Indian Journal of Urology最新文献

{"title":"Impact of diabetes and chronic kidney disease on active surveillance outcomes for small renal masses: A cohort study.","authors":"Nicolas E Alcalá,&nbsp;Cameron D Futral,&nbsp;Caroline A Miller,&nbsp;Alexander L Sinks,&nbsp;Peter E Clark,&nbsp;Ornob P Roy","doi":"10.4103/iju.iju_57_23","DOIUrl":"10.4103/iju.iju_57_23","url":null,"abstract":"<p><strong>Introduction: </strong>The American Cancer Society estimates 79,000 individuals will be diagnosed with kidney cancer in 2022, most of which are initially found as small renal masses (SRMs). Proper management of SRM patients includes careful evaluation of risk factors such as medical comorbidities and renal function. To investigate the importance of these risk factors, we examined their effect on crossover to delayed intervention (DI) and overall survival (OS) in patients undergoing active surveillance (AS) for SRMs.</p><p><strong>Methods: </strong>This is an Institutional Review Board-approved retrospective analysis of AS patients presented at kidney tumor conferences with SRMs between 2007 and 2017. Univariable and multivariable logistic regression analyses were performed to determine how factors including estimated glomerular filtration rate (eGFR), diabetes, and chronic kidney disease are associated with DI and OS.</p><p><strong>Results: </strong>A total of 111 cases were reviewed. In general, AS patients were elderly and had significant comorbidities. On univariate analysis, intervention was more likely to occur in patients with a younger age (<i>P</i> = 0.01), better kidney function (<i>P</i> = 0.01), and higher tumor growth rates (GRs) (<i>P</i> = 0.02). Higher eGFR was associated with better survival (<i>P</i> = 0.03), while higher tumor GRs (<i>P</i> = 0.014), greater Charlson Comorbidity Index (<i>P</i> = 0.01), and larger tumors (<i>P</i> = 0.01) were associated with worse OS. Of the comorbidities, diabetes was found to be an independent predictor of worse OS (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Patient-level factors - such as diabetes and eGFR - are associated with the rate of DI and OS among SRM patients. Consideration of these factors may facilitate better AS protocols and improve patient outcomes for those with SRMs.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/52/IJU-39-142.PMC10249531.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975933","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":"Journal subscriptions in the changing landscape: Are they needed?","authors":"Apul Goel","doi":"10.4103/iju.iju_87_23","DOIUrl":"10.4103/iju.iju_87_23","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/a4/IJU-39-89.PMC10249530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975936","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":"Urodynamics in the evaluation of lower urinary tract symptoms in young adult men: A systematic review.","authors":"Gurpremjit Singh,&nbsp;Ankur Mittal,&nbsp;Sanjay Sinha,&nbsp;Vikas Kumar Panwar,&nbsp;Ajeet Singh Bhadoria,&nbsp;Arup Kumar Mandal","doi":"10.4103/iju.iju_160_22","DOIUrl":"10.4103/iju.iju_160_22","url":null,"abstract":"<p><strong>Introduction: </strong>This review aims to systematically evaluate the available evidence on the different urodynamic diagnoses of lower urinary tract symptoms (LUTS) in young adult men aged 18-50 years and to summarize the various urodynamic parameters based on these diagnoses.</p><p><strong>Methods: </strong>This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement and the search was performed in PubMed, Embase, and Cochrane library from inception till September 2021. A total of 295 records were identified using a combination of keywords such as LUTS, urodynamics (UDS), and young males. The review was registered in PROSPERO (CRD42021214045).</p><p><strong>Results: </strong>All the ten studies, which were included in this analysis, categorised the patients into either of the four primary diagnoses after the UDS - primary bladder neck obstruction (PBNO), dysfunctional voiding, detrusor underactivity (DU), or detrusor overactivity. Five of these studies used the conventional UDS, and in the other five a video UDS was performed. The most common abnormality on the conventional UDS was DU with a pooled estimate of 0.24 (95% confidence interval [CI] - 0.104-0.463, <i>I</i>²-95.35, (τ²-1.07). The most common abnormality on the video UDS was PBNO with a pooled estimate of 0.49 (95% CI - 0.413-0.580, <i>I</i>²-66.59, ²-0.09). The point estimates of various UDS parameters were also recorded.