International Braz J Urol最新文献

{"title":"Urogenital Tuberculosis: A Narrative Review and recommendations for diagnosis and treatment.","authors":"André Avarese Figueiredo, José Carlos Truzzi, Augusto Azevedo Barreto, Eduardo Carvalho Siqueira, Marcos Lucon, Marcos Broglio, Karin Marise Jaeger Anzolch, Antônio Peixoto de Lucena Cunha, Bruno Vilalva Mestrinho, Leandro Koifman, José de Bessa, Luciano Alves Favorito","doi":"10.1590/S1677-5538.IBJU.2024.0590","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0590","url":null,"abstract":"<p><strong>Purpose: </strong>to review the more relevant aspects of urogenital tuberculosis (UGT) and make recommendations about the diagnosis and treatment.</p><p><strong>Materials and methods: </strong>a literature review was conducted in the Pubmed, Embase and Scielo databases in search of studies on UGT in the past 60 years. A narrative review was performed concerning six topics of UGT diagnosis and treatment. Recommendations were made supported on degrees of evidence according to the modified GRADE system.</p><p><strong>Results: </strong>UGT suspicion occurs in persistent hematuria or pollakiuria with sterile pyuria; stenosis and/or thickening of the urinary tract; or chronic prostatitis or epididymitis. Urinary bacteriological tests have low sensitivity, and a negative test does not rule out UGT diagnosis. In ureteral stenosis, a double-J catheter or nephrostomy should be used early (up to 1 month) during pharmacological treatment and in single less than 2 cm stenosis endoscopic treatment may be attempted. Bladder augmentation with ileum, sigmoid or ileocecal segments should be performed when the contracted bladder capacity is less than 100 mL. Spontaneous voiding occurs in most patients after bladder augmentation.</p><p><strong>Conclusion: </strong>The diagnosis of UGT depends on a high degree of suspicion based on non-specific symptoms and radiological findings. Urinary bacteriological tests have low sensitivity, but even in the absence of diagnostic confirmation, treatment can be carried out through a combination of drugs for a period of six months. In the presence of ureteral stenosis or contracted bladder, complex but well stablished reconstruction procedures are necessary.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biplanar or Monoplanar Prostate Biopsy: Should Transrectal and Transperineal Ap-proaches be Combined for Prostate Cancer Detection?","authors":"Zeng Zhou, Tiewen Li, Yichen Zhang, Xuehao Zhou, Xiaohai Wang, Di Cui, Yiping Zhu, Chenyi Jiang, Wenhuan Guo, Bangmin Han, Yuan J Ruan","doi":"10.1590/S1677-5538.IBJU.2024.0630","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0630","url":null,"abstract":"<p><strong>Purpose: </strong>The accurate diagnosis of prostate cancer (PCa) remains challenging, particularly because standard biopsy techniques do not routinely include anterior zone, leading to potential missed diagnoses in this region. This study evaluates the accuracy and safety of biplanar stereotactic biopsy for diagnosing anterior clinically significant PCa (csPCa).</p><p><strong>Materials and methods: </strong>After propensity score matching analysis, data from 256 patients were retrospectively analyzed, including 128 in the biplanar group (transrectal targeted biopsy with transperineal systematic biopsy) and 128 in the monoplanar group (transperineal targeted biopsy with transperineal systematic biopsy). PCa detection rates, lesion locations, csPCa, clinically insignificant PCa (ciPCa), and complication incidences were compared. Univariable and multivariable logistic regression models evaluated factors influencing biopsy outcomes.</p><p><strong>Results: </strong>No significant differences were observed in overall PCa detection, ciPCa, posterior lesions, or postoperative complications between biplanar and monoplanar groups. The biplanar group demonstrated a higher detection rate for anterior csPCa (P=0.025). The overall International Society of Urological Pathology grade group (ISUP GG) distributions for Prostate Imaging Reporting and Data System (PI-RADS) scores 3 to 5 were not significantly different. Logistic regression identified age and PSA levels as independent predictors of higher detection rates, while univariable analysis showed that prostate volume had a significantly smaller effect on PCa detection rates in the biplanar group compared to the monoplanar group. Postoperative complications showed no statistically significant differences.</p><p><strong>Conclusions: </strong>In conclusion, biplanar stereotactic biopsy was superior to monoplanar biopsy in detecting anterior csPCa. Both methods demonstrated no significant differences in overall PCa detection rates and safety.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome.","authors":"Shuai Yang, Zhaokai Zhou, Xingchen Liu, Zhan Wang, Yanping Zhang, He Zhang, Lei Lv, Yibo Wen, Qingwei Wang, Wei Jia, Jinhua Hu, Jian Guo Wen","doi":"10.1590/S1677-5538.IBJU.2024.0311","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0311","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary Tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS.</p><p><strong>Materials and methods: </strong>A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters.</p><p><strong>Results: </strong>A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively.</p><p><strong>Conclusions: </strong>DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking Among Pioneers - Sperm DNA Fragmentation and a Growing Focus on Male Factor Infertility.","authors":"Robert Matthew Coward","doi":"10.1590/S1677-5538.IBJU.2024.9925","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9925","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Technological and Intraoperative Performances of Da Vinci xi and DaVinci 5 Robotic Platforms in Patients Undergoing Robotic-Assisted Radical Prostatectomy.","authors":"Ahmed Gamal, Marcio Covas Moschovas, Shady Saikali, Sumeet Reddy, Yu Ozawa, Rohan Sharma, Avaneesh Kunta, Travis Rogers, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2024.0569","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0569","url":null,"abstract":"<p><strong>Introduction: </strong>In the last two decades, several Da Vinci robotic platforms have been released in the market, revolutionizing the field of robotic-assisted surgery (1, 2).The system has seen numerous modifications, with several Da Vinci® robotic models being introduced, each featuring ongoing technological advancements in ergonomics,instrumentation,high-definition imaging, EndoWrist™ technology, and single-port surgery capabilities (3, 4).Building on this, the new generation Da Vinci 5 robot promises significant hardware and software improvements, with the potential for enhanced operative performance (2, 5). In this video, we will illustrate several technical advancements of the Da Vinci 5.