Indian Journal of Urology最新文献

{"title":"Neoadjuvant chemotherapy for bladder cancer: Two decades on.","authors":"Rishi Nayyar","doi":"10.4103/iju.iju_432_24","DOIUrl":"10.4103/iju.iju_432_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"1-2"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068872","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_478_24","DOIUrl":"10.4103/iju.iju_478_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"3-5"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068484","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":"Shifting tides: A survey analysis of urologists' evolving attitudes toward focal therapy for prostate cancer.","authors":"Jason Koehler, Alon Lazarovich, Shima Tayebi, Vijay Viswanath, Arvin George, Wei-Wen Hsu, Abhinav Sidana","doi":"10.4103/iju.iju_239_24","DOIUrl":"10.4103/iju.iju_239_24","url":null,"abstract":"<p><strong>Introduction: </strong>Focal therapy (FT) is emerging as an alternative to radical treatment for prostate cancer (CaP). The purpose of this study is to assess the current perceptions of FT amongst urologists.</p><p><strong>Methods: </strong>A 22-item questionnaire was e-mailed to members of the American Urological Association. Multivariate logistic regression analysis was used to identify predictors of FT utilization. Results were compared to a previous survey from 2019.</p><p><strong>Results: </strong>Two hundred and sixty-four responses were recorded. Less than half (115/264, 43.6%) of respondents utilize FT; among them, 42% perform FT on more than 10 patients/year. Reasons for avoiding FT included: lack of experience (51.8%), belief that CaP is multifocal (46.0%), and lack of infrastructure (43.1%). The most common modalities for FT were high-intensity focused ultrasound (63.4%) and cryoablation (47.3%). Preferred patients for FT were primarily unilateral/anterior only Gleason Grade Group 2 (95/110, 86.4%). A fellowship training in urologic oncology (odds ratio [OR] = 2.86, <i>P</i> = 0.008) and seeing more than 10 CaP patients per month (OR = 2.46, <i>P</i> = 0.002) were associated with greater utilization of FT. Most respondents (85.4%) cited better imaging methods as a factor that has increased FT utilization. Compared to a previous survey, a higher number of respondents (43% vs. 24%) utilize FT and more respondents believe in the \"index lesion theory.\"</p><p><strong>Conclusions: </strong>Less than half of the respondents utilize FT in their practice. Fellowship training in urologic oncology and a higher volume of CaP patients were correlated with FT utilization. As urologists gain more experience, the trend of further utilization of FT for CaP may continue.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"59-65"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068447","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":"Reply to Letter for the Article, the Impact of Sestamibi Scan on Clinical Decision-Making for Renal Masses: An Observational Single-center Study. Yong, Courtney; Tong, Yan; Tann, Mark; Sundaram, Chandru P. Indian Journal of Urology. 40(3):151-155, Jul-Sep 2024.","authors":"Courtney Yong, Yan Tong, Mark Tann, Chandru Sundaram","doi":"10.4103/iju.iju_424_24","DOIUrl":"https://doi.org/10.4103/iju.iju_424_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"78-79"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068472","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":"Urethral duplication with five openings in anal canal: A novel case report.","authors":"Faisal Masood Pirzada, Rishi Nayyar, Devendra Kumar Yadav","doi":"10.4103/iju.iju_264_24","DOIUrl":"10.4103/iju.iju_264_24","url":null,"abstract":"<p><p>Urethral duplication is a rare congenital anomaly characterized by more than one urethral channel, with varied course, location of the external opening, and presentation. Presentations can be varied, depending upon individual anatomical dispensation but mostly present as obstruction, recurrent urinary infection, or double urinary stream. Treatment depends on the type of duplication and associated anomalies. Here, we report a case of urethral duplication which did not fit into any known reported type of urethral duplication forms and had five openings at the anal verge.