testicular pain,” “orchialgia,” “testicular pain syndrome,” “microdenervation of the spermatic cord,” “post-vasectomy pain syndrome,” “post-inguinal hernia repair pain,” “testialgia,” and “pudendal neuralgia.” This review included only CSCP-related articles published in English language.\u0000 \u0000 \u0000 \u0000 We subdivided CSCP syndrome into 5 clinical presentation types, including hyperactive cremasteric reflex, pain localized in the testicles, pain in the testis, spermatic cord, and groin, pain localized in the testicles, spermatic cord, groin, and pubis, and pain in the testicles, spermatic cord/groin, and penis/pelvis. Treatments were adjusted stepwise for each type and section. We included more information regarding the role of pudendal neuroglia in CSCP syndrome and discussed more options for nerve blocks for CSCP. For microsurgical spermatic cord denervation failure, we included treatment options for salvage ultrasound-guided targeted cryoablation, Botox injections, and posterior-inferior scrotal denervation.\u0000 \u0000 \u0000 \u0000 Different CSCP subtypes could help general urologists assess the appropriate diagnostic and treatment approaches for scrotal pain management in daily practice.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"25 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711560","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}
Pub Date : 2024-02-29DOI: 10.1097/cu9.0000000000000241
Danny Darlington Carbin, Matthew J.A. Perry, W. Abou Chedid
Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.
{"title":"Robotic excision of a giant seminal vesicle cyst","authors":"Danny Darlington Carbin, Matthew J.A. Perry, W. Abou Chedid","doi":"10.1097/cu9.0000000000000241","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000241","url":null,"abstract":"\u0000 Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414503","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}
Pub Date : 2024-02-12DOI: 10.1097/cu9.0000000000000237
Tiejun Pan
{"title":"Diagnosis and treatment of pelvic organ prolapse complicated with stress urinary incontinence: A Chinese expert consensus","authors":"Tiejun Pan","doi":"10.1097/cu9.0000000000000237","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000237","url":null,"abstract":"","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139964878","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}
Pub Date : 2024-01-11DOI: 10.1097/cu9.0000000000000235
N. O’Sullivan, Hugo C. Temperley, Alison Corr, J. F. Meaney, Peter E. Lonergan, Michael E Kelly
Radiomics refers to the conversion of medical images into high-throughput, quantifiable data to analyze disease patterns, aid decision-making, and predict prognosis. Radiogenomics is an extension of radiomics and involves a combination of conventional radiomics techniques with molecular analysis in the form of genomic and transcriptomic data. In the field of bladder cancer, studies have investigated the development, implementation, and efficacy of radiomic and radiogenomic nomograms in predicting tumor grade, gene expression, and oncological outcomes, with variable results. We aimed to perform a systematic review of the current literature to investigate the development of a radiomics-based nomogram to predict oncological outcomes in bladder cancer. The Medline, EMBASE, and Web of Science databases were searched up to February 17, 2023. Gray literature was also searched to further identify other suitable publications. Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Radiomics Quality Score. Radiogenomic nomograms generally had good performance in predicting the primary outcome across the included studies. The median area under the curve, sensitivity, and specificity across the included studies were 0.83 (0.63–0.973), 0.813, and 0.815, respectively, in the training set and 0.75 (0.702–0.838), 0.723, and 0.652, respectively, in the validation set. Several studies have demonstrated the predictive potential of radiomic and radiogenomic models in advanced pelvic oncology. Further large-scale studies in a prospective setting are required to further validate results and allow generalized use in modern medicine.
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Pub Date : 2024-01-08DOI: 10.1097/cu9.0000000000000222
Ashish A. Kumar
Prostate cancer (PC) is the most frequently diagnosed cancer and second leading cause of cancer-related deaths in men. It is heterogeneous, as is evident from the wide spectrum of therapeutic approaches. Most patients with PC are initially responsive to androgen deprivation therapy; however, the majority of cases are either hormone-sensitive PC or castration-resistant PC. Current therapeutic protocols follow the evolution of PC, a continuously progressive process involving a combination of widespread genomic alterations. These genomic alterations are either hereditary germline mutations, such as mutations in BRCA2, or specific only to tumor cells (somatic). Tumor-specific genomic spectra include genomic structural rearrangements, canonical androgen response genes, and many other specific genes such as TMPRSS2-ERG fusion, SPOP/FOXA1, TP53/RB1/PTEN, and BRCA2. New evidence indicates the involvement of signaling pathways including PI3K, WNT/β-catenin, SRC, and IL-6/STAT, which have been shown to promote epithelial-mesenchymal transition cancer stem cell–like features/stemness, and neuroendocrine differentiation in PC. Over the last decade, our understanding of the genotype-phenotype relationships has been enhanced considerably. The genetic background of PC related to canonical genetic alterations and signaling pathway activation genes has shed more insight into the molecular subtype and disease landscape, resulting in a more flexible role of individual therapies targeting diverse genotypes and phenotypes.
前列腺癌（PC）是最常诊断出的癌症，也是导致男性癌症相关死亡的第二大原因。前列腺癌的种类繁多，治疗方法也多种多样。大多数前列腺癌患者最初对雄激素剥夺疗法有反应，但大多数病例要么是激素敏感型前列腺癌，要么是阉割耐药型前列腺癌。目前的治疗方案遵循 PC 的演变过程，这是一个持续进展的过程，涉及广泛的基因组改变。这些基因组改变要么是遗传性种系突变（如 BRCA2 基因突变），要么是肿瘤细胞特异性基因组改变（体细胞改变）。肿瘤特异性基因组谱包括基因组结构重排、典型雄激素反应基因以及许多其他特异性基因，如 TMPRSS2-ERG 融合基因、SPOP/FOXA1、TP53/RB1/PTEN 和 BRCA2。新的证据表明，包括 PI3K、WNT/β-catenin、SRC 和 IL-6/STAT 在内的信号通路参与了 PC 的上皮-间质转化、癌症干细胞样特征/干性和神经内分泌分化。在过去的十年中，我们对基因型与表型关系的认识有了很大的提高。与典型基因改变和信号通路激活基因有关的 PC 遗传背景使我们对分子亚型和疾病状况有了更深入的了解，从而使针对不同基因型和表型的个体疗法发挥更灵活的作用。
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