Central European Journal of Urology最新文献

{"title":"Postoperative complications, emergency department utilisation, and readmission after radical cystectomy.","authors":"Maxwell Sandberg, Claudia Marie-Costa, Rachel Vancavage, Emily Ye, Gavin Underwood, Rainer Rodriguez, Emily Roebuck, Sean Catley, Jorge Seoane, Arjun Choudhary, Stephen Tranchina, Ashok Hemal, Alejandro R Rodriguez","doi":"10.5173/ceju.2024.0166","DOIUrl":"https://doi.org/10.5173/ceju.2024.0166","url":null,"abstract":"<p><strong>Introduction: </strong>There is minimal research on the types of complications patients experience after radical cystectomy (RC). Moreover, the impact of these complications is not well qualified. The primary purpose of this study is to qualify complications after RC and quantify rates of emergency department (ED) utilisation and readmissions to the hospital. The secondary purpose is to associate risk factors for ED visits and hospital readmission.</p><p><strong>Material and methods: </strong>Patients were retrospectively analysed, who underwent RC for bladder cancer. ED visits within 90 days of discharge from RC and readmission at both 30 and 31-90 days of discharge were collected. Complications were graded using the Clavien-Dindo system and classified using the Memorial Sloan-Kettering Cancer Center complication system.</p><p><strong>Results: </strong>Three hundred and eighty-six patients were included. The in-house complication rate before discharge was 36%, and the 90-day complication rate after discharge was 54.8%. 33.7% of patients had ≥1 ED visit postoperatively, 18.7% were readmitted within 30 days, and 17.3% within 31-90 days of discharge. The primary reason for ED presentation, readmission at 30 and 31-90 days was infection. Cutaneous ureterostomy (CU) was associated with greater likelihood of presentation to the ED and readmission 31-90 days postoperatively (p <0.01). Overall survival (OS) was worse in patients who presented to the ED and/or were readmitted at both the 30- and 31-90-day marks (p <0.01).</p><p><strong>Conclusions: </strong>ED utilisation and readmission rates after RC are high. The most common complication is infection. Patients with a CU are at higher risk for healthcare utilisation. OS is worse in patients with an ED visit or readmission to the hospital, and these patients may require closer monitoring.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"5-13"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076295","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":"Prostate biopsy in patients without rectal access: a systematic review and proportional meta-analysis.","authors":"Konstantinos Kotrotsios, Konstantinos Douroumis, Panagiotis Katsikatsos, Evangelos Fragkiadis, Dionysios Mitropoulos","doi":"10.5173/ceju.2024.0097","DOIUrl":"https://doi.org/10.5173/ceju.2024.0097","url":null,"abstract":"<p><strong>Introduction: </strong>Historically, the anal canal plays a substantial role in both screening and diagnosis of pro-state cancer with digital rectal examination (DRE) and transrectal ultrasound (TRUS) guided biopsy, respectively. However, in patients with a prior history of abdominoperineal resection the transrectal route towards the prostate capsule cannot be utilized and thus alternative approaches have to be employed. The aim of this systematic review and proportional meta-analysis is to evaluate the available alternative prostate biopsy techniques in patients without rectal access.</p><p><strong>Material and methods: </strong>The systematic literature review was performed using MEDLINE, Scopus, EMBASE, and the CENTRAL register for randomized controlled trials (RCTs). The following search algorithm was used: \"resection of rectum\" OR \"abdominoperineal resection\" OR \"without rectal access\" AND \"prostate biopsy\" (PROSPERO 2023 CRD42023459080).</p><p><strong>Results: </strong>A total of 21 studies and 203 patients were included in this systematic review and meta-analysis, while 6 different prostate biopsy techniques were detected in the current literature. The transperineal approach under transperineal US (TPUS) and the transgluteal approach guided by computed tomography (CT) were associated with 0.74 [0.48; 0.94] and 0.70 [0.49; 0.89] pooled diagnostic yield estimates as well as 0.01 [0.00; 0.01] and 0 [0.00; 0.01] pooled complication rate estimates. The performance of multiparametric magnetic resonance imaging (mpMRI) prior to transgluteal CT-guided prostate biopsy seemed to significantly affect the biopsy result (p = 0.0002).