Translational andrology and urology最新文献

{"title":"Preface to \"Complex Penile Prosthesis Surgery\".","authors":"David W Barham, Jay Simhan, Martin S Gross","doi":"10.21037/tau-24-355","DOIUrl":"https://doi.org/10.21037/tau-24-355","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475616","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":"Assessing the safety of ureteral stent placement for obstructive urolithiasis in patients during the COVID-19 pandemic.","authors":"Ankur U Choksi, Soum D Lokeshwar, Mursal Gardezi, Christopher S Hayden, Amir I Khan, Timothy Tran, Dinesh Singh, Piruz Motamedinia, Thomas V Martin","doi":"10.21037/tau-24-57","DOIUrl":"10.21037/tau-24-57","url":null,"abstract":"<p><strong>Background: </strong>Patients with an active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] infection are at a higher risk of post-operative mortality. In this retrospective case-control study, we analyzed the post-operative safety of patients undergoing cystoscopy with ureteral stent placement for obstructing ureteral calculi who tested positive for COVID-19.</p><p><strong>Methods: </strong>We retrospectively identified patients who underwent cystoscopy and ureteral stent placement between June 5, 2020 and December 31, 2022 as an add-on case. Patients were stratified by whether they had a positive COVID-19 test on admission. Baseline characteristics were compared using Students <i>t</i>-test for continuous variables and Pearson chi-square test for categorical variables. Univariate and multivariate logistic regression analysis was performed to identify predictors of postoperative 30-day mortality.</p><p><strong>Results: </strong>A total of 1,408 patients underwent add-on cystoscopy with ureteral stent placement for an obstructing calculus, of which 55 (3.9%) patients had a positive COVID-19 test. When stratified by COVID-19 status, both groups were similar with regards to age, sex, race, co-morbidities, indications, procedure duration, and type of anesthesia administered. Of the 137 patients that were admitted to the intensive care unit (ICU), 9 patients were COVID-19 positive (16.4% <i>vs</i>. 9.5%, P=0.09). On multivariate logistic regression, patients with COVID-19 had a higher odds of 30-day mortality [odds ratio (OR) =7.06; 95% confidence interval (CI): 2.03-24.47; P=0.002] when controlling for age, co-morbidities, vaccination status, anesthesia type, and indication for the stent.</p><p><strong>Conclusions: </strong>Patients that underwent cystoscopy and ureteral stent placement for an obstructing ureteral stone with a concurrent COVID-19 diagnosis had an increased risk of perioperative 30-day mortality.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475536","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":"Developing and validating risk predicting models to assess venous thromboembolism risk after radical cystectomy.","authors":"Chin-Hui Lai, Jiaxiang Ji, Mingrui Wang, Haopu Hu, Tao Xu, Hao Hu","doi":"10.21037/tau-24-194","DOIUrl":"10.21037/tau-24-194","url":null,"abstract":"<p><strong>Background: </strong>Radical cystectomy (RC) patients are at significant risk for venous thromboembolism (VTE). Current predictive models, such as the Caprini risk assessment (CRA) model, have limitations. This research aimed to create a novel predictive model for forecasting the risk of VTE after RC.</p><p><strong>Methods: </strong>This single-center study involved RC patients treated between January 1, 2010 and December 31, 2019. The individuals were divided into training and testing groups in a random manner. Multivariate and stepwise logistic regression were utilized to create two novel models. The models' performance was compared to the commonly used CRA model, employing metrics including net reclassification improvement (NRI), integrated discrimination improvement (IDI), and receiver operating characteristic (ROC) curve analyses.