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UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)                     

Showing 1 - 144 of 144 Journals sorted alphabetically
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Hybrid Journal   (Followers: 15)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access   (Followers: 1)
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 53)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 31)
Andrologia     Hybrid Journal   (Followers: 3)
Andrology     Hybrid Journal   (Followers: 5)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 8)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 2)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access   (Followers: 1)
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Asian Pediatric Nephrology Association     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 19)
BJUI Compass     Open Access   (Followers: 1)
BMC Nephrology     Open Access   (Followers: 9)
BMC Urology     Open Access   (Followers: 13)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 7)
Canadian Urological Association Journal     Open Access   (Followers: 1)
Cancer Urology     Open Access   (Followers: 1)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 6)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 8)
Case Reports in Urology     Open Access   (Followers: 11)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 5)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 24)
Clinical Kidney Journal     Open Access   (Followers: 5)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Cuadernos de Cirugía     Open Access  
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 12)
Current Opinion in Urology     Hybrid Journal   (Followers: 11)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access  
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Hybrid Journal   (Followers: 23)
European Urology Focus     Hybrid Journal   (Followers: 4)
European Urology Oncology     Hybrid Journal  
European Urology Open Science     Open Access   (Followers: 8)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Hellenic Urology     Open Access   (Followers: 3)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 10)
International Urology and Nephrology     Hybrid Journal   (Followers: 6)
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 12)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 1)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 5)
Journal of Nephrology Research     Open Access   (Followers: 2)
Journal of Pediatric Nephrology     Open Access   (Followers: 3)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 8)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 2)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 38)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Urology & Nephrology     Open Access  
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 52)
Kidney International Reports     Open Access   (Followers: 6)
Kidney Medicine     Open Access   (Followers: 1)
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access  
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 29)
Nature Reviews Urology     Full-text available via subscription   (Followers: 9)
Nefrología     Open Access  
Nefrología (English Edition)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 26)
Nephron     Hybrid Journal   (Followers: 3)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 3)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 4)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Paediatric Nephrology Journal of Bangladesh     Open Access   (Followers: 4)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 4)
Renal Failure     Open Access   (Followers: 11)
Renal Replacement Therapy     Open Access   (Followers: 3)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access  
Revista Urologia Colombiana     Open Access  
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 6)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Urology     Open Access   (Followers: 3)
Translational Research in Urology     Open Access   (Followers: 1)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Urine     Open Access  
Uro-News     Hybrid Journal  
Urolithiasis     Hybrid Journal   (Followers: 1)
Urologia Internationalis     Full-text available via subscription   (Followers: 1)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 3)
Urologic Nursing     Full-text available via subscription   (Followers: 3)
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 26)
Urology Case Reports     Open Access   (Followers: 3)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access  
World Journal of Nephrology and Urology     Open Access   (Followers: 5)
World Journal of Urology     Hybrid Journal   (Followers: 10)


Similar Journals
Journal Cover
Therapeutic Advances in Urology
Journal Prestige (SJR): 1.171
Citation Impact (citeScore): 3
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1756-2872 - ISSN (Online) 1756-2880
Published by Sage Publications Homepage  [1174 journals]
  • Nanotechnology as a tool to advance research and treatment of
           non-oncologic urogenital diseases

