Investigative and Clinical Urology最新文献_第3页

Extraperitoneal single-port robot-assisted radical prostatectomy: Short-term outcomes and technique description. 腹膜外单孔机器人辅助前列腺癌根治术：短期疗效和技术描述。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-09-01 DOI: 10.4111/icu.20230427

Hyeok Jae Kwon, San Kang, Seung Ah Rhew, Chang Eil Yoon, Dongho Shin, Seokhwan Bang, Hyong Woo Moon, Woong Jin Bae, Hyuk Jin Cho, U-Syn Ha, Ji Youl Lee, Sae Woong Kim, Sung-Hoo Hong

{"title":"Extraperitoneal single-port robot-assisted radical prostatectomy: Short-term outcomes and technique description.","authors":"Hyeok Jae Kwon, San Kang, Seung Ah Rhew, Chang Eil Yoon, Dongho Shin, Seokhwan Bang, Hyong Woo Moon, Woong Jin Bae, Hyuk Jin Cho, U-Syn Ha, Ji Youl Lee, Sae Woong Kim, Sung-Hoo Hong","doi":"10.4111/icu.20230427","DOIUrl":"10.4111/icu.20230427","url":null,"abstract":"Purpose: We evaluated the feasibility, safety, and learning curve of extraperitoneal single-port robot-assisted radical prostatectomy (SP-RARP) and introduced innovative surgical techniques to maintain the instrument positions during the procedures.Materials and methods: A cohort of 100 patients underwent extraperitoneal SP-RARP at our institution from December 2021 to April 2023. The procedures were performed by an experienced urology surgeon utilizing two surgical techniques for dissecting the posterior aspect of the prostate-\"changing instrument roles\" and \"using camera inversion\"-to prevent positional shifts between the camera and instruments.Results: The mean operation time for SP-RARP was 93.58 minutes, and the mean console time was 65.16 minutes. The mean estimated blood loss during the procedures was 109.30 mL. No cases necessitated conversion to multi-port robot, laparoscopy, or open surgery, and there were no major complications during the hospital stay or in the short-term follow-up. Early outcomes of post-radical prostatectomy indicated a biochemical recurrence rate of 4.0% over a mean follow-up duration of 6.40 months, with continence and potency recovery rates of 92.3% and 55.8%, respectively. Analysis of the learning curve showed no significant differences in operation time, console time, and positive surgical margin rates between the initial and latter 50 cases.Conclusions: Extraperitoneal SP-RARP is a feasible and safe option for the treatment of localized prostate cancer in skilled hands. Continued accrual of cases is essential for future comparisons of SP-RARP with multiport approaches.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"442-450"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-term outcomes of intravesical gemcitabine for non-muscle-invasive bladder cancer after recent approval for use in Korea. 韩国最近批准使用膀胱内吉西他滨治疗非肌层浸润性膀胱癌后的短期疗效。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-09-01 DOI: 10.4111/icu.20240047

Gang Kyu Kim, Young Heun Jo, Jongsoo Lee, Hyun Ho Han, Won Sik Ham, Won Sik Jang, Ji Eun Heo

