Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2152237
Hussein Awada, Adel Hajj Ali, Mohammad A Zeineddine, Hasan Nassereldine, Zahy Abdul Sater, Deborah Mukherji
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.
背景:与膀胱癌治疗相关的医疗保健系统费用是可治愈的恶性肿瘤中最高的,并且晚期疾病的预后仍然很差。通过系统地绘制出版物、探索研究主题、支持、差距和需要解决的限制,本综述审查了膀胱癌研究的全球现状。方法:检索Web of Science数据库中使用控制词汇的出版物。结果限定在2000-2020年之间,并根据预先指定的资格标准纳入我们的研究。用于分析的数据包括作者姓名、所属国家、语言、期刊、引文和资助。采用Biblioshiny R和SPSS进行分析。根据作者预先确定的标题词和字符串的子过滤器识别研究主题。结果:检索到40,657个结果,其中19,976篇原创文章和综述符合预设标准。92%的出版物来自20个国家,并被纳入分析。趋势显示全球范围内的增长,其中大部分是由于美国和中国的贡献增加。获得资助的出版物增加了1000%。研究集中于手术、病理和诊断,而放疗、姑息治疗、生活质量和流行病学的描述最少。遗传学的增长幅度最大,同时也获得了最多的资助。GDP、发病率、患病率和死亡率均与膀胱癌总体研究成果呈显著正相关。结论:本文综述了膀胱癌的研究进展。它还确定了需要强调的重大差距和限制,作为研究投资的优先领域。
{"title":"The status of bladder cancer research worldwide, a bibliometric review and recommendations.","authors":"Hussein Awada, Adel Hajj Ali, Mohammad A Zeineddine, Hasan Nassereldine, Zahy Abdul Sater, Deborah Mukherji","doi":"10.1080/2090598X.2022.2152237","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2152237","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2108190
Amr Al-Najar, Ibrahim Al-Nadhari, Sami Basabih, Fawaz Alobathani, Cem Akbal
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.
{"title":"Arabic translation and validation of pediatric lower urinary tract symptom score (PLUTSS).","authors":"Amr Al-Najar, Ibrahim Al-Nadhari, Sami Basabih, Fawaz Alobathani, Cem Akbal","doi":"10.1080/2090598X.2022.2108190","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2108190","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate an Arabic version of the pediatric lower urinary tract symptom score (PLUTSS).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2148867
Francesco Chierigo, Rocco Simone Flammia, Gabriele Sorce, Benedikt Hoeh, Lukas Hohenhorst, Andrea Panunzio, Zhe Tian, Fred Saad, Markus Graefen, Michele Gallucci, Alberto Briganti, Francesco Montorsi, Felix K H Chun, Shahrokh F Shariat, Alessandro Antonelli, Giovanni Guano, Guglielmo Mantica, Marco Borghesi, Nazareno Suardi, Carlo Terrone, Pierre I Karakiewicz
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.
{"title":"Racial/ethnic disparities in the distribution and effect of type and number of high-risk criteria on mortality in prostate cancer patients treated with radiotherapy.","authors":"Francesco Chierigo, Rocco Simone Flammia, Gabriele Sorce, Benedikt Hoeh, Lukas Hohenhorst, Andrea Panunzio, Zhe Tian, Fred Saad, Markus Graefen, Michele Gallucci, Alberto Briganti, Francesco Montorsi, Felix K H Chun, Shahrokh F Shariat, Alessandro Antonelli, Giovanni Guano, Guglielmo Mantica, Marco Borghesi, Nazareno Suardi, Carlo Terrone, Pierre I Karakiewicz","doi":"10.1080/2090598X.2022.2148867","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2148867","url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2023.2178104
Ibrahim A Khalil, Maya Aldeeb, Ahmed Mohammed, Khalid Awad, Tarek Ibrahim, Raed M Al-Zoubi, Omar M Aboumarzouk, Khalid Al-Rumaihi
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.
{"title":"The role of Rezum in the management of refractory urinary retention due to benign prostate hyperplasia: A literature review.","authors":"Ibrahim A Khalil, Maya Aldeeb, Ahmed Mohammed, Khalid Awad, Tarek Ibrahim, Raed M Al-Zoubi, Omar M Aboumarzouk, Khalid Al-Rumaihi","doi":"10.1080/2090598X.2023.2178104","DOIUrl":"https://doi.org/10.1080/2090598X.2023.2178104","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methodology and materials: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2164124
Mohamed Samir, Mahmoud Ahmed Mahmoud, Ahmed Tawfick
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.
