Current Urology最新文献

{"title":"Transperineal anastomotic urethroplasty with distal transection versus proximal transection: How to predict?","authors":"Lin Wang, Wenxiong Song, Gongyi Chen, Zuowei Li, Rong Lyu, C. Jin, Xuxiao Ye, Yidong Liu, Yinglong Sa, Xiangguo Lyu","doi":"10.1097/cu9.0000000000000254","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000254","url":null,"abstract":"\u0000 \u0000 \u0000 To evaluate the pubourethral stump angle (PUA) to determine the site of urethral transection during transperineal anastomotic urethroplasty (TAU).\u0000 \u0000 \u0000 \u0000 Patients diagnosed with pelvic fracture urethral distraction defect who underwent preoperative magnetic resonance (MR) urethrography and were treated with TAU between June 2019 and December 2021 were retrospectively reviewed. According to the site of urethral transection during TAU, patients were classified into proximal and distal groups receiving TAU with proximal and distal transection, respectively. The demographic and clinical data were recorded. The PUA was measured on sagittal T2-weighted MR urethrography. The relationship between the site of urethral transection and PUA was analyzed.\u0000 \u0000 \u0000 \u0000 Sixty-seven patients were included. Forty-one and 26 patients were included in the proximal and distal groups, respectively. Finally, the success rates in the proximal and distal groups were 95.1% and 92.3%, respectively. The PUAs were 123.7° ± 14.6° and 86.5° ± 9.8° (p = 0.005), respectively. The curves for the 2 groups intersected between 90° and 110°. The scribing effects at 90°, 100°, and 110° in the 2 groups were compared in detail. Compared with 90° and 110°, 100° had the highest sensitivity as the demarcation line.\u0000 \u0000 \u0000 \u0000 In the treatment of pelvic fracture urethral distraction defect, the PUA on MR urethrography is an objective and valid parameter for evaluating the site of urethral transection during TAU. A PUA >100° indicates that proximal transection should be preferentially attempted.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"15 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An innovative and effective approach of cervical canal penetration in patients diagnosed with type II vaginal atresia with adequate uterine corpus development: a case series","authors":"Lujie Xue, Lu Zhang, Chenyang Sun, Xiaomei Yang, Bin Li, Li Liu, Xiangyang Jiang, Lihong Chen","doi":"10.1097/cu9.0000000000000253","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000253","url":null,"abstract":"\u0000 \u0000 \u0000 To develop an innovative and effective approach for cervical canal penetration in patients diagnosed with type II vaginal atresia with adequate uterine corpus development.\u0000 \u0000 \u0000 \u0000 Four patients underwent vaginal reconstruction surgery with laparoscopic and ultrasound-guided cervical canal penetration. The length and width of the neovagina were measured 0 and 6 months after surgery. Side effects were recorded during follow-up.\u0000 \u0000 \u0000 \u0000 The average age of the patients was 14.5 ± 3.3 years. After the surgical procedure, all patients had regular menstrual cycles. The average follow-up period was 32.3 ± 8.7 months.\u0000 \u0000 \u0000 \u0000 Laparoscopic and ultrasound-guided cervical canal penetration after vaginal reconstruction is feasible in patients with type II vaginal atresia and adequate uterine corpus development.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":" 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nonsolvent flower pollen extracts in healthy women with urinary incontinence: A randomized, double-blind, placebo-controlled, parallel study","authors":"Marc Moulin, Erin D Lewis, David C. Crowley, Colleen E. May, Malkanthi Evans","doi":"10.1097/cu9.0000000000000248","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000248","url":null,"abstract":"\u0000 \u0000 \u0000 Urinary incontinence (UI) is a debilitating and common condition that adversely affects quality of life. Prescriptive and surgical approaches for managing UI symptoms may result in undesirable risks and complications. This randomized, double-blind, placebo-controlled, parallel study investigated the efficacy of 2 nonsolvent flower pollen extracts on UI in healthy women.\u0000 \u0000 \u0000 \u0000 One-hundred and fourteen women aged 40–75 years who scored ≥5 on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) were randomized to receive either Graminex® RCT Fem™ UI, Graminex® PollenBerry®, or placebo for 24 weeks. The primary outcome was the change in the ICIQ-SF score between the trial and placebo groups after 24 weeks of supplementation. The secondary outcomes included changes in the frequency of nocturia (recorded in 3-day void diaries) and 24-hour leakage volume (assessed via pad weight) after 6, 12, 18, and 24 weeks of supplementation and changes in stress-induced urinary leakage volume (after completion of a provocative maneuver challenge) after 24 weeks of supplementation.\u0000 \u0000 \u0000 \u0000 All the groups demonstrated improvement in ICIQ-SF scores at week 24 (p < 0.001). The RCT Fem™ UI group had the greatest improvement in ICIQ-SF scores (−4.07 ± 3.4), followed by the PollenBerry® group (−3.34 ± 2.87) and placebo group (−2.61 ± 3.52). The RCT Fem™ UI group had corresponding improvements in 24-hour leakage volume (−17.68 ± 39.84 g) and frequency of nocturia (−0.52 ± 1.26) (p ≤ 0.05). PollenBerry® supplementation significantly improved stress-induced urinary leakage volume (−7.12 ± 15.64 g) at week 24. The study products demonstrated safe hematological and chemical profiles.