{"title":"Short-term outcomes of intravesical gemcitabine for non-muscle-invasive bladder cancer after recent approval for use in Korea.","authors":"Gang Kyu Kim, Young Heun Jo, Jongsoo Lee, Hyun Ho Han, Won Sik Ham, Won Sik Jang, Ji Eun Heo","doi":"10.4111/icu.20240047","DOIUrl":"10.4111/icu.20240047","url":null,"abstract":"Purpose: In high-risk non-muscle-invasive bladder cancer (NMIBC), intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy post-transurethral resection of bladder tumor (TURBT). Intravesical gemcitabine, used as an alternative or second-line therapy amid BCG shortages, lacks outcome studies in the Korean population.Materials and methods: Patients who received weekly intravesical gemcitabine for 6 weeks after TURBT from 2019 to 2022 were retrospectively investigated. Based on the American Urological Association risk classification, patients with high- or very high-risk NMIBC who refused cystectomy were included. Maintenance treatment was performed depending on their risk. Recurrence was defined as histologic confirmation on subsequent cystoscopic biopsies or TURBT. Disease free survival (DFS) was evaluated by the Kaplan-Meier method.Results: The study included 60 patients, comprising 45 high-risk (group 1) patients with a median age of 76 years and 15 very high-risk (group 2) patients with a median age of 68 years. Among them, 28 patients had previously received intravesical BCG. Over a median follow-up of 22 months, recurrence occurred in 31 patients in group 1 and 11 in group 2. The DFS rates of the high-risk group and the very high-risk group were 57.8% versus 40% at 1 year, 20.7% versus 21.3% at 2 years and 20.7% versus 21.3% at 3 years, respectively (p=0.831). Tis stage (p=0.042) and prostatic urethra invasion (p=0.028) were significant predictors of DFS. Cancer-specific mortality rates were 2.2% in group 1 and 6.7% in group 2 (p=0.441).Conclusions: Similar DFS outcome between high-risk and very high-risk patients were observed based on short-term results in Korea. This finding is crucial for clinical practice; however, studies analyzing more patients and long-term outcomes are needed.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"435-441"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Occurrence of liver abscess in patients with acute prostatitis. 急性前列腺炎患者出现肝脓肿。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-09-01 DOI: 10.4111/icu.20240152

Jeonghyouk Choi, Dong-Gi Lee

{"title":"Occurrence of liver abscess in patients with acute prostatitis.","authors":"Jeonghyouk Choi, Dong-Gi Lee","doi":"10.4111/icu.20240152","DOIUrl":"10.4111/icu.20240152","url":null,"abstract":"Purpose: Liver abscesses concomitant with acute prostatitis are rare and potentially fatal. We analyzed the occurrence of this condition and clinical characteristics of the affected patients.Materials and methods: The medical records of 474 patients diagnosed with acute prostatitis between June 2006 and July 2022 were retrospectively reviewed. Patients in whom pathogens were not detected in serum or urine cultures were excluded. A total of 271 patients were included in the analysis. Patient characteristics and laboratory test results were compared between patients with acute prostatitis with and without liver abscesses.Results: Fifteen patients (5.5%) were identified with simultaneous liver abscesses and acute prostatitis. The liver abscess group was younger than the non-liver abscess group in terms of mean age. In the univariate analysis, a high proportion of patients had diabetes mellitus, whereas a low proportion had hypertension. None of the underlying diseases, including benign prostatic hyperplasia, malignancy, or alcoholism, demonstrated a significant association with liver abscess in multivariate analysis; however, an association was observed in liver function test results. All patients with liver abscesses tested positive for Klebsiella pneumoniae.Conclusions: When K. pneumoniae is identified in patients with acute prostatitis and abnormal liver function tests, considering the possibility of metastatic infection in other organs, including the liver, and performing an active evaluation is essential.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"480-486"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of prostatic urethral angle and intravesical prostatic protrusion on surgical capsule calculi formation in the prostate: A retrospective study. 前列腺尿道角度和膀胱内前列腺突出对前列腺手术囊结石形成的作用：一项回顾性研究。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-09-01 DOI: 10.4111/icu.20240171

Jonathan Yj Chen, Han-Yu Tsai, Chen-Pang Hou, Shu-Han Tsao, Yu-Ting Chen, Horng-Heng Juang, Yu-Hsiang Lin

{"title":"The role of prostatic urethral angle and intravesical prostatic protrusion on surgical capsule calculi formation in the prostate: A retrospective study.","authors":"Jonathan Yj Chen, Han-Yu Tsai, Chen-Pang Hou, Shu-Han Tsao, Yu-Ting Chen, Horng-Heng Juang, Yu-Hsiang Lin","doi":"10.4111/icu.20240171","DOIUrl":"10.4111/icu.20240171","url":null,"abstract":"Purpose: To investigate the relationship between prostatic urethral angle (PUA) and the development of surgical capsule calculi (SCC) within the prostate, and to examine the presence and impact of intravesical prostatic protrusion (IPP).Materials and methods: A retrospective analysis was conducted on 90 patients who underwent radical prostatectomy, with preoperative assessments using both transrectal ultrasound of the prostate (TRUS) and magnetic resonance imaging. Patients were divided into groups with and without SCC and further categorized into type 1 and type 2 stones based on the location and severity of the calculi. Statistical analysis included chi-square and independent sample t-tests, with p<0.05 considered significant.Results: Of the patients, 82.2% were diagnosed with SCC. No significant difference in PUA was found between patients with and without SCC. However, a notable disparity in IPP presence was observed, suggesting an inverse correlation with SCC development. Additionally, no significant differences were identified when comparing the two types of SCC based on PUA and IPP measurements.Conclusions: The presence of IPP exhibited an inverse relationship with SCC, suggesting diminished urine flow pressure over the prostatic urethra may reduce the likelihood of SCC formation. However, no direct association between PUA and the presence or severity of SCC was identified. These findings highlight the complexity of factors contributing to prostatic calculi development and the potential role of IPP in this context.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"459-465"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scoring system to evaluate meaningful fecal impaction in patients with lower urinary tract dysfunction with simple radiography (KUB). 通过简单射线照相术（KUB）评估下尿路功能障碍患者有意义的粪便嵌塞的评分系统。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240086

