Hellenic Urology最新文献

{"title":"From “micro-” diagnosis to “macro-” treatment, a road full of colors","authors":"Eleni Nikolaidou, M. Iliopoulou, IPanagiotis Mourmouris","doi":"10.4103/huaj.huaj_24_22","DOIUrl":"https://doi.org/10.4103/huaj.huaj_24_22","url":null,"abstract":"Introduction: From 1878 when the first working cystoscope was presented to today's era of big data and artificial intelligence, colorful biomarkers remain one of the urologists' strongest allies. We hereby review the current research frontiers in “color” informatics and their clinical translation in urology through methodologies and applications of visual augmentation of molecular feedback and theragnostic. Results: The multi-dimensional data approach involves firstly lasers' rapid progress as an omnipresent part of modern urology in a variety of diseases, while color Doppler assists the depiction both of the urinary tract and the male genital tract. Both in molecular and systemic level screening, unique techniques using light, histochemical stain enabling color, and fluorescent tracers are improving morphological discrimination between malignant and benign cells, as well as providing anatomical and functional information preoperatively and intraoperatively. Conclusion: Technologies by exploiting the various lengths of the spectrum of light, which clinically it is translated, and it is evident as different color shades, have significantly toward improved our ability to both diagnose and treat urological entities. Thus, improving the management of light's and color's unique attributes could provide urologists with more effective clinical tools.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126862631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary bladder microbiome identification protocol with proteomics in bladder cancer patients and review of the literature","authors":"P. Stamatakos, C. Fragkoulis, Ieronymos Zoidakis, K. Ntoumas, A. Dellis","doi":"10.4103/HUAJ.HUAJ_3_23","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_3_23","url":null,"abstract":"Urine was conventionally thought to be sterile. However, recent evidence about the presence of microorganisms residing the urinary tract has led to an emerging field of investigation about the potential role of urinary microbiome in the pathogenesis of urinary bladder cancer. Urinary microbiota refers to the different microbe populations present in the urinary tract while a variety of genetic, environmental, and experimental parameters have been investigated as predisposing factors of microbial composition. Different methods of urine collection as well as experimental methodology on microbiome's characterization consist of well-defined factors that may alter the microbial composition. Few preliminary data have been reported so far implicating microorganisms as causative and prognostic factors of bladder tumorigenesis, examining mostly midstream-voided urine samples while the most commonly used analyzing technique was 16S rRNA sequencing method. In the present study, a protocol of microbiome identification using proteomics is reported analyzing differences in microbial composition between bladder cancer patients and healthy controls while a review of the current evidence is presented. To the best of our knowledge, proteomics has not been described as a possible method of microbiome characterization before.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129839842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cautionary tale of an unfortunate testis: Testicular infarction and rupture as a rare complication of acute epididymitis","authors":"L. Xanicia, Welras Long","doi":"10.4103/HUAJ.HUAJ_12_22","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_12_22","url":null,"abstract":"Epididymo orchitis is a common cause of unilateral scrotal pain. Infection is caused by retrograde ascent of pathogens to the epididymitis and extension to the testis. This condition typically follows an indolent course and responds well to a course of culture directed antibiotics along with analgesiaand scrotal support. Albeit rare, more severe complications such as abscess formation, testicular infarction, and testicular loss are still possible despite receiving appropriate extended antibiotic therapy. A high index of suspicion of these complications should be maintained in any presentation of acute scrotum, as early recognition could allow for salvage of the testis. We hereby present a rare case of acute epididymo-orchitis progressing to testicular infarction and rupture in a 50 year old male.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124690307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous nephrolithotomy as minimally invasive treatment of urinary calculi","authors":"Themistoklis T Bellos, G. Makris, N. Chatzikrachtis, M. Chrisofos","doi":"10.4103/HUAJ.HUAJ_4_22","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_4_22","url":null,"abstract":"The management of urolithiasis has radically changed over the past two decades. Open surgery has been almost completely replaced by minimally invasive procedures. Percutaneous nephrolithotomy (PCNL) is considered to be the first line of treatment for large renal stones. Its use is associated with a multitude of complications. A thorough bibliographic search was performed for this review. Although PCNL comes with higher morbidity, its efficacy is unbeaten by other minimally invasive modalities. Improved skills and modifications of the procedure may reduce the probability of adverse outcomes. However, it is still associated with complications, even life-threatening ones. Since its introduction more than 30 years ago, PCNL has claimed its position as the minimally invasive procedure of the first choice for the treatment of large and complex renal stones. PCNL numbers are rising in recent years.