Translational andrology and urology最新文献

{"title":"Survival analysis comparing bladder preservation techniques in octogenarians with muscle-invasive bladder cancer.","authors":"Arjun Pon Avudaiappan, Pushan Prabhakar, Benjamin Fleischmann, Muni Rubens, Rohan Garje, Manuel Ozambela, Christopher Gomez, Murugesan Manoharan","doi":"10.21037/tau-24-602","DOIUrl":"10.21037/tau-24-602","url":null,"abstract":"<p><strong>Background: </strong>The gold standard treatment for localized muscle-invasive bladder cancer (MIBC) is neoadjuvant chemotherapy with radical cystectomy (RC). Guidelines suggest concurrent chemoradiation (CRT) could be considered as an alternative, and partial cystectomy (PC) may be considered in carefully selected individuals. The bladder preservation strategies are gaining popularity, and due to the concerns about morbidity associated with RC and limited life expectancy, the octogenarian population is exploring strategies that help preserve bladder function. Hence, it is crucial to understand the outcome of various bladder preservation strategies. Using the National Cancer Database (NCDB), we compared the overall survival (OS) of octogenarians treated with PC and CRT.</p><p><strong>Methods: </strong>We retrospectively evaluated the octogenarians with localized MIBC (cT2N0M0) ≤5 cm and urothelial histology between 2004 and 2018. Our analytic cohorts were the PC cohort, which included patients who underwent PC, and the CRT cohort, which included patients who received chemotherapy and radiotherapy within a 90-day timeframe. After propensity-matching with race and ethnicity, gender, facility type, median income, comorbidity index, and tumor grade, we compared the OS between PC and CRT cohorts.</p><p><strong>Results: </strong>A total of 1,038 were octogenarians who met our selection criteria. Among them, 248 (23.8%) underwent PC, and 790 (76.2%) received CRT. In the PC cohort, tumors were located predominantly in the dome (34.3%) and anterior wall (10.5%), while in the CRT cohort, tumors were in the trigone (8.4%), lateral (22.0%) and posterior walls (10.6%). The median OS for the matched PC and CRT cohort was 38.3 and 32.9 months, respectively (P=0.66). Multivariate Cox regression showed no difference in survival hazards between PC and CRT [hazard ratio =1.07 (95% confidence interval: 0.82-1.39)] (P=0.63).</p><p><strong>Conclusions: </strong>Our study comparing PC and CRT in octogenarians with T2 ≤5 cm tumors showed that PC had comparable OS to CRT. Therefore, PC can be considered a viable option in carefully selected octogenarians.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"280-288"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670793","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":"Prophylactic Use of Biologic Mesh in Ileal Conduit (PUBMIC trial).","authors":"Nikolaos Pyrgidis, Gerald B Schulz, Christian G Stief, Philipp Weinhold, Julian Marcon","doi":"10.21037/tau-2024-734","DOIUrl":"10.21037/tau-2024-734","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"210-213"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670088","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":"The power of the map: testicular mapping to guide surgical sperm retrieval in patients with non-obstructive azoospermia.","authors":"Arash Amighi, Alvaro Santamaria, Theodore Crisostomo-Wynne, Marah C Hehemann, Sarah Holt, Charles H Muller, Tristan M Nicholson, Thomas J Walsh","doi":"10.21037/tau-24-498","DOIUrl":"10.21037/tau-24-498","url":null,"abstract":"<p><strong>Background: </strong>For male infertility patients with suspected non-obstructive azoospermia, fine needle aspiration mapping (FNAM) of the testis identifies and locates sperm and guides surgical sperm retrieval (SSR), offering an alternative approach to microsurgical testicular sperm extraction (mTESE). Our objectives were to (I) identify success rates with less invasive methods of SSR guided by FNAM, (II) understand how hormone levels influence sperm presence on FNAM, and (III) describe surgical complications in a contemporary cohort of individuals undergoing FNAM of the testis.</p><p><strong>Methods: </strong>We completed an institutional review board (IRB) approved retrospective medical records review of men with azoospermia or cryptozoospermia who underwent a 12-point systematic sampling of each testicle between May 2009 and May 2023 including results of subsequent SSR. Possible cytopathologic diagnoses included germ cell aplasia (GCA), maturation arrest (MA), hypospermatogenesis (HS) and normal spermatogenesis (NS). Hormone levels and detection of sperm on FNAM were compared utilizing analysis of variance (ANOVA) and subsequent unpaired <i>t</i>-tests.