{"title":"The First Case of Lynch Syndrome-Associated Penile Cancer Harboring a Heterozygous PMS2 Frameshift Variant.","authors":"Zhiqiang Wu, Liang Xiao, Jibin Qiang, Yan Chen, Dujuan Liu, Deyi Chen, Zhihong Chen","doi":"10.1159/000541252","DOIUrl":"10.1159/000541252","url":null,"abstract":"<p><strong>Introduction: </strong>Penile squamous cell carcinoma (PSCC) is a rare malignancy in men with poor survival in metastatic disease. Lynch syndrome (LS) is a cancer predisposition, autosomal-dominant, inherited disorder that arises from loss of function variants in mismatch repair genes.</p><p><strong>Case presentation: </strong>Here, we reported a PSCC patient who was suspected with LS caused by a heterozygous PMS2 D526Afs*69 variant. A 57-year-old male with PSCC underwent pelvic lymph node dissection and bilateral groin lymph node dissection due to metastatic disease. He has a family history of colon cancer and brain cancer. Comprehensive genomic sequencing of his tumor specimen identified 19 somatic mutations with a high tumor mutation burden (14.03 mutations per Mb) and a high frequency of microsatellite instability. Additionally, a germline PMS2 D526Afs*69 mutation was identified in the peripheral blood sample. Immunohistochemistry analysis showed complete loss of PMS2 and MLH1 expression in his tumor.</p><p><strong>Conclusion: </strong>These observations provided evidence suggesting that PSCC could be part of the LS spectrum.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"97-102"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120747","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":"167-174"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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}
Moustafa Elleisy, Desiree Louise Dräger, Heike Zettl, Oliver W Hakenberg
{"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><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 ","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"135-145"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965829/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic Significance of Albumin-Globulin Ratio in Urachal Carcinoma.","authors":"Hengxin Chen, Menghai Wu, Minfeng Chen","doi":"10.1159/000540665","DOIUrl":"10.1159/000540665","url":null,"abstract":"<p><strong>Introduction: </strong>Although albumin-globulin ratio (AGR) has been used in the prognostic assessment of multiple solid malignancies, so far no research has confirmed the prognostic significance of AGR as a biomarker for urachal carcinoma. We analyzed the relationship between AGR and prognosis in urachal carcinoma, aiming to identify a promising prognostic biomarker for urachal carcinoma.</p><p><strong>Methods: </strong>We reviewed the clinical data of 25 patients diagnosed with urachal carcinoma in the Xiangya Hospital, Central South University, from January 2008 to October 2021. The best cut-off value of preoperative AGR was determined according to the receiver operator characteristic curve. The Kaplan-Meier curve was used to analyze the effect of preoperative AGR on the overall survival (OS) and relapse-free survival (RFS) of patients. Cox proportional hazards model was used to analyze prognostic factors including preoperative AGR.</p><p><strong>Results: </strong>The best cut-off value of preoperative AGR in urachal carcinoma patients is 1.45. Low preoperative AGR is significantly associated with worse OS and RFS. Univariate analysis and multivariate analysis indicated that low preoperative AGR is an independent and reliable factor to predict poor prognosis, OS, and RFS in urachal carcinoma patients.</p><p><strong>Conclusion: </strong>Urachal carcinoma patients with low preoperative AGR have worse prognosis, and preoperative AGR is a valuable prognostic indicator for urachal carcinoma research.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"8-17"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354723","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}
Yuanshan Guo, Caipeng Qin, Chao Li, Xin Xu, Heran Cao, Lei Guo, Jin Zhang, Shen Li, Tao Xu
{"title":"Comparison of Eliminating Artificial Hydronephrosis and Creating Artificial Hydronephrosis in Percutaneous Nephrolithotomy in Oblique Supine Position.","authors":"Yuanshan Guo, Caipeng Qin, Chao Li, Xin Xu, Heran Cao, Lei Guo, Jin Zhang, Shen Li, Tao Xu","doi":"10.1159/000541407","DOIUrl":"10.1159/000541407","url":null,"abstract":"<p><strong>Introduction: </strong>The safety and effectiveness of percutaneous nephroscopic surgery without artificial hydronephrosis remain controversial, and there are few relevant studies. This retrospective study aimed to compare the efficacy of two different methods of eliminating and creating artificial hydronephrosis in percutaneous nephrolithotomy (PCNL) in the oblique supine position.</p><p><strong>Methods: </strong>This is a retrospective study. A total of 162 patients who underwent PCNL in an oblique supine position at our hospital were divided into two groups according to the surgical method: the free artificial hydronephrosis group (group A) and the artificial hydronephrosis group (group B). Group A was directly treated with PCNL under ultrasound guidance, and group B was treated with artificial hydronephrosis before PCNL. Several outcomes were measured, including procedure time, stone clearance rate, and incidence of complications.</p><p><strong>Results: </strong>The procedure time in group A lower than that in group B, and the incidence of sepsis was significantly lower in group A than in group B (p < 0.05). There was no statistical difference in stone clearance rate, success rate of primary establishment of puncture channel, unilateral change in perioperative red blood cell count, change in perioperative renal function, and perioperative complications (except sepsis) between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>For experienced physicians, PCNL without artificial hydronephrosis in an oblique supine position can be attempted to reduce the number of surgical steps without affecting the stone clearance rate and increasing the occurrence of complications.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"112-119"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296561","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}
Baozhu Yi, Xiaowei Xu, Zhendong Lin, Youhua He, Shuaibin Wang
