Translational andrology and urology最新文献

{"title":"Development and validation of an interpretable machine learning model for predicting Gleason score upgrade in prostate cancer.","authors":"Shu-Feng Li, Jin-Ge Zhao, Chen-Yi Jiang, Shi-Yuan Wang, Si-Yu Liu, Yi-Jun Zhang, Hao Zeng, Fu-Jun Zhao","doi":"10.21037/tau-2025-178","DOIUrl":"10.21037/tau-2025-178","url":null,"abstract":"<p><strong>Background: </strong>The high incidence of Gleason score upgrade (GSU) can lead urologists to underestimate tumor aggressiveness, resulting in suboptimal treatment decisions. This study aimed to develop an interpretable machine learning model to predict the risk of GSU in individuals with prostate cancer (PCa) based on readily available clinical parameters.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent radical prostatectomy (RP) at Shanghai General Hospital and West China Hospital. Data from Shanghai General Hospital were categorized into a training set (80%) and a test set (20%), while data from West China Hospital were used for external validation. Preoperative clinical and pathological data were collected. Nine machine learning models [including random forest (RF) and light gradient boosting machine (LightGBM)], were developed, and the model demonstrating the best predictive performance was selected as the final model. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, decision curves, and SHapley Additive exPlanations (SHAP) interpretation.</p><p><strong>Results: </strong>The LightGBM model demonstrated strong predictive performance, achieving an area under the ROC curve of 84.53% in the test set and 76.61% in external validation. Significant factors associated with GSU included the International Society of Urological Pathology (ISUP) grade, age, clinical tumor stage (T stage), body mass index, prostate-specific antigen (PSA), free-to-total PSA ratio (f/t PSA), platelet-to-lymphocyte ratio (PLR), and bilateral tumor involvement. An online prediction tool was developed based on this model.</p><p><strong>Conclusions: </strong>A machine learning model and an online prediction tool were developed to accurately predict GSU and identify factors associated with this process. This approach may assist clinicians in identifying individuals at high-risk for GSU and facilitating evidence-based treatment decisions.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1631-1644"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675776","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":"Exploring the relationship between triglyceride-glucose index and kidney stones in Chinese adults: a cross-sectional study.","authors":"Yixin Tang, Xixuan Cai, Liying Chen","doi":"10.21037/tau-2025-143","DOIUrl":"10.21037/tau-2025-143","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index is increasingly recognized as an important marker of insulin resistance (IR). This study aims to evaluate the relationship between these TyG-related indices and kidney stones.</p><p><strong>Methods: </strong>From January 2020 to December 2024, this study enrolled 142,309 participants aged 18 to 80 years who visited the Health Promotion Center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. For the diagnosis of kidney stones, all individuals in the health screening group received ultrasound evaluations. The TyG index was computed using the formula: ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. To explore the association between various quartiles of the TyG index and the risk of kidney stones, logistic regression analyses were performed.</p><p><strong>Results: </strong>In this study, 10,605 out of 142,309 participants (7.5%) were diagnosed with kidney stones. The mean TyG index values ± standard deviations (SDs) across the four quartiles were Q1 (7.85±0.21), Q2 (8.32±0.11), Q3 (8.73±0.13), and Q4 (9.43±0.45). Results from the multivariable model (fully adjusted version) showed a significant positive association between the TyG index and kidney stone prevalence [odds ratio (OR) =1.51; 95% confidence interval (CI): 1.44-1.58]. Participants in the highest TyG index quartile (Q4) had a notably higher risk of kidney stones compared to those in the lowest quartile (Q1), with an adjusted OR of 2.40 (95% CI: 2.17-2.65).</p><p><strong>Conclusions: </strong>In this study, a significant positive association was observed between the TyG index and the formation of kidney stones. These findings indicate that the TyG index has the potential to serve as a reliable and efficient biomarker for evaluating the latent risk of kidney stone occurrence.