International Urology and Nephrology最新文献

{"title":"Collagen fleece grafting for surgical treatment of patients with mild to severe peyronie's curvatures.","authors":"Radion Garaz, Bastian Amend, Arnulf Stenzl, Jens Bedke, Jörg Hennenlotter, Alexander Rochwarger, Christian M Schürch, Igor Tsaur, Steffen Rausch","doi":"10.1007/s11255-024-04222-2","DOIUrl":"10.1007/s11255-024-04222-2","url":null,"abstract":"<p><strong>Purpose: </strong>Collagen fleece grafting (CFG) is the recommended treatment for severe Peyronie's disease (PD) curvature (> 60°), but its efficacy in mild/moderate curvatures remains uncertain. This study evaluated CFG in patients with mild/moderate curvatures (< 60°) at risk of penile shortening or symptomatic plaque.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients who underwent surgical treatment for PD using plaque incision or partial plaque excision and CFG. Clinical parameters and complications were reviewed. Subgroup analysis was performed on patients with curvatures of > 60° and curvatures ≤ 60°.</p><p><strong>Results: </strong>89 patients with a median age of 59 years and a median curvature of 70 (20-90)° were identified. Dorsal curvature was predominant in 66% of cases, followed by lateral (16%), ventral (8%), and complex curvatures (10%). Partial plaque excision was performed in 98% of patients, with an average grafting area of 2.1 cm²; 71% had a singular penile plaque, while 29% presented two or more plaques. The comparison between patients with curvatures ≤ 60° and > 60° revealed no significant differences in mean operation time (86.3 vs. 94.4 min, p = 0.13) or in the incidence of postoperative complications, including glans necrosis, hypoesthesia, ecchymosis, bleeding, hematoma, infection, residual curvature, revision surgery, or pain.</p><p><strong>Conclusions: </strong>Early postoperative outcomes and complication rates following plaque incision or partial plaque excision and grafting with CFG were comparable in patients with mild/moderate and severe PD deformities. The technique may be a viable option with a similar risk profile for achieving penile straightening in selected PD cases, particularly when plication is not feasible.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"355-362"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic ureteral stent in colorectal surgery: a meta-analysis and systematic review.","authors":"Bernardo Fontel Pompeu, Camila Tur de Arruda Ribeiro, Eric Pasqualotto, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Leonardo Borges, Fernanda Bellotti Formiga","doi":"10.1007/s11255-024-04224-0","DOIUrl":"10.1007/s11255-024-04224-0","url":null,"abstract":"<p><strong>Purpose: </strong>Accidental ureteric injury during colorectal surgery is a rare but dreadful event. It is associated with a higher risk of urinary tract infection (UTI) and acute kidney injury (AKI). Prophylactic placement of double J stents could improve ureteral identification and decrease the chance of accidental ureteral injury.</p><p><strong>Methods: </strong>We searched MEDLINE, Cochrane, Central Register of Clinical Trials, and Web of Science for studies published until March 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled with a random-effects model. Statistical significance was defined as p < 0.05. Heterogeneity was assessed using the Cochran Q test and I² statistics, with p-values inferior to 0.10 and I² > 25% considered significant. Statistical analysis was conducted in RStudio version 4.4.1.</p><p><strong>Results: </strong>Eleven observational studies were included, comprising 71,784 patients. Among them, 11,723 (16.4%) were submitted to a prophylactic ureteral stent while 59,961 (83.6%) were not. There was no significant difference in ureteral injury between the groups (0.66% vs 0.8%; OR 1.45; 95% CI 0.43-4.87; p = 0.552; I² = 56%). Prophylactic stent placement was associated with an increase in AKI (1.7% vs. 0.56%; OR 1.54; 95% CI 1.24-1.91; p < 0.001; I² = 44%), operative time (MD 24.8 min; 95% CI 4.9-44.8; p = 0.01; I² = 91%), and a decrease in mortality (OR 0.11; 95% CI 0.05-0.23; p < 0.001; I² = 42%). No differences were observed in UTI, hematuria, length of hospital stays, and reoperation.</p><p><strong>Conclusion: </strong>In colorectal surgery, prophylactic ureteral stents were associated with increased AKI and operative time. No significant difference was observed in ureteral injury, UTI, hematuria, length of hospital stays, and reoperation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"301-312"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Trimethylamine (TMA)-Producing Bacteria in patients with chronic kidney disease undergoing hemodialysis.","authors":"Livia Alvarenga, Julie Ann Kemp, Júnia Schultz, Ludmila F M F Cardozo, Lia S Nakao, Marcelo Ribeiro-Alves, Alexandre Rosado, Denise Mafra","doi":"10.1007/s11255-024-04191-6","DOIUrl":"10.1007/s11255-024-04191-6","url":null,"abstract":"<p><strong>Introduction: </strong>Trimethylamine (TMA), produced by gut microbiota, is the precursor of trimethylamine-N-oxide (TMAO), a uremic toxin that accumulates in patients with chronic kidney disease (CKD). Elevated TMAO plasma levels are associated with cardiovascular complications and CKD progression.