Urologia Internationalis最新文献

{"title":"Renal Transplantation with Triple Ureter Implantation into the Urinary Bladder after Dissolving a Bilateral Ureterocutaneostomy for Posterior Urethral Valves.","authors":"Jonas Jung, Subhajit Mandal, Christer Groeben, Birgit Kortus-Götze, Joachim Hoyer, Johannes Huber, Luka Flegar","doi":"10.1159/000542302","DOIUrl":"10.1159/000542302","url":null,"abstract":"<p><strong>Introduction: </strong>We report a progressive treatment of a 31-year-old patient with end-stage renal disease secondary to congenital posterior urethral valve and valve bladder syndrome. He underwent a laser ablation of the urethral valve at the age of six, but on continuance of renal function deterioration ultimately a bilateral ureterocutaneostomy (UC) in the left lower abdomen had to be fashioned as a supravesical urinary diversion.</p><p><strong>Case presentation: </strong>For the management of dialysis dependent end-stage renal disease, an allogenic renal transplantation was planned. When a postmortal organ was available, the patient wished for a complete internalisation of the incontinent diversion if possible. To better delineate the current status of the lower urinary tract, an intraoperative cystoscopy was performed. Besides an elevated bladder neck and a low bladder capacity, there were no distinct pathologies. Therefore, a right iliac allogeneic renal transplantation with simultaneous dissolution of the bilateral UC and an anastomosis of all three ureters to the bladder was performed. Placement of a suprapubic catheter enabled safe urine drainage and a prospective evaluation of the voiding function. Because of obstructive voiding, we performed a transurethral resection of the prostate. This resulted in sufficient spontaneous voiding.</p><p><strong>Conclusion: </strong>After a 19-month observation period, the patient now exhibits good renal function with normal excretion and consistent retention parameters with satisfactory transurethral voiding and quality of life (QoL). This is an encouraging case where it was possible to convert an incontinent urinary diversion to a continent urinary diversion after renal transplantation to improve the patient's QoL.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-5"},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Magnetic Resonance Imaging and Computed Tomography with Biological Factor Expression and Lymph Node Metastasis in Aggressive Prostate Cancer.","authors":"Guanghai Ji, Fei Liu, Zhiqing Chen, Jie Peng, Hao Deng, Sheng Xiao, Yun Li","doi":"10.1159/000541953","DOIUrl":"10.1159/000541953","url":null,"abstract":"<p><strong>Introduction: </strong>This article focused on probing the correlation of magnetic resonance imaging (MRI) and computed tomography (CT) manifestations with biological factor expression and lymph node metastasis (LNM) in aggressive prostate cancer (PCa).</p><p><strong>Methods: </strong>A total of 136 PCa patients underwent surgical treatment and received CT and MRI examinations before surgery, whereby the apparent diffusion coefficient (ADC) values of quantitative MRI (qMRI) parameters were obtained. Patients were categorized into the non-aggressive PCa group and the aggressive PCa group according to the postoperative pathological results and Gleason scores. The expression of biological factors (prostate-specific antigen [PSA], proliferating cell nuclear antigen [PCNA], p27, and Ki-67) in both groups was tested. CT and MRI manifestations of aggressive PCa patients were analyzed. The qMRI parameters, biological factors levels, and LNM were compared in two groups; the relationships between CT and MRI manifestations, qMRI parameters, and positive expression of biological factors and LNM were probed in two groups.</p><p><strong>Results: </strong>In the aggressive PCa group, MRI and CT presented different degrees of abnormal prostate changes. In the aggressive PCa group, PSA and p27 expression and ADC values were lower, and PCNA and Ki-67, and LNM rates were higher. Patients' LNM rate was higher than that of ≤2 cm when the tumor diameter was >2 cm. ADC values were positively correlated with PSA and p27 positive expression and negatively correlated with PCNA, Ki-67, and LNM in the aggressive PCa group.