Arab Journal of Urology最新文献

{"title":"Novel urine-based DNA methylation biomarkers for urothelial bladder carcinoma detection in patients with hematuria","authors":"Hassan F. Abol-Elnazer, Amira Awadalla, Asmaa E. Ahmed, Hassan Abol-Enein, Munir Ali Al Ganzouri, Amr A. Elsawy","doi":"10.1080/2090598x.2023.2208492","DOIUrl":"https://doi.org/10.1080/2090598x.2023.2208492","url":null,"abstract":"Background Urothelial bladder carcinoma (UBC) is usually detected during work-up for hematuria. Cystoscopy and/or contrast-enhanced imaging are the gold standard tools for UBC diagnosis, despite limited by being invasive, expensive and low yield in small flat tumors.Objectives To assess the diagnostic performance of urine-based DNA methylation of six genes (GATA4, P16, P14, APC, CDH1 and CD99) for UBC detection in patients with hematuria.Patients and methods Voided urine was collected from consecutive patients presented with hematuria for urine cytology and DNA methylation assay of the assigned genes using methylation-specific Polymerase Chain Reaction (PCR). Further assessment by office cystoscopy and imaging with subsequent inpatient cystoscopic biopsy for positive findings was done. The diagnostic characteristics of DNA methylation and urine cytology were assessed based on its capability to predict UBC.Results We included 246 patients in the study with identified macroscopic hematuria in 204 (82.9%) patients. Positive cytology was found in 78 (31.7%) patients. DNA methylation of GATA4, P16, P14, APC, CDH1 and CD99 genes was identified in 127 (51.6%), 52 (21.1%), 117 (47.6%), 106 (43.1%), 90 (36.6%) and 71 (28.9%) patients, respectively. The sensitivity of the assigned genes for UBC detection ranges from 35% (95%CI: 31–39) to 83% (95%CI: 79–87). Optimal specificity (SP) (100%) was noted for P16, APC and CDH1 genes. While for the other genes (GATA4, P14 and CD99), the SP was 95% (95%CI: 92–98), 96% (95%CI: 92–99) and 97% (95%CI: 93–99), respectively. On multivariate logistic regression analysis, all genes exclusively demonstrated independent prediction of UBC. On receiver operator characteristic (ROC) analysis, all tested genes methylation showed superior area under the curve (AUC) when compared to urine cytology.Conclusions We have developed a novel urine-based DNA methylation assay for detection of UBC in patients with hematuria with superior diagnostic performance and independent predictive capacity over urine cytology.","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135189630","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":"Authors' response:Vitamin D supplementation for improving sperm parameters in infertile men: A systematic review and meta-analysis of randomized clinical trials.","authors":"Clarissa Tania, Edwin Raja Pardamean Lumban Tobing, Christiano Tansol, Patricia Diana Prasetiyo, Caesar Khairul Wallad, Timotius Ivan Hariyanto","doi":"10.1080/2090598X.2023.2203605","DOIUrl":"10.1080/2090598X.2023.2203605","url":null,"abstract":"","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"1 1","pages":"214-215"},"PeriodicalIF":1.3,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41533860","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":"Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis.","authors":"Nitinkumar Borkar,&nbsp;Charu Tiwari,&nbsp;Debajyoti Mohanty,&nbsp;Arvind Sinha,&nbsp;Vijai Datta Upadhyaya","doi":"10.1080/2090598X.2022.2149129","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2149129","url":null,"abstract":"<p><strong>Background: </strong>There is unanimous agreement amongst hypospadias surgeons to use an intermediate layer to cover the neourethra. Dartos fascia and tunica vaginalis (TV) flaps are the most preferred tissues to be used. Tissue glue, sealants and biomaterials are also useful where there is a paucity of local tissue to cover the neourethra. But these blood-derived products have associated infectious and allergic risks. The autologous human platelet concentrate (APC) contains biologically active factors and is safe for wound healing and soft tissue reconstruction. It has been used by few surgeons as an intermediate layer in hypospadias repair. This systematic review and meta-analysis aim to systematically compare the outcomes of hypospadias surgery in children with or without using APCs.