Shima Kianmehr, Mohammad Vahabirad, Atefeh Seghatoleslam, Erfan Sadeghi, Roozbeh Kiani, Hadi Ghasemi
{"title":"Prognostic Value of TGF-β Expression in Bladder Cancer: A Systematic Review and Meta-analysis.","authors":"Shima Kianmehr, Mohammad Vahabirad, Atefeh Seghatoleslam, Erfan Sadeghi, Roozbeh Kiani, Hadi Ghasemi","doi":"10.5152/tud.2024.24024","DOIUrl":"10.5152/tud.2024.24024","url":null,"abstract":"<p><strong>Objective: </strong>Transforming growth factor beta (TGF-β) is a member of the growth factor superfamily that clinical studies address its association with bladder cancer invasion, progression, and metastasis. The present systematic review and meta-analysis aimed to explore the prognostic significance of TGF-β expression in bladder cancer patients.</p><p><strong>Materials and methods: </strong>The major international databases, including PubMed, Web of Science, Embase, and Scopus, were searched for full-text literature citations. The hazard ratio (HR) with a 95% CI as the effect size was applied as the appropriate summarized statistic. We used a random-effects model using the DerSimonian and Laird method to estimate the pooled effect size. To assess the heterogeneity among trials, the I-square (I 2 ) statistic and Cochran's Q test were used. Forest and funnel plots were drawn to respectively demonstrate the findings and detect any existing publication bias.</p><p><strong>Results: </strong>This meta-analysis included 3 studies that met the criteria and included 535 patients. The combined HR for the selected studies was 2.250 (95% CI=(1.411, 3.586), P< .001) and no significant heterogeneity was detected between trials (I 2=58.63, P=.089). Furthermore, no severe asymmetry was seen within the funnel plot, indicating a lack of potential publication bias.</p><p><strong>Conclusion: </strong>Our findings suggest that TGF-β expression can remarkably predict a worse prognosis in patients with bladder cancer. The results of the present meta-analysis may be validated through further updated reviews and additional relevant investigations in future studies.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"148-153"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570416","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}
Augusto de Azevedo Barreto, Humberto Elias Lopes, José Murillo Bastos Netto, André Avarese Figueiredo
{"title":"Urogenital Tuberculosis and Delayed Diagnosis: A Qualitative Study.","authors":"Augusto de Azevedo Barreto, Humberto Elias Lopes, José Murillo Bastos Netto, André Avarese Figueiredo","doi":"10.5152/tud.2024.24028","DOIUrl":"10.5152/tud.2024.24028","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the causes of delayed diagnosis of urogenital tuberculosis (UGT) through a qualitative study of patients with contracted bladder due to UGT.</p><p><strong>Materials and methods: </strong>Eight patients diagnosed with contracted bladder due to UGT were evaluated. Data were obtained using face-to-face in-depth interviews and supplemented with medical records analysis and personal medical files. The identification of situations of diagnosis delay was coded by 2 urologists after data analyses. Codes were divided into 3 categories related to its causes: (1) health system; (2) disease factors; and (3) medical factors.</p><p><strong>Results: </strong>The 8 interviews produced 220 minutes of audio and 1.3 GB of scanned documents. The most frequent categories were \"Medical factors,\" followed by \"Disease factors\" and \"Health system.\" The codes \"No clinical-laboratory-radiological suspicion\" and \"No clinical suspicion\" were the most frequent, both belonging to \"Medical factors.\" Clinically, tuberculosis simulates other pathologies and lacks specific tests with adequate sensitivity. The low representation of \"Health system\" codes indicates that access to public and private health services does not influence delayed diagnosis. The lack of clinical and radiological suspicion and the lack of knowledge of UGT features are the main reasons for diagnosis delay.</p><p><strong>Conclusions: </strong>The causes of delayed diagnosis in our sample were related to \"Medical factors,\" followed by \"Disease factors.\" Better understanding UGT features is an important topic in continuous medical education.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585454","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}
Habeeb Abdulrasheed, Ayokunle Adenipekun, Waleed Elsayed, Mohamed S Mohsin, Daniel Madarshahian, Humood Almedej, Banan Osman
