Asian Journal of Urology最新文献

{"title":"Mesenchymal stem cell secretome: A promising therapeutic strategy for erectile dysfunction?","authors":"","doi":"10.1016/j.ajur.2024.02.003","DOIUrl":"10.1016/j.ajur.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>The secretome, comprising bioactive chemicals released by mesenchymal stem cells (MSCs), holds therapeutic promise in regenerative medicine. This review aimed to explore the therapeutic potential of the MSC secretome in regenerative urology, particularly for treating erectile dysfunction (ED), and to provide an overview of preclinical and clinical research on MSCs in ED treatment and subsequently to highlight the rationales, mechanisms, preclinical investigations, and therapeutic potential of the MSC secretome in this context.</p></div><div><h3>Methods</h3><p>The review incorporated an analysis of preclinical and clinical research involving MSCs in the treatment of ED. Subsequently, it delved into the existing knowledge regarding the MSC secretome, exploring its therapeutic potential. The methods included a comprehensive examination of relevant literature to discern the processes underlying the therapeutic efficacy of the MSC secretome.</p></div><div><h3>Results</h3><p>Preclinical research indicated the effectiveness of the MSC secretome in treating various models of ED. However, the precise mechanisms of its therapeutic efficacy remain unknown. The review provided insights into the anti-inflammatory, pro-angiogenic, and trophic properties of the MSC secretome. It also discussed potential advantages, such as avoiding issues related to cellular therapy, including immunogenicity, neoplastic transformation, and cost.</p></div><div><h3>Conclusion</h3><p>This review underscores the significant therapeutic potential of the MSC secretome in regenerative urology, particularly for ED treatment. While preclinical studies demonstrate promising outcomes, further research is essential to elucidate the specific mechanisms underlying the therapeutic efficacy before clinical application. The review concludes by discussing future perspectives and highlighting the challenges associated with the clinical translation of the MSC secretome in regenerative urology.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 391-405"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388224000146/pdfft?md5=542106f787a6659b2ef9bec2ccff9389&pid=1-s2.0-S2214388224000146-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139886587","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":"Uncovering the epidemiology of bladder cancer in the Arab world: A review of risk factors, molecular mechanisms, and clinical features","authors":"","doi":"10.1016/j.ajur.2023.10.001","DOIUrl":"10.1016/j.ajur.2023.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>Bladder cancer (BC) is a significant public health concern in the Middle East and North Africa, but the epidemiology and clinicopathology of the disease and contributors to high mortality in this region remain poorly understood. The aim of this systematic review was to investigate the epidemiological features of BC in the Arab world and compare them to those in Western countries in order to improve the management of this disease.</p></div><div><h3>Methods</h3><p>An extensive electronic search of the PubMed/PMC and Cochrane Library databases was conducted to identify all articles published until May 2022, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A total of 95 articles were included in the final analysis after title, abstract, and full-text screening, with additional data obtained from the GLOBOCAN and WHO 2020 databases.</p></div><div><h3>Results</h3><p>Most of the included articles were case-control studies examining the risk factors and molecular mechanisms of BC. These studies originated from 10 different countries, with Egypt being the most active contributor. While BC in the Arab world shares some common risk factors with Western countries, such as smoking and occupational exposure, it also exhibits unique features related to schistosomiasis. The high mortality rates in this region are alarming and can be attributed to various factors, including the prevalence of smoking, the impact of schistosomiasis, a combination of genetic and socioeconomic factors, treatment shortages, and limited access to care or inadequate assessment of the quality of care.</p></div><div><h3>Conclusion</h3><p>Despite the relatively low incidence of BC in Arab countries, the mortality rates are among the highest worldwide. BC tends to be more aggressive in the Arab world, making it essential to implement strategies to address this burden.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 406-422"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223001200/pdfft?md5=b41a8e2103068933c2749c479622458c&pid=1-s2.0-S2214388223001200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128948","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":"Comparative study of thulium fiber laser versus holmium:yttrium-aluminum-garnet laser for ureteric stone management with semi-rigid ureteroscopy: A prospective, single-center study","authors":"","doi":"10.1016/j.ajur.2023.01.001","DOIUrl":"10.1016/j.ajur.2023.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the efficacy and safety of thulium fiber laser (TFL) and holmium:yttrium-aluminum-garnet (Ho:YAG) laser for ureteric stone management with semi-rigid ureteroscopy.