Asian Journal of Urology最新文献

{"title":"Effectiveness of virtual reality to manage pain and anxiety in patients undergoing cystoscopy: A systematic review and meta-analysis","authors":"Guilherme M.M. Lopes ,&nbsp;Lucas G.C.R. de Amorim ,&nbsp;Giovanna V. Gomes ,&nbsp;Thaise P. da Silva ,&nbsp;Manuel G.R. Martínez ,&nbsp;Mohammed A. Ramadhan ,&nbsp;Bárbara Vieira Lima Aguiar Melão","doi":"10.1016/j.ajur.2025.01.005","DOIUrl":"10.1016/j.ajur.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to perform a systematic review and meta-analysis to assess the efficacy of virtual reality (VR) distraction technologies in managing pain and anxiety in patients undergoing cystoscopy procedures.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to July 2024, for studies comparing the use of VR distraction technologies versus no VR distraction in patients undergoing cystoscopy. The primary endpoints evaluated were patient-reported anxiety and procedural pain scores, and post-procedural heart rate (HR). Standardized mean differences (SMDs) and their 95% confidence intervals (CIs) were computed with the use of a random-effects model. The statistical analysis was conducted using Review Manager 5.4.</div></div><div><h3>Results</h3><div>A total of 575 patients from four randomized controlled trials were included, of whom 289 (50%) underwent the cystoscopy procedure using VR distraction technologies. The mean age of all patients was 57.25 years old, and 395 (69%) of them were male. In our pooled analysis, we did not observe a statistically significant reduction in patient-reported procedural pain (SMD −0.16; 95% CI −0.32–0.00; <em>p</em>=0.060; <em>I</em>²=0%), anxiety (SMD −0.37; 95% CI −1.65–0.90; <em>p</em>=0.6; <em>I</em>²=93%), or post-procedural HR (SMD −0.58; 95% CI −1.62–0.45; <em>p</em>=0.3; <em>I</em>²=97%).</div></div><div><h3>Conclusion</h3><div>In this comprehensive meta-analysis comprising 575 patients who underwent cystoscopy, the use of VR was not associated with a significant difference in pain, anxiety, or HR levels.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 4","pages":"Pages 462-470"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication, teamwork, and the role of non-technical skills in Urology: A review by the European School of Urology","authors":"Mahir Akram ,&nbsp;Bhaskar Somani ,&nbsp;Evangelos Liatsikos ,&nbsp;Vineet Gauhar ,&nbsp;Steffi Kar Kei Yuen ,&nbsp;Arnulf Stenzl","doi":"10.1016/j.ajur.2024.12.005","DOIUrl":"10.1016/j.ajur.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>While technical operating skills and clinical knowledge are often the goals of surgical training, for overall competency, the required skill set goes far beyond these. Social and cognitive abilities in the form of non-technical skills (NTS) are indispensable competencies that complement a surgeon's procedural efficiency and contribute towards patient safety. The NTS are classified into three unique groups: cognitive (decision-making and situational awareness), social (leadership, teamwork, and communication), and personal resource factors (an individual's ability to manage fatigue and stress). Inadequacy in the aforementioned is often the underlying cause of detrimental operating room outcomes and surgical errors universally.</div></div><div><h3>Methods</h3><div>This review looks at various components of NTS and evaluation tools currently in use, their importance in urological training, and the need to introduce a formal programme. This would not only complement technical skills, but also serve as an integral and mandatory part of training years for all grades of urologists.</div></div><div><h3>Results</h3><div>Assessment of NTS through comprehensively validated rating tools allows for the evaluation of skills and therefore finds room for improvement in competencies. Commonly used systems include the Non-Technical Skills for Surgeons (NOTSS), Non-Technical Skills (NOTECHS), and Observational Teamwork Assessment for Surgery (OTAS).</div></div><div><h3>Conclusion</h3><div>The significance of associating team culture with the safety of surgery is increasingly recognised, given that human error is unavoidable and hard to eradicate. Whilst we now have a clear definition of the NTS and their importance in surgery and the operating theatre, there is still a lack of a validated and standardised NTS training programme directed at urologists, and that is applicable to all levels, whether they be trainees or consultants. Simulation-based learning is an excellent avenue for progressing surgical education and should be taken advantage of in developing a curriculum that is mandatory for NTS training in urology.