</p><p><strong>Conclusion: </strong>MRI and CT manifestations of aggressive PCa had certain characteristics; MRI manifestations and qMRI possessed a correlation with biological factors and LNM; ADC could be employed to assess the aggressiveness of PCa.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Efficacy, Tolerability, and Safety Analysis of Darolutamide for Metastatic Castration-Resistant Prostate Cancer: A Single-Center, Open-Label Study.","authors":"JunJie Yu, KaiChen Zhou, JunQi Wang, LiJun Mao","doi":"10.1159/000541929","DOIUrl":"10.1159/000541929","url":null,"abstract":"<p><strong>Introduction: </strong>Darolutamide is a structurally unique second-generation androgen receptor antagonist that has been approved for indications in patients with non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC). The aim was to assess the efficacy and safety of Darolutamide for mCRPC.</p><p><strong>Methods: </strong>In this single-center, open-label study, patients with previously untreated mCRPC were enrolled and received androgen deprivation therapy (goserelin acetate 3.6 mg every 28 days) and docetaxel (75 mg per square meter of body surface area every 21 days) with Denosumab (120 mg every 28 days) for bone metastases, Darolutamide (300 mg orally twice daily) in the experimental group, and the control group received the corresponding of placebo. Serum PSA changes were detected and recorded, and imaging changes and adverse events (AEs) were evaluated. The primary endpoints were safety, tolerability, and antitumor efficacy, and the second endpoint was radiographic progression-free survival (rPFS).</p><p><strong>Results: </strong>Thirty-seven patients with mCRPC were enrolled. The median time to PSA50 in the Darolutamide group was 1.5 months (95% CI: 0.2619-0.9545), significantly lower than that in the placebo group (3.0 months [95% CI: 1.048-3.818], p = 0.0259). The median time to PSA90 in the experimental group was 4 months (95% CI: 0.3094-1.437), 2 months shorter than that in the placebo group (6.0 months [95% CI: 0.6961-3.232]). With the median follow-up of 6 months, the median decrease in serum PSA was -81.8% (range -60.4 to -99.9%) in the Darolutamide group and -69.4% (range -50.3 to -89.6%) in the placebo group. Tumor-related pain and AEs were not increased, and the median rPFS was not reached.</p><p><strong>Conclusions: </strong>The combination of Darolutamide and docetaxel was well tolerated with more clinically beneficial than docetaxel alone in previously untreated mCRPC. Darolutamide rapidly reduced PSA levels and prolonged rPFS and did not increase the incidence of AEs.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Intrarenal Pressure through Dilatation State of the Renal Collecting System.","authors":"Yujun Chen, Heng Yang, Yue Yu, Haibo Xi, Gongxian Wang, Xiaochen Zhou","doi":"10.1159/000541637","DOIUrl":"10.1159/000541637","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the relationship between the dilation states of the renal collecting system in flexible ureteroscopy (f-URS) view and intrarenal pressure (IRP).</p><p><strong>Methods: </strong>Fifteen porcine kidneys were randomly selected and numbered 1 through 15. Pressure transducers were inserted into the renal calyx via puncture and adjusted to a zero position. The distal end of the f-URS probe was placed within the renal pelvis. Perfusion rates of 50 mL/min, 80 mL/min, and 100 mL/min were utilized. We observed the relationship between the dilation state of the renal collecting system and changes in IRP. The state of complete dilation was defined as an unchanging spatial morphology of the renal collecting system as visualized during f-URS.</p><p><strong>Results: </strong>With irrigation rates of 50 mL/min, 80 mL/min, and 100 mL/min, IRP values at the moment of complete dilation of the renal collecting system ranged from 16 to 18 cm H2O, 16-19 cm H2O, and 16-19 cm H2O, respectively. Maximum IRPs ranged from 47 to 49 cm H2O, 82-85 cm H2O, and 97-100 cm H2O, respectively. Prior to complete dilation of the renal collecting system, IRP consistently remained below 20 cm H2O. However, following full dilation of the renal collecting system, IRP rose rapidly and rapidly surpassed 20 cm H2O. Despite sustained elevations in IRP following full dilation, no significant alterations in the renal collecting system dilated morphological were observed with f-URS.