Investigative and Clinical Urology最新文献

{"title":"Effects of a supplement associating <i>Lactobacillus</i> strains and proanthocyanidin-rich plant extracts against recurrent uncomplicated, urinary tract infections: A prospective, controlled study.","authors":"Samira Ait Abdellah, Anne Leblanc, Quentin Dauchet, Claude Blondeau, Jean Marc Bohbot","doi":"10.4111/icu.20240092","DOIUrl":"10.4111/icu.20240092","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrent cystitis, particularly common in women, substantially diminishes patient quality of life and represents a major clinical practice and public health burden. Increasing development of resistance to antibiotics has encouraged the search for alternative treatments. The benefits of a food supplement associating two <i>Lactobacillus</i> strains with proanthocyanidin A-rich cranberry and cinnamon extracts were evaluated in 80 women with a history of cystitis recurrence.</p><p><strong>Materials and methods: </strong>Post-inclusion recurrence frequency was compared between women taking the investigated supplement daily for 6 months and non-supplemented women, based on patient-completed Acute Cystitis Symptom Score (ACSS) questionnaires.</p><p><strong>Results: </strong>Two-thirds (64.9%) of supplemented women experienced no further episodes of cystitis during the first 6 months of the study compared to only one-third (31.6%) of non-supplemented women (p=0.004), the difference between the two groups being significant from 3 months onward. ACSS scores revealed significantly fewer and less severe urinary symptoms in supplemented women, as well as a significantly reduced impact of these symptoms on quality of life (p<0.0001).</p><p><strong>Conclusions: </strong>The results shown by extensive data on women suffering from recurrent cystitis, collected over 8 months, indicate that taking the tested supplement daily for 6 months can provide significant benefits in terms of recurrence frequency, symptoms, and quality of life. The study is registered on the ClinicalTrials.gov site under the identifier NCT04987164.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"36-46"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949035","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}

{"title":"Artificial intelligence can help individualize Wilms tumor treatment by predicting tumor response to preoperative chemotherapy.","authors":"Ahmed Nashat, Ahmed Alksas, Rasha T Aboulelkheir, Ahmed Elmahdy, Sherry M Khater, Hossam M Balaha, Israa Sharaby, Mohamed Shehata, Mohammed Ghazal, Salama Abd El-Wadoud, Ayman El-Baz, Ahmed Mosbah, Ahmed Abdelhalim","doi":"10.4111/icu.20240135","DOIUrl":"10.4111/icu.20240135","url":null,"abstract":"<p><strong>Purpose: </strong>To create a computer-aided prediction (CAP) system to predict Wilms tumor (WT) responsiveness to preoperative chemotherapy (PC) using pre-therapy contrast-enhanced computed tomography (CECT).</p><p><strong>Materials and methods: </strong>A single-center database was reviewed for children <18 years diagnosed with WT and received PC between 2001 and 2021. Patients were excluded if pre- and post-PC CECT were not retrievable. According to the Response Evaluation Criteria in Solid Tumors criteria, volumetric response was considered favorable if PC resulted in ≥30% tumor volume reduction. Histological response was considered favorable if post-nephrectomy specimens had ≥66% necrosis. Four steps were used to create the prediction model: tumor delineation; extraction of shape, texture and functionality-based features; integration of the extracted features and selection of the prediction model with the highest diagnostic performance. K-fold cross-validation allowed the presentation of all data in the training and testing phases.</p><p><strong>Results: </strong>A total of 63 tumors in 54 patients were used to train and test the prediction model. Patients were treated with 4-8 weeks of vincristine/actinomycin-D combination. Favorable volumetric and histologic responses were achieved in 46 tumors (73.0%) and 38 tumors (60.3%), respectively. Among machine learning classifiers, support vector machine had the best diagnostic performance with an accuracy, sensitivity, and specificity of 95.24%, 95.65%, and 94.12% for volumetric and 84.13%, 89.47%, 88% for histologic response prediction.</p><p><strong>Conclusions: </strong>Based on pre-therapy CECT, CAP systems can help identify WT that are less likely to respond to PC with excellent accuracy. These tumors can be offered upfront surgery, avoiding the cons of PC.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"47-55"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949034","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}