Young Jae Im, Kyeong Chae Lee, Su Been Lee, Kyeong Kim, Kwanjin Park

{"title":"Scoring system to evaluate meaningful fecal impaction in patients with lower urinary tract dysfunction with simple radiography (KUB).","authors":"Young Jae Im, Kyeong Chae Lee, Su Been Lee, Kyeong Kim, Kwanjin Park","doi":"10.4111/icu.20240086","DOIUrl":"10.4111/icu.20240086","url":null,"abstract":"Purpose: The management of bowel bladder disorder (BBD) has only been indicated for subjective constipation without objective evidence. We attempted to highlight the radiological findings in patients with BBD and construct a scoring system to identify patients with BBD prior to treatment.Materials and methods: Forty-five patients with lower urinary tract dysfunction (LUTD) received polyethylene glycol for 2 months before bladder medication for LUTD. Based on partial response to LUTD following treatment, we divided the patients into LUTD-fecal impaction (FI) and LUTD not attributed to FI (LUTD-NFI) groups. Pre/post-treatment kidney, ureter, and bladder (KUB) were compared with respect to several radiographic parameters. Items with significant changes after treatment were included in the scoring system. The accuracy and inter-rater agreement were also evaluated.Results: Cecal dilation, descending colon dilation, fecal quality, and overall haziness were found to undergo significant changes after laxative treatment. We assigned 0 to 2 points for each item, with a total score of 8. Receiver operating characteristic curve analysis revealed a cutoff value of 5 between LUTD-FI and LUTD-NFI, with 79% sensitivity and 88% specificity. The scoring system was instructed to six doctors who were unaware of it and was then tested on previous patients, which showed a substantial concordance rate (κ=0.79, p<0.05).Conclusions: Fecal scoring system based on KUB was beneficial in identifying children with LUTD attributed to FI. This may provide an opportunity to obtain objective FI data as an alternative to subjective assessment of constipation.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"391-399"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimated prospects of demand and supply of urologists in Korea over the next 10 years. 未来 10 年韩国泌尿科医生的供需前景预测。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240101

Young Jae Im, Kwanjin Park, Youngho Oh, Jun Hyuk Hong, Sang Don Lee

{"title":"Estimated prospects of demand and supply of urologists in Korea over the next 10 years.","authors":"Young Jae Im, Kwanjin Park, Youngho Oh, Jun Hyuk Hong, Sang Don Lee","doi":"10.4111/icu.20240101","DOIUrl":"10.4111/icu.20240101","url":null,"abstract":"Purpose: This study aimed to provide the basic data needed to estimate future urologist supply and demand by applying various statistical models related to healthcare utilization.Materials and methods: Data from multiple sources, including the Yearbook of Health and Welfare Statistics, Korean Hospital Association, Korean Medical Association, and the Korean Urological Association, were used for supply estimation. Demand estimation incorporated data on both clinical and non-clinical urologists, along with future population estimates. In-and-out moves and demographic methods were employed for supply estimation, while the Bureau of Health Professions model was utilized for demand estimation. Supply estimation assumptions included fixed resident quotas, age-specific death rates, migration rates, and retirement age considerations. Demand estimation assumptions included combining clinical and nonclinical urologist demands, adjusting population size for age-related healthcare usage variations. Urologist productivity was determined by adjusting productivity levels to 100%, 90%, and 80% of the base year based on actual clinical practice volumes.Results: Estimations of both demand and supply consistently indicate an oversupply of urologists until 2025, followed by an expected shortage by 2035 owing to increased deaths and retirements attributed to the aging urologist population. This shortage becomes more pronounced when employing more reliable models, such as logit or ARIMA (autoregressive integrated moving average), underscoring the growing need for urologists in the future.Conclusions: All estimation models estimated an oversupply of urologists until 2025, transitioning to a deficit due to reduced supply thereafter. However, considering potential unaccounted factors, greater effort is needed for accurate predictions and corresponding measures.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"326-333"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of the gender gap in urology industry payments: An Open Payments Program data analysis. 泌尿外科行业支付中的性别差距评估：开放支付计划数据分析。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240021

