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Comparison of Monotherapies and Combination Therapy of Tamsulosin and Tadalafil for Treating Lower Urinary Tract Symptoms Caused by Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Meta-Analysis. 比较坦索罗辛和他达拉非的单一疗法和联合疗法治疗良性前列腺增生症引起的下尿路症状(伴有或不伴有勃起功能障碍):一项 Meta 分析。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2023-12-11 DOI: 10.1159/000535606
Jianping Liu, Weijian Zhou, Peng Zhang, Wei Zhang, Congwang Chang, Guanghua Fu
{"title":"Comparison of Monotherapies and Combination Therapy of Tamsulosin and Tadalafil for Treating Lower Urinary Tract Symptoms Caused by Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Meta-Analysis.","authors":"Jianping Liu, Weijian Zhou, Peng Zhang, Wei Zhang, Congwang Chang, Guanghua Fu","doi":"10.1159/000535606","DOIUrl":"10.1159/000535606","url":null,"abstract":"<p><strong>Background: </strong>There is limited research into the efficacy and safety of tadalafil combined with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), with or without erectile dysfunction (ED). Therefore, we aimed to investigate the efficacy and safety of combination therapy compared to that of monotherapy.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, Web of Science, SinoMed, CNKI, WanFang Data Service Platform, and <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link> to identify eligible studies. A total of 639 articles were retrieved, of which 12 were randomized controlled trials (RCTs) published as of February 2023 and included in this meta-analysis.</p><p><strong>Results: </strong>After screening 639 articles, 12 RCTs including 1,531 subjects were considered eligible for the meta-analysis. The results showed that the total International Prostate System Score (total IPSS), maximum flow rate (Qmax), and quality of life (QoL) in tadalafil combined with tamsulosin were significantly better than those in monotherapy. Compared with tadalafil monotherapy, combination therapy mainly improved IPSS voiding. As for postvoid residual urine (PVR), the combination therapy did not improve PVR compared to the tadalafil group, but significantly improved PVR compared to the tamsulosin group. For the International Index of Erectile Function (IIEF), the curative effect of the combined group was better than that of the tamsulosin group but not better than that of the tadalafil group. In terms of safety, the adverse reactions (AEs) in the combined treatment group were significantly higher than those in the monotherapy group. None of the 12 RCTs reported serious adverse events.</p><p><strong>Conclusions: </strong>Tadalafil combined with tamsulosin was more effective in the treatment of male LUTS/BPH, with or without ED, on the improvement of total IPSS, QoL, and Qmax. However, the benefits of combination therapy for ED remain unclear. However, combination therapy seemed to have a higher incidence of adverse reactions.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"89-99"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809320","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}
引用次数: 0
How Might the Number of Lymph Nodes Removed during RARP Impact the Postoperative Outcomes? RARP 期间切除的淋巴结数量会如何影响术后效果?
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI: 10.1159/000536317
Mahmoud Farzat, Florian M Wagenlehner
{"title":"How Might the Number of Lymph Nodes Removed during RARP Impact the Postoperative Outcomes?","authors":"Mahmoud Farzat, Florian M Wagenlehner","doi":"10.1159/000536317","DOIUrl":"10.1159/000536317","url":null,"abstract":"<p><strong>Introduction: </strong>Symptomatic lymphocele remains a relevant complication after pelvic tumor surgery. This study aims to investigate how the number of lymph nodes removed may influence postoperative outcomes and if it increases the probability of detecting lymph node metastasis.</p><p><strong>Methods: </strong>The study included 500 patients who underwent RARP including lymphadenectomy performed by a single surgeon. Patients were divided into two groups: group 1 consisted of 308 patients with 20 or fewer lymph nodes removed (mean 15), while group 2 had 192 patients with over 20 nodes removed (mean 27). Perioperative data were analyzed, and postoperative outcomes were compared between groups.