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1542-1550"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675779","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":"High-risk factors for urinary calculus recurrence in Chinese preschool children: findings from a medium-term follow-up survey.","authors":"Hou-Yu Zhou, You-Quan Zhao, Xiao-Chuan Wang, Shao Zhang, Jun Li","doi":"10.21037/tau-2024-650","DOIUrl":"10.21037/tau-2024-650","url":null,"abstract":"<p><strong>Background: </strong>To date, most literature has focused on factors contributing to the initial occurrence of pediatric urinary stones. However, there is scant literature on the risk factors for recurrence following the initial episode. Effective treatment strategies for the initial episode and measures to reduce the risk of stone recurrence are crucial. This study aimed to investigate the impact of children's dietary habits on the recurrence of urinary stones in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of pediatric patients diagnosed with urinary stones by the Department of Urology at Beijing Friendship Hospital Affiliated with Capital Medical University from January 2014 to December 2023. Dietary habits were compared between patients who experienced recurrence and those who did not.</p><p><strong>Results: </strong>We conducted a follow-up study from January 2014 to December 2023 on 310 children with urinary stones. During the follow-up period, which had a median duration of 50.93±1.79 months, 62 patients (20.0%) experienced recurrence, while 248 patients (80.0%) did not. Among the recurrent patients, 9 (14.5%) did not consume animal proteins, 21 (33.9%) had low water intake, and 34 (54.8%) had a high dietary oxalate intake. In comparison, among the non-recurrent patients, 34 (13.7%) did not consume animal proteins, 36 (14.5%) had low water intake, and 120 (48.4%) had a high dietary oxalate intake. Univariate analysis revealed that a high-protein diet [odds ratio (OR) =0.805, 95% confidence interval (CI): 0.707-0.917, P<0.001] was a protective factor against recurrence, while a high oxalate diet (OR =1.335, 95% CI: 1.146-1.554, P<0.001), low water intake (OR =1.138, 95% CI: 1.013-1.279, P=0.03), and younger age at onset (OR =1.062, 95% CI: 1.025-1.110, P=0.001) were identified as risk factors. In multivariate analysis, the high-protein diet remained a protective factor (OR =0.825, 95% CI: 0.725-0.940, P=0.004), while high dietary oxalate intake (OR =1.304, 95% CI: 1.122-1.515, P<0.001), low water intake (OR =1.141, 95% CI: 1.019-1.276, P=0.02), and younger age at onset (OR =1.076, 95% CI: 1.038-1.114, P<0.001) continued to be significant risk factors.</p><p><strong>Conclusions: </strong>The study concluded that a high-protein diet serves as a protective factor, whereas a high oxalate diet, low water intake, and younger age at onset are significant risk factors for the recurrence of pediatric urinary stones. The cumulative five-year recurrence rate of pediatric urinary stones was 18.1%. Therefore, dietary modifications, including increased protein intake and reduced oxalate consumption, along with ensuring adequate hydration, are crucial in managing pediatric urinary stones and preventing early recurrence.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1601-1609"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675781","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":"Leveraging hypoxia-related genes signature for predicting the prognosis of bladder cancer.","authors":"Yang Dong, Yu-Ang Chen, Pei-Ze Yu, Qiang Liu, Ran Zhou, Hui Yu, Zhen-Duo Shi, Lin Hao, Tong Zhao, Jun Ding, Cong-Hui Han","doi":"10.21037/tau-2025-118","DOIUrl":"10.21037/tau-2025-118","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia is common in solid tumors, facilitating tumor growth and treatment resistance, and is crucial for optimizing patient outcomes, but research on the mechanism of hypoxia in bladder cancer (BC) remains limited. This study aims to explore the functional role of hypoxia-related genes (HRGs) in BC.</p><p><strong>Methods: </strong>The HRGs were obtained from GeneCards, and the hypoxia score in BC patients was evaluated by single-sample gene set enrichment analysis (ssGSEA). The prognostic risk model was constructed using differentially expressed prognostic HRGs, and assessed via time-dependent receiver operating characteristic (ROC) curves, Kaplan-Meier (KM) curve, and nomogram analysis. Differential features between high- and low-risk groups were analyzed, including clinical characteristics, biological functions, mutation profiles, immune infiltration, and drug sensitivity. We measured the expression of hub genes <i>in vitro</i> via quantitative real-time polymerase chain reaction (qRT-PCR), assessed their interactions with special herbal monomers, and evaluated the developmental trajectories using single-cell sequencing data of BC.</p><p><strong>Results: </strong>The hypoxia score system was proven effective in BC diagnosis and prognostic prediction based on ROC and KM analyses. The prognostic risk model was constructed with <i>JUN</i>, <i>MYC</i>, <i>EGFR</i>, and <i>SLC2A1</i>, and effectively stratified BC risk. Numerous mutations, especially the frequent <i>TP53</i>, occurred in both risk groups. Besides, the high-risk group exhibited more immune cell infiltration. Moreover, solasonine and rhein were predicted to exhibit well binding affinity for hub genes, especially <i>EGFR</i> and <i>SLC2A1</i>. Additionally, a predominance of malignant epithelial cells in BC was confirmed using single-cell data, with significant variation in JUN along the developmental trajectory and an increase of <i>MYC</i> at developmental endpoint, highlighting their critical roles in BC progression.