Indian Journal of Urology最新文献

{"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":"Oncological outcomes and complications following radical cystectomy with or without neoadjuvant chemotherapy - A retrospective comparative cohort study from a single-center in South India.","authors":"E Selvin Theodore Jayanth, Subhash L Jat, Benedict P Samuel, Ashish Singh, Nirmal Thampi John, Anjana Joel, Rajiv Paul Mukha, Grace Rebecca, Gowri Mahasampath, Chandrasingh Jeyachandra Berry, Antony Devasia, Nitin Kekre, Santosh Kumar","doi":"10.4103/iju.iju_214_24","DOIUrl":"10.4103/iju.iju_214_24","url":null,"abstract":"<p><strong>Introduction: </strong>Neoadjuvant chemotherapy (NAC) in the management of muscle-invasive bladder carcinoma has not been adopted universally. We studied the oncological outcomes and complications in patients who underwent radical cystectomy (RC) with or without NAC.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent RC with or without NAC from June 2009 to June 2020 was conducted. Oncological outcomes, overall survival (OS) and recurrence-free survival (RFS), complications, and prognostic factors were analyzed.</p><p><strong>Results: </strong>Of the 314 patients who underwent RC, 83 patients received NAC (Group A), and 231 underwent RC alone (Group B). The median age was 58 years. The median follow-up duration was 22 (3-64) and 24 (3-62) months, respectively. The median OS in Group A was significantly higher than Group B (38 months [confidence interval (CI): 34-42] and 32 [CI: 29-35], respectively, [<i>P</i> = 0.033]). The RFS in Groups A and B was 34 (CI: 30-39) and 31 (CI: 28-34) months, respectively (<i>P</i> = 0.47). Higher pathological T stage (T3/4), node positivity and lymphovascular invasion (LVI) were predictors of poor OS and RFS (<i>P</i> < 0.0001). Clavien grades 3/4 complications were comparable (8% vs. 15%; <i>P</i> = 0.19). Glomerular filtration rate (GFR) <60 mL/min/1.73 m² was associated with higher postoperative complications in both groups (<i>P</i> = 0.012).</p><p><strong>Conclusion: </strong>The OS with NAC was superior to upfront RC. RFS was, however, comparable. NAC was safe and well-tolerated. Pathologically, higher T stage, node positivity, and LVI were associated with poorer OS and RFS. Low GFR negatively influenced postoperative complications.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"20-27"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067694","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":"Correlation of gallium-68 prostate-specific membrane antigen positron emission tomography - Computed tomography/magnetic resonance imaging with histopathology characteristics in carcinoma prostate patients undergoing radical prostatectomy.","authors":"P Taur Pratik, Deerush Kannan Sakthivel, S Tiwari Madhav, P Bafna Sandeep, Narasimhan Ragavan","doi":"10.4103/iju.iju_143_24","DOIUrl":"10.4103/iju.iju_143_24","url":null,"abstract":"<p><strong>Introduction: </strong>Gallium-68 prostate-specific membrane antigen positron emission tomography (⁶⁸Ga-PSMA PET) is being increasingly used in patients with prostate cancer (PCa) for the staging and detection of lymph node (LN) metastases, despite a lack of prospective, validated evidence. We aimed to investigate the relationship between the PSMA PET findings (maximum standardized uptake [SUV_max] value) and the final histopathology results (Gleason Grade [GG], and LN positivity) in patients undergoing radical prostatectomy.</p><p><strong>Methods: </strong>This is a single centre, prospective, observational study of 63 consecutive eligible patients treated at a tertiary care centre in India. Patients underwent ⁶⁸Ga-PSMA PET computed tomography with fusion magnetic resonance imaging for staging, followed by a Transrectal ultrasound guided prostate biopsy. All patients underwent robotic-assisted radical prostatectomy with extended pelvic LN dissection as per the standard protocol. Clinical parameters and SUV_max values were collected and analysed.