Indian Journal of Urology最新文献

{"title":"Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case.","authors":"Lory Hage, Michael A O'Donnell, Mohamad Abou Chakra, Amel Kime, Mathilde Sibony, Michaël Peyromaure, Igor Duquesne","doi":"10.4103/iju.iju_50_24","DOIUrl":"10.4103/iju.iju_50_24","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory myofibroblastic tumors (IMTs) are intermediate-grade lesions that frequently recur and rarely metastasize. There are currently no guidelines on the management of bladder IMTs. This systematic review aims to describe the clinical presentation and compare the management options for bladder IMTs.</p><p><strong>Methods: </strong>A PubMed/Medline search was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the following Mesh terms: (\"inflammatory myofibroblastic\") AND (\"tumor\") OR (\"tumor\") AND (\"bladder\") AND (\"case report\"). A total of 75 case reports were included in the analysis.</p><p><strong>Results: </strong>The mean age of the patients was 36 years. 65% of the cases initially presented with hematuria. 68% of the tumors stained positive for anaplastic lymphoma kinase, and 20% invaded the muscularis. Patients underwent either transurethral resection of the bladder tumor (TURBT) only (34%), TURBT followed by complementary partial cystectomy (16%), or TURBT followed by radical cystectomy (4%). 36% and 9% of the cases underwent partial and radical cystectomy after the initial diagnosis, respectively. Cystectomies were performed using an open (74%), laparoscopic (14%), robotic-assisted (10%), or unknown (2%) approach. At a mean follow-up of 14 months, the recurrence and metastasis rates were about 9% and 4%, respectively. In addition, we present the case of a 49-year-old woman with a bladder IMT who underwent TURBT followed by laparoscopic partial cystectomy. The patient remains tumor free postoperatively (follow-up period of 12 months).</p><p><strong>Conclusion: </strong>A complete surgical excision of the bladder IMT is crucial for the optimal management of these cases. Proper differentiation of this tumor from sarcoma or leiomyosarcoma leads to the best outcomes.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899897","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}

{"title":"Renal artery pseudoaneurysm post-COVID-19 infection: An unusual delayed complication.","authors":"Gautam Shubhankar, Ankur Mittal, Vikas Kumar Panwar, Siddharth Kumar","doi":"10.4103/iju.iju_454_23","DOIUrl":"10.4103/iju.iju_454_23","url":null,"abstract":"<p><p>This case report discusses a rare and severe complication of COVID-19 recovery - renal mucormycosis leading to right renal artery pseudoaneurysm. A 59-year-old patient, previously treated for COVID-19, presented with dry cough, flank pain, and hematuria. He was diagnosed with renal artery pseudoaneurysm with renal mucormycosis. Successful management included urgent angioembolization, systemic liposomal amphotericin B, and subsequent radical nephrectomy post-stabilization. The case underscores the importance of vigilant post-COVID-19 follow-up, particularly in patients treated with steroids, and highlights the need for a multidisciplinary approach for timely diagnosis and effective management of mucormycosis related complications.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899907","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}

{"title":"Round Up.","authors":"Swarnendu Mandal","doi":"10.4103/iju.iju_105_24","DOIUrl":"10.4103/iju.iju_105_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899946","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}