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted as per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Meta-analysis protocol was registered with INPLASY. A systematic, detailed search was carried out by the authors in the electronic databases, including Medline, Embase, CENTRAL, Scopus, Google Scholar and clinical trial registry. Studies were selected and compared based on primary outcome measures like urethra-cutaneous fistula, meatal stenosis, wound infection and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio and I² heterogeneity.</p><p><strong>Results: </strong>Four randomized studies with a total of 355 patients were included. Pooled analysis for outcome of urethra-cutaneous fistula (UCF) showed no significant difference between the groups with APC and without APC. Pooled analysis for the other outcome like meatal stenosis, wound infection and total complications showed a decrease in incidence of these complications in groups with APC.</p><p><strong>Conclusion: </strong>This meta-analysis shows that there is a reduction in the incidence of wound infection, meatal stenosis and total complications in patients where APC was used to cover the neourethra, although no such difference was observed in UCF rates.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 3","pages":"177-184"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195716","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":"Gene expression analysis and the risk of relapse in favorable histology Wilms' tumor.","authors":"Mariam M Abdel-Monem,&nbsp;Omali Y El-Khawaga,&nbsp;Amira A Awadalla,&nbsp;Ashraf T Hafez,&nbsp;Asmaa E Ahmed,&nbsp;Mohamed Abdelhameed,&nbsp;Ahmed Abdelhalim","doi":"10.1080/2090598X.2022.2127202","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2127202","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Wilms' tumor (WT) relapse occurs in 15% of patients. We aim to investigate the association between the expression of several genetic markers and WT relapse risk.</p><p><strong>Materials and methods: </strong>The study included 51 children treated for WT at a tertiary center between 2001 and 2019: 23 patients had disease relapse (group A) and 28 remained relapse-free after at least 2 years of follow-up (group B). Patients with syndromic, bilateral synchronous or anaplastic WT were excluded. Autologous renal tissue from 20 patients served as control. Total RNA was isolated from tumor tissue and control. Gene expression levels of WT1, HIF1α, b-FGF, c-MYC and SLC22A18 were assessed using quantitative RT-PCR and normalized to GAPDH. Immunohistochemical staining for WT1 and gene expression levels were compared between the study groups.</p><p><strong>Results: </strong>Median patient age was 3 (IQR = 2-5) years and 36 (70.6%) had stage I disease. Baseline characteristics were similar between study groups. Relapse occurred at a median of 6.8 (2.8-24.7) months, predominantly in the lungs (11/23, 47.8%). Tumors that relapsed expressed significantly higher levels of WT1, HIF1α, b-FGF and c-MYC and lower levels of SLC22A18 (p < 0.001). Strong immunohistochemical staining for WT1 was seen in 73.9% of group A and 14.29% of group B (p < 0.001). These associations retained statistical significance irrespective of patient and tumor characteristics.</p><p><strong>Conclusions: </strong>Higher expression levels of WT1, HIF1 α, b-FGF and c-MYC and lower level of SLC22A18 are associated with increased risk of WT relapse. These genetic markers can serve as future prognostic predictors and help stratify patients for treatment.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 1","pages":"45-51"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315933","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":"Preoperative inflammatory biomarkers analysis in prognosis of systemic inflammatory response syndrome following percutaneous nephrolithotomy: A systematic review and meta-analysis.","authors":"Dwi Evan Prima Putra Noviardi,&nbsp;Zuhirman,&nbsp;Indra Jaya,&nbsp;Afdal,&nbsp;Joko Pitoyo,&nbsp;Muhammad A Yashar,&nbsp;Nathanael Ibot David","doi":"10.1080/2090598X.2022.2138891","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2138891","url":null,"abstract":"<p><strong>Introduction: </strong>Urosepsis is one of the most serious complications of percutaneous nephrolithotomy (PCNL). To date, many studies aim to prescreen urosepsis possibility after PCNL through blood components. This meta-analysis aims to determine C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) obtained preoperatively used to predict postoperative sepsis after PCNL.