Scandinavian Journal of Urology最新文献

Urinary stone assessment in a single-phase may replace the unenhanced and multiphase computed tomography protocol in painless visible haematuria. 在无痛肉眼血尿中，单相尿石评估可取代无增强和多相计算机断层扫描方案。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-09-13 DOI: 10.2340/sju.v59.40679

Kristina Flor Galtung,Peter Mæhre Lauritzen,Gunnar Sandbæk,Dag Bay,Eduard Baco,Erik Rud

{"title":"Urinary stone assessment in a single-phase may replace the unenhanced and multiphase computed tomography protocol in painless visible haematuria.","authors":"Kristina Flor Galtung,Peter Mæhre Lauritzen,Gunnar Sandbæk,Dag Bay,Eduard Baco,Erik Rud","doi":"10.2340/sju.v59.40679","DOIUrl":"https://doi.org/10.2340/sju.v59.40679","url":null,"abstract":"OBJECTIVEPainless visible haematuria (VH) necessitates a computed tomography (CT) usually consisting of one unenhanced and two to three contrast enhanced acquisitions to detect urinary tract stones and malignancy. Recently, we demonstrated that a single nephrographic phase (NP) CT sufficed in detecting malignancy in patients with painless VH. Now, we aim to evaluate the diagnostic performance of single NP CT in stone detection and size measurements in the same cohort.MATERIAL AND METHODS\"A Prospective Trial for Examining Haematuria using Computed Tomography\" (PROTEHCT) was a single-center prospective diagnostic study in patients with painless VH between September 2019 and June 2021. All underwent four-phase CT (reference standard) from which a single NP CT (experimental) was extracted. Two randomised readers independently assessed the experimental CT for urinary stones and size. Statistical analysis included diagnostic accuracies and inter-reader agreement (kappa) of experimental CT, and size correlation (Spearman's ρ) between experimental CT and reference standard.RESULTSIn 308 included patients (median age: 68 years, 250 males), urinary stones (median size 5 mm) were diagnosed in 21%. The per-patient experimental CT sensitivity was 86% (97% for stones ≥ 5 mm), specificity was 98% and accuracy was 96%. The experimental CT sensitivity for detecting kidney stones was 78% (89% for stones ≥ 5 mm), and 100% for bladder and ureteral stones. No missed stone required active treatment. The inter-reader agreement was almost perfect (96%, k = 0.85). The correlation in stone size was very strong (ρ = 0.91). Conclusions: A single NP CT is sufficient in detecting and measuring urinary stones in patients with painless VH.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions. 肾小肿块患者肾肿瘤活检的诊断准确性和安全性及其对治疗决策的影响。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-09-11 DOI: 10.2340/sju.v59.40844

Bassam Mazin Hashima,Abbas Chabok,Börje Ljungberg,Erland Östberg,Farhood Alamdari

{"title":"Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions.","authors":"Bassam Mazin Hashima,Abbas Chabok,Börje Ljungberg,Erland Östberg,Farhood Alamdari","doi":"10.2340/sju.v59.40844","DOIUrl":"https://doi.org/10.2340/sju.v59.40844","url":null,"abstract":"OBJECTIVETo assess the safety and diagnostic accuracy of renal tumour biopsy (RTB) in patients with small renal masses (SRM) and to assess if RTB prevents overtreatment in patients with benign SRM.MATERIAL AND METHODSIn a retrospective, single-centre study from Västmanland, Sweden, 195 adult patients (69 women and 126 men) with SRM ≤ 4 cm who had undergone RTB during 2010-2023 were included. The median age was 70 years (range 23-89). The sensitivity, specificity and predictive values of RTB were calculated using the final diagnosis as the reference standard. Treatment outcomes were recorded for a median 42-month follow-up. Complications following the biopsies were assessed according to the Clavien-Dindo system.RESULTSThe overall sensitivity of RTB was 95% (95% confidence interval [CI] 90% - 98%) and specificity was 100% (95% CI 95% - 100%). The positive predictive value was 100% and negative predictive value was 92%. The rate of agreement between RTB and the final diagnosis measured using kappa statistics was 0.92. Of the 195 patients, 62 underwent surgery and 48 were treated with ablation. The concordance rate between the RTB histology and final histology after surgery was 89%. Treatment was withheld in 67 of 195 patients with a benign or inconclusive RTB. No patients developed renal cell carcinoma or metastasis during follow-up. Complications occurred in two patients that were classified with Clavien-Dindo grades I and IV.CONCLUSIONSPercutaneous renal tumour biopsy appears to be a safe diagnostic method that provides accurate histopathological information about small renal masses and reduces overtreatment of benign SRM.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142211054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A population-based registry cohort study on the correlation between bladder-intact event-free survival and overall survival in cystectomy-ineligible/refusal muscle-invasive bladder cancer patients in Sweden. 一项基于人群的登记队列研究，研究对象为瑞典不符合膀胱切除术条件/拒绝肌层浸润性膀胱癌患者的膀胱接触无事件生存期与总生存期之间的相关性。