{"title":"Incidence and mortality of upper tract urothelial carcinoma in Korea: A nationwide population-based study conducted from 2002 to 2020.","authors":"Seongmin Moon, Yun-Sok Ha, Mina Kim, Hoseob Kim, Won Tae Kim, Yong-June Kim, Seok-Joong Yun, Sang-Cheol Lee, Ho Won Kang","doi":"10.4111/icu.20240255","DOIUrl":"10.4111/icu.20240255","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the incidence and mortality of upper tract urothelial carcinoma (UTUC) from 2002-2020 using data from the Korean National Health Insurance Service, which contains data from the entire Korean population.</p><p><strong>Materials and methods: </strong>Reimbursement records for 43,255 patients diagnosed with primary UTUC (according to the International Classification of Disease 10th revision code C65 and C66) between 2002-2020 were retrieved. The study period was split into four: period I (2002-2005), period II (2006-2010), period III (2011-2015), and period IV (2016-2020). Trends were quantified by calculating the annual percentage change (APC). Mortality data were obtained from the Statistics Korea.</p><p><strong>Results: </strong>From 2002-2020, the incidence of UTUC in Korea increased gradually from 9.34 to 11.40 per 100,000 person-years. Although there was a male predominance, the male to female ratio did not change significantly over time; however, age at the time of diagnosis, the comorbidity index, and the proportion of patients undergoing open/laparoscopic surgery increased significantly over time. There was a modest improvement in 5-year survival (both all cause- and cancer-specific) over the study period. Multivariate analysis identified age at diagnosis, sex, the comorbidity index, and open/laparoscopic surgery as being associated with survival.</p><p><strong>Conclusions: </strong>Between 2002 and 2020, the incidence of UTUC in Korea showed a general upward trend; however, survival outcomes have improved. These representative datasets from the Korean population might provide crucial information that enables clinicians to better understand of the epidemiology of UTUC in Korea.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"11-17"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949042","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}

{"title":"A multicenter micro-costing analysis of flexible cystoscopic procedures in Korea.","authors":"Uiemo Je, Woong Kyu Han, Hee-Kyo Jeong, Hankil Lee, Kwang Suk Lee, Sung Ku Kang, Byeong-Ju Kwon, Sung-Uk Kuh","doi":"10.4111/icu.20240289","DOIUrl":"10.4111/icu.20240289","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop and implement an economic evaluation using a micro-costing approach to provide a precise and transparent analysis of the direct costs of cystoscopic procedures in Korean hospitals. The study seeks to identify key cost components and evaluate whether current reimbursement rates accurately reflect these direct costs.</p><p><strong>Materials and methods: </strong>Significant variations in cost items were identified across different studies. An economic evaluation was conducted using a micro-costing methodology for the cost analysis of cystoscopic procedures, developed through literature review, data collection from studies, and expert consultations.</p><p><strong>Results: </strong>Gangnam Severance Hospital (GSH) performed 2,188 cystoscopic procedures, including 1,847 cystoscopies and 341 JJ stent removals, with average costs of $100.8 and $110.6, respectively. At National Health Insurance Service Ilsan Hospital (NHIMC), 1,463 procedures were performed, including 1,167 cystoscopies and 296 JJ stent removals, with average costs of $119.2 and $125.3. Cystoscopy costs at GSH were driven by reprocessing ($45.8, 45.4%) and equipment ($33.1, 32.9%), while NHIMC's were $52.5 (44.0%) for equipment and $48.7 (40.8%) for reprocessing. Both hospitals incurred financial losses, with NHIS (National Health Insurance Service) covering only about 71.7% and 60.6% of costs for cystoscopy, and 71.0% and 62.7% for JJ stent removal.</p><p><strong>Conclusions: </strong>The significant discrepancy between HIRA (Health Insurance Review & Assessment Service)'s estimated costs and those identified here suggests that current fees for cystoscopic procedures may be underestimated and require reassessment. Given the results, reevaluating these rates is essential to ensure fair compensation for healthcare providers and to deliver optimal patient care.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"87-96"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949029","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}

