Uro最新文献

{"title":"Laparoscopic versus Robot-Assisted Partial Nephrectomy for Renal Tumors with Cystic Features: Comparison of Perioperative Outcomes and Trifecta Achievement","authors":"F. Prata, A. Iannuzzi, Marco Ricci, Francesca Liaci, F. Tedesco, A. Ragusa, A. Civitella, M. Pira, M. Fantozzi, Leonilde Sica, R. M. Scarpa, Rocco Papalia","doi":"10.3390/uro4030008","DOIUrl":"https://doi.org/10.3390/uro4030008","url":null,"abstract":"Background: To compare perioperative outcomes and trifecta rates between laparoscopic and robotic partial nephrectomies (PN) using the Hugo™ RAS System, a study was conducted between October 2022 and September 2023. Methods: Twenty-two patients underwent minimally invasive PN for cystic renal tumors at our institution (group A: RAPN = 6; group B: Laparoscopic PN = 16). The trifecta was defined as the coexistence of negative surgical margin status, no Clavien–Dindo grade ≥ 3 complications, and eGFR decline ≤ 30%. Continuous variables were presented as median and IQR and compared using the Mann–Whitney U test, while categorical variables were presented as frequencies (%) and compared using the χ2 test. For all statistical analysis, a two-sided p-value < 0.05 was considered statistically significant. Results: All patients successfully underwent off-clamp minimally invasive PN without the need for conversion or additional port placement. Group A showed a lower preoperative eGFR rate and a higher clinical tumor size, while group B displayed a higher number of male patients and bilateral lesions. However, these differences were not statistically significant (all p > 0.1). Regarding perioperative data, group A showed a lower operative time (79.5 vs. 134.5 min, p = 0.01), while group B showed a higher trend of benign histology (62.5% vs. 33.3%). All the other perioperative data were comparable between the two groups (all p > 0.2). The rate of trifecta achievement was 83.3% and 87.5% (p = 0.80) for group A and B, respectively. Conclusion: This study emphasizes the advantages of RAPN over laparoscopic procedures in terms of operative time. Extensive experience in Laparoscopic PN could be a key factor when approaching RAPN learning curve.","PeriodicalId":515815,"journal":{"name":"Uro","volume":"82 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819243","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 Review on Risk Factors, Diagnostic Innovations, and Plant Based Therapies for the Management of Erectile Dysfunction","authors":"Faris A Alrumaihi, Ravindra Raut, E. Yahia, Vikalp Kumar, S. Anwar","doi":"10.3390/uro4020006","DOIUrl":"https://doi.org/10.3390/uro4020006","url":null,"abstract":"Men of all ages frequently experience erectile dysfunction (ED) or impotence, and it is a difficult health issue that adversely affects the quality of life of those who experience it. There are multiple types of treatment strategies for ED available, depending on the origin and severity of ED, as well as any underlying medical issues. However, these therapeutics are known to have a number of negative health effects. In contrast, plant-based treatments are more effective for managing diseases due to their ability to modulate biological processes like inflammation, oxidative stress, and cell signaling molecules. Many medicinal plants have been reported to be quite helpful in the improvement of ED. In this review, ED and its causes, diagnostic methods, treatment strategies, and some of the most potent plant-based interventions against ED are discussed in greater detail, along with a description of their mechanisms of action and a brief discussion of approaches to increase their efficacy, with a focus on the management of ED using herbal interventions as complementary and alternative medicines. While there is hope that medicinal plants could provide lead substances for erectile dysfunction medications, additional investigation is necessary to ascertain the efficacy and security of these prospective treatments.