Asian Journal of Urology最新文献

{"title":"Single-port transvesical robot-assisted simple prostatectomy with total urethral preservation for patients unable to adopt the lithotomy position: A case report","authors":"Lichen Chen ,&nbsp;Guanqun Ju ,&nbsp;Xinglin Chen ,&nbsp;Mingyue Tan ,&nbsp;Dongliang Xu","doi":"10.1016/j.ajur.2024.10.003","DOIUrl":"10.1016/j.ajur.2024.10.003","url":null,"abstract":"<div><div>Benign prostatic hyperplasia (BPH), prevalent in the aging male population, presented a unique surgical challenge in a 58-year-old patient with a history of multiple pelvic and hip surgeries, precluding conventional lithotomy and transurethral approaches. This report introduces an innovative, single-port transvesical robot-assisted simple prostatectomy with total urethral preservation. This pioneering technique, tailored for complex BPH management, demonstrated its efficacy and potential through favorable postoperative outcomes. This report underscores single-port transvesical robot-assisted simple prostatectomy with total urethral preservation as a promising surgical option for patients with BPH who are unable to assume the lithotomy position.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 407-411"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050653","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":"Short-term urinary continence outcomes after extraperitoneal single-site robot-assisted radical prostatectomy: A retrospective study","authors":"Fadi Mousa Al Kalailah ,&nbsp;Di Gu ,&nbsp;Yubo Wang ,&nbsp;Mingzhao Li ,&nbsp;Guohua Zeng","doi":"10.1016/j.ajur.2025.03.006","DOIUrl":"10.1016/j.ajur.2025.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>Radical prostatectomy (RP) is considered the gold standard treatment for patients with localized prostate cancer (PCa). All patients undergoing RP, either open, laparoscopic, or robotic, are at risk of developing urinary incontinence after RP. Our study aimed to analyze possible predictors of early postoperative (within 3 months) urinary continence (UC) outcomes following extraperitoneal single-site robot-assisted RP (ss-RARP) for localized PCa.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed data from 113 patients with localized PCa who were operated on by a highly experienced surgeon between September 2022 and December 2023. Patient characteristics (age, body mass index, prostate volume, prostate dimensions, preoperative and postoperative membranous urethral length, and percentage of membranous urethra removed) were analyzed using logistic regression to determine the independent factors contributing to short-term UC recovery after extraperitoneal ss-RARP. From the time of urinary catheter removal after surgery, the recovery of UC was followed up every month, and UC was defined as using ≤1 safety pad daily, known as social continence.</div></div><div><h3>Results</h3><div>The proportions of continent patients immediately after urinary catheter removal, 1 month, and 3 months after extraperitoneal ss-RARP were 22%, 49%, and 82%, respectively. The multivariate logistic regression analysis showed that the percentage of membranous urethra removed (<em>p</em>=0.016) and prostate volume (<em>p</em>=0.049) were associated with social UC recovery immediately after urinary catheter removal, and craniocaudal dimension of the prostate (<em>p</em>=0.042) and age (<em>p</em>=0.014) were associated with social UC recovery 1 month and 3 months after extraperitoneal ss-RARP, respectively.</div></div><div><h3>Conclusion</h3><div>The percentage of membranous urethra removed, prostate volume, craniocaudal dimension of the prostate, and age are independent risk factors for social UC early after extraperitoneal ss-RARP.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 350-356"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050670","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":"Investigation of the clinical significance of the expression of immunohistochemical biomarkers Enhancer of zeste homolog 2 and Forkhead box M1 in localized prostate cancer tissue: A Greek retrospective study","authors":"Sotirios Koubardas ,&nbsp;Dimitrios Goutas ,&nbsp;Iliana Mani ,&nbsp;Evangelia Krikou ,&nbsp;Ourania Mpatsi ,&nbsp;Harikleia Gakiopoulou ,&nbsp;Christos Alamanis ,&nbsp;Andreas C. Lazaris","doi":"10.1016/j.ajur.2024.09.007","DOIUrl":"10.1016/j.ajur.