Translational andrology and urology最新文献

{"title":"Breaking barriers in stress urinary incontinence care: TAS-303 as a game-changer in pharmacological innovation.","authors":"Matthias May, Martina Schleder, Anton Kravchuk, Ingmar Wolff, Stephan Siepmann, Kay-Patrick Braun, Christian Gilfrich","doi":"10.21037/tau-2024-691","DOIUrl":"10.21037/tau-2024-691","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"196-201"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seminal plasma PGK2 serves as a predictive biomarker for post-varicocelectomy sperm motility improvement in varicocele subjects.","authors":"Cheng Yang, Jianxiong Li, Shenghao Wu, Cundong Liu, Ranran Zhou, Shan-Chao Zhao","doi":"10.21037/tau-24-629","DOIUrl":"10.21037/tau-24-629","url":null,"abstract":"<p><strong>Background: </strong>Not all varicocele (VC) patients experience improvements in semen quality after undergoing varicocelectomy. This study aims to investigate whether phosphoglycerate kinase 2 (PGK2) protein in seminal plasma could serve as a predictive biomarker for the enhancement of sperm motility post-varicocelectomy.</p><p><strong>Methods: </strong>Sixty patients diagnosed with VC-associated asthenospermia and who underwent varicocelectomy at the Third Affiliated Hospital of Southern Medical University were included in this study. Semen samples from 33 healthy donors were also collected. Hematological and semen analysis parameters were assessed at baseline and at the 6-month postoperative follow-up. The concentration of PGK2 in seminal plasma was determined using enzyme-linked immunosorbent assay (ELISA). Additionally, eleven machine learning algorithms were employed to develop a model to evaluate the effectiveness of varicocelectomy based on PGK2 concentration, hematological parameters, and semen quality indicators.</p><p><strong>Results: </strong>The levels of PGK2 in seminal plasma were significantly lower in VC patients compared to healthy donors (P<0.001). Increased levels of PGK2 were observed in the VC subjects after the varicocelectomy (P<0.001). PGK2 concentration was found to be a significant indicator [area under curve (AUC) =0.735, 95% confidence interval (CI): 0.601-0.860] and an independent predictor (P=0.003, P=0.049) of the success of varicocelectomy. The linear discriminant analysis (LDA) model demonstrated strong classification ability for assessing varicocelectomy outcomes in both the training (AUC =1.000, 95% CI: 1.000-1.000) and testing (AUC =0.804, 95% CI: 0.619-0.963) groups.</p><p><strong>Conclusions: </strong>PGK2 in seminal plasma shows promise as a potential biomarker for predicting improved sperm motility following varicocelectomy, thus aiding in clinical decision-making regarding therapeutic approaches.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"335-350"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status study of clinical application of ureteral access sheath in urology: a narrative review.","authors":"Changxiang Shu, Jun Liu","doi":"10.21037/tau-24-557","DOIUrl":"10.21037/tau-24-557","url":null,"abstract":"<p><strong>Background and objective: </strong>As one of the effective minimally invasive methods for upper urinary tract stone treatment, ureteroscopic lithotripsy has gradually become the mainstream surgical approach. The routine use of ureteral access sheaths (UAS) during ureteroscopic lithotripsy has plenty of advantages. Although many concerns have emerged in the clinical practice of the UAS, the clinically improved devices have addressed these issues. This article reviews the advantages, existing issues, and current improvements of UAS in clinical practice, aiming to provide references for better clinical application and further improvements of UAS.</p><p><strong>Methods: </strong>We searched in PubMed database using the terms: \"ureteral access sheath\", \"ureteroscopic lithotripsy\" or \"flexible ureteroscope\". Articles were independently evaluated for inclusion based on predetermined criteria.