Therapeutic Advances in Urology最新文献

{"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}

{"title":"Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort.","authors":"Felice E E van Veen, Jeroen R Scheepe, Bertil F M Blok","doi":"10.1177/17562872231215181","DOIUrl":"10.1177/17562872231215181","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to evaluate trends and regional differences in the use of indwelling and intermittent urinary catheters in the community setting in the Netherlands from 2012 to 2021.</p><p><strong>Design and methods: </strong>For this population-based cohort study, data on catheter use was collected from the Drug and Medical Devices Information System of the National Healthcare Institute of the Netherlands. This database contains information on the Dutch insured population, which was 100% of the total population in 2018. Users were divided into 12 provinces according to the Nomenclature of Territorial Units for Statistics codes. The number of catheter users was adjusted for the total population of the provinces by sex and age, and was expressed by users per 100,000 people. Negative binomial regression (NBR) was used to test for differences in clean intermittent catheter (CIC) and indwelling catheter (IDC) users across Dutch provinces.</p><p><strong>Results: </strong>Between 2012 and 2021, IDC users increased by 44.6% from 41,619 to 60,172, and CIC users increased by 27.3% from 34,204 to 43,528. The greatest increases were mainly observed among IDC users over 85 years old and male CIC users over 65 years old. NBR showed significant differences for IDC and CIC users between the 12 provinces. CIC incidence was higher in Drenthe and Groningen (Northern Netherlands) compared to Zuid-Holland (Southern Netherlands). IDC incidence was higher in seven provinces dispersed throughout the Netherlands compared to Noord-Holland.</p><p><strong>Conclusion: </strong>CIC and IDC users have continued to increase in recent years; this was especially observed among older men. In addition, there were regional differences in the number of CIC and IDC users; CIC was more prominent in the northern region of the Netherlands, and IDC varied between multiple provinces. Practice variation in urinary catheterization may result from patient population differences or healthcare provider preferences and their alignment with guidelines.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231215181"},"PeriodicalIF":2.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478619","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":"Association of obesity and different metabolic status with prognosis in patients with bladder cancer: a retrospective cohort study.","authors":"Yingchun Dong, Yiping Cheng, Honglin Guo, Jiaxing Sun, Junming Han, Fang Zhong, Qihang Li, Dawei Wang, Wenbin Chen, Xiude Fan, Jiajun Zhao","doi":"10.1177/17562872231213720","DOIUrl":"10.1177/17562872231213720","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with bladder cancer (BC) are at high risk for recurrence rates and readmission costs. However, the evidence about obesity and metabolic abnormalities on the BC prognosis was inconsistent. Our primary aim was to determine the impact of obesity and different metabolic status on the readmission risk in patients with BC.</p><p><strong>Design and methods: </strong>We identified 16,649 patients with BC using the 2018 Nationwide Readmissions Database who were hospitalized from January to June 2018 and followed for 180 days. The primary outcome was 180-day readmission. The multivariate Cox regression analysis and ordered logistic regression were performed to analyze data.</p><p><strong>Results: </strong>Obesity and metabolic abnormalities were associated with an increased readmission risk in patients with BC [obesity: adjusted hazard ratio (aHR) = 1.08, 95% confidence interval (CI): 1.01-1.16; hyperglycemia: aHR = 1.11, 95% CI: 1.05-1.17; hypertension: aHR = 1.09, 95% CI: 1.03-1.15]. Compared with non-obese and no metabolic abnormalities, the risk of readmission was significantly increased in patients with metabolic abnormalities, irrespective of obesity (non-obese and metabolic abnormalities: aHR = 1.07, 95% CI: 1.02-1.13; obese and metabolic abnormalities: aHR = 1.20, 95% CI: 1.10-1.31), but not in obese and no metabolic abnormalities. These associations were consistent in patients aged 60 years or older and the surgery group. Moreover, hyperglycemia, hypertension, and a graded increment of metabolic risk were associated with an increased readmission risk. We also found increased length of stay for readmission in patients with obesity and metabolic abnormalities (aOR = 1.17, 95% CI: 1.00-1.36).</p><p><strong>Conclusion: </strong>Obesity with metabolic abnormalities and metabolic abnormalities alone were associated with higher readmission risks in patients with BC. It is suggested that prevention should focus not only on obesity but also on metabolic abnormalities to decrease the risk of readmission.