Urology Annals最新文献

{"title":"Trend for hypospadias repair among surgeons in Saudi Arabia: Insights and recommendations","authors":"Ehab Mahmoud Ahmed","doi":"10.4103/ua.ua_145_22","DOIUrl":"https://doi.org/10.4103/ua.ua_145_22","url":null,"abstract":"Abstract Background: Currently, there are many techniques available for repairing hypospadias in urogenital reconstructive surgery. Aim: The purpose of this survey is to determine the preferred age of hypospadias repair patients, as well as the preferred surgical techniques among Saudi urologic and pediatric surgeons. Materials and Methods: An E-mail questionnaire was sent to urologic and pediatric surgeons throughout Saudi Arabia. Results: Forty-six participants from the Saudi regions returned completed questionnaires. Sixty-five percent of participants preferred age to do surgery on 6–18 months. While, 50% preferred meatal advancement and glanduloplasty techniques for coronal/glandular hypospadias, and 46% participate that tubularized incised plate (TIP). It was found that 86% of the participants admitted to using TIP procedure for subcoronal/distal penile hypospadias, whereas the majority of them (63%) used TIP for midpenile/proximal hypospadias with significant value P < 0.05. Ninety-eight percentage of surgeons stated that they prefer performing the chordee repair simultaneously. As a final note, 91% of participants have been omitted preoperative androgen in their protocols. Conclusions and Recommendation: We concluded from the surgeons’ preferences regarding hypospadias repair in this study, that their preferences are highly successful rate and have few complications; however, we highly recommend using this study as a basis for future studies.","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135104174","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":"Xanthogranulomatous pyelonephritis: Case series - Clinical, radiologic, therapeutic, and histological aspects.","authors":"João Sakuray Pais,&nbsp;Mirelle Barbosa Rocha,&nbsp;Valdair Francisco Muglia,&nbsp;Fernando Chahud,&nbsp;Carlos Augusto Fernandes Molina,&nbsp;Heitor Ramos Ruellas,&nbsp;Silvio Junior Tucci","doi":"10.4103/ua.ua_180_21","DOIUrl":"https://doi.org/10.4103/ua.ua_180_21","url":null,"abstract":"<p><strong>Purpose: </strong>Xanthogranulomatous pyelonephritis (XGP) is a chronic and severe infection of the kidney. We aimed to review the main clinical, imaging, and histological findings and to assess predictors of surgical complications or hospitalization >10 days (no deaths reported).</p><p><strong>Materials and methods: </strong>We retrospectively searched all patients with XGP treated at our institution from 2005 to 2019, with 57 patients enrolled. Clinical data were retrieved by a single reader, computed tomographic (CT) examinations by two radiologists, and histopathological specimens by an experienced pathologist.</p><p><strong>Results: </strong>The patients' mean age was 44.3 ± 16.2 years and 41 (71.9%) were female. The most common symptoms were flank/lumbar pain (89.5%), fever (43.9%), and recurrent urinary tract infection (43.9%). The mean time until the presumptive diagnosis was 365.1 days and the median hospitalization period was 11 days. Blood tests showed anemia (78.9%), leukocytosis (43.6%) with left shift (21.6%). Urinalysis showed hematuria (75.6%), bacteriuria (40.9%), and leukocytes (93.2%). Urine cultures showed <i>Escherichia coli</i> in 14.8%, <i>Proteus mirabilis</i> in 7.4%, while 59.3% were negative. Of 40 patients with CT examinations, 38 (95%) presented with hydronephrosis and perinephric inflammatory changes (PIC) and 22 (55%) with Bear Paw sign. PIC was the only independent predictor at multivariate analysis for surgical complications. For prolonged hospitalization, fever and PIC were independent predictors at univariate, but only fever at multivariate analysis.</p><p><strong>Conclusions: </strong>XGP is a worrisome condition, with unclear pathophysiological mechanisms. Fever and PIC at CT examinations were predictors of poor outcomes.