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997302","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":"The Value of Adding Exosome-Based Prostate Intelliscore to Multiparametric Magnetic Resonance Imaging in Prostate Biopsy: A Retrospective Analysis","authors":"Noah King, Jacob Lang, Sree Jambunathan, Conner V Lombardi, Barbara Saltzman, Nadiminty Nagalakshmi, P. Sindhwani","doi":"10.3390/uro4020005","DOIUrl":"https://doi.org/10.3390/uro4020005","url":null,"abstract":"Introduction: Currently, there is limited evidence for the relationship of Exosome-based Prostate Intelliscore (EPI) and multiparametric magnetic resonance imaging (mpMRI) in stratifying risk for clinically significant prostate cancer. Using a retrospective cohort study design, we sought to characterize the relationship between these two noninvasive metrics and prostate biopsy outcome. Methods: Data were collected via electronic medical record for all patients who underwent EPI testing from 1 January 2019 to 3 February 2022 and had available medical records at a single mid-western university medical center. Positive test result was defined as >15.6 for EPI, ≥3 PI-RADS score and ≥3 + 4 Gleason Score for biopsy findings. Utility of EPI, mpMRI and combined use was characterized through calculation of sensitivity, specificity, positive predictive value, negative predictive value, and ROC analysis. Results: A total of 226 patients were identified as receiving EPI testing for risk stratification of clinically significant prostate cancer. Sensitivity for EPI was 91%, mpMRI was 90%, and the highest was combined use at 96%. With ROC analysis, AUC for EPI alone was 0.57 (95% CI, 0.47–0.67) and 0.78 (95% CI, 0.70–0.87) for mpMRI alone. With prior positive EPI result, AUC for combined use with mpMRI was 0.80 (95% CI, 0.71–0.89). Further subgroup analysis resulted in increased AUC values of EPI 0.67 (95% CI, 0.48–0.87), mpMRI 0.90 (95% CI, 0.76–1.0), and combined 0.90 (95% CI, 0.75–1.0) in the African American population. Discussion: We observed that the combined use of EPI and mpMRI led to an avoided biopsy in 43% of patients. Using both parameters increased the overall sensitivity and diagnostic accuracy in detecting clinically significant prostate cancer. The best test performance was observed in the African American cohort. Identifying optimal noninvasive tools to assess risk for prostate cancer is crucial to providing accurate and cost-effective care. Future study should utilize a prospective study design to further support the combined use of these metrics.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000525","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":"The Clinical Management of Leukocytospermia in Male Infertility: A Narrative Review","authors":"Usman Hussain, Nikit Venishetty, M. Alkassis, Omer Raheem","doi":"10.3390/uro4020004","DOIUrl":"https://doi.org/10.3390/uro4020004","url":null,"abstract":"A major global health concern, male infertility affects 8–12% of couples globally. Leukocytospermia is a complicated illness that is distinguished from other reasons causing male infertility by having high white blood cell counts in semen. The complex mechanisms behind leukocytospermia’s effects on sperm function and fertility are examined in this review. Leukocytospermia induces oxidative stress and reactive oxygen species (ROS) that impair DNA integrity, mitochondrial function, cytoplasmic extrusion, and sperm quality overall. Leukocytospermia is exacerbated by non-infectious factors, such as substance abuse and varicocele, even though genital tract infections are a common cause. The usefulness and dependability of diagnostic techniques range from immunochemistry to direct counting. Although there is still disagreement on the most effective course of action, clinical-care techniques, such as antioxidant supplementation and antibiotic therapy, attempt to address underlying causes and reduce ROS-induced damage. Prospectively, the combination of artificial intelligence with the latest developments in artificial reproductive technologies presents opportunities for more precise diagnosis and customized treatments.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140685238","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":"The Role of Artificial Intelligence in Male Infertility: Evaluation and Treatment: A Narrative Review","authors":"Nikit Venishetty, M. Alkassis, Omer Raheem","doi":"10.3390/uro4020003","DOIUrl":"https://doi.org/10.3390/uro4020003","url":null,"abstract":"Male infertility has affected an increasingly large population over the past few decades, affecting over 186 million people globally. The advent of assisted reproductive technologies (ARTs) and artificial intelligence (AI) has changed the landscape of diagnosis and treatment of male infertility. Through an extensive literature review encompassing the PubMed, Google Scholar, and Scopus databases, various AI techniques such as machine learning (ML), artificial neural networks (ANNs), deep learning (DL), and natural