Urologia Journal最新文献

{"title":"Efficacy of the Rezūm System for lower urinary tract symptoms in patients with benign prostatic hyperplasia: Long term results from a single centre prospective study.","authors":"Angelo Totaro, Filippo Gavi, Daniele Fettucciari, Francesco Pio Bizzarri, Domenico Sanesi, Luigi Cosenza, Filippo Marino, Antonio Cretì, Pierluigi Russo, Emilio Sacco","doi":"10.1177/03915603241297137","DOIUrl":"10.1177/03915603241297137","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic hyperplasia (BPH) is a prevalent urological condition leading to lower urinary tract symptoms. Minimal invasive surgical treatment (MISTs) such as Rezūm System are emerging aiming to relieve symptoms. We present results from a single centre prospective study.</p><p><strong>Methods: </strong>We prospectively followed patients undergoing Rezūm between 2021 and 2023 from a single centre. International Prostate Symptom Score (IPSS), functional outcomes (maximum urinary flow rate (Qmax) and post-void urinary residual (PVR) and International Index of Erectile Function-5 (IIEF-5) were assessed at 3, 6, 12 and 24 months. Anterograde ejaculation was assessed at 12 months follow up. Linear mixed-effects models (LMMs) for repeated measures were applied to assess differences in the IPSS, maximum flow rate (Qmax), PVR, and International Index of Erectile Function-5 (IIEF-5) from baseline (t0) to 3, 6, 12 and 24 months. Results: After adjusting for prostate volume and symptoms severity, significant differences were observed at 3, 6, 12 and 24 months for IPSS (<i>p</i> < 0.001), Qmax (<i>p</i> < 0.001), PVR (<i>p</i> < 0.001) and IPSS-QoL (<i>p</i> < 0.001) from baseline. No statistically significant changes were found in the IIEF-5 scores at 3, 6, 12 and 24 months from baseline. Anterograde ejaculation remained in 98% of patients after treatment.</p><p><strong>Conclusions: </strong>In conclusion, the study's findings indicate that patients undergoing Rezūm treatment experience sustained improvements in IPSS, Qmax, PVR and IPSS-related quality of life up to 24 months following the intervention. Anterograde ejaculation remained in 98% of patients after treatment.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"141-147"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606646","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":"Epithelioid (Histiocytoid) hemangioma of the testis: A case report and literature review of a rare benign tumor.","authors":"Filippo Marino, Giuseppe Lorusso, Carlo Gandi, Mauro Ragonese, Francesco Pierconti, Emilio Sacco","doi":"10.1177/03915603241292838","DOIUrl":"10.1177/03915603241292838","url":null,"abstract":"<p><p>Testicular hemangioma is a rare benign vascular neoplasm originating from the inner layer of the tunica albuginea, predominantly affecting the pediatric population and often associated with hemangiomas in other organs. Histopathologically can be categorized into four types, including capillary, cavernous, papillary endothelial hyperplasia, and epithelioid (histiocytoid). We report a case of a 24-year-old presenting with left inguinal pain, diagnosed with an epithelioid (histiocytoid) hemangioma of the testis. Diagnostic evaluation included scrotal doppler ultrasonography, which revealed a small, hypoechoic formation with evident vascularization. Serum tumor markers were within normal limits. Surgical excision via testis-sparing surgery (TSS) was performed based on frozen section analysis. A literature review underscores the rarity of testicular histiocytoid hemangiomas. Advancements in diagnostic technique have improved the accuracy of diagnosis and allowed for more conservative surgical approaches, preserving fertility and minimizing long-term adverse effects. In conclusion, while testicular hemangiomas may present characteristic features on ultrasound, frozen section examination remains crucial in guiding surgical decision-making. TSS offers significant advantages over traditional excisional surgery, including reduced morbidity and preservation of cancer control, making it an essential option in the management of testicular hemangiomas, particularly in young patients concerned about fertility preservation.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"169-173"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547812","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":"Exploring retroperitoneal fibrosis: Insights, challenges, and treatment approaches.","authors":"Anass Mehedra, Youssef Maachi, Mouftah Babty, Amine Slaoui, Tarik Karmouni, Khalid Elkhader, Abdellatif Koutani, Ahmed Andaloussi Ibenattya","doi":"10.1177/03915603241270453","DOIUrl":"10.1177/03915603241270453","url":null,"abstract":"<p><p>Retroperitoneal fibrosis (RPF) is a rare fibro-inflammatory condition characterized by abnormal tissue growth around the abdominal aorta and iliac arteries, usually encasing adjacent structures like the ureters. Its etiology remains most of the time idiopathic, but secondary causes, including malignancies and medication use, account for a minority of cases. This review aims to consolidate recent advancements in understanding