{"title":"Rise in intraluminal temperature during ureteroscopy: Is this a concern?","authors":"Hyung Joon Kim, Sung Kyu Hong","doi":"10.4111/icu.20240369","DOIUrl":"10.4111/icu.20240369","url":null,"abstract":"<p><p>The global increase in urolithiasis prevalence has led to a shift towards minimally invasive procedures, such as retrograde intrarenal surgery, supported by advancements in laser technologies for lithotripsy. Pulsed lasers, particularly the holmium YAG and the newer thulium fiber laser, have significantly transformed the management of upper urinary tract stones. However, the use of high-power lasers in these procedures introduces risks of heat-related injury. Laser lithotripsy works through photothermal and photomechanical effects to fragment stones, but up to 96% of the laser energy is converted into heat, increasing the risk of thermal damage to the surrounding urothelial mucosa. Studies show that even at low-power settings, intrarenal temperatures can exceed the threshold for cellular injury, particularly in confined spaces like the ureter. This narrative review explores strategies to mitigate thermal injury, including optimizing laser settings, improving irrigation flow rates, and incorporating novel methods such as cold irrigation, controlling outflow resistance, and using suction. Understanding these approaches is crucial to enhancing patient safety during high-power laser lithotripsy procedures.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949045","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}

{"title":"Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications.","authors":"Dongho Shin, San Kang, Seung Ah Rhew, Chang Eil Yoon, Hyong Woo Moon, Yong Hyun Park, Hyuk Jin Cho","doi":"10.4111/icu.20240308","DOIUrl":"10.4111/icu.20240308","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of robot-assisted ureteral reconstruction as a minimally invasive alternative to open surgery for managing ureteric complications in transplanted kidneys.</p><p><strong>Materials and methods: </strong>From January 2020 to December 2023, robot-assisted ureteral reconstruction was performed on fifteen kidney transplant patients with vesicoureteral reflux (VUR) or ureteral stricture who had previously failed endoscopic treatments.</p><p><strong>Results: </strong>Twelve females and three males, with a mean age of 48.6±6.6 years, were included in the study. Nine patients (60.0%) underwent surgery due to VUR (grade III or higher) of the transplanted kidney, and six patients (40.0%) had transplanted ureteral strictures. Postoperative voiding cystourethrogram (VCUG) was performed at 3.2±1.6 months. Seven patients (77.8%) became VUR-free, while two patients (22.2%) had VUR regression from grade IV to I. All six patients who underwent reconstruction due to anastomosis site stricture became stenosis-free without the need for an indwelling ureteral catheter. In cases where the ureter was too short for reimplantation, a Boari flap or end-to-end anastomosis with the native ureter was performed. The mean hospital stay was 5.9±4.5 days. The urethral catheter was removed after 15.1±5.4 days, and the ureteral catheter was removed after 4.9±1.5 weeks. The mean follow-up period was 23.9±6.8 months, with no additional interventions required after surgery. No complications above Clavien-Dindo grade I were recorded.</p><p><strong>Conclusions: </strong>Robotic ureteral reconstruction is technically feasible and offers an effective, minimally invasive treatment for ureteric complications in kidney transplant patients, serving as an alternative to open surgery.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 1","pages":"18-26"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949048","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}

{"title":"The continuing legacy of <i>Investigative and Clinical Urology</i>.","authors":"Kwangsung Park","doi":"10.4111/icu.6506ed","DOIUrl":"10.4111/icu.6506ed","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"525-526"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591085","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}

