Indian Journal of Urology最新文献

{"title":"Factors influencing urinary retention following freehand transperineal prostate biopsy: Insights from a tertiary care center study.","authors":"Shashank Agrawal, Vivek Dadasaheb Patil, Vishnu Prasad, Arun Ramadas Menon, Ginil Kumar Pooleri","doi":"10.4103/iju.iju_36_24","DOIUrl":"10.4103/iju.iju_36_24","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we evaluated the risk factors for urinary retention after freehand transrectal ultrasound (TRUS) guided transperineal prostate biopsy (TPB).</p><p><strong>Patients and methods: </strong>Data from 102 cases of freehand TPB at a single institution were retrospectively collected and analyzed. All patients underwent magnetic resonance imaging (MRI)-TRUS cognitive fusion TPB using a transperineal needle guide, with systematic biopsies from 10 prostate sectors and additional MRI-guided targeted biopsies. Exclusions comprised patients with coagulation abnormalities, prior prostate surgeries including biopsy, active urinary tract infection, or a lack of pre-biopsy multiparametric MRI.</p><p><strong>Results: </strong>14/102 (13.72%) had urinary retention and required urethral catheterization for voiding difficulty or discomfort along with a bladder volume of ≥500 ml. Patients with retention exhibited significantly larger prostate volumes (median 75 cc vs. 40 cc; <i>P</i> < 0.05). Receiver operating curve analysis revealed a prostate volume threshold of 57.5 cc and a core number cutoff of 23 for predicting post-TPB urinary retention, with sensitivities of 78.57% and 85.71%, specificities of 75% and 82.95%, positive predictive values of 33.33% and 44.44%, and negative predictive values of 95.75% and 97.33%, respectively, whereas the number of biopsy cores correlated positively with the development of urinary retention (median 25 vs. 22; <i>P</i> < 0.05). Urinary retention was independent of the patient's age, comorbidities, presenting prostate-specific antigen levels, prebiopsy severity of lower urinary tract symptoms, and use of alpha-blockers.</p><p><strong>Conclusion: </strong>Patients with larger prostates and higher number of biopsy cores are at a higher risk of postfreehand TPB urinary retention and should receive appropriate counselling. Targeted biopsies alone, rather than a full template, may help mitigate urinary retention in these high-risk groups.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"229-234"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649055","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 grimacing face of adverse upper tract urothelial carcinoma can now POUT with adjuvant chemotherapy!","authors":"Sumit Mandal","doi":"10.4103/iju.iju_87_24","DOIUrl":"10.4103/iju.iju_87_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"281-282"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649288","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":"Artificial intelligence in prostate cancer: The potential of machine learning models and neural networks to predict biochemical recurrence after robot-assisted radical prostatectomy.","authors":"Gurpremjit Singh, Mayank Agrawal, Gagandeep Talwar, Sanket Kankaria, Gopal Sharma, Puneet Ahluwalia, Gagan Gautam","doi":"10.4103/iju.iju_75_24","DOIUrl":"10.4103/iju.iju_75_24","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the usefulness of machine learning (ML) and neural network (NN) models versus traditional statistical methods for estimating biochemical recurrence (BCR) in men following robot-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>Patients who underwent RARP from November 2011 to July 2022 were taken in the study. Patients with BCR were assigned to Group 2, whereas those without BCR were placed in Group 1. Preoperative and postoperative parameters, together with demographic data, were recorded in the database. This study used one NN, the radial basis function NN (RBFNN), and two ML approaches, the K-nearest neighbor and XGboost ML models, to predict BCR.</p><p><strong>Results: </strong>Following the application of exclusion criteria, 516 patients were deemed eligible for the study. Of those, 234 (45.3%) developed BCR, and 282 (54.7%) did not. The results showed that the median follow-up period was 24 (15-42) months, and the median BCR diagnosis was 12.23 ± 15.58 months. The area under the curve (AUC) for the Cox proportional hazard analysis was 0.77. The receiver-operating characteristic curves (AUCs) for the XGBoost and K closest neighbor models were 0.82 and 0.69, respectively. The RBFNN's AUC was 0.82.</p><p><strong>Conclusions: </strong>The classical statistical model was outperformed by XGBoost and RBFNN models in predicting BCR.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"260-265"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648986","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":"Preoperative prostate magnetic resonance imaging does not impact surgical outcomes of radical prostatectomy.","authors":"Christopher K Bozorgmehr, Johnny Wang, James T Gross, Nicholas A Pickersgill, Joel M Vetter, Joseph E Ippolito, Eric H Kim","doi":"10.4103/iju.iju_115_24","DOIUrl":"10.4103/iju.iju_115_24","url":null,"abstract":"<p><strong>Objective: </strong>We reviewed our institutional experience of radical prostatectomy with and without preoperative multiparametric magnetic resonance imaging (mpMRI) to assess the impact of preoperative prostate mpMRI on surgical outcomes of radical prostatectomy.