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>In recent decades, studies have underscored nuclear proteins and signaling pathways in prostate cancer (PCa) development. Key biomarkers like Enhancer of zeste homolog 2 (EZH2) and Forkhead box M1 (FOXM1) are expressed in both healthy and malignant prostate cells. This study aimed to demonstrate the relationship between pathological characteristics, survival, recurrence, and tissue expression of EZH2 and FOXM1 in high-risk PCa patients.</div></div><div><h3>Methods</h3><div>PCa tissues were used in a retrospective analysis that spanned from September 2009 to August 2019. Inclusion criteria comprised pathological tumor stage (pT) 3 patients with positive surgical margins or tumor proximity to inked margins within 5 mm. After case selection, tissue slides were stained for EZH2 and FOXM1 antibodies, and Allred scores were calculated. Patients or relatives of deceased patients were contacted for signed agreements and disease follow-ups.</div></div><div><h3>Results</h3><div>The pT3b, ductal carcinoma component, and moderate EZH2 expression were associated with relapse (odds ratio [OR] 6.21, 95% confidence interval [CI] 1.41–27.27, <em>p</em>=0.016; OR 7.29, 95% CI 1.03–51.43, <em>p</em>=0.046; OR 5.96, 95% CI 1.09–32.48, <em>p</em>=0.039; respectively). The unilateral and bilateral seminal vesicle invasion increased the likelihood of recurrence by 9.98 times and 5.36 times, and the risk of death by around 9.78 times and 10.79 times, respectively. The pT3b was linked to higher death likelihood (OR 7.16, 95% CI 1.38–37.23, <em>p</em>=0.019), while moderate EZH2 expression did not show statistical significance (OR 4.54, 95% CI 0.87–23.60, <em>p</em>=0.072, marginally). Pathological regional lymph node stage (pN) 1 had significantly higher probability of mortality than pN unknown (3.9% <em>vs.</em> 27%, <em>p</em>&lt;0.001). PCa in the neck and apex of the prostate gland increased death risk tenfold.</div></div><div><h3>Conclusion</h3><div>Sufficient immunoexpression of EZH2, ductal carcinoma component, and neoplastic proliferation in the seminal vesicles, apex and neck of the prostate gland correlates with elevated risks of recurrence and mortality. Clinicians should use these criteria for appropriate patient referrals, and a multicenter trial could provide accurate classifications.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 357-365"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050643","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":"Virtual-reality robot-assisted inferior vena cava thrombectomy using virtual vascular endoscopy to identify inferior vena cava invasion","authors":"Qingbo Huang ,&nbsp;Cheng Peng ,&nbsp;Songliang Du ,&nbsp;Xiaohui Ding ,&nbsp;Chenfeng Wang ,&nbsp;Kan Liu ,&nbsp;Jialong Song ,&nbsp;Xinran Chen ,&nbsp;Fei Yan ,&nbsp;Baojun Wang ,&nbsp;Xeng Inn Fam ,&nbsp;David Wei Lee ,&nbsp;Stewart Ping Lee ,&nbsp;Haiyi Wang ,&nbsp;Xu Zhang ,&nbsp;Xin Ma","doi":"10.1016/j.ajur.2024.08.004","DOIUrl":"10.1016/j.ajur.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>Partial or segmental inferior vena cava (IVC) resection is indicated for tumor control in patients with renal tumors invading the IVC. This study aimed to introduce a virtual vascular endoscope to assist surgeons in locating IVC invasion, formulate a surgical plan for robot-assisted IVC thrombectomy (RA-IVCT), and evaluate its potential value.</div></div><div><h3>Methods</h3><div>The reconstruction involves building the construction of deep learning models to predict IVC invasion, which were evaluated via intraoperative findings and pathological analysis. Thirty-six patients with renal tumors and IVC thrombi who underwent RA-IVCT between June 2016 and March 2022 were included in the study. A virtual vascular endoscopy was performed based on preoperative CT findings to identify IVC invasion. Based on the extent of IVC wall invasion and the collateral situation, surgeons could decide whether to perform partial or segmental IVC resection during RA-IVCT.