</p><p><strong>Conclusions: </strong>We developed a novel prognostic risk model as an independent predictor for BC patients, which offers insights into immune microenvironment and carcinogenesis mechanisms of BC. Analyzing mutation patterns, drug sensitivities, and the developmental trajectories of genes within this model would be helpful for refining therapeutic strategies.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1701-1722"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675787","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":"Identification of novel plasma proteins as potential therapeutic targets for benign prostatic hyperplasia: a proteome-wide association study.","authors":"Xinyi Luo, Changjing Wu, Yang Xiong, Wei Wang, Qing Jiang, Zhihong Liu","doi":"10.21037/tau-2025-187","DOIUrl":"10.21037/tau-2025-187","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) represents a prevalent age-related disorder with suboptimal pharmacological management. To systematically identify plasma proteins causally linked to BPH pathogenesis and therapeutic potential, we conducted a proteome-wide association study (PWAS) integrated with multi-omics analytical approaches.</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) datasets of bioavailable testosterone (BAT) and BPH were harmonized by multi-trait analysis of GWAS (MTAG) to enhance discovery power. Subsequent proteomic integration encompassed PWAS, two-sample Mendelian randomization (MR), and Bayesian colocalization analyses, complemented by pathway enrichment evaluation. Validation was performed using conventional BPH GWAS data.</p><p><strong>Results: </strong>This integrative analysis identified 25 plasma proteins exhibiting significant associations with BPH risk (adjusted P<0.05), including two proteins (AIF1 and RSPO3) independently validated in the conventional BPH GWAS dataset. MR analyses established causal relationships for 18 proteins (adjusted P<0.05), with Bayesian colocalization confirming shared causal variants between BPH and key proteins AIF1 [posterior probability 4 (PP4) =0.999], RSPO3 (PP4 =0.714), and COL2A1 (PP4 =0.920). Pathway analysis revealed enrichment in inflammatory signaling and extracellular matrix remodeling.</p><p><strong>Conclusions: </strong>This first PWAS investigation of BPH delineates a panel of circulating proteins with mechanistic and therapeutic implications, particularly highlighting AIF1 and RSPO3 as priority candidates for functional validation and drug development.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1679-1690"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675782","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":"Immune-related genes can accurately predict survival in bladder cancer: a retrospective study via two independent immunotherapy cohorts.","authors":"Juan Shen, Xiang Liu, Chao Li, Lin Hong, Shu-Guang Zhou","doi":"10.21037/tau-2025-28","DOIUrl":"10.21037/tau-2025-28","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BLCA) is an aggressive malignancy characterized by high rate of recurrence. Its steadily increasing incidence and prevalence have made it one of the most prevalent urogenital tract tumors worldwide. Although immunotherapy serves as a first-line treatment for BLCA, patient prognosis shows significant heterogeneity. Risk stratification through immunotherapy risk scoring could substantially improve prognostic predictions. However, current studies examining the use of immune treatment risk scores to predict the prognosis of immunotherapy across various patients with BLCA remain in its early stages. This research aims to identify immune-related genes as potential biomarkers for BLCA immunotherapy guidelines.</p><p><strong>Methods: </strong>To fill this gap, we used two independent immunotherapy datasets from the \"IMvigor210CoreBiologies\" package as the training cohort and the Gene Expression Omnibus (GEO) database as the validation cohort to create a risk score signature based on deep learning algorithm to assess the effectiveness and outlook of BLCA immunotherapy.</p><p><strong>Results: </strong>A risk score model comprising three immunotherapeutic-related genes was established and validated, demonstrating significant predictive power and serving as an independent factor for forecasting overall survival (OS) in BLCA immunotherapy. Furthermore, our model revealed a strong association with drug sensitivity responses and identified immune landscape differences among various BLCA patients.</p><p><strong>Conclusions: </strong>We anticipated that the risk score, which is an independent prognostic factor, would be taken into consideration when deciding whether to provide clinical immunotherapy for BLCA patients.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1661-1678"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675783","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":"Robot-assisted upper urinary tract repair surgery using the MP1000 system: a prospective, single-center, single-arm clinical study.","authors":"Bing Wang, Wenzhi Gao, Kunlin Yang, Yaming Gu, Zhihua Li, Xinfei Li, Zihui Gao, Zheng Zhang, Xuesong Li","doi":"10.21037/tau-2025-228","DOIUrl":"10.21037/tau-2025-228","url":null,"abstract":"<p><strong>Background: </strong>The MP1000 system is a newly developed surgical robot in China. This study, based on our single-center experience, evaluates its feasibility, safety, and effectiveness in upper urological repair surgeries.