Research and Reports in Urology最新文献

{"title":"Assessing the Predictive Accuracy of the S.T.O.N.E. Score for Stone-Free Rates in Semirigid Pneumatic Ureteral Lithotripsy: Implications for Validation.","authors":"Faisal Ahmed, Khaled Al-Kohlany, Khalil Al-Naggar, Ibrahim Alnadhari, Abdulfattah Yahya Altam, Mohamed Badheeb","doi":"10.2147/RRU.S515846","DOIUrl":"https://doi.org/10.2147/RRU.S515846","url":null,"abstract":"<p><strong>Background: </strong>The lack of reliable predictive tools for outcomes following ureteral lithotripsy (ULT) presents significant challenges in clinical decision-making. This study evaluates the efficacy of the S.T.O.N.E. score-an assessment incorporating Size, Topography, Obstruction, Number, and Hounsfield units (HU)-in predicting the likelihood of achieving a stone-free rate (SFR) in patients undergoing semirigid pneumatic ULT.</p><p><strong>Methods: </strong>This retrospective analysis involved 266 patients with ureteral stones who underwent ULT at IBB University Hospitals from April 2021 to September 2023. The S.T.O.N.E. score was derived from preoperative CT scans, and a nomogram was created to predict SFR failure. Discrimination and calibration were assessed using the area under the receiver operating characteristic curve (AUC) and calibration curve, while decision curve analysis (DCA) evaluated clinical utility.</p><p><strong>Results: </strong>The cohort's mean age was 47.7 ± 15 years, with a predominance of males (72.2%). The mean S.T.O.N.E. score was 7.8 ± 1.8. The overall SFR of 85.3% and residual stones were detected in 39 patients (14.7%). Multivariate analysis identified higher HU (AOR: 1.01; 95% CI: 1.00-1.01; P < 0.001), proximal stone location (AOR: 15.13; 95% CI: 1.52-51.13; P = 0.020), moderate (AOR: 34.23; 95% CI: 8.28-141.45; P < 0.001) and severe hydronephrosis (AOR: 33.75; 95% CI: 4.55-250.36; P = 0.0006), and larger stone size (AOR: 1.51; 95% CI: 1.30-1.75; P < 0.0001) as significant predictors of SFR failure. The S.T.O.N.E. score effectively predicts SFR failure, with an optimal threshold of > 8 achieving 85.0% accuracy. The model demonstrated 72.0% sensitivity, 81.0% specificity, and strong calibration. DCA indicated clinical utility, differentiating between low- and high-risk patients based on their S.T.O.N.E. scores.</p><p><strong>Conclusion: </strong>The S.T.O.N.E. score is a valuable tool for predicting post-ULT SFR, aiding preoperative decision-making and potentially improving surgical outcomes by identifying high-risk patients. Further validation in diverse populations is needed to confirm its clinical utility.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"139-152"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Ureteral Stone Treatment During COVID-19: A Single-Center Emergency Department Study.","authors":"Adrian Militaru, Catalin Andrei Bulai, Cosmin Victor Ene, Razvan Ionut Popescu, Cristian Mares, Stefan Marian Balacescu, Razvan Dragos Multescu, Dragos Adrian Georgescu, Petrisor Aurelian Geavlete, Bogdan Florin Geavlete","doi":"10.2147/RRU.S518331","DOIUrl":"https://doi.org/10.2147/RRU.S518331","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the hospitalization rate, length of stay, and management of patients with ureteric lithiasis admitted under emergency conditions at a single institution during the COVID-19 pandemic.</p><p><strong>Patients and methods: </strong>A retrospective study was conducted on 219 patients with ureteral lithiasis, divided into pre-COVID-19 (1.10.2019-29.02.2020) and COVID-19 groups (1.10.2020-29.02.2021). The study examined patient and stone characteristics, hospitalization duration, surgical interventions, creatinine levels, and associated urinary tract infections. It also evaluated the complications related to delayed treatment during the pandemic.</p><p><strong>Results: </strong>The study found a 73.41% reduction in admissions for obstructive ureteral lithiasis during the COVID-19 pandemic compared to the pre-pandemic period. Notable differences were observed in age (61.5 vs 46 years, p=0.000), gender (p=0.046), stone laterality (p=0.024), location (p=0.002), serum creatinine levels (1.59 vs 1.09 mg/dL, p=0.000), and urine cultures (45.65% vs 23.12%, p=0.002). During the pandemic period, the rate of primary stone extraction procedures decreased (32.6% vs 59%, p<0.001), while operative time (52.89 vs 39.84 minutes, p<0.001) and hospital stay significantly increased (13.09 vs 3.76 days, p<0.001).