</p><p><strong>Key content and findings: </strong>The routine use of UAS during ureteroscopic lithotripsy facilitates the entry and exit of the ureteroscope, improves intraoperative visibility, and reduces postoperative complications. However, concerns over ureteral wall injury, difficulty in controlling renal pelvic pressure, lack of reduction in operation time, failure to increase stone free rates, and controversies regarding the ratios of endoscope-sheath diameter have limited the clinical application of UAS. The emergence of clinically improved devices such as intelligent pressure controlled, tip bendable, and rigid ureteroscope aided UAS has addressed these issues, laying a foundation for their further clinical application.</p><p><strong>Conclusions: </strong>The clinical improvement of the UAS can serve as a bridge for the widespread usage of the ureteroscopic lithotripsy. In the future, we anticipate more innovative advancements in UAS, making their clinical use even more practical and convenient.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"441-453"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Super-high levels of serum intact-parathyroid hormone and bone turnover markers descended with recuperating allograft function and a short-term high-dose methylprednisolone during preoperative period of renal transplantation: a retrospective cohort study.","authors":"Wenqing Xie, Junhao Lv, Chuncun Wei, Zhechi He, Suya Wang","doi":"10.21037/tau-24-398","DOIUrl":"10.21037/tau-24-398","url":null,"abstract":"<p><strong>Background: </strong>Secondary hyperparathyroidism is an important factor of chronic kidney disease-mineral and bone disorder (CKD-MBD), which frequently results in maintenance dialysis patients having super-high levels of serum intact-parathyroid hormone (iPTH) and bone turnover markers (BTMs). This study aimed to investigate the immediate changes of iPTH and BTMs levels after renal transplantation during the perioperative period, and to explore the allograft function rapid recovery and the effect of high-dose glucocorticoids on serum iPTH and BTMs.</p><p><strong>Methods: </strong>Between April 2018 and August 2021, a total of 346 Chinese kidney transplantation (KT) recipients (median age, 34.0 years; 236 males and 110 females; median dialysis duration, 12 months) were enrolled in this retrospective cohort study. The included patients had been undergoing maintenance dialysis for at least three months before transplant, and all of them accepted short-term high-dose methylprednisolone (MP) to prevent allograft rejection in the perioperative period. Allograft functions were evaluated and divided into different groups accorded to the CKD staging on the postoperative fifth day. Serum beta C-terminal crosslinking telopeptide of type I collagen (β-CTX), type 1N-terminal propeptide (P1NP), osteocalcin (OC), and iPTH were measured from fasting morning blood samples before surgery and on the postoperative fifth day with an electro-chemiluminescence immunoassay analyzer (2012; Roche Diagnostics).</p><p><strong>Results: </strong>Among the participants, the graft functions were in CKD-II (n=134), CKD-III (n=137), CKD-IV (n=24), and CKD-V (n=51) after the postoperative fifth day. The changes of P1NP level [-95.8 (-84.0 to -2.4) ng/mL] and the OC level [-88.0 (-96.9 to -42.9) ng/mL] were significantly greater than those of the β-CTX level [-62.3 (-73.6 to 0) pg/mL] and the iPTH level [-57.6 (-15.6 to 11.9) pg/mL] (P<0.001). In the CKD-V group, the changes of β-CTX level [-0.7 (-43.15 to 0) pg/mL (+15.7%, P=0.61)] and the iPTH level [-8.69 (226.73 to 17.79) pg/mL (-22.8%), P=0.36] were less than those of the CKD-II group (P<0.001). β-CTX, P1NP, and OC levels related with iPTH (r=0.413, 0.459, 0.482, respectively, P<0.001), and iPTH level with estimated glomerular filtration rate (eGFR; r=-0.474, P<0.001).</p><p><strong>Conclusions: </strong>The super-high levels of BTMs and iPTH rapidly descended with recuperating allograft function during the short-term, indicating that improvement of current dialysis equipment to achieve clean up iPTH could more favorably decrease BMTs and improve CKD-MBD. Osteogenesis markers P1NP and OC still decreased and were not affected in CKD-V group, indicating that high-dose glucocorticoids might strongly inhibit osteoblast activity.