Central European Journal of Urology最新文献

{"title":"Efficacy of botulinum toxin in the management of refractory de novo overactive bladder symptoms in women after midurethral sling placement: retrospective, single center study.","authors":"Sameh Hijazi, Leonidas Karapanos, Luisa Halbe, Axel Heidenreich, Viktoria Hasselhof, Bara Barakat, Pavlo Synoverskyy","doi":"10.5173/ceju.2023.273","DOIUrl":"10.5173/ceju.2023.273","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed o evaluate the efficacy of onabotulinumtoxin A (onaBTX-A) intradetrusor injections in women with refractory de novo overactive bladder (OAB) following midurethral sling (MUS) placement.</p><p><strong>Material and methods: </strong>A retrospective single-center study was conducted. We screened 372 women who underwent MUS surgery between August 2009 and January 2022. 54/372 women diagnosed with pharmacologically refractory de novo OAB following MUS were evaluated using cystoscopy and urodynamics, and after tape erosion and obstructive voiding were excluded, they received onaBTX-A therapy. Outcomes were the reduction of self-reported OAB symptoms and leakage episodes, improvement of validated OAB scores and adverse events of the procedure after a follow-up of 3, 6, and 12 months.</p><p><strong>Results: </strong>Successful results were reported in 81%, 68%, and 43% at 3, 6 and 12 months respectively. Postoperatively, median voiding frequency and median nocturia episodes were significantly improved in 70% and 77% of women, respectively, with a decrease in daily number of voids (-4.1, p = 0.0001) and nocturia episodes (-2.2, p = 0.005). At 3 months, 80% of women reported an >25% reduction in urgency severity and episodes following injection. The median number of pads used was significantly reduced after injection (-2 pads; p = 0.03). Repeat injections of onaBTX-A were performed in 61% of patients after a median of 11 months.</p><p><strong>Conclusions: </strong>Intravesical onaBTX-A injections are clinically effective at 3- and 6-month follow-up for the treatment of refractory de novo OAB after MUS placement. Over 60% of the patients opted for retreatment with onaBTX-A due to a high level of satisfaction.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"213-217"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342532","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":"Advances in urethral stricture diagnostics and urethral reconstruction beyond traditional imaging: a scoping review.","authors":"Hoi Pong Nicholas Wong, Wei Zheng So, Khi Yung Fong, Ho Yee Tiong, Sanjay Kulkarni, Daniele Castellani, Bhaskar Somani, Vineet Gauhar","doi":"10.5173/ceju.2024.121","DOIUrl":"10.5173/ceju.2024.121","url":null,"abstract":"<p><strong>Introduction: </strong>Urethral stricture disease is considered one of the more functionally bothersome aspects of urological conditions. The management of such disease is also traditionally managed with urethroplasty, or in severe cases, reconstruction. With the rise of artificial intelligence (AI) playing its part in diagnostics and treatment of urological conditions, we sought to determine its use case in urethral conditions in today's era of advanced surgical care.</p><p><strong>Material and methods: </strong>A comprehensive literature search was performed to identify literature on advances in diagnosis and management of urethral strictures. Publications in English were selected, whilst studies that were case reports, abstracts only, reviews, or conference posters were excluded.</p><p><strong>Results: </strong>Twelve studies were finalised for review. Conventional neural networks and computational fluid dynamics implemented in retrograde urethrography reduced false positive and negative rates of urethral stricture diagnosis. Four-detector row computed tomography and magnetic resonance imaging voiding with virtual urethroscopy are also emerging imaging combination options for identification, offering decreased duration needed for diagnosis and increased correlation with intra-operative findings of urethral stricturing. For tissue re-engineering for urethral strictures, the role of 3-dimensional bioprinting of both autologous and allogenic sources has been on the rise, with promising findings of sustained tissue viability demonstrated in several <i>in vitro</i> animal studies and showing potential for expansion into human utilisation.