BMC Urology最新文献

{"title":"A rare variant of zinner syndrome with ejaculatory duct cyst: case report and challenges in diagnosis and management.","authors":"Guixing Tang, Yanhua Feng, Zhaohui Wang, Yu Yang, Yupin Liu, Zunguang Bai, Jun Pan","doi":"10.1186/s12894-024-01659-6","DOIUrl":"10.1186/s12894-024-01659-6","url":null,"abstract":"<p><strong>Background: </strong>Zinner syndrome (ZS) is a congenital malformation characterized by a triad of mesonephric (Wolffian) duct dysplasia, first identified by Zinner in 1914. The classical presentation of ZS includes unilateral renal hypoplasia or dysplasia, ipsilateral seminal vesicle cysts, and obstruction of the ejaculatory duct. This case presents a rare variant of the syndrome, where an ejaculatory duct cyst is observed instead of the typical ipsilateral seminal vesicle cyst. The ejaculatory duct cyst affected the vas deferens bilaterally, leading to bilateral atrophy or erosion of the seminal vesicle glands, and resulted in the absence of seminal fluid, ultimately causing azoospermia and infertility.</p><p><strong>Case presentation: </strong>Prior to surgery, the patient experienced a sensation of incomplete defecation, accompanied by mild anal distension. Two semen analyses revealed azoospermia, and magnetic resonance imaging/magnetic resonance urography indicated the absence of the left renal component and suggested the presence of a seminal vesicle cyst. It was hypothesized that the azoospermia resulted from compression of the contralateral ejaculatory duct by the seminal vesicle cyst on the affected side. Consequently, a decision was made to proceed with laparoscopic resection.During the surgical procedure, no seminal vesicle cyst was identified; however, an ejaculatory duct cyst was discovered, wherein the bilateral vasa deferentia converged without any alternative outlet. The cyst was subsequently resected. Postoperatively, the patient's clinical symptoms resolved, although the issue of infertility remained unaddressed.</p><p><strong>Conclusion: </strong>This case describes a rare Zinner syndrome variant where an ejaculatory duct cyst replaces the seminal vesicle cyst, leading to seminal vesicle atrophy, azoospermia, and infertility. An unreported variant was discovered during surgery, underscoring the importance of preoperative imaging. Laparoscopic removal alleviated symptoms but not infertility, indicating that assisted reproduction might be necessary for ZS-related azoospermia. This case expands knowledge of ZS variants and their impact on fertility.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"263"},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779548","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":"Flank-free modified supine vs. prone position for pediatric nephrolithotripsy: an updated systematic review and meta-analysis.","authors":"Breno C Porto, Roberto N Santana, Ingrid M S Duarte, Carlo C Passerotti, Rodrigo A S Sardenberg, Ronaldo S Maia, Jose P Otoch, Jose A S da Cruz","doi":"10.1186/s12894-024-01660-z","DOIUrl":"10.1186/s12894-024-01660-z","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous nephrolithotomy (PCNL) is widely performed as the preferred treatment for kidney stones larger than 20 mm in pediatric patients, with current research focusing on comparing outcomes between prone and supine positions to determine optimal procedural positioning. Therefore, the aim of this study is to compare the efficacy of prone versus supine positioning in pediatric PCNL, providing clarity on this critical aspect of the procedure to guide clinical decision-making.</p><p><strong>Methods: </strong>We conducted a systematic review in PubMed, Embase, Scopus, Cochrane, Web of Science and Google Scholar. We included studies that compared PCNL in prone vs supine positions for pediatric patients. Our primary outcome was stone-free rate (SFR). Secondary outcomes included operative time, length of hospital stay and overall complications rate. The statistical analysis was performed using Review Manager 5.4.