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"402-411"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In silico research of coagulation- and fibrinolysis-related genes for predicting prognosis of clear cell renal cell carcinoma.","authors":"Ming-Hao Deng, Xue-Wen Yang, Yu-Ming Zhou, Lv-Zhong Xie, Tao Zou, Ji-Gen Ping","doi":"10.21037/tau-24-483","DOIUrl":"10.21037/tau-24-483","url":null,"abstract":"<p><strong>Background: </strong>Coagulation- and fibrinolysis-related genes (CFRGs) are involved in tumor progression. However, their regulatory mechanisms in clear cell renal cell carcinoma (ccRCC) remain unclear. The aim of this study was to search for genes related to coagulation and fibrinolytic systems in ccRCC and to investigate their potential role in tumor pathogenesis and progression.</p><p><strong>Methods: </strong>Differentially expressed genes (DEGs) between ccRCC and control samples, as well as key module genes associated with ccRCC, were extracted from The Cancer Genome Atlas-Kidney Renal Clear Cell Carcinoma (TCGA-KIRC) dataset. Differentially expressed CFRGs (DE-CFRGs) were identified by intersecting these DEGs with CFRGs. Prognostic genes were identified through univariate Cox, least absolute shrinkage and selection operator (LASSO), and multivariate Cox analyses of DE-CFRGs. Additional independent prognostic and enrichment analyses were conducted, and potential therapeutic drugs were predicted. In addition, quantitative real-time polymerase chain reaction (RT-qPCR) was performed to validate the expression of prognostic genes.</p><p><strong>Results: </strong>Sixteen DE-CFRGs were identified by intersecting 3,311 DEGs, 1,719 key module genes, and CFRGs. Four prognostic genes-<i>TIMP1, RUNX1, BMP6</i>, and <i>PROS1</i>-were found to be involved in complement and coagulation cascades and other functional pathways. The prognostic model demonstrated strong predictive power for ccRCC, with stage, risk score, and grade all correlating with prognosis. Additionally, 14 potential drugs, such as tamoxifen citrate and cytarabine, were predicted for therapeutic targeting of the identified prognostic genes. RT-qPCR confirmed that the expression levels of <i>TIMP1,</i> and <i>RUNX1</i> were significantly upregulated in ccRCC samples, consistent with bioinformatics analysis.</p><p><strong>Conclusions: </strong>A prognostic model incorporating <i>TIMP1, RUNX1, BMP6</i>, and <i>PROS1</i> was constructed, offering new insights for prognostic evaluation and therapeutic strategies in ccRCC.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"307-324"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone therapy in patients with locoregional prostate cancer treated with prior androgen deprivation therapy and radiation: a retrospective single center review.","authors":"Mostafa Aglan, Yixin Kong, Brendan Connell","doi":"10.21037/tau-24-422","DOIUrl":"10.21037/tau-24-422","url":null,"abstract":"<p><strong>Background: </strong>In locoregional prostate cancer (PC), androgen deprivation therapy (ADT) is combined with radiation therapy (RT) for 4-24 months. Post-ADT, some men remain hypogonadal. Sparse data exist regarding the safety and prostate cancer recurrence risk with testosterone therapy (TTh) after prior ADT/RT. The aim of the study is to share Lahey Hospital & Medical Center's experience with patients receiving TTh after previous treatment with ADT and RT, with the goal of contributing to the existing literature on TTh safety in this population to set the stage for a prospective trial.</p><p><strong>Methods: </strong>We abstracted clinical data in patients with stage I-IVA PC, treated with ADT and RT and subsequently received TTh between 2014-2023. The co-primary endpoints were change in prostate-specific antigen (PSA) and incidence of PC recurrence.</p><p><strong>Results: </strong>Twenty-one patients met criteria. Grade groups (GG) results included: GG1, n=2; GG2, n=2; GG3, n=8; GG4, n=2; and GG5, n=7. American Joint Committee on Cancer (AJCC) stages were: I, n=2; II, n=7; III, n=7; IVA, n=5. Median interval from RT to TTh was 19 months. Prior to TTh, median testosterone was 38 ng/dL. Median follow-up was 15 months. TTh was ongoing in 15 (71.4%) patients and discontinued in 6 (28.6%). Reasons for discontinuation included testosterone recovery (n=1), hospice (not PC-related) (n=2), no perceived benefit (n=2), and physician concern for PSA rise (n=1). After TTh, median testosterone level was 318 ng/dL. Mean PSA pre- and post-TTh were 0.086 and 0.193 ng/dL (P=0.008). No patients experienced PC recurrence. One patient showed PSA bounce without recurrence.