Indian Journal of Urology最新文献

{"title":"Combination therapy for advanced urothelial cancer: LEAP-011 trial","authors":"Kirti Singh","doi":"10.4103/iju.iju_62_24","DOIUrl":"https://doi.org/10.4103/iju.iju_62_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692818","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":"A case report on locally advanced squamous cell carcinoma in permanent perineal urethrostomy: A surgical conundrum!!","authors":"Nitin Madanrao Paighan, Hemant Kumar Goel, Arun Makkar","doi":"10.4103/iju.iju_106_24","DOIUrl":"https://doi.org/10.4103/iju.iju_106_24","url":null,"abstract":"\u0000 Primary urethral cancer is a rare condition often manifesting in the sixth decade of life and is typically associated with urethral stricture disease. A 65-year-old male, a known case of stricture urethra, underwent perineal urethrostomy 10 years back. He presented with a growth at the urethrostomy site and the biopsy revealed squamous cell carcinoma. Magnetic resonance imaging of the pelvis revealed that the lesion extended into the penile and prostatic urethra with possible involvement of the corpus spongiosum, bulbospongiosus, and the bladder neck. Radical cystectomy, penectomy, scrotectomy, and bilateral orchiectomy with ileal conduit were performed. At 18-months of follow-up, the patient is recurrence-free.","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702118","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 sestamibi scan on clinical decision-making for renal masses: An observational single-center study","authors":"Courtney Yong, Yan Tong, M. Tann, Chandru P. Sundaram","doi":"10.4103/iju.iju_436_23","DOIUrl":"https://doi.org/10.4103/iju.iju_436_23","url":null,"abstract":"\u0000 \u0000 \u0000 We aimed to determine whether sestamibi scan changes management of renal masses.\u0000 \u0000 \u0000 \u0000 All patients undergoing sestamibi scan for renal masses between 2008 and 2022 at a single center were retrospectively reviewed. Data were gathered on patient demographics, pre- and postoperative creatinine, sestamibi scan parameters, and cross-sectional imaging characteristics. Outcomes included whether the patient underwent renal mass biopsy or surgical resection and the final pathological diagnosis if tissue was obtained from biopsy or resection. Data regarding postbiopsy as well as postoperative complications were also collected. The odds ratio (OR) for surgery or biopsy based on sestamibi result was calculated.\u0000 \u0000 \u0000 \u0000 Forty-three patients underwent sestamibi scan from 2008 to 2022, with 10 scans consistent with oncocytoma and 33 with nononcocytoma. The mean tumor size at initial presentation was 4.0 ± 1.8 cm with a median RENAL score of 7 (range: 4–11). For patients with sestamibi scans negative for oncocytoma, the OR for surgery was 12.5 (95% confidence interval [CI]: 2.1–71.2, P = 0.005), and the OR for biopsy was 0.04 (95% CI: 0.005–0.39, P = 0.005). Conversely, for patients with sestamibi scans positive for oncocytoma, the OR for surgery was 0.28 (95% CI: 0.03–2.4, P = 0.24) and the OR for biopsy was 24.0 (95% CI: 2.6–222.7, P = 0.005). Creatinine at the last follow-up was similar between patients with positive and negative sestamibi scans. No patients experienced complications from surgery or biopsy. The median follow-up was 19 months (range: 2–163).\u0000 \u0000 \u0000 \u0000 A sestamibi scan positive for oncocytoma led to increased use of renal mass biopsy for confirmation. Sestamibi scans that were negative for oncocytoma were more likely to result in surgical resection without biopsy.\u0000","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708518","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 prognostic role of preoperative neutrophil-to-lymphocyte ratio in upper tract urothelial carcinoma","authors":"R. Ghorai, B. Nayak, R. Goel, Prashant Gupta, Rahul Raj, S. Kaushal, R. Nayyar, Rajeev Kumar, Amlesh Seth","doi":"10.4103/iju.iju_22_24","DOIUrl":"https://doi.org/10.4103/iju.iju_22_24","url":null,"abstract":"\u0000 \u0000 \u0000 The blood-based inflammatory marker, neutrophil-to-lymphocyte ratio (NLR), is a reliable prognostic biomarker for several cancers. Although the literature supports the correlation between preoperative NLR, clinicopathological characteristics, and oncological outcomes in upper tract urothelial carcinoma (UTUC), the cutoff of NLR is still debated. This study aimed to determine the prognostic value of NLR in patients with UTUC.\u0000 \u0000 \u0000 \u0000 This was a retrospective analysis of prospectively collected data from July 2012 to December 2022 evaluating patients with UTUC who underwent radical nephroureterectomy (RNU). NLR was calculated using the neutrophil and lymphocyte counts obtained a day before the surgery and the cutoff value was set as 2.5. Kaplan–Meier and Cox’s proportional hazards regression were used to analyze the association between NLR and the oncological outcomes.