</p><p><strong>Material and methods: </strong>We performed a video compilation comparing the Da Vinci 5 and Da Vinci Xi during radical prostatectomy. The video will highlight the technical modifications of the new platform, showcasing the advancements and improvements in the Da Vinci 5 system. Additionally, this video will illustrate key aspects of the surgery, including anterior bladder neck access, lateral bladder dissection from the prostate, posterior prostate dissection and anastomosis.</p><p><strong>Surgical technique: </strong>We performed our RARP technique with our standard approach in all patients (6-8). With this new platform, we maintained our conventional technique without any modifications or adaptions from the trocar placement until anastomosis. The beginning of the case is performed as usual, we first identify the anterior bladder neck and then complete its dissection with Maryland and Scissors. Then, we proceed to the posterior bladder neck dissection, seminal vesicles control and nerve-sparing. In sequence, we control the prostate arterial pedicles with hem-o-lok clips and then we perform the apical dissection until dividing the urethra. Finally, we perform the hemostasis, posterior reconstruction (Rocco's technique) and anastomosis with barbed suture.</p><p><strong>Results: </strong>The Da Vinci 5 features several key upgrades. The first part of our video described the console, patient cart, and energy tower modifications. The console has been ergonomically redesigned for a flat neck posture to decrease muscle fatigue, and the handgrip now includes a rubber surface for better grip (9). The patient cart, similar to the previous generation, has updated helm interfaces and integrated commands with the console and vision tower. In sequence, we described the instrument modifications and the step-by-step technique showing the DV5 and DV-Xi. Force feedback instruments provide three degrees of tactile feedback, enhancing tissue manipulation. A new security system ensures instruments can only be inserted when clear of tissues and obstructions, reducing the risk of errors. Another modification regards the ability to switch instruments and camera.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Double Helix to Double Trouble: Sperm DNA Fragmentation Unveiled - A Reproductive Urologist Perspective (AUA Bruce Stewart Memorial Lecture - ASRM 2024).","authors":"Sandro C Esteves","doi":"10.1590/S1677-5538.IBJU.2024.9924","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9924","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Telesurgery Connectivity Between North and South America: the first Remote Surgery Conducted Between Orlando and São Paulo in Animal Models.","authors":"Marcio Covas Moschovas, Shady Saikali, Mischa Dohler, Ela Patel, Travis Rogers, Ahmed Gamal, Jeffrey Marquinez, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2024.0601","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0601","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers are fundamental to success of the International Brazilian Journal of Urology.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.01.02","DOIUrl":"10.1590/S1677-5538.IBJU.2025.01.02","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation.","authors":"Carlos Eduardo Rocha Macedo, Antônio Vitor Nascimento Martinelli Braga, Felipe Santos Marimpietri, Beatriz Paixão Argollo, Glicia Estevam de Abreu, Maria Luiza Veiga da Fonseca, Ana Aparecida Nascimento Martinelli Braga, Ubirajara Barroso","doi":"10.1590/S1677-5538.IBJU.2024.0453","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0453","url":null,"abstract":"<p><strong>Background: </strong>Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS.</p><p><strong>Material and methods: </strong>This retrospective case series examined patients aged 4-17 years. Patients were given subsequent treatment options, including: behavioral therapies; oxybutynin; imipramine; a combination of oxybutynin and imipramine; parasacral percutaneous electrical nerve stimulation (PENS); or a repeat course of pTENS. Outcomes were evaluated using the Dysfunctional Voiding Scoring System (DVSS) and the Visual Analogue Scale (VAS).</p><p><strong>Results: </strong>Thirty children were included, with a median age of 7 years. Patients received one or more treatments. Of these, 70% underwent monotherapy. Among them, 57% experienced complete resolution of symptoms, 28% had partial resolution and were satisfied with the results, and 14% discontinued treatment. 30% out of the whole sample continued to experience bothersome symptoms. Complete response, according to initial subsequent, was achieved in: 54% with intensified behavioral therapies, 33% with oxybutynin, and 50% with imipramine alone. The median DVSS score decreased from 7.0 to 2.0 (p=0.025), while the median VAS score increased from 80 to 100 (p<0.001).</p><p><strong>Conclusion: </strong>Children with OAB refractory to pTENS who received structured subsequent treatments showed partial response in all cases, with complete symptom resolution in half of the patients. More intensive urotherapy, medications, or repeat pTENS in combination with oxybutinin can be effective for managing this challenging condition.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Targeting Heme in Sickle Cell disease: New Perspectives on Priapism Treatment.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2024.9926","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9926","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}