Asian Journal of Urology最新文献

{"title":"Predictive factors for percutaneous nephrolithotomy bleeding risks","authors":"U Phun Loo,&nbsp;Chun Hou Yong,&nbsp;Guan Chou Teh","doi":"10.1016/j.ajur.2022.02.003","DOIUrl":"10.1016/j.ajur.2022.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to identify predictive factors for percutaneous nephrolithotomy (PCNL) bleeding risks. With better risk stratification, bleeding in high-risk patient can be anticipated and facilitates early identification.</p></div><div><h3>Methods</h3><p>A prospective observational study of PCNL performed at our institution was done. All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy, planned for additional procedures. Factors including gender, co-morbidities, body mass index, stone burden, puncture site, tract dilatation size, operative position, surgeon's seniority, and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin (Hb) deficiency.</p></div><div><h3>Results</h3><p>Overall, 4.86% patients (<em>n</em>=7) received packed cells transfusion. The mean estimated Hb deficiency was 1.3 (range 0–6.5) g/dL and the median was 1.0 g/dL. Stepwise multivariate regression analysis revealed that absence of hypertension (<em>p</em>=0.024), puncture site (<em>p</em>=0.027), and operative duration (<em>p</em>=0.023) were significantly associated with higher estimated Hb deficiency. However, the effect sizes are rather small with partial eta-squared of 0.037, 0.066, and 0.038, respectively. Observed power obtained was 0.621, 0.722, and 0.625, respectively. Other factors studied did not correlate with Hb difference.</p></div><div><h3>Conclusion</h3><p>Hypertension, puncture site, and operative duration have significant impact on estimated Hb deficiency during PCNL. However, the effect size is rather small despite adequate study power obtained. Nonetheless, operative position (supine or prone), puncture number, or tract dilatation size did not correlate with Hb difference. The mainstay of reducing bleeding in PCNL is still meticulous operative technique. Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient, without increasing risk of bleeding.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 105-109"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000042/pdfft?md5=f69635eed4ce7855ab94312efa88b599&pid=1-s2.0-S2214388222000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43495572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided paravertebral nerve block anesthesia for percutaneous endoscopic laser unroofing treatment of symptomatic simple renal cysts—An innovative ambulatory surgery mode","authors":"Jia Hu ,&nbsp;Yuan Zhang ,&nbsp;Yong Liu ,&nbsp;Xiao Yu ,&nbsp;Shaogang Wang","doi":"10.1016/j.ajur.2021.11.009","DOIUrl":"10.1016/j.ajur.2021.11.009","url":null,"abstract":"<div><h3>Objective</h3><p>This study was designed to evaluate the feasibility, efficacy, and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia.</p></div><div><h3>Methods</h3><p>From December 2015 to September 2017, 33 simple renal cyst patients who had surgical indications were enrolled. Under ultrasound guidance, the T10/T11, T11/T12, and T12/L1 paravertebral spaces were identified, and 7–10 mL 0.5% ropivacaine was injected at each segment. Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring. A guidewire was introduced followed by sequential dilation up to 28/30 Fr. The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser, and a pathological examination was performed.</p></div><div><h3>Results</h3><p>Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients. None of the patients complained of pain during surgery. No serious complications occurred perioperatively. After the surgery, all patients recovered their lower limb muscle strength quickly, got out of bed, resumed oral feeding, and left the hospital within 24 h of admission. The pathologic diagnosis of all cyst walls was a simple renal cyst. The mean follow-up was 35.8 months. At the end of follow-up, the cyst units were reduced in size by more than 50% compared to the preoperative size, and no patient experienced a recurrence.</p></div><div><h3>Conclusion</h3><p>Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible, safe, and effective for the treatment of simple renal cysts in selected patients.