</p><p><strong>Results: </strong>Of the 220 men who underwent FNAM, 84 (38%) were found to have sperm. Of those 84, 52 subsequently underwent SSR based on their FNAM. Of these, 4 (8%) underwent testicular sperm extraction (TESE), 30 (59%) underwent testicular sperm aspiration (TESA), and 18 (33%) underwent mTESE. SSR successfully obtained sperm in all 52 (100%) patients. Average follicle stimulating hormone (FSH) levels were 13.9±11.3 and 19.6±10.7 mU/mL in those with and without sperm on FNAM, respectively (P<0.001). When patients were stratified by detailed cytopathologic FNAM diagnosis, no difference was noted between FSH levels in those with HS from those with GCA or MA, however a difference was noted between HS and NS (P<0.001). In men with FSH levels between 7.7 and 14.9 mU/mL, 36% were found to have sperm and in men with FSH exceeding 15 mU/mL, 28% were found to have sperm on FNAM. Of those patients with FSH levels exceeding 7.6 mU/mL, 47% had successful office-based sperm extraction based on their FNAM.</p><p><strong>Conclusions: </strong>FNAM allows for de-escalation of sperm extraction technique, even in patients with poor clinical predictors of sperm presence, such as those with significantly elevated FSH levels.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"240-249"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670804","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":"Correlation of renal function with intra-patient variability of tacrolimus concentration among recipients of renal transplants: a 10-year study.","authors":"Yan Qin, Yao Li, Tienan Feng, Hui Pan, Jiayong Li, Fang Zhang, Yong Liu, Jianxin Qiu, Bo Sun","doi":"10.21037/tau-24-564","DOIUrl":"10.21037/tau-24-564","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is one of the most commonly used basic immunosuppressants nowadays, but the high variability of tacrolimus blood concentration often leads to kidney transplant recipients frequently experiencing drug concentrations above or below the target concentration, resulting in renal toxicity or rejection of the transplanted kidney. The aim of this study is to explore the correlation of renal function with intra-patient variability (IPV) of tacrolimus blood concentration among recipients of renal transplants at 1-, 3-, 5-, and 10-year post-transplantation.</p><p><strong>Methods: </strong>Recipients of renal transplants who were treated with tacrolimus for immunosuppression at the Shanghai General Hospital between January 2001 and December 2009, and followed up until 2019 were included in this retrospective study. Demographic characteristics and laboratory investigation results at their 1-, 3-, 5-, and 10-year follow-up visits were collected from their hospital medical records. Patients were divided into a low or high IPV group based on the IPV of their tacrolimus concentrations.</p><p><strong>Results: </strong>A total of 167 kidney transplant recipients were included in the study. At the 3-year follow-up visit, patients in the low IPV group had significantly lower blood urea nitrogen (BUN) (6.3±1.8 <i>vs</i>. 8.2±6.2 µmol/L, P=0.04), serum creatinine (Scr) (88.8±23.6 <i>vs</i>. 104.8±39.6 µmol/L, P=0.009), and blood uric acid (UA) (329.1±80.2 <i>vs</i>. 375.9±95.1 µmol/L, P=0.004), as well as significantly higher estimated glomerular filtration rate (eGFR) values than patients in the high IPV group. Blood UA levels were significantly lower in patients in the low IPV group than the high IPV group at the 10-year follow-up (362.7±92.6 <i>vs</i>. 398.5±105.2 µmol/L, P=0.042). There was no significant difference between the low and high IPV groups with respect to BUN, Scr, UA, or eGFR at the 1- and 5-year follow-up.</p><p><strong>Conclusions: </strong>Recipients of renal transplants with lower IPV in tacrolimus concentration appeared to have better renal function over time. Controlling IPV may contribute to improved renal outcomes post-transplantation.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"220-227"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671050","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":"Application of decellularized tilapia skin in rabbit urethral reconstruction: an experimental study.","authors":"Wei Huang, Hongying Zheng, Jiaming Wu, Lingfei Wang, Huaqiong Li, Feng Wen, Congde Chen","doi":"10.21037/tau-24-598","DOIUrl":"10.21037/tau-24-598","url":null,"abstract":"<p><strong>Background: </strong>In urethral reconstruction, autologous tissue grafts are subject to various limitations. Decellularized tissue has attracted significant interest in tissue engineering (TE) and regenerative medicine due to great biocompatibility and bioactivity. We investigated the effect of decellularized tilapia skin (DTS) in a rabbit urethral defect model to explore its feasibility and effectiveness as a TE construction for urethral reconstruction.