Therapeutic Advances in Urology最新文献

{"title":"Oncological outcomes in robot-assisted radical prostatectomy: the value of PSA density as a preoperative predictive factor.","authors":"Roser Vives Dilme, Juan Gómez Rivas, Laura Fernández Hernández, Irene De la Parra Sánchez, Rafael Sánchez Del Hoyo, María Isabel Galante Romo, Enrique Redondo González, José Luis Senovilla Pérez, Lorena Fernández Montarroso, Jesús Moreno Sierra","doi":"10.1177/17562872241229250","DOIUrl":"10.1177/17562872241229250","url":null,"abstract":"<p><strong>Background: </strong>Pretreatment assessment of patients diagnosed with localized prostate cancer (PCa) is essential for therapeutic decision-making. Currently available staging systems based on prostate-specific antigen (PSA), Gleason score, and clinical stage allow for determining the prognostic characteristics of these patients. Several studies have evaluated the preoperative use of prostate-specific antigen density (PSAD) as a prognostic factor for further risk stratification. To date, the role of PSAD in this setting is still an object of debate.</p><p><strong>Objectives: </strong>The present analysis aimed to assess the predictive potential of PSAD for adverse oncological outcomes after robot-assisted radical prostatectomy (RARP) and to compare its accuracy to preoperative PSA (pPSA).</p><p><strong>Design and methods: </strong>We retrospectively reviewed 427 patients diagnosed with localized PCa who underwent RARP at a single institution between January 2015 and January 2020. Generating receiver operator characteristic (ROC) curves, calculating areas under the curves (AUCs), and using a linear regression model, we analyzed the association of PSAD and pPSA with postoperative positive surgical margins (PSM), Gleason score ⩾ 7, persistent PSA, and biochemical recurrence (BCR), with a median follow-up of 47 months.</p><p><strong>Results: </strong>PSAD showed a significant association with PSM (<i>p</i> < 0.0001), PSA persistence (<i>p</i> < 0.0001), and Gleason ⩾ 7 (<i>p</i> < 0.0001), without being statistically significant in predicting BCR (<i>p</i> = 0.098). The predictive value of PSAD was comparable to pPSA for outcomes of PSA persistence (AUC 0.727 <i>versus</i> 0.771) and Gleason ⩾ 7 (AUC 0.683 <i>versus</i> 0.649).</p><p><strong>Conclusion: </strong>PSAD is a predictive factor for postoperative oncological outcomes of PSM, Gleason score ⩾ 7, and persistence of PSA. Despite the need for further studies, PSAD could be useful as a prognostic parameter in conjunction with established staging systems.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"16 ","pages":"17562872241229250"},"PeriodicalIF":2.6,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized trial of mechanotherapy for the treatment of stress urinary incontinence in women.","authors":"Nissrine Nakib, Suzette Sutherland, Kevin Hallman, Marcus Mianulli, David R Boulware","doi":"10.1177/17562872241228023","DOIUrl":"10.1177/17562872241228023","url":null,"abstract":"<p><strong>Background: </strong>Stress urinary incontinence (SUI) presents as unintentional urine leakage associated with activities. It significantly affects quality of life (QoL) and is the most common type of incontinence in women. Current treatment options, particularly non-surgical therapies, are lacking.</p><p><strong>Objective: </strong>To assess the efficacy of mechanotherapy provided by the Flyte^® intra-vaginal device during pelvic floor muscle training (PFMT).</p><p><strong>Design: </strong>This was a randomized, controlled, double-blinded trial.</p><p><strong>Materials and methods: </strong>Flyte is a repeat use device for conditioning and strengthening the pelvic floor muscles (PFMs). It provides two-part mechanotherapy. Part 1 is the stretching and preloading of the PFM from the internal wand. Part 2 integrates mechanical pulses which elicit muscle cellular and tissue level responses that trigger cellular regeneration, improve neuromuscular facilitation and motor learning. Subjects used the device for 5 min/day for 12 weeks. Subjects (144) were randomized and evaluated at 6 and 12 weeks. Arm A (72) received both Part 1 and Part 2 mechanotherapy for 12 weeks, whereas Arm B (72) received Part 1 therapy for 6 weeks, then crossed over to full therapy. Mean age was 50, 49, respectively, prior pelvic/abdominal surgery 26%, 46%, and previous incontinence treatments 13%, 22%. The primary endpoint was 24-h pad weight (24-HR PW) at 6 weeks. Secondary endpoints were 24-HR PW at 12 weeks and QoL [International Consultation on Incontinence Questionnaire (ICIQ), Urinary Incontinence Quality of Life (IQOL)].