</p><p><strong>Conclusions: </strong>In vitro experiments indicate that when the renal collecting system is not fully dilated, the IRP is consistently less than 20 cm H2O. Evaluation of IRP being within a safe range can be determined by assessing the dilation status of the renal collecting system.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic Impact on Uro-Oncological Disease Outcomes at a German Referral Center.","authors":"Moustafa Elleisy, Desiree Louise Dräger, Heike Zettl, Oliver W Hakenberg","doi":"10.1159/000541932","DOIUrl":"10.1159/000541932","url":null,"abstract":"<p><strong>Introduction: </strong>To assess differences in referral and pathologic outcomes for uro-oncology cases prior to, during, and after the COVID-19 pandemic, comparing clinical and pathological data from cancer surgeries performed at a university medical center between 2018 and 2023.</p><p><strong>Methods: </strong>We collected data of 212 patients with radical prostatectomy (RP) for prostate cancer, 157 patients with radical cystectomies (RCs) for bladder cancer, 36 patients with radical nephroureterectomies (RNUs) for upper tract urothelial carcinoma, 133 patients with partial nephrectomies (PNs), and 160 patients with radical nephrectomies (RNs) for renal cancer, 93 patients with orchifunicolectomy for testicular cancer, 39 patients with newly diagnosed penile cancer. Data from patients treated between 2018 and February 2020 (before the COVID-19 pandemic) were compared with data from patients treated between March 2020 and March 2022 (during the COVID-19 pandemic) and between April 2022 and February 2023 (after the COVID-19 pandemic).</p><p><strong>Results: </strong>No differences in terms of main pathologic features were observed in patients undergoing RP, RNU, orchifunicolectomy, or circumcision and/or penectomy. Further, a lower pathological tumor stage was diagnosed for RN after the COVID-19 pandemic (p < 0.05). A higher age at diagnosis for penile cancer was observed during the pandemic cohort in comparison to the pre-COVID-19 pandemic cohort (p < 0.05), but this did not translate into a worse pathological stage or lymph node involvement. Another notable change was the shortening of the length of stay (LOS) for orchifunicolectomy over the pandemic (p < 0.05).</p><p><strong>Conclusion: </strong>Neither decline in uro-oncologic activity nor pathological features were observed at our institution before, during, and after the COVID-19 pandemic. A significantly lower pathological tumor stage for RN after the COVID-19 pandemic was seen. Penile cancer was diagnosed at a significantly higher age during the COVID-19 pandemic, and a decrease in LOS for orchifunicolectomy was observed.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Role of Anticholinergics and α-1 Adrenergic Blockers in Bladder Management in Posterior Urethral Valves: A Pilot Randomized Control Trial.","authors":"Ramyasree Bade, Jai Kumar Mahajan, Akshay Kalavant, Saswati Behera, Palak Singhai, Akshay Saxena","doi":"10.1159/000541245","DOIUrl":"10.1159/000541245","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior urethral valve (PUV) is a major cause of congenital bladder dysfunction, often persisting despite treatment. Emerging therapies, including anticholinergics and α-1 blockers, offer potential but lack clear guidelines. This study evaluates their effectiveness in improving bladder function after valve fulguration.</p><p><strong>Methods: </strong>Twenty PUV patients, aged ≥3 years, were randomized into anticholinergic (group A, n = 11) and α-1 adrenergic blocker (group B, n = 9) groups post-fulguration. Follow-up included clinical, radiological, and urodynamic assessments 6 months posttreatment initiation.</p><p><strong>Results: </strong>In group A, the mean maximum detrusor pressure (Pdet) decreased from 30.17 to 23.45 cm H2O (p = 0.033). Two patients normalized from high detrusor pressure (&gt;40 cm H2O). In group B, 1 patient retained high detrusor pressure posttreatment. Group B improved in average urinary flow (Q avg) and maximum flow rate (Q max), with all patients having initially low Q avg (&lt;10 mL/s). Two group B patients showed improved average flow rates posttreatment (p = 0.016); three in group A showed improvement but were not statistically significant (p = 0.197). Q max/flow time ratio was abnormal in all group B patients pretreatment. Two of the nine improved posttreatment, while only one in group A did.