</p><p><strong>Methods: </strong>A comprehensive literature search was performed through the electronic databases in March 2022. The quality of the included studies was assessed with Newcastle Ottawa Scale (NOS), while the presence of publication bias was assessed using Begg's and Egger's tests. Quantitative analysis was performed using RevMan 5.4 and Comprehensive Meta-Analysis 3.0. The outcome of interest is the difference in blood component count between groups that experienced systemic inflammatory response syndrome (SIRS) and those who did not. Acquired data were pooled as mean difference (MD).</p><p><strong>Results: </strong>Total of 11 studies were included in the quantitative analysis. Leukocyte count showed an increase between the group that experienced SIRS and those who were not (MD 0.69, 95% confidence interval [CI] 0.48 to 0.91, <i>p</i> < 0.00001). Similar result was also found in other analysis, CRP (MD 3.30, 95% [CI] 2.33 to 4.26, <i>p</i> < 0.00001), NLR (MD 0.59, 95% [CI] 0.48 to 0.69, <i>p</i> < 0.00001), and PLR (MD 23.40, 95% [CI] 17.98 to 28.82, <i>p</i> < 0.00001).</p><p><strong>Conclusion: </strong>Preoperative PLR, NLR, and CRP had significant association with postoperative sepsis after PCNL. It is beneficial for urologists to ensure close monitoring of these biomarkers levels before PCNL. The result of this study might serve as a consideration for future clinical approaches in determining beneficial treatment for urolithiasis patients.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 2","pages":"108-117"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10564372","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":"Can a prostate biopsy be safely deferred on PI-RADS 1,2 or 3 lesions seen on pre-biopsy mp-MRI?","authors":"Rickaz Abdul Raheem,&nbsp;Ahsen Razzaq,&nbsp;Victoria Beraud,&nbsp;Richard Menzies-Wilson,&nbsp;Rakan Odeh,&nbsp;Imoh Ibiok,&nbsp;Prashant Mulawkar,&nbsp;Henry Andrews,&nbsp;Iqbal Anjum,&nbsp;Khaled Hosny,&nbsp;Tom Leslie","doi":"10.1080/2090598X.2022.2119711","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2119711","url":null,"abstract":"<p><strong>Introduction: </strong>Multi-parametric magnetic resonance imaging (mp-MRI) is currently used to triage patients with suspected prostate cancer, before deciding on prostate biopsies. In our study, we evaluated normal and equivocal pre-biopsy mp-MRIs to see whether it is safe to avoid biopsy with such findings.</p><p><strong>Methods: </strong>A retrospective study was conducted at a district general hospital in the UK between August 2017 and July 2018. Patients with negative and equivocal prebiopsy mp-MRI with high clinical suspicion of cancer had proceeded to biopsy. MRI reports with prostate imaging reporting and data system (PI-RADS) scores 1, 2, 3 and normal MRI were evaluated against the transrectal ultrasound-guided prostate biopsy (TRUS-PB) outcomes to demonstrate benign pathology, clinically insignificant or clinically significant cancer (csCa). CsCa was defined as Gleason score (GS) ≥3 + 4.</p><p><strong>Results: </strong>Out of 265 mp-MRIs studied, five (1.9%) were PI-RADS 1, 109 (41.1%) and 84 (31.7%) were PI-RADS 2 and 3 lesions respectively; 67 (25.3%) were reported as normal. Seventy-five (27.3%) patients did not have biopsies following their MRI and 73.3% (51/75) of them had benign feeling prostate. Negative MRIs (PI-RADS 1, 2 and normal MRI) showed 8.8% and PI-RADS 3 lesions demonstrated 11.9% csCa. Negative predictive value for normal MRI was 91.2%. Mean PSA density (PSAD) among the benign, GS 3 + 3 and csCa was 0.14, 0.16 and 0.27 ng/ml/ml respectively and this was statistically significant (<i>p</i> < 0.001). The average percentage of cancer found in GS 3 + 3 and csCa was 3.2% and 20.1%, respectively.</p><p><strong>Conclusion: </strong>Avoiding TRUS-PB following normal or equivocal mp-MRI should carefully be decided as 18.5% of cancer was demonstrated in this group and 9.8% of those who were diagnosed with cancer were csCa. PSAD and DRE findings provide additional information to help with this decision.