IF 1.4 4区医学

Scandinavian Journal of Urology Pub Date : 2024-09-02 DOI: 10.2340/sju.v59.40016

Oscar Laurin, Simona Baculea, Sarah Côté, Samuel Spigelman, Robert Szulkin, Kelvin Hm Kwok, Frida Schain, Christina V Jones, Markus Aly

引用次数: 0

Minimising warm ischaemia time during robot-assisted partial nephrectomy. A video-based assessment of tumour excision, kidney reconstruction and intermediate time. 尽量缩短机器人辅助肾部分切除术中的热缺血时间。通过视频评估肿瘤切除、肾脏重建和中间时间。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-06-19 DOI: 10.2340/sju.v59.40397

Ovidiu S Barnoiu, Hamid R Yazdani Arazi, Aage V Andersen

{"title":"Minimising warm ischaemia time during robot-assisted partial nephrectomy. A video-based assessment of tumour excision, kidney reconstruction and intermediate time.","authors":"Ovidiu S Barnoiu, Hamid R Yazdani Arazi, Aage V Andersen","doi":"10.2340/sju.v59.40397","DOIUrl":"https://doi.org/10.2340/sju.v59.40397","url":null,"abstract":"Introduction: Surgical video review is an emerging tool for assessing patient outcomes, especially in complex surgeries such as robot-assisted partial nephrectomy (RAPN). Assessing and measuring warm ischaemia time (WIT) during RAPN by dividing it into the time used for tumour excision time (ExcT), time used for kidney reconstruction time (RecT) and intermediate time (IntT) has not been performed before. This study aimed to analyse the factors that can influence all surgical times and assess their impact on positive surgical margins (PSMs) and complication rates.Methods: We evaluated 32 surgical video recordings from patients undergoing RAPN and measured WIT, ExcT, RecT and IntT with a stopwatch. Factors such as tumour characteristics and surgeon experience were also recorded. SPSS software was used to identify the predictors for all surgical times and to correlate ExcT with PSM and RecT with complication rate.Results: We recorded a median WIT of 1,048 s (17 min and 28 s). The median of ExcT, RecT and IntT was 398 s (37.1% of WIT), 518 s (46.7% of WIT) and 180 s (16.2% of WIT), respectively. We found a significant correlation (P < 0.001) between R.E.N.A.L. score and all surgical times. No correlation was found between ExcT and PSM (P = 0.488) and between RecT and the probability of developing complications (P = 0.544).Conclusion: Tumour morphology influences all surgical times, and surgeon experience influences only ExcT. We observed a short RecT during RAPN though at the cost of increased ExcT, and we believe that improving surgical experience, especially for the excision of more complex tumours, can reduce WIT during RAPN.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Violation of onco-surgical principles is associated with survival outcomes in upper tract urothelial carcinomas after radical nephroureterectomy. 违反并行手术原则与上尿路上皮癌根治性肾切除术后的生存结果有关。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-06-19 DOI: 10.2340/sju.v59.25973

Ioannis Patras, Johan Abrahamsson, Axel Gerdtsson, Martin Nyberg, Ymir Saemundsson, Elin Ståhl, Anne Sörenby, Åsa Warnolf, Johannes Bobjer, Fredrik Liedberg

