World Journal of Urology最新文献

{"title":"Patient-reported outcomes after one-stage neourethral reconstruction in transmen with phalloplasty-associated strictures and fistulas.","authors":"Victor M Schuettfort, Rebecca R Graf, Malte W Vetterlein, Tim A Ludwig, Philipp Gild, Phillip Marks, Armin Soave, Roland Dahlem, Margit Fisch, Silke Riechardt","doi":"10.1007/s00345-024-05246-0","DOIUrl":"10.1007/s00345-024-05246-0","url":null,"abstract":"<p><strong>Introduction: </strong>Urethral strictures and fistulas arising after gender-affirming surgery in transmen require meticulous management strategies. This study evaluates the safety and efficacy of urethral reconstruction and patient satisfaction post-surgery.</p><p><strong>Methods: </strong>A retrospective analysis examined peri- and postoperative data from transmen undergoing urethral reconstruction for urethral fistula and/or strictures at the distal urethral anastomosis between December 2017 and April 2023. Follow-up involved clinical examinations, uroflowmetry, and voiding cystourethrography. Patient satisfaction and quality of life were assessed using USS PROM and ICIQ-S questionnaires.</p><p><strong>Results: </strong>Among 25 patients, 88% (n = 23) had urethral fistulas, and 48% (n = 12) had urethral strictures. 41% of fistula patients also had strictures, while 75% of stricture patients had concurrent fistulas. Previous surgeries for fistula or stricture repair were noted in 26% of cases. Techniques for stricture included modified flap (50%), buccal oral mucosal grafting (33%), and primary anastomosis (17%). Post-operative urethrogram revealed urethral strictures in 15% (n = 3) and urinary extravasation in an equal number. Postoperative uroflow parameters showed improvement (Qmax 18 ml/s, Qave 7.9 ml, time 37 s, volume 332 ml). Perioperative complications were low (n = 6, 24%), all grade one (Clavien-Dindo). Follow-up revealed that 33% required another surgical intervention. The mean six-item LUTS score was 6.7 (SD 3.9). Mean ICIQ-S overall satisfaction score was 8.6 (SD 1.6) and outcome score was 20 (SD 2.8).</p><p><strong>Discussion: </strong>Our study found a significant recurrence rate of urethral strictures and fistulas post-surgery. Despite this, patient satisfaction remains high and complications are generally low-grade, highlighting the importance of expert surgical intervention.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of the MiGUTS nomogram for the prediction of bleeding control intervention after renal trauma.","authors":"Tobias Simon Schmidli, Silvan Sigg, Sorena Keihani, Lars Bosshard, Michael Prummer, Anna S Nowag, Jan Birzele, Chong Zhang, Jeremy B Myers, Räto T Strebel","doi":"10.1007/s00345-024-05231-7","DOIUrl":"https://doi.org/10.1007/s00345-024-05231-7","url":null,"abstract":"<p><strong>Introduction: </strong>The American Association for the Surgery of Trauma (AAST) renal trauma grading leads to a variable management of patients with high-grade renal injuries. For a better prediction of the risk for bleeding interventions, Keihani et al. introduced the multi-institutional genito-urinary trauma study (MiGUTS) renal trauma nomogram in 2019. The aim of this study was to conduct an external validation and generalization for all kidney trauma cases of the nomogram with a European cohort of a Swiss level 1 trauma center.</p><p><strong>Methods: </strong>We collected data from the clinical information system of the Kantonsspital Graubünden, Chur, Switzerland. All patients ≥ 18 years of age from 01.01.2008 to 01.12.2020 with a renal trauma who underwent computed tomography imaging of the abdomen were included. The descriptive analysis was performed by a t-test/Wilcoxon signed-rank test and a Chi-square test. The predictions of the nomogram were analysed by the Pearson correlation coefficient. The threshold of prediction of a bleeding intervention was optimized by a ROC analysis.</p><p><strong>Results: </strong>Overall, 166 patients were included. Most patients were male (80.7%) with a median age of 44 years. Using the prediction from the MiGUTS nomogram developed by Keihani et al. we were able to identify a threshold with a sensitivity of 1.00, specificity of 0.87, positive predictive value of 0.44, negative predictive value of 1.00 and accuracy of 0.88.