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"383-388"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/e1/UA-14-383.PMC9731190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel obstruction incidence in urinary diversion patients: A meta-analysis study.","authors":"Gerhard Reinaldi Situmorang,&nbsp;Gampo Alam Irdam,&nbsp;Aaron Abdullah","doi":"10.4103/ua.ua_32_21","DOIUrl":"https://doi.org/10.4103/ua.ua_32_21","url":null,"abstract":"<p><strong>Background: </strong>Bowel obstruction is a common complication that occurs in patient who underwent urinary diversion with an incidence of 0.7%-11%. Although previous studies have published risk factors, prevention and management of postoperative paralytic ileus, and data on urinary postdiversion bowel obstruction in the literature are still scarce and thus require further investigation of the diversion technique which allegedly has differences in pathogenesis, management, and results. To that end, this study conducted a systematic review study to compare two different diversion techniques, namely ileal conduit and continent diversion, especially orthotopic neobladder.</p><p><strong>Methods: </strong>This study is a systematic review by searching study in online databases such as PubMed, EBSCOhost, and ProQuest. Inclusion criteria included are full-text articles, English language, and articles of the past 10 years. After searching, we analyzed quantitatively using the RevMan application for meta-analysis.</p><p><strong>Results: </strong>From 3403 studies, we got 12 studies that were included in the analysis. In a study conducted from the study of van Hemelrijck <i>et al</i>. stated that intestinal obstruction has an incidence of 50.73-1000, the third-highest when compared with advanced complications such as death (145.07/1000 population) and urinary tract infections (127.03/1000 population). It was found that odds ratio was 0.64 (0.45-0.91).</p><p><strong>Conclusion: </strong>The ileal conduit and orthotopic neobladder methods have no significant difference in the incidence of intestinal obstruction.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"359-364"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/b2/UA-14-359.PMC9731191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is percutaneous nephrolithotomy safe in chronic kidney disease patients!!!","authors":"Pramod Adiga,&nbsp;Sanjay Ramachandra Pudakalkatti,&nbsp;V Shivakumar,&nbsp;Mayank Jain,&nbsp;R Navaneeth Sreenidhi,&nbsp;C S Manohar,&nbsp;Sreenivas Jayaram,&nbsp;M Nagabhushan,&nbsp;Ramaiah Keshavamurthy","doi":"10.4103/ua.ua_100_21","DOIUrl":"https://doi.org/10.4103/ua.ua_100_21","url":null,"abstract":"<p><strong>Introduction: </strong>Management of renal calculus in a patient of chronic kidney disease (CKD) is always challenging. Treatment options include extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy (PCNL). With PCNL being gold standard for renal calculus ≥1.5 cm in normal kidneys, we aimed to analyze the safety and efficacy of PCNL in CKD patients with calculus ≥1.5 cm.</p><p><strong>Materials and methods: </strong>Sixty patients of CKD with renal calculus were included in the study: Group A with glomerular filtration rate (GFR) ≤30 ml/min/m² and Group B with GFR >30 <60 ml/min/m². The estimated GFR (eGFR) pre-PCNL, peak eGFR on follow-up, and eGFR at last follow-up, stone free rates, and complications were recorded. The CKD stage before and after PCNL were also compared at the last follow-up.</p><p><strong>Results: </strong>The mean age of patients was 52 years. A mean of 1.14sittings per renal unit was required for PCNL. Complete clearance was 94% after all auxiliary procedures. The mean prePCNL eGFR was 26.5 ± 4.01 and 43.6 ± 9l. 14 ml/min/1.73 m² in Groups A and B, respectively. The mean post-PCNL eGFR was 32 ± 9.94 and 51 ± 8.85 ml/minute/1.73 m2, respectively, in Groups A and B. At a mean follow-up of 180 days, deterioration with the migration of CKD stage was seen in 13 patients (21.6%) out of which 10 patients were of Groups A and 3 in Group B. Six patients (10%) required maintenance hemodialysis. Postoperative bleeding complication requiring blood transfusions was seen in 12 (20%) and 3 (5%) required intensive care unit care postoperatively. No mortality was observed in our study.</p><p><strong>Conclusion: </strong>PCNL is an effective management strategy for renal calculus in patients with CKD with an acceptable stone clearance rates and manageable complications. Peak eGFR <30 ml/min/m2 and postprocedure complications predict deterioration and need for RRT.