\u0000 \u0000 \u0000 \u0000 The study included 91 patients (78 males, 13 females) in the final analysis with a median follow-up of 49 months (8–130). The mean age of the patients with NLR <2.5 and NLR ≥2.5 was 56.88 years and 56.35 years, respectively, and the pathological stage was pT1 in 48%, pT2 in 20.88%, pT3 in 27.47%, and pT4 in 3.30% of the patients. Multivariable Cox regression analysis showed that the preoperative NLR ≥2.5 was significantly associated (Hz = 7.17) with higher T stage, lymphovascular invasion, necrosis, nodal involvement, adjuvant chemotherapy, and worse overall survival (OS) (Hz = 9.87). The Kaplan–Meier analysis revealed an improved OS in patients with NLR <2.5, but a statistically significant difference in the recurrence-free survival was not found.\u0000 \u0000 \u0000 \u0000 Preoperative NLR is an easily available, inexpensive, and important prognostic biomarker of survival in patients with UTUC and has a potential role in risk stratification by predicting adverse clinicopathological characteristics.\u0000","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689866","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":"Primary Ewing sarcoma/primitive neuroectodermal tumors of the kidney: Case series of eight cases from a single center with follow-up details","authors":"N. Pathak, Abhishek G. Singh, Pavan J. Surwase, Sahil A. Agrawal, A. Ganpule, R. Sabnis, Mahesh R. Desai","doi":"10.4103/iju.iju_175_23","DOIUrl":"https://doi.org/10.4103/iju.iju_175_23","url":null,"abstract":"\u0000 \u0000 \u0000 We aim to share the experience of a single center in the management of eight cases of renal primitive neuroectodermal tumor (PNET) which are uncommon, aggressive tumors. The objectives were to study the presentation of the disease, the treatment offered and its outcomes, and the comparison of the treatment with published literature.\u0000 \u0000 \u0000 \u0000 The single-center renal PNET data of all patients were retrospectively reviewed from 2011 to 2022. Renal PNET was seen in eight patients. Minimum follow-up period of 1 year was required.\u0000 \u0000 \u0000 \u0000 Male-to-female ratio was 7:1. The mean age was 26.5 years. All were locally advanced tumors on presentation. One patient had an inferior vena cava thrombus, one patient had metastases on presentation, and two patients had tumor extending to paranephric space. The diagnosis was made by histopathology supported by immunohistochemistry showing CD99 positivity. All patients were treated with radical nephrectomy, followed by chemotherapy in all and radiotherapy in three patients. Two patients expired at 3½ and 6 years after surgery, the remaining six are alive at a median follow-up period of 34.5 months.\u0000 \u0000 \u0000 \u0000 Renal PNET is an uncommon renal tumor which is aggressive and requires multimodal therapy for prolonged survival.\u0000","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704631","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":"Re: Vasudeva P, Kumar V, Yadav S, Prasad V, Kumar N, Kumar S, et al. Urodynamic assessment of detrusor function in the very acute phase of traumatic spinal cord injury: A prospective cohort study. Indian J Urol 2024;40:31-6","authors":"Kirti Singh, S. Mandal, P. Nayak, M. Das","doi":"10.4103/iju.iju_8_24","DOIUrl":"https://doi.org/10.4103/iju.iju_8_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697656","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":"Glans cap-preserving dorsal inlay-free graft augmentation technique for reconstruction of meatal stenosis and fossa navicularis strictures: Analysis of short-term functional outcomes","authors":"B. Enganti, Prashant A. Nanavati, V. Madduri, Amish Wani, Mallikarjuna Chiruvella","doi":"10.4103/iju.iju_61_24","DOIUrl":"https://doi.org/10.4103/iju.iju_61_24","url":null,"abstract":"\u0000 \u0000 \u0000 Meatal stenosis and fossa navicularis strictures (FNSs) are commonly caused by lichen sclerosus and instrumentation. We present the technique and short-term functional outcomes of glans cap-preserving dorsal inlay-free graft augmentation for the reconstruction of meatal stenosis and FNS.\u0000 \u0000 \u0000 \u0000 This retrospective study analyzed patients with meatal stenosis and FNS who underwent glans cap-preserving dorsal inlay-free graft augmentation at our institute since 2019. The surgical technique included a ventral subcoronal approach, preservation and mobilization of the glans cap, a ventral midline urethrotomy incision over the stricture, and a dorsal midline meatotomy incision extending to the proximal normal urethral mucosa at the fossa navicularis, followed by dorsal inlay graft augmentation. During the follow-up, patients were periodically assessed for symptom scores, urinary flow rates (UFRs), and patient-reported outcomes.