</p><p><strong>Results: </strong>Overall, lymph node metastasis was detected in 17.8% of men. In detail, out of 19.6 lymph nodes removed, an average of 3.14 lymph nodes per patient showed metastasis, with a slightly higher incidence of 19.7% in group 2 compared to 16.5% in group 1, though not statistically significant (p = 0.175). The number of lymph node metastases was significantly higher in group 2 patients (3.47) versus group 1 (2.37) (p = 0.048). All complications except symptomatic lymphoceles (p = 0.004) were not significantly different between groups. Univariate linear regression analysis revealed no correlation between the number of removed lymph nodes and symptomatic lymphocele. However, it did correlate with catheter days and readmissions.</p><p><strong>Conclusion: </strong>A correlation may exist between the number of lymph nodes removed during RARP and an increased incidence of complications, particularly symptomatic lymphocele. A more extensive PLND may result in prolonged catheter days and increased readmissions. With the increased extent of pelvic lymphadenectomy, the probability of detecting lymphogenic metastasis rises. The diagnostic value of PLND is well established. Further randomized trials are needed to weigh its necessity and extent.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"175-182"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693063","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}
引用次数: 0
Real-World Evidence of Tumor and Patient Characteristics and Survival with Avelumab Maintenance after Chemotherapy for Advanced and Metastatic Urothelial Carcinoma. 晚期和转移性尿路上皮癌化疗后维持阿维列单抗治疗的肿瘤和患者特征及生存期的真实证据。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-03-08 DOI: 10.1159/000538237
Séverine Banek, Mike Wenzel, Benedikt Lauer, Quynh Chi Le, Benedikt Hoeh, Florestan Koll, Cristina Cano Garcia, Clara Humke, Jens Köllermann, Felix K H Chun, Marina Kosiba, Luis A Kluth
{"title":"Real-World Evidence of Tumor and Patient Characteristics and Survival with Avelumab Maintenance after Chemotherapy for Advanced and Metastatic Urothelial Carcinoma.","authors":"Séverine Banek, Mike Wenzel, Benedikt Lauer, Quynh Chi Le, Benedikt Hoeh, Florestan Koll, Cristina Cano Garcia, Clara Humke, Jens Köllermann, Felix K H Chun, Marina Kosiba, Luis A Kluth","doi":"10.1159/000538237","DOIUrl":"10.1159/000538237","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the prospective randomized controlled JAVELIN Bladder 100 trial, no real-world evidence exists regarding tumor characteristics, adverse events (AEs), and survival of avelumab maintenance (AVM)-treated patients with partial/complete response or stable disease after previous platinum-based chemotherapy for advanced/metastatic urothelial carcinoma (mUC).</p><p><strong>Methods: </strong>We relied on our institutional database to identify mUC patients who received AVM between January, 2021 and December, 2023. The main outcomes consisted of overall survival (OS) and progression-free survival (PFS) and were computed by Kaplan-Meier estimates. Stratification was performed according to programmed death ligand 1 (PD-L1) status.</p><p><strong>Results: </strong>Overall, 24 AVM patients were identified at a median age of 71 (interquartile range [IQR]: 67-76) years, of which 67% were males. Of these, 63%, 21%, and 17% received AVM therapy for bladder cancer and upper tract urothelial carcinoma or both, respectively. PD-L1 status was positive in 45% of patients. During AVM treatment, AEs were observed in 33% of patients; however, they were limited to ≤2 grade AEs. At a median follow-up of eight (IQR 4-20) months, 71% of patients had progressed under AVM with median PFS of 6.2 months (confidence interval [CI]: 3.2-18.2). Median OS was 13.4 (CI: 6.9 - not reached [NR]) months. One-year OS after AVM was 52%. In PD-L1-positive patients, median PFS and OS were 6.4 (CI: 2.7 - NR) months and 13.4 (CI: 7.7 months - NR), respectively.</p><p><strong>Conclusion: </strong>AVM is associated with moderate AE rates. Despite similarities in baseline characteristics compared to trial-selected JAVELIN Bladder 100 mUC patients, AVM resulted in longer/similar PFS but significantly shorter OS in real-world setting.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"285-291"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050398","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}
