Urologia Journal最新文献

{"title":"Potential value of Prostate Cancer Antigen 3 score in prediction of final cancer pathology parameters in radical prostatectomy patients.","authors":"Mohammad Soleimani, Navid Masoumi, Ali Jouzi, Mohammad Mehdi Darzi","doi":"10.1177/03915603241303637","DOIUrl":"10.1177/03915603241303637","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the potential capability of preoperative urinary Prostate Cancer Antigen 3 (PCA3) in predicting adverse pathologic features in patients with any- risk prostate cancer undergoing open retro-pubic radical prostatectomy.</p><p><strong>Methods: </strong>Sixty-one biopsy-proven, clinically localized prostate cancer patients who underwent open radical prostatectomy were included in a prospectively designed cohort to evaluate the association of PCA3 score with various Adverse Pathologic Features (APF). The Area Under the Curve (AUC) of the Receiver Operating Characteristics (ROC) curve was used to quantify the predictive accuracy of PCA3 and a cut-off point was calculated to determine the predictability potential of PCA3 in foretelling the study parameters.</p><p><strong>Results: </strong>Patients with APFs (e.g. extra-capsular extension, higher tumor volume, etc.) had a higher mean level of PCA3 compared to patients without these features, with statistically significant differences. PCA3 was a significant predictor of any APFs except perineural invasion in our study cohort.</p><p><strong>Conclusion: </strong>Increasing PCA3 level was associated with any APFs except perineural invasion in our study, which comprised mostly of intermediate and high-risk prostate cancer patients. Therefore, PCA3 could be used as an adjunctive measure in selecting patients for definitive treatments.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"259-266"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of hemoglobin, albumin, lymphocyte and platelet (HALP) score with testicular tumor aggressiveness and prognosis.","authors":"Ozgur Ekici, Ugur Akgun, Erkan Buyukdemirci, Sinan Avci, Volkan Caglayan, Abdullah Erdogan, Efe Onen, Ridvan Ozcan, Sedat Oner","doi":"10.1177/03915603241292199","DOIUrl":"10.1177/03915603241292199","url":null,"abstract":"<p><strong>Background: </strong>The hemoglobin, albumin, lymphocyte and platelet (HALP) score integrates readily available blood markers that reflect systemic inflammation, nutritional status, and immune response, all of which can influence cancer progression. This study investigated the association between the HALP score and clinicopathological characteristics in patients with testicular tumor.</p><p><strong>Methods: </strong>Data of patients who underwent radical orchiectomy for testicular tumors between January 2020 and January 2024 were reviewed. Preoperative serum tumor markers, hemogram parameters and albumin levels were recorded. Tumor stages were recorded from postoperative radiological imaging and serum tumor markers. The association between postoperative results and HALP score was analyzed.</p><p><strong>Results: </strong>A total of 74 male patients were included in the study. The mean age of the patients was 30.27 ± 6.42 years. The mean HALP score in the patient group with metastasis and retroperitoneal lypmh node invasion (RPLNI) was statistically significantly lower than the patients without metastasis and RPLNI. HALP score decreased statistically significantly with increasing tumor T stage, N stage and M stage. In addition, the mean HALP score values of patients who received chemotherapy, developed progression and mortality were statistically significantly lower than those of patients who did not.</p><p><strong>Conclusions: </strong>Lower HALP scores are significantly associated with advanced disease and poorer prognosis in patients with testicular tumor. The HALP score, composed of routinely measured blood markers, may serve as a convenient and cost-effective prognostic tool to identify patients at higher risk and guide personalized management strategies.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"317-323"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pyelonephritis in adults. Should we adopt the pediatric guidelines?","authors":"Binyamin B Neeman, Ilan Kafka, Ariel Mamber, Ala Eldin Natsheh, Dmitry Koulikov, Jawdat Jaber, Boris Chertin","doi":"10.1177/03915603241309426","DOIUrl":"10.1177/03915603241309426","url":null,"abstract":"<p><strong>Purpose: </strong>There are no guidelines, what recommend pro or against cystography for identification of VUR for adults who suffer from first episode of pyelonephritis. The aim of this study was to look at incidence of VUR in adults with first episode of pyelonephritis, and to highlight recommendations for possible reflux investigation in these patients.