</p></div><div><h3>Methods</h3><p>In a prospective study from January 2020 to December 2021, we compared 40 patients in each group who underwent semi-rigid ureteroscopic lithotripsy with TFL and that with Ho:YAG laser. Stone volume, stone density, stone fragmentation rates, total lasing time, total operative time, endoscopic vision, retropulsion and stone free rates were analyzed in both groups and compared.</p></div><div><h3>Results</h3><p>Mean stone volume was comparable in the TFL group and the Ho:YAG laser group (282.45 [standard deviation, SD 139.79] mm³ <em>vs.</em> 279.49 [SD 312.52] mm³; <em>p</em>=0.964). Mean stone density was also comparable in the TFL group and the Ho:YAG laser group (1135.30 [SD 317.04] Hounsfield unit <em>vs.</em> 1131.75 [SD 283.03] Hounsfield unit; <em>p</em>=0.959). The mean stone fragmentation rates calculated as stone volume divided by lasing time were 25.85 (SD 10.61) mm³/min and 21.37 (SD 14.13) mm³/min in the TFL group and the Ho:YAG laser group, respectively (<em>p</em>=0.113). The mean total lasing time (10.15 [SD] 4.69 min <em>vs.</em> 11.43 [SD 4.56] min; <em>p</em>=0.222), mean operative time (25.13 [SD 9.51] min <em>vs.</em> 25.54 [SD 10.32] min; <em>p</em>=0.866), and mean total hospital stay (2.62 [SD 0.77] days <em>vs.</em> 2.61 [SD 0.84] days; <em>p</em>=0.893) were comparable in the TFL group and in the Ho:YAG group. The vision was better and retropulsion was less in the TFL group. The stone-free rate at 1 month postoperatively was slightly better in the TFL group (100% <em>vs.</em> 90%; <em>p</em>=0.095).</p></div><div><h3>Conclusion</h3><p>TFL technology was associated with the comparable total surgical time, total lasing time, and stone fragmentation rate with Ho:YAG laser. However, TFL had better endoscopic vision, lesser stone retropulsion, and slightly better stone-free rates.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 460-465"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000164/pdfft?md5=d8ae53c9d44a00b77b3b51143bcb5daa&pid=1-s2.0-S2214388223000164-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49483848","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 the association between the prolonged operative time and 90-day complications in patients undergoing radical cystectomy","authors":"","doi":"10.1016/j.ajur.2023.04.004","DOIUrl":"10.1016/j.ajur.2023.04.004","url":null,"abstract":"<div><h3>Objective</h3><p>Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity. We aimed to assess the operative time (OT) in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.</p></div><div><h3>Methods</h3><p>The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution. The OT of 369 min was set as a cutoff value between short and long OT groups. The primary outcome was 90-day postoperative complication rates. Secondary outcomes were gastrointestinal recovery time, length of hospital stay, and 90-day readmission rates.</p></div><div><h3>Results</h3><p>The overall incidence of 90-day postoperative complications was 79.7% where 43.2% representing low-grade complications according to the Clavien–Dindo classification (Grade 1 and Grade 2), and 36.5% representing high-grade complications (Grade≥3). Gastrointestinal tract and infectious complications are the most common complications in our data set (45.9% and 45.6%, respectively). On multivariable analysis, prolonged OT was significantly associated with odds of high-grade complications (odds ratio 2.340, 95% confidence interval 1.288–4.250, <em>p</em>=0.005). After propensity score-matched analysis, a higher incidence of major complications was identified in the long OT group 55 (51.4%) compared to 35 (32.7%) in the short OT group (<em>p</em>=0.006). A shorter gastrointestinal tract recovery time was noticed in the short OT group (<em>p</em>=0.009). Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses (<em>p</em>&lt;0.001, <em>p</em>=0.001, respectively).</p></div><div><h3>Conclusion</h3><p>Prolonged OT (&gt;369 min) is associated with an increased risk of postoperative complications and readmission rates. The perception of potential postoperative complications requires careful monitoring of these patients which could translate into better operative outcomes.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 429-436"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000747/pdfft?md5=3e161d19989ff6ebbbc1e84e374a88c4&pid=1-s2.0-S2214388223000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43991370","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 interval for delayed retrieval surgery with reciprocating morcellators after enucleation of giant prostatic hyperplasia in holmium laser enucleation of the prostate","authors":"","doi":"10.1016/j.ajur.2023.04.005","DOIUrl":"10.1016/j.ajur.2023.04.005","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate, investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency, and seek to determine the optimal interval between the two surgeries.</p></div><div><h3>Methods</h3><p>This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g, indicative of substantial prostate enlargement. Morcellation was performed on Day 0 (<em>n</em>=4), Day 4 (<em>n</em>=1), Day 6 (<em>n</em>=1), and Day 7 (<em>n</em>=3). The intervals were compared regarding the morcellation efficiency, beach ball presence, and pathology.</p></div><div><h3>Results</h3><p>The mean estimated prostate volume was 383 (range 330–528) mL; the median enucleation weight was 252 (interquartile range [IQR] 222, 342) g; and the median enucleation time was 83 (IQR 62, 100) min. The mean morcellation efficiency was 1.44 (SD 0.55) g/min on Day 0 and 13.69 (SD 2.46) g/min on day 7. The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6, respectively, with significantly higher in the two-stage group compared to one-stage group (11.0 g/min <em>vs.