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"317-321"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/b6/UA-14-317.PMC9731184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10698998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of air pyelogram and contrast pyelogram for initial puncture access and to see its efficacy during percutaneous nephrolithotomy.","authors":"Amit Kumar Sharma, Shweta Sharma, Samir Swain, Gourab Goel, Ajit Gujela, Datteswar Hota, Biswajit Mohapatra, Bhoopendra Sharma","doi":"10.4103/ua.ua_80_21","DOIUrl":"10.4103/ua.ua_80_21","url":null,"abstract":"<p><strong>Objective: </strong>The current investigation was aimed to compare the safety, efficacy, adverse effects, and outcome of air pyelogram versus contrast pyelogram for percutaneous nephrolithotomy.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study conducted from August 2018 to November 2020, which included 400 patients with a clinical diagnosis of renal calculus and randomly (1:1) assigned into Group I (air pyelogram) and Group II (contrast pyelogram). Air was injected in Group I and diatrizoate meglumine 76% was used in Group II for PCS identification. In the case of difficulty in visualization in either group, a mixture of contrast and air was used. The following parameters were assessed: duration of access, total duration of radiation exposure during access, total attempts needed to puncture the desired calyx, failure rate, complications, and outcomes.</p><p><strong>Results: </strong>Both the groups were comparable including renal calculus characteristics. The mean (standard deviation) duration of access was 3.08 (1.21) and 5.23 (1.02) min (<i>P</i> < 0.0001) in Groups I and II, respectively; in 85% and 57.5% of patients (<i>P</i> < 0.0001), respectively, the caliceal puncture was done in a single attempt. The duration of radiation exposure was more in Group II (<i>P</i> < 0.0001). The failure rate (22%) was higher and statistically significant in Group II. The stone clearance rate was not statistically significant between the groups (<i>P</i> = 0.380). No patient had hypoxia, cardiopulmonary complications, and air embolism in perioperative period.</p><p><strong>Conclusion: </strong>Air contrast is effective and safe, and it reduces the duration of caliceal puncture and radiation exposure with lower failure rate. If both air and contrast fail, a combination of both may be effective.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"340-344"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/d8/UA-14-340.PMC9731196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of antimicrobial resistance in patients with complicated urinary tract infection: Suggested empirical therapy and lessons learned from a retrospective observational study in Oman.","authors":"Yousuf Al Mamari,&nbsp;Hiba Sami,&nbsp;Khurram Siddiqui,&nbsp;Hashim Ba Tahir,&nbsp;Zaaima Al Jabri,&nbsp;Zakariya Al Muharrmi,&nbsp;Syed Gauhar A Rizvi,&nbsp;Meher Rizvi","doi":"10.4103/ua.ua_67_22","DOIUrl":"https://doi.org/10.4103/ua.ua_67_22","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Complicated urinary tract infection (cUTI) is defined as an infection associated with structural, functional, or metabolic abnormalities of the genitourinary tract. These infections are caused frequently by multidrug-resistant Gram-negative bacilli. The rapid emergence of extended-spectrum beta-lactamase (ESBL), AmpC, and carbapenemase (CR) producers has made the treatment of such infections increasingly more challenging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The aims of the present study were threefold: to assess the clinical profile, trends in etiology, and antimicrobial susceptibility profile in cUTI over the past 10 years at a tertiary care center in Oman as an interrupted time series on the one hand and to develop guidelines for empirical management of such cases on the other.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a retrospective analysis of cUTI in patients presenting at Sultan Qaboos University Hospital over 3 years (2008, 2013, and 2018) covering a span of 10 years. Data were obtained from the patient's electronic records in the hospital information system. Analysis was done using the Statistical Package for Social Sciences program (SPSS), version 23.