{"title":"Violation of onco-surgical principles is associated with survival outcomes in upper tract urothelial carcinomas after radical nephroureterectomy.","authors":"Ioannis Patras, Johan Abrahamsson, Axel Gerdtsson, Martin Nyberg, Ymir Saemundsson, Elin Ståhl, Anne Sörenby, Åsa Warnolf, Johannes Bobjer, Fredrik Liedberg","doi":"10.2340/sju.v59.25973","DOIUrl":"https://doi.org/10.2340/sju.v59.25973","url":null,"abstract":"Objective: Disease recurrence, particularly intravesical recurrence (IVR) after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), is common. We investigated whether violations of onco-surgical principles before or during RNU, collectively referred to as surgical violation (SV), were associated with survival outcomes. Material and methods: Data from a consecutive series of patients who underwent RNU for UTUC 2001-2012 at Skåne University Hospital Lund/Malmö were collected. Preoperative insertion of a nephrostomy tube, opening the urinary tract during surgery or refraining from excising the distal ureter were considered as SVs. Survival outcomes in patients with and without SV (IVR-free [IVRFS], disease-specific [DSS] and overall survival [OS]) were assessed using multivariate Cox regression analyses (adjusted for tumour stage group, prior or concomitant bladder cancer, comorbidity and preoperative urinary cytology).Results: Of 150 patients, 47 (31%) were subjected to at least one SV. Overall, SV was not associated with IVRFS (HR 0.81, 95% CI 0.4-1.6) but with worse DSS (HR 1.9, 95% CI 1.03-3.7) and OS (HR 1.9, 95% CI 1.2-3) in multivariable analysis. Additional analyses with a broader definition of SV including also preoperative instrumentation of the upper urinary tract (ureteroscopy and/or double J stenting) showed similar outcomes for DSS (HR 2.1, 95% CI 1.1-4.3).Conclusion: Worse survival outcomes, despite no difference in IVR, for patients that were subjected to the violation of sound onco-surgical principles before or during RNU for UTUC strengthen the notion that adhering to such principles is a cornerstone in upper tract urothelial cancer surgery.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reduction of lower urinary tract symptoms in prostate cancer patients treated with robot assisted laparoscopic prostatectomy. 减少接受机器人辅助腹腔镜前列腺切除术的前列腺癌患者的下尿路症状。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-06-18 DOI: 10.2340/sju.v59.40070

Lars Fredrik Qvigstad, Lars Magne Eri, My Diep Lien, Sophie Dorothea Fosså, Kirsti Aas, Viktor Berge

{"title":"Reduction of lower urinary tract symptoms in prostate cancer patients treated with robot assisted laparoscopic prostatectomy.","authors":"Lars Fredrik Qvigstad, Lars Magne Eri, My Diep Lien, Sophie Dorothea Fosså, Kirsti Aas, Viktor Berge","doi":"10.2340/sju.v59.40070","DOIUrl":"https://doi.org/10.2340/sju.v59.40070","url":null,"abstract":"Problem: The aim of this study was to evaluate the change in LUTS in patients treated with RALP and to assess factors that may predict an improvement of LUTS.Materials and method: In our institutional prospective research registry, 1935 patients operated in the period between 2009 and 2021 with complete baseline- and 12-month EPIC-26 questionnaire were eligible for the study. Also SF-12 data estimating general quality of life (QoL) were analyzed. A LUTS summary score was constructed from the two questions concerning voiding stream/residual and frequency, and transformed linearly to a 0-100 scale with higher scores representing less symptoms A change of 6 points or more were considered Meaningful Clinical Differences (MCD). Two summary scores were calculated from the SF-12 - a mental component score (MCS-12) and a physical component score (PCS-12). Multivariate regression was used to estimate covariates associated with postoperative MCD, MCS-12 and PCS-12.Results: Mean change of LUTS-score showed an increase of 10 points 12-months post-RALP. 52% of patients achieved MCD. In multivariate logistic regression, preoperative LUTS was statistically significant associated with MCD. Reduction of LUTS was associated improved mean score of MCS-12 and PCS-12.Discussion and conclusion: Along with information about risk for urinary incontinence after RALP, patients with LUTS at baseline must be informed that these symptoms may be reduced after RALP. In our study, this LUTS reduction was associated with better general QoL.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cutaneous adverse reactions associated to apalumide: two case reports of DRESS syndrome and maculopapular exanthema. 与阿帕鲁胺相关的皮肤不良反应：两例关于 DRESS 综合征和斑丘疹性红斑的报告。

IF 1.4 4区医学

Scandinavian Journal of Urology Pub Date : 2024-06-13 DOI: 10.2340/sju.v59.40198

Sanna Hallamies, Raija Auvinen, Heikki Junkkari, Nicolas Kluger

引用次数: 0

Don't throw out the baby with the bath water! 不要把孩子和洗澡水一起倒掉！

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-05-20 DOI: 10.2340/sju.v59.40629

Amir Sherif

引用次数: 0

End-stage renal disease after renal cancer surgery: risk factors and overall survival. 肾癌术后终末期肾病：风险因素与总体生存率。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-05-15 DOI: 10.2340/sju.v59.40322