    • Authors: Justin Loloi, Mustufa Babar, Kelvin P. Davies, Sylvia O. Suadicani
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Nanotechnology represents an expanding area of research and innovation in almost every field of science, including Medicine, where nanomaterial-based products have been developed for diagnostic and therapeutic applications. Because of their small, nanoscale size, these materials exhibit unique physical and chemical properties that differ from those of each component when considered in bulk. In Nanomedicine, there is an increasing interest in harnessing these unique properties to engineer nanocarriers for the delivery of therapeutic agents. Nano-based drug delivery platforms have many advantages over conventional drug administration routes as this technology allows for local and transdermal applications of therapeutics that can bypass the first-pass metabolism, improves drug efficacy through encapsulation of hydrophobic drugs, and allows for a sustained and controlled release of encapsulated agents. In Urology, nano-based drug delivery platforms have been extensively investigated and implemented for cancer treatment. However, there is also great potential for use of nanotechnology to treat non-oncologic urogenital diseases. We provide an update on research that is paving the way for clinical translation of nanotechnology in the areas of erectile dysfunction (ED), overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), and catheter-associated urinary tract infections (CAUTIs). Overall, preclinical and clinical studies have proven the utility of nanomaterials both as vehicles for transdermal and intravesical delivery of therapeutic agents and for urinary catheter formulation with antimicrobial agents to treat non-oncologic urogenital diseases. Although clinical translation will be dependent on overcoming regulatory challenges, it is inevitable before there is universal adoption of this technology to treat non-oncologic urogenital diseases.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-07-27T05:47:09Z
      DOI: 10.1177/17562872221109023
      Issue No: Vol. 14 (2022)
  • An optimized prostate biopsy strategy in patients with a unilateral lesion
           on prostate magnetic resonance imaging avoids unnecessary biopsies

    • Authors: Auke Jager, Luigi A.M.J.G. van Riel, Arnoud. W. Postema, Theo M. de Reijke, Tim M. van der Sluis, Jorg R. Oddens
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Purpose:The introduction of magnetic resonance imaging (MRI)-targeted biopsy (TBx) besides systematic prostate biopsies has resulted in a discussion on what the optimal prostate biopsy strategy is. The ideal template has high sensitivity for clinically significant prostate cancer (csPCa), while reducing the detection rate of clinically insignificant prostate cancer (iPCa). This study evaluates different biopsy strategies in patients with a unilateral prostate MRI lesion.Methods:Retrospective subgroup analysis of a prospectively managed database consisting of patients undergoing prostate biopsy in two academic centres. Patients with a unilateral lesion (PI-RADS ⩾ 3) on MRI were included for analysis. The primary objective was to evaluate the diagnostic performance for different biopsy approaches compared with bilateral systematic prostate biopsy (SBx) and TBx. Detection rates for csPCa (ISUP ⩾ 2), adjusted csPCa (ISUP ⩾ 3) and iPCa (ISUP = 1) were determined for SBx alone, TBx alone, contralateral SBx combined with TBx and ipsilateral SBx combined with TBx. A subgroup analysis was performed for biopsy-naive patients.Results:A total of 228 patients were included from October 2015 to September 2021. Prostate cancer (PCa) detection rate of combined SBx and TBx was 63.5% for csPCa, 35.5% for adjusted csPCa, and 14% for iPCa. The best performing alternative biopsy strategy was TBx and ipsilateral SBx, which reached a sensitivity of 98.6% (95% CI: 95.1–99.6) for csPCa and 98.8% (95% CI: 96.3–99.9) for adjusted csPCa, missing only 1.4% of csPCa, while reducing iPCa detection by 15.6% compared with SBx and TBx. TBx or SBx alone missed a significant amount of csPCa, with sensitivities of 90.3% (95% CI: 84.4–94.2) and 86.8% (95% CI: 80.4–91.4) for csPCa. Subgroup analysis on biopsy-naive patients showed similar results as the overall group.Conclusion:This study shows that performing TBx with ipsilateral SBx and omitting contralateral SBx is the optimal biopsy strategy in patients with a unilateral MRI lesion. With this strategy, a very limited amount of csPCa is missed and iPCa detection is reduced.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-07-26T12:41:29Z
      DOI: 10.1177/17562872221111410
      Issue No: Vol. 14 (2022)
  • Role of multi-parametric magnetic resonance imaging fusion biopsy in
           active surveillance of prostate cancer: a systematic review