引用次数: 0
Adjuvant Chemotherapy after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma with Variant Histology: A Systematic Review and Meta-Analysis of Survival Outcomes. 变异组织学上尿路上皮癌根治性肾切除术后的辅助化疗:生存结果的系统回顾和荟萃分析。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI: 10.1159/000538545
Jinhyung Jeon, Jae Heon Kim, Jee Soo Ha, Won Jae Yang, Kang Su Cho, Do Kyung Kim
{"title":"Adjuvant Chemotherapy after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma with Variant Histology: A Systematic Review and Meta-Analysis of Survival Outcomes.","authors":"Jinhyung Jeon, Jae Heon Kim, Jee Soo Ha, Won Jae Yang, Kang Su Cho, Do Kyung Kim","doi":"10.1159/000538545","DOIUrl":"10.1159/000538545","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to determine effects of adjuvant chemotherapy (AC) on survival outcomes compared to surgery alone without AC for upper tract urothelial carcinoma (UTUC) patients with variant histology (VH).</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies investigating AC for UTUC in Medline, Embase, the Cochrane Library up to January 2023. Population, intervention, comparator, and outcome were UTUC patients with VH, radical nephroureterectomy with AC, radical nephroureterectomy only, and oncological survival, respectively.</p><p><strong>Results: </strong>Four retrospective studies were included. Regarding overall survival (OS), the pooled hazard ratio was 0.61 (95% confidence interval: 0.42-0.87; p = 0.007) across two studies. Regarding cancer-specific survival (CSS), the pooled hazard ratio was 0.46 (95% confidence interval: 0.25-0.84; p = 0.01) across three studies. All included studies had a high quality based on the Newcastle-Ottawa Scale. Certainty of evidence for OS was low. Certainty of evidence for CSS was moderate due to a strong association (hazard ratio &lt;0.5). Publication bias was not significant for any studies.</p><p><strong>Conclusion: </strong>In UTUC patients with VH, administration of AC after surgery might have better survival outcomes than surgery alone. Our study provides evidence for decision-making of clinicians who treat UTUC patients with VH.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"339-348"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294709","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}
引用次数: 0
Estimated Prostate Volume by Semiautomatic Segmentation of MRI Is More Accurately Correlated with Radical Prostatectomy Specimen Weight than the Volume Calculated by Ellipsoid Formula. MRI半自动分割估计的前列腺体积比椭球公式计算的体积更准确地与根治性前列腺切除术标本重量相关。
IF 1.6 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2023-11-23 DOI: 10.1159/000534742
Shulin Wu, Adam S Feldman, Sharron X Lin, Michelle M Kim, Kristine M Cornejo, Mukesh G Harisinghani, Chin-Lee Wu, Douglas M Dahl
{"title":"Estimated Prostate Volume by Semiautomatic Segmentation of MRI Is More Accurately Correlated with Radical Prostatectomy Specimen Weight than the Volume Calculated by Ellipsoid Formula.","authors":"Shulin Wu, Adam S Feldman, Sharron X Lin, Michelle M Kim, Kristine M Cornejo, Mukesh G Harisinghani, Chin-Lee Wu, Douglas M Dahl","doi":"10.1159/000534742","DOIUrl":"10.1159/000534742","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate in vivo prostate volume (PV) estimation is important for obtaining prostate-specific antigen density (PSAD) and further predicting clinically significant prostate cancer (csPCa). We aimed to evaluate the accuracy of multiparametric magnetic resonance imaging (mpMRI)-estimated PV compared to both volume and weight of radical prostatectomy (RP).</p><p><strong>Methods: </strong>We identified 310 PCa patients who underwent RP following combined targeted and systematic biopsy in our institution from September 2019 to February 2021. The MRI PV was determined using a semiautomated segmentation algorithm. RP PV was calculated using the prolate ellipsoid formula (length × width × height × π/6). Formula (prostate weight = [actual weight-3.8 g]/1.05 g/mL) was applied, and the resulting volume was used in further analysis.</p><p><strong>Results: </strong>The median PV from MRI, RP, and RP weight were 39 mL, 38 mL, and 44 mL, respectively. Spearman's rank correlation coefficients (ρ) were 0.841 (MRI PV vs. RP weight), 0.758 (RP PV vs. RP weight), and 0.707 (MRI PV vs. RP PV) (all p &lt; 0.001). Decreased correlation between the MRI PV and RP PV was observed in the larger (more than 55 mL) prostate. The PSAD derived from MRI PV showed most efficient to detect csPCa in RP specimen (57.9% vs. 57.6% vs. 45.4%).