Yuzhi Wang, Matthew James Davis, Alexandra Rogers, Jonathan Rexroth, Taylor Jane Malchow, Alex Stephens, Mohit Butaney, Samantha Wilder, Samantha Raffee, Firas Abdollah

{"title":"Assessment of the gender gap in urology industry payments: An Open Payments Program data analysis.","authors":"Yuzhi Wang, Matthew James Davis, Alexandra Rogers, Jonathan Rexroth, Taylor Jane Malchow, Alex Stephens, Mohit Butaney, Samantha Wilder, Samantha Raffee, Firas Abdollah","doi":"10.4111/icu.20240021","DOIUrl":"10.4111/icu.20240021","url":null,"abstract":"Purpose: The Open Payments Program (OPP), established in 2013 under the Sunshine Act, mandated medical device and pharmaceutical manufacturers to submit records of financial incentives given to physicians for public availability. The study aims to characterize the gap in real general and real research payments between man and woman urologists.Materials and methods: The study sample included all urologists in the United States who received at least one general or research payment in the OPP database from 2015 to 2021. Recipients were identified using the National Provider Identifier and National Downloadable File datasets. Payments were analyzed by geography, year, payment type, and years since graduation. Multivariable analysis on odds of being in above the median in terms of money received was done with gender as a covariate. This analysis was also completed for all academic urologists.Results: There was a total of 15,980 urologists; 13.6% were woman, and 86.4% were man. Compared to man urologists, woman urologists were less likely to be in the top half of total payments received (odds ratio [OR] 0.62) when adjusted for other variables. When looking at academic urologists, 18.1% were woman and 81.9% were man. However, woman academic urologists were even less likely to be in the top 50% of payments received (OR 0.55).Conclusions: This study is the first to characterize the difference in industry payments between man and woman urologists. The results should be utilized to educate physicians and industry, in order to achieve equitable engagement and funding for woman urologists.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"411-419"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computerized metric assessment of glandular tissue volume within the peripheral zone of the prostate using combined magnetic resonance imaging and histopathology: Possible pathophysiological implications on prostate cancer development. 利用磁共振成像和组织病理学对前列腺外周区腺体组织体积进行计算机计量评估：对前列腺癌发展的可能病理生理学影响。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240040

John M Wolpert, Caroline Presson, Nathaniel Kimball, Benjamin Lin, Luis Brandi, Naseem Helo, Werner T W de Riese