</p><p><strong>Conclusion: </strong>The MiGUTS nomogram by Keihani et al. demonstrated to be reliable in the prediction of an intervention for bleeding control in our validation study in a European cohort.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we rely on magnetic resonance imaging for prostate cancer detection and surgical planning? Comprehensive analysis of a large cohort of patients undergoing transperineal mapped biopsies.","authors":"Nidia Gómez Diez, Pedro de Pablos-Rodríguez, David Sánchez-Mateos Manzaneque, María Isabel Martín García, Paula Pelechano Gómez, María Barrios Benito, Ana Calatrava Fons, Jessica Aliaga Patiño, Juan Boronat Catalá, Álvaro Gómez-Ferrer Lozano, Augusto Wong Gutiérrez, Ángel García Cortés, Miguel Ramírez Backhaus, Juan Casanova Ramón Borja, Manel Beamud Cortés, José Luis Domínguez Escrig, Antonio Coy García","doi":"10.1007/s00345-024-05233-5","DOIUrl":"https://doi.org/10.1007/s00345-024-05233-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate MRI and histological concordance in prostate cancer (PCa) identification via mapped transperineal biopsies.</p><p><strong>Methodology: </strong>Retrospective per-lesion analysis of patients undergoing MRI and transperineal biopsy at the Valencian Institute of Oncology (2016-2024) using CAPROSIVO PCa data. Patients underwent MRI, with or without regions of interest (ROI), followed by transperineal biopsies (3-5 cores/ROI, 20-30 systematic). Sensitivity (Se), specificity (Sp), negative predictive value (NPV), positive predictive value (PPV), and area under the curve (AUC) were calculated, considering PI-RADS 3 lesions as positive or negative. Gleason Grade Group (GG) > 1 defined clinically significant PCa (csPCa).</p><p><strong>Results: </strong>1817 lesions were analyzed from 1325 patients (median age 67, median PSA 6.3 ng/ml). 53% MRI were negative, GG > 1 prevalence was 38.4%. MRI-negative cases showed varying PCa rates: 57.4% negative, 30.2% GG 1, and 12.4% GG > 1. PI-RADS 3 lesions had mixed outcomes: 45.6% benign, 13.1% GG 1, and 41.3% GG > 1. 9.2% PI-RADS 4-5 lesions were negative, 9% GG 1, and 81.7% GG > 1. For PI-RADS 3 lesions considered positive, Se, Sp, NPV, PPV, and AUC were 82.9%, 75%, 87.6%, 67.4%, and 0.79 respectively. Considering PI-RADS 3 as negative yielded 64.8% Se, 91% Sp, 80.6% NPV, 81.7% PPV, and 0.78 AUC.</p><p><strong>Conclusion: </strong>MRI and mapped prostate biopsies exhibited moderate concordance. MRI could miss up to one in five csPCa foci and misinterpret one in three ROIs. Careful MRI interpretation is crucial for optimizing patient care.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyper-realistic rendering-assisted laparoscopic adrenalectomy for giant adrenal tumors: a pilot study.","authors":"Jiamo Zhang, Ke Hu, Jing Qing, Jiangchuan Chen, Changlong Li, Yongxia Zhou","doi":"10.1007/s00345-024-05258-w","DOIUrl":"https://doi.org/10.1007/s00345-024-05258-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the application value of hyperrealistic rendering (HRR) in laparoscopic giant adrenal tumor resection.</p><p><strong>Methods: </strong>We retrospectively analyzed 25 patients with giant adrenal tumors from January 2021 to January 2024, with a median age of 56 (40.5, 58.5) years and a tumor median diameter of 7.20 (6.80, 8.50) cm. All patients underwent preoperative medical HRR based on enhanced computed tomography, followed by laparoscopic adrenal tumor resection.</p><p><strong>Results: </strong>HRR was used to initially determine the nature of the tumor and develop a detailed surgical plan, which was completed in 25 patients preoperatively. All 24 cases of tumors were located in the adrenal gland, 1 case was located in the retroperitoneum, and 13 and 12 cases were on the left and right side, respectively. Preoperative HRR 3D imaging was consistent with the intraoperative situation, and 25 cases had successful surgeries. The median operation time was 165 (120.0, 250.0) min, and median bleeding and blood transfusion volume were 200 (150.0, 450.0) and 200.0 (150.0, 450.0) mL, respectively. There were no collateral injuries to important organs and major vessels and no cases of conversion to open surgery.