Therapeutic Advances in Urology最新文献

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Report of testicular tumour in a toddler: management beyond the testis. 儿童睾丸肿瘤报告:睾丸以外的处理。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872221148382
Amit Sharma, Deepak Biswal, Satyadeo Sharma, Kishore Roy
{"title":"Report of testicular tumour in a toddler: management beyond the testis.","authors":"Amit Sharma,&nbsp;Deepak Biswal,&nbsp;Satyadeo Sharma,&nbsp;Kishore Roy","doi":"10.1177/17562872221148382","DOIUrl":"https://doi.org/10.1177/17562872221148382","url":null,"abstract":"<p><p>Testicular tumours in prepubertal children tend to be pure yolk sac tumours detected in stage I and have good prognosis. We describe a case of a 2-year old male child with a mixed testicular tumour presenting with stage IIC disease and managed with retroperitoneal lymph node dissection for residual retroperitoneal disease post adjuvant chemotherapy.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872221148382"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/90/10.1177_17562872221148382.PMC9896083.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9215691","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}
引用次数: 0
Current state of mobile health apps in endourology: a review of mobile platforms in marketplaces and literature. 泌尿外科移动健康应用程序的现状:对市场和文献中的移动平台的回顾。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231176368
Ali Talyshinskii, Guliev Bakhman, Bm Zeeshan Hameed, Amelia Pietropaolo, Nithesh Naik, Bhaskar K Somani
{"title":"Current state of mobile health apps in endourology: a review of mobile platforms in marketplaces and literature.","authors":"Ali Talyshinskii,&nbsp;Guliev Bakhman,&nbsp;Bm Zeeshan Hameed,&nbsp;Amelia Pietropaolo,&nbsp;Nithesh Naik,&nbsp;Bhaskar K Somani","doi":"10.1177/17562872231176368","DOIUrl":"https://doi.org/10.1177/17562872231176368","url":null,"abstract":"<p><p>Several mobile healthcare (mHealth) apps are available in various marketplaces, but there is still concern about their accuracy, data safety, and regulation. The goal of this review was to critically analyze the mobile apps created for education, diagnosis, and medical and surgical treatment of patients with kidney stone disease (KSD), as well as to assess the level of data security, the contribution of physicians in their development and adherence to the Food and Drug Administration (FDA) and Medical Device Regulation (MDR) guidance. A comprehensive literature search was performed using PubMed (September 2022), in the Apple App Store and Google Play store using relevant keywords and inclusion criteria. Information was extracted for the name of the app, primary and additional functionalities, release and last update, number of downloads, number of marks and average rating, Android/iOS compatibility, initial and in-app payments, data safety statement, physician involvement statement, and FDA/MDR guidance. A total of 986 apps and 222 articles were reviewed, of which based on the inclusion, 83 apps were finally analyzed. The apps were allocated to six categories about their primary purpose: education (<i>n</i> = 8), fluid trackers (<i>n</i> = 54), food content description and calculators (<i>n</i> = 11), diagnosis (<i>n</i> = 3), pre- and intra-operative application (<i>n</i> = 4), and stent trackers (<i>n</i> = 2). Of these apps, the number of apps supported for Android, iOS, and both of them were 36, 23, and 23, respectively. Despite a wide range of apps available for KSD, the participation of doctors in their development, data security, and functionality remains insufficient. Further development of mHealth should be carried out properly under the supervision of urological associations involving patient support groups, and these apps must be regularly updated for their content and data security.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231176368"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/e4/10.1177_17562872231176368.PMC10240556.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645608","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}
引用次数: 0
New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology. 新的多端口机器人手术系统:泌尿外科临床结果的综合文献综述。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231177781
Morgan Salkowski, Enrico Checcucci, Alexander K Chow, Craig C Rogers, Firas Adbollah, Evangelos Liatsikos, Prokar Dasgupta, Gustavo C Guimaraes, Jens Rassweiler, Alexander Mottrie, Alberto Breda, Simone Crivellaro, Jihad Kaouk, Francesco Porpiglia, Riccardo Autorino
