Investigative and Clinical Urology最新文献

{"title":"Application of deep learning for semantic segmentation in robotic prostatectomy: Comparison of convolutional neural networks and visual transformers.","authors":"Sahyun Pak, Sung Gon Park, Jeonghyun Park, Hong Rock Choi, Jun Ho Lee, Wonchul Lee, Sung Tae Cho, Young Goo Lee, Hanjong Ahn","doi":"10.4111/icu.20240159","DOIUrl":"10.4111/icu.20240159","url":null,"abstract":"<p><strong>Purpose: </strong>Semantic segmentation is a fundamental part of the surgical application of deep learning. Traditionally, segmentation in vision tasks has been performed using convolutional neural networks (CNNs), but the transformer architecture has recently been introduced and widely investigated. We aimed to investigate the performance of deep learning models in segmentation in robot-assisted radical prostatectomy (RARP) and identify which of the architectures is superior for segmentation in robotic surgery.</p><p><strong>Materials and methods: </strong>Intraoperative images during RARP were obtained. The dataset was randomly split into training and validation data. Segmentation of the surgical instruments, bladder, prostate, vas and seminal vesicle was performed using three CNN models (DeepLabv3, MANet, and U-Net++) and three transformers (SegFormer, BEiT, and DPT), and their performances were analyzed.</p><p><strong>Results: </strong>The overall segmentation performance during RARP varied across different model architectures. For the CNN models, DeepLabV3 achieved a mean Dice score of 0.938, MANet scored 0.944, and U-Net++ reached 0.930. For the transformer architectures, SegFormer attained a mean Dice score of 0.919, BEiT scored 0.916, and DPT achieved 0.940. The performance of CNN models was superior to that of transformer models in segmenting the prostate, vas, and seminal vesicle.</p><p><strong>Conclusions: </strong>Deep learning models provided accurate segmentation of the surgical instruments and anatomical structures observed during RARP. Both CNN and transformer models showed reliable predictions in the segmentation task; however, CNN models may be more suitable than transformer models for organ segmentation and may be more applicable in unusual cases. Further research with large datasets is needed.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"551-558"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591077","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":"Multi-pharmacological treatment for young subfertile males with chronic prostatitis/chronic pelvic pain syndrome.","authors":"Dong Hyeon Lee, Young Dong Yu","doi":"10.4111/icu.20240191","DOIUrl":"10.4111/icu.20240191","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effectiveness of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) treatments using multiple pharmaceutical agents that could simultaneously preserve or enhance fertility capability.</p><p><strong>Materials and methods: </strong>This was a single-center-based, randomized controlled study, whereas the final analysis evaluated a total 350 CP/CPPS patients (age range, 28-40 years) and 50 patients were randomly allocated to each therapeutic group, with a 1:1 ratio. The therapeutic groups consist of tadalafil (group 1, 5 mg daily), L-carnitine (group 2, 2 g daily), <i>Serenoa repens</i> extract (group 3, 320 mg daily), group 4 (tadalafil+L-carnitine), group 5 (tadalafil+<i>S. repens</i>), group 6 (L-carnitine+<i>S. repens</i>), and group 7 (tadalafil+L-carnitine+<i>S. repens</i>). The treatment outcomes at 3 months post-therapy were analyzed.</p><p><strong>Results: </strong>At 3 months post-therapy, the mean total sperm motility was significantly improved in all groups. A normal morphology improvement was observed in L-carnitine receiving groups. The mean total score on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the mean International Prostate Symptom Score (IPSS) showed the greatest reduction in intensity in group 7. Logistic regression analyses showed that group 5 and group 7 were significantly associated with improvements in total IPSS and total NIH-CPSI scores at 3 months post-therapy. Group 7 was a significant predictor for improving total sperm motility, leukocytospermia and normal form of sperm.</p><p><strong>Conclusions: </strong>Tadalafil, carnitine, and <i>S. repens</i> combination therapy could be considered a feasible treatment option for CP/CPPS males with subfertility.