    • Authors: Elizabeth E. Ellis, Thomas P. Frye
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Background:Our goal is to review current literature regarding the role of multi-parametric magnetic resonance imaging (mpMRI) in the active surveillance (AS) of prostate cancer (PCa) and identify trends in rate of reclassification of risk category, performance of fusion biopsy (FB) versus systematic biopsy (SB), and progression-free survival.Methods:We performed a comprehensive literature search in PubMed and identified 121 articles. A narrative summary was performed.Results:Thirty-two articles were chosen to be featured in this review. SB and FB are complementary in detecting higher-grade disease in follow-up. While FB was more likely than SB to detect clinically significant disease, FB missed 6.4–11% of clinically significant disease. Imaging factors that predicted upgrading include number of lesions on magnetic resonance imaging (MRI), lesion density, and MRI suspicion level.Conclusion:Incorporating mpMRI FB in conjunction with SB should be part of contemporary AS protocols. mpMRI should additionally be used routinely for follow-up; however, mpMRI is not currently sensitive enough in detecting disease progression to replace biopsy in the surveillance protocol.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-07-18T10:43:29Z
      DOI: 10.1177/17562872221106883
      Issue No: Vol. 14 (2022)
  • Updates on enhanced recovery after surgery for radical cystectomy

    • Authors: Grace Lee, Hiren V. Patel, Arnav Srivastava, Saum Ghodoussipour
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Enhanced Recovery after Surgery (ERAS) is a multimodal pathway that provides evidence-based guidance for improving perioperative care and outcomes in patients undergoing surgery. In 2013, the ERAS society released its original guidelines for radical cystectomy (RC) for bladder cancer (BC), adopting much of its supporting data from colorectal literature. In the last decade, growing interest in ERAS has increased RC-specific ERAS research, including prospective randomized controlled trials (RCTs). Collective data suggest ERAS contributes to improved complication rates, decreased hospital length-of-stay, and/or time to bowel recovery. Various institutions have adopted modified versions of the ERAS pathway, yet there remains a lack of consensus on the efficacy of specific ERAS items and standardization of the protocol. In this review, we summarize updated evidence and practice patterns of ERAS pathways for RC since the introduction of the original 2013 guidelines. Novel target interventions, including use of immunonutrition, prehabilitation, alvimopan, and methods of local analgesia are reviewed. Finally, we discuss barriers to implementing and future steps in advancing the ERAS movement.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-07-12T09:55:19Z
      DOI: 10.1177/17562872221109022
      Issue No: Vol. 14 (2022)
  • Radiomics in prostate cancer: an up-to-date review

    • Authors: Matteo Ferro, Ottavio de Cobelli, Gennaro Musi, Francesco del Giudice, Giuseppe Carrieri, Gian Maria Busetto, Ugo Giovanni Falagario, Alessandro Sciarra, Martina Maggi, Felice Crocetto, Biagio Barone, Vincenzo Francesco Caputo, Michele Marchioni, Giuseppe Lucarelli, Ciro Imbimbo, Francesco Alessandro Mistretta, Stefano Luzzago, Mihai Dorin Vartolomei, Luigi Cormio, Riccardo Autorino, Octavian Sabin Tătaru
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Prostate cancer (PCa) is the most common worldwide diagnosed malignancy in male population. The diagnosis, the identification of aggressive disease, and the post-treatment follow-up needs a more comprehensive and holistic approach. Radiomics is the extraction and interpretation of images phenotypes in a quantitative manner. Radiomics may give an advantage through advancements in imaging modalities and through the potential power of artificial intelligence techniques by translating those features into clinical outcome prediction. This article gives an overview on the current evidence of methodology and reviews the available literature on radiomics in PCa patients, highlighting its potential for personalized treatment and future applications.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-07-05T06:44:43Z
      DOI: 10.1177/17562872221109020
      Issue No: Vol. 14 (2022)
  • Understanding and managing the suppression of spermatogenesis caused by
           testosterone replacement therapy (TRT) and anabolic–androgenic steroids