</p><p><strong>Conclusion: </strong>A urodynamic diagnosis was possible in 79% and 98% of the young men who underwent a conventional UDS or a video UDS, respectively. However, the men subjected to the conventional UDS and the video UDS had significant differences in their primary urodynamic diagnostic label. These results will help to plan future trials for the evaluation and management of LUTS in young men.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/f3/IJU-39-97.PMC10249536.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992998","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":"A rare case of air cysto-uretero-pyelogram due to emphysematous cystitis.","authors":"Shakti Swarup Sarangi,&nbsp;Deepak Prakash Bhirud,&nbsp;Shiv Charan Navriya,&nbsp;Arjun Singh Sandhu","doi":"10.4103/iju.iju_48_23","DOIUrl":"10.4103/iju.iju_48_23","url":null,"abstract":"<p><p>Emphysematous infection of the urinary tract is a hazardous condition and is life-threatening if not managed quickly. We report an 82-year-old woman with uncontrolled diabetes mellitus and urethral stricture who presented with emphysematous cystitis with the gas reaching up to the pelvicalyceal system on the left side (emphysematous pyelonephritis) and appearing in X-ray as air pyelogram. The patient was managed with drainage and intravenous antibiotics and she recovered.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/42/IJU-39-169.PMC10249520.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674223","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":"Peri-operative antibiotic usage during endourological surgery: A multi-institutional, national-level, cross-sectional audit of prevalent practice pattern in India.","authors":"Rishi Nayyar,&nbsp;Shritosh Kumar","doi":"10.4103/iju.iju_35_23","DOIUrl":"10.4103/iju.iju_35_23","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic use during endourological procedures is often discordant from the reported guidelines, despite the potential risks of antibiotic resistance, adverse effects, and health-care costs. A nationwide audit was conducted, with the support of the Urological Society of India, to ascertain the current antibiotic prescription practices for the endourological procedures and the reasons associated with them.</p><p><strong>Methods: </strong>A multi-institutional, national-level, cross-sectional audit analyzing elective endourological procedures was performed. The data regarding the disease profile; risk factors for infectious complications; urine culture; pre-, per-, and post-operative antibiotic use; additional antibiotic use; and patient demographics were collected in a standardized pro forma. Reasons for prescribing antibiotics divergent from the guideline recommendations were also noted. Any infectious complication that necessitated the antibiotic use was also noted prospectively up to 1 month. All the data were entered into a single centralized and customized online portal on a real-time basis.</p><p><strong>Results: </strong>One thousand five hundred and thirty-eight cases were recruited from 20 hospitals. A single-dose prophylaxis was prescribed in only 319 (20.7%) of the cases, and the majority received a multi-day prophylaxis. A combination of two or more antibiotics was prescribed as the prophylaxis in 51% of the cases. One thousand three hundred and fifty-six (88.2%) cases were continued on a long-duration prophylaxis after the discharge, with 1191 (77.4%) receiving it for > 3 days. One thousand one hundred and sixty (75.4%) cases received a guideline-discordant prophylaxis solely on the basis of the surgeon's or institution's protocol, rather than any specific case based need. Ninety eight (6.4%) cases developed postoperative urinary tract infection.</p><p><strong>Conclusions: </strong>Multi-dose, combination and post-discharge antibiotic prophylaxis for endourological surgeries is highly prevalent in India. This audit highlights the huge potential to reduce such guideline-discordant overuse of antibiotics during the endourological procedures.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/cb/IJU-39-133.PMC10249522.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975938","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":"Overall survival of prostate cancer from Sangrur and Mansa cancer registries of Punjab state, India.","authors":"Atul Madhukar Budukh,&nbsp;Jarnail S Thakur,&nbsp;Tapas Kumar Dora,&nbsp;Prithviraj R Kadam,&nbsp;Sonali S Bagal,&nbsp;Kamalesh Kumar Patel,&nbsp;Alok K Goel,&nbsp;Sankalp M Sancheti,&nbsp;Ashish R Gulia,&nbsp;Pankaj P Chaturvedi,&nbsp;Rajesh P Dikshit,&nbsp;Rajendra A Badwe","doi":"10.4103/iju.iju_38_23","DOIUrl":"10.4103/iju.iju_38_23","url":null,"abstract":"<p><strong>Introduction: </strong>There is a scarcity of population-based prostate cancer survival data in India. We assessed the population-based, overall survival of patients with prostate cancer from the Sangrur and Mansa cancer registries of the Punjab state, India.