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 65-71"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388221001132/pdfft?md5=394c9938b7173ab39fc57a76854e8f27&pid=1-s2.0-S2214388221001132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43410786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single nucleotide polymorphism within chromosome 8q24 is associated with prostate cancer development in Saudi Arabia","authors":"Awad Elsid Osman ,&nbsp;Sahar Alharbi ,&nbsp;Atif Ali Ahmed ,&nbsp;Asim Ali Elbagir","doi":"10.1016/j.ajur.2022.03.012","DOIUrl":"10.1016/j.ajur.2022.03.012","url":null,"abstract":"<div><h3>Objective</h3><p>Genome-wide association studies have demonstrated that single nucleotide polymorphisms (SNPs) are important risk factors for the development of prostate cancer (PCa). Preliminary studies have suggested that the incidence of PCa in Saudi males is low but is probably familial or genetically related.</p></div><div><h3>Methods</h3><p>To identify any possible association of SNP with PCa development in Saudi patients, we investigated a group of SNPs in Saudi PCa patients (<em>n</em>=85) and compared the outcomes to healthy normal controls (<em>n</em>=115) and nodular hyperplasia patients (<em>n</em>=120). DNA was extracted from paraffin-embedded formalin fixed tissue or whole blood from both patients’ groups and healthy control group. A total of thirteen SNPs were genotyped using TaqMan® minor groove binder polymerase chain reaction assay.</p></div><div><h3>Results</h3><p>The rs16901979A, s629242T and rs1447295A alleles were found at significantly higher frequency in PCa patients than controls (<em>p</em>&lt;0.05). The rs16901979 CA genotype was found at significantly greater frequency in PCa patients than in healthy controls (43% <em>vs.</em> 14%, odds ratio=4.6, <em>p</em>=0.0001) and benign hyperplasia group (43% <em>vs.</em> 25%, odds ratio=2.2, <em>p</em>=0.009).</p></div><div><h3>Conclusion</h3><p>Our study has highlighted the association of rs16901979 SNP with PCa in Saudi males. Such findings have important implications in the PCa diagnosis and in screening unaffected family members of Saudi patients.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 26-32"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000820/pdfft?md5=f31853f9b875ff3d9fb2669600a1564d&pid=1-s2.0-S2214388222000820-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46543601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey","authors":"Bryan Kwun-Chung Cheng ,&nbsp;Steffi Kar-Kei Yuen ,&nbsp;Daniele Castellani ,&nbsp;Marcelo Langer Wroclawski ,&nbsp;Hongda Zhao ,&nbsp;Mallikarjuna Chiruvella ,&nbsp;Wei-Jin Chua ,&nbsp;Ho-Yee Tiong ,&nbsp;Yiloren Tanidir ,&nbsp;Jean de la Rosette ,&nbsp;Enrique Rijo ,&nbsp;Vincent Misrai ,&nbsp;Amy Krambeck ,&nbsp;Dean S. Elterman ,&nbsp;Bhaskar K. Somani ,&nbsp;Jeremy Yuen-Chun Teoh ,&nbsp;Vineet Gauhar","doi":"10.1016/j.ajur.2022.02.011","DOIUrl":"10.1016/j.ajur.2022.02.011","url":null,"abstract":"<div><h3>Objective</h3><p>To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists’ knowledge, attitudes, and practices for benign prostatic obstruction surgeries.</p></div><div><h3>Methods</h3><p>A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were “agree or strongly agree” and less than or equal to 15% responses were “disagree or strongly disagree” (consensus agree), or when more than or equal to 70% responses were “disagree or strongly disagree” and less than or equal to 15% responses were “agree or strongly agree” (consensus disagree).</p></div><div><h3>Results</h3><p>The top three qualities for defining MIST were minimal blood loss (<em>n</em>=466, 80.3%), fast post-operative recovery (<em>n</em>=431, 74.3%), and short hospital stay (<em>n</em>=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (<em>n</em>=361, 62.2%), Rezum® (<em>n</em>=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (<em>n</em>=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL.</p></div><div><h3>Conclusion</h3><p>Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 55-64"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221438822200090X/pdfft?md5=1d0370646ce1dbb1bc027110cb07a160&pid=1-s2.0-S221438822200090X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49115332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study","authors":"Samer Mahmoud Morsy ,&nbsp;Dalia Farouk ,&nbsp;Sara Hassan ,&nbsp;Ahmed Yehia Abdelaziz ,&nbsp;Hussein Aly Hussein","doi":"10.1016/j.ajur.2022.03.014","DOIUrl":"10.1016/j.ajur.2022.03.014","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator (TVT-O) in the treatment of <em>de novo</em> overactive bladder symptoms that appear after surgery.