Current Urology最新文献

{"title":"Redo inferior pubectomy for failed anastomotic urethroplasty in pelvic fracture urethral injury","authors":"Lin Wang, Wenxiong Song, Xufeng Peng, Rong Lyu, Jijian Wang, Chongrui Jin, Chao Feng, Xiangguo Lyu, Yinglong Sa, Yidong Liu","doi":"10.1097/cu9.0000000000000224","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000224","url":null,"abstract":"Abstract Objectives To assess the effect of redo inferior pubectomy on the management of complicated pelvic fracture urethral injury (PFUI) in patients with a history of failed anastomotic urethroplasty. Materials and methods We retrospectively reviewed all patients receiving redo anastomotic urethroplasty with redo inferior pubectomy for failed PFUI between January 2010 and December 2021. Patients with incomplete data and those who were lost to follow-up were excluded. Successful urethroplasty was defined as the restoration of a uniform urethral caliber without stenosis or leakage and further intervention. Functional results, including erectile function and urinary continence, were evaluated. Descriptive statistical analyses were then performed. Results Thirty-one patients were included in this study. Among them, concomitant urethrorectal fistula occurred in 2 patients, and concomitant enlarged bladder neck occurred in 1. The stenosis site was the bulbomembranous urethra in 2 patients and the prostatomembranous urethra in 29. The mean length of urethral stenosis in all patients was 3.1 cm (range, 2.0–5.0 cm). After a mean follow-up of 34.6 months, the final success rate was 96.8%. The incidence of erectile dysfunction reached 77.4% (24/31). Normal continence was achieved in 27 (87.1%) patients. One patient developed urinary incontinence of grade II requiring urinal pads because of an enlarged bladder neck. According to the Clavien-Dindo classification, postoperative complications of grade I occurred in 7 patients and grade II in 4. Conclusions Repeat anastomotic urethroplasty with repeat inferior pubectomy provides reliable success rates for failed PFUI. In complicated cases, it must be known and mastered.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134960278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of postoperative sexual function on health-related quality of life after robot-assisted radical prostatectomy","authors":"Yuya Iwahashi, Ryusuke Deguchi, Satoshi Muraoka, Takahito Wakamiya, Shimpei Yamashita, Kazuro Kikkawa, Yasuo Kohjimoto, Isao Hara","doi":"10.1097/cu9.0000000000000227","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000227","url":null,"abstract":"Abstract Background We investigated potential disparities in health-related quality of life, particularly concerning urinary function, between patients with preserved and those with impaired sexual function after robot-assisted radical prostatectomy (RARP). Materials and methods Between December 2012 and April 2020, 704 men underwent RARP in our hospital. This study included 155 patients with a preoperative 5-item International Index of Erectile Function (IIEF-5) of ≥12 points and an assessable IIEF-5 at 12 months postoperatively. Health-related quality of life was assessed using the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite (EPIC) preoperatively and at 3, 6, and 12 months postoperatively. A logistic regression analysis and Wilcoxon rank sum tests were performed. Results Patients were grouped according to the median IIEF-5 score 12 months after surgery: those with preserved sexual function ( n = 71) and those with impaired sexual function ( n = 84). The mental component summary of the 8-item Short-Form Health Survey was better in the group with preserved sexual function at 6 months postoperatively than in the group with impaired sexual function ( p < 0.01). In the EPIC, the group with preserved sexual function performed better not only in the sexual domain but also in the urinary domain at all time points compared with the group with impaired sexual function ( p < 0.01). In the comparison of the urinary subdomains of the EPIC, there were no significant differences in urinary function or incontinence, but there were significant differences in urinary distress and irritative/obstructive scores ( p < 0.01). Conclusions Patients with preserved postoperative sexual function after RARP showed better urinary function than those with impaired sexual function. Hence, preserved sexual function is closely associated with urinary function.