Indian Journal of Urology最新文献

{"title":"Low-intensity extracorporeal shockwave therapy for Peyronie's disease: An Indian experience.","authors":"Krishnendu Maiti,&nbsp;Swadeep Kumar Srivastava,&nbsp;Dilip Kumar Pal","doi":"10.4103/iju.iju_22_23","DOIUrl":"10.4103/iju.iju_22_23","url":null,"abstract":"<p><strong>Introduction: </strong>Efficacy of low-intensity extracorporeal shockwave therapy (LiESWT) in Peyronie's disease (PD) has not been studied in an Indian population. Here, we studied the effect of LiESWT in Indian PD patients.</p><p><strong>Methods: </strong>This prospective study was conducted on 25 patients who completed weekly sessions of LiESWT for 6 weeks with a follow-up of 6 months. Patients were evaluated using International Index of Erectile Function (IIEF)-5 questionnaire for erectile dysfunction and visual analog scale for pain. Baseline and follow-up examinations included measurement of plaque size and curvature. The primary outcome was to assess remission of pain and reduction of plaque size along with improvement of penile curvature and erectile function as the secondary outcome.</p><p><strong>Results: </strong>Primary goal of pain reduction and ≥50% reduction of plaque size was achieved in 64% and 20% of patients, respectively. Improvement in vaginal penetration during sexual intercourse and IIEF-5 score increase of ≥3 was achieved 20% and 36% cases, respectively. The mean reduction of penile curvature was more with plaque calcification (PC), but the difference was not statistically significant (<i>P</i> = 0.26). The difference in mean visual analog scale reduction was more in noncalcified plaque (<i>P</i> = 0.002). The mean reduction of plaque size in patients with PC was significant (<i>P</i> = 0.03).</p><p><strong>Conclusions: </strong>Shockwave therapy is a probable alternative treatment option. A significant improvement was observed in pain and plaque size in patients treated by LiESWT. The presence of PC may affect the outcome of LiESWT in PD.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/b9/IJU-39-209.PMC10419780.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052253","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":"Clinicoradiological parameters predicting operative difficulty in laparoscopic partial nephrectomy for renal tumors.","authors":"Faisal Masood Pirzada,&nbsp;Rajeev Sood,&nbsp;Anil Taneja,&nbsp;Umesh Sharma,&nbsp;Hemant Kumar Goel,&nbsp;Sumit Gahlawat","doi":"10.4103/iju.iju_384_22","DOIUrl":"10.4103/iju.iju_384_22","url":null,"abstract":"<p><strong>Introduction: </strong>The number of renal tumors amenable to laparoscopic surgery is rising, both, due early detection by improved imaging techniques and due to progressive improvements in minimal access surgery. Conversion to open surgery, which is a significant event, can be minimized by proper case selection. We assessed the pre-operative factors that can predict the operative difficulty and can help in case selection, thus avoiding complications and reducing the chances of conversion to open.</p><p><strong>Methods: </strong>One hundred and sixteen patients (73 males and 43 females) with the mean age of 50.78 ± 14.2 years, meeting the inclusion criteria underwent transperitoneal laparoscopic partial nephrectomy (LPN). Various clinical, anthropometric, radiological, and pathological parameters were recorded. Intraoperative difficulty was assessed and graded on a scale of 1 (easiest) to 4 (most difficult or open conversion) by an independent observer to calculate the difficulty score, which along with the other parameters of operative difficulty, was used to calculate the difficulty scale. Significant parameters on the univariate analysis, were subjected to a multivariate analysis, to find parameters that can predict the operative difficulty.</p><p><strong>Results: </strong>The mean age was 52 ± 14.29 years, mean size was 4 ± 1.04 cm, male:female ratio was 1.6:1, most of the tumors were exophytic (60%) and anteriorly located (62%) and had a mean perinephric fat surface density (PnFSD) of 6446.026 ± 2244 surface density pixel units (SDPU). On the univariate analysis, age >60 years, Eastern Cooperative Oncology Group performance score >1, presence of perinephric fat stranding, increased PnFSD (>10,000 SDPU), large tumor size (>4 cm), hilar/posterior location, endophytic tumors and higher clinical stage were significantly associated with intraoperative difficulty. However, on the multivariate analysis, no single factor could independently predict intraoperative difficulty in LPN for Renal tumors.</p><p><strong>Conclusion: </strong>It is difficult to predict the intra-operative difficulty during LPN. Feasibility of LPN should be based on multiple factors rather than a single factor.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/29/IJU-39-216.PMC10419771.