</p><p><strong>Conclusions: </strong>Based on current data, the TPUS-guided prostate biopsy has the highest pooled diagnostic yield estimate. However, this conclusion is based on poor evidence and more reliable and well-organized studies are needed to thoroughly explore this problem.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"14-22"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076298","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":"Review of different convolutional neural networks used in segmentation of prostate during fusion biopsy.","authors":"Maciej Zwolski, Andrzej Kupilas, Przemysław Cnota","doi":"10.5173/ceju.2024.0064","DOIUrl":"https://doi.org/10.5173/ceju.2024.0064","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of prostate cancer is increasing in Poland, particularly due to the aging population. This review explores the potential of deep learning algorithms to accelerate prostate contouring during fusion biopsies, a time-consuming but crucial process for the precise diagnosis and appropriate therapeutic decision-making in prostate cancer. Implementing convolutional neural networks (CNNs) can significantly improve segmentation accuracy in multiparametric magnetic resonance imaging (mpMRI).</p><p><strong>Material and methods: </strong>A comprehensive literature review was conducted using PubMed and IEEE Xplore, focusing on open-access studies from the past five years, and following PRISMA 2020 guidelines. The review evaluates the enhancement of prostate contouring and segmentation in MRI for fusion biopsies using CNNs.</p><p><strong>Results: </strong>The results indicate that CNNs, particularly those utilizing the U-Net architecture, are predominantly selected for advanced medical image analysis. All the reviewed algorithms achieved a Dice similarity coefficient (DSC) above 74%, indicating high precision and effectiveness in automatic prostate segmentation. However, there was significant heterogeneity in the methods used to evaluate segmentation outcomes across different studies.</p><p><strong>Conclusions: </strong>This review underscores the need for developing and optimizing segmentation algorithms tailored to the specific needs of urologists performing fusion biopsies. Future research with larger cohorts is recommended to confirm these findings and further enhance the practical application of CNN-based segmentation tools in clinical settings.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"23-39"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076305","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":"Clinical, laboratory and ultrasonographic correlates of prostate calcifications in patients with chronic prostatitis/chronic pelvic pain syndrome.","authors":"Igor I Gorpynchenko, Kamil R Nurimanov, Tatiana V Poroshina, Victoria S Savchenko, Andrii M Leonenko, George M Drannik, Oleksandr V Shulyak","doi":"10.5173/ceju.2022.222","DOIUrl":"https://doi.org/10.5173/ceju.2022.222","url":null,"abstract":"<p><strong>Introduction: </strong>The research aim was to determine the role of clinical, laboratory, immunological and sonographic parameters in the development of an assessment tool for the symptomatic manifestations of prostate calcifications in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).</p><p><strong>Material and methods: </strong>All men underwent a transabdominal ultrasonographic examination using a grayscale B-mode and color Doppler mapping, the evaluation of the National Institutes of Health-Chronic Prostatitis Symptom Index and the Patient Health Questionnaire-9, spermogram. Vascular endothelial growth factor (VEGF), serotonin and gamma-aminobutyrate (GABA), interleukins 1β and 10 were determined in blood serum and ejaculate.</p><p><strong>Results: </strong>This study included 102 men aged 18-45 years. Group 1 (n = 34) consisted of patients with CP/CPPS. Group 2 included patients (n = 34) with asymptomatic prostatitis. Group 3 consisted of healthy volunteers (n = 34). More severe symptoms of prostatitis and depression, as well as frequent exacerbations in patients with CP/CPPS, were associated with ultrasound evidence of prostate calcifications, and especially the twinkling artifact (Spearman's r = 0.481; р <0.001; Spearman's r = 0.437; р <0.001, respectively).The presence of prostate calcifications in both CP/CPPS and asymptomatic prostatitis was accompanied by a significantly higher concentration of pro-inflammatory cytokine IL-1β and a lower concentration of anti-inflammatory cytokine IL-10 in the ejaculate (p < 0.05 in both cases, Kolmogorov-Smirnov test). The clinical manifestations observed in patients with CP/CPPS and asymptomatic prostatitis were not correlated with the leukocyte count in the ejaculate or the levels of VEGF, GABA, and serotonin in both blood and ejaculate.