Indian Journal of Urology最新文献

{"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}

{"title":"Author reply 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":"P Jithesh, Sidhartha Kalra, L N Dorairajan, Sreerag Kodakkattil Sreenivasan, Deepanshu Aggarwal","doi":"10.4103/iju.iju_327_24","DOIUrl":"10.4103/iju.iju_327_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"288-289"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648991","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":"Performance and Clinical Implications of VI-RADS in detecting muscle invasion in bladder tumors: A prospective observational study.","authors":"Bommireddy V Reddy, Kasi Viswanath Gali, Arun Chawla, Anshuman Singh, Sunil Pillai Bhaskara, Padmaraj Hegde","doi":"10.4103/iju.iju_462_23","DOIUrl":"10.4103/iju.iju_462_23","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder cancer staging is pivotal for guiding therapeutic decisions. In this study, the primary objective was to assess the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI), The study aimed to classify bladder tumors as either nonmuscle-invasive bladder cancers or muscle-invasive bladder cancers (MIBC) using the Vesical Imaging Reporting and Data System (VI-RADS) scoring. A secondary objective of the study focused on the accuracy of biparametric magnetic resonance imaging (bpMRI) in comparison to mpMRI.</p><p><strong>Methods: </strong>Thirty-three patients with bladder tumors were enrolled and underwent both mpMRI and bpMRI scoring assessments. VI-RADS scores were assigned and subsequently compared with histopathological findings posttransurethral resection of bladder tumor., Statistical measures included sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for VI-RADS scores at cutoff thresholds of ≥4 and 5.</p><p><strong>Results: </strong>MpMRI at a VI-RADS cutoff of ≥4 yielded an 83.33% sensitivity and 100% specificity, with a diagnostic accuracy of 90.91%. At a cutoff of 5, sensitivity was 100%, specificity was 77.27%, and diagnostic accuracy was 84.85%. bpMRI at a cutoff of ≥4 showed an 80% sensitivity and 100% specificity, with diagnostic accuracy matching mpMRI at 90.91%.</p><p><strong>Conclusions: </strong>This prospective analysis demonstrates that VI-RADS scoring with mpMRI provides reliable diagnostic accuracy for bladder cancer staging. mpMRI exhibits high sensitivity and specificity at a cutoff of ≥ 4, making it a robust tool for MIBC detection. bpMRI is an effective alternative in select patients. The study validates the use of VI-RADS scoring in clinical practice for effective treatment planning.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"243-249"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649141","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":"Kidney-sparing management for high-risk upper tract urothelial carcinoma: Where do we stand?","authors":"Nikita Shrivastava","doi":"10.4103/iju.iju_263_24","DOIUrl":"10.4103/iju.iju_263_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"285-286"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648999","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_366_24","DOIUrl":"https://doi.org/10.4103/iju.iju_366_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"218-220"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649302","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":"Beyond the horizon: Immune checkpoint inhibitors reshaping the landscape of urothelial cancer.","authors":"Ojas Patel","doi":"10.4103/iju.iju_51_24","DOIUrl":"10.4103/iju.iju_51_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"283-284"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649007","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":"Challenges facing children with neurogenic lower urinary tract dysfunction in India.","authors":"Sanjay Sinha","doi":"10.4103/iju.iju_333_24","DOIUrl":"10.4103/iju.iju_333_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"213-214"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649016","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 use of amniotic membrane injection as an adjunct in endoscopic urethral stricture management.","authors":"Nicholas Pryde, Jack Vercnocke, Jonathan Lutchka, Aron Liaw, Michael Sessine, Nivedita Dhar","doi":"10.4103/iju.iju_88_24","DOIUrl":"10.4103/iju.iju_88_24","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic urethral stricture treatment has high recurrence rates. Due to research supporting amniotic membrane's (AMs) anti-inflammatory and anti-fibrotic properties reducing scar tissue formation, AM has generated interest in reconstructive urethral surgery. To the best of our knowledge, we performed the first investigation of the success rate of urethral dilation when combined with micronized AM injection for the treatment of urethral stricture.</p><p><strong>Methods: </strong>Eligible patients were adult males with anterior strictures meeting strict criteria for diameter, length, International Prostate Symptom Score (IPSS), and flow rate. Micronized AM was injected in the stricture region during urethral dilation. The primary study endpoint was an anatomical success (≥14Fr) at 6 months. Secondary endpoints were evaluated with the IPSS, urethral stricture surgery - patient-related outcome measure, International Index of Erectile Function, flow rate, and postvoid residual. Outcomes were assessed at baseline and multiple points postinjection. Injection safety was analyzed.