Archivio Italiano di Urologia e Andrologia最新文献

{"title":"The effect of vitamin D in vitro supplementation on sperm deoxyribonucleic acid fragmentation.","authors":"Andri Rezano, Ditto Rezkiawan, Vellyana Lie, Arya Srisadono, Rafly Mochamad Rivaldo, Amelia Reta Purba, Melia Juwita Adha, Tjahjo Djojo Tanojo, Maria P B D Pramesti","doi":"10.4081/aiua.2024.12891","DOIUrl":"https://doi.org/10.4081/aiua.2024.12891","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the direct effect of vitamin D on sperm DNA integrity after swim-up preparation.</p><p><strong>Materials and methods: </strong>Normozoospermia samples were gathered from 12 men and assessed for their baseline characteristics, including DNA Fragmentation Index (DFI). Each sample was then prepared using the swim-up method. Half of the samples were incubated with vitamin D, while the other half were incubated with a standard sperm-washing medium.</p><p><strong>Results: </strong>Vitamin D significantly reduced the DFI compared to the baseline (5.5 ± 3.4% versus 17.6 ± 4.2%; p < 0.001) and the swim-up-only group (5.5 ± 3.4% versus 12.0 ± 4.2%; p < 0.001). Microscopic examination reflected these results, showing a reduction in the number of small halos and no halos with an increased appearance of large to medium-sized halos.</p><p><strong>Conclusions: </strong>These results suggest that vitamin D incubation is valuable in protecting sperm from DNA damage that develops during sperm preparation. However, additional investigation is warranted to explore other preparation methods and to elucidate the underlying mechanisms.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12891"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of transperineal reanastomosis as a salvage treatment for recurrent vesicourethral anastomosis stenosis after radical prostatectomy.","authors":"Piotr Gwara, Łukasz Białek, Marta Rydzińska, Jakub Dobruch, Michał Andrzej Skrzypczyk","doi":"10.4081/aiua.2024.12829","DOIUrl":"https://doi.org/10.4081/aiua.2024.12829","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate transperineal reanastomosis (TRPA) combined with incontinence surgery as a complex treatment for recurring vesicourethral anastomosis stenosis (VUAS) after radical prostatectomy (RP).</p><p><strong>Methods: </strong>Retrospective analysis of 8 patients who underwent TRPA for recurring VUAS. Detailed preoperative and follow up data were assessed.</p><p><strong>Results: </strong>Mean follow up lasted 47 months (range 17-77) with mean age being 63.4 years (range 61-70). All patients achieved patency and 87.5% (7/8) maintained it to the end of follow up. However, four of them required additional procedures to retain patency. Six underwent incontinence surgery - artificial urinary sphincter (AUS) implantation - after which one cuff erosion occurred. In the end 62.5% (5/8) of patients achieved patent urethra and continence.</p><p><strong>Conclusions: </strong>TRPA combined with incontinence surgery is a reasonable treatment for patients with recurrent VUAS. Nonetheless, this is a set of difficult surgeries that may ultimately end in failure, i.e. the inability to restore urethral patency, urinary incontinence or urinary diversion, hence they should be performed by experienced surgeons.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12829"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between intrathecal fentanyl and dorsal penile nerve block for controlling postoperative pain after inflatable penile prosthesis implantation.","authors":"Adel Elatreisy, Yasser Ahmed, Ahmed Elgarhy, Mohamed Hindawy, Tamer Abouelgreed, Ismail Ahmed, Abdalla Abdalla, Hany Ramadan, Mohamed Aboelsuod, Khaled Shrief, Ayman Mohamed, Wael Ibrahim, Saeed Abdelhameed, Mohammad Alghamdi, Mohammed Alzahrani, Hamada Youssof","doi":"10.4081/aiua.2024.12951","DOIUrl":"https://doi.org/10.4081/aiua.2024.12951","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of intrathecal fentanyl and dorsal penile nerve block for postoperative pain management in patients undergoing inflatable penile prosthesis (IPP).