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131706677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of I-methionine in the reduction of recurrences of chronic bacterial prostatitis: A pilot study","authors":"K. Stamatiou, G. Perletti, K. Naber","doi":"10.4103/HUAJ.HUAJ_5_21","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_5_21","url":null,"abstract":"Introduction: L-methionine has been used for many years as an aid in the treatment of urolithiasis and as a prevention of further occurrence of struvite crystal formation by the acidification of the urine. Acidification of urine has been also used as a technique to treat and prevent symptomatic urinary tract infections. The current pharmacological research in the field of bacterial prostatitis focuses on the combinations of available antibiotics with prostatic microenvironmental modifiers for the prevention and treatment of chronic bacterial prostatitis (CBP) clinical recurrences. We aimed to study whether, in addition to antibiotic therapy, acidification of urine and prostatic microenvironment decreases CBP recurrences. Materials and Methods: This study was conducted between February 01, 2019, and December 20, 2020. The patient population included subjects with a confirmed diagnosis of CBP (National Institutes of Health [NIH] category II), history of CBP recurrences, and prostate calcifications confirmed on the transrectal ultrasound (TRUS) examination of the prostate. Symptom severity was self-estimated with the NIH-Chronic prostatitis Symptom Index (CPSI) and the International Prostatic Symptom Score (IPSS) questionnaires. Participants were randomly assigned to two groups. All underwent TRUS and the Meares–Stamey “four-glass” test. Patients of both groups received antimicrobial treatment (according to the results of susceptibility tests) for 30 days, while patients of Group 2 received additionally l-methionine 500 mg b. i. d for 2 months. After 4 weeks of therapy, the NIH-CPSI and IPSS tests were repeated. Follow-up included also interview, physical examination, TRUS, and “four-glass” test. Patients were followed for 6 months. Results: A total of 10 patients (5+5) were investigated in both groups. No significant differences were found between groups regarding median age, prostate volume, and bacterial susceptibility. Microbiological eradication occurred in similar proportions between the two groups. Similarly, the resolution of clinical symptoms occurred in equivalent numbers of patients belonging to Groups 1 and 2. Analysis showed in both groups highly significant improvements of symptoms, assessed with both the NIH-CPSI and IPSS tests. No difference in the number and location of calcifications after treatment between groups was also found. One patient of Group 1 experienced a clinical recurrence within 6 months after conclusion of treatment. Conclusion: No clear recommendations can be made from this pilot study. Thus, the preventive effect of l-methionine remains unknown and evidence for its use in this setting is lacking, but randomized trials with large numbers of participants would help to determine the role of urinary acidification in the treatment or prevention of recurrent CBP.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124777126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the impact of COVID-19 pandemic on urology residence training","authors":"P. Stamatakos, I. Glykas, C. Fragkoulis, A. Dellis","doi":"10.4103/HUAJ.HUAJ_42_21","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_42_21","url":null,"abstract":"Introduction and Objective: Since March 11, 2020, when the World Health Organization declared COVID-19 as a pandemic, a significant strain was placed on the worldwide health-care system. Although urology does not stand at the frontline of care for patients with COVID-19, every practicing urologist has been affected by the global outbreak. The impact of the COVID-19 pandemic on urology residency training was evaluated taking into account the residents' point of view regarding these unprecedented circumstances. Evidence Acquisition: We performed a literature review on the current evidence based on urology residency training during the COVID-19 pandemic. Relevant databases (MEDLINE, Scopus, and Cochrane Library) were searched (until June 2021), and the main inclusion criterion was the presence of residents' or directors' opinion on their residency training program during the COVID-19 pandemic. Evidence Synthesis: The search identified 72 articles. A total of 14 studies reporting on more than 2500 residents were eligible for inclusion. The articles were analyzed, and the results are presented in the current review. Conclusions: This unprecedented situation has critically affected urology residency training. A decrease in operation volume, especially those in which residents were directly involved as well as in the majority of academic activities, has been reported by many studies. Furthermore, the COVID-19 pandemic has generated a significant impact on trainees' mental well-being and lifestyle. On the other hand, the lockdown stressed the opportunity to implement innovative training tools, such as smart training programs and surgical skill development activities monitored by expert urologists.