</p><p><strong>Conclusions: </strong>Twinkling artifact potentially could serve as a valuable tool for evaluating the condition of patients with CP/CPPS and prostate calcifications.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"225-234"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342530","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":"Is urethral stricture really so often idiopathic? Exploring the etiology of urethral strictures in males undergoing urethroplasty: a multicenter retrospective cohort study.","authors":"Łukasz Białek, Marta Rydzińska, Mikołaj Frankiewicz, Adam Kałużny, Jakub Dobruch, Marcin Matuszewski, Michał Skrzypczyk","doi":"10.5173/ceju.2023.261R","DOIUrl":"https://doi.org/10.5173/ceju.2023.261R","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to retrospectively evaluate the etiology of urethral stricture disease (USD) in a large series of patients undergoing urethroplasty.</p><p><strong>Material and methods: </strong>The multicenter retrospective cohort study was conducted at two reconstructive urology referral centers in years 2015-2022. Prior to the surgical intervention, all patients underwent diagnostic procedures including retrograde urethrography and voiding cystourethrography. We collected comprehensive demographic and medical data including the length and location of the stricture. We paid particular attention to identifying the underlying causes of USD in the medical records.</p><p><strong>Results: </strong>The study included 949 patients meeting criteria, with a mean age of 53. The primary cause of USD was identified as iatrogenic (404 cases, 42.6%), followed by trauma (210, 22.1%), previous hypospadias repair (122, 12.9%), lichen sclerosus (32, 3.4%), and infections (12, 1.3%). Notably, 169 patients (17.8%) did not have a discernible cause for their USD and were thus classified as idiopathic. Furthermore, it was observed that 66% of idiopathic USD cases were localized in the bulbar urethra. The etiology of USD varied significantly based on its localization (p <0.01). The mean stricture length differed among different causes, with the longest in patients with USD due to lichen sclerosus (41 mm), followed by previous hypospadias repair (35 mm), and iatrogenic causes (29 mm), p <0.001.</p><p><strong>Conclusions: </strong>Careful medical history-taking can identify the etiology of urethral stricture in over 80% of patients undergoing urethroplasty. The etiology of the USD impacts its location and length and thus can affect surgical treatment strategy and outcomes.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"320-325"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342536","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":"The use of indocyanine green in partial nephrectomy: a systematic review.","authors":"Stamatios Katsimperis, Lazaros Tzelves, Themistoklis Bellos, Ioannis Manolitsis, Panagiotis Mourmouris, Nikolaos Kostakopoulos, Nikolaos Pyrgidis, Bhaskar Somani, Athanasios Papatsoris, Andreas Skolarikos","doi":"10.5173/ceju.2023.155","DOIUrl":"https://doi.org/10.5173/ceju.2023.155","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this review was to assess the outcomes of partial nephrectomy using indocyanine green (ICG) regarding ischemia time, positive surgical margins (PSM), estimated blood loss (EBL) and estimated GFR reduction while also suggesting the optimal dosage scheme.</p><p><strong>Material and methods: </strong>A systematic review was performed using Medline (PubMed), ClinicalTrials.gov, and Cochrane Library (CENTRAL) databases, in concordance with the PRISMA statement. Studies in English regarding the use of indocyanine green in partial nephrectomy were reviewed. Reviews and meta-analyses, editorials, perspectives, and letters to the editors were excluded.</p><p><strong>Results: </strong>Individual ICG dose was 5 mg in most of the studies. The mean warm ischemia time (WIT) on each study ranged from 11.6 minutes to 27.2 minutes. The reported eGFR reduction ranged from 0% to 15.47%. Lowest mean EBL rate was 48.2 ml and the highest was 347 ml. Positive surgical margin rates were between 0.3% to 11%.