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231213720"},"PeriodicalIF":2.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10685784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462778","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":"CO₂ laser therapy for management of stress urinary incontinence in women: a systematic review and meta-analysis.","authors":"Bandr Hafidh, Saeed Baradwan, Hassan M Latifah, Abdulrahim Gari, Hussein Sabban, Hanin Hassan Abduljabbar, Afaf Tawfiq, Ghaidaa Farouk Hakeem, Alya Alkaff, Nabigah Alzawawi, Radiah Iskandarani, Kausar Khurshid, Kausar Aisha Syed, Ammar Y Alkhiary, Ibtihal Abdulaziz Bukhari, Maha Al Baalharith, Ahmed Abu-Zaid","doi":"10.1177/17562872231210216","DOIUrl":"10.1177/17562872231210216","url":null,"abstract":"<p><strong>Background: </strong>Carbon dioxide (CO₂) laser therapy is an emerging treatment for women with stress urinary incontinence (SUI).</p><p><strong>Objectives: </strong>To examine the efficacy of CO₂ laser therapy for management of SUI-related symptoms in women.</p><p><strong>Design: </strong>A systematic review and meta-analysis of randomized controlled trials and cohort studies.</p><p><strong>Data sources and methods: </strong>Four databases were screened until January 2023. All efficacy continuous endpoints were assessed <i>via</i> subtraction of the posttreatment from pretreatment values. The data were summarized as mean difference (MD) with 95% confidence interval (CI) using the random-effects model.</p><p><strong>Results: </strong>A total of 15 studies with 700 patients were analyzed. CO₂ laser therapy significantly decreased the 1-h pad weights at 3 months [<i>n</i> = 5 studies, MD = -3.656 g, 95% CI (-5.198, -2.113), <i>p</i> < 0.001], 6 months [<i>n</i> = 6 studies, MD = -6.583 g, 95% CI (-11.158, -2.008), <i>p</i> = 0.005], and 12 months [<i>n</i> = 6 studies, MD = -3.726 g, 95% CI (-6.347, -1.106), <i>p</i> = 0.005]. Moreover, CO₂ laser therapy significantly decreased the International Consultation of Incontinence Questionnaire-Urinary Incontinence Short Form Scores at 3 months [<i>n</i> = 10 studies, MD = -4.805, 95% CI (-5.985, -3.626), <i>p</i> < 0.001] and 12-months [<i>n</i> = 6 studies, MD = -3.726, 95% CI (-6.347, -1.106), <i>p</i> = 0.005]. Additionally, CO₂ laser therapy significantly decreased the Pelvic Floor Impact Questionnaire scores at 6 months [<i>n</i> = 2 studies, MD = -11.268, 95% CI (-18.671, -3.865), <i>p</i> = 0.002] and 12 months [<i>n</i> = 2 studies, MD = -10.624, 95% CI (-18.145, -3.103), <i>p</i> = 0.006]. Besides, CO₂ laser therapy significantly decreased the Urogenital Distress Inventory-6 scores at 3 months [<i>n</i> = 2 studies, MD = -21.997, 95% CI (-32.294, -11.699), <i>p</i> < 0.001], but not at 6 months [<i>n</i> = 3 studies, MD = -3.034, 95% CI (-7.357, 1.259), <i>p</i> = 0.169]. Lastly, CO₂ laser therapy significantly increased the Vaginal Health Index Score at 6 months [<i>n</i> = 2 studies, MD = 2.826, 95% CI (0.013, 5.638), <i>p</i> = 0.047] and 12 months [MD = 1.553, 95% CI (0.173, 2.934), <i>p</i> = 0.027].</p><p><strong>Conclusion: </strong>CO₂ laser therapy improved the SUI-related symptoms in women. To obtain solid conclusions, future studies should be well-designed with standardized settings, consistent therapeutic protocols, and long-term follow-up periods.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231210216"},"PeriodicalIF":2.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719528","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":"Observational study on the evolution of systemic treatments for advanced renal cell carcinoma in Southwest Finland between 2010 and 2021.","authors":"Olivia Hölsä, Kaisa Teittinen, Anna Anttalainen, Liisa Ukkola-Vuoti, Milla Summanen, Kalle E Mattila","doi":"10.1177/17562872231206243","DOIUrl":"10.1177/17562872231206243","url":null,"abstract":"<p><strong>Background: </strong>Novel receptor tyrosine kinase inhibitors and immune checkpoint inhibitors have been introduced to the treatment of advanced renal cell carcinoma (aRCC) during the past decade. However, the adoption of novel treatments into clinical practice has been unknown in Finland.</p><p><strong>Objectives: </strong>Our aim was to evaluate the use of systemic treatments and treatment outcomes of aRCC patients in Southwest Finland during 2010-2021.</p><p><strong>Design and methods: </strong>Clinical characteristics, treatments for aRCC, healthcare resource utilization, and overall survival (OS) were retrospectively obtained from electronic medical records. Patients were stratified using the International Metastatic RCC Database Consortium (IMDC) risk classification.