World Journal of Mens Health最新文献

{"title":"Liquid Biomarkers in Prostate Cancer Diagnosis: Current Status and Emerging Prospects.","authors":"Yutong Liu, Koji Hatano, Norio Nonomura","doi":"10.5534/wjmh.230386","DOIUrl":"10.5534/wjmh.230386","url":null,"abstract":"<p><p>Prostate cancer (PCa) is a major health concern that necessitates appropriate diagnostic approaches for timely intervention. This review critically evaluates the role of liquid biopsy techniques, focusing on blood- and urine-based biomarkers, in overcoming the limitations of conventional diagnostic methods. The 4Kscore test and Prostate Health Index have demonstrated efficacy in distinguishing PCa from benign conditions. Urinary biomarker tests such as PCa antigen 3, MyProstateScore, SelectMDx, and ExoDx Prostate IntelliScore test have revolutionized risk stratification and minimized unnecessary biopsies. Emerging biomarkers, including non-coding RNAs, circulating tumor DNA, and prostate-specific antigen (PSA) glycosylation, offer valuable insights into PCa biology, enabling personalized treatment strategies. Advancements in non-invasive liquid biomarkers for PCa diagnosis may facilitate the stratification of patients and avoid unnecessary biopsies, particularly when PSA is in the gray area of 4 to 10 ng/mL.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"8-27"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077230","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":"Higher Physical Activity is Associated with Reduced Lower Urinary Tract Symptoms in Korean Men.","authors":"Seo Eun Hwang, Jae Moon Yun, Su Hwan Cho, Kyungha Min, Ji Young Kim, Hyuktae Kwon, Jin Ho Park","doi":"10.5534/wjmh.230303","DOIUrl":"10.5534/wjmh.230303","url":null,"abstract":"<p><strong>Purpose: </strong>Identifying and managing risk factors for lower urinary tract symptoms (LUTS) is crucial because it impacts the quality of life of elderly individuals. Lifestyle factors, including physical activity (PA), and their relationship with LUTS have not been well studied. This objective of this study was to investigate the association between PA and LUTS.</p><p><strong>Materials and methods: </strong>A total of 7,296 men were included in this cross-sectional study. PA was quantified in metabolic equivalent (MET)-hours per week, and LUTS severity was assessed using the international prostate symptom score. Logistic regression was used to analyze the association between PA and LUTS, including voiding and storage symptoms.</p><p><strong>Results: </strong>The average age of the participants was 57.8 years, and the prevalence of LUTS was 41.3%. After adjusting for potential confounders, PA was inversely associated with the prevalence and severity of moderate-to-severe LUTS, showing a dose-response pattern (all p for trend <0.01). Compared to the minimal activity group, which engaged in <5 MET-hours per week of PA, the odds ratios for moderate to severe LUTS were 0.83 (95% confidence interval [CI]: 0.72-0.97) for men engaging in 15-30 MET-hours per week, 0.82 (95% CI: 0.71-0.95) for 30-60 MET-hours per week, and 0.72 (95% CI: 0.62-0.84) for ≥60 MET-hours per week. The possible protective effect of PA was still observed in the additional analysis for voiding and storage symptoms showing the same dose-response pattern (all p for trend <0.01).</p><p><strong>Conclusions: </strong>A higher PA level was associated with a lower prevalence and severity of total, voiding, and storage LUTS in a dose-dependent manner in Korean men.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"166-173"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861559","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":"Antioxidant Supplementation for Erectile Dysfunction: Systematic Review and Meta-Analysis of Double-Blind, Randomized, Placebo-Controlled Trials.","authors":"Ranjith Ramasamy, Samir Bhattacharyya, Taylor P Kohn, Larry E Miller","doi":"10.5534/wjmh.230280","DOIUrl":"10.5534/wjmh.230280","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to determine the efficacy and safety of antioxidant supplementation for treating erectile dysfunction (ED).</p><p><strong>Materials and methods: </strong>We systematically searched MEDLINE, Embase, and the Cochrane Library for double-blind, randomized, placebo-controlled trials of oral antioxidant supplementation in men with ED. Erectile function was assessed by the International Index of Erectile Function-Erectile Function domain (IIEF-EF) score. Using random-effects meta-analysis models, antioxidant and placebo groups were compared for erectile function using the mean difference in IIEF-EF score adjusted to a 6-30 scale and for side effects using the log risk ratio.