Urology research & practice最新文献

{"title":"Preferring Lateral Video Endoscopic Inguinal Lymph Node Dissection Over Classic Video Endoscopic Inguinal Lymph Node Dissection in Squamous Cell Carcinoma of Penis: Lessons Learnt from Twenty-One Patients at a Single Center.","authors":"Pradhuman Yadav, Amit Sharma, Deepak Kumar Biswal, Raghavendra Rt","doi":"10.5152/tud.2023.23097","DOIUrl":"10.5152/tud.2023.23097","url":null,"abstract":"<p><strong>Objective: </strong>Inguinal lymphadenectomy is essential for staging and disease control. Minimally invasive techniques are recently replacing open techniques to reduce complications. We present our experience and lessons learnt from 21 patients who underwent lateral video endoscopic inguinal lymphadenectomy (L-VEIL) for penile malignancy.</p><p><strong>Methods: </strong>All patients above 18 years of age with histopathology-confirmed squamous cell carcinoma penis with stages ≥ T1b and T1a with persistent lymphadenopathy who underwent L-VEIL over a period of 2 years (2020-2022) were included. The data were analyzed on the basis of intraoperative and postoperative complications, lymph node yield, hospital stay, and histopathology report.</p><p><strong>Results: </strong>Forty-one lower limbs of 21 patients underwent L-VEIL during the abovementioned period. Median age was 52 years. Mean operative time (on 1 side) was 80 minutes. Median lymph node yield per side was 7.2. Intraoperatively, 1 patient had a vascular injury at the saphenofemoral junction, requiring conversion to open. Postoperative complications were superficial surgical site infection (n=4), lymphedema (n=1), and lymphocoele (n=3), one of which was drained by pigtail catheter. One patient required exploration on the second postoperative day because of vascular injury. Average duration of hospital stay was 3 days. The median time of drain removal was 13 days. Histopathology suggested seminoma in 1 patient and mature teratoma in 1 patient; the rest of the patients' reports were negative for malignancy.</p><p><strong>Conclusion: </strong>The L-VEIL is safe and feasible, and there is a reduction (~30%) in complications; oncological outcomes are also not affected. It has better ergonomics, resulting in ease and comfort for surgeons when compared with classical VEIL.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":"370-375"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178405","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":"One-year Follow-up Results of Transperineal Biopsy For Patients Undergoing Irreversible Electroporation Treatment in Localized Prostate Cancer.","authors":"Şükrü Ali Altan, Pınar Güleryüz Kızıl, Nefise Çağla Tarhan, Oztug Adsan","doi":"10.5152/tud.2023.23150","DOIUrl":"10.5152/tud.2023.23150","url":null,"abstract":"<p><strong>Objective: </strong>This article reports on the early results of a 1-year follow-up study investigating the efficacy of irreversible electroporation in the treatment of localized prostate cancer.</p><p><strong>Methods: </strong>The study included 18 out of 40 patients diagnosed with low- and intermediate-risk prostate cancer who underwent irreversible electroporation. Treatment results were evaluated through confirmation biopsies, comparing prostate-specific antigen levels, international prostate symptom scoring, and international index of erectile dysfunction scores before irreversible electroporation and at the 12-month mark.</p><p><strong>Results: </strong>The mean age of the patients was 61.1 years (SD ±6.5). Out of the 18 patients, 16 were tumor free (88.8%), while 2 experienced recurrences, one within the treatment field and the other outside of it (P < .001). Irreversible electroporation significantly reduced mean prostate-specific antigen levels (6.73 ng/mL vs. 2.05 ng/mL, P < .001), indicating a 69.5% reduction within 12 months. Furthermore, there was a significant improvement in mean international prostate symptom scores at the 12-month followup (10.05 vs. 7.52, P=.003). The mean international index of erectile dysfunction scores before treatment was 19.17 (SD ±5.85), and after irreversible electroporation, it was 18.67 (SD ±6.34), with no statistically significant change (P=.065).</p><p><strong>Conclusion: </strong>The short-term oncological results of irreversible electroporation treatment are promising, particularly for patients in the low- and intermediate-risk groups. Additionally, irreversible electroporation does not negatively impact the international index of erectile dysfunction; however, it may lead to a decrease in international prostate symptom scores.