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 1","pages":"10-17"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825693","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":"'Sclérose du col vésical': An obsolete terminology still used by French literature?","authors":"Jihad El Anzaoui,&nbsp;Chatar Achraf,&nbsp;Akajai Ali,&nbsp;Amaziane Ahmed,&nbsp;Lakrabti Naceur,&nbsp;Habyebete Soufiane,&nbsp;Abdelghani Ammani","doi":"10.1080/2090598X.2022.2092994","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2092994","url":null,"abstract":"Dear Sir, The evolution of medicine is taken place towards the homogenization of medical terms. The bladder neck contracture (BNC) is a well-known condition to urologists, described as a fibrous narrowing of the bladder neck more or less extended to the prostatic and posterior urethra (Figure 1). It usually occurs as a complication of a surgical or radiotherapeutic approach to the prostate. Albeit its diagnostic and therapeutic aspects have been extensively studied in the literature, its terminology remains a subject of ambiguity, especially in French literature. The French term of « sclérose du col vesical » or « sclérose de la loge prostatique » refers to this entity. In contrast to English literature, which mainly uses the term ‘bladder neck contracture’ or ‘stenosis’ rather than ‘bladder neck sclerosis’, the term ‘sclérose du col vésical’ is the principal terminology used in French literature. In fact, the International Society of Urology (SIU) and the International Consultation on Urological Diseases (ICUD) published, in 2014, recommendations regarding the accuracy of urethral terminology [1]. According to these recommendations, the term ‘bladder neck sclerosis’ should be replaced by ‘bladder neck stenosis’ or ‘stenosis of the vesico-urethral anastomosis’. Despite the effort of learned societies to universally homogenize the medical language, many urologists do not adhere to this terminology and prefer old terms in common practice. This lack of adherence can be seen in both English and French literature. A review of the literature on PubMed, Web of Science, Scopus, and Google Scholar of articles published from 2015 to 2021 using the French terms (sclérose du col), (sclérose de l’anastomose vésico-uréthrale), or (sclérose de la loge prostatique) found 16 articles published in French that continue to use the term ‘sclérose’ to designate the said condition (Table 1), which proves the wide persistent use of this terminology. This letter aims to draw the attention of authors and reviewers to the fact that this terminology is misleading and was previously revisited by learned societies. The term ‘sclerosis’ derives from the Greek word ‘sklēroun’ meaning harden. The French dictionary of ‘Académie de Medecine’ defines ‘sclérose’ as a pathological induration of a tissue affected by fibrosis [2]. The addition of the character of hardness is not constant in all dictionaries. The French dictionary ‘Larousse médical’, for example, considers fibrosis as equivalent to sclerosis [3]. Considering sclerosis as equivalent to fibrosis or just a type of it, Kaynar et al. in 2016, by analyzing the resected specimens of 338 cases of BNC, found varying degrees of inflammation and fibrosis [4]. For all the examined specimens, the term ‘sclerosis’ was not used by the anatomopathologists. Moreover, fibrosis is a physiological healing process constantly found in all previously injured tissues, either by trauma, instrumental maneuvers, infections, or inflammatory proces","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 1","pages":"66-68"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825696","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":"Short and long-term effectiveness of external shock wave therapy for chronic pelvic pain syndrome in men.","authors":"Kareim Khalafalla,&nbsp;Ahmed Albakr,&nbsp;Walid El Ansari,&nbsp;Ahmad Majzoub,&nbsp;Haitham Elbardisi,&nbsp;Khalid AlRumaihi,&nbsp;Mohamed Arafa","doi":"10.1080/2090598X.2023.2207415","DOIUrl":"https://doi.org/10.1080/2090598X.2023.2207415","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men's quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT's short and long - term efficacy in managing CPPS.</p><p><strong>Methods: </strong>This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health - Chronic Prostatitis Symptom Index (NIH - CPSI) questionnaire was used to assess patients' symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded.</p><p><strong>Results: </strong>Patients' mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH - CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications.</p><p><strong>Conclusions: </strong>ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 3","pages":"162-169"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250116","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":"Could the bulbar urethral end location on the cystourethrogram predict the outcome after posterior urethroplasty for pelvic fracture urethral injury?","authors":"Ahmed M Harraz,&nbsp;Adel Nabeeh,&nbsp;Ramy Elbaz,&nbsp;Abdalla Abdelhamid,&nbsp;Mohamed Tharwat,&nbsp;Amr A Elbakry,&nbsp;Ahmed S El-Hefnawy,&nbsp;Ahmed El-Assmy,&nbsp;Ahmed Mosbah,&nbsp;Mohamed H Zahran","doi":"10.1080/2090598X.2022.2138119","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2138119","url":null,"abstract":"<p><strong>Objectives: </strong>To identify cystourethrogram (CUG) findings that independently predict the outcome of posterior urethroplasty (PU) following pelvic fracture urethral injury (PFUI).