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133894626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory pseudotumour post - hernia repair: An unusual cause of a right groin mass","authors":"L. Xanicia","doi":"10.4103/HUAJ.HUAJ_20_22","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_20_22","url":null,"abstract":"Inflammatory pseudotumors (IPTs) are rare benign lesions resulting from unregulated growth of inflammatory cells and can be found in different anatomical locations. They are most commonly reported in the lungs or head-and-neck region, and less commonly in the genitourinary system. We report a case of an 85-year-old male with a history of hernia mesh repair presenting with a right groin mass. Radiological investigations revealed a solid inguinal mass without intrascrotal extension. The mass was excised en bloc, and postoperative histopathological examination revealed an IPT.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132555118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testicular torsion with synchronous adrenal rest tumors in a patient with congenital adrenal hyperplasia","authors":"M. Tuna, Tunkut Doğanca, P. Mourmouris, N. Kurtulmuş, O. Argun, A. Kural","doi":"10.4103/HUAJ.HUAJ_6_21","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_6_21","url":null,"abstract":"This is the case report of a 20-year-old male patient who was admitted to our clinic with a sudden onset of severe left testicular pain. Color Doppler ultrasonography revealed normal vascular supply of both testes nevertheless, but when compared with the right testis, the axis of the left testicular cord was located more posteriorly and along with swelling of the epididymis made the diagnosis of partial torsion highly probable. Bilaterally hypervascularized testicular and epididymal solid masses (up to 20 mm) were also present. Reposition of the left testicle followed by warm sponge compress was performed. The patient was suffering from congenital adrenal hyperplasia (CAH) and he was in steroid replacement therapy all his life. Testicular adrenal rest tumor is an important complication of classical CAH due to 21-hydroxylase deficiency that can potentially lead to gonadal dysfunction and infertility in adulthood. If the presence of enlarged testicular rest tumor deteriorates the stability of the testicular cord stability and renders the testis more vulnerable to torsion is a hypothesis that is hard to prove since these tumors are rare and torsion in these patients is even rarer. Nevertheless, the physicians must be aware of this condition and its benign course in order to correctly differentiate it from other diseases and avoid more radical procedures.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116749027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-operative predictors of postoperative bleeding and sepsis after percutaneous nephrolithotomy","authors":"Ambala Rajeevan, Midhun P. Gopalakrishnan","doi":"10.4103/HUAJ.HUAJ_49_21","DOIUrl":"https://doi.org/10.4103/HUAJ.HUAJ_49_21","url":null,"abstract":"Introduction: Percutaneous nephrolithotomy (PCNL) is the most common minimal access method used for the management of large renal and pelvic stones. The two most common complications after PCNL are bleeding and sepsis. In this context, we did this study to find out perioperative predictors of postoperative bleeding and sepsis after PCNL. Materials and Methods: We conducted this study on 110 patients who came for PCNL at our institute from March 1, 2018 to August 31, 2019. Data were collected using a pro forma, and the same analyzed by appropriate statistical methods using the SPSS software. Results: The perioperative factors correlated to postoperative bleeding were stone size, density of stone, Guy's stone score, size of Amplatz sheath used, number of working tracts created, and duration of surgery. On regression analysis factors which were predictive of postoperative bleeding were size of Amplatz sheath and number of working tracts created. Peri-operative factors correlated with postoperative sepsis were body mass index of the patient, preoperative total count, density of stone, preoperative pyuria, preoperative positive urine culture, superior calyceal puncture, postoperative total leukocyte count, and postoperative fever within 24 h. The factors which were predictive of postoperative sepsis were preoperative pyuria, preoperative urine culture, superior calyceal puncture, and postoperative fever on regression analysis. Conclusion: This study shows perioperative predictors of postoperative bleeding and sepsis after PCNL. Out of 43.63% total complications, 20% were major and 23.63% minor complications.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127162384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary stones: Medical dissolution and monitoring","authors":"L. Tzelves, P. Mourmouris, A. Skolarikos","doi":"10.4103/huaj.huaj_40_21","DOIUrl":"https://doi.org/10.4103/huaj.huaj_40_21","url":null,"abstract":"Surgical management is the cornerstone of urolithiasis treatment, but since prevention is better than treatment, we need to explore other measures for treating and especially for monitoring patients before recurrence. Several laboratory studies have performed testing of experimental treatments to reduce kidney stone formation and cellular damage and showed encouraging results. A few prospective and randomized studies proved the efficacy and safety of oral chemolysis for radiolucent stones. The purpose of this review is to present the most recent data regarding dissolution therapy and ways of monitoring stone patients.","PeriodicalId":185530,"journal":{"name":"Hellenic Urology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134129914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}