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":"381-386"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400955","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":"The Current Challenges in Diagnosing and Treating Malignant Priapism: A Comprehensive Review.","authors":"I Wayan Yudiana, Ronald Sugianto, Putu Eka Dianti Putri, Ni Putu Ekawati, Gede Wirya Kusuma Duarsa","doi":"10.5152/tud.2023.23088","DOIUrl":"10.5152/tud.2023.23088","url":null,"abstract":"<p><p>Malignant priapism (MP) is defined as a condition of persistent erection of the penis without sexual stimulation due to the neoplastic process of the cavernous sinus and the efferent veins. The effectiveness of established therapeutic recommendations in priapism was ineffective in MP. Modalities of therapy for MP varied from medication treatment, nonsurgical treatment, surgical treatment, and radiotherapy. Despite aggressive surgical management combined with radiation therapy, chemotherapy, or targeted therapy, the survival rate remains low. Therefore, the treatment is usually palliative, focusing on the patient's quality of life improvement and symptom relief.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":"360-364"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400958","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":"Primer on Female Infertility for the Reproductive Urologist.","authors":"Matthew Dullea, Joelle Mouhanna, Kyara Marquez, Akhil Muthigi, Braian Ledesma, Joshua White, Ranjith Ramasamy","doi":"10.5152/tud.2023.23167","DOIUrl":"10.5152/tud.2023.23167","url":null,"abstract":"<p><p>This review is intended to serve as an aid in decision-making and patient counseling for the reproductive urologist when female factor infertility is found concurrently with male factor infertility. This review pairs the pathophysiology of female infertility with its implications for the treatment of male infertility, which most commonly includes ovulatory disorders, tubal abnormalities, and uterine abnormalities. By gaining a deeper understanding of these factors, reproductive urologists can employ a tailored approach to managing male factor infertility, taking into account the female partner's specific medical history.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":"338-344"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400956","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":"Seasonal Variation in Serum Testosterone Levels: Evidence from 2 Large Institutional Databases.","authors":"David Miller, Aaron Gurayah, Alexander Weber, Kyle Schuppe, Mohamadhusni Zarli, Alexandra Dullea, Kathleen Hwang, Ranjith Ramasamy","doi":"10.5152/tud.2023.23077","DOIUrl":"10.5152/tud.2023.23077","url":null,"abstract":"<p><strong>Objective: </strong>Seasonal variations in testosterone levels have been reported in some studies, but the results are inconsistent. In this study, we aimed to determine if clinically relevant seasonal variability in testosterone levels exists using a large cohort of men from 2 different institutions, 1 located in an area with seasons (Pittsburgh, Pa) and 1 without seasons (Miami, Fla).</p><p><strong>Methods: </strong>Using 2 institutional databases, testosterone levels were obtained for men ages 18-99 from 2010 to 2021 who had at least 2 morning testosterone levels drawn within a 2-year period. All samples were analyzed with liquid chromatography with tandem mass spectrometry. To avoid potential confounding by testosterone altering medications patients who were currently or previously on exogenous testosterone, endogenous testosterone-stimulating medications, testosterone-suppressing medications, and aromatase inhibitors were excluded from the study.</p><p><strong>Results: </strong>There were 9495 and 16171 total testosterone levels measured from Miami and Pittsburgh, respectively, with all men having 2 or more levels. There was no statistically significant variation in testosterone levels for the overall cohort in Pittsburgh or Miami, respectively. Additionally, when stratified by age group, no individual groups were found to have significant seasonal variability.</p><p><strong>Conclusion: </strong>Our findings suggest that although there is differing total testosterone levels between men who reside in 2 different climates, there is no significant variability in testosterone levels between seasons. Therefore, testosterone levels can be checked and interpreted without the need to account for the season during which they were drawn.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"307-311"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159671","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":"Assessing Infertility Literacy and Knowledge Gaps Among Patients with Cystic Fibrosis.","authors":"Farah Rahman, Katherine Campbell, Nicholas Deebel, Armin Ghomeshi, Mohammed Zarli, Lisa Domaradzki, Maria Gabriela Tupayachi Ortiz, Ranjith Ramasamy","doi":"10.5152/tud.2023.23061","DOIUrl":"10.5152/tud.2023.23061","url":null,"abstract":"<p><strong>Objective: </strong>As patients with cystic fibrosis live longer into their reproductive years, fertility concerns are rising. We hypothesized that while patients with cystic fibrosis may be informed of the impact of their disease on their reproductive potential, they remain unaware of the promising role of assisted reproductive technology in helping them conceive biological children.