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135864741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does dutasteride reduce the bleeding in transurethral resection of the prostate in patients on antiplatelet drugs?","authors":"Ahmed M. Rammah, Alaa Meshref, Ebram Soliman, Islam Nasser Abd Elaziz, Enmar Habib, Ahmed Yehia Abdelaziz, Ahmed H. Abozamel","doi":"10.1097/cu9.0000000000000226","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000226","url":null,"abstract":"Abstract Purpose The aim of this study was to assess the effect of a 4-week dutasteride treatment on reducing the intraoperative and postoperative bleeding, as well as the amount and duration of irrigation required to clear the urine after transurethral resection of the prostate (TURP) ≥50 g in men receiving the antiplatelet drug (APD). Materials and methods This double-blind randomized clinical trial included patients with a prostate size ≥50 g who were indicated for TURP and were already receiving APD. The study was conducted in the Urology Department of Cairo University over a 12-month period. Routine preoperative laboratory investigations were performed in all patients. Moreover, baseline prostate size, serum prostate-specific antigen level, and International Prostate Symptom Score were estimated. The patients were randomly divided into 2 equal groups (groups A and B). Group A, the dutasteride group, received dutasteride (0.5 mg) once daily for 4 weeks. Group B, the placebo group, received a placebo capsule once daily for 4 weeks. Both groups underwent bipolar TURP. Fifteen patients were excluded from the study; 9 patients from group A and 6 patients from group B, either due to drug intolerability or loss follow-up. Results The mean blood loss was insignificant between the 2 groups immediately after and 24 hours after surgery (Δ hemoglobin: 1.41 ± 0.63 g/dL vs. 1.48 ± 0.54 g/dL, 2.12 ± 0.70 g/dL vs. 2.31 ± 0.78 g/dL, respectively, p = 0.631, p = 0.333; Δ hematocrit: 2.97% ± 1.51% vs. 3.16% ± 1.36%, 4.96% ± 1.87% vs. 5.73% ± 4.39%, respectively, p = 0.610, p = 0.380). However, there were significant differences in duration of indwelling urethral catheter (5.10 ± 0.55 days vs. 5.80 ± 1.79 days, p = 0.048), duration of bladder irrigation (13.60 ± 2.85 hours vs. 16.33 ± 6.62 hours, p = 0.044), and the amount of saline used for bladder irrigation (11.03 ± 2.30 L vs. 13.87 ± 6.13 L, p = 0.046) between group A and group B. respectively. Conclusions Treatment with dutasteride for 4 weeks before TURP in men receiving APD did not significantly reduce intraoperative or postoperative bleeding after TURP but could significantly reduce the duration of indwelling catheter placement, as well as the duration and amount of saline irrigation.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135108184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bidirectional cohort study to compare the outcomes of transperitoneal and retroperitoneal approaches in subjects undergoing laparoscopic live donor nephrectomy","authors":"Praveena S., Venkatesh Krishnamoorthy, Krishnaprasad Tyagaraj","doi":"10.1097/cu9.0000000000000220","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000220","url":null,"abstract":"Abstract Background Laparoscopic transperitoneal donor nephrectomy (LDN) is currently the standard procedure for renal donation from living donors. Only a handful of clinical studies have compared the outcomes of retroperitoneoscopic donor nephrectomy (RLDN) and LDN. More robust data and systematic comparative analyses of the outcomes and complications of these 2 techniques are needed. This study aimed to elucidate the noninferiority of RLDN to LDN. Materials and methods All live renal donors who underwent either RLDN or LDN at our institution during the period of January 2015 to March 2021 were considered subjects, excluding those who refused to participate in the study. This was a bidirectional cohort study. Demographic and clinical data were collected and analyzed using standard statistical methods. Statistical significance was set at p < 0.05. Results Our study included 89 subjects: 40 in the LDN group and 49 in the RLDN group. The RLDN group had significantly shorter warm ischemia time (2.85 vs. 6.04 minutes), a lower fall in hemoglobin on postoperative day (POD)-1 (1.73 vs. 2.24 g/dL), lower estimated blood loss (601.93 vs. 797.27 mL), and lower pain on POD-1 (0.78 vs. 1.28). The improvement in recipient’s estimated glomerular filtration rate on POD-30 was significantly higher in the RLDN group (79.98 vs. 63.73 mL/min/1.73 m 2 ). There was a significantly higher fall in estimated glomerular filtration rate of donor after nephrectomy in RLDN group on POD-30 (35.53 vs. 30.60 mL/min/1.73 m 2 ). However, there were no significant differences in other parameters. Conclusions Our study, conducted in India, showed that the majority of RLDN outcomes were better than those of LDN. Hence, RLDN is clearly non-inferior to the gold standard LDN. A well-designed randomized controlled study is required to elucidate the statistical superiority of one approach over another.