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"69-72"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068594","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":"Can lesion volume and prostate-specific antigen density play a role in detecting clinically significant prostate cancer in Prostate Imaging Reporting and Data System-3 lesions on multiparametric magnetic resonance imaging?","authors":"Shashank Agrawal, Vishnu Prasad, Arun Ramadas Menon, Ginil Kumar Pooleri","doi":"10.4103/iju.iju_112_24","DOIUrl":"10.4103/iju.iju_112_24","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the Prostate Imaging Reporting and Data System - 3 lesions (PI-RADS 3) have been sub classified into \"3a\" - lesions with a volume of <0.5 mL and \"3b\" - lesions exceeding 0.5 mL, whereas the prostate-specific antigen density (PSAD) is an established adjunct tool for predicting clinically significant prostate cancer (csPCa). The objective of this study was to evaluate the association between the volume of PI-RADS 3 lesions and PSAD in diagnosing csPCa and to assess the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) when PSAD is combined with the lesion volume.</p><p><strong>Methods: </strong>This retrospective single-center study reviewed the data of transperineal prostate biopsies performed under transrectal ultrasound guidance from January 2018 to December 2023. csPCa was defined as a Gleason score ≥3 + 4. Patients were divided into two groups based on the PIRADS-3 subclassification and PSAD.</p><p><strong>Results: </strong>Out of the 108 PIRADS-3 lesions, 17 patients had csPCa. All the patients with PIRADS-3a (<i>n</i> = 37) had clinically insignificant tumors or benign conditions. Receiver operating characteristic curve analysis for predicting csPCa showed that the (Area under the curve) AUC values of PSAD, prostate volume, and prostate-specific antigen were 0.899, 0.746, and 0.381, respectively. 16 csPCa patients in PIRADS-3b category had PSAD ≥0.29 ng/ml², whereas 1 patient had PSAD <0.29 ng/ml². Sensitivity, specificity, PPV, and NPV of PIRADS-3b lesions were 100%, 40.66%, 23.94%, and 100%, respectively, and it became 94.12%, 74.07%, 53.33%, and 97.56%, respectively, when PSAD was added to PIRADS-3b lesions.</p><p><strong>Conclusion: </strong>The combination of lesion volume of the PI-RADS 3 lesion and PSAD improved the PPV and specificity of detecting csPCa.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"35-39"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068791","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, pathological, and oncological outcomes in unclassified renal cell carcinoma compared to clear cell renal cell carcinoma.","authors":"Guilherme Sawczyn, Caio Brambilla, Gilberto Jose Rodrigues, Maykon William Aparecido Pires Pereira, Leonardo Cardili, Paulo Afonso de Carvalho, Fabio Pescarmona Gallucci, Álvaro Sadek Sarkis, William Carlos Nahas, Mauricio Dener Cordeiro","doi":"10.4103/iju.iju_256_24","DOIUrl":"10.4103/iju.iju_256_24","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the impact of unclassified renal cell carcinoma (uRCC) on clinical, pathological, and oncological outcomes compared with clear cell renal cell carcinoma (ccRCC).</p><p><strong>Materials and methods: </strong>We analyzed the data of 48 uRCC and 688 ccRCC cases, collected from a histopathological database at a single center from July 2011 to August 2019. uRCC cases were confirmed according to the 2016 World Health Organization classification. Baseline characteristics, clinical findings, and oncological outcomes were compared between the groups.</p><p><strong>Results: </strong>Patients with uRCC exhibited the same clinical symptoms as ccRCC patients, a higher prevalence of lymphadenopathy (31.2% vs. 15.8%, <i>P</i> < 0.01), and greater sarcomatoid/rhabdoid differentiation on histology (12.5% vs. 5%, <i>P</i> = 0.03) compared to ccRCC patients. Although there was no difference regarding overall metastasis at initial diagnosis, distant lymphadenopathy (16.7% vs. 7.8%, <i>P</i> = 0.04) and liver metastasis (8.9% vs. 2.8%, <i>P</i> = 0.04) were more common in the uRCC group. The two groups had similar high-grade (HG) frequency on histology (62.5% for uRCC vs. 53.7% for ccRCC, <i>P</i> = 0.23). The estimated recurrence-free survival at 48 months was 94.3% for uRCC, 92.5% for low-grade (LG) ccRCC (<i>P</i> = 0.91), and 66.5% for HG ccRCC (<i>P</i> < 0.01). The estimated overall survival at 48 months was 66.1% for uRCC, 87.4% for LG ccRCC (<i>P</i> = 0.75), and 63.4% for HG ccRCC (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Our study demonstrates that uRCC has significantly higher rates of lymphadenopathy, sarcomatoid differentiation, and liver metastasis compared to ccRCC. Despite these differences, uRCC presents with similar clinical symptoms and histological grade as ccRCC. Furthermore, uRCC exhibits a recurrence rate comparable to LG ccRCC and an overall survival rate similar to HG ccRCC.