{"title":"Virtual and augmented reality systems and three-dimensional printing of the renal model—novel trends to guide preoperative planning for renal cancer","authors":"","doi":"10.1016/j.ajur.2023.10.004","DOIUrl":"10.1016/j.ajur.2023.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the applications of three-dimensional (3D) technology, including virtual reality, augmented reality (AR), and 3D printing system, in the field of medicine, particularly in renal interventions for cancer treatment.</div></div><div><h3>Methods</h3><div>A specialized software transforms 2D medical images into precise 3D digital models, facilitating improved anatomical understanding and surgical planning. Patient-specific 3D printed anatomical models are utilized for preoperative planning, intraoperative guidance, and surgical education. AR technology enables the overlay of digital perceptions onto real-world surgical environments.</div></div><div><h3>Results</h3><div>Patient-specific 3D printed anatomical models have multiple applications, such as preoperative planning, intraoperative guidance, trainee education, and patient counseling. Virtual reality involves substituting the real world with a computer-generated 3D environment, while AR overlays digitally created perceptions onto the existing reality. The advances in 3D modeling technology have sparked considerable interest in their application to partial nephrectomy in the realm of renal cancer. 3D printing, also known as additive manufacturing, constructs 3D objects based on computer-aided design or digital 3D models. Utilizing 3D-printed preoperative renal models provides benefits for surgical planning, offering a more reliable assessment of the tumor's relationship with vital anatomical structures and enabling better preparation for procedures. AR technology allows surgeons to visualize patient-specific renal anatomical structures and their spatial relationships with surrounding organs by projecting CT/MRI images onto a live laparoscopic video. Incorporating patient-specific 3D digital models into healthcare enhances best practice, resulting in improved patient care, increased patient satisfaction, and cost saving for the healthcare system.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 521-529"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278164","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":"Prostatic small cell carcinoma with resultant tumor thrombus to the right iliac vein","authors":"","doi":"10.1016/j.ajur.2024.01.004","DOIUrl":"10.1016/j.ajur.2024.01.004","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 666-668"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636013","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":"Research progress of the Hippo signaling pathway in renal cell carcinoma","authors":"","doi":"10.1016/j.ajur.2024.02.005","DOIUrl":"10.1016/j.ajur.2024.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>This review aimed to summarize the role of the Hippo signaling pathway in renal cell carcinoma (RCC), a urologic malignancy with subtle initial symptoms and high mortality rates due to metastatic RCC. The Hippo signaling pathway, which regulates tissue and organ sizes, plays a crucial role in RCC progression and metastasis. Understanding the involvement of the Hippo signaling pathway in RCC provides valuable insights for the development of targeted therapies and improved patient outcomes.</div></div><div><h3>Methods</h3><div>In this review, we explored the impact of the Hippo signaling pathway on RCC. Through an analysis of existing literature, we examined its role in RCC progression and metastasis. Additionally, we discussed potential therapeutic strategies targeting the Hippo pathway for inhibiting RCC cell growth and invasion. We also highlighted the importance of investigating interactions between the Hippo pathway and other signaling pathways such as Wnt, transforming growth factor-beta, and PI3K/AKT, which may uncover additional therapeutic targets.</div></div><div><h3>Results</h3><div>The Hippo signaling pathway has shown promise as a target for inhibiting RCC cell growth and invasion. Studies have demonstrated its dysregulation in RCC, with altered expression of key components such as yes-associated protein/transcriptional coactivator with PDZ-binding motif (YAP/TAZ). Targeting the Hippo pathway has been associated with suppressed tumor growth and metastasis in preclinical models of RCC. Furthermore, investigating crosstalk between the Hippo pathway and other signaling pathways has revealed potential synergistic effects that could be exploited for therapeutic interventions.</div></div><div><h3>Conclusion</h3><div>Understanding the role of the Hippo signaling pathway in RCC is of paramount importance. Elucidating its functions and molecular interactions contributes to RCC diagnosis, treatment, and the discovery of novel mechanisms. This knowledge informs the development of innovative therapeutic strategies and opens new avenues for research in RCC. Further investigations are warranted to fully comprehend the complex interplay between the Hippo pathway and other signaling pathways, ultimately leading to improved outcomes for RCC patients.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 511-520"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139829651","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":"Urinary incontinence among Jordanian women: Prevalence, types, and associated factors","authors":"","doi":"10.1016/j.ajur.2023.11.003","DOIUrl":"10.1016/j.ajur.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>Urinary incontinence (UI) is a prevalent condition with a negative impact on women's quality of life. Data about UI among Jordanian women are lacking; therefore, we aimed to investigate the prevalence, types, and associated factors.