</p><p><strong>Results: </strong>We retrieved 8 articles, with 269 patients in the prone group and 223 patients in the supine group. The mean age of all patients was 7.92 years old. Our findings presented no statistically significant difference in SFR between the two positions (OR 0.67; CI95 0.38, 1.18; p = 0.17; I² = 0%). Additionally, we noted a significant reduction in operative time in the supine position group (MD 13.75; CI95 4.35, 23.15; p = 0.004; I² = 84%). At the same time, the length of hospital stay after the procedure was lower in supine group (MD 0.61; CI95 0.34, 0.88; p < 0.0001; I² = 21%). No difference was observed regarding the total complication rate (OR 1.47; CI95 0.88, 2.47; p = 0.15; I² = 0%).</p><p><strong>Conclusion: </strong>Our meta-analysis suggests that PCNL performed in the prone position is equivalent to supine PCNL in terms of SFR. However, mainly in the RCT studies, we could observe benefits of the supine position in comparison of prone position in terms of lower operative time, as well as a reduced postoperative hospital stay.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"262"},"PeriodicalIF":1.7,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754788","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":"For upper ureteral stone, semirigid ureteroscopy or flexible ureteroscopy? Strengths and weaknesses.","authors":"Weisong Wu, Wenlong Wan, Junyi Yang, Yirixiatijiang Amier, Xianmiao Li, Jiaqiao Zhang, Xiao Yu","doi":"10.1186/s12894-024-01647-w","DOIUrl":"10.1186/s12894-024-01647-w","url":null,"abstract":"<p><strong>Background: </strong>Flexible and semirigid ureteroscopy are two often used modalities in treating for upper ureteral stone. How about the outcome of each procedure?</p><p><strong>Methods: </strong>A retrospective cohort study among 167 patients who underwent flexible or semirigid ureteroscopic lithotripsy was performed. The pre-, intra-, postoperative and one-year follow-up outcomes were taken into comparison.</p><p><strong>Results: </strong>Significantly higher instant stone-clearance rate (81.3% vs. 92.4%, p = .032) and less operative time (62.1 ± 27.6 min vs. 44.1 ± 24.6 min, p<.001) were found in semirigid ureteroscopy. However, the stone-clearance rate at one month (90.7% vs. 93.5%, p = .500) was similar. Baseline characteristics including patient demographics, stone characteristics, duration of stone symptoms, hospital stay, expense, and complications between groups were approximately same. Three cases of stricture were found in the flexible ureteroscopy, and two in the semirigid ureteroscopy. Outcomes showed no significant difference. Further analysis showed that flexible ureteroscopy was likely more negatively affected by hydronephrosis and stone size, and semirigid ureteroscopy was more affected by stone location.</p><p><strong>Conclusion: </strong>flexible ureteroscopy and semirigid ureteroscopy both had high stone clearance rate in the treatment for upper ureteral stones. They had similar outcomes and follow-up results. However, they also had their each most suitable application object.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"261"},"PeriodicalIF":1.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754808","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":"Comparative study of trace metal concentration in the diagnosis of category III prostatitis.","authors":"Zhidi Lin, Muyan Li, Mingjin Zhang, Yimin Gong, Xiang Gan, Weiyuan Liang, Yanjun Tan, Chong Zhang, Qian Gao, Xiaoli Yang","doi":"10.1186/s12894-024-01656-9","DOIUrl":"10.1186/s12894-024-01656-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic prostatitis (CP) is one of the general diseases in urological practice, with category III prostatitis being particularly prevalent. The trace metal abnormalities might be a primary cause of prostatitis, however, their specific roles in category III prostatitis remain largely unexplored.</p><p><strong>Method: </strong>In total, 42 expressed prostatic secretion (EPS) samples from IIIa prostatitis patients, 42 from IIIb prostatitis patients, and 45 from controls were collected, along with 42 serum samples from IIIa prostatitis patients, 45 from IIIb prostatitis patients, and 50 from controls for analysis in this study. To investigate the diagnostic potential of trace metals in category III prostatitis, we analyzed the concentration of zinc (Zn), copper (Cu), calcium (Ca) and magnesium (Mg) in EPS and serum of patients with category III prostatitis and healthy controls using a flame atomic absorption spectrometer (FAAS).