    • Authors: Ankit Desai, Musaab Yassin, Axel Cayetano, Tharu Tharakan, Channa N. Jayasena, Suks Minhas
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Use of testosterone replacement therapy (TRT) and anabolic–androgenic steroids (AAS) has increased over the last 20 years, coinciding with an increase in men presenting with infertility and hypogonadism. Both agents have a detrimental effect on spermatogenesis and pose a clinical challenge in the setting of hypogonadism and infertility. Adding to this challenge is the paucity of data describing recovery of spermatogenesis on stopping such agents. The unwanted systemic side effects of these agents have driven the development of novel agents such as selective androgen receptor modulators (SARMs). Data showing natural recovery of spermatogenesis following cessation of TRT are limited to observational studies. Largely, these have shown spontaneous recovery of spermatogenesis after cessation. Contemporary literature suggests the time frame for this recovery is highly variable and dependent on several factors including baseline testicular function, duration of drug use and age at cessation. In some men, drug cessation alone may not achieve spontaneous recovery, necessitating hormonal stimulation with selective oestrogen receptor modulators (SERMs)/gonadotropin therapy or even the need for assisted reproductive techniques. However, there are limited prospective randomized data on the role of hormonal stimulation in this clinical setting. The use of hormonal stimulation with agents such as gonadotropins, SERMs, aromatase inhibitors and assisted reproductive techniques should form part of the counselling process in this cohort of hypogonadal infertile men. Moreover, counselling men regarding the detrimental effects of TRT/AAS on fertility is very important, as is the need for robust randomized studies assessing the long-term effects of novel agents such as SARMs and the true efficacy of gonadotropins in promoting recovery of spermatogenesis.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-06-27T06:02:57Z
      DOI: 10.1177/17562872221105017
      Issue No: Vol. 14 (2022)
  • Schema and cancer detection rates for transperineal prostate biopsy
           templates: a review

    • Authors: Abhinav Sidana, Fernando Blank, Hannah Wang, Nilesh Patil, Arvin K. George, Hasan Abbas
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Prostate cancer (PCa) is the most common noncutaneous malignancy in men and is the second leading cause of cancer mortality in men in the United States. Current practice requires histopathological confirmation of cancer achieved through biopsy for diagnosis. The transrectal approach for prostate biopsy has been the standard for several decades. However, the risks and limitations of transrectal biopsies have led to a recent resurgence of transperineal prostatic biopsies. Recent studies have demonstrated the transperineal approach for prostate biopsies to be effective, associated with minimal complications and superior in several aspects to traditional transrectal biopsies. While sextant and extended sextant templates are widely accepted templates for transrectal biopsy, there are a diverse set of transperineal biopsy templates available for use, without consensus on the optimal sampling strategy. We aim to critically appraise the salient features of established transperineal biopsy templates.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-06-27T06:02:42Z
      DOI: 10.1177/17562872221105019
      Issue No: Vol. 14 (2022)
  • Role of molecular imaging in the detection of localized prostate cancer

    • Authors: Samuel J. Galgano, Janelle T. West, Soroush Rais-Bahrami
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Molecular imaging of prostate cancer continues to grow, with recent inclusion of several positron emission tomography (PET) radiotracers into the recent National Comprehensive Cancer Network guidelines and the US Food and Drug Administration approval of prostate-specific membrane antigen (PSMA)-targeted radiotracers. While much of the work for many of these radiotracers is focused on systemic staging and restaging in both newly diagnosed high-risk prostate cancer and biochemically recurrent disease patients, the potential role of molecular imaging for the detection of localized prostate cancer has not yet been fully established. The primary aim of this article will be to present the potential role for molecular imaging in the detection of localized prostate cancer and discuss potential advantages and disadvantages to utilization of both PET/computed tomography (CT) and PET/magnetic resonance imaging (MRI) for this clinical indication of use.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-06-21T12:16:54Z
      DOI: 10.1177/17562872221105018
      Issue No: Vol. 14 (2022)
  • Biomarkers for prostate cancer detection and risk stratification