</p><p><strong>Conclusions: </strong>Anticholinergic medications positively impact cystometric parameters and are effective for detrusor instability and low compliance bladder. α-Adrenergic blockers influence uroflow parameters and can help treat bladder outflow obstruction. Consideration for a larger study with extended follow-up is warranted.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformations in Benign Prostatic Hyperplasia Surgical Practices: A Longitudinal Study of Trends and Predictions.","authors":"Karin Lifshitz, Ziv Savin, Tomer Bashi, Snir Dekalo, Hen Hendel, Yaron Ehrlich, Omer Anis, Zohar Dotan, Guy Verhovsky, Ehud Genessin, Rabeea Moed, Nicola Mabjeesh, Mahmoud Abbas, Ilan Kafka, Ali Safadi, Ran Katz, Ofer Yossepowitch, Mario Sofer","doi":"10.1159/000541752","DOIUrl":"10.1159/000541752","url":null,"abstract":"<p><strong>Introduction: </strong>The workload for benign prostatic hyperplasia (BPH) surgery is expected to rise with an increase in life expectancy and a growing population. Surgical modalities for BPH have evolved, shifting toward minimally invasive transurethral procedures. This study aimed to investigate the trends in BPH surgical procedures across medical centers in Israel.</p><p><strong>Methods: </strong>Data from seven academic medical centers in Israel from 2010 to 2022 were analyzed. Procedures included open prostatectomy, transurethral prostatectomy (TURP), holmium laser enucleation of the prostate (HoLEP), and photovaporization of the prostate (PVP). Statistical analyses were employed, including t tests, ANOVA, and ARIMA models.</p><p><strong>Results: </strong>Over 12 years, 13,478 BPH procedures were performed. TURP was the most common (72%), followed by open surgery (12%), HoLEP (12%), and PVP (3%). Annual procedures increased by approximately 5% each year, with a cumulative surge of 63% cases by 2022. The average patient's age remained stable. TURP and HoLEP showed continual growth, while open surgery declined. HoLEP exhibited a shorter length of hospital stay compared to other modalities. Predictive models suggest open prostatectomy will cease within 2 years, while TURP and HoLEP will continue to rise.</p><p><strong>Conclusion: </strong>This study highlights a significant increase in BPH surgical procedures over time, with a notable preference for TURP and HoLEP. The findings emphasize the importance of size-independent techniques like HoLEP for optimal healthcare management in the future.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SARS-CoV-2 Pandemic on Diagnosis of Prostate Cancer.","authors":"Immanuel A Oppolzer, Marco J Schnabel, Selma Hammer, Hannah Zilles, Maximilian Haas, Christopher Goßler, Maximilian R Müller, Maximilian Burger, Michael Gierth","doi":"10.1159/000541753","DOIUrl":"10.1159/000541753","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to prove if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in a delay in diagnosis and treatment of prostate cancer (PC).</p><p><strong>Methods: </strong>A monocentric, retrospective analysis was conducted at a university cancer center. Included were all patients with untreated PC diagnosed between January 2019 and December 2021. The observation covered 22 months of the SARS-CoV-2 pandemic and 14 months preceding it.</p><p><strong>Results: </strong>Nine hundred sixty-nine men prior (T0) and 1,343 during the pandemic (T1) were included. Mean age was 68.0 (SD 8.2). Median initial prostate-specific antigen was 8.1 ng/mL (T0) and 7.9 ng/mL (T1, p = 0.288). Time from biopsy to tumor board (T0: 1.3 months vs. T1: 0.9 months, p = 0.001), to staging (T0: 1.1 months vs. T1: 0.75 months, p = 0.707), and to therapy (T0: 3.0 months vs. T1: 2.0 months, p < 0.001) was shortened during the pandemic. Classified by d'Amico, a significant shift toward higher risk groups was seen (p = 0.024). Local staging showed an insignificant increase in locally advanced PCs. Metastatic diseases decreased from 10.3% to 8.9% (p = 0.433). Pathological staging showed pT3+ in 44.4% versus 44.7% (p = 0.565) and pN+ in 9.9% versus 9.6% (p = 0.899).