Minerva Urology and Nephrology最新文献

Introduction: Interstitial cystitis/bladder pain syndrome is a chronic bladder condition with a rising incidence that significantly impacts the lives of millions worldwide. The lack of understanding regarding the pathophysiology of this condition has resulted in a deficiency of effective treatment options. However, the development of regenerative medicine has brought platelet-rich plasma into our field of vision. Platelet-rich plasma may address unresolved inflammation in the interstitial cystitis/bladder pain syndrome bladder and facilitate the restoration of bladder and urethral barrier function through repeated injections, potentially reducing bladder pain. Our aim is to investigate the efficacy and safety of intravesical injection of platelet rich plasma in the treatment of interstitial cystitis/bladder pain syndrome.

Evidence acquisition: A comprehensive search was conducted across PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science databases for studies on platelet-rich plasma injection for the treatment of interstitial cystitis/bladder pain syndrome, with a search cutoff date of August 7, 2024.

Evidence synthesis: A total of 11 studies with 391 participants were included. The combined statistics indicated that the baseline interstitial cystitis symptom index score was 11.20±4.60, the interstitial cystitis problem index score was 10.81±3.51, and the pain score was 4.37±3.14. The results showed that compared to pre-treatment, the interstitial cystitis symptom index score decreased by 3.56 (95% CI -4.39 to -2.72, P<0.00001), the interstitial cystitis problem index score decreased by 3.24 (95% CI -3.90 to -2.58, P<0.00001), and the pain score decreased by 1.84 (95% CI -2.19 to -1.48, P<0.00001). Additionally, the average proportion of patients with a global response assessment score of ≥2 after treatment was 48% (95% CI 0.37 to 0.58, P<0.00001). Furthermore, the overall incidence of adverse events among patients was 2.9%.

Conclusions: Evidence-based statistical analysis results suggest that intravesical platelet-rich plasma treatment is effective and safe, potentially serving as a promising approach for managing interstitial cystitis/bladder pain syndrome.

Background: Prostate cancer (PCa) is the second most prevalent cancer globally and a major cause of disability and mortality. Survival rates heavily depend on the stage at which the disease is diagnosed, with substantial geographical variations in the burden of the disease.

Methods: The Global Burden of Disease (GBD) Study 2021 provides detailed national and subnational estimates for the burden of PCa in Italy. This study reports incident cases and age-standardized incidence rates (ASIR), deaths and age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs) and age-standardized DALYs rates (ASDR), as well as the average annual rate of change (ARC). The PCa-related survival is investigated using the mortality-to-incidence ratio (MIR) for 1990 and 2021. Italian estimates were compared with Global and High-middle Socio-Demographic Index (SDI) countries.

Results: GBD 2021 estimated 39,016 new PCa cases, 10,662 deaths, and 173,048 DALYs for Italy in 2021. The average ARC for ASIR was 0.14, while the average ARC for ASMR and ASDR were -0.29 and -0.31, respectively. MIR dropped from 38.0 in 1990 to 23.8 in 2021. At the subnational level, ASIR increased in seven regions, with no regions showing a decrease, while ASMR and ASDR fell significantly in 17 regions. Italy outperformed both global and high-middle SDI countries in reducing PCa mortality and improving survival rates.

Conclusions: PCa remains a critical health issue in Italy. The reduction in ASMR and ASDR indicates progress in early diagnosis and treatment. However, subnational disparities in incidence and mortality highlight the need for targeted healthcare interventions.

Background: In the evolving landscape of nephron-sparing surgery (NSS), the role of minimally invasive redo partial nephrectomy (rMIPN) for solitary renal cancer recurrence (RCR) remains debated, particularly considering its technical demands and perioperative risks. In this dual-institutional study, we aimed to investigate long-term perioperative, oncologic, and functional outcomes of rMIPN, comparing off- versus on-clamp hilar strategies.

Methods: Two prospectively maintained renal cancer databases were queried for patients undergoing rMIPN for ipsilateral solitary RCR between January 2004 and October 2024. Sixty-three patients were included and stratified by hilar control: off-clamp (Group A, N.=41) versus on-clamp (Group B, N.=22). Baseline, surgical, pathological, and renal functional outcomes were compared. Kaplan-Meier analysis assessed overall survival (OS), cancer-specific survival (CSS), and progression to CKD stage ≥3b.

Results: Baseline and perioperative characteristics were comparable between groups (all P>0.01). Overall complication rates were 19.5% and 22.7% (P=0.12), respectively; major complications occurred in 4.9% and 9.1% (P=0.6). Group A exhibited more advanced tumor stage at index NSS (P=0.001). Clear cell renal cell carcinoma predominated in Group B (P<0.001). At a median follow-up of 51 months, OS, CSS, and renal function endpoints were similar (all P>0.3).

Conclusions: Hilar control technique did not significantly influence outcomes following rMIPN. Within the demanding scenario of solitary ipsilateral recurrence, surgical judgment and tailored planning remain essential to preserve function while maintaining oncologic safety at long-term follow-up.

This article was published in Volume 77, issue 1 of publishing year 2025, with a mistake in the "Conflicts of interest", "Funding" and "Acknowledgements" sections. The correct sections are the ones included in this erratum.