</p><p><strong>Conclusion: </strong>The pandemic resulted in fewer hospitalizations for ureteral lithiasis and an increase in complications, likely due to reduced access to medical care and a greater tendency for upper urinary tract drainage.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"129-138"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Magnetic Resonance Imaging-Transperineal Ultrasound Fusion Prostate Biopsy with Use of a Urinary Catheter After Abdominoperineal Resection: A Novel Technique and Literature Review.","authors":"Harutake Sawazaki, Yosuke Kitamura, Atsushi Asano, Sadayoshi Suzuki","doi":"10.2147/RRU.S523114","DOIUrl":"https://doi.org/10.2147/RRU.S523114","url":null,"abstract":"<p><p>A standard prostate biopsy can be performed via a transrectal or transperineal approach using a transrectal ultrasound probe, but not in patients without a rectum. These patients pose a diagnostic challenge to urologists in terms of prostate cancer detection. We report use of a novel technique for cognitive magnetic resonance imaging (MRI)-transperineal ultrasound fusion prostate biopsy with a urinary catheter in two patients without a rectum after abdominoperineal resection. In both cases, a urinary catheter was inserted and clamped after injection of 250 mL of sterile saline into the bladder to improve visualization of the prostate. The inflated catheter balloon was placed to the level of the bladder neck to identify the base of the prostate. Cognitive MRI-transperineal ultrasound fusion biopsy was performed on the MRI-defined lesions after confirmation of anatomic landmarks, including the urethra and base of the prostate. Systemic 8-core biopsies were also obtained. In both patients, the targeted lesion was diagnosed as prostate cancer.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"119-127"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urolithiasis Burden in Somalia: Associated Factors and Regional Distribution Among Patients Undergoing CT Scan in Selected Centers in Mogadishu.","authors":"Najib Isse Dirie, Mohamed Mustaf Ahmed, Omar Mohamed Olad, Iqra Hassan Shire, Abdirahman Khalif Mohamud, Bashiru Garba, Jamal Hassan Mohamoud, Hodo Aideed Asowe, Fartun Abdullahi Hassan Orey, Jihaan Hassan, Mohamed Hussein Adam","doi":"10.2147/RRU.S507836","DOIUrl":"10.2147/RRU.S507836","url":null,"abstract":"<p><strong>Background: </strong>Urolithiasis is a significant global health burden with varying prevalence rates across different regions. In Somalia, data on the prevalence and risk factors associated with urinary stone disease are limited. This study aimed to investigate the prevalence and associated factors of urolithiasis among patients undergoing CT scans at selected centers in Mogadishu.</p><p><strong>Methods: </strong>This cross-sectional study was conducted between January and May 2024 at three medical facilities in Mogadishu, Somalia. This study included 211 patients who underwent non-contrast abdominopelvic CT scans. Data were collected using a structured questionnaire that covered sociodemographic characteristics, lifestyle habits, dietary patterns, and clinical data. Statistical analysis was performed using R statistical software version 4.4.0, employing descriptive statistics, bivariate analyses, and logistic regression.</p><p><strong>Results: </strong>The study revealed a prevalence of 26.07% (95% CI: 20.28-32.54%) for urolithiasis. Significant associations were found with marital status (married individuals showing higher risk, AOR 30.42, 95% CI 3.32-278.58) and education level (higher education showing a protective effect). Dietary factors played a crucial role, with irregular dairy consumption (AOR 37.05, 95% CI 3.44-398.62) and occasional meat consumption (AOR 3.58, 95% CI 1.41-9.08) showing increased risk. Previous diagnosis of urolithiasis (AOR 5.2, 95% CI 1.19-22.81) and history of UTIs (AOR 3.43, 95% CI 1.7-6.95) were significant risk factors.</p><p><strong>Conclusion: </strong>This study identified a substantial prevalence of urolithiasis in Mogadishu, with significant associations between sociodemographic factors, dietary habits, and medical history. These findings emphasize the need for comprehensive screening programs and targeted interventions, particularly for high-risk individuals.