American journal of clinical and experimental urology最新文献

{"title":"Ureteral stenting in the clinic: a safe and cost-effective alternative to the operating room.","authors":"Zachary M Connelly,&nbsp;Ann Stolzle,&nbsp;Robert August Vanlangendonck,&nbsp;Wybra Joey Price,&nbsp;Kevin Morgan,&nbsp;Nazih Khater","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Ureteral stent placement is one of the most common procedures performed by urologists, and is typically done in the operating room. At Ochsner-LSU Health Shreveport, urologists have a unique setting allowing them to place ureteral stents for patients present in the outpatient ambulatory clinic without the need for nitrous oxide. This allows patients to avoid being admitted to the hospital and receiving subsequent general anesthesia in the operating room. Therefore, our novel study evaluates the feasibility, safety, and cost-effectiveness of ureteral stents insertion in the clinic.</p><p><strong>Material and methods: </strong>In this study, we analyzed 240 patients with a total of 279 different ureteral stent insertion encounters to evaluate the safety and costs of stenting in the clinic compared to the operating room. Stents were placed in the outpatient clinic for 126 patients, which required either a new ureteral stent insertion or a scheduled stent exchange.</p><p><strong>Results: </strong>Overall, there was an increased age and length of stent duration among those who were stented in the clinic. We did not observe any increase in narcotics use, pain, adverse injuries, or differences in stent length. The total cost of a stent insertion operating room was $16,349.91 whereas the clinic procedure cost $7,865.69, however: medicare reimbursement remained the same.</p><p><strong>Conclusion: </strong>Our findings demonstrate a novel use of stenting in the clinic is feasible as an outpatient alternative. It is a safe alternative to the operating room, and more cost-effective.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 4","pages":"304-311"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461035/pdf/ajceu0011-0304.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475885","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":"Novel urinary tract obstruction marker discovery by multi-marker profiling of urinary extracellular vesicles derived from a rat UTO model.","authors":"Nora M Haney,&nbsp;Chi-Ju Kim,&nbsp;Morgan D Kuczler,&nbsp;Cheng-Fan Lee,&nbsp;Kara Lombardo,&nbsp;Trinity J Bivalacqua,&nbsp;Kenneth J Pienta,&nbsp;Sarah R Amend","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital urinary obstruction is a common cause of end-stage renal disease in the pediatric population. However, non-invasive diagnostics to predict which patients will benefit from early intervention are lacking.</p><p><strong>Methods: </strong>Using a rat model of upper and lower urinary tract partial obstruction and the Nanostring nCounter Fibrosis V2 Panel, we evaluated the mRNA cargo of urinary small extracellular vesicles (sEVs) and mRNA expression patterns of kidney and bladder tissues from rats with lower tract urinary obstruction and upper tract urinary obstruction.</p><p><strong>Results: </strong>While mRNA hierarchical clustering of urinary sEVs was unable to differentiate upper compared to lower tract urinary obstruction, clustering was able to detect overall disease state (UUTO or LUTO) versus healthy controls. Further, urinary sEVs carried genes unique to each treatment group (UUTO: 59 genes, LUTO: 17 genes), while only one gene was uniquely carried in the control group. Notable genes of interest found in urinary sEVs were VCAM-1 and NOS1 for UUTO, Egfr for LUTO, and Pck1 for healthy controls.</p><p><strong>Conclusion: </strong>This study provides support that differential gene expression of urinary sEV mRNA has potential to act as biomarkers in the diagnosis and prognosis of UTO. Urinary sEVs demonstrated higher numbers of unique genes representative of injury to the kidney than that of injury to the bladder. Importantly, there were genes unique to UUTO sEVs, indicating the extent and reversibility of renal damage can be independent of the function, damage, and architecture of the bladder.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 2","pages":"136-145"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165232/pdf/ajceu0011-0136.