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135827588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve for magnetic resonance imaging/ultrasound fusion prostate biopsy in detecting prostate cancer using cumulative sum analysis.","authors":"Linhan Xu,&nbsp;Nancy Yating Ye,&nbsp;Adrianna Lee,&nbsp;Jasleen Chopra,&nbsp;Michael Naslund,&nbsp;Jade Wong-You-Cheong,&nbsp;Amelia Wnorowski,&nbsp;Mohummad Minhaj Siddiqui","doi":"10.1097/CU9.0000000000000116","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000116","url":null,"abstract":"<p><strong>Background: </strong>Targeted magnetic resonance (MR) with ultrasound (US) fusion-guided biopsy has been shown to improve detection of prostate cancer. The implementation of this approach requires integration of skills from radiologists and urologists. Objective methods for assessment of learning curves, such as cumulative sum (CUSUM) analysis, may be helpful in identifying the presence and duration of a learning curve. The aim of this study is to determine the learning curve for MR/US fusion-guided biopsy in detecting clinically significant prostate cancer using CUSUM analysis.</p><p><strong>Materials and methods: </strong>Retrospective analysis was performed in this institutional review board-approved study. Two urologists implemented an MR/US fusion-guided prostate biopsy program between March 2015 and September 2017. The primary outcome measure was cancer detection rate (CDR) stratified by Prostate Imaging Reporting and Data System (PI-RADS) scores assigned on the MR imaging. Cumulative sum analysis quantified actual cancer detection versus a predetermined target satisfactory CDR of MR/US fusion biopsies in a sequential case-by-case basis. For this analysis, satisfactory performance was defined as >80% CDR in patients with PI-RADS 5, >50% in PI-RADS 4, and <20% in PI-RADS 1-3.</p><p><strong>Results: </strong>Complete data were available for MR/US fusion-guided biopsies performed on 107 patients. The CUSUM learning curve analysis demonstrated intermittent underperformance until approximately 50 cases. After this inflection point, there was consistently good performance, evidence that no further learning curve was being encountered.</p><p><strong>Conclusions: </strong>At a new center implementing MR/US fusion-guided prostate biopsy, the learning curve was approximately 50 cases before a consistently high performance for prostate cancer detection.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"159-164"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/af/curr-urol-17-159.PMC10337819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of pelvic floor disorders and the associated quality of life among institutionalized and noninstitutionalized elderly women: A cross-sectional study.","authors":"Heloisa da Costa Souza,&nbsp;Lívia M T Pires,&nbsp;Gláucia C Vieira,&nbsp;Edna A B Castro,&nbsp;Elaine A Moura,&nbsp;Júlia Engelmann,&nbsp;Diogo S Fonseca","doi":"10.1097/CU9.0000000000000138","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000138","url":null,"abstract":"<p><strong>Background: </strong>An increase in life expectancy has led to an increased elderly population. In turn, this aging population is more likely to develop health conditions, such as pelvic floor disorders (PFDs). This study aimed to assess the prevalence of these disorders and the associated quality of life in institutionalized and noninstitutionalized elderly women.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted with 80 female participants older than 60 years, divided into 2 groups: institutionalized and noninstitutionalized participants. The Pelvic Floor Distress Inventory Short-Form and a sociodemographic questionnaire were used. A chi-squared test was used to assess the differences in prevalence between groups.</p><p><strong>Results: </strong>There was no statistically significant difference between the groups in the prevalence of PFDs or quality of life. In this study, the prevalence of PFDs was higher than that reported previously. In institutionalized women, a higher prevalence of PFDs and impaired quality of life were expected, although not observed.</p><p><strong>Conclusions: </strong>There was a higher prevalence of pelvic disorders and impaired quality of life due to these disorders in elderly women.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"184-187"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/0e/curr-urol-17-184.PMC10337817.