{"title":"New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology.","authors":"Morgan Salkowski,&nbsp;Enrico Checcucci,&nbsp;Alexander K Chow,&nbsp;Craig C Rogers,&nbsp;Firas Adbollah,&nbsp;Evangelos Liatsikos,&nbsp;Prokar Dasgupta,&nbsp;Gustavo C Guimaraes,&nbsp;Jens Rassweiler,&nbsp;Alexander Mottrie,&nbsp;Alberto Breda,&nbsp;Simone Crivellaro,&nbsp;Jihad Kaouk,&nbsp;Francesco Porpiglia,&nbsp;Riccardo Autorino","doi":"10.1177/17562872231177781","DOIUrl":"https://doi.org/10.1177/17562872231177781","url":null,"abstract":"<p><p>Over the past 20 years, the field of robotic surgery has largely been dominated by the da Vinci robotic platform. Nevertheless, numerous novel multiport robotic surgical systems have been developed over the past decade, and some have recently been introduced into clinical practice. This nonsystematic review aims to describe novel surgical robotic systems, their individual designs, and their reported uses and clinical outcomes within the field of urologic surgery. Specifically, we performed a comprehensive review of the literature regarding the use of the Senhance robotic system, the CMR-Versius robotic system, and the Hugo RAS in urologic procedures. Systems with fewer published uses are also described, including the Avatera, Hintori, and Dexter. Notable features of each system are compared, with a particular emphasis on factors differentiating each system from the da Vinci robotic system.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231177781"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/39/10.1177_17562872231177781.PMC10265325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10030404","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}
引用次数: 6
Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis. 同时根治性膀胱切除术和肾输尿管切除术的适应症和结果:系统回顾和比较分析。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231171757
Marwan Zein, Ali A Nasrallah, Nassib F Abou Heidar, Jad Najdi, Layal Hneiny, Albert El Hajj
{"title":"Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis.","authors":"Marwan Zein,&nbsp;Ali A Nasrallah,&nbsp;Nassib F Abou Heidar,&nbsp;Jad Najdi,&nbsp;Layal Hneiny,&nbsp;Albert El Hajj","doi":"10.1177/17562872231171757","DOIUrl":"https://doi.org/10.1177/17562872231171757","url":null,"abstract":"<p><strong>Introduction: </strong>Urothelial carcinoma can arise from the urinary bladder or from the upper urinary tract. In some instances, urinary bladder cancer (UBC) and upper tract urothelial carcinoma (UTUC) can be concurrently diagnosed, necessitating a combined radical cystectomy (RC) with radical nephroureterectomy (RNU). A systematic review was done on the combined procedure exploring outcomes and indications, in addition to a comparative analysis between the combined procedure and cystectomy alone.</p><p><strong>Methods: </strong>For the systematic review, three databases (Embase, PubMed, and Cochrane) were queried, selecting only studies that included intraoperative and perioperative data. For the comparative analysis, using the NSQIP database, CPT codes for RC and RNU were used to identify two cohorts, one with RC and RNU and one with RC alone. A descriptive analysis was performed on all preoperative variables, and propensity score matching (PSM) was performed. Postoperative events were then compared between the two matched cohorts.</p><p><strong>Results: </strong>For the systematic review, 28 relevant articles were included amounting to 947 patients who underwent the combined procedure. The most common indication was synchronous multifocal disease, the most common approach was open surgery, and the most common diversion technique was using an ileal conduit. Almost 28% of patients required blood transfusion and remained in the hospital for an average of 13 days. The most common postoperative complication was prolonged paralytic ileus. For the comparative analysis, 11,759 patients were included of which 97.5% underwent RC only and 2.5% underwent the combined procedure. After PSM, the cohort that had undergone the combined procedure showed an increased risk of renal injury, increased readmission rates, and increased reoperation rates. Whereas the cohort that had undergone RC only showed an increased risk of deep venous thrombosis (DVT), sepsis, or septic shock.</p><p><strong>Conclusion: </strong>A combined RC and RNU is a treatment option for concurrent UCB and UTUC that should be cautiously utilized as it is associated with high morbidity and mortality. Patient selection, discussion of the risks and benefits of the procedure, and explanation of the available treatment options remain the most important pillars in managing patients with this complex disease.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231171757"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/c6/10.1177_17562872231171757.PMC10176578.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9530405","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}