</p><p><strong>Objective: </strong>To evaluate the association between gut microbiota composition and TMAO plasma levels in CKD patients undergoing hemodialysis (HD).</p><p><strong>Methods: </strong>This is a cross-sectional study with 25 patients evaluated (60% female, 53 (18) years, body mass index (BMI) 25.8 (6.75) Kg/m²). They were divided into two groups according to their TMAO plasma levels: normal (≤ 7.4 μM) and high (> 7.4 μM). Uremic toxins such as indoxyl sulfate (IS), p-cresyl sulfate (pCS), and indol acetic acid (IAA) were measured with RP-HPLC, and TMAO plasma levels were quantified using LC-MS/MS. Fecal DNA was extracted with a commercial kit, PCR amplified the V4 region of the 16S rRNA gene, and short-read sequencing was performed on the Illumina platform. Dietary intake, anthropometric measurements, and inflammation markers were also evaluated. Nrf2, NF-κB, IL-1β, and NLRP3 mRNA expressions were measured from peripheral blood mononuclear cells (PBMC) using quantitative real-time polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>There were significant positive correlations between TMAO and plasma levels of pCS, NLPR3 inflammasome mRNA expression, serum phosphorus levels, and negative correlations with dietary lipid intake. The group with TMAO > 7.4 μM showed an increase in the microbiome abundance of Saccharibacteria (genus incertae sedis), Colidextribacter, Dorea, and Staphylococci genera, and a decrease in abundance in the genera Lachnospira, Lactobacilli, and Victivallis. TMAO plasma level was positively correlated with the abundance of bacteria of the genera Colidextribacter and Helicobacter and was negatively correlated with Sphingomanos, Lachnospira, Streptomyces, and Bacillus genera.</p><p><strong>Conclusion: </strong>Saccharibacteria (genus incertae sedis), Colidextribacter, Dorea, and Staphylococci genera showed higher abundance in patients with high TMAO levels. In addition, we observed that elevated plasma TMAO levels are associated with inflammation markers, dietary lipid intake, and serum phosphorus levels in patients undergoing HD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"535-544"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bladder size and shape on the accuracy of formula method for bladder volume evaluation.","authors":"Jintao Shen, Yaqi Zuo, Jing Song, Zhen Su, Shiwen Wang, Haihong Jiang","doi":"10.1007/s11255-024-04211-5","DOIUrl":"10.1007/s11255-024-04211-5","url":null,"abstract":"<p><strong>Background: </strong>To explore the impact of bladder size and shape on the accuracy of the formula method (V = 0.52 × d₁ × d₂ × d₃) for bladder volume evaluation.</p><p><strong>Methods: </strong>Data was retrospectively collected from 220 patients without reportable bladder diseases. CT images were imported into 3D Slicer software to measure the bladder volume V_A (reference standards). Bladder volume was also measured by the formula method V_B = 0.52 × d₁ × d₂ × d₃. Results of these two methods were compared based on bladder size and shape.</p><p><strong>Results: </strong>The bldder volume was 121.0 ± 83.6 mL with the formula method, compared with 128.5 ± 82.6 mL measured by 3D Slicer (P < 0.0001). Patients were divided into three groups based on bladder size, the mean percent deviations between the two methods were 18.8 ± 20.8%, 3.4 ± 12.9% and 4.6 ± 10.6%, respectively. According to the bladder shape, it can be divided into 5 types. For round and triangle shapes, there was no significant statistical difference in the results of the two methods. For bladder shapes with ellipse, rectangle and irregular shape, the volume evaluated by the formula method was statistically lower. Their deviations were 9.7 ± 17.5%, 12.9 ± 9.6% and 14.4 ± 21.2%, respectively.