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"105-118"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of PCA3 and TMPRSS2:ERG Within the Prostate Cancer Prevention Trial Risk Calculator Version 2 in a Lithuanian Cohort.","authors":"Jurate Kemesiene, Carlos Nicolau, Gytis Cholstauskas, Kristina Zviniene, Mantvydas Lopeta, Simona Veneviciute, Ieva Asmenaviciute, Kamile Tamosauskaite, Ingrida Pikuniene, Mindaugas Jievaltas","doi":"10.2147/RRU.S511523","DOIUrl":"10.2147/RRU.S511523","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) remains a significant health concern due to its high incidence and associated mortality. Conventional screening approaches, like PSA testing, often lack specificity, resulting in unnecessary biopsies and overtreatment. This study seeks to overcome these limitations by assessing the integration of novel urinary biomarkers into established risk prediction models.</p><p><strong>Objective: </strong>This study aimed to evaluate the performance of incorporating urinary biomarkers - prostate cancer antigen 3 (PCA3) and transmembrane serine protease 2 (TMPRSS2) gene and ETS-related gene (ERG) fusion genes (T:E) - into the Prostate Cancer Prevention Trial Risk Calculator version 2 (PCPTRC2) in a Lithuanian cohort to enhance the detection of clinically significant prostate cancer (csPCa).</p><p><strong>Materials and methods: </strong>A single-centre prospective study included 246 men scheduled for initial prostate biopsy between January 2021 and August 2024 due to elevated total PSA levels or abnormal digital rectal examination (DRE). Following ethical approval and informed consent, urinary samples were collected post-DRE and analysed for PCA3 and T:E. Each patient's risk was calculated using the basic PCPTRC2 and updated versions incorporating biomarkers. Biopsies were performed based on multiparametric magnetic resonance imaging (mpMRI) findings.</p><p><strong>Results: </strong>Of 209 biopsy samples analysed, 111 (53.1%) were diagnosed with csPCa. The AUC for PCa detection was 59.6% for the original PCPTRC2, improving to 76.2% with PCA3 and further to 79.5% when both PCA3 and T:E were included. Both updated versions demonstrated significantly higher sensitivity compared to the original (p<0.001). However, no significant differences were noted in distinguishing csPCa from non-csPCa.</p><p><strong>Conclusion: </strong>Incorporating PCA3 and T:E into PCPTRC2 substantially enhances diagnostic accuracy for detecting PCa in biopsy-naïve patients. Despite limitations, these findings underscore the potential for optimizing risk calculators in clinical practice, advocating for larger cohorts to validate these results.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"95-103"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Cxbladder^® Triage and Monitor as an Adjunct to Urothelial Carcinoma Diagnosis and Surveillance in a Single Centre.","authors":"Daniel Magee, Ninan Tharakan, Yuigi Yuiminaga","doi":"10.2147/RRU.S516994","DOIUrl":"10.2147/RRU.S516994","url":null,"abstract":"<p><strong>Objective: </strong>Bladder cancer is the 10^th most common cancer worldwide. The investigation and surveillance commonly involve a combination of upper tract imaging along with visual assessment of the bladder via cystoscopy. This study determined the validity of using Cxbladder^® Triage (CxbT) and Cxbladder^® Monitor (CxbM) as a suitable adjunct in ruling out urothelial carcinoma (UC) when investigating haematuria or monitoring for recurrence.</p><p><strong>Materials and methods: </strong>A single centre prospective study where the patients have been referred for investigation of UC or those on routine surveillance of known UC. All patients were counselled with consent obtained prior to midstream urine collection pre-cystoscopy in line with local protocol for urine-analysis to screen for infection with the residual specimen collected for the CxbT or CxbM test. De-identified patient demographic data along with smoking status, risk of environmental exposures, family history, type of hematuria or last date of last recurrence were collected, and the planned cystoscopy would then proceed. The data pertaining to exposure to smoking and type of haematuria are the symptoms and risk factors that are taken into account with CxbT or CxbM to calculate a score, which can then be correlated with the outcome at the end with cystoscopic and imaging investigations.</p><p><strong>Results: </strong>A combined 236 patients were recruited (CxbT = 134, CxbM = 102) with results showing excellent negative predictive value of 96.43% and 95.16%, respectively. A key result showed that CxbT in combination with upper tract imaging done as routine was able to rule out UC completely in low-risk patients.