引用次数: 1
RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study. 使用一次性或可重复使用作用域的RIRS:有区别吗?多中心FLEXOR研究结果。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231158072
Vineet Gauhar, Chu Ann Chai, Ben H Chew, Abhishek Singh, Daniele Castellani, Thomas Tailly, Esteban Emiliani, William Ong Lay Keat, Deepak Ragoori, Mohamed Amine Lakmichi, Jeremy Yuen-Chun Teoh, Olivier Traxer, Bhaskar Kumar Somani
{"title":"RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study.","authors":"Vineet Gauhar,&nbsp;Chu Ann Chai,&nbsp;Ben H Chew,&nbsp;Abhishek Singh,&nbsp;Daniele Castellani,&nbsp;Thomas Tailly,&nbsp;Esteban Emiliani,&nbsp;William Ong Lay Keat,&nbsp;Deepak Ragoori,&nbsp;Mohamed Amine Lakmichi,&nbsp;Jeremy Yuen-Chun Teoh,&nbsp;Olivier Traxer,&nbsp;Bhaskar Kumar Somani","doi":"10.1177/17562872231158072","DOIUrl":"https://doi.org/10.1177/17562872231158072","url":null,"abstract":"<p><strong>Introduction: </strong>With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage.</p><p><strong>Methods: </strong>Retrospective analysis was performed on the FLEXOR registry, which was created as a TOWER group (Team of Worldwide Endourological Researchers, research wing of the Endourological Society) endeavor. Patients who underwent retrograde intrarenal surgery (RIRS) for renal stones from January 2018 to August 2021 were enrolled from 20 centers globally. A total of 6663 patients whose data were available for analysis were divided into Group 1 (Reusable scopes, 4808 patients) <i>versus</i> Group 2 (Disposable scopes, 1855 patients).</p><p><strong>Results: </strong>The age and gender distribution were similar in both groups. The mean stone size was 11.8 mm and 9.6 mm in Groups 2 and 1, respectively (<i>p</i> < 0.001). Group 2 had more patients with >2 cm stones, lower pole stones and of higher Hounsfield unit. Thulium fiber laser (TFL) was used more in Group 2 (<i>p</i> < 0.001). Patients in Group 2 had a slightly higher stone-free rate (SFR) (78.22%) and a lower number of residual fragments (RFs) compared with Group 1 (<i>p</i> < 0.001). The need for further treatments for RF and overall complications was comparable between groups. On multivariate analysis, overall complications were more likely to occur in elderly patients, larger stone size, lower pole stones, and were also more when using disposable scopes with longer operative time. RFs were significantly higher (<i>p</i> < 0.001) for lower pole, larger, harder, multiple stones and in elderly.</p><p><strong>Conclusion: </strong>Our real-world practice observations suggest that urologists choose disposable scopes for bigger, lower pole, and harder stones, and it does indeed help in improving the single-stage SFR if used correctly, with the appropriate lasers and lasing techniques in expert hands.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231158072"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/2e/10.1177_17562872231158072.PMC10009018.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9120344","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}
引用次数: 3
The role of 'artificial intelligence, machine learning, virtual reality, and radiomics' in PCNL: a review of publication trends over the last 30 years. “人工智能、机器学习、虚拟现实和放射组学”在PCNL中的作用:回顾过去30年的出版趋势。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231196676
Carlotta Nedbal, Clara Cerrato, Victoria Jahrreiss, Daniele Castellani, Amelia Pietropaolo, Andrea Benedetto Galosi, Bhaskar Kumar Somani
{"title":"The role of 'artificial intelligence, machine learning, virtual reality, and radiomics' in PCNL: a review of publication trends over the last 30 years.","authors":"Carlotta Nedbal,&nbsp;Clara Cerrato,&nbsp;Victoria Jahrreiss,&nbsp;Daniele Castellani,&nbsp;Amelia Pietropaolo,&nbsp;Andrea Benedetto Galosi,&nbsp;Bhaskar Kumar Somani","doi":"10.1177/17562872231196676","DOIUrl":"https://doi.org/10.1177/17562872231196676","url":null,"abstract":"<p><strong>Introduction: </strong>We wanted to analyze the trend of publications in a period of 30 years from 1994 to 2023, on the application of 'artificial intelligence (AI), machine learning (ML), virtual reality (VR), and radiomics in percutaneous nephrolithotomy (PCNL)'. We conducted this study by looking at published papers associated with AI and PCNL procedures, including simulation training, with preoperative and intraoperative applications.