</p><p><strong>Conclusions: </strong>Advances in detection and management of urethral strictures have steadily been increasing its capacity, especially with the rise in artificial AI-driven learning algorithms and more accurate objectivity. Further studies are awaited to validate the use case of AI models in fields of urethral stricturing disease.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"528-537"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669064","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":"Laparoscopic clampless partial nephrectomy for T1 kidney tumor with subsequent successful transplantation.","authors":"Angelos Samaras, Vasileios Tatanis, Paraskevi Katsakiori, Theodoros Spinos, Angelis Peteinaris, Theofanis Vrettos, Nikolaos Karydis, Evangelos Liatsikos, Panagiotis Kallidonis","doi":"10.5173/ceju.2024.10","DOIUrl":"10.5173/ceju.2024.10","url":null,"abstract":"<p><p>Kidney transplantation is considered the treatment of choice for patients with end-stage renal disease. However, the kidney transplantation rate has remained stable over the last few years while the waiting lists have been steadily increasing. Marginal organs such as kidneys with small renal masses have also been proposed as potential kidney transplants. We report the case of a 57-year-old woman who underwent clampless laparoscopic left partial nephrectomy, and subsequently, the remaining graft was successfully transplanted to her 59-year-old husband.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"456-459"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669101","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":"Robot-assisted versus laparoscopic ileal ureteral replacement: systematic review and meta-analysis.","authors":"Breno C Porto, Mikhael Belkovsky, Giulia V Zogaib, Carlo C Passerotti, Everson L A Artifon, Jose P Otoch, Jose A S Da Cruz","doi":"10.5173/ceju.2023.145","DOIUrl":"https://doi.org/10.5173/ceju.2023.145","url":null,"abstract":"<p><strong>Introduction: </strong>Robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (LS) are the main options for ileal ureteral replacement (IUR). It is not clear which option is superior. The purpose of this study is to compare RALS and LS for IUR.</p><p><strong>Material and methods: </strong>We searched MEDLINE, Embase, Web of Science, Scopus, Cochrane Central, and Google Scholar for studies comparing RALS and LS for IUR. The outcomes of interest are operative time, blood loss, postoperative stay, and Clavien-Dindo complications. Meta-analysis was performed with Rev Man version 5.4.</p><p><strong>Results: </strong>We included 36 patients from 3 studies. The mean age was 44 years, with 53% male patients. Blood loss (MD -89.13 cc, CI -129.03 to -49.22, I² = 0%) was significantly lower in patients undergoing RALS when comparing with LS. No differences were observed when comparing operative time (MD -10.99 minutes, CI -85.66 to 63.59, p = 0.77, I² = 64%), postoperative stay (MD -2.56 days, CI -8.24 to 3.13, p = 0.38, I² = 30%), and postoperative complications (OR 1.63, CI 0.27 to 10.02, p = 0.60, I² = 0%).</p><p><strong>Conclusions: </strong>Overall, we conclude that the robot-assisted technique showed less bleeding compared to the laparoscopic technique.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"304-309"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342545","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":"Safety and effectiveness of mirabegron for children and adolescents with refractory idiopathic overactive bladder for improving urinary symptoms: a systematic review.","authors":"Daniela Franco-Buenaventura, Herney Andrés García-Perdomo","doi":"10.5173/ceju.2023.237","DOIUrl":"https://doi.org/10.5173/ceju.2023.237","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to determine the safety and effectiveness of mirabegron in children with refractory overactive bladder (OAB) for improving urinary symptoms.</p><p><strong>Material and methods: </strong>We conducted a search strategy in MEDLINE (OVID), EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS from inception to September 2023. We performed a systematic review of studies evaluating the effectiveness of improving urinary symptoms and the safety of mirabegron at any dose in children and adolescents with idiopathic refractory OAB. We searched the interception to September 2023. The risk of bias was assessed using the Cochrane risk of bias tool for clinical trials and the MINORS tool for non-randomized studies.