</p><p><strong>Results: </strong>A total of 272 patients were enrolled, among whom 36 were diagnosed with VTE after RC. Model A and Model B were then conducted. The area under ROC of Model A and Model B is 0.806 [95% confidence interval (CI): 0.748-0.856] and 0.833 (95% CI: 0.777-0.880), respectively, which were also determined in the testing cohorts. The two new Models were superior both in classification ability and prediction ability (NRI >0, IDI >0, P<0.01). Model A and Model B had a concordance index (C-index) of 0.806 and 0.833, respectively. In decision curve analysis (DCA), the two new models provided a net benefit between 0.02 and 0.84, suggesting promising clinical utility.</p><p><strong>Conclusions: </strong>Regarding predictive accuracy, both models surpass the existing CRA model, with Model A being advantageous due to its fewer variables. This easy-to-use model enables swift risk assessment and timely intervention for high-risk groups, yielding favorable patient outcomes.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475540","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":"Embryonal rhabdomyosarcoma of prostate combined with prostatic abscess in an adult patient: a case report and literature review.","authors":"Kaifeng Mao, Peifeng Li, Yuan Yuan, Xiang Yi, Jiaqi Fang, Jiabing Yuan, Zhangjun Cao, Zhenquan Lu, Richard Lo, Bingfeng Luo","doi":"10.21037/tau-24-117","DOIUrl":"10.21037/tau-24-117","url":null,"abstract":"<p><strong>Background: </strong>Embryonal rhabdomyosarcoma (ERMS) of the prostate is a rare and aggressive malignant tumor in adults with a poor prognosis in general. The main presenting symptoms are dysuria and acute urinary retention. Prostate ERMS is easily misdiagnosed, which leads to delays in treatment.</p><p><strong>Case description: </strong>We report the case of a previously healthy 31-year-old man who presented with dysuria for 3 months. Digital rectal examination (DRE), ultrasound, and computed tomography (CT) were suggestive of the possibility of a 2.0 cm × 3.0 cm abscess in the left lobe of the prostate. Prostate-specific antigen (PSA) was at a normal level, and C-reactive protein (CRP) concentration was elevated. The patient underwent surgical drainage by transurethral incision of the prostatic abscess. There was a significant improvement in the maximal urinary flow rate on postoperative day 5. However, the patient presented with acute urinary retention again on the 20th postoperative day. DRE and pelvic magnetic resonance imaging (MRI) showed a recurrence of an enlarged mass in the left lobe of the prostate. PSA level was again normal. Cystoscopy revealed a large neoplasm arising from the prostate obstructing the bladder outlet, and a diagnostic transurethral resection of this prostate tumor was performed. Histopathology revealed the mass to be an embryonic rhabdomyosarcoma. Subsequently, the patient was transferred to the Oncology Department and received chemoradiotherapy. After chemoradiotherapy, the size of the prostate became normal. Unfortunately, the patient deteriorated rapidly and eventually succumbed to multiple organ failure 1 year after the initial presentation.</p><p><strong>Conclusions: </strong>Due to its non-specific presenting symptoms, prostate ERMS can be easily misdiagnosed, which can lead to treatment delay. Multimodality approaches, including neoadjuvant/adjuvant chemotherapy, radiotherapy, and radical resection, can improve the survival rate and reduce ERMS patient mortality.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475553","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":"Identifying <i>CDCA3</i> as a pivotal biomarker for predicting outcomes and immunotherapy efficacy in pan-renal cell carcinoma.","authors":"Hongwei Luo, Huichan He, Zezhen Liu, Yuting Liu, Feifei Hou, Yao Xie, Le Zhang, Jianming Lu, Shan Tang, Weide Zhong","doi":"10.21037/tau-24-233","DOIUrl":"10.21037/tau-24-233","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is a heterogeneous disease. Identifying effective biomarkers is crucial for improving prognostic accuracy and therapy outcomes. This study investigates cell division cycle-associated 3 (<i>CDCA3</i>) as a novel biomarker for prognostic assessment and immunotherapy response in RCC.