</em> 1.5 g/min; <em>p</em>=0.014). Efficiency was strongly correlated with intervals (<em>p</em>&lt;0.001); the incidences of beach balls were 100% (4/4) and 60% (3/5) in the immediate and two-stage surgery groups, respectively.</p></div><div><h3>Conclusion</h3><p>The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval, with the maximum efficiency reached on Day 7.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 423-428"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000954/pdfft?md5=2486a03ae6f5d807dbf9d55456e7c4e1&pid=1-s2.0-S2214388223000954-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135429718","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":"Initial experience with robot-assisted adrenalectomy for giant adrenal tumors","authors":"","doi":"10.1016/j.ajur.2023.05.006","DOIUrl":"10.1016/j.ajur.2023.05.006","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 507-508"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223001248/pdfft?md5=937571f7a057a4c991f6cdce406a94ec&pid=1-s2.0-S2214388223001248-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714674","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":"Minimally invasive reconstruction of extensive mid-lower ureteral strictures using a bilateral Boari flap","authors":"","doi":"10.1016/j.ajur.2024.02.009","DOIUrl":"10.1016/j.ajur.2024.02.009","url":null,"abstract":"<div><h3>Objective</h3><p>To describe and evaluate the technique using bilateral Boari flap ureteroneocystostomy (BBFUNC) for bilateral mid-lower ureteral strictures.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed five patients who underwent minimally invasive BBFUNC in our institution (Union Hospital, Wuhan, China) between July 2019 and December 2021. The bilateral ureters were mobilized and transected above the stenotic segments. The bladder was isolated and incised longitudinally from the middle of the anterior wall. Then, an inverted U-shaped bladder flap was created on both sides, fixed onto the psoas tendon, and anastomosed to the ipsilateral distal normal ureter. Following double-J stenting, the Boari flaps were tubularized, and the bladder was closed with continuous sutures. The patients' perioperative data and follow-up outcomes were collected, and a descriptive statistical analysis was performed.</p></div><div><h3>Results</h3><p>No case converted to open surgery, and no intraoperative complication occurred. The median surgical time was 230 (range 203–294) min. The median length of the bladder flaps was 6.2 (range 4.3–10.0) cm on the left and 5.5 (range 4.7–10.5) cm on the right side. All patients had not developed recurrent ureteral stenosis during the median follow-up time of 17 (range 16–45) months and had a normal maximum flow rate after surgery. The median post-void residual was 7 (range 0–19) mL. The maximal bladder capacity was decreased in one (20%) patient.</p></div><div><h3>Conclusion</h3><p>The present study demonstrates that minimally invasive BBFUNC is feasible and safe in treating bilateral mid-lower ureteral strictures, and the impact on lower urinary tract function is limited.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 377-383"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388224000249/pdfft?md5=824f94806f0164b1f806c357be18b2a0&pid=1-s2.0-S2214388224000249-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275079","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":"Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes","authors":"","doi":"10.1016/j.ajur.2023.12.001","DOIUrl":"10.1016/j.ajur.2023.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>A vesicourethral anastomotic leak (VUAL) is a known complication following robotic-assisted radical prostatectomy. The natural history of a VUAL has been well described and is frequently managed with prolonged catheterization. With increasing emphasis on patient reported outcomes, catheter duration and VUAL are associated with significant short-term quality of life impairment. We aimed to present a case series of our robotic early post-prostatectomy anastomotic repair technique, defined as revision within 6 weeks from index surgery.</p></div><div><h3>Methods</h3><p>A single institution prospective database identified eleven patients with a VUAL from July 2016 to October 2022 who underwent robotic early post-prostatectomy anastomotic repair by a single surgeon. Patients were diagnosed with a VUAL on pre-operative CT urogram or CT/fluoroscopic cystogram. The primary outcome was resolution of the anastomotic leak, defined as no contrast extravasation on post-operative cystography. Secondary outcomes included post-repair catheter duration and continence on the last follow-up defined as pad(s) per day.</p></div><div><h3>Results</h3><p>The mean time to intervention after robotic-assisted radical prostatectomy was 21 days. Eight of the eleven (72.7%) patients had no evidence of extravasation on post-repair cystogram. The range from intervention to first cystogram was 7–20 days. The median catheter duration for those with successful intervention was 10 days. The median catheter duration for those with the leak on initial post-operative cystogram was 20 days. At a mean follow-up time of 25 months, eight (72.7%) patients reported using no pads per day, and three (27.3%) patients reported one pad per day.