{"title":"Computerized metric assessment of glandular tissue volume within the peripheral zone of the prostate using combined magnetic resonance imaging and histopathology: Possible pathophysiological implications on prostate cancer development.","authors":"John M Wolpert, Caroline Presson, Nathaniel Kimball, Benjamin Lin, Luis Brandi, Naseem Helo, Werner T W de Riese","doi":"10.4111/icu.20240040","DOIUrl":"10.4111/icu.20240040","url":null,"abstract":"Purpose: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are prevalent urological ailments in elderly males. Numerous clinical studies have revealed an invert association between BPH/prostate size and PCa growth. This study investigates the association between prostate size and total glandular tissue volume of the peripheral zone (GVPZ) using a unique blend of magnetic resonance imaging (MRI) and histo-anatomical imaging technique.Materials and methods: Patients were selected who underwent both radical prostatectomy and preoperative MRI scans. MRI scans provided quantitative measurements of prostatic zone dimensions, while histo-anatomical slides yielded quantitative data on glandular density of the peripheral zone (PZ) using imaging software. Integration of MRI and histopathology enabled the assessment of the GVPZ. Statistical analysis identified relationships between total prostate volume (TPV) and GVPZ.Results: Seventy-two patients were selected and 40 cc was determined to be the optimal cutoff for small-to-moderate versus large prostates. Once the two subgroups in TPV were formed, the relationship between TPV and GVPZ was found to be highly significant (p<0.001).Conclusions: The combination of MRI and histopathology offers a novel approach for precise quantification of glandular tissue within the prostatic PZ. This study corroborates the hypothesis of PZ compression via an enlarging transition zone in larger BPH prostates, resulting in PZ glandular atrophy. Given that most PCa originates in the PZ, these results shed light on the potential protective role of larger BPH prostates against PCa growth.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"334-341"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of family history of prostate cancer on disease progression for prostatic cancer patients undergoing active surveillance: A systematic review and meta-analysis. 前列腺癌家族史对接受主动监测的前列腺癌患者病情进展的影响：系统回顾和荟萃分析。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240053

Jinhyung Jeon, Jae Heon Kim, Jee Soo Ha, Won Jae Yang, Kang Su Cho, Do Kyung Kim

{"title":"Impact of family history of prostate cancer on disease progression for prostatic cancer patients undergoing active surveillance: A systematic review and meta-analysis.","authors":"Jinhyung Jeon, Jae Heon Kim, Jee Soo Ha, Won Jae Yang, Kang Su Cho, Do Kyung Kim","doi":"10.4111/icu.20240053","DOIUrl":"10.4111/icu.20240053","url":null,"abstract":"Purpose: To evaluate how a family history of prostate cancer influences the progression of the disease in individuals with prostate cancer undergoing active surveillance.Materials and methods: We conducted a thorough literature search in PubMed/MEDLINE, Embase, and Cochrane Library up to June 2023. This systematic review was registered in PROSPERO (CRD42023441853). The study evaluated the effects of family history of prostate cancer (intervention) on disease progression (outcome) in prostate cancer patients undergoing active surveillance (population) and compared them to those without a family history (comparators). For time to disease progression outcomes, the extracted data were synthesized using the inverse variance method on the log hazard ratios scale.Results: A total of eight studies were incorporated into this systematic review and meta-analysis. The combined hazard ratio for unadjusted disease progression was 1.06 (95% confidential interval [CI] 0.66-1.69; p=0.82). The combined hazard ratio for adjusted disease progression was 1.31 (95% CI 1.16-1.48; p<0.0001). All the enlisted studies demonstrated high quality based on the Newcastle-Ottawa scale. The certainty of evidence for univariate and multivariate analysis of disease progression was very low and low, respectively. Publication bias for all studies was not significant.Conclusions: For individuals with prostate cancer opting for active surveillance, a family history of prostate cancer may serve as an independent risk factor associated with an elevated risk of disease progression. Clinicians should be counseled about the increased risk of disease progression in patients with a family history of prostate cancer undergoing active surveillance.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"315-325"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes of holmium laser enucleation of the prostate: A large prospective registry-based patient cohort study under regular follow-up protocol. 前列腺钬激光去核术的临床效果：定期随访的大型前瞻性登记患者队列研究。

IF 2.5 3区医学

Investigative and Clinical Urology Pub Date : 2024-07-01 DOI: 10.4111/icu.20240080

Hyomyoung Lee, Sangwon So, Min Chul Cho, Sung Yong Cho, Jae-Seung Paick, Seung-June Oh

{"title":"Clinical outcomes of holmium laser enucleation of the prostate: A large prospective registry-based patient cohort study under regular follow-up protocol.","authors":"Hyomyoung Lee, Sangwon So, Min Chul Cho, Sung Yong Cho, Jae-Seung Paick, Seung-June Oh","doi":"10.4111/icu.20240080","DOIUrl":"10.4111/icu.20240080","url":null,"abstract":"Purpose: To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) in a large prospective cohort of patients with benign prostatic hyperplasia (BPH) through systematic follow-up at a single institution.Materials and methods: Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively.Results: A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0-1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]).Conclusions: Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 4","pages":"361-367"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0