</p><p><strong>Methods: </strong>This study analyzed multi-omics data from The Cancer Genome Atlas (TCGA) for kidney renal clear cell carcinoma (KIRC), kidney renal papillary cell carcinoma (KIRP), and kidney chromophobe (KICH) subtypes to evaluate <i>CDCA3</i> expression and its clinical implications. Functional enrichment and immune infiltration analyses were performed using bioinformatics tools gene set enrichment analysis (GSEA) and xCell. The prognostic value of <i>CDCA3</i> was assessed through Cox regression and Kaplan-Meier survival analysis. Immunohistochemistry (IHC) was employed to confirm <i>CDCA3</i> expression at the protein level in RCC samples.</p><p><strong>Results: </strong>Higher <i>CDCA3</i> expression correlated with poor survival outcomes and reduced response to programmed cell death protein 1 (PD-1) blockade therapies. Statistical analysis indicated that <i>CDCA3</i> was an independent prognostic factor for poor survival in RCC. <i>CDCA3</i> was consistently overexpressed in RCC tissues compared to normal tissues and was associated with adverse clinical features, including high Th2 cell infiltration and suppression of immune pathways.</p><p><strong>Conclusions: </strong><i>CDCA3</i> is a promising biomarker for RCC, offering insights into the tumor's prognosis and potential response to immunotherapy. The strong association between <i>CDCA3</i> expression and poor therapeutic outcomes suggests that <i>CDCA3</i> could be targeted in future therapeutic strategies.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475557","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":"Labial mucosal grafting onlay ureteroplasty without omental wrap for ureteral stricture with occlusion: initial results.","authors":"Haibin Tang, Shengjun Luo, Heng Yuan, Xiaosong Jin, Rutong Xu, Jialei Zhao, Gang Chen","doi":"10.21037/tau-24-266","DOIUrl":"10.21037/tau-24-266","url":null,"abstract":"<p><strong>Background: </strong>The treatment of complex ureteral stricture has always been a hot and difficult topic in urology. The aim of our study is to investigate the feasibility and clinical efficacy of labial mucosal graft (LMG) onlay ureteroplasty without omental wrap for ureteral stricture with occlusion and present our initial experience.</p><p><strong>Methods: </strong>We retrospectively reviewed perioperative and follow-up data of 12 patients admitted to The First Affiliated Hospital of Chongqing Medical University who underwent the LMG ureteroplasty with ureteral occlusion from April 2022 to September 2023. After stricture and occluded segments were incised longitudinally, the LMG was used to expand the ureteral lumen without omental wrap.</p><p><strong>Results: </strong>All patients had successful surgery with no intraoperative complications. The median length of ureteral stricture was 3.5 cm (range, 3-5 cm), the median length of the occlusion was 1.5 cm (range, 1-2 cm), the median length of the LMGs is 4.5 cm (range, 4-6 cm). Ureteroscopy confirmed that the reconstructed ureteral lumen was unobstructed except for one patient with thin film-like ureteral stricture. Only one patient had slight contracture at the graft site, which did not affect movement of lip and appearance. No persistent and obvious discomfort was observed at the graft site in the remaining patients.</p><p><strong>Conclusions: </strong>Our experience suggests that LMG onlay ureteroplasty without omentum wrap appears to be a feasible and safe option for reconstruction of ureteral occlusion.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475610","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":"Lost opportunities: the underutilization of castrate-resistant prostate cancer treatment in real-world settings.","authors":"Rene Gatsinga, Yu Guang Tan, Weiren Chen, Xinyan Yang, Jeffrey Kit Loong Tuan, Melvin Lee Kiang Chua, Johan Chan, Ravindran Kanesvaran, Kae Jack Tay, Kenneth Chen, John Shyi Peng Yuen","doi":"10.21037/tau-24-130","DOIUrl":"10.21037/tau-24-130","url":null,"abstract":"<p><strong>Background: </strong>Various treatment regimens are now available for metastatic castrate-resistant prostate cancer (CRPC). This work evaluates the real-world prescription patterns of CRPC in a large tertiary care center and the factors influencing them.</p><p><strong>Methods: </strong>Health records of 330 patients with <i>de novo</i> metastatic hormone-sensitive prostate cancer (HSPC), treated and progressed to CRPC between 2016 and 2020, were reviewed from a prospective uro-oncological database. We studied their demographics, medical co-morbidities, treatment utilization patterns before and after progression to CRPC, and survival outcomes.