</p><p><strong>Methods: </strong>We have performed retrospective review of all patients who admitted at our department over the last decade with the working diagnosis of acute pyelonephritis. Following discharge from the department, individuals with no pre-existing urological history were advised to undergo a VCUG or CEVUS.</p><p><strong>Results: </strong>We have identified 76 patients (62 females and 14 males) with an average age of 31.73 years who were hospitalized in our departments between 2006 and 2022. Forty-eight (63%) presented with right pyelonephritis, 26(34%) with left, and 2(3%) had bilateral disease. Of those, 23(30%) patients returned for clinical follow-up after completion of VCUG/CEVUS. Reflux was demonstrated in 14(60%) patients comprising 18 renal refluxing units (RRU). Six had grade IV reflux, 4 grade III, 4 grade II, and 4 grade I respectively. DMSA demonstrated 27.2 ± 11.9% relative function of the reflux kidney. Of those VUR patients, 9(64%) underwent endoscopic correction, 1(7%) refused surgery, and 4(29%) are under clinical follow-up.</p><p><strong>Conclusions: </strong>Our data demonstrate high incidence of VUR in adult patients with acute pyelonephritis patients, therefore VUR investigation at least should be considered in adult patients even after first episode of pyelonephritis, especially in cases where there is evidence of nephronia, abscess, kidney scars, atrophic kidney, or hydronephrosis.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"312-316"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging strategies in tackling antimicrobial resistance in urology: Narrative review and expert opinion.","authors":"Tommaso Ceccato, Simone Botti, Carlo Tascini, Massimiliano Lanzafame, Anna Brugnolli, Lorenzo Ruggera, Orietta Massidda, Vito Racanelli, Truls E Bjerklund Johansen, Tommaso Cai","doi":"10.1177/03915603241310389","DOIUrl":"10.1177/03915603241310389","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are highly prevalent and frequently treated with antibiotics, making antimicrobial stewardship (AMS) crucial in this field to benefit both individual patients and society. This narrative review examines recent advancements in managing urinary tract infections, focusing on AMS and antimicrobial resistance (AMR). AMS is essential in urology, where antibiotics are frequently prescribed for UTI. AMS promotes optimal antibiotic use to improve patient outcomes, control AMR, and safeguard public health. Key AMS practices in urology include selecting antibiotics at the appropriate dose and duration, especially for uncomplicated UTIs, asymptomatic bacteriuria, and catheter-associated infections. Following evidence-based guidelines, such as those from EAU and the IDSA, helps prioritize narrow-spectrum antibiotics and discourage empirical broad-spectrum use. Regular audits and feedback on antibiotic use help align practices with AMS goals, reducing inappropriate prescriptions. Multidisciplinary AMS teams, including urologists, microbiologists, and pharmacists, enhance treatment precision and antibiotic optimization in complex cases. Reassessing antibiotic therapy based on culture results after 48-72 h enables clinicians to refine treatment, minimizing unnecessary broad-spectrum use and strengthening AMS efforts in urology. In conclusion, addressing AMR in urology requires a careful approach that combines evidence-based antibiotic use, attention to local resistance patterns, and patient-specific factors. Non-antibiotic strategies for recurrent UTI prevention, judicious catheter management, and tailored treatment for complex infections are key AMS components. Emerging technologies in diagnostics and precision medicine offer tools for targeted, personalized therapy, enhancing AMS efforts, and helping to reduce reliance on broad-spectrum antibiotics.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":"92 2","pages":"185-193"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective comparative study of open versus laparoscopic stage II Fowler-Stephens orchidopexy in pediatric patients.","authors":"Raashid Hamid, Akshit Sudanshu, Mir Fahiem-Ul-Hassan, Ubayer Nabi, Waseem Jan Shah, Nisar A Bhat, Ajaz A Baba, Gowhar Nazir Mufti, Idrees Bashir, Fayaz Ahmad","doi":"10.1177/03915603241313025","DOIUrl":"10.1177/03915603241313025","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic Fowler Stephens orchidopexy, single stage or two-stage, is now routinely performed in non-palpable testis. We performed second stage orchidopexy as open inguinal approach and compared the outcome of this approach to two-staged laparoscopic orchidopexy.