</p><p><strong>Results: </strong>Part 1 therapy had a greater than anticipated therapeutic effect. Thus, the study was underpowered to identify differences between study arms. Therefore, data were pooled to assess the effects of mechanotherapy. Twenty four-HR PW was significantly reduced at 6 weeks (<i>p</i> = <0.0001), with further reduction from 6 to 12 weeks (<i>p</i> = <0.0001). Data were stratified based on 24-HR PW severity. Significant reductions were noted in all severity groups (mild <i>p</i> = <0.0001, moderate <i>p</i> = <0.0001, severe <i>p</i> = <0.01). QoL was similarly improved at 6 weeks (ICIQ <i>p</i> = <0.0001, IQOL <i>p</i> = <0.0001), and 12 weeks (ICIQ <i>p</i> = <0.0001, IQOL <i>p</i> = <0.0001). Compliance was >80% at 6 weeks and 70% at 12 weeks.</p><p><strong>Conclusion: </strong>Two-part mechanotherapy significantly improved 24-HR PW and QoL across all severities of SUI. Improvements were noted in as little as 2 weeks and appeared to be sustained through 2-year follow up.</p><p><strong>Trial registration: </strong>Registered on ClinTrials.gov (NCT02954042).</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"16 ","pages":"17562872241228023"},"PeriodicalIF":2.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful bladder-sparing partial cystectomy for muscle-invasive domal urothelial carcinoma with sarcomatoid differentiation: a case report.","authors":"Mark Sultan, Ahmad Abdelaziz, Muhammed A Hammad, Juan R Martinez, Shady A Ibrahim, Mahra Nourbakhsh, Ramy F Youssef","doi":"10.1177/17562872241226582","DOIUrl":"10.1177/17562872241226582","url":null,"abstract":"<p><p>High-grade (HG) urothelial carcinoma (UC) with variant histology has historically been managed conservatively. The presented case details a solitary lesion of muscle-invasive bladder cancer (MIBC) with sarcomatoid variant (SV) histology treated by partial cystectomy (PC) and adjuvant chemotherapy. A 71-year-old male with a 15-pack year smoking history presented after outside transurethral resection of bladder tumor (TURBT). Computerized tomography imaging was negative for pelvic lymphadenopathy, a 2 cm broad-based papillary tumor at the bladder dome was identified on office cystoscopy. Complete staging TURBT noted a final pathology of invasive HG UC with areas of spindle cell differentiation consistent with sarcomatous changes and no evidence of lymphovascular invasion. The patient was inclined toward bladder-preserving options. PC with a 2 cm margin and bilateral pelvic lymphadenectomy was performed. Final pathology revealed HG UC with sarcomatoid differentiation and invasion into the deep muscularis propria, consistent with pathologic T2bN0 disease, a negative margin, and no lymphovascular invasion. Subsequently, the patient pursued four doses of adjuvant doxorubicin though his treatment was complicated by hand-foot syndrome. At 21 months postoperatively, the patient developed a small (<1 cm) papillary lesion near but uninvolved with the left ureteral orifice. Blue light cystoscopy and TURBT revealed noninvasive low-grade Ta UC. To date, the patient has no evidence of HG UC recurrence; 8 years after PC. Patient maintains good bladder function and voiding every 3-4 h with a bladder capacity of around 350 ml. Surgical extirpation with PC followed by adjuvant chemotherapy may represent a durable solution for muscle invasive (pT2) UC with SV histology if tumor size and location are amenable. Due to the sparse nature of sarcomatous features within UC, large multicenter studies are required to further understand the clinical significance and optimal management options for this variant histology.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"16 ","pages":"17562872241226582"},"PeriodicalIF":2.