</div></div><div><h3>Methods</h3><div>A cross sectional nationwide survey was conducted between 1 March 2020 and 15 April 2020. Women were included if they were 18 years of age or more and had access to the internet. Data collected included women's characteristics, UI types, and associated factors. UI was inventoried by asking women if they have UI (yes/no), and the Arabic language validated International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form was used. Age-group specific prevalence rates of UI were estimated, and associated factors were studied using logistic regression analyses.</div></div><div><h3>Results</h3><div>Data from 2118 women were analysed. The median age was 40 (range 18–85) years; 58.3% gave birth three or more times; and 64.1% consistently reported having UI. Limited mobility and being multiparous increased the likelihood of reporting UI. Compared to women with normal body mass index, overweight and obese women were 1.9 times and 4.4 times more likely to report UI, respectively.</div></div><div><h3>Conclusion</h3><div>The prevalence of UI among Jordanian women is 64.1%, with mixed UI and stress UI being the more prevalent types in women younger than 60 years old. Age, parity body mass index, and limited mobility are all associated factors with UI. The results of this study provide healthcare policy makers with the necessary information to increase awareness and knowledge regarding UI.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 651-659"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779728","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 outcomes of erectile function in adult orchidopexy patients","authors":"","doi":"10.1016/j.ajur.2024.02.001","DOIUrl":"10.1016/j.ajur.2024.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>Cryptorchidism affects up to 6% of full-term male infants, and orchidopexy has been shown to reduce impaired spermatogenesis and malignant risks significantly. However, the relationship between orchidopexy and sexual function has not been investigated. Therefore, this study aimed to evaluate sexual function outcomes in adult patients who underwent orchidopexy for unilateral undescended testis in childhood.</div></div><div><h3>Methods</h3><div>Totally, 58 adult patients who underwent unilateral orchidopexy in childhood were enrolled in the study. Erectile dysfunction (ED) was assessed by the International Index of Erectile Function (IIEF)-15 questionnaire. All participants underwent serum (testosterone and follicular stimulating hormone levels) measurement and semen analysis. Paternity rates were evaluated to assess the patient's fertility. Additionally, anxiety, depression, and stress were measured by the self-rating anxiety scale, self-rating depression scale, and visual analogue scale, respectively.</div></div><div><h3>Results</h3><div>There was no statistically significant difference between IIEF-15 scores (intercourse satisfaction, orgasmic function, sexual desire, or overall satisfaction) comparing the cryptorchidism group with the control group; however, the ED was significantly higher in the cryptorchidism patients (<em>p</em>=0.000). At the median follow-up of 16.3 years, 15.5% of our patients complained of moderate to severe ED. Most patients were satisfied with their overall relationship and only 34.5% were not satisfied. Anxiety, depression, and stress were more prevalent in cryptorchidism than in healthy men (anxiety: 72.4% <em>vs.</em> 20.7%; depression: 19.0% <em>vs.</em> 5.2%; stress: 60.3% <em>vs.</em> 10.3%; <em>p</em>˂0.05). Additionally, ED was negatively associated with anxiety, depression, and stress symptoms (<em>r</em>=<strong>−</strong>0.518, <em>p</em>=0.000; <em>r</em>=<strong>−</strong>0.448, <em>p</em>=0.000; <em>r</em>=<strong>−</strong>0.591, <em>p</em>=0.000, respectively). Moreover, ED had a significant correlation with advancing age, psychological factors (anxiety, depression, and stress), infertility, and low levels of testosterone (<em>p</em>˂0.05).</div></div><div><h3>Conclusion</h3><div>Low testosterone, infertility, and psychological burden (anxiety, depression, and stress) are used as factors for predicting ED outcomes after orchidopexy for undescended testis to guide physicians to evaluate the efficacy of testosterone replacement and psychological support in their management.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 642-650"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823799","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":"A unusual complication following self-catheterization in a young female","authors":"","doi":"10.1016/j.ajur.2023.10.005","DOIUrl":"10.1016/j.ajur.2023.10.005","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 671-672"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139755","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":"Hyper accuracy three-dimensional virtual anatomical rainbow model facilitates surgical planning and safe selective clamping during robot-assisted partial nephrectomy","authors":"","doi":"10.1016/j.ajur.2023.08.006","DOIUrl":"10.1016/j.ajur.2023.08.006","url":null,"abstract":"<div><h3>Objective</h3><div>To highlight the role of hyper accuracy three-dimensional (3D) reconstruction in facilitating surgical planning and guiding selective clamping during robot-assisted partial nephrectomy (RAPN).