</p><p><strong>Methods: </strong>We performed a prospective randomized interventional study of two different approaches for intra-abdominal testis. In group A, Laparoscopic stage I (SFO) followed by open inguinal orchidopexy was compared for final outcome in group B cases, who underwent laparoscopic staged SF orchidopexy. The average duration between stage I SF and stage II SF was 6 months. All the procedures were done under GA and caudal analgesia. The pre-operative and post-operative USG dimensions were compared in cm and cm³/ml. The procedure outcome was considered successful if testis remained inside scrotum below mid-scrotal point. Any testis above the mid-scrotal point was considered as unacceptable or failure of procedure.</p><p><strong>Results: </strong>This study was performed on 74 children with 84 testis (group 'A' 38 patients (48 testis) and group 'B' 36 patients (46 testes)), with average age was 3.3 ± 0.46 and 3.9 ± 0.58 years, respectively. In group 'A', 38 patients (48 testes) underwent lap SFO I followed by inguinal orchidopexy and in group 'B', 36 patients (46 testes) underwent laparoscopic staged SF O. The mean testicular volume pre-operative in group 'A' & 'B' was 0.28 ± 0.04 and 0.23 ± 0.06 cm², respectively. The mean post-operative testicular volume was 0.34 ± 0.07 and 0.28 ± 0.05 cm², respectively. The average follow-up of the patients in group 'A' & 'B' was 24 ± 3.67 and 20 ± 2.90 months, respectively. Testis was having good volume in 87.5% and 76.60% of these successful cases, respectively. There were (3/48) 6.25% (4/46) 8.69% testicular atrophy cases in group 'A' & 'B', respectively. The differences were not statistically significant (<i>p</i> < 0.05). The mean operative time in group A was 20 ± 8.07 min and group B 30 ± 7.19 min in stage II procedure.</p><p><strong>Conclusion: </strong>The success rate in group A was more than the group B which was statistically significant (<i>p</i> > 0.05). Our study connotes that open stage II orchidopexy is still feasible and practicable with better final outcome of management of non-palpable cases.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"361-365"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile dysfunction in railway station workers: A randomized study of different treatment approaches.","authors":"Arkhipova Anzhelika, Neymark Boris, Neymark Alexandr, Tyshkevich Georgy, Morozov Andrey, Korolev Dmitry, Rapoport Leonid, Spivak Leonid, Momot Andrey","doi":"10.1177/03915603251334076","DOIUrl":"https://doi.org/10.1177/03915603251334076","url":null,"abstract":"<p><strong>Introduction: </strong>The profession of a locomotive engineer involves stress, lack of adequate sleep and rest, and a sedentary lifestyle, all of which can contribute to the development of erectile dysfunction (ErD) as well as arterial hypertension.</p><p><strong>Materials and methods: </strong>Consecutive patients of the railway hospital in Barnaul with arterial hypertension aged 30-60 who work as machinists or assistant locomotive drivers were enrolled. Those who have symptoms of ErD were randomized into three groups: group 1 received an endogenous nitric oxide-synthase (NOS) activator, group 2 received a combination of endogenous NOS activator and phosphodiesterase type 5 inhibitor (PDE-5i), and group 3 received no additional treatment for ErD. 20 individuals belonged to the control group without ErD. A follow-up was conducted after 2 and 4 months.</p><p><strong>Results: </strong>A total of 85 individuals were examined (65 with symptoms of ErD). After 2 months of treatment, no significant changes in biomarkers and LDF (laser Doppler flowmetry) values were observed in groups 1 and 3. In group 2, ET-1 (endothelin-1) and hs-CRP (high-sensitivity C-reactive protein) returned to reference levels, and ischemic manifestations decreased. After 4 months, group 1 had increased mean blood flow and hs-CRP returned to reference levels. Group 2 showed improved microhemodynamics and biomarkers values. Group 2 patients had a higher IIEF and ICF total scores.</p><p><strong>Conclusion: </strong>The combination of hypotensive drugs, PDE-5i, and NOS activator was the most effective method of treatment, improving hemodynamics and reparative properties of the endothelium by removing the substrate for thrombus formation. Treatment with an NO-synthase activator was shown to partially eliminate pathological processes in the endothelium.