</p><p><strong>Conclusion: </strong>Regarding the diagnosis and treatment of PC, we could not demonstrate any delays due to the SARS-CoV-2 pandemic.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Response to Anti-PD-1 Therapy in Combination with Nab-Paclitaxel in Metastatic Testicular Germ Cell Tumor Harboring the KRAS-G12V Mutation: A Case Report.","authors":"Jinfeng Pan, Weiqi Yin, Yingzhi Chen, Hui Wang, Wei Wu, Suying Wang, Da Li, Qi Ma","doi":"10.1159/000541588","DOIUrl":"10.1159/000541588","url":null,"abstract":"<p><strong>Introduction: </strong>Cisplatin-based standardized therapy has been established for metastatic testicular germ cell tumors (TGCTs). However, the patient prognosis is considerably less favorable if the disease recurs following failure of first-line therapies. There is a need for novel treatment options for patients with recurrent or metastatic TGCTs, notably for those that are not sensitive to first-line chemotherapy. With the development of next-generation sequencing technologies, an increasing number of gene mutations has been identified in TGCTs. Previously published research studies have established a link between KRAS mutations and chemotherapy resistance, and have demonstrated that KRAS mutations are associated with inflammatory tumor microenvironment and tumor immunogenicity, leading to an improved response to inhibition of programmed death (PD-1) protein expression. Previous studies have reported that the tumor immune microenvironment of TGCT influences therapeutic efficacy.</p><p><strong>Case presentation: </strong>A 65-year-old metastatic patient with TGCT and a KRAS-12 valine-for-glycine gene mutation was described. This patient initially underwent inguinal orchiectomy and received two prior chemotherapeutic regimens. Following the rapid progression of the disease, the patient was treated with anti-PD-1 therapy and nab-paclitaxel chemotherapy, and his condition was successfully controlled by this combination treatment.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first successful case of KRAS-mutation patient with TGCT who achieved partially and sustained disease remission by combining immune checkpoint inhibitors with chemotherapy. This case provides an excellent example for personalized treatment of metastatic TGCTs.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Prophylaxis of Transrectal Biopsy of the Prostate: A Plea for Fosfomycin.","authors":"Philipp Julian Spachmann, Daniel Witt, Johannes Breyer, Stefan Denzinger, Maximilian Burger, Daniel Claudius Vergho, Wolfgang Otto, Marco Julius Schnabel","doi":"10.1159/000541798","DOIUrl":"10.1159/000541798","url":null,"abstract":"<p><strong>Introduction: </strong>According to guidelines, transrectal random biopsy of the prostate (TRBP) is performed under antibiotic prophylaxis (AP). Fosfomycin-trometamol (FOS) is not approved in Germany, but TRBP as indication was listed in the product information falsely. The aim was to investigate infectious complications of TRBP under FOS as a single dose.</p><p><strong>Methods: </strong>All TRBPs under FOS 3,000 mg as a single dose between July 1, 2020, and June 30, 2021, at a university institution were recorded. 357 patients (41-85 years old, median 66) were included. 243 received first TRBP, 321 TRBP were MRI-fusionated. 10-22 cores were taken (median 14). Prostate-specific antigen (PSA) was 0.1-1224 ng/mL (median 7.7 ng/mL), prostate volume 5-263 mL (median 50 mL). Analysis was performed using Chi square test or Fisher's exact test, Mann-Whitney U test, and t test.</p><p><strong>Results: </strong>Four patients suffered an infection (1.1%), without significant difference according to age (p = 0.849), PSA (p = 0.957), number of cores (p = 0.905), and increase in volume (p = 0.456). Limiting is the retrospective character.</p><p><strong>Conclusion: </strong>The complication rate was 1.1%, and FOS single dose therefore represents sufficient AP for TRBP in this collective. FOS as a single dose should be reevaluated in a prospective study to obtain approval in Germany for this indication.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-5"},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}