{"title":"Uncovering the Evidence for Sustainability in Urology: A Scoping Review.","authors":"Habeeb Abdulrasheed, Ayokunle Adenipekun, Waleed Elsayed, Mohamed S Mohsin, Daniel Madarshahian, Humood Almedej, Banan Osman","doi":"10.5152/tud.2024.24093","DOIUrl":"10.5152/tud.2024.24093","url":null,"abstract":"<p><strong>Objective: </strong>This article focuses on the environmental impact of urology devices and procedures in hospitals and identifies practices that can reduce greenhouse gas emissions associated with urology services.</p><p><strong>Materials and methods: </strong>A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted using MEDLINE, EMBASE, and Google Scholar to find studies on the carbon footprint of urologic procedures and sustainable practices.</p><p><strong>Results: </strong>We identified 14 studies, 6 of which used life cycle assessments to compare the environmental impact of single-use and reusable urology devices. Three studies favored single-use devices, 2 favored reusable ones, and 1 found no significant difference, with the sterilization of reusable devices being a major carbon contributor. To enhance sustainability in urology, 8 articles suggested measures including day-case procedures, minimizing low-value care, drapeless cystoscopy, fluid management systems, using quick response (QR) codes in documentation, telehealth initiatives, and low-emission anesthetics.</p><p><strong>Conclusion: </strong>Promoting sustainability in healthcare requires more than just using reusable equipment; it necessitates a comprehensive approach from manufacturing to disposal, including the carbon footprint of sterilization. Encouraging low-emission anesthetics, QR codes, and telemedicine can significantly reduce emissions in urology.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585453","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}
Andreia Cardoso, Sara Anacleto, Catarina Laranjo Tinoco, Ana Sofia Araújo, Mariana Capinha, Luís Borges Pinto, Aparício Coutinho, Catarina Tavares, Vera Marques, Paulo Mota, Miguel Mendes, Carlos Oliveira, João Pimentel Torres, Emanuel Carvalho-Dias
{"title":"\"Minho Technique\" for Laparoscopic Radical Cystectomy with Intracorporeal Ileal Conduit.","authors":"Andreia Cardoso, Sara Anacleto, Catarina Laranjo Tinoco, Ana Sofia Araújo, Mariana Capinha, Luís Borges Pinto, Aparício Coutinho, Catarina Tavares, Vera Marques, Paulo Mota, Miguel Mendes, Carlos Oliveira, João Pimentel Torres, Emanuel Carvalho-Dias","doi":"10.5152/tud.2024.23230","DOIUrl":"10.5152/tud.2024.23230","url":null,"abstract":"<p><strong>Objective: </strong>Radical cystectomy (RC) with ileal conduit (IC) remains a main treatment for muscle-invasive bladder cancer (MIBC). Laparoscopy in this multistage surgery is quite demanding, so laparoscopic RC (LRC) with intracorporeal IC (IIC) is a technically exceptional procedure. We aim to simplify it, demonstrating our technique, step-by-step. We present a 4-port LRC with IIC and Bricker uretero-ileal anastomoses. The main difference is the immediate and complete posterior dissection, similar to the \"Montsouris approach\" for prostatectomy.</p><p><strong>Materials and methods: </strong>A 70-year-old man with a 5 cm MIBC was subjected to our demonstrated procedure.</p><p><strong>Results: </strong>The postoperative period was uneventful. Diet and ambulation: 2 days. Single-J stents removal: 4 weeks. MIBC N0 was confirmed. At 24 months, the patient is well, without complications (namely hydronephrosis or disease recurrence).</p><p><strong>Conclusion: </strong>LRC with IIC is demanding and requires laparoscopic expertise. However, if performed in a standardized fashion, as demonstrated through this case, and considering our center's experience, it seems feasible and safe with 4-port and standard material without a significant operative time increase, nor oncological or functional compromise.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"203-207"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585445","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}
Stephanie Gleicher, Elisabeth M Sebesta, Roger R Dmochowski
{"title":"The Psychosocial Impact of Urinary Dysfunction.","authors":"Stephanie Gleicher, Elisabeth M Sebesta, Roger R Dmochowski","doi":"10.5152/tud.2024.23217","DOIUrl":"10.5152/tud.2024.23217","url":null,"abstract":"<p><p>Urinary dysfunction encompasses a wide range of syndromes and symptoms and is highly prevalent among the adult population. Urinary issues have been associated with psychosocial sequelae. The interplay between psychosocial comorbidity and symptoms impacts perceived severity and treatment success. While the correlation has been described in the literature, much remains unknown. This article describes the psychosocial impact on conditions such as overactive bladder (OAB), neurogenic lower urinary tract dysfunction (LUTD), recurrent urinary tract infection (UTI), and interstitial cystitis/bladder pain syndrome (IC/BPS). This article also highlights potential interventions for patients afflicted with both urinary disorders and psychosocial comorbidity to improve overall treatment success.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"167-172"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585452","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}
Ryo Andy Ogasawara, Shugo Yajima, Naoki Imasato, Kohei Hirose, Ken Sekiya, Madoka Kataoka, Yasukazu Nakanishi, Hitoshi Masuda