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9806441","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":"Corpus spongiosum flap: a unique technique in the management of urosymphyseal fistula.","authors":"Jill S Patel,&nbsp;Sarah C Krzastek,&nbsp;John T Roseman,&nbsp;Adam P Klausner,&nbsp;Uzoma A Anele","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Urosymphseal fistulas are a debilitating but treatable consequence of the combination of radiotherapy and endoscopic interventions in prostate cancer patients. Treatment includes fistula excision with a tissue flap to prevent communication of involved structures and provide structural and vascular support. We introduce a unique surgical approach of mobilizing and utilizing a corpus spongiosum flap in urosymphyseal fistula repair. A retrospective study identified two patients who underwent repair with a pedicled corpus spongiosum flap at our institution. The corpus spongiosum had adequate length and vascularization and limited the need for extra-pelvic muscle flaps, thus maintaining muscle integrity in the abdomen and thighs. Following extirpative surgery, both patients had durable fistula closure, decreased pelvic pain, and resolution of lower urinary tract symptoms and osteomyelitis. These cases highlight the potential of the corpus spongiosum to be a reasonable alternative interpositional flap in genitourinary reconstruction.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 1","pages":"69-74"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10009311/pdf/ajceu0011-0069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9117050","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":"EZH2 and matrix co-regulate phenotype and KCNB2 expression in bladder smooth muscle cells.","authors":"Priyank Yadav,&nbsp;Tabina Ahmed,&nbsp;Suejean Park,&nbsp;Martin Sidler,&nbsp;Annette Schröder,&nbsp;Karen J Aitken,&nbsp;Darius Bägli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Partial bladder outlet obstruction (PBO) is a widespread cause of urinary dysfunction and patient discomfort, resulting in immense health care costs. Previously, we found that obstruction is associated with altered regulation of epigenetic machinery and altered function. Here we examined if PBO and chronic bladder obstructive disease (COBD) affect epigenetic marks in a proof of principle gene and explored mechanisms of its epigenetic regulation using <i>in vitro</i> models.</p><p><strong>Methods: </strong>Archival obstruction tissues from COBD had been created in 200-250 g female Sprague-Dawley rats by surgical ligation of the urethra for 6 weeks, followed by removal of the suture and following animals for 6 more weeks. Obstruction (PBO) is the 6-week ligation only. Sham ligations comprise passing the suture behind the urethra. Histone3 lysine27 trimethylation (H3K27me3) was studied by immunostaining and Chromatin immunoprecipitation (ChIP)/PCR. The interaction of matrix with KCNB2 regulation was studied in human bladder SMC plated on damaged matrix and native collagen and treated with vehicle or UNC1999. Cells were analyzed by immunostaining for cell phenotype, and western blotting for KCNB2, H3K27me3 and EZH2. Effects of conditioned media from these cells were also examined on cell phenotype. siRNA against KCNB2 was examined for effects on cell phenotype and gene expression by RT-qPCR.</p><p><strong>Results: </strong>H3K27me3 increased by immunofluorescence during PBO, and by ChIP/PCR during COBD in the CpG Island (CGI) as well as 350 bp upstream. Obstruction vs. sham also showed an increase in H3K27me3 deposition. In SMC <i>in vitro</i>, EZH2 inhibition restored KCNB2 expression and partially restored SMC phenotype.</p><p><strong>Conclusions: </strong>Regulation of KCNB2 at the promoter demonstrated dynamic changes in H3K27me3 during COBD and obstruction. <i>In vitro</i> models suggest that matrix plays a role in regulation of EZH2, H3K27me3 and KCNB2, which may play a role in the regulation of smooth muscle phenotype <i>in vivo</i>.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 4","pages":"293-303"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461034/pdf/ajceu0011-0293.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118303","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":"Impact of exercise on continence in prostate cancer patients post robotic assisted radical prostatectomy: a systematic review.","authors":"Shirin Razdan,&nbsp;Krunal Pandav,&nbsp;Joshua Altschuler,&nbsp;Kate Moody,&nbsp;Lily Martin,&nbsp;Hiten D Patel,&nbsp;Nihal Mohamed,&nbsp;Zachary Dovey,&nbsp;Ashutosh K Tewari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary incontinence is one of the most common long term side effects after robotic prostatectomy (RALP), and significantly impacts patient quality of life. Pelvic floor muscle training (PFMT) has been a standard part of the urologist's armamentarium for maximizing continence outcomes post-op. Recently, aerobic and resistance exercises have been described as improving functional outcomes post RALP. We performed a systematic review to determine the influence of exercise, in the form of PFMT, aerobic exercise, and resistance training, on incontinence post-RALP.