\u0000 \u0000 \u0000 \u0000 RCT Fem™ UI supplementation resulted in significant and clinically meaningful reductions in UI severity, with corresponding improvements in daily urinary leakage volume and frequency of nocturia. PollenBerry® significantly improved stress-induced urinary leakage volume, suggesting that it may be efficacious in women who are prone to stress UI. The study products were safe and well tolerated in this population.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"36 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization","authors":"Zhichao Wang, Zicheng Tan, Mengzhen Qiu, Longyang Zhang","doi":"10.1097/cu9.0000000000000247","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000247","url":null,"abstract":"\u0000 \u0000 \u0000 We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP).\u0000 \u0000 \u0000 \u0000 Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels.\u0000 \u0000 \u0000 \u0000 Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I\u0000 2 = 92%), 3 months (MD, 2.78, 95% CI, 0.53 to 5.02, p = 0.02, I\u0000 2 = 89%), 6 months (MD, 2.13, 95% CI, 1.11 to 3.15, p < 0.0001, I\u0000 2 = 87%), and 12 months (MD, 3.98, 95% CI, 2.06 to 5.89, p < 0.0001, I\u0000 2 = 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005).\u0000 \u0000 \u0000 \u0000 Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"52 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 outbreak impact on urolithiasis treatments: A multicenter retrospective study across 9 urological centers","authors":"G. Mazzon, S. Ferretti, E. Serafin, Francesco Claps, Pietro Acquati, Davide Brusa, F. Germinale, G. Celentano, Andrea Pescuma, A. Fugini, D. Campobasso, U. Maestroni, G. Costa, T. Morena, Flavia Di Marco, A. Baudo, M. Creta, Nicola Pavan, M. Ticonosco, Angelo Peroni, D. Collura, M. Cerruto, Alessandro Antonelli, L. Carmignani, Salvatore Micali, Carlo Trombetta, G. Muto, A. Celia","doi":"10.1097/cu9.0000000000000246","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000246","url":null,"abstract":"\u0000 \u0000 \u0000 The coronavirus disease (COVID-19) pandemic has posed challenges to the global health care community, affecting the management of upper urinary tract stones.\u0000 \u0000 \u0000 \u0000 This retrospective study involved 9 Italian centers. We compared the 12-month period prior to COVID-19 (March 1, 2019, to February 28, 2020; Period A) with the COVID-19 period (March 1, 2020, to February 28, 2021, Period B). This study aimed to compare outcomes during Periods A and B, specifically focusing on the overall number of treatments, rate of urgent/elective cases, and operational complexity.\u0000 \u0000 \u0000 \u0000 A total of 4018 procedures were collected, comprising 2176 procedures during Period A and 1842 during Period B, indicating a loss of 15.35% (p < 0.001). In the elective cases, 1622 procedures were conducted in Period A, compared with 1280 in Period B, representing a 21.09% reduction in cases (p = 0.001). All types of stone treatments were affected: extracorporeal shock wave lithotripsy (−29.37%, p = 0.001), percutaneous nephrolithotomy (−26.47%, p = 0.008), retrograde surgeries for renal stones (−10.63%, p = 0.008), and semirigid ureterolithotripsy (−24.86%, p = 0.008). Waiting lists experienced significant delays during Period B. The waiting time for elective procedures increased during Period B (p < 0.001). For ureteral stones, the mean waiting time in Period A was 61.44 days compared with 86.56 days in Period B (p = 0.008). The waiting time for renal stones increased from 64.96 days in Period A to 85.66 days in Period B for retrograde intrarenal surgery (p = 0.008) and from 96.9 days to 1103.9 days (p = 0.035) for percutaneous nephrolithotomy procedures.\u0000 \u0000 \u0000 \u0000 Our study demonstrates that COVID-19 significantly disrupted endourological services across the country. Our data underline how patients received treatment over a prolonged period, potentially increasing the risk of stone-related complications and patient discomfort.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"69 s99","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simplified treatment algorithm for chronic scrotal content pain syndrome","authors":"Sergey Kravchick, S. Parekattil, Gennady Bratslavsky, M. Beamer, Robert Moldwin, Daniel Shulman, J. Nickel","doi":"10.1097/cu9.0000000000000240","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000240","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic scrotal content pain (CSCP) is a devastating condition characterized by localized scrotal pain that persists for ≥3 months and interferes with daily activities. Approximately 2.5% of all urology outpatient visits are associated with CSCP. General urologists may have difficulty treating these patients because of uncertainties regarding the etiology and pathophysiology of CSCP. Therefore, we aimed to provide a simplified diagnostic and treatment approach for CSCP by subdividing it into distinct categories.\u0000 \u0000 \u0000 \u0000 We systematically reviewed the published literature in the PubMed, MEDLINE, and Cochrane databases for all reports on CSCP diagnosis and treatment using the keywords “chronic scrotal content pain,” “testicular pain,” “orchialgia,” “testicular pain syndrome,” “microdenervation of the spermatic cord,” “post-vasectomy pain syndrome,” “post-inguinal hernia repair pain,” “testialgia,” and “pudendal neuralgia.” This review included only CSCP-related articles published in English language.