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 4","pages":"Pages 455-461"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral knee-flexion prone split-leg percutaneous nephrolithotomy: A versatile technique","authors":"Shuhang Luo ,&nbsp;Xuanfan Liu ,&nbsp;Nueraili Nuermaimaiti ,&nbsp;Shuangjian Jiang ,&nbsp;Chengqiang Mo ,&nbsp;Baohua Bai ,&nbsp;Rongpei Wu ,&nbsp;Qinsong Zeng","doi":"10.1016/j.ajur.2024.10.004","DOIUrl":"10.1016/j.ajur.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study developed a novel technique for performing percutaneous nephrolithotomy (PCNL) in the knee-flexion prone split-leg (KF-PSL) position; this technique aimed to address the shortcomings of the traditional prone (TP) position and the PSL position. The study evaluated the safety, advantages, and feasibility of the KF-PSL position compared to the TP position.</div></div><div><h3>Methods</h3><div>A novel technique was developed based on the common PSL position. A retrospective analysis was conducted on the data of 276 patients who underwent PCNL in either the KF-PSL or TP position between January 2022 and June 2023. Demographic and perioperative clinical data of the KF-PSL and TP groups were reviewed and compared.</div></div><div><h3>Results</h3><div>A total of 276 patients were divided into two groups based on the operative position. The preoperative parameters of the two groups did not differ significantly. The mean stone size (represented by the aggregation of the diameter of all the stones) was 40.03 (SD 23.89) mm. Significant differences were found in both the mean operative time (80.9 [SD 47.2] min in KF-PSL <em>vs.</em> 107.3 [SD 57.7] min in TP, <em>p</em>&lt;0.001) and the stone-free rates (73% in KF-PSL <em>vs.</em> 61% in TP, <em>p</em>=0.046). Braden Scale scores of the two groups did not differ significantly (<em>p</em>=0.12). No significant difference was observed between the groups in the total complication rate (<em>p</em>=0.6).</div></div><div><h3>Conclusion</h3><div>The KF-PSL is a promising modified position for PCNL that allows for a shorter operative time, a higher stone-free rate, and a more simplified surgical procedure compared to the TP position without compromising outcomes. It is more convenient for combined therapy, allowing access to the entire urinary tract without the need for position changes.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 4","pages":"Pages 544-553"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical dissection-based enucleation versus laser energy-based enucleation during thulium laser enucleation of a large prostate: A prospective randomized analysis","authors":"Ahmed Assem ,&nbsp;Wahed Fawzy ,&nbsp;Islam Nasser Abd Elaziz ,&nbsp;Samer Morsy ,&nbsp;Islam Kamal ,&nbsp;Ahmed Abdalla Ashmawy","doi":"10.1016/j.ajur.2024.11.001","DOIUrl":"10.1016/j.ajur.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study attempted to compare the laser energy-based enucleation with the mechanical dissection-based enucleation regarding the enucleation efficiency and the functional outcomes.</div></div><div><h3>Methods</h3><div>This was a prospective multicenter study including patients with a prostate exceeding 80 g. Thulium laser enucleation of the prostate was conducted using a high-power thulium laser either through mechanical dissection-based enucleation (Group A) or through laser energy-based enucleation (Group B) according to the preoperative randomization. In Group A, the resectoscope sheath beak was used to liberate the prostate adenoma and laser energy was reserved for adhesions and for hemostasis. In Group B, laser energy was implemented throughout the procedure.</div></div><div><h3>Results</h3><div>Groups A and B included 68 and 71 patients, respectively, for analysis. The mean (standard deviation [SD]) enucleation time was shorter in Group A than in Group B (55.2 [SD 9.4] min <em>vs.</em> 77.3 [SD 12.5] min, <em>p</em>=0.021). The enucleation efficiency and total operative time were statistically different between the two groups (<em>p</em>=0.032 and 0.039, respectively). Black eschars were observed in 21% of Group A and 100% of Group B. A larger percentage of Group B (35%) expressed more storage symptoms in the first 3 months after surgery than that of Group A (13%). There was no statistically significant difference between the two groups regarding the postoperative transient stress urinary incontinence. Additionally, there was no statistically significant difference between the two techniques regarding the overall bleeding, or the hospital stay in patients on antiplatelet or anticoagulant therapy.