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"567-578"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591080","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":"Association between soy products and prostate cancer: A systematic review and meta-analysis of observational studies.","authors":"Yiping Huang, Wenyan Wang, Jianxiang Jin","doi":"10.4111/icu.20240186","DOIUrl":"10.4111/icu.20240186","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of soy products on prostate cancer (PCA) remains a topic of debate. This study aimed to investigate the association between soy products consumption and the incidence of PCA.</p><p><strong>Materials and methods: </strong>A search was conducted in the PubMed, EBSCO, Web of Science, and Cochrane Library databases up to December 2023. The adjusted odds ratio (OR) and corresponding 95% confidence interval (CI) were used to assess the association.</p><p><strong>Results: </strong>A total of 22 articles, comprising 1,409,213 participants, were included for this meta-analysis. The results indicate that soy products reduce the risk of PCA (OR=0.94, 95% CI=0.91-0.97, p<0.001), especially in cases of localized or low-grade PCA (OR=0.94, 95% CI=0.90-0.97, p<0.001), but exhibit no effect on non-localized or high-grade PCA (OR=0.96, 95% CI=0.91-1.01, p=0.085). Furthermore, increased consumption frequency was negatively associated with PCA risk. Specifically, soy products can reduce the risk of PCA in African Americans (OR=0.89, p=0.006) and Latinos (OR=0.93, p=0.036), but have no impact on Japanese (OR=0.99, p=0.655), Chinese (OR=0.90, p=0.155), and Whites (OR=0.96, p=0.133). Non-fermented soy products were associated with a reduction in the incidence rate of PCA (OR=0.93, 95% CI=0.90-0.96, p<0.001), while fermented soy products had no effect on the incidence rate of PCA (OR=1.10, 95% CI=0.98-1.22, p=0.096).</p><p><strong>Conclusions: </strong>The consumption of soy products can reduce the overall risk of PCA among men. Various factors, including soy products-related factors (e.g., consumption, frequency), population-related factors (e.g., race), and PCA-related factors (e.g., PCA stage) collectively influence the effect of soy products on PCA.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"540-550"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591078","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":"Prevalence and economic burden of male anogenital wart in Korea: A population-based big data analysis from 2007 to 2018.","authors":"Hong Chung, Jin Bong Choi, Sooyoun Kim, Seung-Ju Lee, Sangrak Bae","doi":"10.4111/icu.20240274","DOIUrl":"10.4111/icu.20240274","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence of anogenital warts (AGW) caused by human papillomavirus in men and the characteristics and changes of the disease in Korea.</p><p><strong>Materials and methods: </strong>From 2007 to 2018, male AGW corresponding to the International Classification of Disease-10 A63.0 were targeted. Through a big data analysis of the Health Insurance Review & Assessment Service, data of patients diagnosed with AGW as either the main or secondary diagnosis were extracted. The overall prevalence and prevalence by age were calculated through the population by year and the population by 5-year-old unit of the National Statistical Office. Additionally, the amount accrued through the disease code was confirmed and compared as AGW-related medical expenses.</p><p><strong>Results: </strong>The annual number of patients increased by 3.5 times from 32,709 in 2007 to 114,734 in 2018. Additionally, the annual prevalence increased by 3.34 times from 132.83 per 100,000 to 443.57. The age-specific prevalence was the highest among the 25- to 29-year age group. The highest prevalence was observed in the 25- to 29-year age group in 2018 (1,492.15 per 100,000), and the lowest was noted in the 10- to 14-year age group in 2014 (7.28 per 100,000). AGW-related medical expenses increased by approximately 9.76 times from US$ 2,789,215.1 in 2007 to US$ 27,227,254.9 in 2018.</p><p><strong>Conclusions: </strong>In Korea, cases of male AGW are increasing yearly, with the 25- to 29-year age group having the highest prevalence. Medical costs related to AGW are also increasing tenfold. For male AGW, further studies and national interventions are needed.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"579-586"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591081","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":"Dasatinib induces apoptosis and autophagy by suppressing the PI3K/Akt/mTOR pathway in bladder cancer cells.","authors":"Jin-Nyoung Ho, Seok-Soo Byun, Danhyo Kim, Hoyoung Ryu, Sangchul Lee","doi":"10.4111/icu.20240250","DOIUrl":"10.4111/icu.20240250","url":null,"abstract":"<p><strong>Purpose: </strong>Bladder cancer is a common genitourinary malignant disease worldwide. Dasatinib is a small molecule inhibitor of Src family kinases. We investigated the anticancer effect and putative molecular mechanisms of dasatinib on T24 and cisplatin-resistant T24R2 human bladder cancer cells.