</p><p><strong>Conclusion: </strong>The accuracy of the formula method for estimating bladder volume is affected by bladder size and shape. Overall, the formula method tends to underestimate the bladder volume. The error of small-sized bladders is much greater than that of large-sized bladders. Furthermore, the formula method has high accuracy in measuring bladder volume with round and triangle shapes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"333-339"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening core genes for minimal change disease based on bioinformatics and machine learning approaches.","authors":"Dingfan Hao, Xiuting Yang, Zexuan Li, Bin Xie, Yongliang Feng, Gaohong Liu, Xiaojun Ren","doi":"10.1007/s11255-024-04226-y","DOIUrl":"10.1007/s11255-024-04226-y","url":null,"abstract":"<p><p>Based on bioinformatics and machine learning methods, we conducted a study to screen the core genes of minimal change disease (MCD) and further explore its pathogenesis. First, we obtained the chip data sets GSE108113 and GSE200828 from the Gene Expression Comprehensive Database (GEO), which contained MCD information. We then used R software to analyze the gene chip data and performed functional enrichment analysis. Subsequently, we employed Cytoscape to screen the core genes and utilized machine learning algorithms (random forest and LASSO regression) to accurately identify them. To validate and analyze the core genes, we conducted immunohistochemistry (IHC) and gene set enrichment analysis (GSEA). Our results revealed a total of 394 highly expressed differential genes. Enrichment analysis indicated that these genes are primarily involved in T cell differentiation and p13k-akt signaling pathway of immune response. We identified NOTCH1, TP53, GATA3, and TGF-β1 as the core genes. IHC staining demonstrated significant differences in the expression of these four core genes between the normal group and the MCD group. Furthermore, GSEA suggested that their up-regulation may be closely associated with the pathological changes in MCD kidneys, particularly in the glycosaminoglycans signaling pathway. In conclusion, our study highlights NOTCH1, TP53, GATA3, and TGF-β1 as the core genes in MCD and emphasizes the close relationship between glycosaminoglycans and pathogenesis of MCD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"655-671"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Native nephrectomy in patients with autosomal dominant polycystic kidney disease in kidney transplant program: long-term single-center experience.","authors":"Pavel Navratil, Jiri Chalupnik, Tomas Merkl, Jiri Spacek, Michaela Matyskova Kubisova, Roman Safranek, Ivo Novak, Jaroslav Pacovsky, Pavel Navratil, Igor Gunka","doi":"10.1007/s11255-024-04234-y","DOIUrl":"10.1007/s11255-024-04234-y","url":null,"abstract":"<p><strong>Introduction: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder that frequently leads to end-stage renal disease. In this study, we examine the indications, procedures, and outcomes of native nephrectomy (NN) in ADPKD patients at our transplant center. Drawing on 25 years of clinical practice, we aim to provide insights into the surgical management of ADPKD, focusing on the specific factors influencing NN.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted involving ADPKD patients who underwent KT and NN between 1999 and 2023. Collected data encompassed demographics and surgery parameters, such as duration, hospital stay length, blood loss, and complications. Patients were classified based on the urgency (acute/planned) of the NN and its type (unilateral/bilateral), followed by an analysis of the outcomes per group.</p><p><strong>Results: </strong>Out of 152 patients post-KT for ADPKD, 89 (58.6%) underwent NN. The procedures were predominantly unilateral (71; 64%), with bilateral NN accounting for 40 (36%) cases. NN timing relative to KT was 31 (27.9%) pretransplant, 9 (8.1%) concomitant, 51 (45.9%) posttransplant, and 10 (9%) patients undergoing the sandwich technique. Acute NN were performed in 42 cases, while 69 were planned. Acute NNs were associated with longer surgeries, greater blood loss, and a higher incidence of perioperative complications compared to planned NNs. Specifically, unilateral acute NN had a 23.8% complication rate compared to 2.9% in planned cases; bilateral acute NN showed a 28.6% complication rate versus 4.3% in planned cases.</p><p><strong>Conclusion: </strong>This investigation accentuates the significance of planning and selection in NN for ADPKD, factoring in the heightened risk of complications. Acute NN are linked to worse outcomes, including higher rates of complications. The data emphasize the necessity of tailored surgical approaches based on individual patient circumstances.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"391-398"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided kidney biopsy: a ten-year retrospective single-center experience and the promising role of clinical hypnosis.","authors":"Andrea Angioi, Giacomo Mascia, Danilo Sirigu, Riccardo Cao, Paola Bianco, Daniela Onnis, Matteo Floris, Gianfranca Cabiddu, Antonello Pani, Nicola Lepori","doi":"10.1007/s11255-024-04196-1","DOIUrl":"10.1007/s11255-024-04196-1","url":null,"abstract":"<p><p>This retrospective analysis investigates the outcomes and complications of 682 kidney biopsies performed at ARNAS G. Brotzu from 2010 to 2021. Our findings indicate a minor complication rate of 9.1%, with severe complications being exceedingly rare at 0.3%. Age did not contribute to an increased