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251334076"},"PeriodicalIF":0.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the success of intravesical onabotulinum toxin A injection in the treatment of refractory idiopathic overactive bladder.","authors":"Recep Burak Degirmentepe, Mehmet Gokhan Culha, Musab Umeyir Karakanli, Kenan Sabuncu, Emre Can Polat, Caner Baran, Alper Otunctemur","doi":"10.1177/03915603251334081","DOIUrl":"https://doi.org/10.1177/03915603251334081","url":null,"abstract":"<p><strong>Background: </strong>Onabotulinum toxin A injection is recommended for overactive bladder (OAB) resistant to medical treatments. However, success is not universal, and factors influencing outcomes remain unclear. This study evaluates the factors affecting the success of onabotulinum toxin A injection in refractory idiopathic OAB.</p><p><strong>Methods: </strong>Data from patients with resistant idiopathic OAB treated with 100 IU onabotulinum toxin A (BOTOX^®, Allergan, Dublin, Ireland) between January 2019 and August 2023 were analyzed. Demographic data and symptom duration were recorded. Patients were evaluated pre- and post-procedure using the overactive bladder symptom score (OABSS) and 3-day bladder diaries. A ⩾50% improvement in OABSS was considered treatment success. Botox was injected at 20 sites (5 IU per site) via 22 Fr rigid cystoscope under sedoanalgesia.</p><p><strong>Results: </strong>A total of 210 patients (80.5% female, <i>n</i> = 169) with a mean age of 53.76 ± 14.90 years were included. Symptom duration averaged 39.82 ± 22.28 months. Wet OAB was diagnosed in 83.3% (<i>n</i> = 175), while 16.7% (<i>n</i> = 35) had dry OAB. Pre-procedure mean OABSS was 9.18 ± 1.31, daily micturition 8.67 ± 1.52, urge incontinence 2.57 ± 1.28, nocturia 1.87 ± 0.75, and pad use 2.44 ± 1.24/day. Treatment success was achieved in 82.4% (<i>n</i> = 173).</p><p><strong>Conclusion: </strong>The degree of patient complaints, particularly daily micturition frequency, significantly affects treatment success. Patients with higher daily micturition may require advanced interventions beyond Botox.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251334081"},"PeriodicalIF":0.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Z\" Anatomical Needle Cut Leads Ejaculation (ZANCLE): Unilateral incision for bladder neck obstruction with ejaculation-sparing intent: A single-surgeon experience.","authors":"Alessandro Calarco, Pietro Viscuso, Beatrice Filippi, Rosario Leonardi, Guglielmo Mantica, Cosimo Magazzino, Antonio Tufano","doi":"10.1177/03915603251334084","DOIUrl":"https://doi.org/10.1177/03915603251334084","url":null,"abstract":"<p><p>This study aimed to evaluate functional outcomes and anterograde ejaculation rates in patients undergoing monopolar, unilateral transurethral incision of the prostate (TUIP) with \"Z\" shaped incision with ejaculatory sphincter sparing for primary bladder neck obstruction (PBNO) in a case series performed by a single surgeon. Between December 2018 and July 2023, data from patients who underwent monopolar, unilateral TUIP were prospectively collected. Patients with a prostate volume of less than 30 mL were included. Functional outcomes, including maximum flow rate (Qmax, mL/s), post-void residual volume (PVR, mL), International Prostate Symptom Score (IPSS), and IPSS Quality of Life (IPSS QoL) score, were assessed preoperatively and at 1, 6, and 12 months postoperatively. A total of 106 patients met the inclusion criteria, with a median age of 42 years (range: 37-57) and a median prostate volume of 27 mL (range: 20-29). The median hospital stay was 1 day, and the median catheterization time was 3 days. At 1-month follow-up, the mean Qmax increased from 10.2 ± 2.5 mL/s to 22.8 ± 3.9 mL/s, while the mean IPSS score and IPSS QoL score decreased from 16 ± 2.7 to 6.9 ± 1.5 and from 4.3 ± 0.9 to 1.9 ± 1.6, respectively (<i>p</i> < 0.001). The mean PVR volume decreased from 125.5 ± 16.1 mL to 27.7 ± 7.3 mL (<i>p</i> < 0.001). Uroflowmetry results remained statistically significant at 12 months of follow-up (each <i>p</i> < 0.001). Anterograde ejaculation was preserved in all cases. Unilateral monopolar TUIP confirms to be a feasible and safe procedure for the treatment of BNO in young and sexually active patients.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251334084"},"PeriodicalIF":0.