{"title":"Survival outcomes of postchemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell tumors: A retrospective cohort study from a single tertiary center in South India.","authors":"Rakesh Kumar, Madhuri Evangeline Sadanala, Santosh Nagasubramanian, Anjana Joel, Arun Joseph Philip George, S Mahasampath Gowri, Partho Mukherjee, Ashish Singh, Rajiv Paul Mukha, Santosh Kumar, Antony Devasia, Thampi John Nirmal","doi":"10.4103/iju.iju_456_23","DOIUrl":"10.4103/iju.iju_456_23","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy, postchemotherapy retroperitoneal lymph node dissection (pcRPLND), and metastasectomy remain the standard of care for the management of advanced nonseminomatous germ cell tumor (NSGCT).</p><p><strong>Methods: </strong>We retrospectively studied 73 patients who had pcRPLND at a single tertiary-care center (2003-2022). Surgical and clinicopathological features and oncological outcomes are presented.</p><p><strong>Results: </strong>The mean age was 28.27 years (15-48). Three-fourths had Stage III disease at diagnosis. International Germ Cell Cancer Collaborative Group risk stratification was 54.54% and 21.21% in intermediate risk, and poor risk, respectively. Sixty-two patients had Standard, 7 had Salvage and 4 underwent Desperation pcRPLND. Eleven patients (15.06%) required adjunctive procedures. Thirteen patients (17.8%) had ≥ class 3 Clavien-Dindo complications and postoperative mortality occurred in 5 (6.8%) patients. The histopathologies (HPE) of the pcRPLNDs were necrosis, teratoma, and viable tumor in 39.7%, 45.2%, and 15.1%, respectively. Seven patients underwent metastasectomy. An 85% size reduction in the size of RPLN predicted necrosis. There was 71.4% concordance between pcRPLND and metastasectomy HPEs. The median follow-up was 26.72 months (inter-quartile range - 13.25-47.84). The 2-year recurrence-free survival (RFS) rate was 93% (95% confidence interval [CI]-83%-97%) and the overall survival (OS) rate was 90% (95% CI-80%-95%). This is the largest series of pcRPLND for NSGCT in India to our knowledge.</p><p><strong>Conclusion: </strong>Although most of the cohort belonged to stage III, an RFS and OS rate of >90% at 2 years was achieved. We believe that successful management of postchemotherapy residual masses in NSGCT is contingent on the availability of multidisciplinary expertise and is therefore best done at tertiary-care referral centers.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899949","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}

{"title":"Clinical study of steroid receptors in nonmuscle invasive bladder cancer: A domain worth revisiting.","authors":"Aditya Prakash Sharma, Puranjay Pratap Singh, Rohit Chauhan, Ipsita Panda, Sudheer Kumar Devana, Girdhar S Bora, Ravimohan Suryanarayan Mavuduru, Nandita Kakkar, Santosh Kumar, Uttam Mete","doi":"10.4103/iju.iju_324_23","DOIUrl":"10.4103/iju.iju_324_23","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic significance of steroid receptors in bladder cancer remains controversial. This study was designed to determine the expression status of androgen receptor (AR), estrogen receptors (ERα and Erβ), and its potential role in predicting survival in patients with nonmuscle invasive bladder cancer (NMIBC).</p><p><strong>Methods: </strong>Sixty patients of NMIBC were screened and 57 (41 males and 16 females) were included in our study. The tissue microarray slides were evaluated by pathologists blinded to the clinical information. Association of distribution of steroid receptors with stage, grade, progression, and recurrence was seen.</p><p><strong>Results: </strong>The mean age of the population was 60.9 ± 9.3 years. Pathologically, majority of the patients were Ta (Ta: T1 stage 61.4% vs. 38.6%). Nine (15.8%) of the tumors stained positive for AR while one (1.8%) tumor stained positive for ERα and 36 (63.2%) tumors stained for ERβ. A higher proportion of male NMIBC stained positive for AR (19.5% vs. 6.2%, <i>P</i> = 0.420) while ERβ positivity was higher in females (58.5% vs. and 75%,<i>P</i> = 0.247). AR-negative tumors showed higher recurrence (20/48%-42%) as compared to AR-positive tumors (2/9%-22%). ERβ-positive tumors showed higher recurrence (15/36%-42% vs. 7/21%-33%, <i>P</i> = 0.179). Progression-free survival (PFS) was found to be significantly lower for ERβ-negative group (log-rank test <i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>AR and ERβ positivity is found in NMIBC patients while ERα shows minimal staining in NMIBC patients. Although it did not reach a statistical significance, a higher proportion of AR-negative and ERβ-positive tumors recurred as compared to AR-positive and ERβ-negative patients. PFS was significantly lower in ERβ-negative group. Further exploratory studies on larger sample sizes are required to validate these findings in NMIBC patients.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899889","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}