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated ventral congenital penile curvature treated by incisionless plication of tunica albuginea in adults: A prospective case series.","authors":"Rabea A Gadelkareem,&nbsp;Mohammed A Elgendy,&nbsp;Adel Kurkar,&nbsp;Ahmed M El-Taher,&nbsp;Islam F Abdelkawi","doi":"10.1097/CU9.0000000000000121","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000121","url":null,"abstract":"Abstract Background Numerous surgical techniques are available for the correction of isolated ventral congenital penile curvature (IVCPC). This study aimed to assess the outcomes and predictors of IVCPC treatment in adults using an incisionless plication technique. Materials and methods This prospective case series examined patients with IVCPC who were treated in our hospital between October 2017 and February 2020 using incisionless plication of the tunica albuginea (Essed-Schroeder technique) with a covering pair of absorbable sutures. The primary outcomes were successful correction (defined as a residual curvature ≤15 degrees) and patient satisfaction. Postoperative follow-ups were performed at 3, 6, and 12 months. Results A total of 23 patients were treated for IVCPC with a mean (range) age of 25.3 (18–31) years. Eighteen patients (78.3%) were single with cosmetic complaints, whereas the other 5 patients (21.7%) were married and presented with a difficult vaginal intromission. The mean (range) curvature, length, and operative time were 40 (30–50) degrees, 15 (10–19) cm, and 82 (65–100) minutes, respectively. Postoperative penile pain and numbness occurred in 13 patients (56.5 %) and 7 patients (30.4%) only within the first month, respectively. Palpable suture knots were reported in 15 patients (65.5%) without being bothersome up to 12 months. The postoperative means (ranges) of penile curvature and length were significantly different from that of the preoperative values at 3 (5 [0–20] degrees and 14.5 [9–18.5] cm), 6 (5 [0–20] degrees and 14.5 [9–18.5] cm), and 12 months (5 [0–30] degrees and 14.5 [9–18.5] cm; all p < 0.001). Age, preoperative penile curvature, penile length, postoperative pain, wound infections, and knot palpation insignificantly affected curvature recurrence. Seventeen patients (73.9%) were very satisfied with their surgical outcomes. Conclusions Incisionless plication of the tunica albuginea is effective and safe for the correction of IVCPC in adults with high success and patient satisfaction rates.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"206-212"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/6f/curr-urol-17-206.PMC10337818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10138019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of urolithiasis management options in patients with horseshoe kidney: A systematic review and meta-analysis.","authors":"Yazan Qaoud,&nbsp;Merella Al Tali,&nbsp;Fiona Boland,&nbsp;Andrew Simpson,&nbsp;Niall Davis","doi":"10.1097/CU9.0000000000000199","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000199","url":null,"abstract":"<p><strong>Background: </strong>Horseshoe kidney is a rare congenital anomaly commonly complicated by urolithiasis. Extracorporeal shockwave lithotripsy (ESWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL) are treatment options for horseshoe kidney stones. The aim of this systematic review is to compare the benefits and risks of these management options.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and Cochrane Library databases were searched from inception to February 2022. A total of 516 nonduplicate studies were screened against the inclusion and exclusion criteria. Studies comparing at least 2 interventions with ≥10 patients per intervention were included.</p><p><strong>Results: </strong>Nine retrospective observational studies published from 2007 to 2021 with a total of 565 patients were included. Reported mean ± SD or mean (range) stone sizes ranged between 17.90 ± 2.43 mm and 27.9 ± 8.6 mm for PCNL, 8.4 (2-25) mm and 22.3 ± 9.1 mm for URS, and 11.9 ± 2.0 mm and 16.8 ± 4.4 mm for ESWL. There was no difference in single-session and overall stone-free rate (SFR) between PCNL and URS, with a risk ratio of 1.04 (95% confidence interval, 0.95-1.13; <i>I</i>² = 20.63%). Ureteroscopy had better stone clearance than ESWL, with an overall SFR risk ratio of 1.38 (95% confidence interval, 1.04-1.82; <i>I</i>² = 0%). There was no statistically significant difference in overall SFR between PCNL and ESWL. Most patients who underwent URS and ESWL experienced Clavien-Dindo (CD) grade I-II complications. Percutaneous nephrolithotomy was associated with the highest complication rates, including 5 CD grade III and 3 CD grade IV complications and a mean postoperative hemoglobin drop of 0.47 to 1.83 g/dL. There were no CD grade V complications across all studies.