</div></div><div><h3>Results</h3><div>Twenty patients were retrospectively analysed for training in virtual vascular endoscopy (the training cohort), and 16 patients were prospectively analysed to evaluate the accuracy of this technique (the validation cohort). Sixteen patients with IVC invasion underwent cavectomy, whereas six patients underwent partial IVC resection. In the validation cohort, pathological analysis confirmed the exact location of IVC invasion in eight of the nine patients, as indicated by virtual vascular endoscopy. Patients who underwent partial IVC wall resection had less lower extremity edema than those who underwent cavectomy.</div></div><div><h3>Conclusion</h3><div>Our initial experience showed that the virtual vascular endoscopy could assist surgeons in identifying IVC invasion and creating a surgical plan for RA-IVCT.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 375-384"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050645","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":"Two DNAH5 mutations in a Kartagener syndrome patient with azoospermia","authors":"Yang Xiong ,&nbsp;Mingyu Hu ,&nbsp;Qing Jiang,&nbsp;Wei Wang,&nbsp;Jiuhong Yuan,&nbsp;Yangchang Zhang,&nbsp;Feng Qin","doi":"10.1016/j.ajur.2025.04.001","DOIUrl":"10.1016/j.ajur.2025.04.001","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 414-416"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050647","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":"Optimized graph neural network-multilayer perceptron fusion classifier for metastatic prostate cancer detection in Western and Asian populations","authors":"Fengxian Han ,&nbsp;Xiaohui Fan ,&nbsp;Pengwei Long ,&nbsp;Wenhui Zhang ,&nbsp;Qiting Li ,&nbsp;Yingxuan Li ,&nbsp;Xingpeng Guo ,&nbsp;Yinran Luo ,&nbsp;Rongqi Wen ,&nbsp;Sheng Wang ,&nbsp;Shan Zhang ,&nbsp;Yizhuo Li ,&nbsp;Yan Wang ,&nbsp;Xu Gao ,&nbsp;Jing Li","doi":"10.1016/j.ajur.2024.09.009","DOIUrl":"10.1016/j.ajur.2024.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate cancer (PCa) exhibits significant genomic differences between Western and Asian populations. This study aimed to design a predictive model applicable across diverse populations while selecting a limited set of genes suitable for clinical implementation.</div></div><div><h3>Methods</h3><div>We utilized an integrated dataset of 1360 whole-exome and whole-genome sequences from Chinese and Western PCa cohorts to develop and evaluate the model. External validation was conducted using an independent cohort of patients. A graph neural network architecture, termed the pathway-aware multi-layered hierarchical network-Western and Asian (P-NETwa), was developed and trained on combined genomic profiles from Chinese and Western cohorts. The model employed a multilayer perceptron (MLP) to identify key signature genes from multi-omics data, enabling precise prediction of PCa metastasis.</div></div><div><h3>Results</h3><div>The model achieved an accuracy of 0.87 and an F1-score of 0.85 on Western population datasets. The application of integrated Chinese and Western population data improved the accuracy to 0.88, achieving an F1-score of 0.75. The analysis identified 18 signature genes implicated in PCa progression, including established markers (<em>AR</em> and <em>TP53</em>) and novel candidates (<em>MUC16, MUC4,</em> and <em>ASB12</em>). For clinical adoption, the model was optimized for commercially available gene panels while maintaining high classification accuracy. Additionally, a user-friendly web interface was developed to facilitate real-time prediction of primary versus metastatic status using the pre-trained P-NETwa-MLP model.</div></div><div><h3>Conclusion</h3><div>The P-NETwa-MLP model integrates a query system that allows for efficient retrieval of prediction outcomes and associated genomic signatures via sample ID, enhancing its potential for seamless integration into clinical workflows.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 327-337"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050234","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 comparison between thulium fiber laser enucleation of the prostate and robot-assisted simple prostatectomy in the surgical management of large benign prostatic hyperplasia","authors":"Victor Audige,&nbsp;Davy Benarroche,&nbsp;Louis Lenfant,&nbsp;Christophe Vaessen,&nbsp;Jérôme Parra,&nbsp;Emmanuel Chartier-Kastler,&nbsp;Aurélien Beaugerie,&nbsp;Pierre Mozer,&nbsp;Quentin Dubourg,&nbsp;Margaux Felber,&nbsp;Thomas Seisen,&nbsp;Morgan Roupret,&nbsp;Ugo Pinar","doi":"10.1016/j.ajur.2025.03.016","DOIUrl":"10.1016/j.ajur.2025.03.016","url":null,"abstract":"<div><h3>Objective</h3><div>Thulium fiber laser enucleation of the prostate (ThuFLEP) and robot-assisted simple prostatectomy (RASP) are two options for treating large benign prostatic hyperplasia. The most appropriate technique remains a matter of debate. We evaluated the efficacy and safety of ThuFLEP compared to RASP.