</p><p><strong>Conclusion: </strong>MRI PV is correlated better with RP weight than calculated RP PV, especially in larger prostate. The high csPCa detection rate in final pathology suggested that PSAD derived from MRI PV can be confidently used in clinical practice.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"35-41"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300077","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}
引用次数: 0
An Empirical Survey on the Adaption of Neoadjuvant Chemotherapy in Bladder Cancer. 关于膀胱癌新辅助化疗适应性的经验调查。
IF 1.6 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000536321
Moritz J Reike, Alina Reicherz, Karl H Tully, Henning Bahlburg, Moritz Maas, Peter Bach, Niklas Klümper, Markus Eckstein, Arndt Hartmann, Johannes Breyer, Philipp Erben, Christian Bolenz, Joachim Noldus, Sebastian Berg, Florian Roghmann
{"title":"An Empirical Survey on the Adaption of Neoadjuvant Chemotherapy in Bladder Cancer.","authors":"Moritz J Reike, Alina Reicherz, Karl H Tully, Henning Bahlburg, Moritz Maas, Peter Bach, Niklas Klümper, Markus Eckstein, Arndt Hartmann, Johannes Breyer, Philipp Erben, Christian Bolenz, Joachim Noldus, Sebastian Berg, Florian Roghmann","doi":"10.1159/000536321","DOIUrl":"10.1159/000536321","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to determine the adaption of neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC) in Germany, Austria, and Switzerland and especially underlying reasons for potential low adherence to guidelines.</p><p><strong>Methods: </strong>We conducted a non-validated survey among 336 urologic departments in Germany, Austria, and Switzerland. RedCap questionnaires were electronically distributed and included 23 items concerning the general NAC administration standards and guideline compliance in patient counseling regarding the actual treatment.</p><p><strong>Results: </strong>The return rate of the questionnaire was 19.1% (63/336). Although 45 departments (71.4%) claim to perform NAC as the standard of care, only 49% of eligible patients actually receive NAC. An advanced disease stage (≥cT3) and a high tumor volume were mentioned to support the application of NAC, whereas 35% of responders worry about deterioration of patients' preoperative status due to NAC. Furthermore, 26.7% of respondents are concerned about the low extent of survival benefit.</p><p><strong>Conclusion: </strong>Application of NAC in eligible MIBC patients in Germany, Austria, and Switzerland remains low. Although the majority of urologic departments discuss NAC and acknowledge the need for intensified treatment in advanced disease stages, not all eligible patients will actually receive NAC before radical cystectomy.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"183-189"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513751","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}
引用次数: 0
Risk Factors for Bladder Neck Contracture following Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement. 良性前列腺增生患者经尿道前列腺切除术后膀胱颈挛缩的风险因素。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-05-13 DOI: 10.1159/000539296
Shu-Han Chuang, Chew-Teng Kor, Po-Hung Tseng, Chin-Pao Chang, Hung-Jen Shih, Yueh Pan, Sheng-Hsien Huang
{"title":"Risk Factors for Bladder Neck Contracture following Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement.","authors":"Shu-Han Chuang, Chew-Teng Kor, Po-Hung Tseng, Chin-Pao Chang, Hung-Jen Shih, Yueh Pan, Sheng-Hsien Huang","doi":"10.1159/000539296","DOIUrl":"10.1159/000539296","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic enlargement (BPE) and lower urinary tract symptoms present challenges in aging men, often addressed through transurethral resection of the prostate (TURP). Despite technological advancements, bladder neck contracture (BNC) remains a concern. This study explores predictors, including comorbidities, influencing BNC after TURP.</p><p><strong>Methods: </strong>A retrospective cohort study at Changhua Christian Hospital analyzed 2041 BPE patients undergoing bipolar TURP. Preoperative urinary catheterization and resection speed were categorized. Patient data included demographics, comorbidities, operative details, and outcomes. Statistical analyses utilized χ2, Kruskal-Wallis tests, and Cox regression models.