</div></div><div><h3>Conclusion</h3><div>Both mechanical dissection-based and laser energy-based thulium laser enucleation of the prostate are safe and feasible for successful reduction of bladder outlet resistance. The mechanical dissection-based enucleation technique provides higher enucleation efficiency with lower postoperative transient storage symptoms.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 4","pages":"Pages 504-511"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting bladder cancer: Potent anti-cancer effects of cannabichromene and delta-9-tetrahydrocannabinol-rich Cannabis sativa strains","authors":"Omer Anis ,&nbsp;Vered Bar ,&nbsp;Adi Zundelevich ,&nbsp;Seegehali M. Anil ,&nbsp;Yaron Shav-Tal ,&nbsp;Amos Toren ,&nbsp;Dan Dominissini ,&nbsp;Gil Raviv ,&nbsp;Menachem Laufer ,&nbsp;Alon Lazarovich ,&nbsp;Tomer Drori ,&nbsp;Jacob Ramon ,&nbsp;Zohar Dotan ,&nbsp;Hinanit Koltai","doi":"10.1016/j.ajur.2025.03.004","DOIUrl":"10.1016/j.ajur.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the anticancer potential of <em>Cannabis sativa</em> (<em>C. sativa</em>) strains, specifically PARIS, Dairy Queen (DQ), and super cannabidiol (sCBD), on bladder cancer cells. Given the increasing interest in cannabinoids like cannabichromene (CBC) and delta-9-tetrahydrocannabinol (THC) for their therapeutic properties, we evaluated their cytotoxic effects on urothelial carcinoma (UC) cell lines and their ability to inhibit cell migration and induce apoptosis in both two-dimensional cell models and three-dimensional <em>ex vivo</em> organ cultures (EVOCs).</div></div><div><h3>Methods</h3><div><em>C. sativa</em> strains were screened for their cytotoxicity against UC cell lines (HTB-4 and HTB-9) using XTT assays. Their phytocannabinoid content was analyzed using high-performance liquid chromatography. We employed fluorescence-activated cell-sorting to determine apoptosis and cell cycle, migration assays to determine cell migration, and EVOCs to evaluate the cytotoxic effect on UC. Gene expression was determined by quantitative polymerase chain reaction.</div></div><div><h3>Results</h3><div>Three commercial <em>C. sativa</em> strains, PARIS, DQ, and sCBD, were found to have the most potent anticancer effects on bladder cancer cells. All extracts contain CBC and THC at different concentrations. In XTT assays on UC cell lines, PARIS had a half-maximal inhibitory concentration (IC₅₀) of 21.58 μg/mL, while DQ and sCBD had similar cytotoxic activity with IC₅₀ values for 48-h treatment of 17.99 μg/mL and 17.88 μg/mL, respectively. DQ and sCBD extracts were found to significantly reduce cell migration and increase the percentage of cells in S phase and G₂/M phase within the cell population. In EVOCs, the extracts initiated cell death with the expression of apoptosis-related genes increased following exposure to treatment.</div></div><div><h3>Conclusion</h3><div>The findings suggest that <em>C. sativa</em> strains PARIS, DQ, and sCBD, containing CBC and THC, exhibit significant anticancer activity against UC cell lines and <em>ex vivo</em> models. These results underscore the therapeutic potential of CBC- and THC-rich <em>C. sativa</em> extracts in bladder cancer treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 4","pages":"Pages 534-543"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review based on expert opinions for robot-assisted simple prostatectomy for large benign prostatic hyperplasia","authors":"Bin Xu ,&nbsp;Linhui Wang ,&nbsp;Qingyi Zhu ,&nbsp;Xing Ai ,&nbsp;Wei Guan ,&nbsp;Guoqing Ding ,&nbsp;Dongliang Xu ,&nbsp;Liaoyuan Li ,&nbsp;Gutian Zhang ,&nbsp;Liping Xie ,&nbsp;Chinese Benign Prostatic Hyperplasia Consortium","doi":"10.1016/j.ajur.2025.03.002","DOIUrl":"10.1016/j.ajur.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Robot-assisted simple prostatectomy (RASP) is increasingly used as a surgical treatment option for large benign prostatic hyperplasia (BPH) (&gt;80 mL). However, there is no sufficient expert consensus or guidelines to guide clinical practice. We aimed to obtain expert opinions for RASP for large BPH.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was performed in April 2024 using the PubMed, Embase, and Web of Science databases. Search terms were combined to construct the following search strings: (robotic) AND (simple OR benign) AND (prostatectomy). Search results were filtered by language (English only), species (human), and publication type (original article). This study used a two-phase modified Delphi approach.