{"title":"Does bacterial colonization influence ureteral stent-associated morbidity? A prospective study.","authors":"Mohamed Samir, Mahmoud Ahmed Mahmoud, Ahmed Tawfick","doi":"10.1080/2090598X.2022.2164124","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2164124","url":null,"abstract":"<p><strong>Objective: </strong>to evaluate the effect of bacterial colonization on ureteral stent-associated morbidity.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2023.2202930
Mohamed Awad, Ahmed M Harraz, Hashim Farg, Hady S Gabr, Doaa E Sharaf, Mohamed Abou-El-Ghar, Ahmed S El-Hefnawy, Yasser Osman
Purpose: Cystoscopy (rigid/flexible [FC]) is the standard surveillance tool for non-muscle invasive bladder cancer (NMIBC). Nevertheless, it has its drawbacks. The objective of this study is to evaluate the performance of microscopic hematuria (MH), abdominal ultrasonography (US), and urine cytology (UC) as potential substitutes for FC in patients with T1-low-grade (T1-LG) NMIBC.
Methods: Over a 12-month period, patients attending our tertiary referral center for T1-LG NMIBC follow-up underwent urine analysis for MH and UC, and then US and FC were performed as outpatient surveillance procedures. Those with positive findings underwent inpatient rigid cystoscopy under anesthesia and biopsy. The negative predictive values (NPV) and sensitivity of different combinations of MH, UC, US, and FC were compared with the standard histopathology.
Results: In 218 evaluated patients, FC had the highest NPV (97.9%). However, this figure showed no statistically significant difference if compared with the combination of negative MH and US (93.8%) (difference = 0.04, p = 0.1) or the combination of MH, US, and UC (94.9%) (difference = 0.03, p = 0.2). The reported sensitivity results were similarly comparable between FC (94.2%) and the aforementioned combinations (90.4% and 92.3%; differences: 0.038 and 0.019; p = 0.4 and 0.7, respectively).
Conclusions: During the surveillance of NMIBC for patients diagnosed with T1-LG disease, the combination of MH/US has comparable sensitivity and NPV with FC. This non-invasive combination could be considered the first station that might preclude the need for FC in a considerable percentage of this group of patients.
{"title":"Microscopic hematuria and pelvic ultrasonography could rule out flexible cystoscopy during surveillance for T1-low grade non-muscle invasive bladder cancer.","authors":"Mohamed Awad, Ahmed M Harraz, Hashim Farg, Hady S Gabr, Doaa E Sharaf, Mohamed Abou-El-Ghar, Ahmed S El-Hefnawy, Yasser Osman","doi":"10.1080/2090598X.2023.2202930","DOIUrl":"https://doi.org/10.1080/2090598X.2023.2202930","url":null,"abstract":"<p><strong>Purpose: </strong>Cystoscopy (rigid/flexible [FC]) is the standard surveillance tool for non-muscle invasive bladder cancer (NMIBC). Nevertheless, it has its drawbacks. The objective of this study is to evaluate the performance of microscopic hematuria (MH), abdominal ultrasonography (US), and urine cytology (UC) as potential substitutes for FC in patients with T1-low-grade (T1-LG) NMIBC.</p><p><strong>Methods: </strong>Over a 12-month period, patients attending our tertiary referral center for T1-LG NMIBC follow-up underwent urine analysis for MH and UC, and then US and FC were performed as outpatient surveillance procedures. Those with positive findings underwent inpatient rigid cystoscopy under anesthesia and biopsy. The negative predictive values (NPV) and sensitivity of different combinations of MH, UC, US, and FC were compared with the standard histopathology.</p><p><strong>Results: </strong>In 218 evaluated patients, FC had the highest NPV (97.9%). However, this figure showed no statistically significant difference if compared with the combination of negative MH and US (93.8%) (difference = 0.04, <i>p</i> = 0.1) or the combination of MH, US, and UC (94.9%) (difference = 0.03, <i>p</i> = 0.2). The reported sensitivity results were similarly comparable between FC (94.2%) and the aforementioned combinations (90.4% and 92.3%; differences: 0.038 and 0.019; <i>p</i> = 0.4 and 0.7, respectively).</p><p><strong>Conclusions: </strong>During the surveillance of NMIBC for patients diagnosed with T1-LG disease, the combination of MH/US has comparable sensitivity and NPV with FC. This non-invasive combination could be considered the first station that might preclude the need for FC in a considerable percentage of this group of patients.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2146835
Abdelqawey Yousef, Salah Nagla, Mohamed Fathy, Mohamed Negm
Introduction: Improper penile assessment, together with carrying out circumcision by an inexperienced person, results in major complications. One of the complex complications is the complete or sub-complete penile skin loss, which in many cases, necessitates one or staged repair.