language processing (NLP) were examined in the context of evaluating seminal quality, predicting fertility potential, and improving semen analysis. Research indicates that AI models can accurately estimate the quality of semen, diagnose problems with sperm, and provide guidance on reproductive health decisions. In addition, developments in smartphone-based semen analyzers and computer-assisted semen analysis (CASA) are indicative of initiatives to improve the price, portability, and accuracy of results. Future directions point to possible uses for AI in ultrasonography assessment, microsurgical testicular sperm extraction (microTESE), and home-based semen analysis. Overall, AI holds significant promise in revolutionizing the diagnosis and treatment of male infertility, offering standardized, objective, and efficient approaches to addressing this global health challenge.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 674","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140382752","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":"Patient Factors and Their Effect on Operating Room Time for Urologic Procedures","authors":"Wei-Shin Lu, Ali Zia, Nagalakshmi Nadiminty, Barbara Saltzman, Andrew B. Casabianca, P. Sindhwani","doi":"10.3390/uro4010002","DOIUrl":"https://doi.org/10.3390/uro4010002","url":null,"abstract":"Introduction: We examined three patient characteristics: body mass index (BMI), the American Society of Anesthesiologists (ASA) status, and pre-admission testing (PAT), and their effect on total operating room (OR) time for six urologic procedures, including ureteroscopy, transurethral resection of the prostate (TURP), transurethral resection of bladder tumor (TURBT), prostatectomy, nephrectomy, and kidney transplants. Methods: We investigated the effect of these patient factors on OR time using linear regression for urologic procedures from The University of Toledo Medical Center from 2015 to 2020. Results: An increase in BMI was found to correlate with a statistically significant increase in total OR time for ureteroscopy, prostatectomy, and kidney transplant. The PAT showed a decrease in OR time for TURBT cases and an increase for kidney transplant cases. We found no correlation between the ASA status and changes in the total OR time. Conclusions: A higher BMI significantly increases the total OR time for robotic-assisted prostatectomy and kidney transplant but has a minimal effect on endoscopic procedures. Our results do not support ASA status as a predictor of total OR time. Due to the lack of consistency in results for PAT for the different procedures analyzed, further exploration of the effect of this patient factor on OR efficiency is needed.","PeriodicalId":515815,"journal":{"name":"Uro","volume":"59 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140080122","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 Exploratory Study of Early Immune Response Markers for Pembrolizumab in Urothelial Tract Cancer","authors":"D. R. Stormoen, Lise H. Omland, K. Mouw, Zoltan Szallasi, S. Ostrowski, Susanne D. Nielsen, H. Pappot","doi":"10.3390/uro4010001","DOIUrl":"https://doi.org/10.3390/uro4010001","url":null,"abstract":"Background: This prospective pilot study explored the potential of the innate immune system’s response to cancer-related immuno-stimulants as a predictive biomarker for Immune Checkpoint Inhibitor (ICI) effectiveness, using pembrolizumab-treated metastatic urothelial tract cancer (mUTC) patients as the study population. Methods: We included ten mUTC patients and assessed their innate immune responses before the first and second pembrolizumab cycles with the TruCulture® immunoassay. We also executed survival analysis and compared cytokine release. Results: R848-induced IFNα and HKCA-induced IL-10 values decreased in patients with disease progression (n = 7), while these values increased in non-progressing patients (n = 3), denoting a significant difference (p = 0.00192 and p = 0.00343, respectively). Further, an increased R848-induced IFNα response correlated with extended survival (log-rank p-value of 0.048). Conclusion: Our small study identified distinct immune response patterns following pembrolizumab’s first cycle in mUTC patients, hypothesizing the potential of an increased R848-induced IFNα response for improved survival outcomes. Further confirmatory studies are in progress.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624280","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}