</p><p><strong>Results: </strong>We included three studies in the analysis. All of them included children and adolescents receiving mirabegron as monotherapy at different doses. Also, none of them reported a control group. Improvement and safety rates were high in every study in objective and subjective measurements. Compliance was also high in all studies. Most of the evaluated items had a low risk of bias within and across studies.</p><p><strong>Conclusions: </strong>Mirabegron as monotherapy appears to be a safe and effective alternative for children with refractory idiopathic OAB or those who are intolerant to antimuscarinic therapy.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"206-212"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342546","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":"Transurethral resection and other minimally invasive treatment options for BPH: would we treat ourselves as we treat our patients? Results from EAU Section of Uro-Technology (ESUT) decision-making survey among urologists.","authors":"Holly Colvin, Max Johnston, Francesco Ripa, Mriganka Mani Sinha, Amelia Pietropaolo, James Brewin, Christian Fiori, Ali Gozen, Bhaskar K Somani","doi":"10.5173/ceju.2023.278","DOIUrl":"https://doi.org/10.5173/ceju.2023.278","url":null,"abstract":"<p><strong>Introduction: </strong>With the introduction of novel treatment options for benign prostatic hyperplasia (BPH), decision making regarding surgical management has become ever more complex. Factors such as clinical exposure, equipment availability, patient characteristics and hospital setting may affect what treatment is offered and an informed patient choice. The aim of this study was to investigate how urologists help patients make decisions regarding BPH management and whether their practice would differ if they were the patient themselves.</p><p><strong>Material and methods: </strong>A 52-question survey presenting hypothetical clinical scenarios was distributed to European urologists and trainees/residents online and in person. In each scenario, regarding treatment options for BPH, the participant considered themselves firstly as the treating clinician and secondly as the patient themselves. Details regarding the participants' clinical experience, awareness of treatment options and exposure to these options were obtained.</p><p><strong>Results: </strong>There were 139 participants; 69.8% of whom were consultants, with 82.1% of participants having practiced urology for more than 5 years. A total of 59.7% of urologists consider themselves BPH specialists. Furthermore, 93.5% of those surveyed had performed transurethral resection of the prostate (TURP), whilst procedures performed the least by participants were minimally invasive surgical therapy (MIST) options. Only 17.3% had seen and 1.4% had performed all of the treatment options. When considering themselves as a patient within standard practice, there was a preference for HoLEP amongst participants.</p><p><strong>Conclusions: </strong>The majority of urologists surveyed had minimal experience to newer BPH techniques and MIST, suggesting that more exposure is required. A higher rate of HoLEP was chosen as a treatment option for urologists themselves as a patient than what they would choose as an option for their patients.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"243-255"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342551","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":"Baseline characteristics and clinical outcomes of prostate cancer patients on delayed palliative management: a PIONEER analysis based on big data.","authors":"Lana Yh Lai, Vasileios Sakalis, Christos Chatzichristos, Irene de la Parra, Carl Steinbeisser, Asieh Golozar, Bertrand de Meulder, Ayman Hijazy, Robert Snijder, Qi Feng, Thomas Falconer, Philip Cornford, Anders Bjartell, Susan Evans-Axelsson, James N'Dow, Giorgio Gandaglia, Juan Gómez Rivas","doi":"10.5173/ceju.2024.83","DOIUrl":"10.5173/ceju.2024.83","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed palliative management (DPM) is an alternative for prostate cancer (PCa) patients with poor performance status, or those who received radical treatment but progressed and no longer meet the criteria for curative treatment. PIONEER is a large network of federated data analytic platforms in PCa that aims to improve its care through the application of big data analytics. The objective of this study was to describe clinical baseline characteristics and outcomes of PCa patients receiving DPM using big data.