Urologia Internationalis最新文献

{"title":"The Impact of Diabetes and Antidiabetics on the Obesity Paradox in Renal Cell Cancer.","authors":"Moustafa Elleisy, Heike Zettl, Desiree Louise Dräger, Oliver W Hakenberg","doi":"10.1159/000543072","DOIUrl":"10.1159/000543072","url":null,"abstract":"","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"311-312"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839730","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":"Erratum.","authors":"","doi":"10.1159/000544959","DOIUrl":"10.1159/000544959","url":null,"abstract":"","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"313-314"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803535","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":"213-220"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140584/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}

{"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":"175-181"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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":"Urinary Leakage after Robot-Assisted Radical Prostatectomy: Is Always Predictive of Functional Results?","authors":"Nicolò Fiorello, Alessandro Zucchi, Francesco Gregori, Gregorio Romei, Salvatore Fiorenzo, Andrea Di Benedetto, Riccardo Bossa, Andrea Mogorovich, Daniele Summonti, Sandro Benvenuti, Antonio Luigi Pastore, Carlo Alberto Sepich","doi":"10.1159/000541409","DOIUrl":"10.1159/000541409","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate if and when the presence of radiological urinary leakages of vesico-urethral anastomosis, after robotic radical prostatectomy, could provoke urethral strictures or affect continence recovery.</p><p><strong>Methods: </strong>We enrolled 216 patients, undergoing robot-assisted radical prostatectomy between January 2020 and December 2022 in three high-volume referenced centres for robotic surgery. Before removal of the bladder catheter, all patients underwent a cystourethrography in which the presence/absence of leakage was assessed at level of vesico-urethral anastomosis. Based on degree of severity of urinary leakage on cystourethrography, patients were classified as no leakage or grade 0, grade 1 with transversal diameter ≤1 cm, and grade 2 with transversal diameter ≥1 cm. At follow-up, urethral stenosis formation and urinary continence recovery were assessed; furthermore, post-operative 12-month functional outcome was determined using EORTC-QLQ-PR25 questionnaire.</p><p><strong>Results: </strong>Radiological urinary leakage was found in 30 patients with grade 1 and 33 patients with grade 2, for a total of 63 patients. Only 1 patient (1.5%), grade 2 urinary leakage, developed significant urethral stricture and required endoscopic urethrotomy after 6 months. Analysing the differences in those who removed the bladder catheter after 7-9 days and those who kept it longer, we found no statistically significant differences regarding recovery of continence (p = 0.23) or about urinary symptoms (p = 0.94).</p><p><strong>Conclusions: </strong>RARP remains gold-standard approach for treatment of localized prostate cancer and the superiority of this technique is safe in preventing urethral strictures and continence recovery, even in presence of significant anastomotic urinary leakage.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"68-73"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296565","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":"Application Value of Ureteral Stents in Adjunctive Treatment for Renal Tuberculosis.","authors":"Yeqiang Wang, Sida Hao, Pengju Liu, Guofeng Cai, Yong Qin","doi":"10.1159/000542780","DOIUrl":"10.1159/000542780","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to assess and enhance the application value of ureteral stents in the adjunctive treatment of renal tuberculosis, thus providing a robust evidence-based framework for guiding clinical management strategies.</p><p><strong>Methods: </strong>A total of 360 patients diagnosed with renal tuberculosis between January 2019 and December 2023 were meticulously selected for this study. Utilizing a random number table, the patients were stratified into a control group and a study group, with 180 patients in each cohort. The control group received standard antituberculosis treatment, while the study group underwent adjunctive treatment with ureteral stents. A comparative analysis was conducted to evaluate the differential clinical efficacy, renal excision rate, renal function, degree of renal pelvis separation, and renal parenchymal thickness between the two groups.</p><p><strong>Results: </strong>The study group showed significantly better clinical cure rates and effectiveness compared to the control group. While the 12-month renal excision rate was similar between groups, the 18-month rate was significantly lower in the study group. The study group also had lower posttreatment BUN and serum creatinine levels, reduced renal pelvis separation, and greater renal parenchymal thickness. At 3 and 9 months, complications were significantly fewer in the study group (p < 0.001, p < 0.05), with no severe complications reported. Additionally, the study group had higher overall SF-36 scores (p < 0.001), indicating better quality of life. The treatment success rate (87.2% vs. 70.6%, p < 0.001), renal function preservation (76.7% vs. 60.6%, p = 0.001), and lower recurrence rate (16.1% vs. 26.1%, p = 0.028) further highlighted the benefits of ureteral stenting.</p><p><strong>Conclusion: </strong>The adjunctive use of ureteral stents in the treatment of renal tuberculosis presents a significantly enhanced application value. It not only improves clinical efficacy but also diminishes the need for renal excision, effectively preserves renal function, reduces the degree of renal pelvis separation, and maintains optimal renal parenchymal thickness. Thus, advocating for the widespread implementation of ureteral stents as an adjunctive therapeutic modality for managing renal tuberculosis is strongly recommended.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"260-269"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740683","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":"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":"206-210"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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":"Prediction of Clinically Significant Prostate Cancer Using Multiparametric MRI, Biparametric MRI, and Clinical Parameters.","authors":"Maximilian Oberneder, Thomas Henzler, Martin Kriegmair, Tibor Vag, Matthias Roethke, Sabine Siegert, Roland Lang, Julia Lenk, Joshua Gawlitza","doi":"10.1159/000541152","DOIUrl":"10.1159/000541152","url":null,"abstract":"<p><strong>Introduction: </strong>Multiparametric MRI (mpMRI) is gold standard for the primary diagnostic work-up of clinically significant prostate cancer (csPCa). The aim of this study was to assess the benefit of the perfusion sequence and the non-inferiority of an MRI without contrast administration (bpMRI) compared to mpMRI while taking clinical parameters into account.</p><p><strong>Methods: </strong>In this retrospective, non-interventional study we examined MRI data from 355 biopsy-naïve patients, performed on a 3T MRI system, evaluated by a board-certified radiologist with over 10 years of experience with subsequent mpMRI-TRUS fusion biopsy.</p><p><strong>Discussion: </strong>Only 16/355 (4.5%) patients benefited from dynamic contrast enhanced. In only 3/355 (0.8%) patients, csPCa would have been missed in bpMRI. BpMRI provided sensitivity and specificity (81.4%; 79.4%) comparable to mpMRI (75.2%; 81.8%). Additionally, bpMRI and mpMRI were independent predictors for the presence of csPCa, individually (OR: 15.36; p < 0.001 vs. 12.15; p = 0.006) and after accounting for established influencing factors (OR: 12.81; p < 0.001 vs. 6.50; p = 0.012). When clinical parameters were considered, a more balanced diagnostic performance between sensitivity and specificity was found for mpMRI and bpMRI. Overall, PSA density showed the highest diagnostic performance (area under the curve = 0.81) for the detection of csPCa.</p><p><strong>Conclusion: </strong>The premise of the study was confirmed. Therefore, bpMRI should be adopted as soon as existing limitations have been lifted by prospective multi-reader studies.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"26-33"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112351","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":"197-205"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","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}