</p><p><strong>Methods: </strong>Findings of CUG included the location of the proximal end of the bulbar urethra in zones A (superficial) or B (deep) according to its relationship with the pubic arch. Others included the presence of pelvic arch fracture, bladder neck, and posterior urethral appearance. The primary outcome was the need for reintervention either endoscopically or by redo urethroplasty. Independent predictors were modeled using a logistic regression model and a nomogram was constructed and internally validated using 100-bootstrap resampling. Time-to-event analysis was performed to validate the results.</p><p><strong>Results: </strong>A total of 196 procedures in 158 patients were analyzed. The success rate was 83.7% with 32 (16.3%) procedures requiring direct vision internal urethrotomy, urethroplasty, or both in 13 (6.6%), 12 (6.1%), and 7 (3.6%) patients, respectively. On multivariate analysis, bulbar urethral end located at zone B (odds ratio [OR]: 3.1; 95% confidence interval [CI]: 1.1-8.5; p = 0.02), pubic arch fracture (OR: 3.9; 95%CI: 1.5-9.7; p = 0.003), and previous urethroplasty (OR: 4.2; 95% CI: 1.8-10.1; p = 0.001) were independent predictors. The same predictors were significant in the time-to-event analysis. The nomogram discrimination was 77.3% and 75% in the current data and after validation.</p><p><strong>Conclusions: </strong>The location of the proximal end of the bulbar urethra and redo urethroplasty could predict the need for reintervention after PU for PFUI. The nomogram could be used preoperatively for patient counseling and procedure planning.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 2","pages":"94-101"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194078","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":"Foreign body granuloma development after calcium hydroxylapatite injection for stress urinary incontinence: A literature review and case report.","authors":"David A Csuka,&nbsp;John Ha,&nbsp;Andrew S Hanna,&nbsp;Jisoo Kim,&nbsp;William Phan,&nbsp;Ahmed S Ahmed,&nbsp;Gamal M Ghoniem","doi":"10.1080/2090598X.2022.2146859","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2146859","url":null,"abstract":"<p><strong>Objectives: </strong>To present a case of foreign body granuloma (FBG) development after injection of calcium hydroxylapatite as a urethral bulking agent and to review all documented cases of this phenomenon in the literature.</p><p><strong>Methods: </strong>We analyzed a new case of calcium hydroxylapatite-induced FBG. We also conducted a literature review of the PubMed, Embase, CINAHL, and Web of Science databases through March 2022. Reports were included if they contained stress urinary incontinence patients that developed an FBG after calcium hydroxylapatite injection. The cases were reviewed for presenting symptoms, patient demographics, granuloma details, and surgical treatment.</p><p><strong>Results: </strong>We screened 250 articles and included six articles between 2006 and 2015 in addition to the present case. The median age of the patients was 65.5 years (range 45-93), and all patients were female. The most common presenting symptoms and the proportion of patients affected were difficulty voiding (4/8), recurrent urinary incontinence (3/8), and dyspareunia (2/8). The median time between the first CaHA injection and discovery of the FBG was 5 months (range 1-50). The median longest dimension of the FBGs was 1.85 cm (range 1.0-3.0). The 8 masses observed were evenly distributed throughout the urethra, with 3 in the bladder neck, 2 in the midurethra, and 3 in the distal urethra. Surgical excision was the predominant management choice, with some variation in technique.</p><p><strong>Conclusions: </strong>Severe, persistent lower urinary tract symptoms after calcium hydroxylapatite injection may indicate an FBG, which has been successfully managed with surgical excision.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"21 2","pages":"118-125"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194080","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}