</p><p><strong>Methods: </strong>We distributed a voluntary and anonymous survey to cystic fibrosis patients and organizations to assess patient understanding of cystic fibrosis-related infertility. The survey questions aimed to capture demographic information, their reproductive education regarding cystic fibrosis, and their preferences for future fertility.</p><p><strong>Results: </strong>Forty respondents completed the survey (median age of 36 ± 14 years). The median age reported for learning about cystic fibrosis-associated infertility was 18 years. Respondents preferred that reproductive and infertility education be provided early; 43% reported the optimal age of education was younger than 18 years while 50% reported between 18 and 24 years. Of the respondents trying to conceive, 43% of patients have been trying to conceive for 1-3 years qualifying for infertility. Yet, the majority of those patients (69%) have not been offered a semen analysis and 90% have not had previous fertility treatments.</p><p><strong>Conclusion: </strong>Our findings highlight that cystic fibrosis patients are knowledgeable about cystic fibrosis-related impacts on their fertility, with high-rated self-confidence. A fraction of patients still desire to conceive but have not been provided with assisted reproductive services. We recommend the establishment of active partnerships between cystic fibrosis care teams and fertility specialists to maximize their chances of conception.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"312-315"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159751","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":"A Single-Center, Randomized, Double-Blind, and Placebo-Controlled Comparative Human Study to Verify the Functionality and Safety of the Lespedeza cuneata G. Don Extract for the Improvement of Aging Male Syndrome.","authors":"Hyungjee Kim, Yu-Mi Seo, Seong Lee, Dahye Kang, Changhee Kim","doi":"10.5152/tud.2023.23065","DOIUrl":"10.5152/tud.2023.23065","url":null,"abstract":"<p><strong>Objective: </strong>Aging male syndrome is a clinical biochemical syndrome characterized by typical aging symptoms and serum testosterone deficiency. Although it is accompanied by various health problems, directly affects life satisfaction, and requires proper management, no clear prevention or treatment other than hormone replacement therapy is currently available for this syndrome. Here, we aimed to determine the efficacy and safety of the Lespedeza cuneata extract in the management of the aging male syndrome.</p><p><strong>Methods: </strong>Males aged 43-70 years who provided consent for participation and had a total Aging Males' Symptom questionnaire score ≥ 37 and testosterone level ≤ 500 ng/dL were enrolled in this study. This study was conducted in a randomized, double-blind manner. Participants were randomly assigned to either the experimental or control groups and orally administered the assigned product twice a day. Efficacy was evaluated by measuring changes in Aging Males' Symptom score, Androgen Deficiency in the Aging Male questionnaire score, International Index of Erectile Function score, International Prostatic Symptom Score, blood test results, and body mass index at 8 weeks.</p><p><strong>Results: </strong>After 8 weeks, the experimental group had significantly improved symptom scores compared to the control group on the Aging Males' Symptom and Androgen Deficiency in the Aging Male questionnaires. However, no significant differences in the International Index of Erectile Function score, International Prostatic Symptom Score score, blood test results, and body mass index were observed between the experimental and control groups.</p><p><strong>Conclusion: </strong>Lespedeza cuneata extract safely alleviates andropause symptoms without any significant side effects, suggesting its potential for the treatment of the aging male syndrome.