RPF, focusing on its pathophysiology, diagnosis, and treatment. Literature search was conducted using databases like PubMed, with emphasis on recent publications. Biomarkers such as elevated CRP levels and imaging techniques like CT scans and MRI play pivotal roles in diagnosis and monitoring. Medical management primarily revolves around corticosteroids, with adjunctive therapies like tamoxifen and immunosuppressants showing promise. Surgical intervention, typically ureterolysis, becomes necessary in cases of urinary tract obstruction. This review studies the importance of a comprehensive approach to RPF management, integrating medical and surgical modalities for optimal patient outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"14-20"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296603","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":"Randomised controlled trial comparing safety and efficacy of Urolift to monopolar TURP.","authors":"Mostafa Sheba, Farouk El Gamal, Mohamed Abd El Wahed, Sameh Kotb, Alaa Meshref, Hussien Aly Hussein, Amr Mostafa Zahran","doi":"10.1177/03915603241277905","DOIUrl":"10.1177/03915603241277905","url":null,"abstract":"<p><strong>Objectives: </strong>Benign Prostatic Hyperplasia (BPH) is the most common cause of the Lower Urinary Tract Symptoms (LUTS) in ageing men. TURP is still the gold-standard procedure for the treatment of LUTS-BPH, however new minimally invasive modalities like Urolift procedure has been introduced.</p><p><strong>Methods: </strong>Patients with prostate size up to 100 g were offered both treatment modalities. Hundred patients were included in the study, 100 in TURP group (group A) and 100 in Urolift group (group B). International Prostate Symptom Score (IPSS) was used at initial contact and for evaluation of response to treatment. Group A underwent TURP under regional anaesthetic, while group B underwent Urolift under sedation.</p><p><strong>Results: </strong>The mean age in both groups was 66.4 years. The IPSS score improvement among both groups is attached in the diagram. Group B patients had less hospital stay, better erectile and ejaculatory function compared to group B, and no stress incontinence was detected in group B while 6.7% of the patients in group A suffered some stress incontinence.</p><p><strong>Conclusion: </strong>Urolift has the benefit of preserving the ejaculatory function and less complications. Nevertheless, it has size limitations and the IPSS score improvement is less satisfactory when compared to TURP.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"59-64"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296606","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":"Sheathless RIRS in the era of slim and single use flexible ureteroscopy (ssFURS): Prospective analysis of clinical outcome.","authors":"Faris Abushamma, Rola Abu Alwafa, Sa'ed H Zyoud","doi":"10.1177/03915603241282734","DOIUrl":"10.1177/03915603241282734","url":null,"abstract":"<p><strong>Introducation: </strong>the purpose is to assess the feasibility of sheathless and time-limited retrograde intrarenal surgery (RIRS) using slim and single use flexible ureteroscopy (ssFURS) in view of the stone-free rate (SFR), complication rate and upfront ureteral stenting.</p><p><strong>Methods: </strong>A prospective, cross-sectional study of patients who underwent RIRS for kidney stones between December 2021 and December 2023 at our tertiary urology center was performed. Patient demographics, clinical presentations and stone characteristics were calculated. The SFR and complication rate were included.</p><p><strong>Results: </strong>Hundred and eighteen patients were included. The median age was 48 (35.7-60.0) years. Diabetes mellitus (DM) was present in 32 patients (27.1%). The median length of the kidney stones was 1.15 (range [0.4-3.0]), and the median width was 1 (range [0.05-3.7]). The pelvi-ureteric junction (PUJ) represented 75 (63.6%) patients. The lower pole stone (LP) consisted of 27 (22.9%) patients. Thirty-seven (31.4%) of the patients had multiple kidney stones. An overall complete SFR after the first session was observed for 94 (79.7%) patients. The second session of complete SFR was observed in 15 patients (12.7%). A median stone length of 1 (0.8-1.5) cm and a median stone width of 0.95 (0.7-1.3) cm were both significantly associated with a complete SFR after the first session (<i>p</i> < 0.001). A single kidney stone in 69 (73.4%) patients was significantly more strongly associated with a complete SFR after the first session than was multiple kidney stones in 25 (26.6%) patients (<i>p</i> = 0.027). Upfront stenting was performed in 74 patients (62.7%). The complete SFR after the first session was significantly greater in patients who underwent upfront stenting (65; 69.1%) than in those who underwent primary ssFURS (29; 30.9%, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Sheathless and time-limited RIRS using ssFURS is a feasible and successful procedure with low complication rate.