{"title":"Using machine learning to construct the diagnosis model of female bladder outlet obstruction based on urodynamic study data.","authors":"Quan Zhou, Guang Li, Kai Cui, Weilin Mao, Dongxu Lin, Zhenglong Yang, Zhong Chen, Youmin Hu, Xin Zhang","doi":"10.4111/icu.20240111","DOIUrl":"10.4111/icu.20240111","url":null,"abstract":"<p><strong>Purpose: </strong>To intelligently diagnose whether there is bladder outlet obstruction (BOO) in female with decent detrusor contraction ability by focusing on urodynamic study (UDS) data.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the UDS data of female patients during urination. Eleven easily accessible urinary flow indicators were calculated according to the UDS data of each patient during voiding period. Eight diagnosis models based on back propagation neural network with different input feature combination were constructed by analyzing the correlations between indicators and lower urinary tract dysfunction labels. Subsequently, the stability of diagnostic models was evaluated by five-fold cross-validation based on training data, while the performance was compared on test dataset.</p><p><strong>Results: </strong>UDS data from 134 female patients with a median age of 51 years (range, 27-78 years) were selected for our study. Among them, 66 patients suffered BOO and the remaining were normal. Applying the 5-fold cross-validation method, the model with the best performance achieved an area under the receiver operating characteristic curve (AUC) value of 0.949±0.060 using 9 UDS input features. The accuracy, sensitivity, and specificity for BOO diagnosis model in the testing process are 94.4%, 100%, and 89.3%, respectively.</p><p><strong>Conclusions: </strong>The 9 significant indicators in UDS were employed to construct a diagnostic model of female BOO based on machine learning algorithm, which performs preferable classification accuracy and stability.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"559-566"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591087","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}

{"title":"Analysis of sleep pattern in patients with nocturnal enuresis: A prospective, observational, pilot study.","authors":"Dong-Gi Lee, Seong Cheol Kim","doi":"10.4111/icu.20240280","DOIUrl":"10.4111/icu.20240280","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the sleep patterns of patients with nocturnal enuresis (NE) using a wearable brain-wave-sensing device.</p><p><strong>Materials and methods: </strong>We prospectively analyzed 10 of the 14 patients who visited the hospital for NE between August 2023 and July 2024 and agreed to participate in the study. Four patients were excluded owing to pairing errors and loss to follow-up. Participants were instructed to maintain a frequency volume chart for 1 week and sleep while wearing MUSE-S™, a wearable brain-wave detection device. We monitored the arousal threshold state based on sleep patterns when NE occurred in all patients.</p><p><strong>Results: </strong>The median age of the patients was 8.7 years (interquartile range, 7.0-10.6), and 4 patients (40.0%) were male. In all participants, non-rapid eye movement (NREM) deep sleep was the dominant stage in the early part of sleep, whereas NREM light sleep was dominant in the middle part. The arousal threshold was high in the early part of sleep and decreased toward the end. A poor response to enuretic alarms was observed when NE occurred during the NREM deep-dominant period. In contrast, a good response was observed when NE occurred during the NREM light-dominant period.</p><p><strong>Conclusions: </strong>Differences in sleep stages influence the arousal threshold more than individual characteristics. To effectively manage the NE, focusing on the timing of urination is important in the latter part of the sleep period.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"587-592"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591036","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}

{"title":"Prostate cancer theragnostics biomarkers: An update.","authors":"Sathish Kumar Am, Prabhakar Rajan, Mohammad Alkhamees, Merrel Holley, Vinoth-Kumar Lakshmanan","doi":"10.4111/icu.20240229","DOIUrl":"10.4111/icu.20240229","url":null,"abstract":"<p><p>Biomarkers are molecules such as proteins, genes, or other substances that may be tested to determine the stage of the tumor in a patient. The role of prostate cancer biomarkers is pivotal and the combination of prostate cancer immunotherapy with efficient biomarkers has emerged as a beneficial treatment strategy and its use has increased rapidly. The two primary objectives of this current prostate cancer early detection programs were recognizing non-symptomatic individuals with prostate cancer requiring prostatic core biopsy and identifying men with prostate cancer who might benefit from definitive medical treatment. The progress that has been made so far in the identification of the biomarkers that can be used for the classification, prediction and prognostication of prostate cancer, and as major targets for its clinical intervention has been well summarized in this review.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"527-539"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591083","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}