</p><p><strong>Conclusions: </strong>In men with locoregional PC who remained hypogonadal after prior ADT and RT, we found that TTh was not associated with a clinically significant rise in mean PSA and no cases of PC recurrence were documented. These findings support the case for a prospective trial in this setting.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"250-257"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation-free ureteroscopy: risky business or a safe alternative?","authors":"Patrick Juliebø-Jones, Arman Tsaturyan, Esteban Emiliani, Lazaros Tzelves, Christian Beisland, Øyvind Ulvik","doi":"10.21037/tau-2024-742","DOIUrl":"10.21037/tau-2024-742","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"214-216"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic appendiceal onlay flap ureteroplasty combined with Boari flap-psoas hitch ureteroneocystostomy for repair of the 20 cm ureteral avulsion: initial experience and case report.","authors":"Xingyuan Xiao, Ruoyu Li, Chaoqi Liang, Manshun Dong, Yuancheng Zhou, Bing Li","doi":"10.21037/tau-2024-655","DOIUrl":"10.21037/tau-2024-655","url":null,"abstract":"<p><strong>Background: </strong>Ureteral avulsion is a rare but serious complication of ureteroscopic lithotomy. As a common treatment for long segment ureteral avulsion, ileal ureteral replacement has many complications, such as anastomotic site stricture and retrograde infection, and prolonged exposure of the intestinal mucosa to urine may result in postoperative metabolic acidosis. Autologous tissue is becoming increasingly popular in ureteroplasty, including oral mucosa, appendix and bladder. Recent advancements in ureteral reconstruction techniques have highlighted the utility of the appendix and bladder, but the length of autologous tissue is limited. In order to reduce complications and save autologous tissue, we propose a novel combined technique. This study aims to evaluate the feasibility and outcomes of appendiceal onlay flap ureteroplasty combined with Boari flap-psoas hitch ureteroneocystostomy in the treatment of long segment ureteral avulsion, with a 15-month follow-up.</p><p><strong>Case description: </strong>We report a 64-year-old male patient diagnosed with right ureteral avulsion. In this case, the ureteral reconstruction was accomplished through our new technique. Antegrade urography revealed no obstruction of the reconstructed ureteral segment at 7 weeks after surgery. After a 15-month follow-up period, no postoperative complications occurred, radiological resolution of hydronephrosis and improved renal function were observed.</p><p><strong>Conclusions: </strong>Our initial experience demonstrated that appendiceal onlay flap ureteroplasty combined with Boari flap-psoas hitch ureteroneocystostomy is safe and feasible. This novel surgical method provides a promising option for treating long segment ureteral avulsion.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"471-480"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and prognostic factors of low metastatic burden prostate cancer with non-regional lymph node metastases: role of cytoreductive radiotherapy?","authors":"Lixin Mai, Ruiqi Liu, Xinyue Zhang, Qiwen Pan, Lingling Cai, Wufei Cao, Yonghong Li, Fangjian Zhou, Jianming Gao, Yang Liu, Liru He","doi":"10.21037/tau-24-489","DOIUrl":"10.21037/tau-24-489","url":null,"abstract":"<p><strong>Background: </strong>Low metastatic burden prostate cancer (LMBPC) is a special transitional clinical status between localized and disseminated disease, but the clinical prognostic factors and potential therapeutic interventions of those with non-regional lymph node metastases (NRLNM) remain less understood. We aim to explore the prognostic factors and investigate the potential treatment strategy for LMBPC patients with NRLNM.