</p><p><strong>Conclusion: </strong>We have validated the use of Cxbladder as an adjunct in the investigation and surveillance of UC. It is a non-invasive, accurate and reproducible test that can aid in ruling out UC, specifically for low-risk patients.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"87-94"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Advances and Emerging Innovations in Transurethral Resection of Bladder Tumor (TURBT) for Non-Muscle Invasive Bladder Cancer: A Comprehensive Review of Current Literature.","authors":"Rei Ben Muvhar, Reem Paluch, Matan Mekayten","doi":"10.2147/RRU.S386026","DOIUrl":"10.2147/RRU.S386026","url":null,"abstract":"<p><p>Bladder cancer management, particularly non-muscle-invasive bladder cancer (NMIBC), has evolved significantly due to advancements in imaging techniques and surgical methodologies. Enhanced tumor visualization methods, including Photodynamic Diagnosis (PDD) and Narrow-Band Imaging (NBI), offer improved detection rates for both papillary tumors and carcinoma in situ (CIS), compared to traditional white-light cystoscopy (WLC). Recent studies suggest that these technologies enhance diagnostic accuracy, reduce recurrence rates, and improve oncological outcomes. Additionally, transurethral resection of bladder tumors (TURBT), performed with advanced imaging, has demonstrated better resection quality, particularly in terms of detrusor muscle presence. Despite these innovations, challenges remain in the long-term impact on recurrence-free and progression-free survival. Artificial intelligence (AI) integration into cystoscopic imaging further promises enhanced diagnostic precision and cost-effective bladder cancer management. As personalized treatment paradigms emerge, predictive biomarkers, including genomic and pathological markers, may help stratify patients for aggressive treatment, sparing those at lower risk from unnecessary interventions. Future research should focus on validating these AI models and combining them with enhanced imaging modalities to refine treatment protocols further. These advancements collectively represent a significant leap toward precision medicine in bladder cancer care.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"69-85"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing High-Quality Retroperitoneal Lymph Node Dissection for Testicular Cancer at an Australian Tertiary Hospital: Challenging the Centralisation Paradigm in High-Need Areas.","authors":"Prassannah Satasivam, Samith Alwis, Sudheshan Sundaralingam, Owen Niall","doi":"10.2147/RRU.S474281","DOIUrl":"https://doi.org/10.2147/RRU.S474281","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal lymph node dissection (RPLND) plays an integral role in the curative management of metastatic testicular cancer. As a major surgery, RPLND poses a risk of significant complications, particularly in the post-chemotherapy (PC-RPLND) setting. We assessed the safety of introducing RPLND as a new service at an Australian tertiary hospital.</p><p><strong>Methods: </strong>A strict protocol prioritising appropriate case selection, multidisciplinary surgical expertise and ready access to intensive care facilities was implemented to introduce RPLND. Prospective data was collected on patients who underwent PC-RPLND between October 2020 and October 2022 at the Northern Hospital in Melbourne. Primary and secondary endpoints were 30-day postoperative Clavien-Dindo (CD) classification complication rate and perioperative quality measures, respectively.</p><p><strong>Results: </strong>Six patients (mean age 28.7 ± 4.3 years) underwent bilateral template open PC-RPLND. Median node count was 17 (IQR = 16) with metastatic germ cell tumour identified in all patients on histopathology. Median length of stay was 6 days (IQR = 3) with 1 day in intensive care. No blood transfusions were required, and no 30-day CD complications were encountered. Median follow-up was 22 months (IQR = 21) with no recurrences or significant delayed complications.</p><p><strong>Conclusion: </strong>Following a strict protocol, RPLND has been safely introduced as a new service at our tertiary institution. Perioperative quality endpoints match those of high-volume international centres.