Scandinavian Journal of Urology最新文献_第3页

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":"59 ","pages":"131-136"},"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":"59 ","pages":"121-125"},"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

Don't throw out the baby with the bath water!

IF 1.4 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":"59 ","pages":"109-116"},"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 1.4 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":"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":"59 ","pages":"98-103"},"PeriodicalIF":1.4,"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

Anorectal function and symptoms 6 months after robot-assisted laparoscopic radical prostatectomy: a single-center study. 机器人辅助腹腔镜前列腺癌根治术后6个月的肛门直肠功能和症状：一项单中心研究。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-05-13 DOI: 10.2340/sju.v59.35396

Theodoros Psarias, Susanna Walter, Martin Holmbom, Issa Khayoun Issa, Firas Abdul-Sattar Aljabery, Olof Hallböök

{"title":"Anorectal function and symptoms 6 months after robot-assisted laparoscopic radical prostatectomy: a single-center study.","authors":"Theodoros Psarias, Susanna Walter, Martin Holmbom, Issa Khayoun Issa, Firas Abdul-Sattar Aljabery, Olof Hallböök","doi":"10.2340/sju.v59.35396","DOIUrl":"https://doi.org/10.2340/sju.v59.35396","url":null,"abstract":"Introduction: Robot-assisted laparoscopic radical prostatectomy (RALP) is a common procedure for the treatment of localised prostate cancer. Anorectal symptoms such as fecal incontinence (FI), rectal urgency or disturbed defecation have been reported after the operation. Anorectal function is dependent on the integrity of anal and pelvic nerves and muscles, rectal sensory function as well as rectal reservoir function. The aim of this study was to investigate the potential influence of RALP on anorectal physiological function and bowel symptoms.Materials and methods: In this pilot study, 29 patients with localised prostate cancer scheduled for RALP were included. Anorectal physiology was used to measure rectal sensitivity and reservoir function as well as anal sphincter pressures. Bowel symptoms were measured by a bowel function questionnaire and a 2-week bowel function diary. Measurements were done before the operation and repeated at 6 months after the operation.Results: The study observed a significant postoperative increase in rectal sensory threshold for rectal balloon distention, from 20 to 40 mmHg, P < 0.001. This change is indicative of a decrease in rectal sensation after RALP. There were no other statistical significant differences in any of the physiological tests performed. Importantly, there was no change in any of the bowel symptoms after surgery.Conclusion: This study showed that RALP may lead to impaired rectal sensory function. This finding did not, however, seem to have any influence on the patients´ postoperative clinical bowel function.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"59 ","pages":"104-108"},"PeriodicalIF":1.5,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911968","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 novel model of artificial intelligence based automated image analysis of CT urography to identify bladder cancer in patients investigated for macroscopic hematuria. 基于人工智能的 CT 尿路造影术自动图像分析新模型，用于识别大镜下血尿患者的膀胱癌。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-05-02 DOI: 10.2340/sju.v59.39930

Suleiman Abuhasanein, Lars Edenbrandt, Olof Enqvist, Staffan Jahnson, Henrik Leonhardt, Elin Trägårdh, Johannes Ulén, Henrik Kjölhede