</p><p><strong>Patients and methods: </strong>A prospective single-center study included 80 patients amenable to IPP. Patients were divided equally into two groups. Group I included 40 patients who were managed with spinal anesthesia with intrathecal fentanyl before undergoing IPP. Group II comprised 40 patients who received spinal anesthesia with dorsal penile block before IPP. Study groups were compared regarding postoperative VAS (Visual Analog Scale) scores, total narcotics consumption, patient satisfaction levels, and perioperative complications.</p><p><strong>Results: </strong>The study groups were comparable regarding baseline patients' criteria. The operative time was comparable between the study groups, with group I and group II having respective median times of 64 minutes (interquartile range: 55-78) and 67 minutes (interquartile range: 56-81) (p = 0.65). Additionally, both groups demonstrated similar distributions in IPP implant cylinder and reservoir size (p = 0.9). Postoperative pain was higher in group I, with a statistically significant difference (p < 0.001). Eight patients in group I (20%) called the physician's office asking for pain medication, compared to two patients in group II (5%) (p = 0.04). 85% of patients in group II were highly satisfied compared to 50 % in group I (p = 0.003). We reported a 5% complication rate in group I compared to 2.5% in group II (p = 0.6).</p><p><strong>Conclusions: </strong>The present study found that the dorsal penile nerve block offers superior postoperative pain control and patient satisfaction compared to intrathecal fentanyl for patients undergoing inflatable penile prosthesis insertion.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12951"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of DOPA decarboxylase inhibitor supplements on the incidence of urinary tract infections in Parkinson's disease patients: A systematic review and meta-analysis of randomized controlled trials.","authors":"Ismaeel AlShoaibi, Basheer Abdo, Mohammed Abdullah, Khaled Alzanen, Mohammed Alhakamy, Mamoon Al-Namer, Abdulghani Al-Hagri, Morshed Salah, Afrah Salem, Mohammed Almogahed, Ibrahim Alnadhari, Faisal Ahmed","doi":"10.4081/aiua.2024.12833","DOIUrl":"10.4081/aiua.2024.12833","url":null,"abstract":"<p><strong>Objectives: </strong>Parkinson's disease is the most common neurodegenerative disease. Combining levodopa with other drugs, including decarboxylase inhibitors (DCI) is its most effective treatment. Urinary tract infection (UTI) is the most common cause of hospitalization in Parkinson's patients, making it crucial to find an appropriate treatment to reduce the incidence of this complication. This study aimed to investigate UTIs in Parkinson's patients using levodopa with DCI supplements.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, databases such as PubMed, Scopus, Embase, Cochrane, and Web of Science were searched up to March 2024. Only randomized controlled trials involving Parkinson's patients were included in the present study. Parkinson's patients who used levodopa along with carbidopa or benserazide were considered the intervention group, while those who used levodopa with another drug were considered the control group.</p><p><strong>Results: </strong>Nine interventional studies were ultimately analyzed. The relative risk (RR) of UTI in patients taking DCI was 26% lower than those who did not (RR Treatment/Control = 0.74, 95% CI: 0.58-0.95, p = 0.019). Furthermore, observations at different times of follow-up showed that at 13-24 weeks and at > 24 weeks of treatment with DCI, there was a reduction in the incidence of UTI (RR = 0.68, 95% CI: 0.46-1.01 and RR = 0.77, 95% CI: 0.58-1.0, respectively). On the contrary, there was an increase of the risk of UTI in the first 12 weeks of treatment with DCI (RR = 1.11, 95% CI: 0.37-3.33).</p><p><strong>Conclusions: </strong>The results of this study indicated that using DCI drugs is associated with a reduced relative risk of developing UTIs. The beneficial effect of the drug showed after 12 weeks of treatment after an initial negative effect on the risk of UTI.