</p><p><strong>Results: </strong>The review included 23 trials of 1,583 men (median age 51 years) treated with antioxidant supplementation or placebo for a median of 12 weeks (range, 4 weeks to 6 months). Antioxidant supplementation significantly improved erectile function compared to placebo, with a mean difference of 5.5 points (95% confidence interval [CI]: 3.7 to 7.3; p<0.001) on the IIEF-EF. In meta-regression, the treatment benefit was greater in men with more severe ED (p<0.001). Side effects were uncommon, none were serious, and the frequency was comparable between antioxidant (3.8%) and placebo (2.1%) groups (log risk ratio=0.36; 95% CI: -0.24 to 0.97; p=0.24).</p><p><strong>Conclusions: </strong>Antioxidant supplementation appears safe and significantly improves erectile function in men with ED, particularly those with more severe symptoms. Limitations of this review included unknown long-term efficacy and safety and the inability to make specific product and dosing recommendations due to the variety of antioxidants and regimens studied.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"81-91"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077219","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":"Role of p57KIP2 in Stem and Progenitor Leydig Cells of Mouse Testes.","authors":"Seung Hyun Park, Kyung Noh Yoon, Yang Xu, Myung Chan Gye","doi":"10.5534/wjmh.230299","DOIUrl":"10.5534/wjmh.230299","url":null,"abstract":"<p><strong>Purpose: </strong>Precise control of proliferation and differentiation of Leydig cells is important for gonadal androgenesis and spermatogenesis. Though cyclin-dependent kinase inhibitors are crucial for cell proliferation and differentiation, their role in the development of early adult Leydig cells (ALCs) remained unanswered. To understand mechanism for ALC development, functional expression of p57KIP2 (cdkn1c) was investigated in the stem Leydig cells (SLCs) and progenitor Leydig cells (PLCs) in mice.</p><p><strong>Materials and methods: </strong>The roles of p57KIP2 in the proliferation, differentiation, apoptosis, and steroidogenesis in SLCs and PLCs were investigated by antibodies and bromodeoxyuridine (BrdU) labeling in the early neonatal testes and <i>p57^kip2</i> siRNA in the isolated SLCs and PLCs. Steroidogenic differentiation of PLCs was examined by progesterone and testosterone production in cell culture.</p><p><strong>Results: </strong>From postnatal day (PND) 1 to 14, p57KIP2(+) spindle-shaped cells in the testis interstitium were α-smooth muscle actin (αSMA)(-), a peritubular myoid cells marker, suggesting that they are SLCs and PLCs. Besides, p57KIP2 was also expressed in HSD3β(+) fetal Leydig cells. From PND1 to 14, BrdU(+)/αSMA(-), Ki67(+)/p57KIP2(+), and BrdU(+)/p57KIP2(+) spindle-shaped cells were gradually decreased. From PND1 to 14, p57KIP in the αSMA(-)/p57KIP2(+) cells was peaked at PND7 and decreased thereafter. In THY1(+) isolated SLCs, <i>p57^kip2</i> siRNA significantly increased <i>ki67</i> and <i>pcna</i> mRNA and <i>pdgfrα</i> mRNA, a differentiation marker and decreased <i>nestin</i> mRNA, a SLC marker. No significant difference in apoptosis related genes mRNA was found after <i>p57^kip2</i> siRNA treatment. In HSD3β(+) PLCs, <i>p57^kip2</i> siRNA increased proapoptotic genes mRNA, annexin V(+) early-apoptotic cells. Importantly, <i>p57^kip2</i> siRNA significantly decreased <i>hsd3β6</i> and <i>cyp17a1</i> mRNA and progesterone production.</p><p><strong>Conclusions: </strong>p57KIP2 may suppress proliferation and support stemness of SLCs. In PLCs, p57KIP2 may suppress apoptosis and potentiate the steroidogenic differentiation.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"174-187"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077315","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":"Bisphenol Analogs Downregulate the Self-Renewal Potential of Spermatogonial Stem Cells.","authors":"Seo-Hee Kim, Seung Hee Shin, Seok-Man Kim, Sang-Eun Jung, Beom-Jin Shin, Jin Seop Ahn, Kyoung Taek Lim, Dong-Hwan Kim, Kichoon Lee, Buom-Yong Ryu","doi":"10.5534/wjmh.230166","DOIUrl":"10.5534/wjmh.230166","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we investigated the effect of bisphenol-A (BPA) and its major analogs, bisphenol-F (BPF), and bisphenol-S (BPS), on spermatogonial stem cells (SSCs) populations using <i>in vitro</i> SSC culture and <i>in vivo</i> transplantation models.