</p><p><strong>Methods: </strong>There were 88 patients retrospectively identified. Kaplan-Meier method and Cox proportional hazards model were used for prognostic analyses. Patients receiving non-regional lymph node (NRLN) radiotherapy (NRLN RT group) after prostate-directed local therapy were matched to patients without NRLN RT (control group) by propensity score matching (PSM).</p><p><strong>Results: </strong>The majority of patients had Gleason score >8 (61.4%), retroperitoneal metastases (93.2%), upward NRLNM (78.4%) and hormone-sensitive prostate cancer (HSPC) (68.2%) at diagnosis. Patients with upward NRLNM showed better survival outcome (75.4 <i>vs.</i> 32.8 months, P=0.04). HSPC [hazard ratio (HR) =0.32, P=0.003], bone metastases (HR =3.79, P<0.001), androgen-receptor-axis-targeted agents (ARATAs) (HR =0.40, P=0.007), and notably, NRLN RT (HR =0.23, P=0.001) were independent prognostic factors of overall survival (OS). The median follow-up was 43.3 months. The prostate-specific antigen (PSA) response and median progression-free survival (PFS) after NRLN RT were 70.6% and 29.5 months. The 4-year OS for NRLN RT group and control group were 62% and 46% (P=0.04). After PSM, NRLN RT was still associated with improved OS (HR =0.39, P=0.04). No grade ≥3 NRLN RT-related adverse event was observed.</p><p><strong>Conclusions: </strong>Upward NRLNM was the main pattern for LMBPC with NRLNM and associated with better clinical outcome. HSPC, bone metastases, ARATAs and NRLN RT were independent prognostic factors. Applying cytoreductive RT to NRLNM may benefit LMBPC patients. Further studies are still needed.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"228-239"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive report of complex cystic renal mass fluid cytology: a cross-sectional analysis.","authors":"Francis A Jefferson, Tal D Cohen, Gang Zheng, Sounak Gupta, Matthew S Lee, Halle E Foss, Amber Schneider, Valerie Straubmuller, Abhinav Khanna, George K Chow, Theodora A Potretzke, Aaron M Potretzke","doi":"10.21037/tau-24-464","DOIUrl":"10.21037/tau-24-464","url":null,"abstract":"<p><strong>Background: </strong>During surgical extirpation of cystic renal masses, surgeons attempt to avoid cyst rupture due to the theoretical risk of tumor seeding. Whether the concern regarding tumor seeding is warranted is debatable. Our objective was to evaluate the presence of malignant cells in the fluid of complex renal cysts.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of adult patients undergoing radical or partial nephrectomy to address a cystic renal mass. Patients undergoing a partial or radical nephrectomy by open or robotic approach for a clinically localized (< cT2N0M0) cystic renal mass were included. Following excision, fluid from the mass was aspirated and sent for cytologic analysis. Cyst fluid was prepared by processing up to 50 mL into a PreservCyt^® vial on a ThinPrep^® 2000 or ThinPrep^® 5000 processor using standard protocols, resulting in a pap-stained ThinPrep glass slide. The second half of the fluid was processed into a cellblock using a plasma/thrombin process resulting in a Formalin-Fixed Paraffin-Embedded (FFPE) block cut to produce a hematoxylin and eosin (H&E)-stained slide. Both the pap-stained and H&E slides were evaluated for malignant cells by a cytotechnologist and pathologist.</p><p><strong>Results: </strong>Twenty-three patients underwent resection of 24 cystic tumors including 17 (73.9%) males and 6 (26.1%) females. The median patient age was 58 years [interquartile range (IQR), 43-68 years]. The median tumor diameter was 3.7 cm (IQR, 3.2-6.1 cm). Most patients underwent robotic partial nephrectomy (n=19, 83%). Renal cyst cytology was benign in 46% (n=11), atypical in 29% (n=7), suspicious in 8% (n=2), positive for neoplasm in 4% (n=1), and positive for malignancy in 4% (n=1). Clear cell renal cell carcinoma was the most common histologic subtype (n=17, 71%).</p><p><strong>Conclusions: </strong>Based on routine cytologic analysis, there is no clear pattern with the presence or absence of malignant cells in the fluid of complex renal cysts. More sophisticated testing may provide insight into the malignant potential of renal cyst fluid.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"289-295"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}