</p><p><strong>Conclusion: </strong>For large retroperitoneal adrenal tumors, HRR for three-dimensional (3D) reconstruction imaging enables the operator to fully understand the relationship between the tumor and surrounding organs and blood vessels preoperatively, which can reduce intraoperative bleeding and collateral injuries, improve the success rate of laparoscopic resection, and safety of the operation.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young age and adequate BCG are key factors for optimal BCG treatment efficacy in non-muscle-invasive bladder cancer.","authors":"Kang Liu, Rossella Nicoletti, Hongda Zhao, Xuan Chen, Hongwei Wu, Chi-Ho Leung, David D'Andrea, Ekaterina Laukhtina, Francesco Soria, Andrea Gallioli, Marcelo Langer Wroclawski, Daniele Castellani, Vineet Gauhar, Juan Gomez Rivas, Dmitry Enikeev, Paolo Gontero, Shahrokh F Shariat, Peter Ka-Fung Chiu, Chi-Fai Ng, Jeremy Yuen-Chun Teoh","doi":"10.1007/s00345-024-05218-4","DOIUrl":"https://doi.org/10.1007/s00345-024-05218-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of ageing on survival outcomes in Bacillus Calmette-Guérin (BCG) treated non-muscle invasive bladder cancer (NMIBC) patients and its synergy with adequate BCG treatment.</p><p><strong>Method: </strong>Patients with NMIBC who received BCG treatment from 2001 to 2020 were divided into group 1 (< = 70 years) and group 2 (> 70 years). Overall Survival (OS), Cancer-Specific Survival (CSS), Recurrence-Free Survival (RFS), and Progression-Free Survival (PFS) were analyzed using the Kaplan-Meier method. Multivariable Cox regression analysis was used to adjust potential confounding factors and to estimate Hazard Ratio (HR) and 95% Confidence Interval (CI). Subgroup analysis was performed according to adequate versus inadequate BCG treatment.</p><p><strong>Results: </strong>Overall, 2602 NMIBC patients were included: 1051 (40.4%) and 1551 (59.6%) in groups 1 and 2, respectively. At median follow-up of 11.0 years, group 1 (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS as compared to group 2 (> 70 years). At subgroup analysis, patients in group 1 treated with adequate BCG showed better OS, CSS, RFS, and PFS as compared with inadequate BCG treatment in group 2, while patients in group 2 receiving adequate BCG treatment had 41% less progression than those treated with inadequate BCG from the same group.</p><p><strong>Conclusions: </strong>Being younger (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS. Older patients (> 70 years) who received adequate BCG treatment had similar PFS as those younger with adequate BCG treatment.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor for the article \"Pubic bone osteomyelitis and fstulas after radiation therapy of the pelvic region: patient-reported outcomes and urological management of a rare but serious complication\".","authors":"Yi Zhang, Shaoping Feng, Yaxiang Huang, Chenghua Zhu","doi":"10.1007/s00345-024-05257-x","DOIUrl":"https://doi.org/10.1007/s00345-024-05257-x","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green and methylene blue dye guided sentinel lymph node biopsy in patients with penile cancer (PeCa): results of 50 inguinal basins assessed at a single institution in India.","authors":"Mohan Amaresh, Rakesh M Sharma, Anupam Choudhary, Abhijit Shah, B Vishal Rao, Thammineedi Subramanyeshwar Rao","doi":"10.1007/s00345-024-05250-4","DOIUrl":"10.1007/s00345-024-05250-4","url":null,"abstract":"<p><strong>Aim: </strong>The primary aim of this study was to validate the reliability, sensitivity and safety profile of novel combination of ICG- methylene blue dye as an SN tracer for PeCa.</p><p><strong>Methods: </strong>This is a validation and non-randomised prospective observational study involving 25 patients (50 inguinal basins) who underwent SLNB where in ICG and methylene blue were used for localisation. The patients with clinically node negative groins were recruited in the study. SNs were identified intraoperatively using near infrared fluorescence imaging (NIRF Imaging system, SPY-PHI, Stryker, Sweden) and blue dye. The numbers of SNs identified by each tracer and the rates of complications and nodal recurrence during the followup.