\u0000 \u0000 \u0000 \u0000 We subdivided CSCP syndrome into 5 clinical presentation types, including hyperactive cremasteric reflex, pain localized in the testicles, pain in the testis, spermatic cord, and groin, pain localized in the testicles, spermatic cord, groin, and pubis, and pain in the testicles, spermatic cord/groin, and penis/pelvis. Treatments were adjusted stepwise for each type and section. We included more information regarding the role of pudendal neuroglia in CSCP syndrome and discussed more options for nerve blocks for CSCP. For microsurgical spermatic cord denervation failure, we included treatment options for salvage ultrasound-guided targeted cryoablation, Botox injections, and posterior-inferior scrotal denervation.\u0000 \u0000 \u0000 \u0000 Different CSCP subtypes could help general urologists assess the appropriate diagnostic and treatment approaches for scrotal pain management in daily practice.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"25 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic excision of a giant seminal vesicle cyst","authors":"Danny Darlington Carbin, Matthew J.A. Perry, W. Abou Chedid","doi":"10.1097/cu9.0000000000000241","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000241","url":null,"abstract":"\u0000 Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and treatment of pelvic organ prolapse complicated with stress urinary incontinence: A Chinese expert consensus","authors":"Tiejun Pan","doi":"10.1097/cu9.0000000000000237","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000237","url":null,"abstract":"","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139964878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current role of radiomics and radiogenomics in predicting oncological outcomes in bladder cancer","authors":"N. O’Sullivan, Hugo C. Temperley, Alison Corr, J. F. Meaney, Peter E. Lonergan, Michael E Kelly","doi":"10.1097/cu9.0000000000000235","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000235","url":null,"abstract":"\u0000 \u0000 \u0000 Radiomics refers to the conversion of medical images into high-throughput, quantifiable data to analyze disease patterns, aid decision-making, and predict prognosis. Radiogenomics is an extension of radiomics and involves a combination of conventional radiomics techniques with molecular analysis in the form of genomic and transcriptomic data. In the field of bladder cancer, studies have investigated the development, implementation, and efficacy of radiomic and radiogenomic nomograms in predicting tumor grade, gene expression, and oncological outcomes, with variable results. We aimed to perform a systematic review of the current literature to investigate the development of a radiomics-based nomogram to predict oncological outcomes in bladder cancer.\u0000 \u0000 \u0000 \u0000 The Medline, EMBASE, and Web of Science databases were searched up to February 17, 2023. Gray literature was also searched to further identify other suitable publications. Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Radiomics Quality Score.\u0000 \u0000 \u0000 \u0000 Radiogenomic nomograms generally had good performance in predicting the primary outcome across the included studies. The median area under the curve, sensitivity, and specificity across the included studies were 0.83 (0.63–0.973), 0.813, and 0.815, respectively, in the training set and 0.75 (0.702–0.838), 0.723, and 0.652, respectively, in the validation set.\u0000 \u0000 \u0000 \u0000 Several studies have demonstrated the predictive potential of radiomic and radiogenomic models in advanced pelvic oncology. Further large-scale studies in a prospective setting are required to further validate results and allow generalized use in modern medicine.\u0000","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"15 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139438580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer genotyping for risk stratification and precision treatment","authors":"Ashish A. Kumar","doi":"10.1097/cu9.0000000000000222","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000222","url":null,"abstract":"\u0000 Prostate cancer (PC) is the most frequently diagnosed cancer and second leading cause of cancer-related deaths in men. It is heterogeneous, as is evident from the wide spectrum of therapeutic approaches. Most patients with PC are initially responsive to androgen deprivation therapy; however, the majority of cases are either hormone-sensitive PC or castration-resistant PC. Current therapeutic protocols follow the evolution of PC, a continuously progressive process involving a combination of widespread genomic alterations. These genomic alterations are either hereditary germline mutations, such as mutations in BRCA2, or specific only to tumor cells (somatic). Tumor-specific genomic spectra include genomic structural rearrangements, canonical androgen response genes, and many other specific genes such as TMPRSS2-ERG fusion, SPOP/FOXA1, TP53/RB1/PTEN, and BRCA2. New evidence indicates the involvement of signaling pathways including PI3K, WNT/β-catenin, SRC, and IL-6/STAT, which have been shown to promote epithelial-mesenchymal transition cancer stem cell–like features/stemness, and neuroendocrine differentiation in PC. Over the last decade, our understanding of the genotype-phenotype relationships has been enhanced considerably. The genetic background of PC related to canonical genetic alterations and signaling pathway activation genes has shed more insight into the molecular subtype and disease landscape, resulting in a more flexible role of individual therapies targeting diverse genotypes and phenotypes.","PeriodicalId":510120,"journal":{"name":"Current Urology","volume":"49 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139448018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}