Scandinavian Journal of Urology最新文献

{"title":"The association between gender, stage and prognosis in bladder cancer patients undergoing radical cystectomy.","authors":"Mathilde Sofie Secher,&nbsp;Josephine Hyldgaard,&nbsp;Jørgen Bjerggaard Jensen","doi":"10.1080/21681805.2023.2166103","DOIUrl":"https://doi.org/10.1080/21681805.2023.2166103","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of bladder cancer is three times as high in men compared to women. Moreover, women are generally diagnosed with a more severe tumor stage and have poorer prognosis. This study aimed to examine the association between gender, stage, and prognosis among a subgroup of bladder cancer patients treated with radical cystectomy.</p><p><strong>Patients and methods: </strong>A total of 460 patients (131 women, 329 men) with bladder cancer undergoing radical cystectomy at Aarhus University Hospital in 2015-2018 were retrospectively selected for this study and followed until 2021 at the latest. Correlations between gender, patient and tumor characteristics and oncological outcomes were analyzed by the Chi-squared test. By the use of multiple linear regression, we adjusted for age, comorbidity and the proportion of organ-confined and non-organ-confined disease at diagnosis.</p><p><strong>Results: </strong>Female patients were found to be younger and less comorbid than male patients. A higher proportion of patients with muscle-invasive bladder cancer and non-organ-confined disease at the time of cystectomy was observed among female patients. Recurrence of cancer occurred 3.4 (0.1-6.7) months earlier in female patients, and they had a 47% higher cancer-specific mortality (RR = 1.47 (1.04-2.1)) compared to male patients. In the adjusted analysis, the association of an earlier recurrence in female patients remained.</p><p><strong>Conclusion: </strong>This study verifies that gender disparities exist among bladder cancer patients, even after adjusting for age, comorbidity and for the proportion of organ-confined and non-organ-confined disease at cystectomy. Further investigations are required to investigate the etiology of this observed difference between sexes.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"57 1-6","pages":"10-14"},"PeriodicalIF":1.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9340409","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}

{"title":"Implementation of sacral neuromodulation for urinary indications. A Danish prospective study during the initial 15 months of a new service in a tertiary referral hospital.","authors":"Hanne Kobberø,&nbsp;Margrethe Andersen,&nbsp;Karin Andersen,&nbsp;Torben Brøchner Pedersen,&nbsp;Mads Hvid Poulsen","doi":"10.1080/21681805.2022.2120066","DOIUrl":"https://doi.org/10.1080/21681805.2022.2120066","url":null,"abstract":"<p><strong>Objective: </strong>Sacral neuromodulation (SNM) is a well-established treatment modality for idiopathic overactive bladder and urgency incontinence, idiopathic fecal incontinence and non-obstructive urinary retention. This study describes the start-up phase of establishing the SNM service. <i>Primary objective:</i> To investigate the patient-reported outcome measures of SNM on lower urinary tract dysfunction symptoms. <i>Secondary objectives</i>: To investigate bowel function, sexual satisfaction and to monitor SNM safety.</p><p><strong>Materials and methods: </strong>Twenty-two patients with refractory idiopathic and neurogenic lower urinary tract dysfunction were offered a two-stage test-phase procedure and SNM device implantation. On completing the study, the patients rated their satisfaction with the treatment using a five-point Likert scale and a bother score of urinary, bowel and sexual symptoms on a scale of 1-10 (the worst). Their complications were assessed.</p><p><strong>Results: </strong>Nineteen patients (86%) were responders during the test phase and had the pulse generator implanted. Seventeen patients were very satisfied/satisfied. A statistically significant change in urinary symptoms bother score was observed in the idiopathic and neurogenic patients, a reduction from 10 to 4 (<i>p</i> = .0057) and 10 to 3 (<i>p</i> = .014), respectively. Eleven patients (58%) had symptoms from two or three pelvic compartments. Nine patients (47%) had complications. All but one event was resolved.</p><p><strong>Conclusions: </strong>SNM is safe in this heterogeneous group of patients with refractory lower urinary tract dysfunction of various etiologies. A substantial improvement was observed in the pelvic organ dysfunction, demanding a multidisciplinary approach. More studies are required to standardize the evaluation of the subjective and objective outcomes of SNM.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"404-411"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10436866","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}