</p><p><strong>Methods: </strong>This prospective, single-center, single-arm clinical study was conducted from June 2023 to December 2023. One surgeon performed 20 upper urinary tract repair operations using the MP1000 system. Prospective demographic data and perioperative outcomes were collected, and postoperative complications and success rates were analyzed. The ergonomics were evaluated using national aeronautics and space administration task load index (NASA-TLX).</p><p><strong>Results: </strong>All cases were successfully completed without the need to switch to standard laparoscopic or open surgery. The average docking time was 4.1 [interquartile range (IQR), 3-5] min, the average control time was 145.1 (IQR, 102-195) min, and the average operation time was 189.1 (IQR, 145-248) min. The average estimated blood loss (EBL) was 58.5 (IQR, 20-100) mL. The mean length of stay was 6.95 (IQR, 4-8) days. All patients had no postoperative lumbago symptoms and no Clavien-Dindo grade III or higher-grade complications. The estimated glomerular filtration rate (eGFR) was 99.29 (IQR, 95.39-126.14) mL/min/1.73 m² on the first day after surgery, 101.13 (IQR, 89.73-124.7) mL/min/1.73 m² on the third day after surgery, and 78.38 (IQR, 57.12-91.84) mL/min/1.73 m² on the third months after surgery. The short-term success rate was 100%. The overall score of NASA-TLX is 6.70±4.81.</p><p><strong>Conclusions: </strong>The MP1000 system is safe and effective for a variety of upper urinary tract repair procedures.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1723-1733"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675805","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":"Association of visceral adiposity index and overactive bladder: insights from NHANES 2007-2018.","authors":"Panpan Jiao, Xinmiao Ni, Jingsong Wang, Xiangxiang Yang, Haonan Mei, Xiaodong Weng, Lei Wang, Zhiyuan Chen, Qingyuan Zheng, Xiuheng Liu","doi":"10.21037/tau-2024-717","DOIUrl":"10.21037/tau-2024-717","url":null,"abstract":"<p><strong>Background: </strong>In the exploration of the pathogenesis of overactive bladder (OAB), emerging evidence suggests a potential link between OAB and obesity. However, the association between visceral fat accumulation and OAB has not been definitively established. The aim of the study is to analyze and establish the relationship between visceral adiposity index (VAI) and OAB in large population studies.</p><p><strong>Methods: </strong>The study included 13,694 participants from the National Health and Nutrition Examination Survey (NHANES) database covering the years 2007 to 2018. VAI was calculated using waist circumference (WC), body mass index (BMI), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-c). OAB was defined via the Overactive Bladder Symptom Score (OABSS ≥3). It utilized weighted multivariable logistic regression to analyze the association between VAI and OAB, as well as the relationship between the two across various subgroups. Additionally, restricted cubic spline (RCS) analysis was employed to explore the nonlinear relationship between VAI and OAB.</p><p><strong>Results: </strong>Weighted multivariable logistic regression indicated a significant association between VAI and OAB (P<0.05). After adjusting for covariates, a notable association was found between the \"Q4\" of VAI and the occurrence of OAB (all P<0.05). Subgroup analysis results were consistent with those of the overall population (P for interaction >0.05). RCS revealed a nonlinear positive dose-response relationship (P<0.001), with a significant inflection point at VAI =1.41.</p><p><strong>Conclusions: </strong>The study identified a nonlinear positive dose-response relationship between VAI and the occurrence of OAB. Incorporating VAI into comprehensive management strategies for OAB is a meaningful exploration.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1652-1660"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675800","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 role of double-lumen irrigation-suction tube in the treatment of disseminated Fournier's gangrene: a single-center retrospective cohort study.","authors":"Yuan-Zhi Li, Qing-Qiang Gao","doi":"10.21037/tau-2025-248","DOIUrl":"10.21037/tau-2025-248","url":null,"abstract":"<p><strong>Background: </strong>The double-lumen irrigation-suction tube (DLIST) has demonstrated excellent efficacy in the treatment of complex infectious diseases; however, its application value in disseminated Fournier's gangrene (FG) remains undetermined. This research aims to assess the clinical efficacy and feasibility of DLIST in the treatment of disseminated FG.