</p><p><strong>Results: </strong>In total, 1112 RCC patients were identified, 336 (30%) patients presented with aRCC, and 57% of them (<i>n</i> = 191) had received systemic treatment. Pre-2018, sunitinib (79%) was the most common first-line treatment, and pazopanib (17%), axitinib (17%), and cabozantinib (5%) were frequently used in the second-line. Post-2018, sunitinib (52%), cabozantinib (31%), and the combination of ipilimumab and nivolumab (10%) were most commonly used in the first-line, and cabozantinib (23%) in the second-line. Median OS for patients with favorable, intermediate, and poor risk were 61.9, 28.6, and 8.1 months, respectively. A total of 73%, 74%, and 35% of the patients with favorable, intermediate, and poor risk had received second-line systemic treatment. In poor-risk patients, the number of hospital inpatient days was twofold higher compared to intermediate and fourfold higher compared to favorable-risk patients.</p><p><strong>Conclusion: </strong>New treatment options were readily adopted into routine clinical practice after becoming reimbursed in Finland. OS and the need for hospitalization depended significantly on the IMDC risk category. Upfront combination treatments are warranted for poor-risk patients as the proportion of patients receiving second-line treatment is low.</p><p><strong>Registration: </strong>Clinical trial identifier: ClinicalTrials.gov NCT05363072.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231206243"},"PeriodicalIF":2.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522604","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 implications when offering percutaneous nephrostomy for the management of malignant obstructive uropathy secondary to urological malignancy: can we be more selective?","authors":"Elizabeth Osinibi,&nbsp;Hong Doan,&nbsp;Alejandro Mercado-Campero,&nbsp;Jayasimha Abbaraju,&nbsp;Shikohe Masood,&nbsp;Sanjeev Madaan","doi":"10.1177/17562872231207729","DOIUrl":"https://doi.org/10.1177/17562872231207729","url":null,"abstract":"Background & Objectives: Percutaneous nephrostomy (PN) for malignant ureteric obstruction (MUO) is increasingly accessible with high success rates. However, it is not without associated risks and morbidity, impacting quality of life, while not improving overall survival. In two UK hospitals, we investigated the outcomes of undergoing PN for MUO, to inform future patient counselling and selection for this intervention. Methods: A retrospective audit of electronic records identified patients that received PN for bladder, and prostate cancer (PCa) between January 2015 and December 2018. Hospital 1 had a 24-h nephrostomy service, while Hospital 2 had a limited service; Group A: recurrent or treatment-resistant PCa, Group B: primary PCa, Group C: Bladder cancer. Results: A total of 261 patients (Hospital 1 = 186, Hospital 2 = 75), had PN insertion. Seventy-eight had prostate or bladder cancer. Group A n = 30, Group B n = 12, Group C n = 36. Median age = 79 [interquartile range (IQR) = 72–86]. Following PN insertion, 12-month mortality was significantly greater in Hospital 1 at 82%, versus 52% in Hospital 2 (p = 0.015). Median survival: Group A: 177 days (IQR = 80–266), Group B: 209 days (IQR = 77–352), Group C: 145 days (IQR = 97–362). There was no significant difference in same-admission mortality, although group A had the greatest same-admission mortality at 17%. A total of 69% of all patients received bilateral nephrostomies. Patients with bilateral versus unilateral PN had no difference in mortality or nadir creatinine. Conclusion: Most patients with malignant obstruction secondary to prostate or bladder cancer lived less than 12 months after PN insertion. When offering PN, careful consideration of disease prognosis should be made, and frank discussion of the implications of a life-long nephrostomy with patients and relatives.","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231207729"},"PeriodicalIF":2.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413997","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":"Outcome following the surgical management of varicocele in children and adolescents: a systematic review and meta-analysis.","authors":"Sarthak Tandon,&nbsp;Daniel Bennett,&nbsp;Ramesh Mark Nataraja,&nbsp;Maurizio Pacilli","doi":"10.1177/17562872231206239","DOIUrl":"10.1177/17562872231206239","url":null,"abstract":"<p><strong>Background: </strong>The ideal surgical approach for the management of varicocele in children and adolescents remains controversial. Several techniques are available including artery- or lymphatic-sparing with optical magnification (<i>via</i> open inguinal or sub-inguinal approach), laparoscopic, antegrade and retrograde embolization/sclerotherapy.</p><p><strong>Objectives: </strong>We aimed to appraise the clinical outcomes of these techniques in children and adolescents.</p><p><strong>Data sources and methods: </strong>A systematic review was conducted (1997-2023). Meta-analysis or proportional meta-analysis for non-comparative studies (Freeman-Tukey transformation) using the random effects model was conducted. Results are expressed as overall proportion % and 95% confidence interval (CI).