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The natural history of benign prostatic hyperplasia-related voiding symptoms following penile prosthesis implantation.","authors":"Raevti Bole, Prajit Khooblall, Petar Bajic","doi":"10.1177/17562872241226579","DOIUrl":"10.1177/17562872241226579","url":null,"abstract":"<p><strong>Background: </strong>There is a rising prevalence of benign prostatic hyperplasia (BPH)-related urinary symptoms along with erectile dysfunction in the aging male population. Therefore, assessment of lower urinary tract symptoms (LUTS) is advised before penile prosthesis surgery with some men requiring preoperative transurethral surgical management to reduce the risk of post-procedure complications. However, less is known about the natural history of men with uncomplicated LUTS who do not require surgical management for BPH before penile prosthesis.</p><p><strong>Objective: </strong>We sought to assess the natural history of BPH-related uncomplicated LUTS in men following penile prosthesis surgery.</p><p><strong>Design: </strong>Single institution retrospective review.</p><p><strong>Methods: </strong>Following institutional review board approval, we performed a retrospective review of all adult males with a preoperative diagnosis of LUTS undergoing penile prosthesis surgery at our institution from January 2017 to November 2022. The primary outcome was progression to transurethral surgery.</p><p><strong>Results: </strong>From 2017 to 2022, 211 patients with preexisting LUTS underwent penile prosthesis surgery and met all criteria for inclusion including no history of transurethral surgery. The median (interquartile range, IQR) AUA symptom score (AUA-SS) was 12 (12). Post-void residual was below 200 cc in 96.2% of patients preoperatively and 99.1% of patients after surgery. At a median (IQR) follow-up duration of 9 (23) months after surgery, 5.7% (12/211) of patients had progressed to bladder outlet surgery and 35.5% of patients endorsed LUTS bother with a median (IQR) AUA-SS of 14.5 (11.8).</p><p><strong>Conclusion: </strong>The majority of patients with uncomplicated LUTS did not require bladder outlet surgery following penile prosthesis implantation and could be managed with conservative or pharmacologic measures alone. Prostate gland size was significantly larger in patients who progressed to bladder outlet surgery. While the results are overall reassuring, further study is needed to identify specific factors associated with pursuing bladder outlet surgery in this small subset of patients.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"16 ","pages":"17562872241226579"},"PeriodicalIF":2.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10787523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and benefits of penile length preservation techniques during penile prosthesis implantation: a systematic review by the young academic urologists sexual and reproductive health working group.","authors":"Marco Falcone, Mirko Preto, Afonso Ribeiro Morgado, Ioannis Sokolakis, Selçuk Sarıkaya, Marco Capece, Paolo Capogrosso, Celeste Manfredi, Georgios Tsampoukas, Giorgio Russo","doi":"10.1177/17562872231215177","DOIUrl":"10.1177/17562872231215177","url":null,"abstract":"<p><strong>Background: </strong>Penile shortening, frequently resulting from end-stage Peyronie's disease (PD), has a negative impact on patients' sexual activity and overall quality of life, especially when accompanied by Erectile dysfunction (ED). Various surgical techniques have been described to manage concomitant ED and penile shortening through penile prosthesis (PP) implantation.</p><p><strong>Objectives: </strong>To evaluate the benefits and risks of different penile length preservation techniques during PP implantation.</p><p><strong>Design: </strong>A systematic review of the available literature on the use of penile length preservation maneuvers in conjunction with PP implantation was conducted.</p><p><strong>Data sources and methods: </strong>For this systematic review, three databases (Medline, Embase and Cochrane) and clinical trial.gov were queried for relevant publications from 1 January 1990 to 1 September 2022. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.