{"title":"A new important tool to report and analyse adverse incidents that all urologists should use Editorial comment to: Nisen H, Erkkilä K, Ettala O, Ronkainen H, et al. Intraoperative complications in kidney tumor surgery: critical grading for the European Association of Urology intraoperative adverse incident classification. Scand J Urol. 2022 Jun 22:1-8.","authors":"Lars Lund","doi":"10.1080/21681805.2022.2119276","DOIUrl":"https://doi.org/10.1080/21681805.2022.2119276","url":null,"abstract":"","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"423-424"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10473491","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}

{"title":"Kidney tumor biopsy - an unmet need for personalized treatment.","authors":"Börje Ljungberg","doi":"10.1080/21681805.2022.2119275","DOIUrl":"https://doi.org/10.1080/21681805.2022.2119275","url":null,"abstract":"Biopsies of kidney tumors have been utilized for decades but have not reached a widespread use despite high specificity and sensitivity. In contrast, biopsies are generally used in patients with other urological malignancies as prostate, bladder, and upper tract cancers. The reason for the rare use of biopsies for kidney masses might be historical. Previously, renal tumors were large at the time of diagnosis and the only treatment option was surgery since systemic treatment was ineffective. After the introduction of targeted treatments and especially immunotherapies, prolonged survival and complete responses have been observed [1]. In addition, immunotherapy of sarcomatoid dedifferentiated renal cell carcinoma (RCC) has shown promising effects in these tumors that have a dismal prognosis [2]. It has been claimed that renal tumor biopsy is not necessary in patients with a contrast-enhancing renal mass for whom surgery is planned. However, even large contrastenhancing renal masses can occasionally be benign. The proportion of renal masses with benign histology is inverse to tumor size, and at a tumor diameter of 2 cm the proportion between benign and malignant histology is roughly even. It was shown in a large multicenter study that benign histology in the nephrectomy specimens was significantly less common in centers where biopsies were performed compared with hospitals where regular biopsies were not performed (5% vs. 16%) [3]. This study showed that tumor biopsies reduced surgery for patients with benign histology with a decreased risk for short-term and long-term morbidity associated with surgery. Biopsies can also be useful in patients on surveillance, before ablative, i.e. minimally invasive therapy and during follow-up for patients on these treatment strategies. It is currently recommended that biopsies are obtained before any ablative treatment in order to reduce unnecessary treatment of benign tumors [4]. It might also be important to diagnose malignant histology, e.g. RCC, since prolonged waiting time for surgical can reduce overall survival [5]. Histological characterization by percutaneous biopsies of undefined retroperitoneal masses diagnosed by imaging seems to be especially valuable for decision-making in younger patients [6]. For more advanced or larger kidney tumors, the value of biopsies has been less evaluated. In this issue of Scandinavian Journal of Urology, Nazzani et al., present their results on renal tumor biopsy in patients with cT1b-T4-M0 RCC [7]. The authors conclude that renal tumor biopsy is a safe procedure that confirms the indication of nephrectomy in most tumors larger than 4 cm. However, around 15% of the patients exhibited non-RCC histology while in only 3% of the patients the biopsies were non-diagnostic. This preoperative histological information, combined with clinical information on patient characteristics, is useful since it can lead to alternative treatment decisions other than radical nephrectomy, includin","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"373-374"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10839178","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}

{"title":"Editorial comment to \"Implementation of sacral neuromodulation for urinary indication. A Danish prospective cohort study from the first 15 months\" by Kobberø H, Andersen M, Andersen K, et al.","authors":"Magnus Fall","doi":"10.1080/21681805.2022.2094463","DOIUrl":"10.1080/21681805.2022.2094463","url":null,"abstract":"","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"412-413"},"PeriodicalIF":1.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10528638","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}