</p><p><strong>Methods: </strong>Fresh tilapia skins were decellularized and verified through its residual deoxyribonucleic acid (DNA) content measurement. The physical properties and degradation profile of DTS were characterized as well. Finally, we established a rabbit urethral defect model and evaluated the effect of DTS on urethral defect healing through pathological examination and immunohistochemistry (IHC) staining.</p><p><strong>Results: </strong>The residual DNA content in the DTS was 32.94 ng/mg. Electron microscopy showed that the DTS retained its three-dimensional structure. <i>In vitro</i>, degradation experiments showed that DTS degraded at a faster rate than that of small intestinal submucosa (SIS). After implantation of the DTS, the penile tissue was well repaired. In the early stage of tissue repair, the tissue was gradually replaced by new collagen. In addition, smooth muscle content was significantly increased. No significant immune rejection was observed in the tissues during the repair process and the inflammatory response was significantly milder than other group. Nevertheless, angiogenesis markers, the numbers of blood vessels and blood vessel area in DTS intervention groups were the highest at 4 weeks post-implantation.</p><p><strong>Conclusions: </strong>DTS could degrade gradually during urethral reconstruction and demonstrated its better biocompatibility in terms of <i>de novo</i> tissue morphology, microanatomy of tissues, severity of inflammation, collagen deposition and angiogenesis in defect region <i>vs.</i> its match control groups. As an excellent TE material, it is expected to be used in clinical urethral reconstruction in future.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"266-279"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671030","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":"DNA methylation alterations in prostate cancer: from diagnosis to treatment.","authors":"Francesco Barletta, Marco Bandini, Giuseppe Ottone Cirulli, Paolo Zaurito, Roberta Lucianò, Francesca Giannese, Giulia Maria Scotti, Caterina Oneto, Nazario Tenace, Federico Scarfò, Marco J Morelli, Dejan Lazarevic, Francesco De Cobelli, Maurilio Ponzoni, Claudio Doglioni, Giovanni Tonon, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti","doi":"10.21037/tau-24-382","DOIUrl":"10.21037/tau-24-382","url":null,"abstract":"<p><p>Epigenetics, particularly DNA methylation, plays a crucial role in gene activation and deactivation. Indeed, modification of this pathway has been well described as promoter of cancer development in many settings. Hypermethylation of CpG islands has also been described as a significant epigenetic alteration in prostate cancer (PCa), being associated with gene silencing and tumour progression. Key studies have shown that specific genes, such as <i>GSTP1</i>, <i>APC</i>, and <i>RARb2</i>, exhibit significant epigenetic alterations in PCa, with their methylation profiles showing potential utility as biomarkers in the diagnostic setting. Furthermore, comprehensive methylation analyses have identified numerous differentially methylated CpGs and relative molecular pathways associated with PCa carcinogenesis and progression, thus enhancing the understanding of its molecular underpinnings. Finally, therapies targeting DNA methylation, such as DNA methyltransferases (DNMTs) inhibitors, show potential in overcoming drug resistance in advanced PCa treatment. Consequently, dissecting epigenetic mechanisms, and in particular DNA methylation, is fundamental for understanding PCa carcinogenesis, providing valuable insights for clinical decisions and development of targeted therapies. Given the above premises, this review aims to provide an overview of the role of DNA methylation aberrations in PCa, highlighting current and future directions for exploring the epigenetic landscape to better understand the origins and progression of this disease.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"454-462"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671044","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":"Neourethra reconstruction using an anterior bladder wall flap for the treatment of complex urethral obliteration and absence.","authors":"Wei-Dong Zhu, Hui Guo, Hong Xie, Lu-Jie Song, Yue-Min Xu","doi":"10.21037/tau-24-443","DOIUrl":"10.21037/tau-24-443","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical approach for complex proximal urethral strictures remains unclear. This study evaluates the outcomes of 11 male patients with complex proximal urethral obliteration and 16 female patients with complete urethral stricture or absence, all treated with urethral reconstruction using an anterior bladder wall flap.