Urology Annals最新文献

{"title":"A rare presentation of medullary thyroid cancer metastasis to the prostate in a patient with multiple endocrine neoplasia 2B syndrome treated with laparoscopic radical prostatectomy.","authors":"Theodoros Spinos,&nbsp;Dimitrios Ermidis,&nbsp;Christos Zabaftis,&nbsp;Filippos Nikitakis,&nbsp;Nikolaos Grivas,&nbsp;Markos Karavitakis","doi":"10.4103/ua.ua_157_22","DOIUrl":"10.4103/ua.ua_157_22","url":null,"abstract":"<p><p>Multiple endocrine neoplasia (MEN) syndromes are rare and potentially malignant hereditary entities. Clinical manifestations of MEN 2B include medullary thyroid cancer, pheochromocytoma, gastrointestinal ganglioneuromatosis, and musculoskeletal and ophthalmologic lesions. Metastases to the prostate from the cancers of other organs are extremely rare. There are only a few cases of metastases to the prostate gland, originating from medullary thyroid cancer, found in literature, especially associated with MEN 2B syndrome. In this case report, we present the extremely rare case of a 28-year-old patient, diagnosed with MEN 2B syndrome, with medullary thyroid cancer metastasis to the prostate. Although a few reports of medullary thyroid cancer metastasis into the prostate gland can be found in the literature, to our knowledge, this is the first case of a laparoscopic radical prostatectomy procedure performed as a metastasectomy to treat the prostatic metastasis. Laparoscopic radical prostatectomy, performed as a metastasectomy, for the treatment of metastatic cancer, is an extremely rare surgical indication with distinctive requirements and difficulties. The extraperitoneal access enables the realization of the laparoscopic radical prostatectomy procedure even in the cases of patients with a history of multiple intra-abdominal operations.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"245-248"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/e4/UA-15-245.PMC10252784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992966","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":"Renal BCGosis managed conservatively with antituberculous medications.","authors":"Amr Elmekresh,&nbsp;Yazan Al Shaikh,&nbsp;Rafe Alhayek,&nbsp;Yaser Saeedi","doi":"10.4103/ua.ua_117_22","DOIUrl":"10.4103/ua.ua_117_22","url":null,"abstract":"<p><p>Intravesical <i>Bacillus</i> Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer rarely leads to the development of granulomatous renal masses (renal BCGosis). The management includes nephroureterectomy, antitubercular therapy (ATT), or both. Here, we present a case of a 62-year-old male who was treated with ATT alone for renal masses. Six months after intravesical BCG therapy for transitional cell carcinoma, he developed high-grade fever and night sweat and had multiple renal parenchymal hypodensities on computed tomography (CT) scan. Repeat CT scan 6 months after ATT revealed full resolution of renal hypodensities. This case report highlights the importance of follow-up for early detection of adverse effects of BCG treatment.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"232-234"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/35/UA-15-232.PMC10252775.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975899","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":"Treatment of a hemorrhage secondary to nephrostomy tube placement for derivation of monstrous hydronephrosis in upper tract urothelial carcinoma.","authors":"Iacopo Meneghetti,&nbsp;Francesco Paolo Tarantino,&nbsp;Luca Mosillo,&nbsp;Chiara Catalano","doi":"10.4103/ua.ua_23_23","DOIUrl":"10.4103/ua.ua_23_23","url":null,"abstract":"<p><p>A 85-year-old female patient underwent nephrostomy tube insertion for a huge hydronephrosis due to a papillary mass involving the right ureteral ostium diagnosed by at computed tomography scan. As soon as the nephrostomy tube was inserted, a pulsatile bleeding was found and a renal angiography was done. A massive bleeding from the main and unique right renal artery was found such as to require prompt endovascular embolization. A transurethral resection of the bladder was performed and the pathology report confirmed high-grade pTa transitional cell carcinoma. An open drainage was then placed to empty the contents of the pyelocalyceal system of the kidney. Once obtained the volumetric reduction of the abdominal mass the patient underwent the right nephroureterectomy.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"238-241"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/d9/UA-15-238.PMC10252770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975904","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":"The safety and efficacy of ultrasound versus fluoroscopic percutaneous nephrostomy: A prospective randomized study.","authors":"Ahmed M Moeen,&nbsp;Mostafa Kamel,&nbsp;Mahmoud Khalil,&nbsp;Fathy G Elanany,&nbsp;Mohamed Abdel Basir Sayed,&nbsp;Hosny M Behnsawy","doi":"10.4103/ua.ua_57_22","DOIUrl":"10.4103/ua.ua_57_22","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to compare the outcome of percutaneous nephrostomy by ultrasound (US) versus fluoroscopy including access time, volume of anesthesia required, success rate, and complications.