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12833"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barts flank-free modified supine position vs prone position in percutaneous nephrolithotomy: Systematic review and meta analysis.","authors":"I Gede Yogi Prema Ananda, Kadek Budi Santosa, I Wayan Yudiana, Pande Made Wisnu Tirtayasa, Ida Bagus Putra Pramana, Nyoman Gede Prayudi, Gede Wirya Kusuma Duarsa","doi":"10.4081/aiua.2024.12944","DOIUrl":"10.4081/aiua.2024.12944","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous Nephrolithotomy (PCNL) has been performed in various positions, including prone position and several modifications of supine position. The Barts flank-free modified supine (FFMS) position is a newly enhanced version of the supine positions. This study aims to compare the outcomes of Barts FFMS and prone position in PCNL.</p><p><strong>Methods: </strong>This study followed PRISMA 2020 guideline and was registered to PROSPERO CRD42024530426. Comprehensive search in PubMed, Sciencedirect, and Scopus was conducted until May 2024. Stone-free rates, complications, surgery duration, fluoroscopy duration, use of nephrostomy, and length of stay were collected. Data were analyzed using RevMan 5.4.</p><p><strong>Results: </strong>A total of 4 studies were included in this review. There was no significant difference in stone-free rates between Barts FFMS and prone positions (OR = 1.12, 95% CI 0.64-1.95, p = 0.70). There were no significant difference in incidence of fever (OR = 0.91, 95% CI 0.38-2.18, p = 0.84), need for blood transfusion (OR = 0.46, 95% CI 0.11-1.88, p = 0.28), and urine leakage (OR = 0.41, 95% CI 0.16-1.05, p = 0.06). The surgery duration was significantly shorter in Barts FFMS position than in prone position (MD = -15.48, 95% CI [(-26.42)-(-4.55)], p = 0.006). There was no significant difference in patients requiring nephrostomy (OR = 0.19, 95% CI 0.01-3.75, p = 0.28). There were no significant difference in fluoroscopy duration (MD = 0.27, 95% CI [(-6.85)-7.40], p = 0.94) and the length of hospital stay (MD = -0.20, 95% CI [(-0.74)-0.33], p = 0.46).</p><p><strong>Conclusions: </strong>The surgery duration was significantly shorter in Barts FFMS position than in prone position. There were no significant differences regarding stone-free rates, complications, fluoroscopy duration, use of nephrostomy, and length of hospital stay. This indicates that neither Barts FFMS nor prone position is superior, and the choice should be based on the surgeon's preference and the patient's clinical status.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 4","pages":"12944"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can serum 17-hydroxy progesterone predict an improvement in semen parameters following micro-varicocelectomy? A prospective study.","authors":"Mohamed Wael Ragab, Mohamed Abbas, Tarek Ramzy, Sameh Fayek GamalEl Din, Mohamed Yousry Elamir, Mohammed H Alkandari, Abdullah Salem Alshammari, Mohamed Ragab Shehata, Ashraf Zeidan","doi":"10.4081/aiua.2024.12545","DOIUrl":"10.4081/aiua.2024.12545","url":null,"abstract":"<p><strong>Background & objectives: </strong>Notably, 17-hydroxy progesterone (17-OHP) (17-OHP) is a precursor for testosterone (T) synthesis, and intratesticular testosterone (ITT) is essential for spermatogenesis. Varicocele (Vx) has an estimated prevalence of 15% in the general population and 35% in those with primary infertility. We aimed to evaluate the correlation between changes of serum 17-OHP after sub-inguinal micro-varicocelectomy and improvement of semen parameters.</p><p><strong>Patients and methods: </strong>The current prospective study included 45 infertile men attending the andrology clinic form February 2021 to August 2021. Two semen analyses and hormonal profile were evaluated. Colored duplex ultasonography (CDUS) was done in standing and supine position for accurate measurements of testicular volumes and confirmation of Vx. Patients underwent sub-inguinal micro-varicocelectomy using a surgical microscope HB surgitech. We followed them prospectively up for three months following micro-varicocelectomy with serum TT and 17-OHP.</p><p><strong>Results: </strong>Sperm concentration improved significantly from 8.36 ± 5.04 million/ml to 12.52 ± 8.42 million/ml after 3 months following sub-inguinal micro-varicocelectomy (p= 0.001), with normalization of concentration in 15/45 (33%) patients. Total motility did not improve significantly but progressive motility improved significantly from 8.62 ± 8.74% to 16.24 ± 14.45% (p=0.001). Abnormal forms significantly declined from 96.67 ± 2.03% to 95.75 ± 2.47% (p=0.009).  