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052264","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":"Upper moiety vascular ureteropelvic junction obstruction in an incomplete duplex kidney: A variant of the Fraley's syndrome?","authors":"Somanath Karmungikar,&nbsp;Siddharth Yadav,&nbsp;Ankit Goel","doi":"10.4103/iju.iju_30_23","DOIUrl":"10.4103/iju.iju_30_23","url":null,"abstract":"<p><p>Although duplication of the collecting system is fairly common, ureteropelvic junction obstruction of the upper moiety in a patient with duplex system is rare, more so if the obstruction is extrinsic and vascular. Herein, we report a case of obstruction of the upper moiety infundibulum by a crossing vein, in a patient with partially duplex system who presented with flank pain and focal hydronephrosis of the superior calyx, a clinical presentation similar to that of Fraley's syndrome. The infundibulum was transected and transposed anterior to the crossing vessel.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/ac/IJU-39-245.PMC10419786.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052258","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_226_23","DOIUrl":"10.4103/iju.iju_226_23","url":null,"abstract":"Sitravatinib inhibits angiogenesis and mitigates immunosuppressive effects in the tumor microenvironment (TME), thereby improving the efficacy of immune checkpoint inhibitors by producing a less immunosuppressive TME.[1] In this single-arm, interventional, phase 2 study, neoadjuvant sitravatinib in combination with nivolumab was administered to 17 patients with T2b–T3a clear cell renal cell carcinoma.[2] The median follow-up was 26 months. The objective response rate was 11.8% with two radiologic partial responses, and 88.2% (n = 15) had stable disease. No patient experienced progressive disease before surgery or an increase in lesion size; the median observed tumor shrinkage was 13.5% (range: 0%–33%). The estimated 12-month disease-free survival (DFS) probability was 94% (95% confidence interval [CI], 65–99); the estimated 24-month DFS probability was 88% (95% CI, 61–97). There were no grade 4/5 treatment-related adverse events. Correlative blood and tissue analyses showed changes in the TME, resulting in an immunologically active tumor by the time of surgery (median time to surgery was 50 days).","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/e0/IJU-39-183.PMC10419782.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052266","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: Budukh AM, Thakur JS, Dora TK, Kadam PR, Bagal SS, Patel KK, <i>et al</i>. Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India. Indian J Urol 2023;39:148.","authors":"Atul Madhukar Budukh, Jarnail S Thakur, Tapas Kumar Dora, Prithviraj R Kadam, Sonali S Bagal, Kamalesh Kumar Patel, Alok K Goel, Sankalp M Sancheti, Ashish R Gulia, Pankaj P Chaturvedi, Rajesh P Dikshit, Rajendra A Badwe","doi":"10.4103/iju.iju_208_23","DOIUrl":"10.4103/iju.iju_208_23","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/b4/IJU-39-253.PMC10419781.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052249","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":"EphrinB2: Expression of a novel potential target in renal cell carcinoma.","authors":"Chhavi Gupta,&nbsp;Akash Pramod Sali,&nbsp;Alexandra Jackovich,&nbsp;Binyun Ma,&nbsp;Sarmad Sadeghi,&nbsp;David Quinn,&nbsp;Parkash Gill,&nbsp;Inderbir Gill","doi":"10.4103/iju.iju_92_23","DOIUrl":"10.4103/iju.iju_92_23","url":null,"abstract":"<p><strong>Introduction: </strong>Renal cell carcinoma (RCC) is primarily managed by surgery with the use of systemic targeted therapy in a metastatic setting. Newer targeted therapeutic options are evolving; Eph-ephrin is a potential new pathway. The therapeutic potential of targeting the EphB4-EphrinB2 pathway has been demonstrated in many solid tumors; however, its expression in RCC has only been evaluated in a few studies with limited cases. We herein determine the immunohistochemical expression of EphrinB2 in RCC.</p><p><strong>Methods: </strong>A tissue microarray comprising 110 cases of different histological subtypes of RCC and 10 normal kidney tissues were stained with monoclonal anti-EphrinB2 antibody (Abcam, AB201512). The tumor and endothelial cells expressing the EphrinB2 were examined and its expression was correlated with sex, histological subtypes, and tumor nodes metastasis (TNM) stage.</p><p><strong>Results: </strong>Twenty cases of urothelial carcinoma and two unsatisfactory conventional clear cell RCC cases were excluded, and EphrinB2 expression was interpreted in the remaining 88 tumors. EphrinB2 was expressed in 42 out of 88 tumors (47.7%) and was negative in the normal renal parenchyma. There was a statistically significant difference in the expression of EphrinB2 in males (55%) and females (32%). However, no such difference of expression was noted for the histological subtypes and the stages. Half (51%) of Stage 1 (<i>n</i> = 30) and Stage 2 (<i>n</i> = 11) tumors showed EphrinB2 positivity.</p><p><strong>Conclusions: </strong>EphrinB2 is expressed in approximately half of RCC cases. EphrinB2 expression in the early stage cancer might indicate its induction as an early event.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/4b/IJU-39-223.PMC10419785.