</p><p><strong>Methods: </strong>In this retrospective study, 11 male patients and 16 female patients with complex urethral obliteration or absence were treated from January 1990 to December 2023. Causes included traumatic urethral injury, urethral cancer, and congenital bladder exstrophy. All patients had a closed bladder neck and proximal urethral obliteration or absence, confirmed by urethrography, and underwent reconstruction with an anterior bladder wall flap. Postoperative outcomes were assessed by voiding cystourethrogram and uroflowmetry.</p><p><strong>Results: </strong>The mean age was 29.3 (range, 4-63) years in 11 male patients and 37.1 (range, 4-73) years in 16 female patients. The mean stricture length in male patients was 7.1 (range, 5-15) and 3.6 (range, 3-5) cm in 16 female patients with complete absence of the urethra or stricture. The mean postoperative follow-up duration was 56.5 (range, 13-350) months. Urethral complications developed in 10 patients (37%), including dysuria in 4 (14.8%) cases, two in male patients and two in female patients, stress incontinence in 6 (22.2%), two in male patients and four in female patients; irregular edema or prolapse of the new urethra mucosa in the bladder neck caused obstruction in two male patients and one in female patient, while the cause was urethral external meatal stenosis in another one case. These patients could easily void after resection of the prolapsed mucosa or meatoplasty via the flap. A supplementary vaginoplasty procedure was performed in four female patients.</p><p><strong>Conclusions: </strong>Reconstruction of the urethra using an anterior bladder wall flap is an effective technique. This treatment of urethral reconstruction can not only achieve anatomical restoration, but also restore functional urinary continence. Small bladder capacity and inflammation can prevent successful urethra reconstruction using a bladder wall flap.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"432-440"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671127","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":"Reassessment of approaches to prostate biopsy in the era of magnetic resonance imaging-targeted biopsy: insights from the ProBE-PC study.","authors":"Yoichiro Tohi, Takuma Kato, Mikio Sugimoto","doi":"10.21037/tau-2024-707","DOIUrl":"10.21037/tau-2024-707","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"205-209"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670743","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":"Evaluating local anesthetic strategies in ambulatory urologic surgery: insights from the Baby ORIOLES randomized clinical trial.","authors":"Shayan Smani, Nishan Sohoni, Aleksandra Golos, Peter Palencia, Olamide Olawoyin, Soum D Lokeshwar","doi":"10.21037/tau-2024-711","DOIUrl":"10.21037/tau-2024-711","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"202-204"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671120","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":"Time-sensitive elements in elective treatment of urinary lithiasis: a narrative review.","authors":"Gino Pigatto Filho, Sandro Augusto Nichele, Flávia Vargas de Oliveira, Luiz Sergio Santos, Rogério de Fraga","doi":"10.21037/tau-24-596","DOIUrl":"10.21037/tau-24-596","url":null,"abstract":"<p><strong>Background and objective: </strong>Managing surgical queues for urinary lithiasis is a persistent challenge in healthcare systems. Despite substantial research in this area, clear criteria for prioritizing patients and determining those who can safely wait longer without complications remain elusive. This review aims to develop a rational framework for optimizing surgical queue management in urinary stone treatment by analyzing primary literature.</p><p><strong>Methods: </strong>We conducted a review of relevant guidelines, held departmental discussions to identify additional factors, and performed an extensive PubMed search using key terms related to queue management and expectant care in lithiasis.</p><p><strong>Key contents and findings: </strong>Significant factors identified include stone volume and location, presence of hydronephrosis, patient frailty and comorbidities, recurrent urinary infections, nephrostomy or double-J stent, urinary diversion, high occupational risk, limited healthcare access, and refractory pain impacting quality of life. A detailed analysis of these factors is presented in the article.</p><p><strong>Conclusions: </strong>Effective management of surgical waitlists for urinary lithiasis requires a comprehensive assessment of factors such as stone characteristics, hydronephrosis, patient frailty, comorbidities, infections, drainage devices, accessibility, and quality of life, as prioritization based solely on waiting time is insufficient and potentially harmful.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 1","pages":"181-190"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459186","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}