</div></div><div><h3>Methods</h3><div>Between January 2020 and December 2023, all patients who underwent either RASP or ThuFLEP for a prostate volume &gt;80 mL were retrospectively included. The surgical procedure choice was left to the surgeon's and patient's discretion. Preoperative patient evaluation included the assessment of functional parameters. The groups were compared.</div></div><div><h3>Results</h3><div>A total of 234 patients were included: 106 (45%) underwent RASP and 128 (55%) underwent ThuFLEP. The mean operative time was shorter in the ThuFLEP group compared to the RASP group (106.4 with standard deviation [SD] 46.1 min <em>vs.</em> 123.2 [SD 32.8] min, <em>p</em>=0.012). The mean lengths of catheterization and stay were significantly longer in the RASP group (5.0 [SD 3.9] days <em>vs.</em> 1.7 [SD 2.0] days, <em>p</em>=0.009 [catheterization] and 4.9 [SD 3.0] days <em>vs.</em> 1.9 [SD 1.8] days, <em>p</em>=0.009 [stay]). The overall complication rate was significantly higher in the ThuFLEP group (12% <em>vs.</em> 2.8% in the RASP group, <em>p</em>=0.022). However, we did not observe significant differences in major complications (Clavien-Dindo ≥3) between the two groups (four [3.1%] in the ThuFLEP group <em>vs.</em> one [0.94%] in the RASP group, <em>p</em>=0.073). At 3 months, the rate of stress urinary incontinence was 4.7% after ThuFLEP and 1.9% after RASP (<em>p</em>=0.2). Finally, the quality of life score and maximum urinary flow were comparable between the ThuFLEP and RASP groups, but the International Prostate Symptom Score at 3 months postoperatively was lower in the RASP group (<em>p</em>=0.012).</div></div><div><h3>Conclusion</h3><div>Both ThuFLEP and RASP are safe techniques with comparable functional outcomes for large benign prostatic hyperplasia. ThuFLEP allows a reduction in catheterization and hospitalization durations but presents more complications compared to RASP.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 320-326"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050233","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":"Enhancing postoperative functional recovery: Impact of the MAIA™ telerehabilitation platform in robot-assisted radical prostatectomy patients","authors":"Daniele Amparore ,&nbsp;Sabrina De Cillis ,&nbsp;Michele Sica ,&nbsp;Federico Piramide ,&nbsp;Enrico Checcucci ,&nbsp;Alberto Piana ,&nbsp;Alberto Quara ,&nbsp;Edoardo Cisero ,&nbsp;Federica Pini ,&nbsp;Cecilia Gatti ,&nbsp;Matteo Manfredi ,&nbsp;Cristian Fiori ,&nbsp;Francesco Porpiglia","doi":"10.1016/j.ajur.2024.07.005","DOIUrl":"10.1016/j.ajur.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and user satisfaction of the MAIA™ telemedicine platform for postoperative telemonitoring and telerehabilitation in patients undergoing robot-assisted radical prostatectomy (RARP).</div></div><div><h3>Methods</h3><div>Patients undergoing RARP (from April 2022 to January 2023) were divided into Group A, following the standard rehabilitation protocol, and Group B using the MAIA™ platform for the first 30-day post-intervention period. Perioperative, pathological, and functional variables (continence and potency rates, assessed via validated questionnaires) were collected and telerehabilitation protocol's adherence was monitored. The telerehabilitation system included an online platform for medical providers and a patient application, facilitating data acquisition, management, treatment planning, and monitoring. Patient and provider satisfaction were evaluated using the visual analogue scale score and validated telemedicine satisfaction questionnaire.