</p><p><strong>Results: </strong>The qualitative analysis included 15 relevant articles involving 1186 adult patients who underwent penile length preservation techniques during PP implantation. Penile lengthening of 1-7 cm was reported. Overall, postoperative complications were described in up to 21.7% of cases. Only five studies reported functional outcomes, showing a significant improvement in postoperative period based on the administered questionnaire (e.g. IIEF - International Index of Erectile Function, EDITS - Erectile Dysfunction Inventory of Treatment Satisfaction).</p><p><strong>Conclusion: </strong>Penile length preservation procedures appear to offer a viable option for managing acquired penile shortening, particularly in cases of PD. However, they are associated with a significant risk of complications. Proper patient selection, thorough discussion of risks and benefits, and referral to high-volume centers are mandatory to achieve optimal outcomes and minimizing complications.</p><p><strong>Trial registration: </strong>PROSPERO database registration CRD42022360758.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"16 ","pages":"17562872231215177"},"PeriodicalIF":2.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of pelvic lipomatosis: a systematic review of 231 cases.","authors":"Mancheng Xia, Shengwei Xiong, Zhihua Li, Shubo Fan, Yuke Chen, Liqun Zhou, Kai Zhang, Xuesong Li","doi":"10.1177/17562872231217842","DOIUrl":"10.1177/17562872231217842","url":null,"abstract":"<p><strong>Background: </strong>Pelvic lipomatosis (PL) is a rare condition that is characterized by excessive growth of fat in the pelvic cavity. Studies have yet to systematically review surgical treatments for PL.</p><p><strong>Objectives: </strong>To provide a reference for selecting reasonable surgical treatments for PL patients according to previous literature on the surgical treatment of PL.</p><p><strong>Design and methods: </strong>We conducted this systematic review in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) of Individual Participant Data guidelines. Literature on PL published from 1968 to 2022 was retrieved from the PubMed and EMBASE databases. Data were collected and analyzed independently by two independent investigators.</p><p><strong>Results: </strong>A total of 42 studies, involving 231 patients with PL, were included in the analysis. The surgical treatments included transurethral resection (TUR) (48.5%), ureteral stent placement (11.7%), percutaneous nephrostomy (1.3%), ureterocutaneostomy (1.3%), ureteral reimplantation (10.4%), ileal conduit (13%), and allograft kidney transplantation (0.4%). After excluding patients with unclear prognoses, 42.9% of patients showed improvement in lower urinary tract symptoms (LUTS) after TUR. Ureteral stent placement provided relief of hydronephrosis in 62.5% of PL patients. Percutaneous nephrostomy resulted in stable renal function in 33.3% of PL patients, while ureterocutaneostomy led to remission of postoperative hydronephrosis in 33.3% of PL patients. After ureteral reimplantation, 70.8% of patients experienced relief of hydronephrosis or had stable renal function. Ileal conduit led to remission of hydronephrosis, alleviation of symptoms, or maintenance of stable renal function in 83.3% of PL patients. One patient with PL had stable renal function after allograft renal transplantation.</p><p><strong>Conclusion: </strong>The surgical treatments for PL include TUR, ureteral stent placement, urinary diversion, and allograft renal transplantation. However, the choice of surgical method should be determined after comprehensive consideration of the patient's condition.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231217842"},"PeriodicalIF":2.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and options for management of stones in anomalous kidneys: a review of current literature.","authors":"Mudassir Wani, Ahmed Haider Abdalla Mohamed, Gareth Brown, Seshadri Sriprasad, Sanjeev Madaan","doi":"10.1177/17562872231217797","DOIUrl":"10.1177/17562872231217797","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) represent a wide range of disorders that result from developmental abnormalities of the kidneys, urinary collecting tract, and lower urinary tract. There has been extensive development in approaches to the management of stones in normal kidneys with the advent of retrograde intra-renal surgeries (RIRS)/ureteroscopies, extracorporeal shock wave lithotripsy (ESWL) percutaneous nephrolithotomy (PCNL), and minimally invasive surgery (laparoscopy/robotics). However, the management of stones in CAKUT is not straightforward and is often challenging for urologists. There are no clear guidelines available to help navigate stone management in such patients.