</p><p><strong>Results: </strong>Overall 137 SNs were identified intraoperatively. Among the 137 SNs excised fluorescence, blue dye and Combined (blue + green) identified 57(41.6%), 27 (19.7%), and 51 (37.2%), respectively. The average number of SLNs removed per patient was 5 (range, 1-11) with sentinel lymph nodes detection rate at 94% (47/50). Seven patients had malignancy on SLNB and underwent ipsilateral radical inguinal lymphadenectomy. One patient had false negative SN and positive node in modified inguinal lymphadenectomy specimen. No adverse events were observed in all cases.</p><p><strong>Conclusion: </strong>The Novel combination of ICG fluorescence-Methylene blue dye technique is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it avoids radiation exposure.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor for the article \"Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma\".","authors":"Feng Jin, Yiqi Huang, Yanling Zhang","doi":"10.1007/s00345-024-05254-0","DOIUrl":"https://doi.org/10.1007/s00345-024-05254-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: letter to the editor for the article \"Health-related quality of life following salvage radical prostatectomy for recurrent prostate cancer after radiotherapy or focal therapy\".","authors":"Severin Rodler, Christian Stief, Thilo Westhofen","doi":"10.1007/s00345-024-05255-z","DOIUrl":"https://doi.org/10.1007/s00345-024-05255-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial prostatectomy for localized prostate cancer.","authors":"Yue Wu, Chengwei Wang, Xiangyu Long, Tao Wang, Zhihua Wang, Chunguang Yang, Shaogang Wang","doi":"10.1007/s00345-024-05242-4","DOIUrl":"10.1007/s00345-024-05242-4","url":null,"abstract":"<p><strong>Background and objective: </strong>Localized prostate cancer treatment aims to balance cancer control with preserving urinary and erectile function. While focal ablative therapies have emerged, their uncertain prognosis prompts exploration of partial prostatectomy. We systematically reviewed its efficacy as a primary treatment, particularly in low-to-intermediate-risk patients.</p><p><strong>Methods: </strong>Our review comprehensively analyzed existing studies on partial prostatectomy for localized cancer. We focused on patient selection, surgical techniques, and postoperative outcomes, emphasizing tumor control, continence, and erectile function. Studies involving multiparametric MRI and targeted biopsies for candidate selection were included.</p><p><strong>Key findings and limitations: </strong>Partial prostatectomy, encompassing various techniques, demonstrates promising short-term outcomes in tumor control and functional preservation. Preoperative imaging and biopsy aid in candidate selection. However, longer-term data on cancer recurrence are limited, warranting further investigation. Heterogeneity among studies and the lack of standardized follow-up protocols are notable limitations.</p><p><strong>Conclusions and clinical implications: </strong>Partial prostatectomy offers a minimally invasive and effective treatment option for localized prostate cancer, particularly in selected patients. Preoperative imaging and biopsy play crucial roles in patient selection, while standardized follow-up protocols are needed to assess long-term outcomes. Future research should focus on elucidating its precise role and optimizing patient selection criteria, contributing to improved prostate cancer management strategies.</p><p><strong>Advancing practice: </strong>Partial prostatectomy is explored for localized prostate cancer treatment, aiming to balance cancer control with preserving function. Short-term outcomes are promising, but long-term data on recurrence are lacking. Further research is needed to optimize patient selection and standardize follow-up protocols.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}