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"59-67"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Size Matter? A Retrospective Study Analysing the Size of PI-RADS 4 Lesions and Its Associated Prostate Cancer Positivity with Transperineal Prostate Biopsy.","authors":"Ali Hooshyari, David Scholtz, Keu Maoate, Samuel Robertson, Lodewikus Petrus Vermeulen, Luiz Gustavo Modelli De Andrade, Paulo Roberto Kawano, Peter Gilling, Mark Fraundorfer, Flavio Vasconcelos Ordones","doi":"10.2147/RRU.S499930","DOIUrl":"https://doi.org/10.2147/RRU.S499930","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance imaging (MRI) is an essential tool in Prostate Cancer (PCa) diagnosis. PI-RADS v2.1 score correlates with clinically significant prostate cancer (CSPCa) and according to the most recent guidelines, prevalence of CSPCa with PI-RADS 4 is 33-41%, while PI-RADS 5 is 62-79%. These groups are separated only by a size of 15 mm yet the difference in risk is significant. This study aims to find a size threshold associated with CSPCa within the PI-RADS 4 group, which may be used in combination with other prostatic parameters, such as PSA density in order to help with risk stratification and patient counselling in the pre-biopsy setting. This may also aid with surveillance of smaller PI-RADS 4 lesions in the setting of a negative biopsy and avoid unnecessary repeat biopsies unless triggered by a size threshold.</p><p><strong>Methods: </strong>A retrospective study was performed with data from 407 patients undergoing transperineal prostate biopsy (TPPB) between April 2022 and November 2023. A subgroup of patients with PI-RADS 4 was included for analysis. A ROC-AUC was obtained.</p><p><strong>Results: </strong>Median age was 67 (interquartile range: 61-71) and PSA density 0.20 (interquartile range 0.13-0.28). PI-RADS score correlated with CSPCa: for PI-RADS 1 and 2, the frequency of CSPCa was 10%; for PI-RADS 3, it was 20%; for PI-RADS 4, it was 60%; and for PI-RADS 5, it was 80%, Pearson correlation = 0.51, p < 0.001. The Receiver Operating Characteristic Area Under the Curve (ROC-AUC) was determined to be 0.664 [0.579-0.7499]. The optimal cut-off point was 8.5 mm. Patients with lesions larger than 8.5 mm had 2.31 times higher risk CSPCa.</p><p><strong>Conclusion: </strong>PI-RADS 4 size does matter and is a useful predictor of CSPCa. In our study, a cut-off of 8.5 mm was identified. The combination of PI-RADS 4 with PSA density provides a specificity higher than 80% for CSPCa detection.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"49-57"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genitofemoral Neuromodulation as a Novel Pain Management Solution for Patients with Chronic Testicular Pain: A Proof-of-Concept Study.","authors":"Tran Ngoc An Huynh, Jeffrey Jiang, Paul Manohar","doi":"10.2147/RRU.S507805","DOIUrl":"10.2147/RRU.S507805","url":null,"abstract":"<p><strong>Introduction: </strong>Severe chronic testicular pain that has failed medical therapy and physiotherapy poses a treatment dilemma. This study presents a proof of concept for the use of genitofemoral neuromodulation (GFM) as a potential pain management solution for patients with persistent testicular pain unresponsive to conservative and surgical management.</p><p><strong>Methods: </strong>Patients with chronic testicular pain refractory to conventional treatments were selected for GFM. A total of three patients were included in this proof-of-concept study. Demographic information, prior medical and surgical interventions, and pre- and post-operative pain scores using the Numerical Rating Pain Scale were collected. All patients must have had temporary relief from pain with a spermatic cord block.</p><p><strong>Results: </strong>Patient 1 (75 years old) had a history of opioid medication use, physiotherapy, radiofrequency ablation, and nerve block. His pain score reduced from 10/10 to 4/10 six months post-operatively. Patient 2 (59 years old) had a history of opioid, nortriptyline, baclofen medication use, and physiotherapy. His pain score reduced from 9/10 to 2/10 six months post-operatively. Patient 3 (36 years old) had a history of opioid medication use and physiotherapy, and bilateral orchidectomy for pain relief. His pain score reduced from 8/10 to 6/10 six months post-operatively.</p><p><strong>Conclusion: </strong>This study suggests that GFM is effective in reduce pain scores and could be a viable option for patients with chronic testicular pain refractory to traditional interventions. Further research is essential to establish the long-term efficacy and safety of GFM in this cohort.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"43-47"},"PeriodicalIF":2.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}