</div></div><div><h3>Results</h3><div>In this expert consensus, some frequently used RASP techniques, including robot-assisted retropubic prostatectomy, robot-assisted transvesical prostatectomy, and robot-assisted urethra-sparing prostatectomy, are described. RASP offers a short learning curve for surgeons with experience in robotic surgery. Severe complications are rare in patients who undergo RASP.</div></div><div><h3>Conclusion</h3><div>RASP technique can be recommended as a safe and effective minimally invasive treatment for symptomatic BPH patients with large prostate glands.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 290-294"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features and prognosis of small cell carcinoma of the urinary bladder","authors":"Xintao Tian ,&nbsp;Huiqing Jia ,&nbsp;Yue Liu ,&nbsp;Ye Liang ,&nbsp;Shaonan Yang ,&nbsp;Zhijuan Liang ,&nbsp;Guofeng Ma ,&nbsp;Haitao Niu","doi":"10.1016/j.ajur.2024.10.008","DOIUrl":"10.1016/j.ajur.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the clinicopathological features and prognosis of small cell carcinoma of the urinary bladder (SCCUB).</div></div><div><h3>Methods</h3><div>Clinicopathological data and prognosis of 24 patients with primary SCCUB treated at the Affiliated Hospital of Qingdao University (from January 2016 to December 2021) were retrospectively collected and compared with 335 patients with primary high-grade urothelial carcinoma (HG-UC) during the same period. The study endpoints were disease-free survival (DFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>Of the 24 patients with SCCUB, 19 were male and five were female. Eight (33%) cases were pure SCCUB (pSCCUB). Sixteen (67%) cases were mixed SCCUB (mSCCUB), all of which were mixed with urothelial carcinoma. All patients underwent surgery and 13 (76%, 13/17; seven patients were lost to follow-up) patients received postoperative adjuvant chemotherapy. We found no significant difference in clinicopathological features between pSCCUB and mSCCUB. However, compared to HG-UC, SCCUB had higher lymph node metastasis (<em>p</em>=0.014), more lymphovascular invasion (<em>p</em>=0.024), higher Ki-67 expression (<em>p</em>&lt;0.001), and more disease progression events (<em>p</em>=0.001). Median DFS and OS for SCCUB were 22 months and 38 months, respectively. The Kaplan-Meier survival curve showed that the pathological type or surgical type did not affect DFS or OS of SCCUB. However, SCCUB patients had worse DFS and OS than HG-UC patients (both <em>p</em>&lt;0.05). The multivariate Cox analysis showed that the tumor size (hazard ratio 1.44, 95% CI 1.96–2.15, <em>p</em>=0.048) was an independent factor affecting DFS of SCCUB patients.</div></div><div><h3>Conclusion</h3><div>Compared with the common HG-UC, SCCUB is rare with specific clinicopathological features and a worse prognosis.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 393-401"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney-sparing approach for upper tract urothelial carcinoma: An update on current evidence","authors":"Ivan Ching Ho Ko ,&nbsp;Chris Ho Ming Wong ,&nbsp;David Ka Wai Leung ,&nbsp;Alex Qin-yang Liu ,&nbsp;Kevin Cheuk Kin Cheng ,&nbsp;Brian Wai Hei Siu ,&nbsp;Steffi Kar Kei Yuen ,&nbsp;Nikhil Vasdev ,&nbsp;Keiichiro Mori ,&nbsp;Karl H. Tully ,&nbsp;Dmitry Enikeev ,&nbsp;Anthony Chi Fai Ng ,&nbsp;Jeremy Yuen Chun Teoh","doi":"10.1016/j.ajur.2024.08.003","DOIUrl":"10.1016/j.ajur.2024.08.003","url":null,"abstract":"<div><h3>Objective</h3><div>This article reviews the latest updates and outcomes of kidney-sparing surgery (KSS) in patients with upper tract urothelial carcinoma (UTUC).</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years. Key search words included “upper urinary tract tumour/cancer/carcinoma”, “kidney-sparing surgery or approach”, “endoscopic treatment for upper tract tumour/cancer/carcinoma”, “topical instillation in the upper urinary tract”, and “urinary marker for urothelial carcinoma”. References within the identified literature were explored and evaluated for relevance.</div></div><div><h3>Results</h3><div>KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney. Studies have shown comparable oncological outcomes after KSS including endoscopic ablation, segmental ureterectomy, and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases. The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.