</p><p><strong>Material and methods: </strong>Descriptive study of patients on DPM from four databases in PIONEER (Pharmetrics Plus, Optum Clinformatics, Marketscan and Columbia University Irving Medical Center (CUIMC)). Baseline characteristics, including comorbidities (hypertension, type 2 diabetes (T2DM), asthma/chronic obstructive pulmonary disease (COPD) and obesity), were stratified by age. Outcomes of interest were annual emergency department (ED) visits, hospitalization and symptomatic progression. Additional outcomes were time to death, hospitalization and time to symptomatic progression for CUIMC.</p><p><strong>Results: </strong>We included 13246 men with a median age of 68-75 and Charlson Comorbidity index of 6-8. The three most common comorbidities were hypertension (80-93% [>80 years] vs 69-80% [55-80 years] vs 59-64% [<55 years]), T2DM (29-41% [>80 years] vs 26-38% [55-80 years] vs 23-26% [<55 years] and asthma/COPD (28-37% [>80 years] vs 19-30% [55-80 years] vs 16-19% [<55 years]). ED visits and hospitalizations were highest in the first year of follow-up (19-33% and 21-48% respectively). The median time to death was 548 days (IQR 1265 days) and to symptomatic progression was 408 days (IQR 1125 days) in CUIMC.</p><p><strong>Conclusions: </strong>Men on DPM were in their mid-seventies, with the three most common comorbidities being hypertension, T2DM and asthma/COPD, regardless of age groups. This study reflects the potential of PIONEER as a federated network of databases that may be used to harness big data in PCa research.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"403-410"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669069","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":"Safety and efficacy of ureteroscopy and laser lithotripsy with a single-use 7.5Fr ureteroscope: a multicenter prospective pilot study.","authors":"Victoria Jahrreiss, Mahir Akram, Vincent De Coninck, Guido Kamphuis, Joyce Baard, Oriol Angerri, Esteban Emiliani, Sarah Schippers, Eva Van Bos, Kim Pauwaert, Thomas Tailly, Amelia Pietropaolo, Bhaskar Somani","doi":"10.5173/ceju.2024.85","DOIUrl":"10.5173/ceju.2024.85","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of kidney stone disease (KSD) has evolved significantly with the introduction of minimally invasive endourological techniques. Advancements in technology, particularly the transition from fibreoptic to digital and single use systems and the development of smaller-diameter instruments, has improved intraoperative view and efficacy in stone treatment. The miniaturization in single-use scopes represent a recent innovation, offering potential benefits, especially in challenging cases. However, there is limited evidence on their safety and clinical outcomes. This study aims to evaluate the efficacy and safety of stone treatment using a single-use 7.5 Fr flexible ureteroscope.</p><p><strong>Material and methods: </strong>Consecutive patients with urinary stones undergoing flexible ureteroscopy with a 7.5 Fr single-use flexible ureteroscope across five tertiary endourology centers were included. Data on patient demographics, stone characteristics, intra- and postoperative outcomes were prospectively collected and analyzed. Procedures were performed by experienced endourology surgeons following standard protocols.</p><p><strong>Results: </strong>50 patients with a mean age of 54.5 years (IQR: 25-65.8) and a male to female ratio of 34:16 underwent flexible ureteroscopy (FURS). Mean cumulative stone size was 18.9 mm (SD ±10.9 mm) with a mean stone volume of 2031.2 mm³ (SD ±2869.4 mm³) and mean Hounsfield units of 1087.4 (SD ±384.9). 36 (72%) had multiple stones and a bilateral FURS was performed in 9 cases (18%). 24 patients (48%) had a preoperative stent inserted. A ureteral access sheath was used in 22 (44%) cases and 46 (92%) patients had a postoperative stent inserted. The median operative time was 60min (IQR: 53-90), 32 patients (64%) were stone free after the first procedure (SFR for <2 cm and ≥2 cm stones was 85.2% and 36.2% respectively), perioperative and postoperative complications (Clavien ≤II) were observed in 3 patients (6%).</p><p><strong>Conclusions: </strong>This multicentric study demonstrates the safety and efficacy of using the 7.5Fr single-use flexible ureteroscope for urinary stone treatment. While the results are promising, larger studies are needed to validate these findings further.