</p><p><strong>Materials and methods: </strong>SSCs enriched from 6- to 8-day-old C57BL/6-eGFP⁺ male mice testes were treated with varying concentrations of bisphenols for 7 days to examine bisphenol-derived cytotoxicity and changes in SSC characteristics. We utilized flow cytometry, immunocytochemistry, real-time quantitative reverse transcription-PCR, and western blot analysis. The functional alteration of SSCs was further investigated by examining donor SSC-derived spermatogenesis evaluation through <i>in vivo</i> transplantation and subsequent testis analysis.</p><p><strong>Results: </strong>BPF exhibited a similar inhibitory effect on SSCs as BPA, demonstrating a significant decrease in SSC survival, inhibition of proliferation, and induction of apoptosis. On the other hand, while BPS was comparatively weaker than BPA and BPF, it still showed significant SSC cytotoxicity. Importantly, SSCs exposed to BPA, BPF, and BPS exhibited a significant reduction in donor SSC-derived germ cell colonies per total number of cultured cells, indicating that, like BPA, BPF, and BPS can induce a comparable reduction in functional SSCs in the recipient animals. However, the progress of spermatogenesis, as evidenced by histochemistry and the expressions of PCNA and SSC specific markers, collectively indicates that BPA, BPF, and BPS may not adversely affect the spermatogenesis.</p><p><strong>Conclusions: </strong>Our findings indicate that the major BPA substitutes, BPF and BPS, have significant cytotoxic effects on SSCs, similar to BPA. These effects may lead to a reduction in the functional self-renewal stem cell population and potential impacts on male fertility.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"154-165"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874132","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":"Cannabidiol Alleviates Chronic Prostatitis and Chronic Pelvic Pain Syndrome <i>via</i> CB2 Receptor Activation and TRPV1 Desensitization.","authors":"Jun Jie Piao, Soomin Kim, Dongho Shin, Hwa Jong Lee, Kyung-Hwa Jeon, Wen Jie Tian, Kyung Jae Hur, Jong Soo Kang, Hyun-Je Park, Joo Young Cha, Aeri Song, Sang-Hyuck Park, Mahadevan Rajasekaran, Woong Jin Bae, Sungjoo Kim Yoon, Sae Woong Kim","doi":"10.5534/wjmh.230352","DOIUrl":"10.5534/wjmh.230352","url":null,"abstract":"<p><strong>Purpose: </strong>This study elucidates the mechanism of the physiological effect of cannabidiol (CBD) by assessing its impact on lipopolysaccharide (LPS)-induced inflammation in RWPE-1 cells and prostatitis-induced by 17β-estradiol and dihydrotestosterone in a rat model, focusing on its therapeutic potential for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).</p><p><strong>Materials and methods: </strong>RWPE-1 cells were stratified <i>in vitro</i> into three groups: (1) controls, (2) cells with LPS-induced inflammation, and (3) cells with LPS-induced inflammation and treated with CBD. Enzyme-linked immunosorbent assays and western blots were performed on cellular components and supernatants after administration of CBD. Five groups of six Sprague-Dawley male rats were assigned: (1) control, (2) CP/CPPS, (3) CP/CPPS and treated with 50 mg/kg CBD, (4) CP/CPPS and treated with 100 mg/kg CBD, and (5) CP/CPPS and treated with 150 mg/kg CBD. Prostatitis was induced through administration of 17β-estradiol and dihydrotestosterone. After four weeks of CBD treatment, a pain index was evaluated, and prostate tissue was collected for subsequent histologic examination and western blot analysis.</p><p><strong>Results: </strong>CBD demonstrated efficacy <i>in vivo</i> for CP/CPPS and <i>in vitro</i> for inflammation. It inhibited the toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) pathway by activating the CB2 receptor, reducing expression of interleukin-6, tumor necrosis factor-alpha, and cyclooxygenase-2 (COX2) (p<0.01). CBD exhibited analgesic effects by activating and desensitizing the TRPV1 receptor.</p><p><strong>Conclusions: </strong>CBD inhibits the TLR4/NF-κB pathway by activating the CB2 receptor, desensitizes the TRPV1 receptor, and decreases the release of COX2. This results in relief of inflammation and pain in patients with CP/CPPS, indicating CBD as a potential treatment for CP/CPPS.