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"81-88"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354787","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":"Much ado about nothing? Assessing the actual benefits of proton beam therapy for prostate cancer.","authors":"Mario Terlizzi, Alberto Bossi","doi":"10.1177/03915603241283296","DOIUrl":"10.1177/03915603241283296","url":null,"abstract":"<p><p>We are discussing and commenting on the paper by Yu et al. titled \"Updated Analysis of Comparative Toxicity of Proton and Photon Radiation for Prostate Cancer,\" published in the <i>Journal of Clinical Oncology</i> in June 2024.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"65-66"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475998","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":"Epididymal sonographic findings in infertile males with isolated asthenozoospermia and their correlation with seminal plasma l-carnitine: An observational study.","authors":"Ahmed Mahmoud ElShibany, Emad Abd El Raheem Taha, Dalia Tarek Kamal, Sameh Fayek GamalEl Din, Yasser Mohamed Abo El Yamen, Hosam A Hasan, Abdel Rahman Bakry","doi":"10.1177/03915603241273886","DOIUrl":"10.1177/03915603241273886","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to show epididymal sonographic findings in infertile males with isolated asthenozoospermia as well as their correlation with seminal plasma l-carnitine.</p><p><strong>Methods: </strong>Eighty married men were recruited in the study. Fifty infertile men with isolated asthenozoospermia and 30 fertile controls with normal semen parameters were included. Semen analysis was done with estimation of seminal plasma l-carnitine level. Scrotal ultrasonography was used as the diagnostic method for assessing epididymal morphology.</p><p><strong>Results: </strong>Epididymal heterogeneous echogenicity was significantly higher in the infertile group compared to the controls. Whereas homogeneous epididymal echotexture and seminal plasma l-carnitine levels were significantly higher in the controls compared to the infertile patients. Interestingly, it was observed that within each group, seminal l-carnitine and sperm total motility were significantly higher in those with homogeneous rather than heterogeneous epididymal echotexture.</p><p><strong>Conclusions: </strong>Our study demonstrated a significant association between epididymal echo-texture, seminal plasma l-carnitine and sperm motility. Thus, we recommend performing epididymal sonographic evaluation as one of the basic investigations for infertile men.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"126-133"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296602","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":"Current role of focal therapy in prostate cancer.","authors":"Sara Tamburini, Lorenzo Bianchi, Pietro Piazza, Angelo Mottaran, Amelio Ercolino, Valeria Rotaru, Valerio Pirelli, Massimiliano Presutti, Matteo Droghetti, Riccardo Schiavina, Eugenio Brunocilla","doi":"10.1177/03915603241258713","DOIUrl":"10.1177/03915603241258713","url":null,"abstract":"<p><strong>Background: </strong>Thanks to the improved accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) to detect and localize the dominant index lesion on prostate cancer (PCa), the concept of minimally invasive focal treatments (FT) has gained popularity. Nevertheless, although high-quality evidence that FT has favorable functional outcomes, definitive proof of its oncological effectiveness compared to standard treatments remains underreported.</p><p><strong>Objective: </strong>This study aims to explore the efficacy, safety, oncologic and functional outcomes of different type of FT for PCa.</p><p><strong>Evidence acquisition: </strong>A non-systematic literature review was conducted by searching on PubMed \"prostate cancer\" AND \"focal treatment\" OR \"HIFU\" OR \"irreversible electroporation\" OR \"cryoablation\" OR \"focal laser ablation.\" Overall, 22 articles published in English literature from 2018 to 2023 describing FT techniques for PCa were included.</p><p><strong>Evidence synthesis: </strong>Related to the field ablated, focal therapies include hemiablation (half gland), focal ablation (zonal-base) or targeted therapy (lesion-based). FT modalities can be categorized in thermal and non-thermal energy: thermal energy techniques include high-intensity focused ultrasound (HIFU), cryotherapy, radiofrequency ablation (RFA), and focal laser ablation (FLA). Focal brachytherapy, irreversible electroporation (IRE), and vascular-targeted photodynamic therapy (VTP) are classified as non-thermal ablation. Each focal ablative treatments could be promising alternative to conventional radical therapies to treat PCa in term of mid-term oncologic and functional outcomes, however, limited data are available in comparison with standardized radical treatments. HIFU and Cryo are the most studied techniques and seem to be superior to radical treatments in term of functional outcomes despite associated with higher recurrence and retreatment rate.