</div></div><div><h3>Conclusion</h3><div>Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology, driven by advances in technology, better diagnostic tools, and novel therapeutic agents. Our article provides a comprehensive review of the latest advancements and clinical recommendations. While current evidence is mainly based on retrospective studies, prospective trials are required to address important but unanswered clinical questions in this field.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 295-308"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental evaluation of the optimum applied pressure and number of cuffs for artificial sphincter in fluid flow control in an ex vivo model","authors":"Pourya Shokri ,&nbsp;Seyed Amir Mohsen Ziaee ,&nbsp;Nasrin Borumandnia ,&nbsp;Shahin Tabatabaei","doi":"10.1016/j.ajur.2024.12.004","DOIUrl":"10.1016/j.ajur.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design, and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.</div></div><div><h3>Method</h3><div>In this study, five sheep bladders were used to design and build a biomechanical evaluation system. The biomechanical system included the bladder, pressure gauge, pressure regulator system of the bladder, and force application system by the cuff. In this study, we increased the fluid pressure inside the bladder from 0 cmH₂O to 200 cmH₂O (1 cmH₂O=0.098 kPa), and at each point, the force applied by the cuff to prevent fluid leakage was measured and recorded.</div></div><div><h3>Results</h3><div>The study revealed that a mean tensile force of 2.81 (standard deviation 0.23) N for a single cuff and 1.63 (standard deviation 0.16) N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH₂O to 100 cmH₂O (<em>p</em>&lt;0.001). However, there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use. Furthermore, using three cuffs instead of two did not yield significantly different outcomes.</div></div><div><h3>Conclusion</h3><div>Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force. Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study, it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis. Future <em>in vivo</em> studies are recommended to further evaluate efficiency.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 402-406"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder preservation alternatives in non-metastatic muscle-invasive bladder tumor: A systematic review and meta-analysis","authors":"Diego Parrao ,&nbsp;Nemecio Lizana ,&nbsp;Catalina Saavedra ,&nbsp;Valentina Fernández ,&nbsp;Carolina B. Lindsay ,&nbsp;Matías Larrañaga ,&nbsp;Mario I. Fernández ,&nbsp;Juan Cristóbal Bravo","doi":"10.1016/j.ajur.2024.08.005","DOIUrl":"10.1016/j.ajur.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the most recent scientific literature regarding modern strategies for organ preservation in the treatment of non-metastatic muscle-invasive bladder cancer.</div></div><div><h3>Methods</h3><div>Literature search was made using PubMed, Google Scholar, EMBASE, Wiley Library, and ClinicalTrials.gov following the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. The primary outcome was 5-year overall survival rate, which was addressed by a systematic review and meta-analysis. The risk of bias and quality of evidence were assessed according to the Cochrane Collaboration and the Grading of Recommendations, Assessment, Development and Evaluation system.</div></div><div><h3>Results</h3><div>The evidence is consistent in showing that 5-year survival of trimodality therapy is similar to radical cystectomy in selected patients, ranging between 29% and 73%. Patients undergoing bladder-sparing therapy were found to have better outcomes in terms of quality of life and sociability than those undergoing radical cystectomy. Immunotherapy is establishing itself as a strategy for organ-preservation treatment, showing complete response rates between 42% and 100%. However, most of these results have been obtained from ongoing clinical trials. Furthermore, there are still no studies comparing the efficacy among the different available therapies.</div></div><div><h3>Conclusion</h3><div>Although radical cystectomy remains the gold standard treatment for muscle-invasive bladder cancer, its significant morbidity has prompted the exploration of alternative therapies. In this context, bladder preservation therapies, though supported by limited literature, emerge as a potential alternative that could offer comparable oncological outcomes in selected patients.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 309-319"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}