</p><p><strong>Conclusions: </strong>Indocyanine green seems to be a useful tool in partial nephrectomy as it can assist surgeons in identifying tumor and its related vasculature. Thereby, warm ischemia time can be reduced and, in some cases, selective ischemia can be implemented leading to better renal functional preservation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"15-21"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849939","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":"The role of gel-infused translabial ultrasound as a new modality in evaluation of female urethral stricture.","authors":"Nastaran Mahmoudnejad, Alireza Abrishami, Farzaneh Sharifiaghdas, Ramin Borabadi, Mehdi Dadpour, Amirhossein Nayebzade, Mehdi Khazaei","doi":"10.5173/ceju.2024.168","DOIUrl":"https://doi.org/10.5173/ceju.2024.168","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the role of trans-labial ultrasound study in detection of female urethral stenosis (FUS) compared to former cysto-urethroscopy as the currently available definitive diagnostic modality.</p><p><strong>Material and methods: </strong>In this cross-sectional study, 60 consecutive patients with bladder outlet obstruction diagnosed by clinical symptoms and urodynamic study, were included from 2019 to 2022. For additional assessment, all these patients underwent gel-Infused trans-labial ultrasound (GITLUS) and cystourethroscopy. Trans-labial real-time ultrasonography was performed following the insertion of 20 ml steady stream viscous jelly into the urethral meatus to assess the length of the urethra and exact location and length of the probable narrowing, as well as the presence of peri-urethral fibrosis (PUF).</p><p><strong>Results: </strong>In GITLUS evaluation, urethral stricture was found in 27 patients. Mean urethral length and stricture length were 35.63 ±4.78 and 17.04 ±10.59, respectively. All these stenosis were confirmed via cysto-urethroscopy. PUF was found in 20 of 27 patients. In cysto-urethroscopy, urethral stricture was confirmed in 40 patients: 13 in urethral meatus and 27 in other parts or pan-urethra. GITLUS could not reveal urethral stricture in 13 patients with meatal stenosis, confirmed with cystoscopy. GITLUS detected FUS less accurately when it involves pure distal urethra compared to other parts of urethra or pan-urethral stenosis (p value = 0.002).</p><p><strong>Conclusions: </strong>GITLUS is a safe, non-invasive, and valuable technique for detecting FUS. The location and the length of the stricture and probable peri-urethral fibrosis can be identified by this method. However, in meatal or pure short-length distal urethral strictures, this method should be used with caution.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"152-156"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847539","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":"Initial experience of the Versius robotic system in robot-assisted radical prostatectomy: a study of 58 cases.","authors":"Wojciech Polom, Marcin Matuszewski","doi":"10.5173/ceju.2023.241","DOIUrl":"https://doi.org/10.5173/ceju.2023.241","url":null,"abstract":"<p><strong>Introduction: </strong>The study presents the initial outcomes of robot-assisted radical prostatectomies (RARPs) using the Versius robotic system in a urological centre with no prior robotic surgery experience.</p><p><strong>Material and methods: </strong>A retrospective analysis of 58 RARPs was conducted, including patients' parameters as well as Versius system performance.</p><p><strong>Results: </strong>The study involved 58 patients (average age 66.9 years). Median preoperative prostate specific antigen (PSA) was 9.8 ng/ml, with 48% having ISUP grade group ≥ 3 on biopsy and 25.8% showing extraprostatic extension on MRI. Median blood loss was 437 ml, with complications (10.3% Clavien-Dindo grade II and 4 grade III cases). One conversion to open surgery occurred (0.58%). Final pathology revealed 46.5% extraprostatic disease, and 25.8% had positive margins. Post-surgery, 96.5% had undetectable PSA at 6 weeks. Continence rates were 89.7% at 6 weeks, increasing to 91.3% at 12 months. Median catheter duration was 7.9 days, and the hospital stay was 4.5 days. Console time averaged 150.9 minutes, with a median operative time of 213 minutes. The Versius system reported medium priority alarms in 24.1% of operations, including 1266 alarms related to robotic arm clashes and 43 instrument swaps. One bedside unit exchange occurred with no console or robotic system failures.</p><p><strong>Conclusions: </strong>The Versius robotic system can be successfully introduced in a urological centre without prior robotic surgery experience. Our setup and operating room positioning are effective, safe, and reproducible. We encountered and resolved surgical and technical challenges. Further follow-up studies are needed to assess the system's performance.