</div></div><div><h3>Methods</h3><div>A transperitoneal RAPN was performed in a 62-year-old male patient presenting with a 4 cm right anterior interpolar renal mass (R.E.N.A.L nephrometry score 7A). An abnormal vasculature was observed, with a single renal vein and two right renal arteries originating superiorly to the vein and anterior, when dividing in their segmental branches. According to the hyper accuracy 3D (HA3D®) rainbow model (MEDICS Srl, Turin, Italy), one branch belonging to one of the segmental arteries was feeding the tumor. This allowed for an accurate prediction of the area vascularized by each arterial branch. The 3D model was included in the intraoperative console view during the whole procedure, using the TilePro feature. A step-by-step explanation of the procedure is provided in the video attached to the present article.</div></div><div><h3>Results</h3><div>The operative time was 90 min with a warm ischemia time on selective clamping of 13 min. Estimated blood loss was 180 mL. No intraoperative complication was encountered and no drain was placed at the end of the procedure. The patient was discharged on postoperative Day 2, without any early postoperative complications. The final pathology report showed a pathological tumor stage 1 clear cell renal cell carcinoma with negative surgical margins.</div></div><div><h3>Conclusion</h3><div>The present study and the attached video illustrate the value of 3D rainbow model during the planning and execution of a RAPN with selective clamping. It shows how the surgeon can rely on this model to be more efficient by avoiding unnecessary surgical steps, and to safely adopt a “selective” clamping strategy that can translate in minimal functional impact.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 660-665"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638458","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":"An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux","authors":"","doi":"10.1016/j.ajur.2023.05.007","DOIUrl":"10.1016/j.ajur.2023.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>Vesicoureteral reflux (VUR) index is a simple, validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children. The aim of this study was to evaluate and compare the ureter diameter ratio (UDR) and VUR index (VURx) of patients treated with endoscopic injection (EI) and ureteroneocystostomy (UNC) methods in the pediatric age group due to primary VUR.</p></div><div><h3>Methods</h3><p>Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants. The UDR was assessed using voiding cystourethrography, and the VURx score was determined prior to treatment based on hospital records included in the study.</p></div><div><h3>Results</h3><p>A total of 255 patients, 60 (23.5%) boys and 195 (76.5%) girls, with a mean age of 76.5 (range 13.0–204.0) months, were included in the study. EI was applied to 130 (51.0%) patients and UNC was applied to 125 (49.0%) patients due to primary VUR. The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0% and 63.0%, respectively. The positive and negative predictive values were 66.0% and 70.0%, respectively.</p></div><div><h3>Conclusion</h3><p>When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group, it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 437-442"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223001418/pdfft?md5=d9eaa5c2d278af0a738cac9b56f92287&pid=1-s2.0-S2214388223001418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138623762","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":"Optimal sequential therapy using tyrosine kinase inhibitors as the first-line treatment in patients with metastatic renal cell carcinoma: A nationwide multicenter study","authors":"","doi":"10.1016/j.ajur.2022.11.004","DOIUrl":"10.1016/j.ajur.2022.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of the study was to identify the best sequence of therapy beginning with a tyrosine kinase inhibitor (TKI) as the first-line therapy for patients with metastatic renal cell carcinoma (mRCC) in terms of overall survival (OS), progression-free survival (PFS), and rates of discontinuation and adverse effects during the treatment period.</p></div><div><h3>Methods</h3><p>This is a retrospective, nationwide multicenter study of patients with mRCC after diagnosis at 10 different tertiary medical centers in Korea from January 1992 to December 2017. We focused on patients at either “favorable” or “intermediate” risk according to the International mRCC Database Consortium criteria, and they were followed up (median 335 days). Finally, a total of 1409 patients were selected as the study population. We generated a Cox proportional hazard model adjusted for covariates, and the different therapy schemes were statistically tested in terms of OS as well as PFS. In addition, frequencies of discontinuation and adverse events were compared among the therapy schemes.</p></div><div><h3>Results</h3><p>Of the primary patterns of treatment sequences (24 sequences), “sunitinib–pazopanib” and “sunitinib–everolimus–immunotherapy” showed the most beneficial results in both OS and PFS with significantly lower hazards than “sunitinib”, which is the most commonly treated agent in Korea. Considering that the “TKI–TKI” structure showed relatively higher discontinuation rates with higher adverse effects, the overall beneficial sequence would be “sunitinib–everolimus–immunotherapy”.</p></div><div><h3>Conclusion</h3><p>Among several sequential therapy starting with TKIs, “sunitinib–everolimus– immunotherapy” was found to be the best scheme for mRCC patients with “favorable” or “intermediate” risks.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 450-459"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000280/pdfft?md5=efceb69432d5f88a379daff0710d6cd1&pid=1-s2.0-S2214388223000280-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42030609","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}