</p><p><strong>Materials and methods: </strong>The aim of this literature review was to focus on stone management in anomalous kidneys. Most common abnormalities were considered. The studies were very heterogeneous with different approaches. The methodology involved evaluating studies looking into individual surgical approaches to the management of stones in these anomalous kidneys as well as looking at different approaches to stone management, in particular renal abnormality.</p><p><strong>Results: </strong>We found RIRS is a feasible approach in most stones with sizes <20 mm and PCNL holds the upper hand in stones more than 20 mm. However, ESWL, laparoscopy, and robotics have their places in managing some of these cases.</p><p><strong>Conclusion: </strong>We concluded that stones in anomalous kidneys can be challenging but can be managed safely. There is no straightforward answer to the right technique but rather the right planning based on the anatomy of the kidney in terms of vascularity and drainage, stone size and density, and expertise available.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231217797"},"PeriodicalIF":2.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated renal and urinary tract aspergillosis: a systematic review.","authors":"Felix Bongomin, Bethan Morgan, Bassey E Ekeng, Martha F Mushi, Winnie Kibone, Ronald Olum, David B Meya, Davidson H Hamer, David W Denning","doi":"10.1177/17562872231218621","DOIUrl":"10.1177/17562872231218621","url":null,"abstract":"<p><strong>Background: </strong>Aspergillosis localized to the kidneys and the urinary tract is uncommon. We conducted a comprehensive systematic review to evaluate risk factors and clinical outcomes of patients with isolated renal and genito-urinary tract aspergillosis.</p><p><strong>Methods: </strong>We systematically searched Medline, CINAHL, Embase, African Journal Online, Google Scholar, and the Cochrane Library, covering the period from inception to August 2023 using the key terms 'renal' OR 'kidney*' OR 'prostate' OR 'urinary bladder' OR 'urinary tract*AND 'aspergillosis' OR 'aspergillus' OR 'aspergilloma' OR 'mycetoma'. We included single case reports or case series. Review articles, guidelines, meta-analyses, animal studies, protocols, and cases of genitourinary and /or renal aspergillosis occurring as a part of disseminated disease were excluded.</p><p><strong>Results: </strong>We identified 91 renal and urinary aspergillosis cases extracted from 76 publications spanning 1925-2023. Among the participants, 79 (86.8%) were male, with a median age of 46 years. Predominantly, presentations consisted of isolated renal infections (74 instances, 81.3%), followed by prostate (5 cases, 5.5%), and bladder (7 cases, 7.7%) involvement. <i>Aspergillus fumigatus</i> (42.9%), <i>Aspergillus flavus</i> (9.9%), and <i>Aspergillus niger/glaucus</i> (1.1% each) were isolated. Underlying risk factors included diabetes mellitus (29.7%), HIV (12.1%), haematological malignancies (11%), and liver cirrhosis (8.8%), while common symptoms encompassed flank pain (36.3%), fever (33%), and lower urinary tract symptoms (20.9%). An autopsy was conducted in 8.8% of cases. Diagnostic work-up involved histopathology (70.5%), renal CT scans and urine microscopy and culture (52.6% each), and abdominal ultrasound (17.9%). Treatments included amphotericin B (34 cases, 37.4%) and azole-based regimens (29 cases, 31.9%). Nephrectomy was performed in 16 of 78 renal cases (20.5%). All-cause mortality was 24.4% (19 cases). No significant mortality rate difference was observed among antifungal regimens (<i>p</i> = 0.739) or nephrectomy status (<i>p</i> = 0.8).</p><p><strong>Conclusion: </strong>Renal and urinary aspergillosis is an important cause of morbidity and mortality, particularly in immunocompromised and people with diabetes mellitus. While varied treatment strategies were observed, mortality rates showed no significant differences based on treatments or nephrectomy status. Further research is needed to refine diagnostics, optimize treatments, and enhance awareness among clinicians for early detection and management.