Purpose: To evaluate modified one-stage bilateral anterolateral scrotal-based flaps to compensate for penile skin loss after circumcision.
Methods: This study was performed on patients with almost penile skin loss after circumcision from February 2013 to July 2021. In all cases, one-stage modified bilateral anterolateral scrotal skin flaps were used to compensate for penile skin loss. The modification includes scrotal skin flap fashioning in a novel way, in addition to the use of penodermal fixation sutures at the penoscrotal junction, to create a stable penoscrotal junction and new penile skin coverage. Patients were discharged from the hospital on the same day of surgery. The dressing was left for 5 days. Follow-up visits were scheduled weekly in the first month, 3 and 6 months later, then annually.
Results: Forty-six children were included in this study. Their mean age was 4.5 ± 1.5 years. The mean operative time was 139.6 ± 11.5 min. No flap ischemia or necrosis was reported. One case (2.2%) developed a scrotal hematoma managed conservatively. Three (6.5%) cases presented with wound dehiscence at the penoscrotal angle. Three (6.5%) cases had self-limited penile edema. Two (4.3%) cases had dorsal midline hypertrophic scar; one improved after treatment with triamcinolone acetonide ointment, and the other needed scar revision. The mean follows up was 23.33 ± 9.13 months.
Conclusion: The modified scrotal skin flap technique provides a good substitution for stable penile skin coverage and a one-stage reconstruction of penile skin loss. It results in good parents' satisfaction with acceptable complications.
{"title":"Post-circumcision penile skin loss: reporting the outcome of one-stage anterolateral scrotal based flaps in children.","authors":"Abdelqawey Yousef, Salah Nagla, Mohamed Fathy, Mohamed Negm","doi":"10.1080/2090598X.2022.2146835","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2146835","url":null,"abstract":"<p><strong>Introduction: </strong>Improper penile assessment, together with carrying out circumcision by an inexperienced person, results in major complications. One of the complex complications is the complete or sub-complete penile skin loss, which in many cases, necessitates one or staged repair.</p><p><strong>Purpose: </strong>To evaluate modified one-stage bilateral anterolateral scrotal-based flaps to compensate for penile skin loss after circumcision.</p><p><strong>Methods: </strong>This study was performed on patients with almost penile skin loss after circumcision from February 2013 to July 2021. In all cases, one-stage modified bilateral anterolateral scrotal skin flaps were used to compensate for penile skin loss. The modification includes scrotal skin flap fashioning in a novel way, in addition to the use of penodermal fixation sutures at the penoscrotal junction, to create a stable penoscrotal junction and new penile skin coverage. Patients were discharged from the hospital on the same day of surgery. The dressing was left for 5 days. Follow-up visits were scheduled weekly in the first month, 3 and 6 months later, then annually.</p><p><strong>Results: </strong>Forty-six children were included in this study. Their mean age was 4.5 ± 1.5 years. The mean operative time was 139.6 ± 11.5 min. No flap ischemia or necrosis was reported. One case (2.2%) developed a scrotal hematoma managed conservatively. Three (6.5%) cases presented with wound dehiscence at the penoscrotal angle. Three (6.5%) cases had self-limited penile edema. Two (4.3%) cases had dorsal midline hypertrophic scar; one improved after treatment with triamcinolone acetonide ointment, and the other needed scar revision. The mean follows up was 23.33 ± 9.13 months.</p><p><strong>Conclusion: </strong>The modified scrotal skin flap technique provides a good substitution for stable penile skin coverage and a one-stage reconstruction of penile skin loss. It results in good parents' satisfaction with acceptable complications.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2156655
Ahmed M Elshal, Fady K Ghobrial, Mahmoud Laymon, Mohamed Elegeezy, Ahmed R El-Nahas
Objectives: Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the outcomes of XPS™-180 W GL-LP for treatment of BPH in patients who had uncorrectable bleeding tendency due to hepatic dysfunction.