</p></div><div><h3>Methods</h3><p>This is a prospective randomized controlled study performed in the Urology and Gynecology Departments, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt. Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study. Patients were divided into two groups, 105 patients in Group A (treatment group) and 105 patients in Group B (control group). Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months, while patients in Group B underwent transvaginal TVT-O only. The study included any postmenopausal female with urodynamic stress urinary incontinence. All patients had to fulfill a 3-day bladder diary, overactive bladder symptoms score, urine analysis, urodynamic study, and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.</p></div><div><h3>Results</h3><p>At 6-month follow-up, daytime frequency was reduced to 8% in Group A (increased to 21% in Group B) with a statistically significant difference between both groups (<em>p</em>=0.009). At 6-month follow-up, nocturia was 8% in Group A (11% in Group B) with no statistically significant difference between both groups (<em>p</em>=0.469). There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up (<em>p</em>=0.024). There was a statistically significant difference in postoperative wound healing events as regards to cure, hyperemia, gapping, and wound infection 1 week after intervention between both groups (<em>p</em>=0.008). No local or systemic side-effects were reported from local estrogen use.</p></div><div><h3>Conclusion</h3><p>Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency. Long-term follow-up is needed.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 86-92"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222001382/pdfft?md5=f94355a54b299a67cdad5884a7f1c95a&pid=1-s2.0-S2214388222001382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48693439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous antegrade management of large proximal ureteral stones using non-papillary puncture","authors":"Arman Tsaturyan ,&nbsp;Angelis Peteinaris ,&nbsp;Constantinos Adamou ,&nbsp;Konstantinos Pagonis ,&nbsp;Lusine Musheghyan ,&nbsp;Anastasios Natsos ,&nbsp;Theofanis Vrettos ,&nbsp;Evangelos Liatsikos ,&nbsp;Panagiotis Kallidonis","doi":"10.1016/j.ajur.2022.01.006","DOIUrl":"10.1016/j.ajur.2022.01.006","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy (npPCNL) for the management of large proximal ureteral stones.</p></div><div><h3>Methods</h3><p>We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL. Depending on stone size, <em>in-toto</em> stone removal or lithotripsy using the Lithoclast® Trilogy (EMS Medical, Nyon, Switzerland) was performed. Perioperative parameters including operative time (from start of puncture to the skin suturing), stone extraction time (from the first insertion of the nephroscope to the extraction of all stone fragments), and the stone-free rate were evaluated.</p></div><div><h3>Results</h3><p>Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi. The median age and stone size of treated patients were 58 (interquartile range [IQR]: 51–69) years and 19.3 (IQR: 18.0–22.0) mm, respectively. The median operative time and stone extraction time were 25 (IQR: 21–29) min and 8 (IQR: 7–10) min, respectively. One case (2.7%) of postoperative bleeding and two cases (5.4%) of prolonged fever were managed conservatively. The stone-free rate at a 1-month follow-up was 94.6%.</p></div><div><h3>Conclusion</h3><p>The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter. Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 110-114"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000522/pdfft?md5=944406bd4f2b0ac5c4f738c5d5243ea6&pid=1-s2.0-S2214388222000522-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48030281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity","authors":"Mohammad Sajjad Rahnama'i ,&nbsp;Amin Bagheri ,&nbsp;Elham Jahantabi ,&nbsp;Hanieh Salehi-Pourmehr ,&nbsp;Hadi Mostafaei ,&nbsp;Brigitte Schurch ,&nbsp;Aida Javan Balegh Marand ,&nbsp;Sakineh Hajebrahimi","doi":"10.1016/j.ajur.2022.02.012","DOIUrl":"10.1016/j.ajur.2022.02.012","url":null,"abstract":"<div><h3>Objective</h3><p>Only a few numbers of studies have been published on the use of abobotulinumtoxinA (Dysport®) in idiopathic detrusor overactivity (IDO). This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport® injections.