</p><p><strong>Materials and methods: </strong>This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with database searches performed on January 14, 2022 and again on August 10, 2022 to account for any new publications. The search identified 1675 papers. Of the 1675 papers, 1007 were found to be duplicates, leaving 668 total studies for screening. Of the 668 papers, nine met all inclusion criteria. Of the nine, four studies presented data from patients who had undergone RALP and were included in the final descriptive systematic review.</p><p><strong>Results: </strong>Sayilan et al. and Milios et al. showed postoperative PFMT and physical activity resulted in significantly improved continence outcomes at 1 and 6 months and 2, 6, and 12 weeks postoperatively, respectively. Heydenreich et al. combined PFMT with an oscillating rod therapy, which was found to significantly improve both postoperative urinary continence and health related quality of life compared to PFMT and relaxation techniques alone. On the contrary, Goode et al. examined delivery of exercise information and demonstrated no difference in continence outcomes between focused telehealth PFMT program and generic prostate cancer education.</p><p><strong>Conclusion: </strong>Pelvic floor muscle training, with or without adjunct therapies, results in improved continence outcomes post RALP. Supervised training programs may or may not accelerate this finding. There is no recent literature to support or refute the benefit of aerobic exercise or resistance training on reducing post-prostatectomy incontinence after RALP.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 4","pages":"320-327"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461030/pdf/ajceu0011-0320.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176409","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":"Resveratrol used as nanotherapeutic: a promising additional therapeutic tool against hormone-sensitive, hormone-insensitive and resistant prostate cancer.","authors":"Jasmin Katrin Badawi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prostate cancer is one of the most common cancers in men. Despite the development of diverse therapeutic agents for different types and stages, the progression or spread of the disease is inevitable. Another problem is the development of resistance of cancer cells to available therapeutics. Therefore, additional medicaments are urgently needed. Resveratrol is a polyphenolic phytoalexin found in numerous plants and fruits like red grapes or blueberries. Resveratrol possesses antiproliferative, anti-angiogenic and anticancer activities well proven in different types of cancer including prostate cancer. To date, it is not used clinically due to poor solubility, low bioavailability, and other limiting factors. In order to overcome these limitations, novel nanoparticle-based formulations were developed over the past years. In this review article, studies about the effect of resveratrol on prostate cancer cells are discussed focusing especially on those studies using nanotechnology. An electronic literature research was performed utilizing PubMed in August 2022. Scientific publications, which examine resveratrol using nanotechnology, are discussed. The studies clearly indicate that resveratrol-loaded nanoparticles exhibited a remarkable anti-cancer activity in various hormone-sensitive and hormone-insensitive prostate cancer cell lines including docetaxel-resistant prostate-cancer cells. The types of nanoparticles that were used varied and influenced the outcome. Additionally, the meaning of the surface functionality of the nanoparticles is emphasized. No reduction of the anti-proliferative activity of resveratrol was shown when used encapsulated. Additionally, synergistic effects of resveratrol and docetaxel were proven. Resveratrol-loaded nanoparticles, especially when combined, may represent the next generation of anticancer substances. However, further in vivo/clinical studies are necessary to confirm their clinical effectiveness.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 1","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10009313/pdf/ajceu0011-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9122062","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":"Three piece penile prosthesis salvage with chlorhexidine gluconate and length preservation: our technique and outcomes.","authors":"Shirin Razdan,&nbsp;Alexandra R Siegal,&nbsp;Kenan E Celtik,&nbsp;Rafael Carrion,&nbsp;Robert J Valenzuela","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Since the advent of the Mulcahy technique of three-piece inflatable penile prosthesis (IPP) salvage, there have been multiple iterations of salvage prosthesis procedures reported in the literature. All of these techniques employ traditional antibiotic irrigation with or without rechanneling. We present our technique of salvage IPP using 0.05% chlorhexidine gluconate (Irrisept^®) with corporal rechanneling for length preservation.