    • Authors: Mark W. Farha, Simpa S. Salami
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Although prostate cancer (PCa) is the most commonly diagnosed cancer in men, most patients do not die from the disease. Prostate specific antigen (PSA), the most widely used oncologic biomarker, has revolutionized screening and early detection, resulting in reduced proportion of patients presenting with advanced disease. However, given the inherent limitations of PSA, additional diagnostic and prognostic tools are needed to facilitate early detection and accurate risk stratification of disease. Serum, urine, and tissue-based biomarkers are increasingly being incorporated into the clinical care paradigm, but there is still a limited understanding of how to use them most effectively. In the current article, we review test characteristics and clinical performance data for both serum [4 K score, prostate health index (phi)] and urine [SelectMDx, ExoDx Prostate Intelliscore, MyProstateScore (MPS), and PCa antigen 3 (PCA3)] biomarkers to aid decisions regarding initial or repeat biopsies as well as tissue-based biomarkers (Confirm MDx, Decipher, Oncotype Dx, and Polaris) aimed at risk stratifying patients and identifying those patients most likely to benefit from treatment versus surveillance or monotherapy versus multi-modal therapy.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-06-14T08:54:27Z
      DOI: 10.1177/17562872221103988
      Issue No: Vol. 14 (2022)
  • Pentosan polysulfate in patients with bladder pain syndrome/interstitial
           cystitis with Hunner’s lesions or glomerulations: systematic review and

    • Authors: Bagrat Grigoryan, George Kasyan, Laura Pivazyan, Dmitry Pushkar
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Background:Bladder pain syndrome/interstitial cystitis (BPS/IC) is a persistent pain perceived in the urinary bladder region, accompanied by at least one symptom, such as pain worsening with bladder filling and daytime or nighttime urinary frequency without any proven infection or obvious pathology. The aim of this study is to evaluate the efficacy and safety of pentosan polysulfate (PPS) in patients with BPS/IC.Methods:Systematic search was performed by PRISMA checklist. Electronic databases, including PubMed and Cochrane library, were checked until 2021 using keywords: ‘pentosan polysulfate’, ‘pain syndrome’, ‘interstitial cystitis’, and bibliography of relevant papers was checked.Inclusion criteria:Patients with confirmed diagnosis of BPS/IC and cystoscopy criteria – Hunner’s lesions. Exclusion criteria included hypersensitivity, pregnancy, lactation, and oral therapy for BPS/IC in the period of 1 month before the study and abstracts or unpublished papers.Results:In total, 13 clinical trials were included in systematic review and 7 were included in meta-analysis. Studies evaluated the effectiveness and safety of oral PPS versus placebo or other treatment options. In the first meta-analysis, three studies compared oral PPS with placebo: [relative risk (RR) = 2.07, 95% confidence interval (CI): 1.37–3.13, p = 0.0006]. The second meta-analysis of two studies compared oral PPS with another treatment options (intravesical liposome and CyA): (RR = 0.44, 95% CI: 0.10–1.93, p = 0.28). The third meta-analysis of two studies included intravesical regimen of PPS compared with intravesical placebo: (RR = 1.09, 95% CI: 0.54–2.22, p = 0.80). The majority of studies do not report any particular serious side effects.Conclusion:PPS treatment has a statistically significant effect over placebo on the subjective improvement of patients with BPS/IC. There was no difference between PPS and other treatment options. Intravesical regimen of PPS had no significant impact on response rates. None of included studies reported severe side effects after intervention.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-06-02T07:07:12Z
      DOI: 10.1177/17562872221102809
      Issue No: Vol. 14 (2022)
  • Role of low- versus high-power laser in the treatment of lower pole
           stones: prospective non-randomized outcomes from a university teaching