{"title":"Optimizing Antibiotic Treatment for Urinary Tract Infections Secondary to Escherichia coli in Elderly Diabetic Patients: Considering Age and Blood Glucose Control.","authors":"Baozhu Yi, Xiaowei Xu, Zhendong Lin, Youhua He, Shuaibin Wang","doi":"10.1159/000541435","DOIUrl":"10.1159/000541435","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine the susceptibility profile of Escherichia coli in urinary tract infections (UTIs) among elderly diabetic patients to support judicious and evidence-based antibiotic use.</p><p><strong>Methods: </strong>From January 2021 to December 2022, urine culture results were analyzed to determine the distribution of pathogens, especially E. coli, and their drug susceptibility.</p><p><strong>Results: </strong>E. coli infection was the most prevalent infection in elderly diabetic patients with UTIs, accounting for 32.6% of cases. Moreover, this bacterium's multiple resistance rate (38.3%) was significantly higher than other bacteria's multiple resistance rate (χ2 = 81.644, p < 0.05). Compared to older diabetic patients with optimal glucose control (HbA1c ≤7.0%), patients with poor glycemic control (HbA1c >7.0%) had lower resistance rates to lactams, and urine pH values were higher (p < 0.05).</p><p><strong>Conclusion: </strong>The most common cause of UTIs is E. coli, with advanced age and diabetes being the main risk factors. To optimize UTI treatment safety and efficacy, antibiotics should be administered based on the patient's age and blood glucose control.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"103-111"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296563","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 (>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 (<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":"120-127"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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}
Ozan Dogan, Pinar Kadirogullari, Duygu Ucar Kartal, Murat Yassa
{"title":"Urge Symptoms after Vaginal Uterosacral Plication in Urinary Incontinence Patients without Proximal Urethral Mobility: A Prospective Study.","authors":"Ozan Dogan, Pinar Kadirogullari, Duygu Ucar Kartal, Murat Yassa","doi":"10.1159/000541225","DOIUrl":"10.1159/000541225","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of this study was to evaluate the impact of vaginal uterosacral plication on urge symptoms and quality of life in a cohort of patients with uterosacral ligament insufficiency and urge symptoms.</p><p><strong>Methods: </strong>A total of 40 female patients were included in the study, and their posterior fornix was supported with gauze to simulate the surgical procedure. Uterosacral plication was applied to patients who experienced a decrease in urinary incontinence, nocturia, a sense of urgency, and a decrease in urge urinary incontinence symptoms or complete recovery. Images of the bladder, bladder neck, urethra, and symphysis pubis were obtained preoperatively and 1 year postoperatively. POP-Q staging was also performed, and patients completed the Overactive Bladder Evaluation Form (OAB-V8) and the Incontinence Impact Questionnaire Short Form (ICIQ-SF).</p><p><strong>Results: </strong>Results from the OAB-V8 questionnaire showed that postoperative nocturia scores improved by 72.1% compared to preoperative scores, and the need to urinate at night and waking up scores improved by 68.3%. The mean bladder neck thickness and the mean detrusor thickness were significantly decreased from 10 to 9.2 (p < 0.0001) and from 8.7 to 6.4 (p < 0.0001), respectively. The ICIQ-SF questionnaire scores showed a 68.4% improvement in urinary incontinence affecting daily life after the operation.</p><p><strong>Conclusion: </strong>This study adds to the clinical evidence that uterosacral ligament support improves symptoms of overactive bladder syndromes, including urgency and nocturia. The use of pelvic floor ultrasound and the apical tamponade test is important in patient selection for the correct indication.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"74-80"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296564","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}
Guillermo Lendínez-Cano, Carmen Belén Congregado Ruíz, Miguel Ángel Gómez Luque, Rafael Antonio Medina López
{"title":"Description of Baseline Quality of Life in Patients Diagnosed with Metastatic Renal Cell Carcinoma.","authors":"Guillermo Lendínez-Cano, Carmen Belén Congregado Ruíz, Miguel Ángel Gómez Luque, Rafael Antonio Medina López","doi":"10.1159/000540970","DOIUrl":"10.1159/000540970","url":null,"abstract":"<p><strong>Introduction: </strong>Renal cancer (RC) is not typically symptomatic until it reaches a considerable size and an advanced stage [World J Oncol. 2020;11(3):79-87]. The 5-year survival rate for metastatic renal cancer (mRC) is estimated at 13% [CA Cancer J Clin. 2021;71(1):7-33]. Health-related quality of life (HRQoL), obtained as patient-reported outcomes (PRO), reflects the patient's subjective perception of the disease and treatment impact on their normal activity and well-being [Lancet Oncol. 2016;17(11):e510-4]. Measuring HRQoL can facilitate doctor-patient communication, aid in decision-making, and improve clinical outcomes [Eur Urol Focus. 2020;6(1):26-30]. We will analyse the baseline quality of life of patients diagnosed with mRC, who are candidates for systemic treatment, in our setting, as measured by responses to the NCCN-FKSI 19 questionnaire.</p><p><strong>Methods: </strong>We analysed 78 consecutive patients diagnosed and treated for mRC from September 2012 to September 2019. We described the baseline questionnaire responses of our patients before initiating systemic treatment and analysed their responses.</p><p><strong>Results: </strong>Over 60% of the patients reported some degree of lack of energy or fatigue, 60.8% were very or extremely worried about their disease worsening, and 47.9% had some issues related to rest. Additionally, 26.8% of the patients were not at all satisfied with their quality of life at that time.</p><p><strong>Conclusions: </strong>Patients diagnosed with mRC exhibit deterioration in their quality of life, mostly showing asthenia and concern about their disease. The quality of life of \"real-life patients\" seems to be worse than that of those included in clinical trials.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"18-25"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141226","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}