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"507-511"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669222","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":"Value of baseline PSA in predicting prostate cancer diagnosis and death. Spanish arm of the European Randomized Study of Screening for Prostate Cancer.","authors":"Alba María García-Cano-Fernández, Álvaro Páez Borda, Luis Llanes González, Marcos Luján Galán","doi":"10.5173/ceju.2024.31.R1","DOIUrl":"10.5173/ceju.2024.31.R1","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have suggested that prostate-specific antigen (PSA) in young men may predict the risk of developing prostate cancer (PC). Our aim is to study baseline PSA as a prognostic factor in the lifetime risk of developing PC, clinically significant PC (csPC), and metastatic PC (mPC), as well as to assess its impact on long-term mortality.</p><p><strong>Material and methods: </strong>This study was a retrospective analysis involving 2,415 men aged 45-70 years, all participants in the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). These men underwent PSA testing, and prostate biopsies were performed if their PSA levels were ≥3 ng/ml. The follow-up period spanned from September 2, 1996, to February 11, 2021. Kaplan-Meier survival analysis was conducted to calculate the probability of prostate cancer diagnosis and death. The relationship between these probabilities and baseline PSA levels was assessed using the log-rank test.</p><p><strong>Results: </strong>After 25 years of follow-up, the probability of being free of a diagnosis of PC was 95.5%, 89.6%, 80.0%, and 69.4%; and of PC death: 99.6%, 99.6%, 98.9%, and 98.3% for the categories of PSA <1 ng/ml, 1-1.9 ng/ml, 2-2.9 ng/ml, and >3 ng/ml, respectively. There is an association between baseline PSA level and the probability of PC diagnosis (which is maintained in age stratification), csPC, mPC (p <0.001), and PC death (p = 0.047).</p><p><strong>Conclusions: </strong>There is a clear relationship between baseline PSA and the probability of detection of PC, csPC and mPC during follow-up, as well as PC death, in a cohort belonging to the Spanish branch of the ERSPC, with a median follow-up of more than 23 years. Baseline PSA level can be used to define the most appropriate PC screening interval for everyone.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"383-388"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669228","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":"Lesion volume on multiparametric magnetic resonance imaging as a non-invasive prognosticator for clinically significant prostate cancer.","authors":"Manish Kumar Choudhary, Kaushik P Kolanukuduru, Neeraja Tillu, Ahmed Kotb, Zachary Dovey, Maurizio Buscarini, Osama Zaytoun","doi":"10.5173/ceju.2024.0157","DOIUrl":"https://doi.org/10.5173/ceju.2024.0157","url":null,"abstract":"<p><strong>Introduction: </strong>The association between prostate cancer (PCa) lesion volume on multiparametric magnetic resonance imaging (mpMRI) and clinically significant PCa (csPCa) remains a poorly studied aspect of diagnostic workup in patients with suspicion of PCa. The aim of this study was to assess the diagnostic value of mpMRI lesion volume in detecting csPCa.</p><p><strong>Material and methods: </strong>Patients with an elevated prostate-specific antigen (PSA) and suspicion of PCa underwent mpMRI as part of routine workup. Following this, patients underwent systematic and fusion targeted biopsy of the region of interest (ROI). All target lesions were sampled once in both axial and sagittal planes, with at least 2 cores per target. csPCa was defined as Gleason grade group ≥2, while highly suspicious lesions were considered as those with PI-RADS score ≥4. Multivariate logistic regression was performed for factors predicting csPCa.</p><p><strong>Results: </strong>Fifty men with a total of 108 mpMRI lesions were included, with a mean age of 71 ±6 years. 52% had prior negative biopsies. The mean lesion volume was 0.95 ±0.04 ml. Thirty-two patients (64%) had positive biopsies, among whom 20 had csPCa. Fifteen patients (30%) had highly suspicious PI-RADS lesions. Multivariate analysis demonstrated that capsular bulging, younger age, small prostate, highly suspicious lesions, high PSA density, and lesion volume >1mL were predictive of csPCa.</p><p><strong>Conclusions: </strong>Lesion volume on mpMRI may be used as a non-invasive indicator of csPCa. Future studies exploring the correlation between lesion volume and csPCa may enable patients to be monitored by non-invasive means, while ensuring early intervention when needed.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 4","pages":"592-598"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954879","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}