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 34 patients with disseminated FG admitted from October 2012 to February 2025. The severity of the disease was evaluated using the Fournier's Gangrene Severity Index (FGSI) and the modified Uludag Fournier's Gangrene Severity Index (UFGSI). The patients were divided into the DLIST group (group A) and the conventional dressing change group (group B) according to whether the DLIST technique was used after debridement. Data from the two groups were compared and analyzed.</p><p><strong>Results: </strong>Sixteen patients were treated with DLIST irrigation and suction, and 18 patients were treated with conventional dressing changes. No statistically significant differences were observed in FGSI and UFGSI scores between the two groups (P=0.49 and P=0.28, respectively). Compared with the conventional group, the DLIST group had significantly shorter wound closure time, lower daily gauze change frequency, reduced analgesic use frequency, and lower visual analogue scale scores (P=0.02, P<0.001, P<0.001, and P=0.02, respectively). The length of hospital stay (LOS) was also significantly shorter in the DLIST group (P=0.02). No deaths occurred in either group during the observation period.</p><p><strong>Conclusions: </strong>The application of DLIST after debridement significantly shortens wound closure time and LOS in patients with disseminated FG, while reducing dressing change frequency and alleviating pain. However, these results require further validation through large-scale, prospective, randomized controlled trials.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1520-1527"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675809","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":"Primary aldosteronism patients with bilateral adrenal vein sampling success achieve better outcomes through unilateral adrenalectomy.","authors":"Zhipeng Sun, Baoan Hong, Yuxuan Wang, Xuezhou Zhang, Wei Wang, Qi Miao, Mingchuan Li, Yuxuan Bo, Ning Zhang","doi":"10.21037/tau-2025-89","DOIUrl":"10.21037/tau-2025-89","url":null,"abstract":"<p><strong>Background: </strong>Adrenal vein sampling (AVS) is the gold standard for diagnosing the dominant side in patients with primary aldosteronism (PA). <i>CYP11B2</i> encodes aldosterone synthase. The aim of this study was to investigate the prognosis of dominant-side adrenalectomy in patients with PA identified by AVS in the context of aldosterone synthase expression in the postoperative pathology of those patients.</p><p><strong>Methods: </strong>This retrospective study included 73 PA patients who underwent AVS followed by unilateral adrenalectomy. Patients were categorized into AVS bilateral success group, AVS unilateral success group, and AVS bilateral failure group based on their AVS status. Immunohistochemistry (IHC) for CYP11B2 was combined with postoperative pathology in these patients, and the clinical and biochemical prognosis of these patients was assessed 6 months after adrenalectomy.</p><p><strong>Results: </strong>Between September 2023 and September 2024, 73 patients underwent unilateral adrenalectomy guided by AVS at our institution, with CYP11B2 IHC successfully performed in 63 cases. Among these, 21 patients (33.33%) achieved bilateral AVS success, 20 (31.75%) demonstrated unilateral AVS success, and 22 (34.92%) exhibited bilateral AVS failure. Pathological analysis of the bilateral AVS success group revealed aldosterone-producing adenoma (APA) in 12 cases, aldosterone-producing micronodule (APM) in 1, multiple-aldosterone-producing micronodules/nodules (MAPM/MAPN) in 2, aldosterone-producing diffuse hyperplasia (APDH) in 1, APA with MAPM in 3, and APA with APDH in 2. In this group, complete and partial clinical success rates were 47.62% (10/21) and 52.38% (11/21), respectively, while biochemical success rates reached 95.24% (20/21) for complete and 4.76% (1/21) for partial success. The unilateral AVS success cohort included APA (n=8), aldosterone-producing nodule (APN) (n=2), MAPM/MAPN (n=3), APA with MAPM (n=4), APA with APDH (n=2), and 1 CYP11B2 IHC-negative lesion, with clinical success rates of 40.00% (8/20) complete and 60.00% (12/20) partial, alongside 90.00% (18/20) complete and 10.00% (2/20) partial biochemical success. The bilateral AVS failure group comprised APA (n=8), MAPM/MAPN (n=1), APA with MAPM (n=5), APA with APDH (n=2), and 6 CYP11B2 IHC-negative lesions, demonstrating 36.36% (8/22) complete, 50.00% (11/22) partial, and 13.64% (3/22) no clinical success, with biochemical outcomes of 72.73% (16/22) complete, 18.18% (4/22) partial, and 9.09% (2/22) no success. Notably, bilateral AVS success correlated with significantly superior biochemical outcomes compared to bilateral failure (P=0.045).</p><p><strong>Conclusions: </strong>Adrenalectomy guided by AVS yields better outcomes in patients with PA when AVS is successful on both sides compared to those with bilateral AVS failure. The source of excess aldosterone secretion on the dominant side identified by AVS is not necessarily an APA/APN. It may also inclu","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1503-1519"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675803","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}