Serum 17 OHP and 17 OHP/total testosterone (TT) improved significantly from 1.21 ± 0.45 ng/ml and 0.26 ± 0.09 to 1.42 ± 0.76 ng/ml and 0.3 ± 0.16 (p= 0.013, p= 0.004), respectively, while serum TT did not improve significantly. A significant correlation was found between improvement in sperm concentration and both serum 17 OHP and 17 OHP/TT ratio (p=0.001, p=004). Furthermore, change in abnormal sperm forms showed significant correlations with changes in both 17-OHP and 17-OHP/TT.</p><p><strong>Conclusion: </strong>17 OHP and 17OHP/ TT ratio can be used as biomarkers to detect improvement in semen parameters following sub-inguinal micro-varicocelectomy.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 3","pages":"12545"},"PeriodicalIF":1.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of surgical technique on very early functional outcomes after radical prostatectomy.","authors":"Mladen Stankovic","doi":"10.4081/aiua.2024.12531","DOIUrl":"10.4081/aiua.2024.12531","url":null,"abstract":"<p><strong>Introduction: </strong>To determine the very early functional as well as oncological outcomes after robot-assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP) at a single institution.</p><p><strong>Methods: </strong>We identified patients who underwent RARP or ORP at our institution between August 2021 and July 2023. The main criterion for surgical technique selection was patient preference. Primary endpoints included anastomosis leakage rate, very early continence rate reported by standardized pad-test, and positive surgical margin rate. Furthermore, we analyzed operation time, hospital stay, postoperative analgesia, and complication rates.</p><p><strong>Results: </strong>In this prospective study, we analyzed data from 222 radical prostatectomies (111 RARP and 111 ORP). There were no significant differences in preoperative age, prostate size, and risk stratification among the groups. Patients who underwent RARP had lower anastomosis leakage rates (8.1% vs. 18.9%) and slightly lower early continence rates (76.6% vs. 78.4%) when compared to patients who underwent ORP. Positive surgical margin rates were similar, and complication rates were also comparable. Operation time was similar for both techniques, but the hospital stay was significantly shorter in the RARP group (6.3 vs. 9.1 days, p=0.03). The ORP group experienced significantly higher opioid administration postoperatively (p<0.001).</p><p><strong>Conclusions: </strong>From a functional and oncological point of view, both techniques are safe and provide excellent outcomes when performed by experienced surgeons. Nevertheless, patients are likely to benefit from a shortened hospital stay and reduced postoperative pain after RARP.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 3","pages":"12531"},"PeriodicalIF":1.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-component artificial urinary sphincter: Outcomes from one centre in Portugal.","authors":"João Aragão Vital, Miguel Marques Monteiro, Bernardo Lobão Teixeira, Gonçalo Grilo Mendes, Alexandra Rocha, Mariana Madanelo, Sofia Mesquita, Nuno Vinagre, Beatriz Oliveira, Martinha Magalhães, Ana Isabel Lopes, Carlos Ferreira, Paulo Príncipe, Avelino Fraga","doi":"10.4081/aiua.2024.12661","DOIUrl":"https://doi.org/10.4081/aiua.2024.12661","url":null,"abstract":"<p><strong>Purpose: </strong>Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS).</p><p><strong>Materials and methods: </strong>Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented.</p><p><strong>Results: </strong>Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points.</p><p><strong>Conclusions: </strong>The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 3","pages":"12661"},"PeriodicalIF":1.