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 650 cases of cUTI, 284 (44%) were males and 366 (56%) were females, with dysuria being the most common symptom (34%). The biggest risk factor for developing cUTI was diabetes (35%). The predominant pathogen was &lt;i&gt;Escherichia coli&lt;/i&gt; (53%), followed by &lt;i&gt;Klebsiella&lt;/i&gt; spp. (16%), &lt;i&gt;Enterococcus faecalis&lt;/i&gt; (7%), &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; (7%), &lt;i&gt;Candida&lt;/i&gt; spp. (2%), and &lt;i&gt;Enterobacter cloacae&lt;/i&gt; (2%). Over the years, &lt;i&gt;E. coli&lt;/i&gt; emerged as the predominant ESBL and AmpC producer, &lt;i&gt;Acinetobacter baumannii&lt;/i&gt; as the multidrug-resistant bug, and &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; as the major carbapenem-resistant Enterobacterales (CRE) producer. Nitrofurantoin emerged as the most effective drug for cystitis. Aminoglycosides, piperacillin-tazobactam, and carbapenems demonstrated the highest activity with an overall resistance of less than 10%. Higher resistance (30%) was observed against cephalosporins, fluoroquinolones, and trimethoprim/sulfamethoxazole. Analysis of the 10-year trend threw up some unexpected results. As expected, resistance increased from 2008 to 2013. Surprisingly, however, antimicrobial resistance in 2018 was lower against majority of the antimicrobials compared to 2013.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There is a paucity of data for developing evidence-based guidelines management of cUTI. Targeted antibiograms and not cumulative antibiograms are essential for promoting appropriate prescribing and optimizing patient care. The welcome decline in resistance may be attributed cascade reporting, introduction of more ID physicians. Another possibility is increased utilization of fluoroquinolones which spared the other groups of antimicrobials. Judicious heterogeneous mixing o","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"345-352"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/e8/UA-14-345.PMC9731183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic surgery in pediatric urology.","authors":"Mohamad Waseem Salkini","doi":"10.4103/ua.ua_36_22","DOIUrl":"https://doi.org/10.4103/ua.ua_36_22","url":null,"abstract":"<p><p>Robotic surgery revolutionized minimally invasive surgery. Urology is the widest surgical field in implementing robotic technology. Pediatric urology followed the footsteps of adult urology in utilizing da Vinci™ surgical system for urinary tract reconstruction. Indeed, day after day robotics is gaining more applications and popularity in pediatric urology due to the need for less invasive approach to reconstruct the urinary tract in pediatric population. In this manuscript, we reviewed in this article the steps of evolution of robotic pediatric urology.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"314-316"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/64/UA-14-314.PMC9731187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10330892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the accessibility and content of urology residency websites.","authors":"Alexander P Nocera,&nbsp;Hunter S Boudreau,&nbsp;Carter J Boyd,&nbsp;Kimberly D Martin,&nbsp;Soroush Rais-Bahrami","doi":"10.4103/ua.ua_45_21","DOIUrl":"https://doi.org/10.4103/ua.ua_45_21","url":null,"abstract":"<p><strong>Introduction: </strong>Students applying for urology residency often have limited resources for obtaining information on prospective programs. Applicants commonly rely on institutional websites to compare program elements. The information on these websites can attract or deter applicants and can have a major impact on application costs, rank lists, and career goals. The objective of this study was to determine the accessibility and content of urology residency program websites.</p><p><strong>Materials and methods: </strong>A list of accredited urology residency programs was obtained from the American Urological Association residency directory in 2020. A total of 141 program websites were evaluated for the presence of 53 criteria, which were categorized into five groups: Personnel information, applicant information, program information, training/research, and resident benefits. Residencies lacking an available website or functional links were excluded from the study.</p><p><strong>Results: </strong>Of the 53 criteria analyzed, only 24 were featured on more than 50% of the websites. Less than 10% of the programs had available information regarding resident contact information (5.67%), alumni contact information (2.84%), frequently asked questions (9.22%), electives (9.93%), night float (5.67%), and board pass rates (5.67%). The three factors most commonly available included program description (100%), coordinator contact information (88.65%), and clinical sites (87.94%). None of the 141 programs had all 53 criteria available on their website.