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"316-323"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159750","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":"Diagnosis and Management of Intrascrotal Nerve Tumors: A Systematic Review of the Literature.","authors":"Ilias Giannakodimos, Alexis Giannakodimos, Afroditi Ziogou, Konstantinos Tzelepis","doi":"10.5152/tud.2023.23050","DOIUrl":"10.5152/tud.2023.23050","url":null,"abstract":"<p><p>Scrotal tumors of nerve origin are extremely rare and occur mostly in the extratesticular tissues of scrotum, such as the spermatic cord and epididymis. A systematic search of the literature in PubMed, Medline, and Google Scholar databases concerning intrascrotal nerve tumors was performed by 2 independent investigators. The systematic search retrieved 45 male adults, with a mean age of included patients at 43.9 ± 18.8 years. The majority of nerve tumors were extra-testicular (86.7%), and only 13.3% originated from the testis. Out of that, 51.1% of neoplasms were histologically proved as schwannomas, 44.4% as neurofibromatosis, and 4.4% as malignant peripheral nerve sheath tumors. The majority of patients presented with atypical symptoms such as scrotal swelling (51.1%), while only 4.4% of patients were asymptomatic. Ultrasonography is the diagnostic modality of choice (97.2%) for the detection of primary lesion, while magnetic resonance imaging and computed tomography comprise supplementary diagnostic tools. Surgical excision of the mass was the preferred type of surgery performed (75.6%), whereas orchiectomy was performed only in 22.2% of patients. Intrascrotal tumors of nerve origin are extremely rare neoplasms that present mainly in middle-aged males. Increased clinical suspicion is required for accurate diagnosis of this rare entity.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"274-279"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159752","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":"Selective Transarterial Embolization for Intractable Hematuria Due to Bladder Carcinomas: A Single-Center Experience.","authors":"Azad Hekimoglu, Onur Ergun, Baki Hekimoglu","doi":"10.5152/tud.2023.22224","DOIUrl":"10.5152/tud.2023.22224","url":null,"abstract":"<p><strong>Objective: </strong>Malignant bladder neoplasms can cause life-threatening persistent hematuria. Selective transarterial embolization is an effective way to achieve hemostasis in such patients. The purpose of our study is to share our experience in these patients and to evaluate the short- and long-term effectiveness of this procedure.</p><p><strong>Methods: </strong>Twelve male patients with intractable hematuria due to bladder carcinoma were included in the study. A total of 17 selective transarterial embolization procedures (bilateral in 5 patients) were performed in 12 patients with microspherical particles and microcoils.</p><p><strong>Results: </strong>Complete control of bleeding was achieved in 9 patients after the procedures whereas the need for transfusion continued in 3 patients. Approximately 75% bleeding control was achieved during our average 6-month (4- to 12-month) follow-up period. After the procedure, the patients had mild complaints that lasted for a few days, such as pain (66%), fever (42%), and nausea (50%). No major complications occurred.</p><p><strong>Conclusion: </strong>Selective transarterial internal iliac artery embolization is a reliable method that can be used for the palliative treatment of intractable hematuria due to bladder carcinomas.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"334-337"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159672","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":"The Prime Time for Flexible Ureteroscopy for Large Renal Stones Is Coming: Is Percutaneous Nephrolithotomy No Longer Needed?","authors":"Senol Tonyali, Hakan Bahadir Haberal, Francesco Esperto, Zeeshan Hamid, Lazaros Tzelves, Amelia Pietropaolo, Esteban Emiliani","doi":"10.5152/tud.2023.23142","DOIUrl":"10.5152/tud.2023.23142","url":null,"abstract":"<p><p>Advances in laser technology and surgical telescopic systems have propelled retrograde intrarenal surgery (RIRS) to the forefront as a viable alternative to percutaneous nephrolithotomy (PCNL). Currently, RIRS is being increasingly utilized as a treatment option, even for kidney stones larger than 2 cm. In this narrative review, we aimed to take a snapshot of current practice in renal stone treatment and the latest technological and technical developments and to evaluate the efficacy of RIRS in larger renal stones. With low complication rates and acceptable stone-free rates, RIRS offers patients a less invasive option with favorable outcomes. There are insufficient data comparing PCNL with RIRS using a new-generation high-power laser and suctioning ureteral access sheath (UAS). Further studies with novel lasers and UAS could provide superiority in terms of RIRS. It is crucial to take into account various patient-specific considerations, such as stone location and burden, when deciding on the appropriate treatment approach.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"49 5","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159673","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}