</p><p><strong>Methods: </strong>One hundred patients were enrolled in a prospective randomized study. Patients were divided into two groups, 50 cases each. Comparing the two groups was done regarding the need for dye, radiation effect, time taken, trial number, rate of complication, volume of anesthesia, and success rate.</p><p><strong>Results: </strong>Patient demographics were comparable between both groups with no statistically significant difference. According to the modified Clavien-Dindo classification, the complications were Grade I (pain and mild hematuria) in each group. Procedural pain was present in 41 (82%) patients in Group I and in 48 (96%) patients in Group II. It was treated in both groups with a simple analgesic. Mild hematuria was present in 5 (10%) patients in the US group and 13 (26%) in the fluoroscopic group and treated by hemostatic drugs only. There was a statistically significant difference between both groups regarding the volume of required local anesthesia, the trial numbers, the puncture numbers, bleeding, extravasation, and change in the hemoglobin level.</p><p><strong>Conclusion: </strong>US percutaneous renal access is a safe and effective modality with a high success rate, less operative time, and complication rate. However, a minimum of 50 cases with some pelvicalyceal system dilation may be preliminary requisites to achieve good orientation and competence in achieving safe US percutaneous renal access for future endourological procedures.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"215-219"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/fd/UA-15-215.PMC10252783.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992964","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":"The effect of percutaneous tract dilation technique on renal parenchymal trauma: An experimental <i>in vivo</i> study on a porcine model.","authors":"Arman Tsaturyan,&nbsp;Constantinos Adamou,&nbsp;Lampros Pantazis,&nbsp;Christina Kalogeropoulou,&nbsp;Vasiliki Tzelepi,&nbsp;Dimitris Apostolopoulos,&nbsp;Konstantinos Pagonis,&nbsp;Angelis Peteinaris,&nbsp;Anastasios Natsos,&nbsp;Theofanis Vrettos,&nbsp;Abdulrahman Al-Aown,&nbsp;Evangelos Liatsikos,&nbsp;Panagiotis Kallidonis","doi":"10.4103/ua.ua_25_22","DOIUrl":"10.4103/ua.ua_25_22","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate renal parenchymal trauma of two-step dilation compared to the conventional Amplatz gradual dilation during percutaneous nephrolithotomy on a porcine model.</p><p><strong>Materials and methods: </strong>A nonpapillary percutaneous access tract was established under fluoroscopic guidance in both kidneys of four female pigs. On the right kidney of each pig, gradual dilation was performed using an Amplatz dilator set with a gradual dilation to 30 Fr, whereas on the left, a two-step dilation was utilized using only 16 Fr and 30 Fr dilators. Two of the animals were euthanized immediately after the procedure and the remaining two 1 month later. The pigs that were kept alive underwent a contrast-enhanced computed tomography immediately, 15, and 30 days postoperatively. A dimercaptosuccinic acid (DMSA) scintigraphy and single-photon emission computed tomography-computed tomography (CT) were also performed after the last CT and afterward, the pigs were sacrificed. All kidneys were harvested for pathohistological examination.</p><p><strong>Results: </strong>The follow-up radiologic imaging showed similar parenchymal damage caused by the compared dilation techniques and an expected reduction in scar size in the later scans. No scar was identified by DMSA in any kidney. Gross and microscopic examinations conducted both on the kidneys that were harvested immediately after the procedure and the ones from the animals that were left to heal, revealed no significant differences in tissue damage, grade of fibrosis, or inflammation depending on the dilation method.</p><p><strong>Conclusions: </strong>Our study showed no inferior outcomes caused by two-step dilation compared to gradual dilation regarding renal parenchymal damage following a nonpapillary puncture. In fact, postoperative imaging findings suggested a trend toward better healing and less scar tissue when the two-step method was used.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"191-196"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/3e/UA-15-191.PMC10252767.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623271","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":"Safety of transurethral resection of large prostate.","authors":"Ayman Al-Bakri,&nbsp;Abdullah Al-Jaser,&nbsp;Khalid Al-Gamdi,&nbsp;Reshaid Al-Reshaid,&nbsp;Abdullah Al-Enizi,&nbsp;Ali Ali Al-Kharji,&nbsp;Ibrahim Al-Zahrani,&nbsp;Nawaf Al-Modahi,&nbsp;Moath Al-Harbi,&nbsp;Abdullah Al-Mani","doi":"10.4103/ua.ua_192_21","DOIUrl":"10.4103/ua.ua_192_21","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia is a common benign disease occurs in older men. Some patients can be treated medically but eventually, most of them will need a surgical intervention, and the most commonly applied procedure is transurethral resection of the prostate (TURP).