</p><p><strong>Methods: </strong>We identified patients at our institution who underwent radical prostatectomy for prostate cancer (PCa) between January 2012 and December 2017 (<i>n</i> = 1044). Using propensity scoring analysis, patients who underwent preoperative mpMRI (<i>n</i> = 285) were matched 1:1 to patients who did not receive preoperative mpMRI (<i>n</i> = 285). Multivariable regression analysis was performed to identify factors predictive of operative time, estimated blood loss (EBL), lymph node yield, rates of complications within 30 days, and positive surgical margin (PSM).</p><p><strong>Results: </strong>There were no significant differences in operative time, EBL, PSM, lymph node yield, or complication rates between the two cohorts. Multivariable analysis demonstrated that preoperative mpMRI was not predictive of the measured perioperative outcomes. Significant comorbidity (Charlson Comorbidity Index ≥3) was the sole predictor of perioperative complications (<i>P</i> = 0.015). Increasing biopsy Gleason score predicted increased lymph node yield (<i>P</i> < 0.001). The probability of PSM was associated with increasing preoperative prostate-specific antigen (odds ratio 1.036, <i>P</i> = 0.009). Body mass index was a predictor of operative time (<i>P</i> = 0.016) and EBL (<i>P</i> = 0.001).</p><p><strong>Conclusions: </strong>Although preoperative mpMRI has an important role in the diagnosis and staging of PCa, it does not impact perioperative radical prostatectomy outcomes. Our findings do not support the routine use of preoperative mpMRI for surgical planning in patients already diagnosed with clinically localized PCa.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"266-271"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649111","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":"Editorial Comment.","authors":"Arvind P Ganpule","doi":"10.4103/iju.iju_335_24","DOIUrl":"10.4103/iju.iju_335_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"242"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649049","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":"Postpercutaneous nephrolithotomy pseudoaneurysm embolization - Immediate endovascular coil migration into the pelvicalyceal system causing obstruction.","authors":"D Paul Vincent, R Ravichandran, Abhineet Gupta","doi":"10.4103/iju.iju_25_24","DOIUrl":"10.4103/iju.iju_25_24","url":null,"abstract":"<p><p>Bleeding is the most dreaded complication after percutaneous nephrolithotomy (PCNL). We report a case of post PCNL hematuria managed with selective angioembolization of the pseudoaneurysm. During the embolization, the emolization coil along with the glue migrated into the pelvicalyceal system from the pseudoaneurysmal cavity. The pseudoaneurysm was again embolized using cyanoacrylate glue and a screening computed tomography was immediately performed which showed the migrated coil along with the glue into the pelvicalyceal system resulting in pelviureteric junction obstruction. The coil was retrieved endoscopically, after the patient was stabilized. To our knowledge, this is the first reported case of an immediate migration of the coil and the urologists should be aware of it.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"276-278"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649107","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 extra-peritoneal robotic radical prostatectomy in a patient with hostile abdomen.","authors":"Sina Sobhani, Sij Hemal","doi":"10.4103/iju.iju_188_24","DOIUrl":"10.4103/iju.iju_188_24","url":null,"abstract":"<p><p>This video explores the technique and outcomes of robotic radical prostatectomy (RP) using the da Vinci single-port robot in a 42-year-old obese male with localized intermediate-risk prostate cancer and a prior history of extensive abdominal surgeries. The patient was placed in a supine position, with minimal Trendelenburg, and an extraperitoneal approach was taken, the abdominal cavity was not entered, and standardized steps of robotic RP were executed. The surgery lasted 190 min and the blood loss was 100 mL. The patient was discharged on the postoperative day 1, and the prostate-specific antigen was undetectable after 6 months and he had excellent functional outcomes.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 4","pages":"279-280"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649284","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_246_24","DOIUrl":"https://doi.org/10.4103/iju.iju_246_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 3","pages":"148-150"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890413","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":"Authors reply Re: Sharma AP, Singh PP, Chauhan R, Panda I, Devana SK, Bora GS, <i>et al</i>. Clinical study of steroid receptors in nonmuscle invasive bladder cancer: A domain worth revisiting. Indian J Urol 2024;40:127-32.","authors":"Aditya Prakash Sharma, Puranjay Pratap Singh, Rohit Chauhan","doi":"10.4103/iju.iju_196_24","DOIUrl":"10.4103/iju.iju_196_24","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":"40 3","pages":"210-211"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890411","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":"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":"40 3","pages":"208-209"},"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}