</p><p><strong>Materials and methods: </strong>Cell proliferation was measured using Cell Counting Kit-8 (CCK-8) and colony formation in dasatinib treated bladder cancer cells. Flow cytometry was used to determined cell cycle arrest and apoptosis. The expression of apoptosis and autophagy related proteins were detected by western blot analysis.</p><p><strong>Results: </strong>In bladder cancer cells, dasatinib significantly reduced cell proliferation, colony formation, and induced G1-phase arrest. Dasatinib triggered apoptosis along with an increased expression of apoptosis-related genes (caspases, PARP, and cytochrome c). Down-regulation of Bcl-2 and up-regulation of Bad, which are hallmarks of apoptosis, were found to play a dominant role in mediating the effects of dasatinib treatment. We further showed that dasatinib inhibits p-Src, p-PI3K, p-Akt, and p-mTOR in bladder cancer cells. Dasatinib also increased the expression of markers of autophagy flux such as LC3-II and p62.</p><p><strong>Conclusions: </strong>These results confirmed that dasatinib is a potent chemotherapeutic drug which induces apoptosis and autophagy by suppressing the PI3K/Akt/mTOR pathway in bladder cancer cells.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"593-602"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591079","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":"Pseudoepitheliomatous hyperplasia of the penis: A rare mimic of squamous cell carcinoma.","authors":"Mohammed Taher Mujahid, Vikas Kumar Panwar, Gautam Shubhankar, Ankur Mittal","doi":"10.4111/icu.20240253","DOIUrl":"10.4111/icu.20240253","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 6","pages":"603-605"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591084","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":"Pelvic hematoma post prostatic urethral lift: A need to be vigilant in high-risk patients.","authors":"Gautam Shubhankar, Vikas Kumar Panwar, Avin Singhal, Ankur Mittal","doi":"10.4111/icu.20240228","DOIUrl":"10.4111/icu.20240228","url":null,"abstract":"","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"518-521"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154065","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":"Comparative analysis of health-related quality of life between children with bladder and bowel dysfunction versus lower urinary tract dysfunction and healthy controls.","authors":"Hirokazu Ikeda, Takahiro Ono, Chisato Oyake, Yuta Oonuki, Yoshitaka Watanabe, Tsuneki Watanabe","doi":"10.4111/icu.20240137","DOIUrl":"10.4111/icu.20240137","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare health-related quality of life (HRQoL) between children with bladder and bowel dysfunction (BBD) and lower urinary tract dysfunction (LUTD) alone and healthy controls based on self-report forms and parent-proxy report forms.</p><p><strong>Materials and methods: </strong>In this retrospective study, clinical records were reviewed. Children with LUTD, with or without bowel dysfunction, and healthy children were included in this study. The dysfunctional voiding scoring system and Rome IV Diagnostic Criteria were used to assess lower urinary tract symptoms. The Rome IV Diagnostic Criteria was also used to evaluate bowel symptoms. The Pediatric Quality of Life Inventory 4.0 (PedsQL) questionnaire was administered to investigate pediatric HRQoL.</p><p><strong>Results: </strong>Of the total 252 children (mean age, 7.3±2.1 years) who participated in this study, 78 were classified into the BBD group and 174 into the LUTD group. Compared with the control group, the BBD group had significantly lower total PedsQL scores (p<0.001) and psychosocial healthy summary scores (p<0.001). The BBD group had significantly lower emotional functioning scores than the LUTD group (p=0.023). Children with BBD who presented with fecal incontinence (FI) had a significantly lower social functioning score than those without FI (p=0.023).</p><p><strong>Conclusions: </strong>Children with BBD who present with FI are at higher risk of decreased psychosocial HRQoL, and they require special emotional support. These findings underscore the need for effective treatment and follow-up to improve the HRQoL of children with BBD who presented with FI.