</p><p><strong>Results: </strong>The Results showed that the concentrations of Zn, Ca and Mg in both serum and EPS samples of all subjects with category III prostatitis were significantly different compared to controls (all P < 0.05), while Cu levels were significantly altered in all EPS samples (P < 0.000). In the category of IIIa prostatitis group, the levels of Zn, Ca, Mg in EPS, as well as Ca in serum were significantly reduced (all P < 0.000), whereas the serum Zn level was markedly elevated (P < 0.000). In the category IIIb prostatitis group, the EPS levels of Zn, Ca, Mg were decreased significantly (all P < 0.05), and the levels of serum Ca, Mg were markedly decreased (all P < 0.000), however, the EPS Cu level increased significantly (P < 0.05). Moreover, receiver operating characteristic (ROC) analysis showed that the levels of Mg and Zn/Mg in EPS had better diagnostic value for category IIIa prostatitis (Area Under the ROC Curve(AUC) = 0.796, 0.791, respectively, all P < 0.0001); while Cu and Cu/Ca levels exhibited better diagnostic value for category IIIb prostatitis (AUC = 0.880, 0.901, respectively, all P < 0.0001).</p><p><strong>Conclusion: </strong>Summarily, there are significant abnormalities in the concentrations of Cu, Mg, Ca, and Zn in EPS and serum samples of patients with category III prostatitis. The levels of Mg, Cu, Zn/Mg, Cu/Ca in EPS may serve as potential diagnostic markers for category III prostatitis.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"259"},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738387","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":"Body mass index and penile cancer incidence: results from a Norwegian cohort study of 829,081 men.","authors":"Dagfinn Aune, Marie Nordsletten, Tor Åge Myklebust, Trude Eid Robsahm, Bjørn Steen Skålhegg, Tom Mala, Sheraz Yaqub, Usman Saeed","doi":"10.1186/s12894-024-01636-z","DOIUrl":"10.1186/s12894-024-01636-z","url":null,"abstract":"<p><strong>Background: </strong>A few previous studies have suggested a possible association between adiposity and increased risk of penile cancer, however, the evidence is to date limited for this rare cancer. We investigated the association between body mass index (BMI) and penile cancer risk in a large Norwegian cohort.</p><p><strong>Methods: </strong>The analyses included 829,081 men aged 16-75 years at baseline in 1963-1975. Multivariable Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between BMI and penile cancer incidence.</p><p><strong>Results: </strong>A total of 725 incident penile cancer cases occurred during 25.6 million person-years of follow-up. Compared to men with BMI 18.5-<25, the HRs (95% CIs) of those with a BMI of 15-<18.5, 25-<30, and ≥ 30 were 0.45 (0.15-1.41), 1.14 (0.97-1.33) and 1.63 (1.20-2.22), respectively, and the HR was 1.26 (1.12-1.42) per 5 kg/m² increase in BMI. When the obese category was further subdivided in grade 1 (BMI 30-<35) and grade 2 obesity (≥ 35), the respective HRs were 1.52 (1.10-2.10) and 3.28 (1.46-7.35, p_trend<0.001). The positive association persisted in sensitivity analyses excluding the first 5 years of follow-up. The association between BMI in early adulthood and penile cancer risk was less precise (1.23, 0.91-1.65 per 5 kg/m², n = 143 cases) and for BMI and early-onset penile cancer was null (1.03, 0.51-2.06 per 5 kg/m², n = 27 cases).</p><p><strong>Conclusion: </strong>High BMI is associated with increased risk of penile cancer. Further studies are needed to investigate the potential underlying mechanisms.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"260"},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738386","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":"Correction: Bilateral duplex kidney and ureter with multiple stones: a case report.","authors":"Guoqing Liu, Xin Zhang, Xinyuan Yu, Junjie Chen, ZhaoRong Xu, Xiao Li","doi":"10.1186/s12894-024-01642-1","DOIUrl":"10.1186/s12894-024-01642-1","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"258"},"PeriodicalIF":1.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686070","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 relationship between neuropathic pain and lower urinary tract symptom scores in patients with primary Sjögren's syndrome.","authors":"Nilay Erdik, Anil Erdik, Damla Kizil, Gokhan Yavuzbilge, Sumeyye Merve Turk, Cansu Arslanturk Guneysu, Abbas Karakurt, Sedat Ozmen, Emel Gonullu","doi":"10.1186/s12894-024-01650-1","DOIUrl":"10.1186/s12894-024-01650-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of neuropathic pain on lower urinary tract symptoms (LUTS) scores in patients with primary Sjögren's syndrome (pSS).