</p><p><strong>Conclusions: </strong>Current evidences of oncologic and functional outcomes of FT are based mainly on retrospective, non-comparative and single center studies. Thus, none of the focal therapies available should be considered safe alternative to standardized treatments in routine practice and should be offered only for well selected PCa patients with low or at least favorable-intermediate risk disease, unfit for radical options.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"67-74"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629229","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":"The prognostic value of cystography-measured bladder capacity on very early continence rates after radical prostatectomy.","authors":"Stankovic Mladen, Schumacher Bastian","doi":"10.1177/03915603241293839","DOIUrl":"10.1177/03915603241293839","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the utility and reliability of cost-effective cystography-measured bladder capacity as a prognostic tool for predicting very early continence recovery following radical prostatectomy. Additionally, the study aims to discuss the clinical implications of the findings, including their potential impact on patient management, postoperative rehabilitation strategies, and the development of personalized care pathways for prostate cancer patients.</p><p><strong>Methods: </strong>In this prospective monocentric study, we analyzed 223 patients who underwent either robot assisted radical prostatectomy (RARP) or open radical prostatectomy (ORP) between January 2022 and January 2024. Postoperative cystography was routinely performed 5 days after robot-assisted radical prostatectomy and 7 days after open radical prostatectomy. Very early continence rates were determined using a standardized pad-test conducted on the first day following catheter removal. The bladder capacity during cystography was measured and documented for every patient. The correlation between the rate of continence recovery and the bladder capacity was then assessed. To determine other predictive factors for recovery of continence, several parameters were analyzed using multivariate logistic regression analysis, including age, prostate volume, nerve-sparing technique and surgical procedure.</p><p><strong>Results: </strong>Urinary continence rates at day 1 after catheter removal were 73.5% for patients who underwent RARP and 72.6% for patients who underwent ORP. A strong prognostic value of cystography-measured bladder capacity on very early continence rates was reported (<i>p</i> < 0.001), with a cut-off value calculated to be 140 ml of bladder capacity. After adjusting for additional variables such as age, surgical procedure, prostate volume and nerve-sparing technique, multivariate linear model analysis still found a strong correlation between cystography-measured bladder capacity and very early continence rates (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The cystography-measured bladder capacity may be a good predictor of the recovery of post-prostatectomy urinary continence.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"148-153"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629253","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":"En-bloc resection of non-muscle invasive urinary bladder tumors using low power Holmium laser-A new promise.","authors":"Sunirmal Choudhury, Shahbaaz Ahmed, Surajit Sasmal, Prakhar Patel","doi":"10.1177/03915603241277914","DOIUrl":"10.1177/03915603241277914","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary bladder tumors are one of the most common urological malignancies. Traditionally, it has been initially managed with conventional trans-urethral resection of urinary bladder tumors (cTURBT) which has certain drawbacks and complications. Efforts have been made to find newer methods for management. In this study, we have used low power Holmium laser en-bloc resection and have assessed its safety, efficacy and feasibility.</p><p><strong>Materials and methods: </strong>Forty patients have been included in this prospective observational study who underwent low power Holmium laser en-bloc resection of urinary bladder tumor after taking Institutional ethical committee clearance and informed consent from all the patients. Intra-operative and post-operative data were collected.</p><p><strong>Results: </strong>The average tumor size was 21.68 ± 9.55 mm. Out of those, 65% of the patients had a tumor less than 3 cm in size. Fourteen patients (35%) had tumors at multiple sites. The average duration of resection per tumor was 24.84 ± 6.83 min. None of the cases required conversion to cTURBT. There was no obturator reflex or urinary bladder perforation in any of the cases. Detrusor muscle was present in the histopathology reports of 92.5% patients. The average duration of catheterization was 1.82 ± 0.61 days.</p><p><strong>Conclusion: </strong>For NMIBC's, low power Holmium laser en-bloc resection is a safe procedure with minimum risk of complications. High rate of detrusor-positive specimens indicates its efficacy and feasibility.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"39-43"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126826","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}