Arab Journal of Urology最新文献

Objectives: To present a case of foreign body granuloma (FBG) development after injection of calcium hydroxylapatite as a urethral bulking agent and to review all documented cases of this phenomenon in the literature.

Methods: We analyzed a new case of calcium hydroxylapatite-induced FBG. We also conducted a literature review of the PubMed, Embase, CINAHL, and Web of Science databases through March 2022. Reports were included if they contained stress urinary incontinence patients that developed an FBG after calcium hydroxylapatite injection. The cases were reviewed for presenting symptoms, patient demographics, granuloma details, and surgical treatment.

Results: We screened 250 articles and included six articles between 2006 and 2015 in addition to the present case. The median age of the patients was 65.5 years (range 45-93), and all patients were female. The most common presenting symptoms and the proportion of patients affected were difficulty voiding (4/8), recurrent urinary incontinence (3/8), and dyspareunia (2/8). The median time between the first CaHA injection and discovery of the FBG was 5 months (range 1-50). The median longest dimension of the FBGs was 1.85 cm (range 1.0-3.0). The 8 masses observed were evenly distributed throughout the urethra, with 3 in the bladder neck, 2 in the midurethra, and 3 in the distal urethra. Surgical excision was the predominant management choice, with some variation in technique.

Conclusions: Severe, persistent lower urinary tract symptoms after calcium hydroxylapatite injection may indicate an FBG, which has been successfully managed with surgical excision.

Objectives: The objective of our study is to discover and evaluate the effects of repeated intralesional injections inside the tunica albuginea of platelet-rich plasma (PRP) in the treatment of Peyronie's disease (PD).

Methods: As part of a prospective study over 12 months from February 2020 until February 2021, on Sixty-five patients with Peyronie's disease, and penile curvature between 25 and 45°. Patients were stratified into two groups, the first with a curvature between 25 and 35° and the second between 35 and 45°. Gathered data included patient-demographics, Injection technique, outcomes: both quantitative (curvature assessments) and qualitative (state of erectile function, pain during intercourse), and complications.

Results:

Patients in both groups received an average of 6.1 injections of PRP during the study period. Angulation was significantly improved in both groups an average final improvement of 16.88° (SD = 3.35) (p < 0.001) in the first group and 17.27° (SD = 4.22) (p < 0.001) in the second group. Pain during sex decreased from 70.7% to 34.25%, and 55.5% of patients had easier sexual intercourse.

Conclusions:

The positive results of our series of treatment for Peyronie's disease by injection of platelet-rich plasma are encouraging both methodologically (simplicity) and clinical (safety and efficacy) as well as patient satisfaction.

Background: To date, no previous research assessed the bibliometrics of men's sexual and reproductive healthcare (SRHC) across Arab countries. This study appraised the current standing of men's SRHC research in the MENA (Middle East and North Africa) region.

Methods: We performed a bibliometric analysis to assess qualitatively and quantitatively the peer-reviewed articles published from Arab countries from inception to 2022. In addition, we conducted a visualization analysis, and assessed outputs, trends, shortcomings and hotspots over the given time period.

Results: There was a generally low numbers of publications, 98 studies were identified, all with cross-sectional design, and two thirds explored prevention and control of HIV/other STDs. Studies were published in 71 journals, of which the Eastern Mediterranean Health Journal, Journal of Egyptian Public Health Association, AIDS Care and BMC public health were most common. The Journal of Adolescent Health, Fertility Sterility and Journal of Cancer Survivorship were among the highest IF ranking. Publishers were commonly USA or UK-based, median journal IF was 2.09, and five articles were in journals of IF > 4. Saudi Arabia had the highest published output followed by Egypt, Jordan and Lebanon, while 10 Arab countries had no publications on the topic. Corresponding authors expertise fields were most commonly public health, infectious diseases and family medicine). Collaborations in-between MENA countries were notably low.

Conclusions: There is general paucity of published outputs on SRHC. More research across MENA is needed, with more inter-MENA collaborations, and with inclusion of countries that currently have no outputs on SRHC. In order to accomplish such goals, R&D funding and capacity building are required. Research and published outputs should address SRHC burdens.

Objective: We appraised the reporting quality of abstracts of systematic reviews/meta-analyses (SR/MAs) published in one urology journal and explored associations between abstract characteristics and completeness of reporting.

Methods: The Arab Journal of Urology (AJU) was searched for SR/MAs published between January 2011 and 31 May 2022. SR/MAs with structured abstract and quantitative synthesis were eligible. Two reviewers simultaneously together selected the SR/MAs by title, screened the abstracts, and included those based on inclusion/exclusion criteria. Data of a range of characteristics were extracted from each SR/MAs into a spreadsheet. To gauge completeness of reporting, the PRISMA-Abstract checklist (12 items) was used to appraise the extent to which abstracts adhered to the checklist. For each abstract, we computed item, section, and overall adherence. Chi-square and t-tests compared the adherence scores. Univariate and multivariate analyses identified the abstract characteristics associated with overall adherence.