\u0000 \u0000 \u0000 \u0000 A total of 26 patients with a mean age of 45 ± 15 years were assessed. The predominant cause of stricture was lichen sclerosus (n = 15; 58%). The mean stricture length was 3.8 ± 0.5 cm, 73% had a circumcised phallus, and an oral mucosa graft augmentation was performed in 22 (85%) patients. Notable postoperative complications included intractable meatal hemorrhage (n = 1) and glans suture granuloma (n = 1), which required intervention. At a mean follow-up of 40 months, there were four failures, of which one patient required redo-urethroplasty. The remaining patients (n = 22; 85%) showed improved symptom scores (P < 0.05), UFRs (P < 0.05), and satisfactory patient-reported outcomes.\u0000 \u0000 \u0000 \u0000 Glans cap-preserving dorsal inlay-free graft augmentation is a safe and feasible technique with satisfactory short-term functional outcomes for the management of meatal stenosis and FNS in carefully selected patients.\u0000","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703576","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":"Intravesical bupivacaine in reducing catheter-related bladder discomfort and lower urinary tract symptoms after transurethral surgery: A randomized controlled trial","authors":"Jithesh Purushothaman, S. Kalra, L. Dorairajan, S. Selvarajan, K. S. Sreerag, Deepanshu Aggarwal","doi":"10.4103/iju.iju_431_23","DOIUrl":"https://doi.org/10.4103/iju.iju_431_23","url":null,"abstract":"\u0000 \u0000 \u0000 The objectives of this study were to investigate the efficacy and safety of intravesical bupivacaine instillation in reducing catheter-related bladder discomfort (CRBD) and lower urinary tract symptoms (LUTS) after transurethral surgery.\u0000 \u0000 \u0000 \u0000 The study enrolled 100 American Society of Anesthesiologists (ASA) grade I–III patients aged ≥18 years undergoing transurethral resection of the prostate or transurethral resection of the bladder tumor, randomly assigned to Group B (intravesical bupivacaine) or Group S (saline). Double blinding was employed. Independent variables included demographics, surgery type, ASA grade, and intervention details. Dependent variables comprised CRBD severity, Patient Perception of Bladder Condition (PPBC), Pelvic Pain Urgency Frequency (PUF), Visual Analog Scale (VAS) for pain, need for additional analgesics, and International Prostate Symptom Score (IPSS). SPSS version 19 was used for analysis with a significance level of P < 0.05. Side effects such as hematuria were also recorded.\u0000 \u0000 \u0000 \u0000 Group B reported significantly lower “moderate” CRBD immediately (2% vs. 40%, P < 0.001) and at 12 h (0% vs. 18%, P = 0.003) post-instillation compared to Group S and also required fewer additional analgesics (4% vs. 46%). The PPBC at catheter removal also favored Group B (P = 0.003) and day 1 (P < 0.001). The PUF scores were also significantly lower in Group B at catheter removal (P = 0.001) and at day 1 (P = 0.028). The IPSS was also significantly lower in the Group B on day 1 (P = 0.003) and 7 (P = 0.001). The VAS scores also favored the Group B consistently and although the side effects were higher in Group B but this was not statistically significant.\u0000 \u0000 \u0000 \u0000 Intravesical bupivacaine administration has the potential to alleviate CRBD and postoperative LUTS following lower urinary tract transurethral electrosurgery. The study’s findings underscore the importance of personalized pain management strategies in optimizing the patient comfort during the postoperative recovery.\u0000","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705937","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":"Change of the suprapubic catheter: Not always safe!","authors":"Ajay S. Kanbur, Shrivastava Pushkar, Pankaj N. Maheshwari","doi":"10.4103/iju.iju_126_24","DOIUrl":"https://doi.org/10.4103/iju.iju_126_24","url":null,"abstract":"\u0000 Suprapubic catheterization (SPC) is a commonly used technique for urinary bladder drainage. As an SPC may be needed for long term, the catheter needs to be changed every 2–6 weeks. Change of SPC is a simple and a safe outpatient procedure. Presented here are three unusual complications that occurred when changing the SPC catheter such as catheter getting misplaced up the ureter, balloon extruding outside the urethra and one case of bowel perforation. It is possible that greater awareness of risks and use of a proper technique could have prevented all three complications.","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704138","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":"Authors reply Re: Vasudeva P, Kumar V, Yadav S, Prasad V, Kumar N, Kumar S, <i>et al</i>. Urodynamic assessment of detrusor function in the very acute phase of traumatic spinal cord injury: A prospective cohort study. Indian J Urol 2024;40:31-6.","authors":"Pawan Vasudeva, Vinod Kumar, Siddharth Yadav, Vishnu Prasad, Niraj Kumar, Sandeep Kumar, Amitabh Kumar","doi":"10.4103/iju.iju_109_24","DOIUrl":"10.4103/iju.iju_109_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}