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"228-238"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051048","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":"Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan.","authors":"Akira Tsujimura, Shinichiro Fukuhara, Koji Chiba, Tsuyoshi Yoshizawa, Hikaru Tomoe, Masato Shirai, Kazunori Kimura, Eiji Kikuchi, Eri Maeda, Yoshikazu Sato, Atsushi Nagai, Koichi Nagao, Haruaki Sasaki","doi":"10.5534/wjmh.240137","DOIUrl":"10.5534/wjmh.240137","url":null,"abstract":"<p><strong>Purpose: </strong>Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.</p><p><strong>Materials and methods: </strong>Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.</p><p><strong>Results: </strong>Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.</p><p><strong>Conclusions: </strong>The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"239-248"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332336","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 Importance of Discordant Follicle Stimulating Hormone and Inhibin B Levels in Primary Infertile Men: Findings from a Cross-Sectional Study.","authors":"Fausto Negri, Luca Boeri, Simone Cilio, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Massimiliano Raffo, Giuseppe Fallara, Eugenio Ventimiglia, Luigi Candela, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.5534/wjmh.230298","DOIUrl":"10.5534/wjmh.230298","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the relationship between follicle stimulating hormone (FSH) and inhibin B (InhB).</p><p><strong>Materials and methods: </strong>Data from 1,230 consecutive men presenting for primary couple's infertility were analyzed. Health-significant comorbidities were scored with Charlson comorbidity index. Quartiles of FSH and InhB were considered to determine threshold values. Descriptive statistics and logistic regression models tested association between FSH and InhB values.</p><p><strong>Results: </strong>Overall, 1,080 (87.8%) men had concordant FSH and InhB values. Conversely, 150 patients (12.2%) had discrepancies in FSH and InhB, with 78 (6.3%) and 72 (5.9%) men reporting both low and high FSH and InhB values, respectively. Infertile men with discordant values were younger (median [interquartile range] 38.0 years [34-41 years] <i>vs.</i> 36.0 years [31-40 years]); had smaller testicular volume (TV) (12 mL [10-15 mL] <i>vs.</i> 15 mL [12-20 mL]); and, had more frequently a sperm DNA fragmentation test >30% (179 [59.1%] <i>vs.</i> 40 [78.4%]) than those with concordant values (all p<0.05). Moreover, a higher frequency of previous cryptorchidism (27.3% <i>vs.</i> 11.9%), lower sperm concentration (3.0 million/mL [0.9-11.0 million/mL] <i>vs.</i> 13.8 million/mL [3.1-36.0 million/mL]), lower progressive sperm motility rates (12.0% [5.0%-25.3%] <i>vs.</i> 20.0% [7.0%-36.0%]), and greater rates of non-obstructive azoospermia (36.4% <i>vs.</i> 23.9%) were found in men with discordant FSH and InhB values (all p≤0.005). At multivariable logistic regression analysis, higher body mass index (odds ratio [OR], 1.08; p=0.001), smaller TV (OR, 0.91; p<0.001), and a history of cryptorchidism (OR, 2.49; p<0.001) were associated with discordant FSH and InhB values.</p><p><strong>Conclusions: </strong>More than one out of ten infertile men had discordant FSH and InhB values in the real-life setting showing worse clinical profiles than those with concordant levels. Smaller TV and history of cryptorchidism could be used as clinical markers to better tailor the need to test InhB.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":"134-141"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050994","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":"Risk of Incontinence after Radical Prostatectomy According to Procedural Types: Retrospective Cohort Study Using National Health Insurance Data.","authors":"Ki Min Kim, Jeong Woo Lee, Gi Hwan Bae, Min Gi Chun, Serin Lee, Eun Ji Lee, Jaehun Jung, Jae Heon Kim","doi":"10.5534/wjmh.240013","DOIUrl":"https://doi.org/10.5534/wjmh.240013","url":null,"abstract":"<p><strong>Purpose: </strong>Although surgical procedures including robotic surgery in radical prostatectomy have evolved, urinary incontinence after surgery are still not resolved. This study was to evaluate the risk of clinically significant incontinence after radical prostatectomy according to various procedural types.