</p><p><strong>Methods: </strong>Seventy-two patients diagnosed with pSS were included in the study. The patients with pSS were divided into two groups according to the presence/absence of neuropathic pain. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire was recorded assess neuropathic pain. LUTS was evaluated using the International Prostate Symptom Score (IPSS), International Incontinence Consultation Questionnaire Short Form (ICIQ-SF) and Overactive Bladder Questionnaire (OAB-V8).</p><p><strong>Results: </strong>The mean age of the patients was 52.4 ± 11.2 years. Neuropathic pain was recorded in 21 (29.2%) patients. Among the patients, the number of patients with mild symptoms was recorded as 41 (56.9%), moderate symptoms in 25 (34.7%), and severe symptoms in 6 (8.3%) according to IPSS. IPSS and IPSS voiding subscores were statistically significantly higher in patients with neuropathic pain than non-neuropathic pain group (p = 0.035; p = 0.001, respectively). Although ICIQ-SF, OAB-V8 and IPSS storage subscores were found to be higher in patients with neuropathic pain group, there was no statistically significant difference between the groups (p = 0.299; p = 0.283; p = 0.237, respectively).</p><p><strong>Conclusion: </strong>Neuropathic pain concomitant with PSS patients may negatively affect bladder voiding functions.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"257"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675213","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":"Multidrug resistance in urinary E. coli higher in males compared to females.","authors":"Narayan Khanal, Colin H Cortie, Chloe Story, Sandra Jones, Kylie J Mansfield, Spiros Miyakis, Caitlin Keighley","doi":"10.1186/s12894-024-01654-x","DOIUrl":"10.1186/s12894-024-01654-x","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are common however the widespread use of antibiotics has led to a rise in antimicrobial resistance (AMR) amongst uropathogens, rendering a significant proportion of infections resistant to first line treatment. AMR in UTIs may differentially affect men and women, younger and older patients. The purpose of this study was to investigate MDR (multi-drug resistance) and AMR in males and females in an Australian health district.</p><p><strong>Methods: </strong>There were 85,844 E. coli urinary isolates (2007-2020) analysed from adult patients. An E. coli isolate with MDR was defined as resistant to at least 1 agent in ≥ 3 antimicrobial classes. Chi-square tests and relative risk were calculated by comparing resistance in males and females and by age for antibiotics commonly used to treat UTIs in hospital and community collected samples.</p><p><strong>Results: </strong>There was a higher proportion of MDR E. coli in males compared to females in both the community (6.4% vs. 5.2%, P < 0.001) and hospital datasets (16.5% vs. 12.8%, P < 0.001). The proportions of MDR for both males and females were significantly higher in the hospital setting. Resistance rates were higher in males compared to females for amoxicillin, amoxicillin/clavulanate, cephalexin and norfloxacin (p < 0.005), though not for trimethoprim. Antibiotic resistance was seen to increase over time.</p><p><strong>Conclusions: </strong>A higher proportion of MDR E. coli were noted in urine samples from males compared with females, possibly due to the increased likelihood of prior treatment for UTIs in men. Antimicrobial stewardship interventions could be targeted towards this cohort to address increasing rates of AMR.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"255"},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646630","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":"Urothelial carcinoma of the renal pelvis with squamous and sarcomatoid differentiation complicated by hydronephrosis and pyelonephritis: a case report and literature review.","authors":"Zheng-Ping Yang, Guan-Tian Yang, Zheng Zeng, Zhuang Gong","doi":"10.1186/s12894-024-01651-0","DOIUrl":"10.1186/s12894-024-01651-0","url":null,"abstract":"<p><strong>Background: </strong>Renal pelvic urothelial carcinoma with multiple histological variants co-occurs with hydronephrosis and pyelonephritis extremely rarely. The diagnosis of renal pelvic urothelial carcinoma can be complicated by these conditions, leading to delayed or missed diagnosis or misdiagnosis.