Methods: A prospectively maintained database for all patients who underwent GL-LP for symptomatic BPH was reviewed. Patients were divided into two groups based on the degree of hepatic dysfunction using Fib-4 index: Group 1 (indexed patients; low-risk Fib-4) and Group 2 (non-indexed patients; intermediate-high-risk Fib-4) included those who had chronic liver disease associated with either thrombocytopenia and/or hypoprothrombinemia. Primary outcome was the difference in perioperative bleeding complications between the two groups. Other outcome measures included all perioperative findings and complications as well-functional outcome measures.
Results: The study included 140 patients (93 indexed patients and 47 non-indexed). There were no significant differences between both groups in operative time, laser time and energy, auxiliary procedures, catheter time, hospital stay, and hemoglobin deficit. The need for blood transfusion was significantly more in group 2 (two patients (4.3%) versus no patients in group 1, P = 0.045). Perioperative and late postoperative complications were comparable for both groups (P = 0.634 and 0.858, respectively). There were no significant differences in the postoperative uroflow, symptoms score, and PSA reduction between the two groups (P = 0.57, 0.87, and 0.05, respectively).
Conclusions: XPS™-180 W GL-LP is a safe and effective technique for treatment of BPH in patients with uncorrectable bleeding tendency due to hepatic dysfunction.
目的:GreenLight™激光前列腺切除术(GL-LP)用于正在使用血液稀释剂的患者的安全性已得到证实。然而,与治疗无法纠正的出血倾向患者相比,药物操纵的可能性使其不那么具有挑战性。在此,我们旨在评估XPS™-180 W GL-LP治疗因肝功能障碍而有不可纠正出血倾向的BPH患者的结果。方法:回顾了所有因症状性前列腺增生而接受GL-LP治疗的患者的前瞻性数据库。采用Fib-4指数将患者根据肝功能障碍程度分为两组:1组(有索引的患者;低危Fib-4)和2组(未索引患者;中高危Fib-4)包括伴有血小板减少症和/或低凝血酶原血症的慢性肝病患者。主要观察结果为两组围手术期出血并发症的差异。其他结果测量包括围手术期的所有发现和并发症作为功能良好的结果测量。结果:纳入140例患者,其中93例纳入索引,47例未纳入索引。两组在手术时间、激光时间和能量、辅助手术、导尿管时间、住院时间、血红蛋白缺损等方面无显著差异。第2组的输血需求明显更多(2例患者(4.3%),而第1组无患者,P = 0.045)。两组围手术期和术后后期并发症比较,P值分别为0.634和0.858。两组患者术后尿流、症状评分、PSA降低差异无统计学意义(P值分别为0.57、0.87、0.05)。结论:XPS™- 180w GL-LP是一种安全有效的治疗因肝功能障碍而有无法纠正出血倾向的BPH患者的技术。
{"title":"Greenlight laser (XPS<sup>TM</sup>) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency.","authors":"Ahmed M Elshal, Fady K Ghobrial, Mahmoud Laymon, Mohamed Elegeezy, Ahmed R El-Nahas","doi":"10.1080/2090598X.2022.2156655","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2156655","url":null,"abstract":"<p><strong>Objectives: </strong>Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the outcomes of XPS™-180 W GL-LP for treatment of BPH in patients who had uncorrectable bleeding tendency due to hepatic dysfunction.</p><p><strong>Methods: </strong>A prospectively maintained database for all patients who underwent GL-LP for symptomatic BPH was reviewed. Patients were divided into two groups based on the degree of hepatic dysfunction using Fib-4 index: Group 1 (indexed patients; low-risk Fib-4) and Group 2 (non-indexed patients; intermediate-high-risk Fib-4) included those who had chronic liver disease associated with either thrombocytopenia and/or hypoprothrombinemia. Primary outcome was the difference in perioperative bleeding complications between the two groups. Other outcome measures included all perioperative findings and complications as well-functional outcome measures.</p><p><strong>Results: </strong>The study included 140 patients (93 indexed patients and 47 non-indexed). There were no significant differences between both groups in operative time, laser time and energy, auxiliary procedures, catheter time, hospital stay, and hemoglobin deficit. The need for blood transfusion was significantly more in group 2 (two patients (4.3%) versus no patients in group 1, P = 0.045). Perioperative and late postoperative complications were comparable for both groups (P = 0.634 and 0.858, respectively). There were no significant differences in the postoperative uroflow, symptoms score, and PSA reduction between the two groups (P = 0.57, 0.87, and 0.05, respectively).</p><p><strong>Conclusions: </strong>XPS™-180 W GL-LP is a safe and effective technique for treatment of BPH in patients with uncorrectable bleeding tendency due to hepatic dysfunction.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10248693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2023.2206336
Mohammed Mahdi, Ahmad Majzoub, Haitham Elbardisi, Mohamed Arafa, Kareim Khalafalla, Sami Al Said, Walid El Ansari
Background: Few studies assessed the relationships between BMI and post varicocelectomy semen quality and fertility potential and they reported inconsistent findings.