</p><p><strong>Results: </strong>The median age was 74 years [interquartile range (IQR), 67-80 years] at diagnosis of CRPC. At CRPC, beyond androgen deprivation therapy (ADT) monotherapy, 70.3% (n=232) of patients received at least one additional line, 21.5% (n=71) received two lines, and 5.5% (n=18) received three lines of systemic treatments. As first-line treatment, novel hormonal agents (NHAs) were the most prescribed at 57.6% (n=190). The likelihood of receiving treatment was associated with age <65 years [odds ratio (OR) 2.08, P=0.01, 95% confidence interval (CI): 1.22-3.57] and lower Charlson Comorbidity Index (CCI) score (OR: 2.62, P=0.04, 95% CI: 1.07-6.45), treatment intensification for HSPC (OR 2.45, P=0.04, 95% CI: 1.07-5.62) and primary physician being an oncologist (OR 1.59, P=0.04, 95% CI: 1.04-2.48). Patients who received additional treatment lines at CRPC had longer survival (median: 23 <i>vs.</i> 17 months, OR 1.72, P<0.01, 95% CI: 1.23-2.38).</p><p><strong>Conclusions: </strong>More than one in four patients do not receive any additional treatment line beyond ADT monotherapy and have worse survival outcomes. Health status, prescribing physician, and treatment at HSPC appear to affect prescription patterns at the CRPC stage.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475612","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":"Optimizing prostate cancer detection in transition zone: an analysis of apparent diffusion coefficient values in prostate magnetic resonance imaging evaluation with Prostate Imaging Reporting and Data System (PI-RADS) assessment.","authors":"Yu Imai, Fumihiko Urabe, Ibuki Sadakane, Takahiro Oguchi, Kosuke Iwatani, Masaya Murakami, Kojiro Tashiro, Manabu Aoki, Shun Sato, Hiroyuki Takahashi, Shunsuke Tsuzuki, Kenta Miki, Takahiro Kimura","doi":"10.21037/tau-24-235","DOIUrl":"10.21037/tau-24-235","url":null,"abstract":"<p><strong>Background: </strong>Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for the early detection of clinically significant prostate cancer (csPCa). However, the achievement of accurate detection rates, particularly for transition zone (TZ) lesions, remains challenging. We investigated the relationship between apparent diffusion coefficient (ADC) values in Prostate Imaging Reporting and Data System (PI-RADS) 3-5 lesions and csPCa within the TZ.</p><p><strong>Methods: </strong>We retrospectively evaluated TZ lesions in patients who underwent 3.0 Tesla MRI followed by MRI-targeted/transrectal ultrasound fusion biopsies (MRI-FBx). Fusion biopsies were performed for potentially cancerous lesions, defined as lesions with PI-RADS scores 3-5. We analyzed 196 lesions for which fusion biopsies were performed.</p><p><strong>Results: </strong>The overall prostate cancer (PCa) detection rate was 53.6% (105/196); csPCa constituted 33.7% (66/196) of cases. The minimum ADC value was significantly lower for patients with csPCa (484.9±112.3 µm²/s) than for patients with benign histology or non-csPCa (P<0.001). Older age, higher initial prostate-specific antigen level, larger region of interest, and minimum and mean ADC values were associated with the presence of csPCa. Multivariate analysis indicated that only the minimum ADC value was an independent predictor of csPCa. Using a cutoff minimum ADC value <561 µm²/s to detect csPCa in TZ lesions increased the detection rate to 57.4% (54/94).</p><p><strong>Conclusions: </strong>The minimum ADC value provides substantial additional information regarding the presence of csPCa in the TZ, potentially improving the detection rates for lesions rated as PI-RADS 3-5 and informing the need for follow-up biopsies in areas that are initially cancer-free.