</p><p><strong>Results: </strong>We identified 1910 studies; 632 duplicates were removed, 1278 were screened, 203 were reviewed and 56 were included, with 12 reporting on 2 different techniques (total of 68 data sets). Optical magnification <i>via</i> inguinal approach (498 cases): recurrence 2.5% (0.6-5.6), hydrocele 1.6% (0.47-3.4), testicular atrophy 1% (0.3-2.0), complications 1.1% (0.2-2.6); optical magnification <i>via</i> sub-inguinal approach (592 cases): recurrence 2.1% (0.7-4.4), hydrocele 1.26% (0.5-2.3), testicular atrophy 0.5% (0.1-1.3), complications 4% (1.0-8.8). Laparoscopic with mass-ligation/division (1943 cases): recurrence 2.9% (1.5-4.6), hydrocele 11.4% (8.3-14.9); complications 1.5% (0.6-2.9); laparoscopic with lymphatic-sparing (974 cases): recurrence 2.4% (1.5-3.5), hydrocele 1.2% (0.45-3.36), complications 1.2% (0.05-3.9); laparoscopic with artery-sparing (228 cases): recurrence 6.6% (2.3-12.9), hydrocele 6.5% (2.6-12.0). Antegrade embolization/sclerotherapy (403 cases): recurrence 7.6% (5.2-10.4), hydrocele 0.8% (0.17-1.9), technical failure 0.6% (0.1-1.6), complications 4.0% (2.3-6.1); retrograde embolization/sclerotherapy (509 cases): recurrence 6.9% (4.6-9.5), hydrocele 0.8% (0.05-2.5), technical failure 10.2% (4.6-17.6), and complications 4.8% (1.0-11.2).</p><p><strong>Conclusion: </strong>The recurrence rate varies between 2.1% and 7.6% and is higher with the embolization/sclerotherapy techniques. Post-operative hydrocele rate varies between 0.8% and 11.4% and is higher with the laparoscopic mass-ligation/division technique. Testicular atrophy has not been reported with the laparoscopic and embolization/sclerotherapy techniques. The retrograde embolization technique is associated with 10% technical failure (inability to complete the procedure). The laparoscopic lymphatic-sparing technique is characterized by the lowest recurrence rate, incidence of hydrocele and other complications, and no reports of testicular atrophy.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231206239"},"PeriodicalIF":2.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/7e/10.1177_17562872231206239.PMC10590051.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692522","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":"Chronic scrotal content pain: the experiences of patients undergoing microsurgical spermatic cord denervation.","authors":"Davina Banner,&nbsp;Darby Cassidy,&nbsp;Colin Appleby,&nbsp;Shayna Dolan,&nbsp;Shannon Freeman,&nbsp;Tammy Klassen-Ross,&nbsp;Kiranpreet Ghag","doi":"10.1177/17562872231196685","DOIUrl":"https://doi.org/10.1177/17562872231196685","url":null,"abstract":"Background: Chronic scrotal content pain, sometimes referred to as chronic orchialgia, is a common urological condition that gives rise to persistent and often severe painful stimuli to the scrotum and surrounding structures. Despite its relative commonality, accounting for over 2% of urological visits, chronic scrotal content pain is complex to manage and patients may be required to access multiple providers and undergo invasive procedures, including microsurgical spermatic cord denervation (MSCD) surgery. Objective: The objective of this study was to understand the experiences and perspectives of persons with chronic scrotal content pain and accessing MSCD surgery. Design: An exploratory qualitative design, guided by interpretive description and integrated knowledge translation, was adopted. Methods: We conducted in-depth qualitative interviews with six patients with chronic scrotal content pain who underwent MSCD surgery in a surgical center in Western Canada. Data were analyzed thematically. Results: Analysis of the study data resulted in three core themes: living with chronic scrotal content pain, quality of life, and MSCD procedure and outcomes. We highlight the debilitating nature of pain and the broad impacts upon health, quality of life, and social functioning. Participants described how MSCD surgery offered an effective solution for persistent and debilitating pain. For the participants, MSCD surgery offered hope and the chance to regain their normality. Conclusion: For those with chronic scrotal content pain, access to a pain specialist, along with the adoption of a biopsychosocial approach to pain and early access to MSCD surgery, may improve patient experiences and outcomes. Considering the high prevalence of urological pain, greater interdisciplinary care is needed in order to support more effective and timely management.","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231196685"},"PeriodicalIF":2.