</p><p><strong>Materials and methods: </strong>Our technique of IPP salvage begins with access via a 5 cm vertical midline scrotal incision. Dissection down to the corpora is performed with a combination of blunt dissection and dissection with fine tipped Metzenbaum scissors. Each component of the prior IPP is sequentially removed starting with the cylinders, followed by the pump, and finally the reservoir. Irrisept^® is used to copiously irrigate out both cavernosal bodies as well as the scrotal compartment and prior reservoir location. A two minute dwell time of the Irrisept^® is employed after mechanical irrigation. A penrose drain is placed from the space of Retzius through a separate stab incision in the scrotum. Corporotomies are closed, followed by Dartos fascia and scrotal skin. A complete change in gown and gloves of all members of the surgical team and a new set of drapes and instruments is performed. Through a separate subcoronal incision, two new corporotomies are made and separate channels created using nine inch Metzenbaum scissors. These channels are irrigated with Irrisept^®. A 9 mm malleable penile prosthesis (MPP) is inserted and corporotomies and skin incision are closed.</p><p><strong>Results: </strong>A total of four men with prior penoscrotal IPP placement underwent salvage IPP with MPP from January 2022 to October 2022. Median operative time was 165 minutes. Median preoperative cylinder size was 23.5 cm. Median postoperative malleable cylinder size was 23 cm. Median length of follow up was 4.8 months. There were no cases of MPP erosion or infection. Two patients elected to undergo repeat IPP insertion after 6 months with same cylinder size.</p><p><strong>Conclusion: </strong>IPP salvage with chlorhexidine irrigation and soak as well as separate corporal channeling in a noninfected field for MPP insertion is a viable strategy for infected prostheses given the ease of performance, low risk of repeat infection of the malleable device, and maintenance of corporal length of any subsequent prostheses.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 2","pages":"155-159"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165229/pdf/ajceu0011-0155.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9453375","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":"Comparative proteomic profiling of uric acid, ammonium acid urate, and calcium-based kidney stones.","authors":"Johnathan A Khusid,&nbsp;Alex Vasquez,&nbsp;Areeba S Sadiq,&nbsp;Jennifer A Stockert,&nbsp;Blair Gallante,&nbsp;Alan Yaghoubian,&nbsp;Roman Shimonov,&nbsp;Aryeh Stock,&nbsp;William Atallah,&nbsp;Natasha Kyprianou,&nbsp;Wei Yang,&nbsp;Mantu Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney stone matrix proteins may help explain cellular mechanisms of stone genesis. However, most existing proteomic studies have focused on calcium oxalate stones. Here, we present a comparative proteomic analysis of different kidney stone types.</p><p><strong>Methods: </strong>Proteins were extracted from the stones of patients undergoing percutaneous nephrolithotomy (PCNL). Approximately 20 μg of protein was digested into tryptic peptides using filter aided sample preparation, followed by liquid chromatography tandem-mass-spectrometry using an EASY-nLC 1200 and Orbitrap Fusion Lumos mass spectrometer. A standard false discovery rate cutoff of 1% was used for protein identification. Stone analysis was used to organize stone samples into similar groups. We selected the top 5% of proteins based on total ion intensities and used DAVID and Ingenuity Pathway Analysis to identify and compare significantly enriched gene ontologies and pathways between groups.</p><p><strong>Results: </strong>Six specimens were included and organized into the following four groups: 1) mixed uric acid (UA) and calcium-based, 2) pure UA, 3) pure ammonium acid urate (AAU), and 4) pure calcium-based. We identified 2,426 unique proteins (1,310-1,699 per sample), with 11-16 significantly enriched KEGG pathways identified per group and compared via heatmap. Based on number of unique proteins identified, this is the deepest proteomic study of kidney stones to date and the first such study of an AAU stone.</p><p><strong>Conclusions: </strong>The results indicate that mixed UA and calcium-based kidney stones are more similar to pure UA stones than pure calcium-based stones. AAU stones appear more similar to pure calcium-based stones than UA containing stones and may be related to parasitic infections. Further research with larger cohorts and histopathologic correlation is warranted.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 3","pages":"265-274"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333134/pdf/ajceu0011-0265.