John Åkerlund, Börje Ljungberg, Sven Lundstam, Ralph Peeker, Erik Holmberg, Marianne Månsson, Anna Grenabo Bergdahl

{"title":"End-stage renal disease after renal cancer surgery: risk factors and overall survival.","authors":"John Åkerlund, Börje Ljungberg, Sven Lundstam, Ralph Peeker, Erik Holmberg, Marianne Månsson, Anna Grenabo Bergdahl","doi":"10.2340/sju.v59.40322","DOIUrl":"https://doi.org/10.2340/sju.v59.40322","url":null,"abstract":"Objective: Several risk factors for end-stage renal disease (ESRD), in patients undergoing surgical treatment for renal cell carcinoma (RCC), have been suggested by others. This study aimed to investigate such risk factors and disclose the effect of developing ESRD, postoperatively, on overall survival. The risk of developing ESRD after RCC diagnosis was also evaluated.Material and methods: The data of 16,220 patients with RCC and 162,199 controls were extracted from the Renal Cell Cancer Database Sweden, with linkages across multiple national registers between 2005 and 2020. Cox proportional hazards regression, Kaplan-Meier curves and cumulative incidence were used for statistical analysis.Results: The 5-year cumulative incidence of ESRD following RCC diagnosis was 2.4% (95% confidence interval [CI] 2.1-2.6) and 0.4% (95% CI 0.3-0.4) for the patients with RCC and controls, respectively. Age, chronic kidney disease, higher T-stage and radical nephrectomy (RN) were significant risk factors for ESRD within 1-year of surgery. A total of 104 and 12,152 patients with and without ESRD, respectively, survived 1-year postoperatively. The 5-year overall survival rates of patients with ESRD and those with RCC only were 50% (95% CI 0.40-0.60) and 80% (95% CI 0.80-0.81), respectively.Conclusions: Patients who developed ESRD following renal cancer surgery had significantly poorer survival outcomes. Advanced age, comorbidities, higher-stage tumours and RN were identified as risk factors for developing ESRD. Surgical decisions are crucial. Efforts to spare renal function, including nephron-sparing surgery and active surveillance in appropriate cases, are highly relevant to reduce the development of severe kidney dysfunction.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of prostate cancer death in men diagnosed with prostate cancer at cystoprostat-ectomy. A nationwide population-based study. 膀胱前列腺切除术后确诊为前列腺癌的男性死于前列腺癌的风险。一项基于全国人口的研究。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-05-13 DOI: 10.2340/sju.v59.40001

Pietro Scilipoti, Fredrik Liedberg, Hans Garmo, Andri Wilberg Orrason, Pär Stattin, Marcus Westerberg

{"title":"Risk of prostate cancer death in men diagnosed with prostate cancer at cystoprostat-ectomy. A nationwide population-based study.","authors":"Pietro Scilipoti, Fredrik Liedberg, Hans Garmo, Andri Wilberg Orrason, Pär Stattin, Marcus Westerberg","doi":"10.2340/sju.v59.40001","DOIUrl":"https://doi.org/10.2340/sju.v59.40001","url":null,"abstract":"Background and aims: One out of three men who undergo cystoprostatectomy for bladder cancer is diagnosed with incidental prostate cancer (PCa) at histopathological examination. Many of these men are PSA tested as part of their follow-up, but it is unclear if this is needed. The aim of this study was to assess the risk of PCa death in these men and the need of PSA-testing during follow-up.Methods: Between 2002 and 2020, 1,554 men were diagnosed with PCa after cystoprostatectomy performed for non-metastatic bladder cancer and registered in the National Prostate Cancer Register (NPCR) of Sweden. We assessed their risk of death from PCa, bladder cancer and other causes up to 15 years after diagnosis by use of data in The Cause of Death Register. The use of androgen deprivation therapy (ADT) as a proxy for PCa progression was assessed by fillings in The Prescribed Drug Register.Results: Fifteen years after diagnosis, cumulative incidence of death from PCa was 2.6% (95% CI 2.3%-2.9%), from bladder cancer 32% (95% CI: 30%-34%) and from other causes 40% (95% CI: 36%-44%). Only 35% of men with PCa recorded as primary cause of death in The Cause of Death Register had started ADT before date of death, indicating sticky-diagnosis bias with inflated risk of PCa death.Conclusions: For a large majority of men diagnosed with incidental PCa at cystoprostatectomy performed for bladder cancer, the risk of PCa death is very small so there is no rationale for PSA testing during follow-up.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0