{"title":"Renal tumor biopsy in patients with cT1b-T4-M0 disease susceptible to radical nephrectomy: analysis of safety, accuracy and clinical impact on definitive management.","authors":"Sebastiano Nazzani,&nbsp;Carlotta Zaborra,&nbsp;Davide Biasoni,&nbsp;Mario Catanzaro,&nbsp;Alberto Macchi,&nbsp;Silvia Stagni,&nbsp;Antonio Tesone,&nbsp;Tullio Torelli,&nbsp;Rodolfo Lanocita,&nbsp;Tommaso Cascella,&nbsp;Carlo Morosi,&nbsp;Carlo Spreafico,&nbsp;Maurizio Colecchia,&nbsp;Alfonso Marchianò,&nbsp;Emanuele Montanari,&nbsp;Roberto Salvioni,&nbsp;Nicola Nicolai","doi":"10.1080/21681805.2022.2092549","DOIUrl":"https://doi.org/10.1080/21681805.2022.2092549","url":null,"abstract":"<p><strong>Purpose: </strong>Renal tumor biopsy was provided in patients candidate to radical nephrectomy for a renal mass ≥4 cm, to evaluate treatment deviation.</p><p><strong>Methods: </strong>Between 2008 and 2017, 102 patients with a solid renal mass ≥4 cm with no distant metastases underwent preliminary renal tumor biopsy. We investigated the proportion of patients who proceeded with radical nephrectomy, variables predicting non-renal cell carcinoma (RCC) and concordance between biopsy findings and definitive pathology.</p><p><strong>Results: </strong>Median tumor size was 70 mm (IQR 55-110). Clinical stage was cT1b in 41, cT2 in 33, cT3 in 25 and cT4 in three patients. A median of three (IQR 2-3) renal tumor biopsies were taken with 16/18 Gauge needles in 97% of cases. Clavien grade I complications occurred in five cases. Malignant tumors were documented in 84 patients: 78 RCCs and six non-RCCs. Fifteen biopsies documented oncocytoma and three were non-diagnostic. Grade was reported in 50 RCCs: 42 (84%) were low and eight (16%) high grade. Eighty-three patients proceeded with radical nephrectomy; six non-RCC malignant tumors underwent combined and/or intensified treatment; 13 of 15 patients with oncocytoma did not undergo radical nephrectomy (eight underwent observation). Definitive pathology confirmed diagnosis in all cases. Grade concordance was 84%, considering two tiers (high vs low grade). No preoperative clinical variable predicted definitive pathology.</p><p><strong>Conclusions: </strong>Renal tumor biopsy is a safe procedure that leads to radical nephrectomy in most tumors ≥4 cm. Nonetheless, 20% of patients exhibited non-RCC histology. Renal tumor biopsy should be considered in this setting.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"367-372"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10446721","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}

{"title":"The pursuit of excellence.","authors":"Jonathan Aning","doi":"10.1080/21681805.2022.2137231","DOIUrl":"https://doi.org/10.1080/21681805.2022.2137231","url":null,"abstract":"We present here because it will be so easy for you to access the internet service. As in this new era, much technology is sophistically offered by connecting to the internet. No any problems to face, just for this day, you can really keep in mind that the book is the best book for you. We offer the best here to read. After deciding how your feeling will be, you can enjoy to visit the link and get the book.","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"351-352"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472084","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}

{"title":"Facing urosepsis- the most deadly of all urological diseases.","authors":"Truls E Bjerklund Johansen,&nbsp;Tommaso Cai","doi":"10.1080/21681805.2022.2137230","DOIUrl":"https://doi.org/10.1080/21681805.2022.2137230","url":null,"abstract":"Sepsis","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"421-422"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472094","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}