{"title":"Diagnostic value of voiding scores of the \"International prostate symptom score\" and the \"Bristol female lower urinary system symptoms-short form\" questionnaires in women with voiding dysfunction.","authors":"Mehmet Erkan Erbay, Burcu Hanci Sevinç, Fatih Tarhan","doi":"10.4103/iju.iju_162_23","DOIUrl":"10.4103/iju.iju_162_23","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate the diagnostic value of International Prostate Symptom Score voiding symptom score (IPSS-VS) and Bristol Female Lower Urinary Tract Symptoms-short form voiding score (BFLUTS-VS) in female patients with urodynamically diagnosed voiding dysfunction.</p><p><strong>Methods: </strong>The medical records of female patients who underwent urodynamic examination between May 2007 and November 2021 for lower urinary tract complaints were retrospectively evaluated. A total of 1858 female patients were included in the study. Patients investigated between 2007 and 2014 were asked to fill the IPSS, and patients investigated after 2015 were asked to fill the BFLUTS-SF.</p><p><strong>Results: </strong>The mean age of the patients was 49.06 ± 0.33 in the IPSS group and 50.02 ± 0.47 in the BFLUTS group. On the pressure flow study, voiding dysfunction was found in 14.8% (<i>n</i> = 95) in the IPSS group and 15.1% (<i>n</i> = 183) in the BFLUTS group. The area under curve value was found to be 0.58 for IPSS and 0.64 for BFLUTS. Threshold values were found as >9 for IPSS-VS and >4 for BFLUTS-VS. The sensitivity, specificity, false negative, and false positive rates for IPSS-VS were 33.3%, 78.8%, 66.7%, and 21.2%, respectively. The same parameters were 45.5%, 78.9%, 54.5%, and 21.1% for BFLUTS-VS, respectively.</p><p><strong>Conclusion: </strong>The diagnostic performance of both the questionnaires was found to be low for diagnosing voiding dysfunction in female patients according to our data. Therefore, the assessment of the voiding phase in women should not solely rely on the current questionnaires. However, further studies using questionnaires including all voiding symptoms are required.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899891","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}

{"title":"Robotic reconstruction of necrosed ileal ureter: Technical challenges, intra-operative difficulty, and learning points.","authors":"Deepanshu Aggarwal, Sidhartha Kalra, Lalgudi Narayanan Dorairajan, K S Sreerag, Poojan Thakor","doi":"10.4103/iju.iju_492_23","DOIUrl":"10.4103/iju.iju_492_23","url":null,"abstract":"<p><p>This video explores the challenges faced during a re-do robotic intra-corporeal ileal ureter reconstruction in a previously operated case. A 24-year-old woman presented with a 12-cm long stricture after robotic ileal ureter replacement surgery. A proper preoperative evaluation in the form of ureteroscopy and a nephrostogram is essential and the key steps include adhesiolysis, identification of the necrotic ileal ureter, and meticulous dissection. A 13-cm long segment of the ileum was isolated and was anastomosed to the renal pelvis and the bladder. The surgery lasted for 420 min with 300 ml of blood loss. Post-operatively, the patient recovered well and had a normal drainage with no complications at 1-year of follow-up. The factors such as a broad mesentery, a tension-free anastomosis, and avoiding the twisting of the pedicle are crucial for success of robotic ileal ureter replacement surgery.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899943","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}

{"title":"Re: Gyawali, Sushil; Luitel, Bhoj Raj; Bhattarai, Amit Sharma; Sharma, Uttam Kumar. Comparison of efficacy of intercostal nerve block versus peritract infiltration with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial. Indian Journal of Urology 40(1):p 37-43, Jan-Mar 2024.","authors":"Singh Kirti, Swarnendu Mandal, Das Manoj Kumar, Nayak Prasant","doi":"10.4103/iju.iju_6_24","DOIUrl":"10.4103/iju.iju_6_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899903","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}