risk, underscoring the procedure's safety across age groups. Clinical hypnosis was incorporated into the biopsy protocol in a subset of patients (n = 45) from April 2019 to December 2023. Over 90% of these patients reported no perception of the procedure, and 60% experienced no pain. According to STAY-Y test scores, this approach significantly reduced anxiety post-procedure (p = 0.001); no major or minor complications were observed in this group. While our study reaffirms the very low risk of severe complications in kidney biopsies, it also highlights the potential benefits of adjunct clinical hypnosis in enhancing patient comfort and cooperation during the procedure. This exploration opens a promising avenue for further investigation to improve patient experiences and procedural outcomes in kidney biopsies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"553-559"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review on adult patients with de novo glomerular diseases following COVID-19 infection or vaccine.","authors":"Liam Qi, Aman Deep, Jordan Fox, Mark Yii, Muhammad Rahman, Mar Myint, Htoo Myat, Zaw Thet","doi":"10.1007/s11255-024-04189-0","DOIUrl":"10.1007/s11255-024-04189-0","url":null,"abstract":"<p><strong>Background: </strong>There are increasing reports of glomerular disease (GD) following COVID-19 infection and vaccination. Current evidence on the possible link between COVID-19 infection or vaccination and GD is conflicting.</p><p><strong>Objective: </strong>The present study undertakes a scoping review of research to describe the relationship between COVID-19 infection and vaccination with GD and the common management strategies and overall outcomes of the disease to identify knowledge gaps and guide further research.</p><p><strong>Eligibility criteria: </strong>All original research studies published in English until 5th September 2022 were considered for inclusion in the review. Exclusion criteria were animal studies, autopsy studies, and data involving patients who were paediatric patients (< 16 years), were transplant recipients, had a recurrence of glomerular disease, had concomitant cancer or non-COVID-19 infection which may cause glomerular disease, or did not receive a renal biopsy.</p><p><strong>Sources of evidence: </strong>The five electronic databases searched were MEDLINE, PubMed, Scopus, EMBASE, and Cochrane.</p><p><strong>Methods: </strong>Two separate search strings related to COVID-19, and glomerular disease were combined using the Boolean operator 'AND'. Filters were used to limit publications to original research studies published in English. Search results from each database were imported into Covidence software ( www.covidence.org ) and used for de-duplication, article screening, and data extraction. Descriptive analyses were used to summarise demographics, diagnoses, and treatment outcomes.</p><p><strong>Results: </strong>After removing duplicates, 6853 titles and abstracts were screened. Of the 188 studies included, 106 studies described 341 patients with GD following COVID-19 infection and 82 described 146 patients with GD following a COVID-19 vaccination. IgA nephropathy was the most common GD pathology reported following COVID-19 vaccination with GD most common following mRNA vaccines. Collapsing focal segmental glomerulosclerosis was the most common GD following COVID-19 infection. Immunosuppressive treatment of GD was more common in the vaccine cohort than in the infection cohort.</p><p><strong>Conclusion: </strong>Despite the significant number of COVID-19 infections and vaccinations around the world, our understanding of GD associated with COVID-19 infection and vaccination remains poor, and more research is needed to understand the possible relationship better.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"447-462"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical manifestations, diagnosis and treatment of hereditary fibrinogen Aα-chain renal amyloidosis: one case report and systematic review.","authors":"Linying He, Jiahui Zhou, Miner Wang, Jianxiang Chen, Chang Liu, Jiazhen Shi, Yanxia Rui, Henglan Wu","doi":"10.1007/s11255-024-04236-w","DOIUrl":"10.1007/s11255-024-04236-w","url":null,"abstract":"<p><strong>Purpose: </strong>We reported a confirmed case of Fibrinogen Aa-chain (AFib) amyloidosis and conducted systematic review of the genetic and protein mutation types, clinical manifestations, diagnostic methods and treatment for patients with this disease worldwide.</p><p><strong>Methods: </strong>We reported a case of AFib amyloidosis. Meanwhile, a systematic search was performed using defined terms and updated up to November 2023 in the Wanfang, China National Knowledge Infrastructure, VIP, PubMed, and Web of Science databases to identify reported cases of AFib renal amyloidosis worldwide, according to PRISMA guidelines.