{"title":"Hounsfield Unit on Preoperative Computed Tomography as an Indicator of Prognosis in Patients with Liposarcoma.","authors":"Ryo Andy Ogasawara, Shugo Yajima, Naoki Imasato, Kohei Hirose, Ken Sekiya, Madoka Kataoka, Yasukazu Nakanishi, Hitoshi Masuda","doi":"10.5152/tud.2024.24032","DOIUrl":"10.5152/tud.2024.24032","url":null,"abstract":"<p><strong>Objective: </strong>Liposarcoma (LPS) is classified into 4 subtypes. As some subtypes have a high recurrence rate, knowing the risk of recurrence before surgery is important. Here, we aimed to investigate the relationship between Hounsfield units (HU) derived from preoperative computed tomography (CT) and the prognosis of patients undergoing surgery.</p><p><strong>Materials and methods: </strong>We included 32 patients who underwent surgery for LPS between 2014 and 2022. Preoperative plain CT images were collected, and the HU value of each LPS was measured. The association between 2 HU categories (HU < cut-off vs. ≥ cut-off) and clinical variables was assessed. The optimal cut-off value was determined using statistical methods. We used the Kaplan-Meier method to determine the differences between the 2 HU categories at 2 endpoints: recurrence-free survival (RFS) and overall survival (OS).</p><p><strong>Results: </strong>The dedifferentiated subtype showed significantly higher HU values than the other subtypes (P < .001). The optimal cut-off value for HU was 20. HU < 20 was associated with young age, low-performance status, low Charlson Comorbidity Index, and well-differentiated pathology. The Kaplan-Meier curves demonstrated that RFS and OS were significantly shorter in patients with HU ≥ 20 than in those with HU < 20 (P = .007 and .04, respectively). However, when stratified based on subtype, no significant differences were observed between dedifferentiated and other subtypes.</p><p><strong>Conclusion: </strong>HU ≥ 20 on preoperative CT was associated with poor prognosis in LPS patients. Our findings suggest that preoperative CT-derived HU values may serve as useful predictors of prognosis.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"187-192"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585449","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}
{"title":"Scoring System to Personalize Management of Emphysematous Pyelonephritis.","authors":"Ankur Mittal, Deepak Kumar, Vikas Kumar Panwar, Rohit Ranjan, Shiv Charan Navriya, Akshay Upadhyaya, Harshit Agarwal, Gautam Shubhankar, Arup Kumar Mandal","doi":"10.5152/tud.2024.23165","DOIUrl":"10.5152/tud.2024.23165","url":null,"abstract":"<p><strong>Objective: </strong>Emphysematous pyelonephritis (EPN) is a life-threatening condition that requires prompt diagnosis and treatment. The prognosis of EPN is variable, and there is no single treatment that is universally effective.</p><p><strong>Materials and methods: </strong>In this study, we developed a scoring system to predict the prognosis of EPN and to guide management. The scoring system was developed based on a retrospective analysis of 91 patients with EPN. Nineteen risk factors for emphysematous pyelonephritis were assessed with univariate and multivariate analysis.</p><p><strong>Results: </strong>Seven factors were found significant on analysis. The scoring system was developed by including these 7 risk factors: renal stone disease, leukocytosis, raised creatinine, EPN grade, and septic shock. The score ranged from 1 to 18, with a higher score indicating a worse prognosis. The scoring system was able to stratify patients into three risk groups: good risk, intermediate risk, and poor risk. The scoring system can be used to personalize the management of EPN. Patients in the good-risk group may be managed with conservative treatment, while patients in the intermediate-risk and poor-risk groups may require intervention, such as DJ stenting, percutaneous nephrolithotomy or nephrectomy. The scoring system is a valuable tool for predicting the prognosis of EPN and guiding management. It can help clinicians to tailor treatment to the individual patient and to improve outcomes.</p><p><strong>Conclusion: </strong>The prognostic score helps identify patients who are at high risk. This score helps in the selection of appropriate management options.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"193-197"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585451","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}
{"title":"Pelvic Floor Muscle Anatomy and its Contribution to Penile Erection in Olive Baboons.","authors":"Roman Ovchinnikov, Ilya Pyatnitskiy","doi":"10.5152/tud.2024.23020","DOIUrl":"10.5152/tud.2024.23020","url":null,"abstract":"<p><strong>Objective: </strong>Despite the number of studies on the contribution of pelvic floor muscles (PFM) to the penile erection process, their significance is still underestimated. The goal of this study was to investigate the role of PFM in the erection process in non-human primates.</p><p><strong>Materials and methods: </strong>First, we performed an anatomical study of the penile structures in 12 baboon cadavers. Next, we created chronic electrophysiological models of normal erectile function in 25 olive baboons. We implanted electrodes on the cavernous nerves to control penile blood filling and placed other electrodes on the pudendal nerve to stimulate the ischiocavernosus muscles (ICM) contractions after sufficient blood filling, thus simulating both vascular and muscular phases of penile erection. We controlled the intracavernous pressure (ICP) during nerve stimulations and further performed a mathematical analysis of the collected data.