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic ureteral reimplantation - Comparison of intravesical versus extravesical techniques in the management of unilateral primary vesicoureteral reflux in children: Does approach matter?","authors":"Anupam Shukla, Kunj B Patel, Himanshu Raj, Priyank Yadav, Mohammed Suleh Ansari","doi":"10.1177/03915603251321984","DOIUrl":"https://doi.org/10.1177/03915603251321984","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Laparoscopic extravesical and intravesical (transvesicoscopic) ureteral reimplantation are widely accepted procedures but there is limited literature on comparison of these techniques. This study compares the efficacy and outcomes of laparoscopic intravesical and extravesical ureteral reimplantation for unilateral primary vesicoureteral reflux (VUR) in children.</p><p><strong>Materials and methods: </strong>We retrospectively analysed the case records of 62 children between ages of 1 and 18 years who underwent laparoscopic unilateral ureteral reimplantation at our institute between January 2019 and January 2023. Patients divided into two groups; those who underwent laparoscopic intravesical ureteric reimplantation were Group A and those who underwent laparoscopic extravesical ureteric reimplantation were Group B. We analysed the blood investigations, pre- and post-operative grade of reflux, operative time, complications, analgesic requirements, and pre- and post-operative nuclear scans. The success of surgery was defined as the resolution of VUR on voiding cystourethrography (VCUG) performed 6 months post operatively.</p><p><strong>Results: </strong>24 patients were in Group A and 38 patients in Group B. The mean age and grades of reflux were comparable in the groups. The difference in operative time was statistically significant (Group A: 131.3 ± 30.4 min and Group B: 96 ± 20.4 min, <i>p</i> = 0.009). The success rate (95.8% vs 94.7%), complication rate (16.7% vs 15.7%), time to discharge (2.6 vs 3.3 days) of both group was comparable. Less analgesics were needed in intravesical group (186 vs 204 mg/kg) though it was not statistically significant (<i>p</i> = 0.22).</p><p><strong>Conclusion: </strong>Laparoscopic ureteric reimplantation by both extravesical and intravesical route is equally safe and effective with similar efficacy, outcome and comparable acceptable complication rate.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251321984"},"PeriodicalIF":0.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of kidney cancer with associated vena cava tumor thrombus: A single-center multidisciplinary experience.","authors":"Vito Lorusso, Franco Palmisano, Valentina Bernasconi, Alessandra De Ponti, Chiara Vaccaro, Monica Contino, Antonio Maria Granata, Giacomo Piero Incarbone, Maria Chiara Sighinolfi, Bernardo Rocco, Andrea Gregori","doi":"10.1177/03915603251331358","DOIUrl":"https://doi.org/10.1177/03915603251331358","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney cancer (KC) with vena cava thrombus (VCT) is a rare but challenging disease. Surgery is associated with significant morbidity and mortality. The aim of our study is to report outcomes of patients with KC and VCT treated at our institution.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed data from 15 patients who underwent surgical treatment for KC with VCT at our institution between January 2004 and December 2022.</p><p><strong>Results: </strong>Median age of patients was 70 years (range: 66-77 years) and 13 (86%) were males. The level of thrombus was infrahepatic in 11 patients (73%), retrohepatic in 1 case (6%), and atrial in 3 patients (20%). Radical nephrectomy with vena cava thrombectomy was performed in all patients. Cardiopulmonary bypass was required in three patients (20%). The median operative time was 4.2 h (range: 4.0-4.6 h) and median estimated blood loss was 675 ml (range: 300-1500 ml). Postoperatively, eight patients (53%) experienced complications, and 5 (62%) were Clavien-Dindo >3. After a median follow-up of 15 months (range: 10-49 months), seven patients (46.5%) were alive without evidence of disease, one was alive with disease, among the remainder 7 (46.5%), 5/7 (72%) patients died of other causes, only 2/7 (28%) died because of cancer.</p><p><strong>Conclusions: </strong>Surgical resection of KC involving VCT represents a challenge for its high rate of complications. Multidisciplinary approach is often needed to achieve radicality safely. Oncological outcomes confirm the aggressiveness of the disease, with only roughly half (46.5%) of patients alive without disease at a median follow-up of 15 months.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251331358"},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}