</p><p><strong>Case presentation: </strong>We report the evolutionary course of a rare case of renal pelvic urothelial carcinoma containing squamous and sarcomatoid differentiation associated with hydronephrosis and pyelonephritis in a low-functioning kidney. Preoperative clinical and imaging manifestations were highly suggestive of hydronephrosis and pyelonephritis; however, all corresponding therapeutic measures failed. Eventually, nephrectomy was performed, and postoperative pathological examination revealed renal pelvic urothelial carcinoma with squamous and sarcomatoid differentiation. Further residual ureter and bladder cuff resection was refused by the patient. Regular cisplatin-based postoperative chemotherapy and bladder perfusion were arranged, and cystoscopy and imaging examinations were performed regularly for follow-up.</p><p><strong>Conclusion: </strong>Hydronephrosis and pyelonephritis can mask the typical clinical and imaging manifestations of renal pelvic urothelial carcinoma. Renal pelvic malignancy should be considered in patients with intractable pyelonephritis and hydronephrosis. There is no standard treatment for renal pelvic carcinoma with multiple pathological types. Radical surgery is considered an appropriate option and should be performed as early as possible. Chemotherapy and immunotherapy may improve patient survival.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"256"},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646568","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":"Pitfalls of frozen section diagnosis in ureter margin evaluation of plasmacytoid urothelial carcinoma of urinary bladder.","authors":"Ji Min Kim, Sanghui Park","doi":"10.1186/s12894-024-01643-0","DOIUrl":"10.1186/s12894-024-01643-0","url":null,"abstract":"<p><strong>Background: </strong>Plasmacytoid urothelial carcinoma (PUC) is a rare and aggressive subtype that often presents at advanced stages with poor prognosis. This study investigated tumor invasion to better understand tumor behavior and potentially to improve management strategies by comparing the clinicopathologic characteristics of PUC with positive ureter resection margin (+ URM) with PUC with negative URMs (-URM).</p><p><strong>Methods: </strong>This retrospective analysis used pathology reports from 2017 to 2023 for cases diagnosed with PUC during radical cystectomy (RC). All applicable H&E slides of RC specimens were reviewed. Cases with a plasmacytoid component greater than 25% in the RC specimens were analyzed. Frozen section analyses (FSAs) and permanent section analyses (PSAs) of ureter resection margins were performed.</p><p><strong>Results: </strong>Fifteen patients with a plasmacytoid component greater than 25% in their RC specimens were identified. Compared with -URM PUC cases, +URM PUC cases were located more frequently at the trigone or bladder neck, and all + URM cases exhibited ureter orifice involvement. Among 6 PSA-positive cases, three (50%) cases showed discrepancies with FSA. Three + URM cases exhibited PUC tumor cells along the submucosa and muscularis propria layer, and the 3 remaining cases showed PUC tumor cells along the adventitia. We observed a consistent adventitia invasion in all the discordant cases, with sectioning errors and misinterpretation identified as the primary causal factors.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study to demonstrate two separate patterns of tumor infiltration along the ureter and to discuss the significance of comparing FSA with PSA in PUC. The significance of comprehensive management strategies for PUC patients, including a thorough evaluation of ureteral margins and accurate interpretation of periureteral fat tissue, is highlighted. Large, well-designed studies are needed to strengthen the evidence and to establish optimal management strategies for patients with PUC.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"254"},"PeriodicalIF":1.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643412","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}