</p><p><strong>Results: </strong>A 46-year-old male patient was admitted for more than half a month because of oedematous lower limbs. Renal tissue mass spectrometry suggested an AFib type. Gene detection demonstrated that the patient carried the c.1673del (p.Lys558Argfs*10) locus heterozygous mutation of Fibrinogen Aα-chain gene (FGA). The patient was treated with haemodialysis because of uncontrollable hypertension. This systematic review comprised 46 cases. We found the onset age to be lower in women than in men (P < 0.05). All patients showed incipient symptoms including proteinuria; 10 (21.7%) patients progressed to end-stage renal disease (ESRD) or received renal replacement therapy (including dialysis and kidney transplantation) within 1 year; 18 (39.1%) patients progressed to ESRD or received renal replacement therapy within 1-5 years, and 4 (8.7%) patients did not progress to ESRD or received renal replacement therapy within 5 years.</p><p><strong>Conclusion: </strong>AFib amyloidosis progresses rapidly. The diagnosis of this disease is primarily based on renal biopsy, mass spectrometry, and molecular gene detection. Reducing proteinuria is the main method of treating this disease.</p><p><strong>Prospero registration number: </strong>CRD42024516146.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"517-533"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A closer look: sperm analysis and clinical outcomes of microscopic and loupe-assisted varicocele repair in male infertility due to moderate-to-severe varicocele.","authors":"Hooman Kamran, Iman Shamohammadi, Abdolreza Haghpanah","doi":"10.1007/s11255-024-04242-y","DOIUrl":"10.1007/s11255-024-04242-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The aim of the study was to compare the clinical outcomes, sperm parameters, and complications of loupe-assisted and microscopic varicocele repair in patients with infertility due to moderate-to-severe varicocele.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included all male individuals over 18 years of age who underwent inguinal varicocele repair at our center due to infertility. Subjects with azoospermia, genetic abnormalities such as Kallmann syndrome, incomplete medical records, or those lost to follow-up were excluded from the study. Patients were divided into two groups based on the magnification tool used (microscope or loupe). Follow-ups were conducted at 3 months and 1 year post-surgery. Sperm parameters, pregnancy rates, and surgical complications were recorded to compare the efficacy of the magnification tools. The Improvement Index for sperm parameters was calculated by dividing the difference between the post-operative and pre-operative parameters by the pre-operative parameter. An Improvement Index above 0.5 was considered a good outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 104 patients, 58 underwent loupe-assisted and 46 underwent microscopic varicocele repair. Sperm concentration and progressive motility increased significantly in the semen analyses at three months and one year post-operation compared to pre-operative semen analyses. However, increases in sperm morphology were not statistically significant in either follow-up semen analysis. An Improvement Index greater than 0.5 (indicating a good outcome) was observed in 35.3%, 34.1%, and 15.2% of patients for sperm concentration, progressive motility, and morphology, respectively, after 3 months, and 38.9%, 43.4%, and 22.4% after 1 year. Nonetheless, there were no significant differences in the Improvement Index of sperm parameters between the two magnification methods. The operative duration was significantly longer with microscopic magnification (median of 70.0 [20.0] minutes vs. 45.0 [20.0] minutes) (p value &lt; 0.001). Conversely, the pregnancy rates were 34.5% (20 patients) in the loupe-assisted group and 37.0% (17 patients) in the microscopic group, which was not significantly different (p value: 0.794). Similarly, the rate of complications was not significantly different, with 5 patients (10.9%) experiencing complications (4 hydroceles and 1 wound infection) in the microscopic group compared to 4 patients (6.9%) (3 hydroceles and 1 wound infection) in the loupe-assisted group (p value: 0.504).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The current study's results indicate that the clinical outcomes, sperm parameters, and complications associated with loupe-assisted varicocele repair are comparable to those of microsurgical varicocele repair, which is considered the gold standard. We suggest conducting prospective studies to assess whether loupe-assisted varicocele repair is a safe alternative, especially in centers with limited or no access to surgical micro","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"435-442"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}