</p><p><strong>Prospero registration number: </strong>CRD42023430959.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231218621"},"PeriodicalIF":2.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ‘Mini-Jupette’ technique for climacturia: a systematic review","authors":"Mykoniatis Ioannis, Tsiakaras Stavros, Savvides Eliophotos, Langas Georgios, Anastasiadis Anastasios, Koenraad van Renterghem, Andrianne Robert","doi":"10.1177/17562872231215180","DOIUrl":"https://doi.org/10.1177/17562872231215180","url":null,"abstract":"Background: The leakage of urine during sexual arousal, known as climacturia, is an under-recognized clinical condition often overshadowed by erectile dysfunction in men who have undergone radical prostatectomy. Objectives: This study aims to determine and evaluate the role of the Mini-Jupette technique and its alternatives in the treatment of climacturia. Data sources and methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. We searched Medline via PubMed, Scopus, and the Cochrane Library databases until October 2022. Results: We included seven studies involving 120 patients with climacturia. Different types of grafts were used, ranging from synthetic mesh to autologous grafts. In all seven studies, the use of the Adrianne Mini-Jupette (AMJ) and its alternatives showed a high percentage of improvement in climacturia, with reported complete resolution ranging from 65% to 93%. Regarding postoperative complications, one study reported the highest sling explantation rate at 11% (4/38), while other studies reported complications ranging from subjective symptoms such as dysuria and perineal pain to the need for subsequent artificial urinary sphincter placement. Conclusion: The AMJ sling and its variations are low-cost, time-efficient, and relatively safe procedures with high patient satisfaction rates among those treated for climacturia.","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"11 37","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584295","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":"Current evidence of robotic-assisted surgery use in functional reconstructive and neuro-urology.","authors":"Hermione Tsoi, Sameh F Elnasharty, Mehmet Gokhan Culha, Sabrina De Cillis, Cyrille Guillot-Tantay, François Hervé, Tanja Hüesch, Nicholas Raison, Véronique Phé, Nadir I Osman","doi":"10.1177/17562872231213727","DOIUrl":"10.1177/17562872231213727","url":null,"abstract":"<p><p>The use of robot-assisted technology has been widely adopted in urological oncological surgery and its benefits have been well established. In recent years, robotic technology has also been used in several functional reconstructive and neuro-urology (FRNU) procedures. The aim of this review was to evaluate the current evidence in the use of robotic technology in the field of FRNU. We performed a PubMed-based literature search between July and August 2022. The keywords we included were 'robotic assisted', 'ureteric reimplantation', 'cystoplasty', 'ileal conduit', 'neobladder', 'sacrocolpopexy', 'colposuspension', 'artificial urinary sphincter', 'genitourinary fistula' and 'posterior urethral stenoses'. We identified the latest available evidence in the use of robotic technology in specific FRNU procedures such as the reconstruction of the ureters, bladder and urinary sphincter, urinary diversion, and repair of genitourinary prolapse and fistula. We found that there is a lack of prospective studies to assess the robotic-assisted approach in the field of FRNU. Despite this, the advantages that robotic technology can bring to the field of FRNU are evident, including better ergonomics and visual field, less blood loss and shorter hospital stays. There is therefore a need for further prospective studies with larger patient numbers and longer follow-up periods to establish the reproducibility of these results and the long-term efficacy of the procedures, as well as the impact on patient outcomes. Common index procedures and a standardized approach to these procedures should be identified to enhance training.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231213727"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}