</p><p><strong>Materials and methods: </strong>Although MeSH terms research on the PubMed database, we performed a comprehensive review of the literature from 1994 to 2023 for all published papers on 'AI, ML, VR, and radiomics' in 'PCNL', with papers in all languages included. Papers were divided into three 10-year periods: Period 1 (1994-2003), Period 2 (2004-2013), and Period 3 (2014-2023).</p><p><strong>Results: </strong>Over a 30-year timeframe, 143 papers have been published on the subject with 116 (81%) published in the last decade, with a relative increase from Period 2 to Period 3 of +427% (<i>p</i> = 0.0027). There was a gradual increase in areas such as automated diagnosis of larger stones, automated intraoperative needle targeting, and VR simulators in surgical planning and training. This increase was most marked in Period 3 with automated targeting with 52 papers (45%), followed by the application of AI, ML, and radiomics in predicting operative outcomes (22%, <i>n</i> = 26) and VR for simulation (18%, <i>n</i> = 21). Papers on technological innovations in PCNL (<i>n</i> = 9), intelligent construction of personalized protocols (<i>n</i> = 6), and automated diagnosis (<i>n</i> = 2) accounted for 15% of publications. A rise in automated targeting for PCNL and PCNL training between Period 2 and Period 3 was +247% (<i>p</i> = 0.0055) and +200% (<i>p</i> = 0.0161), respectively.</p><p><strong>Conclusion: </strong>An interest in the application of AI in PCNL procedures has increased in the last 30 years, and a steep rise has been witnessed in the last 10 years. As new technologies are developed, their application in devices for training and automated systems for precise renal puncture and outcome prediction seems to play a leading role in modern-day AI-based publication trends on PCNL.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231196676"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/03/10.1177_17562872231196676.PMC10492475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220049","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}
引用次数: 0
Instrumental dead space and proximal working channel connector design in flexible ureteroscopy: a new concept. 软输尿管镜下仪器死区及近端工作通道接头设计:新概念。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872231179332
Jia-Lun Kwok, Vincent De Coninck, Amelia Pietropaolo, Patrick Juliebø-Jones, Eugenio Ventimiglia, Thomas Tailly, Florian Alexander Schmid, Manuela Hunziker, Cédric Poyet, Olivier Traxer, Daniel Eberli, Etienne Xavier Keller
{"title":"Instrumental dead space and proximal working channel connector design in flexible ureteroscopy: a new concept.","authors":"Jia-Lun Kwok,&nbsp;Vincent De Coninck,&nbsp;Amelia Pietropaolo,&nbsp;Patrick Juliebø-Jones,&nbsp;Eugenio Ventimiglia,&nbsp;Thomas Tailly,&nbsp;Florian Alexander Schmid,&nbsp;Manuela Hunziker,&nbsp;Cédric Poyet,&nbsp;Olivier Traxer,&nbsp;Daniel Eberli,&nbsp;Etienne Xavier Keller","doi":"10.1177/17562872231179332","DOIUrl":"https://doi.org/10.1177/17562872231179332","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate a new concept in flexible ureteroscopy: instrumental dead space (IDS). For this purpose, various proximal working channel connector designs, as well as the impact of ancillary devices occupying the working channel were evaluated in currently available flexible ureteroscopes.</p><p><strong>Design and methods: </strong>IDS was defined as the volume of saline irrigation needed to inject at the proximal connector for delivery at the distal working channel tip. Because IDS is related to working channel diameter and length, proximal connector design, as well as occupation of working channel by ancillary devices, these parameters were also reviewed.</p><p><strong>Results: </strong>IDS significantly varied between flexible ureteroscope models, ranging from 1.1 ml for the Pusen bare scopes, to 2.3 ml for Olympus scopes with their 4-way connector (<i>p</i> < 0.001). Proximal connector designs showed a high degree of variability in the number of available Luer locks, valves, seals, angles, and rotative characteristics. The measured length of the working channel of bare scopes ranged between 739 and 854 mm and significantly correlated with measured IDS (<i>R</i><sup>2</sup> = 0.82, <i>p</i> < 0.001). The coupling of scopes with an alternative ancillary proximal connector and the insertion of ancillary devices into the working channel significantly reduced IDS (mean IDS reduction of 0.1 to 0.5 ml; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>IDS appears as a new parameter that should be considered for future applications of flexible ureteroscopes. A low IDS seems desirable for several clinical applications. The main factors impacting IDS are working channel and proximal connector design, as well as ancillary devices inserted into the working channel. Future studies should clarify how reducing IDS may affect irrigation flow, intrarenal pressure, and direct in-scope suction, as well as evaluate the most desirable proximal connector design properties.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872231179332"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10291398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9729787","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}