Objective: To assess the association of BMI with semen parameters and reproductive hormones before and after microsurgical varicocelectomy.
Materials and methods: Retrospective chart review in a tertiary infertility center. Of 1170 patients with clinical varicocele during the study period (8 years), 813 patients were eligible and included. Patients were grouped into: Group A (kg/m2, n = 251 patients), B (BMI 25-29.9 kg/m2, n = 289), C (BMI 30-34.9 kg/m2, n = 183) and D (kg/m2, n = 90). Clinical data, semen parameters, sperm DNA fragmentation and hormonal profile were collected before and 3 months after microsurgical varicocelectomy.
Results: Patients' mean age was 35.87 ± 8.17 years. Higher-grade varicocele was significantly more prevalent in the lower BMI groups. BMI was significantly negatively correlated with preoperative sperm concentration, total motility progressive motility and total motile sperm count. Pre-operatively, sperm concentration, total motility, progressive motility and total motile sperm count showed significant differences between BMI groups, where higher BMI (Groups C and D) exhibited the poorest semen parameters. Postoperatively, all groups showed significant improvement in sperm concentration compared with pre-operative values. However, total and progressive motility were significantly improved in Groups A, B and C, while in Group D (highest BMI), total motility improved clinically but not statistically, progressive motility did not display improvement, and total motile sperm count was significantly improved only in Groups B and C. Postoperatively, mean improvements in semen parameters across the BMI groups were not significantly different, except for morphology, which improved significantly more in the less obese patients.
Conclusion: For infertile patients with clinical varicocele undergoing micro-surgical varicocelectomy, BMI appears not to impact the improvements across most of the semen parameters and hormones. The procedure might improve the fertility potential.
背景:很少有研究评估BMI与精索静脉曲张切除术后精液质量和生育潜力之间的关系,并且报告的结果不一致。目的:探讨显微精索静脉曲张切除术前后BMI与精液参数及生殖激素的关系。材料和方法:回顾性图表回顾在一个三级不孕症中心。在研究期间(8年)1170例临床精索静脉曲张患者中,813例患者符合条件并纳入研究。患者分为:A组(kg/m2, n = 251例)、B组(BMI 25 ~ 29.9 kg/m2, n = 289例)、C组(BMI 30 ~ 34.9 kg/m2, n = 183例)和D组(kg/m2, n = 90例)。收集显微精索静脉曲张切除术前及术后3个月的临床资料、精液参数、精子DNA片段及激素谱。结果:患者平均年龄35.87±8.17岁。高级别精索静脉曲张在低BMI组中更为普遍。BMI与术前精子浓度、总运动力、进展运动力、总运动精子数呈显著负相关。术前精子浓度、总活动力、渐进活动力和总活动精子数在BMI组间存在显著差异,其中BMI越高(C组和D组)的精液参数越差。术后各组精子浓度均较术前有明显改善。然而,A、B、C组的总运动能力和进行性运动能力均有显著改善,而D组(BMI最高)的总运动能力有临床改善但无统计学意义,进行性运动能力无改善,总运动精子数只有B、C组有显著改善。术后,除形态外,BMI组间精液参数的平均改善无显著差异。肥胖程度较低的患者改善更明显。结论:对于临床精索静脉曲张的不孕症患者行显微外科精索静脉曲张切除术,BMI似乎不影响大多数精液参数和激素的改善。这个过程可能会提高生育潜力。
{"title":"Impact of body mass index on semen parameters and reproductive hormones among men undergoing microsurgical subinguinal varicocelectomy.","authors":"Mohammed Mahdi, Ahmad Majzoub, Haitham Elbardisi, Mohamed Arafa, Kareim Khalafalla, Sami Al Said, Walid El Ansari","doi":"10.1080/2090598X.2023.2206336","DOIUrl":"https://doi.org/10.1080/2090598X.2023.2206336","url":null,"abstract":"<p><strong>Background: </strong>Few studies assessed the relationships between BMI and post varicocelectomy semen quality and fertility potential and they reported inconsistent findings.</p><p><strong>Objective: </strong>To assess the association of BMI with semen parameters and reproductive hormones before and after microsurgical varicocelectomy.