</p><p><strong>Materials and methods: </strong>The retrospective cohort study included prostate cancer (n=14,484) in South Korea between 2002 and 2017 as shown in the National Health Insurance Data. Clinically significant incontinence was defined as postprostatectomy incontinence (PPI) requiring anti-incontinence surgery or received specific medication within months after surgery. The prevalence and relative risks of PPI were evaluated according to different procedural types after propensity score matching (PSM). The risks of PPI were compared among those difference procedural types including robotic-assisted radical prostatectomy (RALP), open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP) using the hazard ratio (HR).</p><p><strong>Results: </strong>Among 25,903 cohort participants including RALP (n=18,937), ORP (n=4,979), and LRP (n=1,987), overall prevalence of PPI was 2.06% (n=536). According to procedural types, prevalence of PPI in LRP, RARP, and ORP were 3.67%, 1.81%, and 2.43%, respectively. Risk of PPI after PSM and after adjustment of age, Charlson comorbidity index, and hospital volume was 0.456 (95% confidence interval [95% CI] 0.30-0.69) between LRP and RARP, 0.67 (95% CI 0.46-0.98) between LRP and ORP, and 1.404 (1.06-1.86) between RARP and ORP. Adjusted HR after PSM was 0.495 (95% CI 0.33-0.74) between LRP and RARP, 0.674 (95% CI 0.46-0.98) between LRP and ORP, 1.242 (95% CI 0.94-1.64) between RARP and ORP.</p><p><strong>Conclusions: </strong>The prevalence of PPI which needed anti-incontinence surgery was not low among who received radical prostatectomy. Those patients who underwent LRP had higher risk for PPI than those who underwent ORP. However, further research is required to fully determine whether RARP can help to prevent PPI.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The In-depth Comparative Analysis of Four Large Language AI Models for Risk Assessment and Information Retrieval from Multi-Modality Prostate Cancer Work-up Reports.","authors":"Lun-Hsiang Yuan, Shi-Wei Huang, Dean Chou, Chung-You Tsai","doi":"10.5534/wjmh.240173","DOIUrl":"https://doi.org/10.5534/wjmh.240173","url":null,"abstract":"<p><strong>Purpose: </strong>Information retrieval (IR) and risk assessment (RA) from multi-modality imaging and pathology reports are critical to prostate cancer (PC) treatment. This study aims to evaluate the performance of four general-purpose large language model (LLMs) in IR and RA tasks.</p><p><strong>Materials and methods: </strong>We conducted a study using simulated text reports from computed tomography, magnetic resonance imaging, bone scans, and biopsy pathology on stage IV PC patients. We assessed four LLMs (ChatGPT-4-turbo, Claude-3-opus, Gemini-Pro-1.0, ChatGPT-3.5-turbo) on three RA tasks (LATITUDE, CHAARTED, TwNHI) and seven IR tasks. It included TNM staging, and the detection and quantification of bone and visceral metastases, providing a broad evaluation of their capabilities in handling diverse clinical data. We queried LLMs with multi-modality reports using zero-shot chain-of-thought prompting via application programming interface. With three adjudicators' consensus as the gold standard, these models' performances were assessed through repeated single-round queries and ensemble voting methods, using 6 outcome metrics.</p><p><strong>Results: </strong>Among 350 stage IV PC patients with simulated reports, 115 (32.9%), 128 (36.6%), and 94 (26.9%) belonged to LATITUDE, CHAARTED, and TwNHI high-risk, respectively. Ensemble voting, based on three repeated single-round queries, consistently enhances accuracy with a higher likelihood of achieving non-inferior results compared to a single query. Four models showed minimal differences in IR tasks with high accuracy (87.4%-94.2%) and consistency (ICC>0.8) in TNM staging. However, there were significant differences in RA performance, with the ranking as follows: ChatGPT-4-turbo, Claude-3-opus, Gemini-Pro-1.0, and ChatGPT-3.5-turbo, respectively. ChatGPT-4-turbo achieved the highest accuracy (90.1%, 90.7%,91.6%), and consistency (ICC 0.86, 0.93, 0.76) across 3 RA tasks.</p><p><strong>Conclusions: </strong>ChatGPT-4-turbo demonstrated satisfactory accuracy and outcomes in RA and IR for stage IV PC, suggesting its potential for clinical decision support. However, the risks of misinterpretation impacting decision-making cannot be overlooked. Further research is necessary to validate these findings in other cancers.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}