</p><p><strong>Conclusions: </strong>The majority of current urology residency websites may lack the accessibility and content necessary for candidates to make application decisions for desired programs. Residency programs should consider revising their websites to enhance resident recruitment and facilitate applicants' decision-making process.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"322-327"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/56/UA-14-322.PMC9731186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent diameter and stent-related symptoms, does size matter? A systematic review and meta-analysis.","authors":"Syed Ali Ehsanullah,&nbsp;Angus Bruce,&nbsp;Charlotte Juman,&nbsp;Anil Krishan,&nbsp;Alisha Krishan,&nbsp;Jake Higginbottom,&nbsp;Shehab Khashaba,&nbsp;Ziad Alnaib","doi":"10.4103/ua.ua_158_21","DOIUrl":"https://doi.org/10.4103/ua.ua_158_21","url":null,"abstract":"<p><p>The ureteral insertion of a silicone tube was first performed in 1967. A validated ureteral stent symptom questionnaire (USSQ) is used for an objective assessment of patient-reported stent-related symptoms. As the impact of stent diameter on the incidence of stent-related symptoms is unclear, we aimed to perform a systematic review and meta-analysis comparing USSQ reported outcomes when using a 6 Fr diameter ureteric stent, versus smaller diameter stents (4.7-5 Fr) when inserted for ureteric stones. All randomized control trials and comparative studies of 6 Fr versus 4.7-5 Fr ureteric stents were reviewed. The USSQ outcomes were considered as the primary outcome measures while stent migration was considered as a secondary outcome measure. A total of 61 articles were identified of which four studies met the eligibility criteria. There was a statistically significant association between the use of wider (6 Fr) diameter stents and the incidence of urinary symptoms as measured by the urinary index score. Larger stent diameters were associated with a statistically significant increase in the pain index score. There was no statistically significant difference in the scores between the compared stent diameters with regard to work performance score, general health index score, additional problems index score, and stent migration. There were insufficient reported outcomes to perform a meta-analysis of sexual matters index score. Our meta-analysis shows that using smaller diameter ureteric stents is associated with reduced urinary symptoms and patient-reported pain. Other USSQ parameter outcomes are statistically similar in the 6 Fr ureteric stent cohort versus the 4.7-5 Fr ureteric stent cohort. Our meta-analysis was limited due to the limited number of studies and gross heterogeneity of reporting parameters in various studies. We hope a large-scale homogeneous randomized control trial will further shed more insight into the stent symptoms response to stent diameter.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"295-302"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/70/UA-14-295.PMC9731185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant transformation of testicular teratoma to primitive neuroectodermal tumor.","authors":"Daniyah Elagi,&nbsp;Rodney Young,&nbsp;Abdulmajeed Dayili","doi":"10.4103/ua.ua_162_21","DOIUrl":"https://doi.org/10.4103/ua.ua_162_21","url":null,"abstract":"<p><p>Teratoma is a common germ cell tumor that affects young adult males. A small number of testicular teratomas have the potential for malignant transformation along endodermal, ectodermal, or mesodermal lines. The metastatic mixed germ cell tumor we reported consists of the primitive neuroectodermal tumor (PNET) with mature teratoma. PNET is a highly aggressive tumor with a poor prognosis given its poor response to standard platinum-based chemotherapy. The primary treatment for PNET is surgical resection. Malignant transformation of teratoma to PNET is a rare phenomenon. Only a few cases of malignant transformation of teratomas to PNET are reported in the literature. Here, we present a rare case of PNET arising in a malignant mixed germ cell tumor in a 23-year-old male who underwent adjuvant adriamycin, cyclophosphamide (VAC) alternating with ifosfamide and etoposide (IE) chemotherapy and retroperitoneal lymph node dissection.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"14 4","pages":"403-406"},"PeriodicalIF":0.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/17/UA-14-403.PMC9731200.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}