{"title":"A novel model of artificial intelligence based automated image analysis of CT urography to identify bladder cancer in patients investigated for macroscopic hematuria.","authors":"Suleiman Abuhasanein, Lars Edenbrandt, Olof Enqvist, Staffan Jahnson, Henrik Leonhardt, Elin Trägårdh, Johannes Ulén, Henrik Kjölhede","doi":"10.2340/sju.v59.39930","DOIUrl":"https://doi.org/10.2340/sju.v59.39930","url":null,"abstract":"Objective: To evaluate whether artificial intelligence (AI) based automatic image analysis utilising convolutional neural networks (CNNs) can be used to evaluate computed tomography urography (CTU) for the presence of urinary bladder cancer (UBC) in patients with macroscopic hematuria.Methods: Our study included patients who had undergone evaluation for macroscopic hematuria. A CNN-based AI model was trained and validated on the CTUs included in the study on a dedicated research platform (Recomia.org). Sensitivity and specificity were calculated to assess the performance of the AI model. Cystoscopy findings were used as the reference method.Results: The training cohort comprised a total of 530 patients. Following the optimisation process, we developed the last version of our AI model. Subsequently, we utilised the model in the validation cohort which included an additional 400 patients (including 239 patients with UBC). The AI model had a sensitivity of 0.83 (95% confidence intervals [CI], 0.76-0.89), specificity of 0.76 (95% CI 0.67-0.84), and a negative predictive value (NPV) of 0.97 (95% CI 0.95-0.98). The majority of tumours in the false negative group (n = 24) were solitary (67%) and smaller than 1 cm (50%), with the majority of patients having cTaG1-2 (71%).Conclusions: We developed and tested an AI model for automatic image analysis of CTUs to detect UBC in patients with macroscopic hematuria. This model showed promising results with a high detection rate and excessive NPV. Further developments could lead to a decreased need for invasive investigations and prioritising patients with serious tumours.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"59 ","pages":"90-97"},"PeriodicalIF":1.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871172","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

Cystectomy for bladder cancer in Sweden - short-term outcomes after centralization. 瑞典的膀胱癌切除术--集中化后的短期疗效。

IF 1.5 4区医学

Scandinavian Journal of Urology Pub Date : 2024-04-29 DOI: 10.2340/sju.v59.40120

Fredrik Liedberg, Oskar Hagberg, Firas Aljabery, Ove Andrén, Victor Falini, Truls Gårdmark, Viveka Ströck, Tomas Jerlström

{"title":"Cystectomy for bladder cancer in Sweden - short-term outcomes after centralization.","authors":"Fredrik Liedberg, Oskar Hagberg, Firas Aljabery, Ove Andrén, Victor Falini, Truls Gårdmark, Viveka Ströck, Tomas Jerlström","doi":"10.2340/sju.v59.40120","DOIUrl":"https://doi.org/10.2340/sju.v59.40120","url":null,"abstract":"Objective: Radical cystectomy (RC) for bladder cancer is associated with an inherent risk of complications and even postoperative mortality. The number of hospitals performing RC has decreased in Sweden over time, and since a formal regional centralization in 2017 cystectomy care is currently provided by nine hospitals.Material and methods: In the Swedish National Urinary Bladder Cancer Register (SNRUBC) 90-day complications after RC have been registered with high coverage since 2012. Descriptive data and short-term outcomes were compared in relation to centralization of the cystectomy care by stratifying data before (2012-2016) and after (2017-2023).Results: Out of all 4,638 cystectomies, 2,738 (59%) were performed after the centralization in 2017 and onwards. The median age at RC increased from 71 (Inter Quartile Range [IQR] 65-76) to 73 (IQR 67-77) years, and the proportion of patients with comorbidity (American Society of Anesthesiologists [ASA] 3 or 4) increased from 32% to 37% after the centralization (p < 0.001). The number of patients suffering from high-grade complications within 90 days of surgery corresponding to Clavien grade three were 345 (18%) and 407 (15%), and corresponding to Clavien grade four 61 (3%) and 64 (2%) before and after centralization, respectively. Reoperations within 90 days of RC decreased from 234/1,900 (12%) to 208/2,738 (8%) (p < 0.001), and 90-day mortality decreased from 84/1,900 (4%) to 85/2,738 (3%) (p = 0.023) before and after centralization, respectively.Conclusion: After the centralization of the cystectomy-care in Sweden, older patients and individuals with more extensive comorbidity were offered RC whereas 90-day mortality and the proportion of patients subjected to reoperations within 90 days of surgery decreased without increasing waiting times.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"59 ","pages":"84-89"},"PeriodicalIF":1.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866251","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