引用次数: 0
Insights from the AQUA Registry: a retrospective study of anticholinergic polypharmacy in the United States. AQUA登记处的见解:美国抗胆碱能综合用药的回顾性研究。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI: 10.1177/17562872221150572
Matthew R Cooperberg, Rachel Mbassa, David Walker, William Meeks, Amy Lockefeer, Baoguo Jiang, Tina Li, Karissa Johnston, Raymond Fang
{"title":"Insights from the AQUA Registry: a retrospective study of anticholinergic polypharmacy in the United States.","authors":"Matthew R Cooperberg,&nbsp;Rachel Mbassa,&nbsp;David Walker,&nbsp;William Meeks,&nbsp;Amy Lockefeer,&nbsp;Baoguo Jiang,&nbsp;Tina Li,&nbsp;Karissa Johnston,&nbsp;Raymond Fang","doi":"10.1177/17562872221150572","DOIUrl":"https://doi.org/10.1177/17562872221150572","url":null,"abstract":"<p><strong>Background: </strong>Anticholinergic (ACH) burden is a risk factor for negative health outcomes among older adults. Several medications contribute to ACH burden, including antimuscarinics used to manage overactive bladder (OAB).</p><p><strong>Objectives: </strong>This study aimed to understand the extent of ACH burden in an OAB population in the United States.</p><p><strong>Design: </strong>Non-interventional retrospective analysis.</p><p><strong>Methods: </strong>Adults with OAB whose care providers participated in the American Urological Association Quality (AQUA) Registry between 2014 and 2020 were included in this study. An adapted version of the Pharmacy Quality Alliance (PQA) measure of anticholinergic polypharmacy (poly-ACH) was used to assess ACH burden. The primary outcome was the annual prevalence of poly-ACH, and a secondary outcome was the percentage of patients taking 0, 1, 2, 3, 4, or ⩾ 5 ACH medications by calendar year. Analyses were stratified by age category at diagnosis and sex.</p><p><strong>Results: </strong>The sample comprised 552,840 patients with OAB. The mean age at initial OAB diagnosis was 65.7 years (58.2% male; 57.4% white). Prevalence of poly-ACH was highest in 2015 (3.7%) and lowest in 2020 (1.9%). Patients prescribed no ACH medications made up the largest proportion of each cohort, while those prescribed five or more comprised the smallest. The trend of decreasing proportions of patients taking increasing numbers of ACH medications was consistent. The proportion of patients prescribed no ACH medications increased from 63.3% in 2014 to 74.6% in 2020. The percentage of those prescribed three or more ACHs remained largely unchanged. Poly-ACH was highest among younger individuals (< 65 years of age) and females; temporal trends were similar overall and within each age and sex stratum.</p><p><strong>Conclusion: </strong>In this study, poly-ACH in patients with OAB was relatively infrequent and decreased over the study period. Further evaluation of poly-ACH is needed to assess whether the study findings reflect increased awareness of the negative effects of poly-ACH.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"15 ","pages":"17562872221150572"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/59/10.1177_17562872221150572.PMC9871979.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10628116","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}
引用次数: 1
Multiparametric ultrasound of prostate: role in prostate cancer diagnosis. 前列腺多参数超声:在前列腺癌诊断中的作用。
IF 2.6 4区 医学
Therapeutic Advances in Urology Pub Date : 2022-12-26 eCollection Date: 2022-01-01 DOI: 10.1177/17562872221145625
Masatomo Kaneko, Maria Sarah L Lenon, Lorenzo Storino Ramacciotti, Luis G Medina, Aref S Sayegh, Anibal La Riva, Laura C Perez, Alireza Ghoreifi, Maria Lizana, Donya S Jadvar, Amir H Lebastchi, Giovanni E Cacciamani, Andre Luis Abreu
