Urology research & practice最新文献

{"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}

{"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}

{"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}

{"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}

{"title":"Role of Chemoablation Using UGN-101 in Upper Tract Urothelial Carcinoma: A Systematic Review and MetaAnalysis of Available Evidence.","authors":"Abdalla Ali Deb, Pragnitha Chitteti, Naufal Naushad, Wael Asaad, Steve Leung, Hartley Alice, Serag Hosam","doi":"10.5152/tud.2024.23215","DOIUrl":"10.5152/tud.2024.23215","url":null,"abstract":"<p><p>To examine the safety and efficacy of chemoablation using UGN-101 in patients with upper tract urothelial cancer (UTUC). We conducted a systematic search through 7 databases/registries to identify key observational and experimental studies reporting either the efficacy or safety of UGN-101 in UTUC patients regardless of the risk or grade of the disease. The outcomes included efficacy (complete/partial/no response, survival, death, recurrence, or progression) and safety endpoints. All meta-analyses were conducted through STATA. The prevalence rate and its 95% CI were pooled across studies. A subgroup meta-analysis was conducted on follow-up. The quality was assessed using the Newcastle Ottawa Scale. Twenty studies (1051 patients) were analyzed. Complete response was reported in 49% (39%-60%) of cases, and 5% (0%- 15%) had disease progression. Treatment cessation was reported in 13% (3%-27%) of patients. Four percent of cases needed radical nephroureterectomy. Recurrence and death occurred in 14% (7%-23%) and 6% (2%-10%) of patients. Complications occurred in 63% (39%-85%), the majority of which were of grades I, II, and III. Ureteral stenosis was the most common complication accounting for 35% of cases. Chemoablationrelated complications occurred more than procedure-related ones. Based on available evidence, the intracavitary instillation of UGN-101 gel provides an alternative therapeutic option for upper tract urothelial cancer. Chemoablation provides good clinical outcomes in terms of complete response, disease progression and recurrence, and the need to undergo nephroureterectomy. Complications were encountered in more than half the population; however, most of them were of low grades.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"72-84"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984204","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":"Can We Predict Renal Function Recovery After Pyeloplasty in Pediatrics with Ureteropelvic Junction Obstruction? A Systematic Review.","authors":"Safendra Siregar, Akhmad Mustafa, Steven Steven","doi":"10.5152/tud.2024.23220","DOIUrl":"10.5152/tud.2024.23220","url":null,"abstract":"<p><p>Chronic unilateral renal obstruction, primarily caused by ureteropelvic junction obstruction (UPJO), poses challenges in determining the optimal timing for corrective surgery. The goal is to preserve renal function and alleviate symptoms, but there is no definitive diagnostic test to reliably predict the outcomes of surgery. This systematic review aimed to identify predictors for renal function recovery after pyeloplasty in order to guide effective treatment options. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A literature search was performed on PubMed, Embase, and Scopus using keywords related to renal function, pyeloplasty, and predictors. The search was conducted on March 10, 2022. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Out of 344 potentially relevant articles, 11 met the eligibility criteria for this study. These included 6 retrospective and 5 prospective studies, with a total of 925 participants. Most studies evaluated renal function using differential renal function (DRF). The overall quality of the included studies was considered average. The findings indicated that age at the time of surgery and gender did not significantly influence functional recovery after pyeloplasty. However, preoperative DRF consistently emerged as a critical predictor. Preoperative DRF can serve as the most common predictors used for renal function recovery following pyeloplasty. These findings contribute to understanding effective treatment options for chronic unilateral renal obstruction. However, further research for each predictor is needed to validate these predictors and their clinical utility. Cite this article as: Siregar S, Mustafa A, Steven S. Can we predict renal function recovery after pyeloplasty in pediatrics with ureteropelvic junction obstruction? A systematic review. Urol Res Pract. Published online March 31, 2024. DOI:10.5152/tud.2024.23220.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154746","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":"Advancements in Hypospadias Management: Trends, Techniques, Training, and Patient-Centric Outcomes.","authors":"Vinaya Bhatia, Nicolas Fernandez, Christopher Long, Renea Sturm, Walid Farhat, Fardod O'Kelly","doi":"10.5152/tud.2024.23219","DOIUrl":"10.5152/tud.2024.23219","url":null,"abstract":"<p><p>Hypospadias has drawn increasing attention due to its prevalence, complex etiology, and significant impacts on psychological and sexual quality of life. This comprehensive review delves into the facets of hypospadias management, exploring pivotal themes that shape present understanding and practice. We demonstrate potential explanatory factors for its incidence through an analysis of geographic, genetic, and environmental influences. We then contextualize care by exploring historical and evolving surgical techniques, and highlight that advances in surgical approaches employ a spectrum of repair strategies. Innovation in surgical training, with a focus on simulation-based methodologies, offers a bridge between didactic learning and real-world application, which is particularly relevant due to the demonstrated effect of personal experience with hypospadias repair outcomes. Considering the importance of mentorship, case exposure, and hands-on practice, a holistic understanding of expertise cultivation at each training stage is essential. Lastly, patient-centric outcomes research must take center stage, particularly as the impact of our interventions on children with hypospadias will be judged by them as adults. Shifting from solely surgeon-reported outcomes to patient-reported outcomes is emphasized in the review, allowing for a more comprehensive assessment of the influence of surgical interventions across the lifespan. Integrating patients' perspectives refines surgical decision-making to align with expectations, ultimately enhancing overall satisfaction. Our multi-pronged exploration of advancements in hypospadias underscores the symbiotic relationship between evolving surgical techniques, training methodologies, personal experience, and patientreported outcomes. As the field progresses, these insights will collectively contribute to optimizing hypospadias care, advancing both medical practice and patient well-being.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"94-101"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904119","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":"Guidelines of Guidelines: Conservative, Pharmacological, and Surgical Management for Neurogenic Lower Urinary Tract Dysfunction.","authors":"Diana Carolina Ochoa, Alessia Christina Mahoney, Christina Fontaine, Hashim Hashim","doi":"10.5152/tud.2024.23232","DOIUrl":"10.5152/tud.2024.23232","url":null,"abstract":"<p><p>Neurogenic lower urinary tract dysfunction (NLUTD) encompasses a broad spectrum of neurological conditions affecting the lower urinary tract. Managing NLUTD requires a tailored approach focused on preserving kidney function and enhancing patients' quality of life. Clinical guidelines provide valuable guidance for healthcare professionals, but discrepancies in recommendations arise among other factors due to limited high-quality clinical evidence. Prominent guidelines from organisations like the International Consultation of Incontinence, the European Association of Urology, the American Urological Association, and the National Institute for Health and Care Excellence offer varying recommendations for NLUTD management. This study reviews and summarizes the recommendations for conservative, pharmacological, and surgical management options across these guidelines. Cite this article as: Ochoa DC, Mahoney AC. Fontaine C, Hashim H. Guidelines of guidelines: conservative, pharmacological, and surgical management for neurogenic lower urinary tract dysfunction (NLUTD). Urol Res Pract. Published online March 31, 2024. doi: 10.5152/tud.2024.23232.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154901","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}