</p><p><strong>Results: </strong>Ten men with a mean age of 52 years were included in the study. At 6 months, 7 of 10 patients demonstrated recurrence of the urethral stricture on cystoscopy. Improvements in secondary endpoints were noted in 10 of 10 patients at 3 months and 3 of 10 patients at 6 months. No adverse events were observed.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study evaluating micronized AM injection as an adjunct treatment at the time of urethral dilation. The urethral stricture recurrence rate did not improve with the injection of AM despite the hypothesized benefits of anti-fibrotic and anti-inflammatory properties.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"256-258"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649299","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 artificial intelligence aid the urologists in detecting bladder cancer?","authors":"Antoninus Hengky, Stevan Kristian Lionardi, Christopher Kusumajaya","doi":"10.4103/iju.iju_39_24","DOIUrl":"10.4103/iju.iju_39_24","url":null,"abstract":"<p><strong>Introduction: </strong>The emergence of artificial intelligence (AI)-based support system endoscopy, including cystoscopy, has shown promising results by training deep learning algorithms with large datasets of images and videos. This AI-aided cystoscopy has the potential to significantly transform the urological practice by assisting the urologists in identifying malignant areas, especially considering the diverse appearance of these lesions.</p><p><strong>Methods: </strong>Four databases, the PubMed, ProQuest, EBSCOHost, and ScienceDirect were searched, along with a manual hand search. Prospective and retrospective studies, experimental studies, cross-sectional studies, and case-control studies assessing the utilization of AI for the detection of bladder cancer through cystoscopy and comparing with the histopathology results as the reference standard were included. The following terms and their variants were used: \"artificial intelligence,\" \"cystoscopy,\" and \"bladder cancer.\" The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A random effects model was used to calculate the pooled sensitivity and specificity. The Moses-Littenberg model was used to derive the Summary Receiver Operating Characteristics (SROC) curve.</p><p><strong>Results: </strong>Five studies were selected for the analysis. Pooled sensitivity and specificity were 0.953 (95% confidence interval [CI]: 0.908-0.976) and 0.957 (95% CI: 0.923-0.977), respectively. Pooled diagnostic odd ratio was 449.79 (95% CI: 12.42-887.17). SROC curve (area under the curve: 0.988, 95% CI: 0.982-0.994) indicated a strong discriminating power of AI-aided cystoscopy in differentiation normal or benign bladder lesions from the malignant ones.</p><p><strong>Conclusions: </strong>Although the utilization of AI for aiding in the detection of bladder cancer through cystoscopy remains questionable, it has shown encouraging potential for enhancing the detection rates. Future studies should concentrate on identification of the patients groups which could derive maximum benefit from accurate identification of the bladder cancer, such as those with intermediate or high-risk invasive tumors.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"221-228"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649012","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":"Creation and evaluation of a three-dimensional-printed synthetic vas deferens for microsurgical training.","authors":"Parth Joshi, Tamar Jacobsohn, Andrew Polis, Darshi Shah, Brian Gillette, Richard Schoor","doi":"10.4103/iju.iju_185_24","DOIUrl":"10.4103/iju.iju_185_24","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals choose to undergo vasectomy reversal for a variety of reasons, including remarriage or due to the death of a child. To be proficient in this procedure, the surgeons need to be high volume and the trainees require a safe environment to develop their microsurgical skills. To overcome this challenge, we used three-dimensional (3D) printing to create a synthetic model of the vas deferens with properties similar to the human vas deferens. We distributed this model to experienced microsurgeons for evaluation.</p><p><strong>Methods: </strong>The vas deferens model was created using thermoplastic polyurethane filament. The filament was then infused with a foaming agent to allow for temperature-dependent tuning of the material's stiffness. The model's outer diameter was 1 mm and the inner lumen was 0.5 mm. Fellowship-trained male reproductive urologists were recruited from the Society for the Study of Male Reproduction website. They used our model and judged it on several factors by completing a 13-question survey.</p><p><strong>Results: </strong>We received completed evaluations from five microsurgeons. Eighty percent of the surgeons were able to complete a full anastomosis on the model using 9-0 and 10-0 sutures. The majority of the completed anastomoses were performed using the one-layer technique. The average responses for the model's usefulness as a practice tool, a training tool, and overall assessment ranged from 72 to 79 out of 100. Comments for the improvement included the need for a more flexible and softer model.</p><p><strong>Conclusions: </strong>We created a 3D-printed synthetic vas deferens that serves as a valuable training and practice tool.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"250-255"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649025","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}