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10051763","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":"Human papillomavirus infection causing refractory lower urinary tract symptoms in a young female.","authors":"Vagan Barsegian,&nbsp;Inga Kosova","doi":"10.4103/iju.iju_398_22","DOIUrl":"10.4103/iju.iju_398_22","url":null,"abstract":"<p><p>We describe a rare case of refractory lower urinary tract symptoms in a young woman caused by human papillomavirus (HPV) infection. Concurrently, vulvar and vaginal warts were present, particularly near the external urethral meatus. Biopsy of the whitish plaque in the trigone of the bladder demonstrated signs of HPV infection and bladder leukoplakia; polymerase chain reaction analysis of this tissue was positive for HPV16. Systemic and local treatments for HPV infection were prescribed. All symptoms resolved. Follow-up examination revealed negative HPV DNA in the bladder tissue.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/6b/IJU-39-242.PMC10419769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350986","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: Kumar A, Yadav S, Krishnappa RS, Gautam G, Raghavan N, Bakshi G, <i>et al</i>. The Urological Society of India guidelines for the evaluation and management of prostate cancer (executive summary). Indian J Urol 2022;38:252-7.","authors":"Shyam Singh Bisht, Deepak Gupta, Susovan Banerjee, Tejinder Kataria","doi":"10.4103/iju.iju_103_23","DOIUrl":"10.4103/iju.iju_103_23","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/75/IJU-39-249.PMC10419779.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052250","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":"Evaluation of modified RENAL nephrometry score in the prediction of perioperative outcomes of open partial nephrectomy.","authors":"K Annappa Kamath,&nbsp;Vasudevan S Pothy,&nbsp;Himanshu Pandey","doi":"10.4103/iju.iju_66_23","DOIUrl":"10.4103/iju.iju_66_23","url":null,"abstract":"<p><strong>Introduction: </strong>RENAL nephrometry score (RNS) is a standardized system to grade the complexity of renal masses, but it does not correlate well with the perioperative outcomes of open partial nephrectomy (OPN). To overcome these shortcomings, a modified RNS (MRNS) has been proposed. In this study, we evaluated the MRNS and its role in predicting the perioperative outcomes of OPN.</p><p><strong>Methods: </strong>This was a prospective observational study performed at a tertiary care hospital to evaluate the efficacy of MRNS in predicting the perioperative outcomes of OPN. Sixty-four cases were included in the study. Demographic parameters, tumor characteristics, and perioperative outcomes were analyzed. Correlation with the post-operative outcomes and the strengths of MRNS were compared with various other nephrometry scores.</p><p><strong>Results: </strong>The mean age of the patients was 52.89 years, 60.9% were male and 53.1% had a right-sided mass. The comorbidities, body mass index, and performance scores were evenly distributed across the complexity groups (<i>P</i> > 0.05). The mean tumor size was 4.13 cm and the mean MRNS and RNS were 9.45 and 6.1, respectively. 60.9% of the cases had no complications. Major complications (Clavien-Dindo grade [CDG] 3+) were noted in five cases (7.8%). The trifecta of neargin, ischemia, and complications (MICs) score was achieved in 85.9% and was achieved in 71.9% of the cases. MRNS was found to be an independent predictor of the trifecta outcomes (<i>P</i> = 0.04). Receiver-operating characteristic curve of MRNS analyzing the major complications as per the CDG showed an area under the curve of. 804, indicating good prediction of complications by the MRNS.</p><p><strong>Conclusions: </strong>MRNS improves the predicting power of RNS by attributing enhanced scores to key elements and by adding new elements. Also, MRNS has good ability to predict the achievement of the trifecta and MIC.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/2d/IJU-39-202.PMC10419784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052251","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:Kumar A, Yadav S, Krishnappa RS, Gautam G, Raghavan N, Bakshi G, <i>et al</i>. The Urological Society of India guidelines for the evaluation and management of prostate cancer (executive summary). Indian J Urol 2022;38:252-257.","authors":"Gagan Saini,&nbsp;Anup Kumar,&nbsp;Siddharth Yadav","doi":"10.4103/iju.iju_185_23","DOIUrl":"https://doi.org/10.4103/iju.iju_185_23","url":null,"abstract":"The point about the dose of radiation therapy, whether conventional or hypofractionated regimens, is well put. Radiation therapy doses are a discussion unto themselves due to the very nuanced approach that is optimized by the radiation oncologist in terms of the technology available in their department, its functioning in terms of protocols for immobilization/target delineation and planning. For example, a lack of access to image-guided radiation therapy can lead to uncertainty in the execution of some well made plans. The same uncertainty plays even more when hypofractionated regimens are used. Thus, the committee has not kept the discussion of radiation doses and techniques within its defined scope.","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/e9/IJU-39-251.PMC10419776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044820","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}