{"title":"The impact of anticholinergics on cognitive function in patients with neurogenic lower urinary tract dysfunction: A narrative review.","authors":"Blayne Welk","doi":"10.4103/iju.iju_352_23","DOIUrl":"10.4103/iju.iju_352_23","url":null,"abstract":"<p><p>This narrative review discusses the relationship between anticholinergic medications and cognitive change specifically in patients with neurogenic lower urinary tract dysfunction (NLUTD). NLUTD is prevalent in various conditions, including spinal cord injury (SCI), spina bifida (SB), multiple sclerosis (MS), Parkinson's, stroke, and dementia and often requires anticholinergic overactive bladder (OAB) medications. In the general population, and among those with OAB, several studies have found a significant association between this class of medications and cognitive side effects, mostly when used for > 90 days. These cognitive side effects may be particularly relevant to people with NLUTD due to their higher baseline risk of cognitive impairment. Two studies (one in people with SCI and another in MS) found evidence of cognitive impairment with the use of OAB anticholinergics (specifically oxybutynin and tolterodine). People with dementia commonly use OAB anticholinergics, and there is evidence that oxybutynin and tolterodine may impair cognition in this population. Two recent studies in children with SB studied 12 months of solifenacin and 6 months of fesoterodine/oxybutynin and found there was no significant change in neuropsychological testing. Clinical studies in people with Parkinson's disease and prior stroke have not shown that trospium, darifenacin, or fesoterodine have a significant impact on cognitive measures. In summary, oxybutynin and tolterodine may pose a higher risk of cognitive impairment than newer OAB anticholinergics in people with NLUTD; there is no evidence that children with SB experience cognitive impairment with OAB anticholinergics. Further study is necessary to confirm cognitive safety, particularly as the NLUTD population may have a high exposure to OAB anticholinergics. Advocating for potentially safer OAB medications is necessary if there is concern about cognitive risks.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899865","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}

{"title":"Translation, cross-cultural adaptation, reliability, validation of King's Health Questionnaire in the Marathi language.","authors":"Reema Joshi, Manisha Rathi","doi":"10.4103/iju.iju_263_23","DOIUrl":"10.4103/iju.iju_263_23","url":null,"abstract":"<p><strong>Introduction: </strong>Outcome measurement is a crucial component of contemporary professional practice. Many Indian rehabilitation facilities employ the King's Health Questionnaire (KHQ), but there has never been an official Marathi translation with its reliability and validity.</p><p><strong>Materials and methods: </strong>As per the recommendations for cross-cultural validation of an outcome assessment, KHQ was translated into the Marathi language at a tertiary hospital in Pune, India. A study was conducted to assess the dependability of 123 patients from tertiary hospitals in India. The reliability of the study was assessed by two competent physiotherapists. The interrater reliability of the KHQ total scores and each item was evaluated using Cronbach's alpha coefficient. To compare the interrater dependability with the findings of other investigations, the intraclass correlation (ICC) coefficient was determined.</p><p><strong>Results: </strong>When evaluated by domain, the KHQ's standardized Cronbach's alpha ranged from 0.49-0.92. All domains had reliability that was rated as moderate to strong by ICC, and the severity rating scale varied from 0.53 to 0.81. The Pearson correlation coefficient between KHQ and short form-36 (SF-36) in the majority of related areas was found to be weak to moderate, with values ranging from -0.27 to -0.53.</p><p><strong>Conclusions: </strong>The Marathi version of the KHQ was translated and adapted for use in Marathi language-speaking Indian women with urinary incontinence complaints. It represents an important instrument for the evaluation of incontinent women in clinical research with good interrater reliability and validity with SF-36 quality-of-life measure.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899872","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}