</div></div><div><h3>Results</h3><div>Totally, 227 patients were enrolled. No differences in perioperative or pathological variables were found. Group B had higher potency recovery rates than Group A (<em>p</em>=0.031); the potency recovery rates at 1 month and 3 months for Group B were 45% and 57%, respectively, and in Group A were 34% and 48%, respectively. At the multivariate analysis, MAIA™ use and the nerve-sparing (NS) were independent predictors of erectile function at both 1 month (MAIA™ use: odd ratio [OR] 2.03, 95% confidence interval [CI] 1.13–3.63, <em>p</em>=0.018; NS: OR 2.08, 95% CI 1.06–4.12, <em>p</em>=0.034) and 3 months (MAIA™ use: OR 1.89, 95% CI 1.07–3.34, <em>p</em>=0.028; NS: OR 1.90; 95% CI 1.02–3.54, <em>p</em>=0.044). Adherence monitoring revealed 4.6% of patients in Group B reported exercise issues due to pelvic pain onset and 10% did not take oral phosphodiesterase 5-inhibitors due to myalgia. All those patients restarted the rehabilitation program after televisit to address the causing problem, allowing restarting of a rehabilitation program. Patients reported high satisfaction with the MAIA™ platform use (mean visual analogue scale score: 88.7).</div></div><div><h3>Conclusion</h3><div>The MAIA™ telemedicine platform seems to have a role in optimizing early potency recovery after RARP. Patient and provider satisfaction levels were high, emphasizing the user-friendliness of the platform.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 366-374"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050644","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":"Risk analysis of adverse pathological changes in cT2cN0M0 prostate cancer after robot-assisted radical prostatectomy: Results from a population-based study","authors":"Jianhui Qiu ,&nbsp;Ruiyi Deng ,&nbsp;Jiaheng Shang ,&nbsp;Zihou Zhao ,&nbsp;Jingcheng Zhou ,&nbsp;Lin Cai ,&nbsp;Kan Gong ,&nbsp;Yi Liu","doi":"10.1016/j.ajur.2024.09.005","DOIUrl":"10.1016/j.ajur.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To explore clinicopathological predictors of adverse pathological changes (APCs) (upgrading, upstaging, and positive surgical margin [PSM]) after robot-assisted radical prostatectomy (RARP) in clinical tumor stage 2c (cT2c) prostate cancer (PCa) patients.</div></div><div><h3>Methods</h3><div>From January 2018 to December 2022, cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included. Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs. Nomograms were constructed based on these predictive models. The performance of the nomograms was evaluated by receiver operating characteristic curves, decision curve analyses, and calibration plots.</div></div><div><h3>Results</h3><div>A total of 423 eligible cT2cN0M0 PCa patients were included. The rates of upgrading, upstaging, and PSM in our cohort were 33%, 51%, and 35%, respectively. The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs. The score of the Prostate Imaging Reporting and Data System, PSA density, and the International Society of Urological Pathology grade group (IGG) of needle-biopsy specimens (or clinical IGG [cIGG]) were significantly associated with upgrading. The PSA density, percentage of positive cores in systematic biopsy, and largest tumor percentage in all cores of each patient (LTP) were significantly associated with upstaging. The PSA density and LTP were significantly associated with the PSM. Based on these results, four nomograms were developed. Receiver operating characteristic curves, decision curve analyses, and calibration plots implied that the nomograms exhibited excellent accuracy.</div></div><div><h3>Conclusion</h3><div>The predictive models we developed could help to identify high-risk PCa early, and optimize clinical decisions of cT2cN0M0 PCa patients.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 338-349"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050235","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":"Re: Aboutaleb H, Sultan M, Zaghloul A, Farahat Y, Gawish M, Zanaty F. Is fluoroscopy-free single-use flexible ureteroscopy a feasible treatment for kidney stones with abnormal renal anatomy? Asian J Urol 2024;11:591–5. Fluoroscopic-free procedures: Is this the future of endourology?","authors":"Guglielmo Mantica,&nbsp;Alessandro Calarco","doi":"10.1016/j.ajur.2025.03.014","DOIUrl":"10.1016/j.ajur.2025.03.014","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 417-418"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050648","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}