    • Authors: Amelia Pietropaolo, Mriganka Mani, Thomas Hughes, Bhaskar K. Somani
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Introduction:Ureteroscopy and laser stone fragmentation [flexible ureteroscopy and laser lithotripsy (FURSL)] has risen over the last two decades. Laser technology has also evolved over the time, shifting from low- to high-power lasers with the addition of MOSES technology that allows for ‘dusting and pop-dusting’ of stones. The aim of the study was to look at the outcomes of FURSL in lower pole stones (LPS) using low- and high-power lasers.Patient and Methods:In this study, we compared the outcomes of low-power holmium laser (group A, 20 W) and high-power holmium laser (group B, including both 60 W MOSES integrated system and 100 W lasers) for all patients with LPS treated with laser lithotripsy. Data were collected for patient demographics, stone location, size, pre- and postoperative stent, length of stay, complications and stone free rate (SFR).Results:A total of 284 patients who underwent FURSL procedure for LPS were analysed (168 group A, 116 group B). Outcomes showed that compared with group A, group B had a higher SFR (91.6% versus 96.5%, p = 0.13) and shorter operative time (52 versus 38 min, p 
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-26T07:19:51Z
      DOI: 10.1177/17562872221097345
      Issue No: Vol. 14 (2022)
  • Hundred years of transperineal prostate biopsy

    • Authors: Benjamin Schmeusser, Brandon Levin, Daniel Lama, Abhinav Sidana
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      The earliest recorded efforts to biopsy prostate, in the early 20th century, were made through transperineal (TP) approach, with open perineal prostate biopsy (PBx) being considered the gold standard for prostate cancer (PCa) diagnosis in that era. Later, to minimize morbidity and increase diagnostic accuracy, several technical modifications and transrectal ultrasound (TRUS) assistance were incorporated. However, in the 1980s, the transrectal (TR) approach became the predominant PBx method following the introduction of TRUS-TR PBx with sextant sampling, providing a convenient and efficacious method for prostate sampling. With modernization of PCa diagnosis, a recent resurgence of the TP PBx has been observed, driven primarily by TR drawbacks of infectious complications and sampling limitations. TP PBx is rapidly emerging as the new PBx standard, being officially recommended as the initial approach for biopsy in Europe and is increasingly being conducted and studied in the United States. The modern era of TP PBx is based on the improvements in local anesthesia techniques, TP access systems, and robotic assistance. These modifications and advancements have improved the ease of use, patient comfort, and diagnostic outcomes with TP PBx. Herein, we present a history of the evolution of TP PBx spanning over 100 years and explore the basis of the technique that merits future utilization.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-21T08:33:19Z
      DOI: 10.1177/17562872221100590
      Issue No: Vol. 14 (2022)
  • Inflammatory myofibroblastic tumour of the bladder: a case report and
           review of the literature

    • Authors: Bernard Marais, Paula Eyal, Ken Kesner, Jeff John
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Inflammatory myofibroblastic tumours (IMTs) are rare neoplasms of uncertain malignant potential that closely resemble other more aggressive spindle cell tumours. The distinction of IMT from the latter is of importance. We report a case of IMT in a 27-year-old man who presented with intermittent painless, macroscopic haematuria and was found to have a large bladder mass arising from the dome of the bladder. The tumour was resected transurethrally, and histology and immunohistochemistry were consistent with an IMT of the bladder. Our patient remained asymptomatic at follow-up 3 months later, when cystoscopy noted no regrowth of the residual tumour. Transurethral resection resection of bladder tumour, partial cystectomy and radical cystectomy form the mainstay of treatment of IMT. However, the optimal management of this condition remains uncertain due to the sparsity of reported cases.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-17T07:25:52Z
      DOI: 10.1177/17562872221096385
      Issue No: Vol. 14 (2022)
  • Integration of magnetic resonance imaging into prostate cancer nomograms

    • Authors: Garrett J. Brinkley, Andrew M. Fang, Soroush Rais-Bahrami
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      The decision whether to undergo prostate biopsy must be carefully weighed. Nomograms have widely been utilized as risk calculators to improve the identification of prostate cancer by weighing several clinical factors. The recent inclusion of multiparametric magnetic resonance imaging (mpMRI) findings into nomograms has drastically improved their nomogram’s accuracy at identifying clinically significant prostate cancer. Several novel nomograms have incorporated mpMRI to aid in the decision-making process in proceeding with a prostate biopsy in patients who are biopsy-naïve, have a prior negative biopsy, or are on active surveillance. Furthermore, novel nomograms have incorporated mpMRI to aid in treatment planning of definitive therapy. This literature review highlights how the inclusion of mpMRI into prostate cancer nomograms has improved upon their performance, potentially reduce unnecessary procedures, and enhance the individual risk assessment by improving confidence in clinical decision-making by both patients and their care providers.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-13T09:21:00Z
      DOI: 10.1177/17562872221096386
      Issue No: Vol. 14 (2022)
  • Metastatic prostate carcinoma presenting as a gluteal soft tissue mass