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"30-36"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859554","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":"Efficacy and safety of photoselective vaporization of the prostate using the Greenlight XPS 180W laser and simple prostatectomy for high-volume prostate hypertrophy: a comparative analysis.","authors":"Hubert Burdziak, Tomasz Syryło, Agnieszka Grabińska, Karol Burdziak, Janusz Ławiński, Monika Tomaka, Henryk Zieliński","doi":"10.5173/ceju.2023.191","DOIUrl":"https://doi.org/10.5173/ceju.2023.191","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the safety and efficacy of treatment using simple prostatectomy (SP) and using photoselective vaporization of the prostate (PVP) with a 180W GreenLight XPS laser in patients with high-volume prostate hypertrophy.</p><p><strong>Material and methods: </strong>The study included 120 patients with LUTS symptoms caused by prostatic enlargement of more than 80 ml; 79 patients were treated with SP, while 41 were treated with PVP. The analysis included subjective the International Prostate Symptom Score (IPSS) and Quality of Life (QoL), and objective (Qmax), (Qave), and post-void residual volume (PVR) parameters before treatment and at an average of 38 months after surgical treatment. Early and late adverse effects and length of hospitalisation were assessed. Complication reports were performed according to the modified Clavien-Dindo system.</p><p><strong>Results: </strong>The analysis independently showed the effectiveness of both methods. Subjective parameters (IPSS, QoL), showed no significant differences. Patients treated with SP scored slightly better on objective parameters (Qmax, Qave, and PVR). Analysis of adverse effects and hospitalisation time were more favourable after PVP.</p><p><strong>Conclusions: </strong>SP and PVP were found to be comparable and highly effective in treating benign prostatic hyperplasia in terms of IPSS and QoL. Patients treated with the SP method obtained slightly better results of objective parameters such as Qmax, Qave, and PVR. Compared with SP, PVP has a more favourable safety profile.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"64-76"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859928","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":"Prostate cancer genetic background. The introduction of genetic testing in the determination of high-risk prostate cancer cases and selection of targeted chemotherapy in advanced prostate cancer patients.","authors":"Jakub Kazik","doi":"10.5173/ceju.2024.0049","DOIUrl":"https://doi.org/10.5173/ceju.2024.0049","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer (PCa) is a major challenge in urology, with increasing incidence and mortality. Despite advances in diagnosis and treatment, certain patient groups remain poorly served. Genetic factors, particularly in hereditary prostate cancer (HPCa), are now recognized as significant contributors to disease progression. This review focuses on the role of genetic mutations in PCa, their impact on diagnosis, and management.</p><p><strong>Material and methods: </strong>This review summarizes current literature on genetic mutations linked to PCa, including <i>BRCA1, BRCA2, ATM, CHEK2</i>, and others. These mutations are associated with more aggressive disease, earlier onset, and may influence treatment strategies. Guidelines from the Philadelphia Prostate Cancer Consensus Conference (PPCCC), the American National Comprehensive Cancer Network (NCCN), and the European Association of Urology (EAU) on genetic testing are also discussed.</p><p><strong>Results: </strong>Genetic screening is increasingly recommended for high-risk individuals, such as those with a family history or aggressive PCa. Identifying mutations allows for early detection and tailored treatment, including more frequent screening and targeted therapies. Specific mutations, like those in <i>BRCA</i> genes, can benefit from chemotherapy in advanced stages. Genetic testing provides valuable information to guide patient management, improving early detection and patient outcomes.</p><p><strong>Conclusions: </strong>Genetic testing plays a crucial role in PCa management, enabling personalized care for high-risk patients. As genetic research advances, incorporating genetic screening into clinical practice will enhance early diagnosis and treatment outcomes, ultimately improving patient survival and quality of life.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 4","pages":"625-636"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983288","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}