</p><p><strong>Results: </strong>The median preoperative prostate specific antigen (PSA) was 15.0 ng/ml (interquartile range: 9.4-28.0). A statistically significant correlation was observed between the PSA values and the SUV_max uptake (<i>P</i> < 0.001). Additionally, there was a statistically significant correlation between the SUV_max of the prostatic lesion and the GG on the radical prostatectomy specimens (<i>P</i> = 0.025), and SUV_max of LN and LN involvement (<i>P</i> < 0.001). The sensitivity and specificity of the ⁶⁸Ga-PSMA PET scan were 77.8% and 88.7%, respectively.</p><p><strong>Conclusions: </strong>SUVmax of the PCa lesion and the GG Group on the final histopathology correlates significantly. There is an increased SUV uptake in Gleason's Score (GS) 8, 9 tumours as compared to GS 6 and 7.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"41 1","pages":"40-44"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068823","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: Purushothaman J, Kalra S, Dorairajan LN, Selvarajan S, Sreerag KS, Aggarwal D. Intravesical bupivacaine in reducing catheter-related bladder discomfort and lower urinary tract symptoms after transurethral surgery: A randomized controlled trial. Indian J Urol 2024;40:161-6.","authors":"Kirti Singh, Swarnendu Mandal, Manoj K Das, Prasant Nayak","doi":"10.4103/iju.iju_273_24","DOIUrl":"10.4103/iju.iju_273_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"287-288"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649112","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_357_24","DOIUrl":"10.4103/iju.iju_357_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"215-217"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649149","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 reused-disposable scope in flexible ureteroscopy for stones as a cost-conscious approach: Reporting the outcomes of a real-world practice multicenter study of 2183 patients by the team of worldwide endourological researchers group.","authors":"Vineet Gauhar, Olivier Traxer, Ravindra B Sabnis, Khi Yung Fong, Parimalsinh Gharia, Rishi Grover, Deepak Ragoori, Ee Jean Lim, Yiloren Tanidir, Amish Mehta, Mehmet Ilker Gökce, Mohamed Amine Lakmichi, Boyke Soebhali, Nariman Gadzhiev, Ben H Chew, Bhaskar Kumar Somani, Daniele Castellani","doi":"10.4103/iju.iju_38_24","DOIUrl":"10.4103/iju.iju_38_24","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess complications and stone-free rate of flexible ureteroscopy (FU) reusing disposable scopes (RDS) after repeated sterilization.</p><p><strong>Methods: </strong>Data from adults from 11 centers were retrospectively reviewed (January 2020-December 2022). Inclusion criteria were proximal ureteral/renal stone(s). All cases were performed using an RDS to save costs for patients who come from economically challenged environments. Residual fragments (RFs) were defined as single fragment ≥4 mm or multiple fragments of any size within 3 months. Continuous variables are presented as median and interquartile range.</p><p><strong>Results: </strong>Two thousand one hundred and eighty-three patients were included, of whom 67.0% were male. Median age was 48.0 (36-59) years. The median stone diameter was 10.2 (9-14) mm. Flash sterilization was used in 90.2% (plasma in 60.5%). Approximately, 88% had FU with an RDS used ≤2 times (12%: 3-5 times). RDS needed to be changed intraoperatively in 3.9% of cases due to its malfunction. Commonly, defects in RDS function were reported in upward (1.6%) and downward deflection (6.5%) and image quality on white balancing (4.7%). Fever >38C was seen in 13.7% of cases, and sepsis in 0.5%. RFs were found in 31.4% of cases. Lower pole (odds ratio [OR] 5.63) or pelvis stone (OR 4.67), faulty scopes (OR 12.8), and total operation time (OR 1.05) were factors associated with higher odds of RFs. Stone size (OR 1.09), positive urine culture (OR 1.67), interpolar stone (OR 1.68), and prestenting (OR 1.37) were factors associated with higher odds of fever/sepsis.</p><p><strong>Conclusions: </strong>RDS was used as a cost-conscious approach with a low rate of serious infections but with a high rate of RFs.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"235-241"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649290","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}