</p></div><div><h3>Conclusion</h3><p>Management of a VUAL has traditionally relied on prolonged catheter drainage and the tincture of time. As the role of robotic reconstruction has been shown to be a viable modality for management of bladder neck contracture, it is important to reconsider prior dogmas of urologic care. Our case series suggests that an early repair is safe and has a high success rate. Early robotic intervention gives providers an additional tool in aiding patient recovery.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 366-372"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388224000493/pdfft?md5=b477868ce4bb45d26dc3dbd654a4573e&pid=1-s2.0-S2214388224000493-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407234","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 review of complications after ureteral reconstruction","authors":"","doi":"10.1016/j.ajur.2024.02.007","DOIUrl":"10.1016/j.ajur.2024.02.007","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to provide a comprehensive overview of the complications unique to ureteral reconstruction in adults, emphasizing their presentation, diagnosis, and management in the treatment of ureteral structure disease.</p></div><div><h3>Methods</h3><p>This review involves an in-depth analysis of existing literature and case studies pertaining to ureteral reconstruction, with a focus on examining the range of complications that can arise post-surgery. Special attention is given to the presentation of each complication, the diagnostic process involved, and the subsequent management strategies.</p></div><div><h3>Results</h3><p>Ureteral reconstruction can treat ureteral stricture disease with low morbidity; however, complications, although uncommon, can have severe consequences. The most notable complications include urinary extravasation, stricture recurrence, urinary tract infections, compartment syndrome, symptomatic vesicoureteral reflux, and Boari flap necrosis. Each complication presents unique diagnostic challenges and requires specific management approaches.</p></div><div><h3>Conclusion</h3><p>Ureteral reconstruction is a highly effective treatment for ureteral stricture disease. Having a strong understanding of the potential complications that patients may experience following ureteral reconstruction is not only critical to adequately counsel patients but also facilitate prompt diagnosis and management of complications when they arise.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 348-356"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388224000201/pdfft?md5=f9c7e239eda8b0b56705da150724a671&pid=1-s2.0-S2214388224000201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465651","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":"Prospective randomized study correlating intra-operative urethral mucosal injury with early period after transurethral resection of the prostate stricture urethra: A novel concept","authors":"","doi":"10.1016/j.ajur.2024.02.006","DOIUrl":"10.1016/j.ajur.2024.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the incidence of urethral stricture during the early period after transurethral resection of the prostate (TURP) and correlate its incidence with intra-operative urethral mucosal injury during TURP. Also to compare the other established risk factors affecting the development of urethral stricture among patients undergoing monopolar or bipolar TURP over a period of 6 months follow-up as the prospective randomized study.</p></div><div><h3>Methods</h3><p>One hundred and fifty men older than 50 years with lower-urinary tract symptoms associated with benign prostatic hyperplasia were randomized to undergo either standard monopolar TURP with glycine as the irrigation fluid or bipolar TURP with normal saline as irrigant. The prostate size, operative time, intra-operative mucosal rupture, catheter time, catheter traction duration, uroflowmetry, and post-operative stricture rate were compared.</p></div><div><h3>Results</h3><p>A total of 150 patients underwent TURP, including 74 patients undergoing monopolar TURP (one patient was excluded as his post-operative histopathological examination report was of adenocarcinoma prostate) and 75 patients undergoing bipolar-TURP, all of which were performed using a 26 Fr sheath resectoscope. The mean International Prostate Symptom Score and maximum urinary flow rate score at post-operative 3 months and 6 months were comparable between the groups. Out of 149 patients, nine patients (6.0%) developed urethral stricture. The severity of the injury (urethral mucosal injury) correlated with the likelihood of developing a subsequent complication (stricture urethra). Patients with stricture had significantly larger prostate volume than patients without stricture (65.0 mL <em>vs.</em> 50.0 mL; <em>p</em>=0.030). Patients with stricture had longer operative time than patients without stricture (55.0 min <em>vs</em>. 40.0 min; <em>p</em>=0.002). In both procedures, formation of post-operative stricture urethra was independently associated with intra-operative mucosal injury.</p></div><div><h3>Conclusion</h3><p>Intra-operative recognition of urethral mucosal injury helps in prediction of stricture urethra formation in early post-operative period.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 466-472"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388224000171/pdfft?md5=018a57fd2a6a8563c738be771a776cef&pid=1-s2.0-S2214388224000171-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466074","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}