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475614","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":"Retrograde transurethral injection of indocyanine green better assists complete transperitoneal nephroureterectomy in a single-position.","authors":"Hong-Chen Song, Meng-Hua Wu, Jia-Xin Liu, Zi-Bing Cao, Yuan Du, Ming-Jun Shi, Jian Song, Xuan-Hao Li","doi":"10.21037/tau-24-247","DOIUrl":"10.21037/tau-24-247","url":null,"abstract":"<p><strong>Background: </strong>Complete transperitoneal nephroureterectomy (CTNU) in a single-position is an advanced surgical technique for the treatment of upper urinary tract urothelial carcinoma (UTUC), performed entirely through a transperitoneal approach without the need for patient repositioning. Indocyanine green (ICG) has been extensively studied in urologic surgery, with applications ranging from sentinel lymph node mapping to tumor localization. This study aimed to evaluate the performance of retrograde ureteral fluorescence imaging in CTNU.</p><p><strong>Methods: </strong>This retrospective cohort enrolled 81 patients diagnosed with UTUC and underwent single-position CTNU. Cohorts were divided into two groups according to whether the ICG was applied. Perioperative data and oncology outcomes were recorded and analyzed.</p><p><strong>Results: </strong>In total, 81 eligible participants were finally included, with 40 in the ICG group and 41 in the non-ICG group. The ICG group presented significantly shorter ureter identification time (8.5±3.3 <i>vs.</i> 17.3±4.2 min, P<0.001) and duration of surgery (132±40 <i>vs.</i> 162±49 min, P=0.003), as well as lower estimated blood loss (EBL) (108±94 <i>vs.</i> 183±126 mL, P=0.003) compared to the non-ICG group. The rates of intravesical and extravesical carcinoma recurrence were comparable between the two groups. At a median follow-up of 16.7 months, there were no significant differences in terms of the recurrence-free survival (RFS) and overall survival (OS) between groups.</p><p><strong>Conclusions: </strong>ICG guided ureteral fluorescence imaging in single-position CTNU showed significant advantages in precisely and effectively locating the ureter, with improved surgical outcomes. Meanwhile, the enhanced visualization of the ureteral intramural segment and bladder cuff facilitated the complete removal of the specimen en bloc and the watertight closure of the bladder.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475630","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":"Risk factors and nomogram for predicting urinary tract infection in patients with ureterolithiasis complicated with hydronephrosis.","authors":"Qiao Qi, Yongtao Hu, Bingbing Hou, Kaiguo Xia, Yuexian Xu, Chaozhao Liang, Zongyao Hao","doi":"10.21037/tau-24-217","DOIUrl":"10.21037/tau-24-217","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infection (UTI) is a common disease in urology and often occurs in patients with urolithiasis. This study aimed to identify the risk factors for UTI in patients with ureterolithiasis complicated with hydronephrosis, and to construct a simple and practical nomogram to predict the incidence of UTI for patients.</p><p><strong>Methods: </strong>A total of 383 patients were enrolled from September 2019 to June 2022. The results from univariate and multivariate logistic regression showed the risk factors for predicting UTI and a prediction model was constructed. Subsequently, the differentiation, calibration, and clinical applicability of the model were estimated by receiver operating characteristic (ROC) curve analysis, calibration curve, and decision curve analysis (DCA), respectively.</p><p><strong>Results: </strong>The study included 72 (18.80%) patients with UTI. Multivariate logistic regression showed that tissue rim sign (P=0.04), positive urinary nitrite (P<0.001), and positive urinary leukocyte esterase (P=0.005) were independent predictive indexes of UTI for patients with ureterolithiasis complicated with hydronephrosis, and a nomogram was constructed in accordance with these indicators. The area under the ROC curve was 0.773, which indicated good prediction ability. The Hosmer-Lemeshow test (P=0.97) indicated that the model fitted well. The calibration curve and DCA showed good consistency and clinical applicability, respectively.</p><p><strong>Conclusions: </strong>The prediction model constructed with the risk factors including tissue rim sign, positive urinary nitrite, and positive urinary leukocyte esterase can better detect patients with UTI early and take timely intervention measures.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475632","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}