</p><p><strong>Objectives: </strong>The objective of this study is to assess the feasibility and safety of performing transurethral resection of large prostate (80 g and more).</p><p><strong>Methodology: </strong>Out of 153 patients reviewed 48 cases included in this study. The main data collected from patients' files and patient interview. The criteria of exclusion were prostate size <80 g and previous history of TURP. The collected data were analyzed by the Statistical Package for the Social Sciences (SPSS).</p><p><strong>Results: </strong>The main results showed that 93.7% of patients did not experience major bleeding postoperatively, neither major drop in hemoglobin level. Moreover, the patient's distribution according to the presence of TUR syndrome was only 2.1% with mild symptoms. No patient had an episode of retention during the hospital stay or in the follow-up.</p><p><strong>Conclusion: </strong>Surgeon experience, systematic resection approach, and strict time of resection are important factors to assure the safety of TURP in large prostate. In cases of huge prostate size >100 g, staged TURP can be offered safely or if patients' obstructive symptoms do not resolve after the first procedure.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"162-165"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/88/UA-15-162.PMC10252772.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674184","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":"Electronic medical records-based retrospective, longitudinal, observational study to understand the patient management of benign prostatic hyperplasia with alpha-blockers monotherapy in Indian population.","authors":"Rahul Gupta,&nbsp;Sameer Trivedi,&nbsp;Surya Prakash Vaddi,&nbsp;Mrinal Borgohain,&nbsp;Rajan Mittal,&nbsp;Sucheta Pandit,&nbsp;Amey Mane","doi":"10.4103/ua.ua_114_21","DOIUrl":"10.4103/ua.ua_114_21","url":null,"abstract":"<p><strong>Objective: </strong>The present retrospective study evaluates the effectiveness and tolerability of alpha-blockers as monotherapy in patients with benign prostatic hyperplasia associated with lower urinary tract symptoms (LUTS).</p><p><strong>Materials and methods: </strong>A total of 335 male patients >50 years were categorized into four groups (Alfuzosin: 166, Silodosin: 67, Tamsulosin: 70, Prazosin: 32). The efficacy evaluated as a change in International Prostate Symptom Score (IPSS), peak flow rate (Qmax), residual urine volume, and relief from LUTS, and tolerability of the various alpha-blockers was assessed across the study group.</p><p><strong>Results: </strong>At baseline, most of the patients in alfuzosin (60%), silodosin (77%), and tamsulosin (90%) groups presented with severe IPSS (20-35), whereas patients in the prazosin group (69%) presented with a moderate score. At the end of the study, the mean IPSS gradually improved to moderate (41%, 62%, 66%, and 28%) and mild (59%, 38%, 28%, and 72%) in the alfuzosin, silodosin, tamsulosin, and prazosin groups, respectively (<i>P</i> = 0.004), with improvement in mean change in residual urine volume and complete relief from LUTS symptoms with no surgical or radiological interventions. Overall, 194 adverse events (AEs) were observed in 38.8% of patients. Of the total AEs, patients in the alfuzosin, silodosin, tamsulosin, and prazosin groups experienced 21%, 22%, 39%, and 18% of AEs, respectively.</p><p><strong>Conclusion: </strong>The nonselective alpha-adrenergic receptor antagonist, alfuzosin, emerged as noninferior in effectiveness and superior in tolerability than other selective alpha-blockers, silodosin, tamsulosin, and prazosin.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"138-147"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/59/UA-15-138.PMC10252785.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674185","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 mathematical method to estimate angle and distance for percutaneous renal puncture based on computed tomography data: Description and validation.","authors":"Shady Mohamed Salem,&nbsp;Saad A Aldousari","doi":"10.4103/ua.ua_82_22","DOIUrl":"10.4103/ua.ua_82_22","url":null,"abstract":"<p><strong>Introduction: </strong>Gaining access to the kidney is crucial step in percutaneous nephrolithotomy (PCNL); it has a steep learning curve.</p><p><strong>Objective: </strong>Describe the mathematical method to predict renal puncture angle and distance based on preoperative computed tomography (CT) measurements. Then evaluating how it correlates with measured values.