{"title":"Watch out for sticky diagnosis bias in older men with prostate cancer.","authors":"Oskar Bergengren,&nbsp;Marcus Westerberg","doi":"10.1080/21681805.2022.2124305","DOIUrl":"https://doi.org/10.1080/21681805.2022.2124305","url":null,"abstract":"Ever heard of sticky diagnosis bias, when death from other causes is erroneously attributed to the target diagnosis, thus incorrectly increasing cause specific mortality estimates? The article by Innos et al. featured in the current issue of the Scandinavian Journal of Urology highlights this important topic [1]. In this article, the authors evaluated the validity in the official mortality statistics in Estonia for prostate cancer as the underlying cause of death. An expert panel performed a blinded review of medical records to assess if prostate cancer stated as the underlying cause of death in the death certificate was accurate. The authors found a substantial 1.5-fold overestimation of prostate cancer mortality in Estonia. The overestimation was more than two-fold in men age 85 years but was also present and ranged from 1.3 to 1.4 in other age groups. Medical review verified less than half of prostate cancer deaths in men who had localized prostate cancer at diagnosis, while the verification rate was close to 90% in men who had distant metastases. Only a modest underreporting of prostate cancer deaths was observed among men previously recorded to have died of other causes. In other words, the authors found a strong sticky diagnosis bias. The current study is in accordance with several previous studies that have assessed the validity of prostate cancer as the underlying cause of death in official mortality statistics in Nordic countries. Danish [2] and Norwegian [3] studies reported that the cause of death was misclassified in cause of death registers, resulting in an overestimation of the proportion of deaths from prostate cancer. For example, in the Norwegian study over-reporting of prostate cancer deaths was as high as 33% and misattribution of prostate cancer death increased significantly with increasing age and decreasing Gleason score. However, it is important to point out that the absence of evidence is not evidence of absence [4] and it is close to impossible to prove that someone did not die from a particular cause. Therefore, it is challenging to evaluate the accuracy of reported prostate cancer death among men without any recorded signs of death by prostate cancer, in particular among older men with multiple comorbidities [3]. Older men with localized prostate cancer without signs of progression are often followed in primary care, with little use of PSA testing or imaging, resulting in absence of evidence. This may result in misclassification of death in a review of medical records, both among men for whom death was originally attributed to prostate cancer and to other causes. Without evidence of a specific cause of death, we argue that an otherwise seemingly healthy man with a prior prostate cancer diagnosis is more likely to have his prostate cancer assigned as the cause of death, again due to a sticky diagnosis bias. His assigned cause of death to prostate cancer will be challenging to validate retrospectively but may be wrong. Ad","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"365-366"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10477747","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}

{"title":"^99mTc-Sestamibi SPECT/CT and histopathological features of oncocytic renal neoplasia.","authors":"Antonios Tzortzakakis,&nbsp;Thomas Papathomas,&nbsp;Ove Gustafsson,&nbsp;Stefan Gabrielson,&nbsp;Kiril Trpkov,&nbsp;Linnea Ekström-Ehn,&nbsp;Alexandros Arvanitis,&nbsp;Maria Holstensson,&nbsp;Mattias Karlsson,&nbsp;Georgia Kokaraki,&nbsp;Rimma Axelsson","doi":"10.1080/21681805.2022.2119273","DOIUrl":"https://doi.org/10.1080/21681805.2022.2119273","url":null,"abstract":"<p><strong>Background: </strong>^99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC) by characterising renal tumours as Sestamibi positive or Sestamibi negative regarding their ^99mTc-Sestamibi uptake compared to the non-tumoral renal parenchyma.</p><p><strong>Purpose: </strong>To determine whether ^99mTc- Sestamibi uptake in renal tumour and the non-tumoral renal parenchyma measured using Standard Uptake Value (SUV) SPECT, has a beneficial role in differentiating RO from RCC.</p><p><strong>Material and methods: </strong>Fifty-seven renal tumours from 52 patients were evaluated. In addition to visual evaluation of ^99mTc-Sestamibi uptake, SUV_max measurements were performed in the renal tumour and the ipsilateral non-tumoral renal parenchyma. Analysis of the area under the receiver operating characteristic curve identified an optimal cut-off value for detecting RO, based on the relative ratio of ^99mTc- Sestamibi uptake.</p><p><strong>Results: </strong>Semiquantitative evaluation of ^99mTc-Sestamibi uptake did not improve the performance of ^99mTc- Sestamibi SPECT/CT in detecting RO. ^99mTc- Sestamibi SPECT/CT identifies a group of mostly indolent Sestamibi-positive tumours with low malignant potential containing RO, Low-Grade Oncocytic Tumours, Hybrid Oncocytic Tumours, and a subset of chromophobe RCCs.</p><p><strong>Conclusion: </strong>The imaging limitations for accurate differentiation of Sestamibi-positive renal tumours mirror the recognised diagnostic complexities of the histopathologic evaluation of oncocytic neoplasia. Patients with Sestamibi-positive renal tumours could be better suited for biopsy and follow-up, according to the current active surveillance protocols.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"56 5-6","pages":"375-382"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10436859","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}