</p><p><strong>Materials and methods: </strong>Retrospective chart review in a tertiary infertility center. Of 1170 patients with clinical varicocele during the study period (8 years), 813 patients were eligible and included. Patients were grouped into: Group A (kg/m<sup>2</sup>, <i>n</i> = 251 patients), B (BMI 25-29.9 kg/m<sup>2</sup>, <i>n</i> = 289), C (BMI 30-34.9 kg/m<sup>2</sup>, <i>n</i> = 183) and D (kg/m<sup>2</sup>, <i>n</i> = 90). Clinical data, semen parameters, sperm DNA fragmentation and hormonal profile were collected before and 3 months after microsurgical varicocelectomy.</p><p><strong>Results: </strong>Patients' mean age was 35.87 ± 8.17 years. Higher-grade varicocele was significantly more prevalent in the lower BMI groups. BMI was significantly negatively correlated with preoperative sperm concentration, total motility progressive motility and total motile sperm count. Pre-operatively, sperm concentration, total motility, progressive motility and total motile sperm count showed significant differences between BMI groups, where higher BMI (Groups C and D) exhibited the poorest semen parameters. Postoperatively, all groups showed significant improvement in sperm concentration compared with pre-operative values. However, total and progressive motility were significantly improved in Groups A, B and C, while in Group D (highest BMI), total motility improved clinically but not statistically, progressive motility did not display improvement, and total motile sperm count was significantly improved only in Groups B and C. Postoperatively, mean improvements in semen parameters across the BMI groups were not significantly different, except for morphology, which improved significantly more in the less obese patients.</p><p><strong>Conclusion: </strong>For infertile patients with clinical varicocele undergoing micro-surgical varicocelectomy, BMI appears not to impact the improvements across most of the semen parameters and hormones. The procedure might improve the fertility potential.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2127236
Mounir Jamali, Amine Cherraqi, Alexis Melang Mvomo, Youness Boukhlifi, Mohammed Alami, Ahmed Ameur
The first described case of deep dorsal vein thrombosis of the penis secondary to vaccine-induced thrombotic thrombocytopenia (VITT), a complication of COVID adenoviral vector vaccines. The patient reported pain in the penis one month after vaccination. On ultrasound, a deep dorsal vein thrombosis was found and a biological workup was ordered to confirm the VITT trail. Anticoagulant therapy was immediately initiated and the patient responds well while suffering from erectile dysfunction. VITT is a potentially serious event that can be life-threatening; every practitioner should know how to deal with it.
{"title":"Thrombosis of the deep dorsal vein of the penis caused by vaccine-induced thrombotic thrombocytopenia: First reported case.","authors":"Mounir Jamali, Amine Cherraqi, Alexis Melang Mvomo, Youness Boukhlifi, Mohammed Alami, Ahmed Ameur","doi":"10.1080/2090598X.2022.2127236","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2127236","url":null,"abstract":"<p><p>The first described case of deep dorsal vein thrombosis of the penis secondary to vaccine-induced thrombotic thrombocytopenia (VITT), a complication of COVID adenoviral vector vaccines. The patient reported pain in the penis one month after vaccination. On ultrasound, a deep dorsal vein thrombosis was found and a biological workup was ordered to confirm the VITT trail. Anticoagulant therapy was immediately initiated and the patient responds well while suffering from erectile dysfunction. VITT is a potentially serious event that can be life-threatening; every practitioner should know how to deal with it.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}