</p></div><div><h3>Methods</h3><p>Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500–900 units of Dysport® between April 2014 and July 2015. All patients were followed up for 5 years after their initial injection and interviewed on the phone.</p></div><div><h3>Results</h3><p>A total of 236 women with IDO aged from 18 years to 84 years (mean±standard deviation: 49.6±15.9 years) were included in our study. The median follow-up time for patients was 36.5 (range: 10–70) months, and the median recovery time after injection was 18.5 (range: 0–70) months. A total of 83 (35.2%) patients stated that they had subjective improvement of their symptoms whereas 84 (35.6%) patients did not report any improvement in symptoms. The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9 (standard deviation 3.4). There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire.</p></div><div><h3>Conclusion</h3><p>In a sub-population of overactive bladder patients with IDO who have failed first-line therapy, a single intravesical Dysport® injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 93-98"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222001023/pdfft?md5=fc925f12199e8283109527884e2880e8&pid=1-s2.0-S2214388222001023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41269607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy","authors":"Vanessa A. Lukas ,&nbsp;Rahul Dutta ,&nbsp;Ashok K. Hemal ,&nbsp;Matvey Tsivian ,&nbsp;Timothy E. Craven ,&nbsp;Nicholas A. Deebel ,&nbsp;David D. Thiel ,&nbsp;Ram Anil Pathak","doi":"10.1016/j.ajur.2022.06.004","DOIUrl":"10.1016/j.ajur.2022.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre- and peri-operative variables associated with length of stay (LOS) greater than 3 days and readmission within 30 days.</p></div><div><h3>Methods</h3><p>Records from 2008 to 2018 for “laparoscopy, surgical; partial nephrectomy” for prolonged LOS and readmission cohorts were compiled. Univariate analysis with Chi-square, <em>t</em>-tests, and multivariable logistic regression analysis with odds ratios (ORs), <em>p</em>-values, and 95% confidence intervals assessed statistical associations.</p></div><div><h3>Results</h3><p>Totally, 20 306 records for LOS greater than 3 days and 15 854 for readmission within 30 days were available. Univariate and multivariable analysis exhibited similar results. For LOS greater than 3 days, undergoing non-elective surgery (OR=5.247), transfusion of greater than four units within 72 h prior to surgery (OR=5.072), pre-operative renal failure or dialysis (OR=2.941), and poor pre-operative functional status (OR=2.540) exhibited the strongest statistically significant associations. For hospital readmission within 30 days, loss in body weight greater than 10% in 6 months prior to surgery (OR=2.227) and bleeding disorders (OR=2.081) exhibited strongest statistically significant associations.</p></div><div><h3>Conclusion</h3><p>Multiple pre- and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data. Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection, optimization strategies, and patient education.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 72-79"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222001011/pdfft?md5=881e618dab3bc69431f0a34b4cf8e5cf&pid=1-s2.0-S2214388222001011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48388918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology: A single centre retrospective study","authors":"Anthony Franklin ,&nbsp;Troy Gianduzzo ,&nbsp;Boon Kua ,&nbsp;David Wong ,&nbsp;Louise McEwan ,&nbsp;James Walters ,&nbsp;Rachel Esler ,&nbsp;Matthew J. Roberts ,&nbsp;Geoff Coughlin ,&nbsp;John W. Yaxley","doi":"10.1016/j.ajur.2023.01.007","DOIUrl":"10.1016/j.ajur.2023.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>To review the risk of prostate cancer (PCa) in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[¹⁸F]fluoro-<span>d</span>-glucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) ordered at Department of Urology, The Wesley Hospital, Brisbane, QLD, Australia for non-PCa related pathology.