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"51-58"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068815","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":"Single-port robot-assisted pyeloplasty through supine anterior retroperitoneal access.","authors":"Sina Sobhani, Sij Hemal","doi":"10.4103/iju.iju_389_24","DOIUrl":"10.4103/iju.iju_389_24","url":null,"abstract":"<p><p>This video explores the technique of robot-assisted pyeloplasty using the Da-Vinci Single-Port robot through the supine anterior retroperitoneal access in a 28-year-old male with a right-sided ureteropelvic junction obstruction. The patient was placed in a supine position, with a 10°-20° elevation of the ipsilateral flank. Retroperitoneal access was obtained at the McBurney's point for the placement of the port. The standardized steps of the Anderson-Hynes pyeloplasty technique were executed. Operative time was 120 min with 10 mL of blood loss. The patient was discharged on the same day without complications. At 4-months follow-up, on the renal scan, the right kidney showed stable function with improved drainage.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"73-74"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068517","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":"What's inside.","authors":"Abhishek Gajendra Singh","doi":"10.4103/iju.iju_489_24","DOIUrl":"10.4103/iju.iju_489_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"6-8"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068600","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":"Assessing neoadjuvant chemotherapy's impact on complications following radical cystectomy.","authors":"Mounish Nuthalapati, Arun Ramdas Menon, Vivek Dadasaheb Patil, Sheejamol Velickakathu Sukumaran, Prashanth Reddy Yensani, Shashank Agrawal, Nikhil Krishna Haridas, Haridas Nair, Sohini Chandra Ganesuni, Nivedita Suresh, Bindu Mangalath Rajamma, Ginil Kumar Pooleri","doi":"10.4103/iju.iju_217_24","DOIUrl":"10.4103/iju.iju_217_24","url":null,"abstract":"<p><strong>Introduction: </strong>Despite level 1 evidence supporting neoadjuvant chemotherapy (NACT) followed by radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), its adoption is hindered by concerns about toxicity and detrimental impact on post-RC complications. We retrospectively reviewed post-RC complications at a tertiary care hospital, particularly assessing impact of NACT.</p><p><strong>Methods: </strong>Data from the institutional bladder cancer database were retrieved for patients aged ≥18 with MIBC (≥American Joint Committee on Cancer Clinical Stage T2), treated with RC between May 2013 and July 2023. Exclusions were nonurothelial histology, salvage cystectomy, and palliative intent. Data abstracted included patient characteristics, NACT administration, surgery, and outcomes. Patients were divided into two groups based on NACT and compared. Complications were categorized as early (≤30 days) or late (31-90 days) and graded. Statistical analysis set significance at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Of 154 patients who underwent RC, 33 were excluded due to non-MIBC, nonurothelial histology, or salvage cystectomy. The 121 patients analyzed had a mean age of 64 years and a Charlson Comorbidity Index (CCI) of 4.9. Among them, 61 received NACT and 60 did not. There was no significant difference between the NACT+RC and RC-only groups in overall complication rates (85.3% vs. 75.0%, <i>P</i> = 0.16) or in major complications (50.8% vs. 58.3%, <i>P</i> = 0.41). CCI >5 predicted major complications, while NACT did not.</p><p><strong>Conclusion: </strong>In our study of MIBC patients managed at a tertiary care institute in India, NACT administration did not increase postoperative complications.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"28-34"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068788","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}