</p><p><strong>Methods: </strong>In the year 2013-2016, a total of 171 prostate cancer cases were registered in these two registries. Based on these registries, survival analysis was performed using the date of diagnosis as the starting date and the last follow-up date being December 31, 2021 or the date of death. Survival was calculated using STATA software. Relative survival was calculated using the Pohar Perme method.</p><p><strong>Results: </strong>Follow up was available for all the registered cases. Of the 171 cases, 41 (24%) were alive and 130 (76.0%) were dead. Of the prescribed treatments, 106 (62.7%) cases completed the treatment and 63 (37.3%) cases did not complete the treatment. Overall, 5-year age-standardized prostate cancer relative survival was 30.3%. Patients who completed the treatment had a 7.8 times higher 5-year relative survival (45.5%) compared to those who did not (5.8%). The difference between the two groups is statistically significant (hazard ratio 0.16, 95% confidence interval [0.10-0.27]).</p><p><strong>Conclusion: </strong>To improve survival, we need to raise awareness in the community and among primary physicians so that prostate cancer cases can reach the hospital early and should be treated effectively. The cancer center should develop the systems in their hospital so that there will be no hurdles to the patients in treatment completion. We found a low overall relative survival among patients of prostate cancer in these two registries. Patients who received treatment had a significantly higher survival.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/8f/IJU-39-148.PMC10249534.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975939","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 Singh","doi":"10.4103/iju.iju_105_23","DOIUrl":"10.4103/iju.iju_105_23","url":null,"abstract":"","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/ac/IJU-39-94.PMC10249527.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975937","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":"A rare diagnosis of renal replacement lipomatosis.","authors":"Rajnandini Dasgupta,&nbsp;Chandan J Das,&nbsp;Amit Gupta","doi":"10.4103/iju.iju_24_23","DOIUrl":"10.4103/iju.iju_24_23","url":null,"abstract":"<p><p>Renal replacement lipomatosis (RRL) is a rare, benign entity characterized by marked fat proliferation within the renal sinus and perinephric space. We present images of a patient with RRL.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/cf/IJU-39-165.PMC10249532.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992996","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":"Early and late complications of suprapubic cystostomy - Report of two cases.","authors":"Anandan Murugesan,&nbsp;Devdas Madhavan","doi":"10.4103/iju.iju_64_23","DOIUrl":"10.4103/iju.iju_64_23","url":null,"abstract":"<p><p>Suprapubic cystostomy (SPC), although a common procedure, may be associated with complications. We present two cases of transperitoneal tract of SPC. The early complication was ileal perforation, resulting in perforation peritonitis and late complication was incisional hernia around the SPC tract. Avoiding peritoneal violation helps in preventing such complications.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/07/IJU-39-167.PMC10249517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992999","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":"Primary retroperitoneal fibrosis presenting as a renal mass.","authors":"Nikita Shrivastava,&nbsp;Divya Aggarwal,&nbsp;Rahul Jena","doi":"10.4103/iju.iju_391_22","DOIUrl":"10.4103/iju.iju_391_22","url":null,"abstract":"<p><p>A 67-year-old male was incidentally found to have a large left perinephric mass with a poorly functioning left kidney. A differential diagnosis of renal cell carcinoma, lymphoma, retroperitoneal fibrosis (RPF), and IgG4 renal disease was suggested on imaging studies and biopsy of the mass. A left radical nephrectomy was performed as malignancy could not be ruled out. The final diagnosis was RPF without periaortitis and the patient is doing well at 9 months of follow-up. RPF, although characterized as a manifestation of periaortitis and large vessel vasculitis, might also present as an isolated perinephric mass without aortic involvement. Surgical management is an alternative, especially when malignancy is suspected.</p>","PeriodicalId":47352,"journal":{"name":"Indian Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/b3/IJU-39-157.PMC10249537.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993000","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}