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817968","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":"Extramural venous invasion: a novel magnetic resonance imaging biomarker for adverse pathology in bladder cancer.","authors":"Soroush Bazargani,&nbsp;Chandana Lall,&nbsp;Dheeraj Reddy Gopireddy,&nbsp;Shiguang Liu,&nbsp;Ashley Way,&nbsp;Mohammed Al-Toubat,&nbsp;Ahmed Elshafei,&nbsp;Allison Feibus,&nbsp;Seyed Behzad Jazayeri,&nbsp;Umar Muhammed Alam,&nbsp;Victor Chalfant,&nbsp;Jatinder Kumar,&nbsp;Robert Marino,&nbsp;Joseph Costa,&nbsp;Hariharan Palayapalayam Ganapathi,&nbsp;Shahriar Koochekpour,&nbsp;Shiva Gautam,&nbsp;K C Balaji,&nbsp;Mark G Bandyk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Extramural venous invasion (EMVI) recognized on magnetic resonance imaging (MRI) is an unequivocal biomarker for detecting adverse outcomes in rectal cancer: however it has not yet been explored in the area of bladder cancer. In this study, we assessed the feasibility of identifying EMVI findings on MRI in patients with bladder cancer and its avail in identifying adverse pathology. In this single-institution retrospective study, the MRI findings inclusive of EMVI was described in patients with bladder cancer that had available imaging between January 2018 and June 2020. Patient demographic and clinical information were retrieved from our electronic medical records system. Histopathologic features frequently associated with poor outcomes including lymphovascular invasion (LVI), variant histology, muscle invasive bladder cancer (MIBC), and extravesical disease (EV) were compared to MRI-EMVI. A total of 38 patients were enrolled in the study, with a median age of 73 years (range 50-101), 76% were male and 23% were females. EMVI was identified in 23 (62%) patients. There was a significant association between EMVI and MIBC (OR = 5.30, CI = 1.11-25.36; P = 0.036), and extravesical disease (OR = 17.77, CI = 2.37-133; P = 0.005). We found a higher probability of presence of LVI and histologic variant in patients with EMVI. EMVI had a sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of 90%, 73%, 94% and 63% respectively in detecting extravesical disease. Our study suggests, EMVI may be a useful biomarker in bladder cancer imaging, is associated with adverse pathology, and could be potentially integrated in the standard of care with regards to MRI reporting systems. A larger study sample size is further warranted to assess feasibility and applicability.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 2","pages":"185-193"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165227/pdf/ajceu0011-0185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823486","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":"Usage of ultrasound indices in nocturnal enuresis treated with desmopressin therapy.","authors":"Maryam Riahinezhad,&nbsp;Alireza Merikhi,&nbsp;Alale Gheisari,&nbsp;Aryan Golabbakhsh,&nbsp;Fatemeh Khounsarian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal enuresis is a common problem in children and could be treated with desmopressin therapy. Here we assessed ultrasound indices affecting disease severity and treatment responses in candidates for pharmacotherapy for nocturnal enuresis.</p><p><strong>Methods: </strong>This prospective study was conducted in 2021-2022 on children diagnosed with nocturnal enuresis and candidates for desmopressin therapy. Demographic data of patients including age and gender were collected by a checklist. The severity of the disease was categorized into mild, moderate and severe. We measured the bladder volume index (BVI), bladder wall thickness (BT) and bladder volume wall thickness index (BVWI) by ultrasound. Patients were treated with desmopressin (administered 120 µg, stat and before sleeping) for 4 months and treatment responses were determined and compared.</p><p><strong>Results: </strong>In this study, data from 72 patients were analyzed. Complete response was achieved in 16 patients (22.2%), 25 patients (34.7%) had a good response to treatments, 18 patients (25%) had a partial response and 13 patients (18.1%) had no response. There was a significantly positive correlation between low and normal BVWI and the severity of the disease. Normal BVWI was found mostly in children with a mild degree of nocturnal enuresis; while low BVWI was associated with severe cases. There was a significant inverse correlation between response to treatment and bladder wall thickness. BVWI was significantly correlated with response to treatment. It was shown that 81.3% of children with complete responses and 76% of children with good responses had a normal BVWI, while 76.9% of children who showed no response to treatment had a low BVWI.</p><p><strong>Conclusion: </strong>BVWI and bladder wall thickness were significantly correlated with treatment response and BVWI had significant correlations with disease severity.</p>","PeriodicalId":7438,"journal":{"name":"American journal of clinical and experimental urology","volume":"11 3","pages":"220-227"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333133/pdf/ajceu0011-0220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872396","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}