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"494-500"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154044","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":"Comparing thulium fiber versus high power holmium laser in bilateral same sitting retrograde intrarenal surgery for kidney stones: Results from a multicenter study.","authors":"Chu Ann Chai, Takaaki Inoue, Bhaskar Kumar Somani, Steffi Kar Kei Yuen, Deepak Ragoori, Nariman Gadzhiev, Yiloren Tanidir, Esteban Emiliani, Saeed Bin Hamri, Mohamed Amine Lakmichi, Vaddi Chandramohan, Angelo Naselli, Boyke Soebhali, Mehmet Ilker Gokce, Azimdjon N Tursunkulov, Fernando Ramón de Fata Chillón, Ben Hall Chew, Olivier Traxer, Daniele Castellani, Vineet Gauhar","doi":"10.4111/icu.20240185","DOIUrl":"10.4111/icu.20240185","url":null,"abstract":"<p><strong>Purpose: </strong>Traditionally, bilateral urolithiasis treatment involved staged interventions due to safety concerns. Recent studies have shown that same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) is effective, with acceptable complication rates. However, there's no clear data on the optimum laser for the procedure. This study aimed to assess outcomes of SSB-RIRS comparing thulium fiber laser (TFL) and high-power holmium:yttrium-aluminum-garnet (Ho:YAG) laser in a multicenter real-world practice.</p><p><strong>Materials and methods: </strong>Retrospective analysis was conducted on patients undergoing SSB-RIRS from January 2015 to June 2022 across 21 centers worldwide. Three months perioperative and postoperative outcomes were recorded, focusing on complications and stone-free rates (SFR).</p><p><strong>Results: </strong>A total of 733 patients were included, with 415 in group 1 (Ho:YAG) and 318 in group 2 (TFL). Both groups have similar demographic and stone characteristics. Group 1 had more incidence of symptomatic pain or hematuria (26.5% vs. 10.4%). Operation and lasing times were comparable. The use of baskets was higher in group 1 (47.2% vs. 18.9%, p<0.001). Postoperative complications and length of hospital stay were similar. Group 2 had a higher overall SFR. Multivariate regression analysis indicated that age, presence of stone at the lower pole, and stone diameter were associated with lower odds of being stone-free bilaterally, while TFL was associated with higher odds.</p><p><strong>Conclusions: </strong>Our study shows that urologists use both lasers equally for SSB-RIRS. Reintervention rates are low, safety profiles are comparable, and single-stage bilateral SFR may be better in certain cases. Bilateral lower pole and large-volume stones have higher chances of residual fragments.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"451-458"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154045","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":"Investigation and quantification of composition variability in urinary stone analysis.","authors":"Binh Duy Le, Kyung-Jin Oh, Anh Tuan Le, Long Hoang, Ilwoo Park","doi":"10.4111/icu.20240275","DOIUrl":"10.4111/icu.20240275","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the variability in urinary stone composition analysis due to sampling and suggest potential solutions.</p><p><strong>Materials and methods: </strong>We collected 1,135 stone fragments from 149 instances that had undergone a stone removal at Hanoi Medical University Hospital from January 2022 to August 2022. Each fragment was ground into fine powder and divided into separate specimens if the amount was abundant. For composition analyzing every specimen, Fourier transform infrared spectroscopy was performed. The composition of a given fragment was the average of its belonging specimens. The variability in composition was assessed on the fragment level (i.e., between fragments of an instance). We defined an instance as \"significantly variable\" if the maximum difference in any composition across its belonging fragments was equal to or greater than a given threshold.</p><p><strong>Results: </strong>On average, there were 7.6±3.3 stone fragments per instance and 2.3±0.5 specimens per fragment. We found that the variability could be substantial on the fragment level. Eighty-nine (69.5%) and 70 (54.7%) out of 128 multiple-component instances were significantly variable if the threshold was set at 20% and 30%, respectively. The variability of an instance on the fragment level was correlated with the size of fragment and the number of components.</p><p><strong>Conclusions: </strong>Our study demonstrated the significant variability in urinary stone composition and showed that it correlated with the size and the impurity of samples. Mapping denotation while sampling and analyzing as well as reporting the composition of individual fragments could be valuable to reduce potential variability.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"65 5","pages":"511-517"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154053","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}