</p><p><strong>Results: </strong>Within 3 years, 306 (15%) patients developed BNC. Univariate Cox regression identified chronic heart failure (p = 0.033), chronic obstructive pulmonary disease (COPD; p = 0.002), preoperative urinary catheterization (p &lt; 0.001), and low resection speed (p = 0.045) as significant BNC risk factors. Notably, COPD (p = 0.011) and preoperative urinary catheterization (p &lt; 0.001) emerged as independent risk factors for BNC development in multivariate Cox regression analysis.</p><p><strong>Conclusions: </strong>Preoperative urinary catheterization and COPD were significant predictors of BNC post-TURP, while resection speed showed no significant influence. These findings offer clinicians insights for risk assessment, enhancing patient outcomes, and optimizing resources post-TURP.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"442-448"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917277","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}
引用次数: 0
Perioperative Rates of Incidental Prostate Cancer after Aquablation and Holmium Laser Enucleation of the Prostate. 前列腺水消融术和前列腺钬激光去核术(HoLEP)围术期偶发前列腺癌的发生率。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-05-27 DOI: 10.1159/000539014
Simon Gloger, Laszlo Paulics, Christos Philippou, Stathis Philippou, Joern H Witt, Burkhard Ubrig
{"title":"Perioperative Rates of Incidental Prostate Cancer after Aquablation and Holmium Laser Enucleation of the Prostate.","authors":"Simon Gloger, Laszlo Paulics, Christos Philippou, Stathis Philippou, Joern H Witt, Burkhard Ubrig","doi":"10.1159/000539014","DOIUrl":"10.1159/000539014","url":null,"abstract":"<p><strong>Introduction: </strong>Aquablation and holmium laser enucleation of the prostate (HoLEP) have evolved as established therapeutic options for men with benign prostatic obstruction (BPO). We sought to compare the rates of incidental prostate cancer (iPCa) after aquablation and HoLEP.</p><p><strong>Methods: </strong>At our center, between January 2020 and November 2022, 317 men underwent aquablation, and 979 men underwent HoLEP for BPO. Histopathological assessment of resected tissue was conducted in all cases. If iPCa was detected, the Gleason score and percentage of affected tissue were assessed. Differences in important predictive factors for prostate cancer between study groups were accounted for by additional matched pairs analysis (with matching on age ± 1 year; PSA ± 0.5 ng/mL; and prostate volume ± 5 mL).</p><p><strong>Results: </strong>Histopathology revealed iPCas in 60 patients (4.6%): 59 (6.03%) after HoLEP and 1 (0.3%) after aquablation (p = 0.001). Of 60 of incidental cancers, 11 had a Gleason score ≥7 (aquablation: 1/1 [100%]; HoLEP: 10/59 [16.9%]). The aquablation and HoLEP study groups differed in patient age, preoperative PSA, and prostate volume. Therefore, matched pairs analysis (aquablation: 132 patients; HoLEP: 132 patients) was conducted to improve comparability. Also after the matching procedure, significantly fewer iPCas were diagnosed after aquablation than HoLEP (aquablation: 0 [0%]; HoLEP: 6 [4.5%]; p = 0.015).</p><p><strong>Conclusion: </strong>Significantly fewer iPCas were identified after aquablation than HoLEP procedures. Histopathologic assessment of tissue after aquablation is feasible and may lead to the diagnosis of clinically significant iPCa. Therefore, histopathologic examination of the aquablation resective tissue should not be omitted.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"449-456"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158254","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}
引用次数: 0
The Role of Multiparametric MRI (mpMRI) in the Prediction of Adverse Prostate Cancer Pathology in Radical Prostatectomy Specimen. 多参数磁共振成像(mpMRI)在预测根治性前列腺切除术标本中前列腺癌不良病理结果中的作用。
IF 1.6 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000536256
Andreas Riedel, Marlene Michael, Jenny Grünberg, Sherif Mehralivand, Katharina Böehm, Jakob Hachtel, Ivan Platzek, Ulrich Sommer, Martin Baunacke, Christian Thomas, Angelika Borkowetz