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electromagnetic stimulation to reduce the hypertonia of the pelvic floor muscles and improve chronic pelvic pain in women.","authors":"Nicola Mondaini, Mauro Gacci, Tommaso Cai, Francesco Lotti, Vincenzo Li Marzi, Fabio Crocerossa, Francesco Cantiello, Sara Tanguenza, Alessandra Comito, Irene Fusco, Beatrice Pennati, Rocco Damiano","doi":"10.4081/aiua.2024.12623","DOIUrl":"https://doi.org/10.4081/aiua.2024.12623","url":null,"abstract":"<p><strong>Background: </strong>The increased hypertonicity or activity of pelvic floor muscles can lead to chronic pelvic pain (CPP). It represents an aspecific and persistent pain with no apparent clinical reason, affecting an estimated 6% to 16% of women worldwide. This study aimed to evaluate with validated questionnaires the efficacy and the safeness of a new device that uses Top flat Magnetic Stimulation for the management of muscular hypertonia in women with CCP.</p><p><strong>Methods: </strong>All patients underwent 8 treatments with a non-invasive electromagnetic therapeutic device. The device produces a TOP Flat Magnetic Stimulation with a uniform profile so, the muscle work aims to reduce pain while also inhibiting muscle activity. The PISQ-12 questionnaire was used for the evaluation of improvements. Side effects were monitored.</p><p><strong>Results: </strong>The PISQ-12 total mean score decreases from 29,2 (±3.3) to 17 (±2). Regarding the behavioural-emotive items (1-4), a decrease from 12 (±2) to 7 (±0.9) was visible. Physical items (5-9) decrease from 10,6 (±1.8) to 6 (±1.4) and the Partner Related items (10-12) from 6,6 (±1.6) to 3,9 (±0.4).  Conclusions: The device we used in this research demonstrated to be a valid solution for the treatment of chronic pelvic pain in female patients.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 3","pages":"12623"},"PeriodicalIF":1.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing artificial neural network system to predict the residual valve after endoscopic posterior urethral valve ablation.","authors":"Mehdi Shirazi, Zahra Jahanabadi, Faisal Ahmed, Davood Goodarzi, Alimohammad Keshtvarz Hesam Abadi, Mohammad Reza Askarpour, Sania Shirazi","doi":"10.4081/aiua.2024.12530","DOIUrl":"10.4081/aiua.2024.12530","url":null,"abstract":"<p><strong>Purpose: </strong>To build, train, and assess the artificial neural network (ANN) system in estimating the residual valve rate after endoscopic valve ablation and compare the data obtained with conventional analysis.</p><p><strong>Methods: </strong>In a retrospective cross-sectional study between June 2010 and December 2020, 144 children with a history of posterior urethral valve (PUV) who underwent endoscopic valve ablation were enrolled in the study. MATLAB software was used to design and train the network in a feed-forward backpropagation error adjustment scheme. Preoperative and postoperative data from 101 patients (70%) (training set) were utilized to assess the impact and relative significance of the necessity for repeated ablation. The validated suitably trained ANN was used to predict repeated ablation in the next 33 patients (22.9%) (test set) whose preoperative data were serially input into the system. To assess system accuracy in forecasting the requirement for repeat ablation, projected values were compared to actual outcomes. The likelihood of predicting the residual valve was calculated using a three-layered backpropagating deep ANN using preoperative and postoperative information.</p><p><strong>Results: </strong>Of 144 operated cases, 33 (22.9%) had residual valves and needs to repeated ablation. The ANN accuracy, sensitivity, and specificity for predicting the residual valve were 90.75%, 92.73%, and 73.19%, respectively. Younger age at surgery, hyperechogenicity of the renal parenchyma, presence of vesicoureteral reflux (VUR), and grade of reflux before surgery were among the most significant characteristics that affected postoperative outcome variables, the need for repeated ablation, and were given the highest relative weight by the ANN system.  Conclusions: The ANN is an integrated data-gathering tool for analyzing and finding relationships among variables as a complex non-linear statistical model. The results indicate that ANN is a valuable tool for outcome prediction of the residual valve after endoscopic valve ablation in patients with PUV.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 3","pages":"12530"},"PeriodicalIF":1.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}