Results: In total, 66 SR/MAs published during the examined period; 62 were included. Partial reporting was not uncommon. In terms of adherence to the 12 PRISMA-A items were: two items exhibited 100% adherence (title, objectives); five items had 80% to <100% adherence (interpretation, included studies, synthesis of results, eligibility criteria, and information sources); two items displayed 40% to <80% adherence (description of the effect, strengths/limitations of evidence); and three items had adherence that fell between 0% and 1.6% (risk of bias, funding/conflict of interest, registration). Multivariable regression revealed two independent predictors of overall adherence: single-country authorship (i.e. no collaboration) was associated with higher overall adherence (P = 0.046); and abstracts from South America were associated with lower overall adherence (P = 0.04).

Conclusion: This study is the first to appraise abstracts of SR/MAs in urology. For high-quality abstracts, improvements are needed in the quality of reporting. Adoption/better adherence to PRISMA-A checklist by editors/authors could improve the reporting quality and completeness of SR/MAs abstracts.

Background: Healthcare system costs associated with bladder cancer treatment are among the highest of curable malignancies, and prognosis in advanced disease remains poor. This scoping review examines the worldwide status of bladder cancer research by systematically mapping publications, exploring research topics, support, gaps and limitations that need to be addressed.

Methods: We searched the Web of Science database for publications using controlled vocabulary. Results were limited between 2000-2020, and were included in our study based on pre-specified eligibility criteria. Data used for analysis included author's names, country of affiliation, language, journal, citations, and funding. Analysis was conducted using Biblioshiny R and SPSS. Research topics were identified according to sub-filters of title words and strings pre-determined by authors.

Results: 40,657 results were retrieved, of which 19,976 original articles and reviews met the pre-specified criteria. 92% of the publications originated from 20 countries and were included in the analysis. Trends show an increase across the world, most of which is due to increasing contributions from USA and China. An increase by 1000% in funded publications has been achieved. Studies focused on Surgery, Pathology, and Diagnosis, while Radiotherapy, Palliative care, quality of life and Epidemiology were the least described. Genetics had the most increase while being the most funded. GDP, incidence, prevalence and mortality were each significantly positively correlated with overall bladder cancer research output.

Conclusion: This review described the evolution of bladder cancer research. It also identified significant gaps and limitations that need to be highlighted as priority areas for research investment.

Objectives: To develop and validate an Arabic version of the pediatric lower urinary tract symptom score (PLUTSS).

Methods: The linguistic translation of the PLUTSS into Arabic was carried out by following the guidelines that have been set out for cross-cultural adaptation of health-related QoL measures (Translation, Reconciliation, Retranslation, Review of retranslation, Debriefing and final review). The questionnaires were applied to 80 patients, 40 patients seeking urology clinic for lower urinary tract symptoms (LUTS) and 40 patients visiting a pediatric clinic without urological compliant. The discrimination validity and strength of association were tested using Mann-Whitney and chi-square tests. Reliability of translation was tested for internal consistency using the Cronbach's α and ROC Curve was used to evaluate the ability of the questionnaire to discriminate between cases and controls.

Results: Patients with LUTS had a higher PLUTSS score and QoL score than controls (P < 0.001). The value of Cronbach's alpha of the 13 items (excluding Qol) evaluated on the scale was 0.717 (95% CI: 0.616-0.800). The ROC curve determined the ability of the questionnaire to discriminate between cases and controls where the area under the curve was 0.901 (95% CI: 0.830-0.972).

Conclusion: The Arabic translated version of the PLUTSS is an acceptable and reliable tool for assessing and evaluating pediatric patients with LUTS in Arabic-speaking countries.

Objective: To assess safety and efficacy of hyaluronic acid (HA) gel injection in glans penis for treatment of premature ejaculation (PE) using our new five puncture technique.

Patients and methods: This is a prospective, non-randomized clinical trial on HA gel injection in glans penis for all patients with lifelong PE; all patients were circumcised having heterosexual normal marital life and sexually active. Patients with history of ejaculatory medication use within the previous 3 months, psychiatric disorders, erectile dysfunction, lower urinary tract symptoms (LUTS) due to prostatitis and acquired PE were excluded from the study. A local anesthetic was applied to the skin of glans penis for 30 minutes before the injection of 2 ml HA in glans penis via 30-gauge needle using our new Five-puncture technique. Intra-vaginal ejaculatory latency time (IELT) was measured at 1, 3, 6 and 12 months after injection.