</p><p><strong>Patients and methods: </strong>The study was prospectively designed. After ethical committee approval, the study uses data from preoperative CT to construct a triangle so we can estimate puncture depth and angle. A triangle of three points, the first is point of entry to the pelvicalyceal system (PCS), the second is point on the skin perpendicular to it, and the third where the needle punctures the skin. The needle travel is estimated using the Pythagorean theorem and puncture angle using the inverse sine function. We evaluated 40 punctures in 36 PCNL procedures. After PCS puncture using fluoroscopy-guided triangulation, we measured the needle travel distance and angle to the horizontal plane. Then compared the results with mathematically estimated values.</p><p><strong>Results: </strong>We targeted posterior lower calyx in 21 (70%) case. The correlation between measured and estimated needle travel distance with Rho coefficient of 0.76 with <i>P</i> < 0.001. The mean difference between the estimated and the measured needle travel was - 0.37 ± 1.2 cm (-2.6-1.6). Measured and estimated angle correlate with Rho coefficient of 0.77 and <i>P</i> < 0.001. The mean difference between the estimated and the measured angle was 2° ± 8° (-21°-16°).</p><p><strong>Conclusion: </strong>Mathematical estimation of needle depth and angle for gaining access to the kidney correlates well with measured values.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"197-201"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/99/UA-15-197.PMC10252774.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992962","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":"Seminal vesicle metastasis from hepatocellular carcinoma and renal cell carcinoma.","authors":"Marius Wai-Lok Chan,&nbsp;Wing-Hung Lau,&nbsp;Chi-Fai Kan,&nbsp;Wing-Hang Au","doi":"10.4103/ua.ua_123_22","DOIUrl":"10.4103/ua.ua_123_22","url":null,"abstract":"<p><p>We presented two rare cases of secondary seminal vesicle (SV) metastasis from hepatocellular carcinoma of the liver and renal cell carcinoma from the right kidney. Diagnosis of secondary SV metastasis should be made based on clinical history, radiological examination, histopathological examination, and, more importantly, the directed panel of immunohistochemistry. Via our experience in the investigation and diagnostic process, a better understanding of this unusual disease can be achieved.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"235-237"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/23/UA-15-235.PMC10252773.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992963","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":"Comparative analysis of partial versus radical nephrectomy for renal cell carcinoma: Is oncologic safety compromised during nephron sparing in higher stage disease?","authors":"Nizar Hakam,&nbsp;Nassib Abou Heidar,&nbsp;Jose El-Asmar,&nbsp;Mark Khauli,&nbsp;Jad Degheili,&nbsp;Mouhamad Al-Moussawy,&nbsp;Rami Nasr,&nbsp;Albert El-Hajj,&nbsp;Wassim Wazzan,&nbsp;Muhammad Bulbul,&nbsp;Raja B Khauli","doi":"10.4103/ua.ua_98_22","DOIUrl":"10.4103/ua.ua_98_22","url":null,"abstract":"<p><strong>Objectives: </strong>Over the past 20 years, the utility of partial nephrectomy (PN), compared to radical nephrectomy (RN), for the management of localized renal cell carcinoma (RCC) has progressively increased, particularly for larger and more complex masses. We sought to compare the recurrence-free survival (RFS) outcomes of PN versus RN in a single-institution cohort.</p><p><strong>Methods: </strong>Between 2002 and 2017, 228 patients underwent RN or PN for lcT1a-T2b, N0M0 RCC at a single tertiary referral center, performed by five surgeons. The clinical end point result was (local or distant) RFS. Univariate and multivariate (cox regression) models were used to evaluate the association between type of surgery (PN vs. RN) and RFS, in the overall cohort and in a subgroup of patients with cT1b.</p><p><strong>Results: </strong>The median age was 59 (interquartile range [IQR] 48-66), and the median tumor size was 4.5 cm (IQR 3-7). There were 1<b>28</b> PN and 10<b>0</b> RN. Over a median follow-up of 4.2 years (IQR 2.2-6.9), the Kaplan-Meier analysis showed no significant RFS difference between PN and RN (logrank <i>P</i> = 0.53). On multivariate analysis, pathologic stage ≥T2a, Fuhrman Grade ≥3, and chromophobe histology were associated with a worse RFS. PN was not significantly associated with diminished RFS (Hazard ratio [HR] 1.78, 95% confidence interval [CI] 0.74-4.3, <i>P</i> = 0.199) in the overall cohort compared to RN. However, in the cT1b subgroup, PN was associated with a significant increase in recurrence compared to RN (HR = 12.4, 95% CI 1.45-133.4, <i>P</i> = 0.038).</p><p><strong>Conclusions: </strong>Our institutional data highlight the possibility of compromise in RFS for clinically localized RCC treated with PN compared to RN, particularly for larger and more complex masses. These data raise concern, especially in light of the nonproven association of survival benefit of PN over RN, warranting future randomized prospective studies for further evaluation.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"15 2","pages":"226-231"},"PeriodicalIF":0.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/2c/UA-15-226.PMC10252787.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674186","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}