</p><p><strong>Results: </strong>We described the main pro-erectile muscle anatomy and its relationship with penile structures in monkeys. During neurostimulation studies, we showed the key role of ICM in achieving full penile rigidity with suprasystolic ICP up to 120-300 mm Hg. We also developed a math model for calculating the pro-erectile muscle's contraction force with high accuracy.</p><p><strong>Conclusion: </strong>In this study, we demonstrated the crucial role of PFM in the penile erection process using the monkey model, supporting the previous studies' data. We consider these results essential for a better, more complex understanding of the penile erection process and the participating structures in each stage. This is essential for further improving and designing novel erectile dysfunction diagnostics and treatment techniques.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"173-180"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585450","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}
Stamatios Katsimperis, Themistoklis Bellos, Ioannis Manolitsis, Ioannis Kyriazis, Panagiotis Angelopoulos, Panagiotis Neophytou, Sotirios Kapsalos, Nikolaos Kostakopoulos, Lazaros Tzelves, Ioannis Varkarakis, Athanasios Papatsoris, Andreas Skolarikos, Iraklis Mitsogiannis
{"title":"Reporting and Grading of Complications in Urological Surgery: Current Trends and Future Perspectives.","authors":"Stamatios Katsimperis, Themistoklis Bellos, Ioannis Manolitsis, Ioannis Kyriazis, Panagiotis Angelopoulos, Panagiotis Neophytou, Sotirios Kapsalos, Nikolaos Kostakopoulos, Lazaros Tzelves, Ioannis Varkarakis, Athanasios Papatsoris, Andreas Skolarikos, Iraklis Mitsogiannis","doi":"10.5152/tud.2024.24050","DOIUrl":"10.5152/tud.2024.24050","url":null,"abstract":"<p><p>There has been a growing need for enhancements in healthcare delivery, especially for the improvement of surgical outcomes. Therefore, implementing consistent reporting of complications enables the evaluation of data quality and facilitates its comparison. There are currently many available reporting and grading systems each with its own set of benefits and drawbacks. In this comprehensive review, we tried to present and assess each of them by demonstrating their criteria and their strong and weak points. To sum up, it seems that there is a need for developing a new reporting and categorization system for complications that are specific to urology.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"154-159"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570419","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}
Ali Çift, Can Benlioğlu, Mehmet Özgür Yücel, Muhammer Özgür Çevik, Bedreddin Kalyenci, Alper Gök, Sait Sever, Hasan Sulhan, Haydar Bağış, Ali Ayyıldız
{"title":"A New Sperm Concentration Threshold for Y Chromosome Microdeletion Analysis in Infertile Men: Could It Be Azoopermia?","authors":"Ali Çift, Can Benlioğlu, Mehmet Özgür Yücel, Muhammer Özgür Çevik, Bedreddin Kalyenci, Alper Gök, Sait Sever, Hasan Sulhan, Haydar Bağış, Ali Ayyıldız","doi":"10.5152/tud.2024.24061","DOIUrl":"10.5152/tud.2024.24061","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the frequency of Y-chromosome microdeletions (YCMs) in a non-multiethnic urban population in our region, define predictive factors, and determine a new clinical threshold for YCMs in infertile men.</p><p><strong>Materials and methods: </strong>A total of 281 patients with a sperm concentration ≤5 million/mL were retrospectively evaluated. Oligozoospermic and/or azoospermic patients with a sperm concentration of ≤5 million/mL were screened for the YCM analysis.</p><p><strong>Results: </strong>Y-chromosome microdeletion was detected in 9 (3.2%) of the 281 patients. All patients with YCM were azoospermic. The presence of azoospermia, a high folliclestimulating hormone level, and a high luteinizing hormone level were found to be important determinants for the identification of a microdeletion (P = .002, P = .002, and P=.021, respectively). If the presence of azoospermia and a sperm concentration threshold of <1 million/mL had been applied for the YCM test, the number of tests performed would have been reduced by 54.4% (153 tests) and 42.7% (120 tests), respectively, resulting in cost saving of approximately $11 474 and $9000, respectively.</p><p><strong>Conclusion: </strong>We recommend that the threshold for sperm concentration for YCM analysis be set at <1 million in individuals in developed countries and only in patients with azoospermia in developing countries, in order to reduce costs and save labor by excluding unnecessary tests. These proposed thresholds (azoospermia and sperm counts less than <1 million/mL) provide cost-effectiveness by significantly reducing the number of genetic tests ordered without affecting the diagnosis rate.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 3","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585447","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}