{"title":"The Role of Multiparametric MRI (mpMRI) in the Prediction of Adverse Prostate Cancer Pathology in Radical Prostatectomy Specimen.","authors":"Andreas Riedel, Marlene Michael, Jenny Grünberg, Sherif Mehralivand, Katharina Böehm, Jakob Hachtel, Ivan Platzek, Ulrich Sommer, Martin Baunacke, Christian Thomas, Angelika Borkowetz","doi":"10.1159/000536256","DOIUrl":"10.1159/000536256","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer (PCa) risk stratification is essential in guiding therapeutic decision. Multiparametric magnetic resonance tomography (mpMRI) holds promise in the prediction of adverse pathologies (AP) after prostatectomy (RP). This study aims to identify clinical and imaging markers in the prediction of adverse pathology.</p><p><strong>Methods: </strong>Patients with PCa, diagnosed by targeted biopsy after mpMRI and undergoing RP, were included. The predictive accuracy of mpMRI for extraprostatic extension (ECE), seminal vesicle infiltration (SVI), and lymph node positivity was calculated from the final histopathology.</p><p><strong>Results: </strong>846 patients were involved. Independent risk parameters include imaging findings such as ECE (OR 3.12), SVI (OR 2.55), and PI-RADS scoring (4: OR 2.01 and 5: OR 4.34). mpMRI parameters such as ECE, SVI, and lymph node metastases showed a high prognostic accuracy (73.28% vs. 95.35% vs. 93.38%) with moderate sensitivity compared to the final histopathology. The ROC analysis of our combined scoring system (D'Amico classification, PSA density, and MRI risk factors) improves the prediction of adverse pathology (AUC: 0.73 vs. 0.69).</p><p><strong>Conclusion: </strong>Our study supports the use of mpMRI for comprehensive pretreatment risk assessment in PCa. Due to the high accuracy of factors like ECE, SVI, and PI-RADS scoring, utilizing mpMRI data enabled accurate prediction of unfavorable pathology after RP.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"146-152"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511129","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}
引用次数: 0
Analysis of Postoperative Urinary Incontinence and Influencing Factors of Transurethral Holmium Laser Enucleation of the Prostate. 经尿道前列腺钬激光去核术后尿失禁及影响因素分析。
IF 1.5 4区 医学
Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-05-14 DOI: 10.1159/000539201
Hui-Ning Huang, Yi-Hai Sun, Xin Liu, Wei-Qi Tao
{"title":"Analysis of Postoperative Urinary Incontinence and Influencing Factors of Transurethral Holmium Laser Enucleation of the Prostate.","authors":"Hui-Ning Huang, Yi-Hai Sun, Xin Liu, Wei-Qi Tao","doi":"10.1159/000539201","DOIUrl":"10.1159/000539201","url":null,"abstract":"<p><strong>Introduction: </strong>Aims of the study were to investigate the related factors of urinary incontinence after transurethral holmium laser enucleation of the prostate (HoLEP) and to provide guidance for clinical urinary control of HoLEP.</p><p><strong>Methods: </strong>The clinical data of 548 patients who underwent HoLEP were retrospectively analyzed. The patients were followed up for the occurrence of urinary incontinence in the short term (2 weeks), medium term (3 months), and long term (6 months) after HoLEP.</p><p><strong>Results: </strong>Among the 548 benign prostatic hyperplasia patients, 79 cases (14.42%) had urinary incontinence at 2 weeks, 19 cases (3.47%) at 3 months, and 2 cases (0.36%) at 6 months after surgery. Logistic regression analysis showed that age, prostate volume, diabetes mellitus, operation time, prostate tissue weight, and histological prostatitis were risk factors for recent urinary incontinence (p &lt; 0.05). Age, diabetes, and operation time were risk factors for mid-term urinary incontinence (p &lt; 0.05). The incidence of long-term urinary incontinence was low and no risk factor analysis was performed.</p><p><strong>Conclusions: </strong>For good urinary control after HoLEP, in addition to surgery-related factors such as surgical skills, proficiency, and precise anatomy, patients' risk factors should also be paid attention to in order to improve postoperative urinary control more effectively and reduce the incidence of urinary incontinence.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"457-463"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922678","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}
引用次数: 0
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