{"title":"Multiparametric ultrasound of prostate: role in prostate cancer diagnosis.","authors":"Masatomo Kaneko, Maria Sarah L Lenon, Lorenzo Storino Ramacciotti, Luis G Medina, Aref S Sayegh, Anibal La Riva, Laura C Perez, Alireza Ghoreifi, Maria Lizana, Donya S Jadvar, Amir H Lebastchi, Giovanni E Cacciamani, Andre Luis Abreu","doi":"10.1177/17562872221145625","DOIUrl":"10.1177/17562872221145625","url":null,"abstract":"<p><p>Recent advances in ultrasonography (US) technology established modalities, such as Doppler-US, HistoScanning, contrast-enhanced ultrasonography (CEUS), elastography, and micro-ultrasound. The early results of these US modalities have been promising, although there are limitations including the need for specialized equipment, inconsistent results, lack of standardizations, and external validation. In this review, we identified studies evaluating multiparametric ultrasonography (mpUS), the combination of multiple US modalities, for prostate cancer (PCa) diagnosis. In the past 5 years, a growing number of studies have shown that use of mpUS resulted in high PCa and clinically significant prostate cancer (CSPCa) detection performance using radical prostatectomy histology as the reference standard. Recent studies have demonstrated the role mpUS in improving detection of CSPCa and guidance for prostate biopsy and therapy. Furthermore, some aspects including lower costs, real-time imaging, applicability for some patients who have contraindication for magnetic resonance imaging (MRI) and availability in the office setting are clear advantages of mpUS. Interobserver agreement of mpUS was overall low; however, this limitation can be improved using standardized and objective evaluation systems such as the machine learning model. Whether mpUS outperforms MRI is unclear. Multicenter randomized controlled trials directly comparing mpUS and multiparametric MRI are warranted.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"14 ","pages":"17562872221145625"},"PeriodicalIF":2.6,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/f3/10.1177_17562872221145625.PMC9806443.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119015","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}
引用次数: 0
Nanotechnology as a tool to advance research and treatment of non-oncologic urogenital diseases. 纳米技术作为推进非肿瘤性泌尿生殖疾病研究和治疗的工具。
IF 2 4区 医学
Therapeutic Advances in Urology Pub Date : 2022-01-01 DOI: 10.1177/17562872221109023
Justin Loloi, Mustufa Babar, Kelvin P Davies, Sylvia O Suadicani
{"title":"Nanotechnology as a tool to advance research and treatment of non-oncologic urogenital diseases.","authors":"Justin Loloi,&nbsp;Mustufa Babar,&nbsp;Kelvin P Davies,&nbsp;Sylvia O Suadicani","doi":"10.1177/17562872221109023","DOIUrl":"https://doi.org/10.1177/17562872221109023","url":null,"abstract":"<p><p>Nanotechnology represents an expanding area of research and innovation in almost every field of science, including Medicine, where nanomaterial-based products have been developed for diagnostic and therapeutic applications. Because of their small, nanoscale size, these materials exhibit unique physical and chemical properties that differ from those of each component when considered in bulk. In Nanomedicine, there is an increasing interest in harnessing these unique properties to engineer nanocarriers for the delivery of therapeutic agents. Nano-based drug delivery platforms have many advantages over conventional drug administration routes as this technology allows for local and transdermal applications of therapeutics that can bypass the first-pass metabolism, improves drug efficacy through encapsulation of hydrophobic drugs, and allows for a sustained and controlled release of encapsulated agents. In Urology, nano-based drug delivery platforms have been extensively investigated and implemented for cancer treatment. However, there is also great potential for use of nanotechnology to treat non-oncologic urogenital diseases. We provide an update on research that is paving the way for clinical translation of nanotechnology in the areas of erectile dysfunction (ED), overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), and catheter-associated urinary tract infections (CAUTIs). Overall, preclinical and clinical studies have proven the utility of nanomaterials both as vehicles for transdermal and intravesical delivery of therapeutic agents and for urinary catheter formulation with antimicrobial agents to treat non-oncologic urogenital diseases. Although clinical translation will be dependent on overcoming regulatory challenges, it is inevitable before there is universal adoption of this technology to treat non-oncologic urogenital diseases.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":"14 ","pages":"17562872221109023"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/5d/10.1177_17562872221109023.PMC9340423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10799567","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}
引用次数: 0
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