</p><p><strong>Conclusions: </strong>There was no difference in SFR between PCNL and URS. Ureteroscopy was associated with a smaller stone burden and fewer and less severe complications. Ureteroscopy was found to be more effective than ESWL with a higher SFR and comparable safety profile. Further large-scale randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"193-205"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/04/curr-urol-17-193.PMC10337821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and prostate multiparametric magnetic resonance imaging findings as predictors of general and clinically significant prostate cancer risk: A retrospective single-center study.","authors":"Matteo Massanova,&nbsp;Rebecca Vere,&nbsp;Sophie Robertson,&nbsp;Felice Crocetto,&nbsp;Biagio Barone,&nbsp;Lorenzo Dutto,&nbsp;Imran Ahmad,&nbsp;Mark Underwood,&nbsp;Jonathan Salmond,&nbsp;Amit Patel,&nbsp;Giuseppe Celentano,&nbsp;Jaimin R Bhatt","doi":"10.1097/CU9.0000000000000173","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000173","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the predictive values of Prostate Imaging Reporting and Data System version 2 (PI-RADS v2), prostate-specific antigen (PSA) level, PSA density (PSAD), digital rectal examination findings, and prostate volume, individually and in combination, for the detection of prostate cancer (PCa) in biopsy-naive patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 630 patients who underwent transrectal systematic prostate biopsy following prostate multiparametric magnetic resonance imaging. A standard 12-core biopsy procedure was performed. Univariate and multivariate analyses were performed to determine the significant predictors of clinically significant cancer but not PCa.</p><p><strong>Results: </strong>The median age, PSA level, and PSAD were 70 years, 8.6 ng/mL, and 0.18 ng/mL/mL, respectively. A total of 374 (59.4%) of 630 patients were biopsy-positive for PCa, and 241 (64.4%) of 374 were diagnosed with clinically significant PCa (csPCa). The PI-RADS v2 score and PSAD were independent predictors of PCa and csPCa. The PI-RADS v2 score of 5 regardless of the PSAD value, or PI-RADS v2 score of 4 plus a PSAD of <0.3 ng/mL/mL, was associated with the highest csPCa detection rate (36.1%-82.1%). Instead, the PI-RADS v2 score of <3 and PSAD of <0.3 ng/mL/mL yielded the lowest risk of csPCa.</p><p><strong>Conclusion: </strong>The combination of the PI-RADS v2 score and PSAD could prove to be a helpful and reliable diagnostic tool before performing prostate biopsies. Patients with a PI-RADS v2 score of <3 and PSAD of <0.3 ng/mL/mL could potentially avoid a prostate biopsy.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"147-152"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/e4/curr-urol-17-147.PMC10337816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Microwave focal therapy of prostate cancer: A non-clinical study and exploratory clinical trial.","authors":"Wei Phin Tan","doi":"10.1097/CU9.0000000000000167","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000167","url":null,"abstract":"The authors conducted an animal model study and a phase 2 clinical trial to evaluate the safety and efficacy of focal therapy using microwave tissue coagulation (MTC) to treat prostate cancer. [1] The results indicated thatfocaltherapyusingmicrowaveablationisrelatively safe and may be an option for lesion-targeted therapy for prostate cancer. In a canine prostate model, the authors demonstrated that the thermocoagulative effect of MTC can successfully cause coagulative necrosis on histological evaluation of healthy prostate tissue. This was evaluated by removing the prostate and the surrounding tissue from the animal model a few hours after treatment with MTC. The authors found that the extent of coagulation necrosis and cell death produced by MTC was proportional to both the energy output and irradiation time. The authors then demonstrated that intraoperative ultrasonographic measurements were correlated with pathological measurements of the ablated tissue. Although this study demonstrated the potential utility of MTC for the treatment of prostate cancer, the study had some notable limitations. First, microwave","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"173"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/48/curr-urol-17-173.PMC10337811.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}