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/34/10.1177_17562872231196685.PMC10521267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154003","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":"Transperineal laser ablation as a new minimally invasive surgical therapy for benign prostatic hyperplasia: a systematic review of existing literature.","authors":"Lazaros Tzelves,&nbsp;Santhosh Nagasubramanian,&nbsp;Alexandros Pinitas,&nbsp;Patrick Juliebø-Jones,&nbsp;Sanjeev Madaan,&nbsp;Giampaolo Sienna,&nbsp;Bhaskar Somani","doi":"10.1177/17562872231198634","DOIUrl":"https://doi.org/10.1177/17562872231198634","url":null,"abstract":"<p><strong>Introduction: </strong>Transperineal laser ablation (TPLA) of the prostate is a new, minimally invasive technique for benign prostatic hyperplasia (BPH) with promising effectiveness and safety outcomes. This systematic review aims to provide an update of existing literature.</p><p><strong>Methods: </strong>A literature review was performed in Pubmed/MEDLINE, Embase, Cochrane Library, and clinicaltrials.gov from January 2000 up to April 2023. Data extraction and risk of bias were performed independently by three authors.</p><p><strong>Results: </strong>A total of 11 studies were included, among which 9 were observational, 1 randomized controlled trial, 1 animal study, while 2 of them were comparative (1 with prostatic artery embolization and 1 with transurethral resection of the prostate). Functional outcomes were improved in the majority of studies both for objective (maximum flow rate and post-void residual) and subjective outcomes (improvement of International Prostate Symptom Score and quality of life). Complication rates ranged between 1.9% and 2.3% for hematuria, 3.7% and 36.3% for dysuria, 1.9% and 19% for acute urinary retention, 0.6% and 9.1% for orchitis/urinary tract infections, and 0.6% and 4.8% for prostatic abscess formation. Regarding sexual function, >95% of patients retained their ejaculation while erectile function was maintained or improved.</p><p><strong>Conclusion: </strong>TPLA of the prostate is an innovative, minimally invasive technique for managing patients with BPH. Existing studies indicate an effective technique in reducing International Prostate Symptom Score and quality of life scores, post-void residual reduction, and increase in Qmax, albeit the measured improvements in terms of Qmax are not equal to transurethral resection of the prostate. Although sexual function is maintained, the mean catheterization time is 7 days, and no long-term data are available for most patients.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231198634"},"PeriodicalIF":2.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/61/10.1177_17562872231198634.PMC10515526.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41130220","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":"Insertion of inflatable penile prosthesis in the neophallus of assigned female at birth individuals: a systematic review of surgical techniques, complications and outcomes.","authors":"Karl H Pang,&nbsp;Nim Christopher,&nbsp;David J Ralph,&nbsp;Wai Gin Lee","doi":"10.1177/17562872231199584","DOIUrl":"10.1177/17562872231199584","url":null,"abstract":"<p><p>Devices such as inflatable penile prostheses (IPP) can be used to achieve erectile rigidity after phalloplasty in assigned female at birth (AFAB) individuals. The approach to inserting an IPP in a neophallus is different and more challenging compared to that of an anatomical penis due to the absence of anatomical structures such as the corpora cavernosa, and the more tenuous blood supply of the neophallus and reconstructed urethra. In addition, the ideal surgical techniques and devices for use in the neophallus have not been defined. This review systematically summarises the literature on the insertion of IPP in the neophallus of individuals AFAB. In particular, the described techniques, types of devices used and peri-operative and patient-reported outcomes are emphasised. An initial search of the PubMed database was performed on 16 September 2022 and an updated search was performed on 26 May 2023. Overall, 185 articles were screened for eligibility and 15 studies fulfilled the inclusion criteria and were included in the analysis. Two studies reported outcomes on the zephyr surgical implant 475 FTM device and the others reported outcomes on the Boston Scientific AMS 600/700^TM CX 3-piece inflatable, AMS Ambicor^TM 2-piece inflatable, Coloplast Titan^® or Dynaflex devices. Overall, 1106 IPPs were analysed. The infection rate was 4.2%-50%, with most studies reporting an infection rate of <30%. Mechanical failure or dysfunction occurred in 1.4%-36.4%, explantation was required in 3.3%-41.6%, and implant revision or replacement was performed in 6%-70%. Overall, 51.4%-90.6% of patients were satisfied and 77%-100% were engaging in sexual intercourse. An IPP in a neophallus is an acceptable option to achieve rigidity for sexual intercourse. However, this challenging procedure has good reports of patient and partner satisfaction despite significant risks of complications.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231199584"},"PeriodicalIF":2.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/c3/10.1177_17562872231199584.PMC10503286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339560","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}