Results: Thirty patients completed our study follow up schedule. Mean age of the patients was 41.72 ± 8.50, while mean age of female partner was 37.23 ± 8.54 years. IELT was highly significantly increased (P-value < 0.001) after HA gel injection from baseline, which was in maximum 37.83 ± 11.01 sec at baseline to 323.03 ± 42.06, 281.07 ± 41.05, 241.03 ± 43.09 and 235.6 ± 41.87 sec after 1, 3, 6 and 12 months, respectively, after injection. Three patients complained from discomfort at the site of injection, two from bullae formation at the site of injection and one from ecchymosis, and all resolved spontaneously after 1 week to 10 days after injection.

Conclusion: HA gel injection in glans penis using our new five-puncture technique is a safe and effective method that ensures a modest long-term significant increase in IELT and improves ejaculatory control.

Objective: To assess differences in the distribution of type and number of D'Amico high-risk criteria (DHRCs) according to race/ethnicity (R/E) and their effect on cancer-specific mortality (CSM) in prostate cancer (PCa) patients treated with external beam radiotherapy (RT).

Methods: In the SEER database (2004-2016), we identified 31,002 PCa patients treated with RT with at least one DHRCs, namely PSA >20 ng/dL, biopsy Gleason Grade Group 4-5, and clinical T stage ≥T2c. Competing risks regression (CRR) model tested the association between DHRCs and 5-year CSM in all R/E subgroups.

Results: Of 31,002 patients, 20,894 (67%) were Caucasian, 5256 (17%) were African American, 2868 (9.3%) were Hispanic-Latino, and 1984 (6.4%) were Asian. The distributions of individual DHRCs and combinations of two DHRCs differed according to R/E, but not for the combination of three DHRCs. The effect related to the presence of a single DHRC, and combinations of two or three DHRCs on absolute CSM rates was lowest in Asians (1.2-6.8%), followed by in African Americans (2.3-12.2%) and Caucasians (2.3-12.1%), and highest in Hispanic/Latinos (1.7-13.8%). However, the opposite effect was observed in CRR, where hazard ratios were highest in Asians vs. other R/Es: Asians 1.00-2.59 vs. others 0.5-1.83 for one DHRC, Asians 3.4-4.75 vs. others 0.66-3.66 for two DHRCs, and Asians 7.22 vs. others 3.03-4.99 for all three DHRCs.

Conclusions: R/E affects the proportions of DHRCs. Moreover, within the four examined R/E groups, the effect of DHRCs on absolute and relative CSM metrics also differed. Therefore, R/E-specific considerations may be warranted in high-risk PCa patients treated with RT.

Objective: to evaluate the effect of bacterial colonization on ureteral stent-associated morbidity.

Methods: This was a prospective study that took place between February 2019 and March 2022. We examined one hundred fifteen patients for ureteric stents application. On the same day of stent removal, the Arabic version of Ureteral Stent Symptoms Questionnaire (USSQ) was used to assess stent-associated morbidity. The stent-associated morbidity and the specificity and sensitivity of culture in the stent and midstream urine were recorded.

Results: In 15.6% of the patients stent colonization was positive; E. coli was the most common isolated organism. There was no statistically significant difference between sex, age, irrigation fluid volume and duration of operation for stent colonization. However, stent indwelling time was significantly higher in patients with stents with positive cultures. In the colonized stents, there was a statistically significant difference with regards to the total score of USSQ, pain, urinary symptoms, work performance and additional problems of USSQ. Meanwhile, there was no statistically significant difference in the general health and sexual matter.

Conclusions: stent colonization may be a contributing factor in stent-related morbidity. Stent bacterial colonization increases with the time of stent retention. Stent cultures are not needed as the same microorganisms are detected in urine cultures.

Background: Benign prostatic hyperplasia is the most common cause of urinary retention in men (BPH). The gold standard surgical treatment is transurethral resection of the prostate (TURP). However, due to the morbidity and mortality associated with TURP, more minimally invasive treatments, such as vaporizing the prostate with the Rezum system, have been introduced. We investigated the efficacy of Rezum in the treatment of refractory urinary retention due to BPH in this review.

Methodology and materials: To conduct this review, the Cochrane methodology for systematic reviews was used. All studies that used Rezum to treat catheter-dependent patients with enlarged prostates were included. The literature search showed 111 studies, 84 of which were excluded due to non-relevance based on titles and 18 due to lack of relevance based on abstract review. Full manuscripts were reviewed in nine studies, three of which were excluded because they did not meet the inclusion criteria.

Results: This review included 301 patients in total. The rate of a successful trial of voiding post Rezum therapy was 85%. The complication rated between 3.8 and 4.3% all of which were mild and self-limited. As there was no major complication of Rezum (clavien dindo >2), the procedure-related morbidity is negligible.

Conclusion: In this review, Rezum was found to be an efficacious and safe alternative in the treatment of refractory retention with mild complications and minimal morbidity.