</p></div><div><h3>Methods</h3><p>Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for ¹⁸F-FDG PET/CT for non-prostate related conditions was conducted. Men were classified as benign, indeterminate, or malignant depending of the results of prostate-specific antigen (PSA), PSA velocity, biopsy histopathology, and three-Tesla (3 T) multiparametric MRI (mpMRI) Prostate Imaging Reporting and Data System score, or gallium-68-prostate-specific membrane antigen (⁶⁸Ga-PSMA) PET/CT results.</p></div><div><h3>Results</h3><p>Three percent (273/9122) of men demonstrated ¹⁸F-FDG avidity within the prostate. Eighty-five percent (231/273) were further investigated, including with PSA tests (227/231, 98.3%), 3 T mpMRI (68/231, 29.4%), ⁶⁸Ga-PSMA PET/CT (33/231, 14.3%), and prostate biopsy (57/231, 24.7%). Results were considered benign in 130/231 (56.3%), indeterminate in 31/231 (13.4%), and malignant in 70/231 (30.3%). PCa was identified in 51/57 (89.5%) of the men who proceeded to biopsy, including 26/27 (96.3%) men with Prostate Imaging Reporting and Data System scores 4–5 mpMRI and six men with a positive ⁶⁸Ga-PSMA PET/CT. The most common Gleason score on biopsy was greater than or equal to 4+5 (14/51, 27.5%). ⁶⁸Ga-PSMA PET/CT was concordant with the ¹⁸F-FDG findings in 26/33 (78.8%). All 13 men with a positive concordant ¹⁸F-FDG, 3 T mpMRI, and ⁶⁸Ga-PSMA PET/CT had PCa on biopsy. There was no statistically significant difference in the ¹⁸F-FDG maximum standardized uptake value between the benign or malignant groups (5.7 <em>vs.</em> 6.1; <em>p</em>=0.580).</p></div><div><h3>Conclusion</h3><p>In this study, after an incidental finding of an avid intraprostatic lesion on ¹⁸F-FDG PET/CT, 70 of the 231 cases (30.3%; 0.8% of the entire cohort) had results consistent with PCa, most commonly as Gleason score greater than or equal to 4+5 disease. Unless there is limited life expectancy due to competing medical co-morbidity, men with an incidental finding of intraprostatic uptake on ¹⁸F-FDG should be further investigated using principles of PCa detection.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 33-41"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000310/pdfft?md5=0ff54bc78afbc5b58c9bb3d4f721cfa1&pid=1-s2.0-S2214388223000310-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management","authors":"Randi M. Pose ,&nbsp;Sophie Knipper ,&nbsp;Jonas Ekrutt ,&nbsp;Mara Kölker ,&nbsp;Pierre Tennstedt ,&nbsp;Hans Heinzer ,&nbsp;Derya Tilki ,&nbsp;Florian Langer ,&nbsp;Markus Graefen","doi":"10.1016/j.ajur.2022.01.007","DOIUrl":"10.1016/j.ajur.2022.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the perioperative impact of factor V Leiden mutation on thromboembolic events' risk in radical prostatectomy (RP) patients. With an incidence of about 5%, factor V Leiden mutation is the most common hereditary hypercoagulability among Caucasians and rarer in Asia. The increased risk of thromboembolic events is three- to seven-fold in heterozygous and to 80-fold in homozygous patients.</p></div><div><h3>Methods</h3><p>Within our prospectively collected database, we analysed 33 006 prostate cancer patients treated with RP between December 2001 and December 2020. Of those, patients with factor V Leiden mutation were identified. All patients received individualised recommendation of haemostaseologists for perioperative anticoagulation. Thromboembolic complications (deep vein thrombosis and pulmonary embolism) were assessed during hospital stay, as well as according to patient reported outcomes within the first 3 months after RP.</p></div><div><h3>Results</h3><p>Overall, 85 (0.3%) patients with known factor V Leiden mutation were identified. Median age was 65 (interquartile range: 61–68) years. There was at least one thrombosis in 53 (62.4%) patients and 31 (36.5%) patients had at least one embolic event in their medical history before RP. Within all 85 patients with factor V Leiden mutation, we experienced no thromboembolic complications within the first 3 months after surgery.</p></div><div><h3>Conclusion</h3><p>In our cohort of patients with factor V Leiden mutation, no thromboembolic events were observed after RP with an individualised perioperative coagulation management concept. This may reassure patients with this hereditary condition who are counselled for RP.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 1","pages":"Pages 42-47"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388222000534/pdfft?md5=11daaf4a23af3385b023276fce97a015&pid=1-s2.0-S2214388222000534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49499082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}