    • Authors: Jeff John, Noma Mngqi, Alessandro Pietro Aldera
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Metastatic lesions from prostate adenocarcinoma to the bone and lymph nodes and less frequently to the lungs, pleura, liver and adrenal glands are well documented. The presence of soft tissue metastases from a prostate adenocarcinoma is extremely rare. We report a case of a 56-year-old male who presented with a 2-year history of a painless buttock mass. MRI showed a well-defined, right gluteal intermuscular soft tissue mass and multifocal hypointense lesions of the pelvic bones and appendicular skeleton suggestive of secondary metastatic disease. Tru-cut biopsy of the gluteal mass demonstrated metastatic adenocarcinoma. Further workup showed an elevated prostate-specific antigen, and acinar adenocarcinoma of the prostate was confirmed on transrectal biopsy of the prostate. Androgen deprivation therapy with long-acting three monthly goserelin and short-term cover with bicalutamide was initiated as was systemic taxane-based chemotherapy. He has shown an excellent PSA response and remains asymptomatic with complete resolution of the size of the gluteal metastasis at the most recent follow-up 9 months later.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-04T11:36:28Z
      DOI: 10.1177/17562872221096384
      Issue No: Vol. 14 (2022)
  • A narrative review of biparametric MRI (bpMRI) implementation on
           screening, detection, and the overall accuracy for prostate cancer

    • Authors: Jacob W. Greenberg, Christopher R. Koller, Crystal Casado, Benjamin L. Triche, L. Spencer Krane
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Prostate cancer is the most common malignancy in American men following skin cancer, with approximately one in eight men being diagnosed during their lifetime. Over the past several decades, the treatment of prostate cancer has evolved rapidly, so too has screening. Since the mid-2010s, magnetic resonance imaging (MRI)–guided biopsies or ‘targeted biopsies’ has been a rapidly growing topic of clinical research within the field of urologic oncology. The aim of this publication is to provide a review of biparametric MRI (bpMRI) utilization for the diagnosis of prostate cancer and a comparison to multiparametric MRI (mpMRI). Through single-centered studies and meta-analysis across all identified pertinent published literature, bpMRI is an effective tool for the screening and diagnosis of prostate cancer. When compared with the diagnostic accuracy of mpMRI, bpMRI identifies prostate cancer at comparable rates. In addition, when omitting dynamic contrast-enhanced (DCE) protocol to the MRI, patients incur reduced costs and shorter imaging time while providers can offer more tests to their patient population.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-05-04T10:55:15Z
      DOI: 10.1177/17562872221096377
      Issue No: Vol. 14 (2022)
  • Robot-assisted sacro(hystero)colpopexy with anterior and posterior mesh
           placement: impact on lower bowel tract function and clinical outcomes at
           mid-term follow-up

    • Authors: Vincenzo Li Marzi, Simone Morselli, Fabrizio Di Maida, Stefania Musco, Luca Gemma, Francesco Bracco, Riccardo Tellini, Gianni Vittori, Andrea Mari, Riccardo Campi, Marco Carini, Sergio Serni, Andrea Minervini
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Background:Robotic sacrocolpopexy (RSCP) is an established option for the treatment of apical, anterior, and proximal posterior compartment pelvic organ prolapses (POP). However, there is lack of evidence investigating how lower bowel tract symptoms (LBTS) may change after RSCP.Methods:Data from consecutive patients treated with RSCP for stage 3 or higher POP from 2012 to 2019 at a single tertiary referral center with at least 1 year of follow-up were prospectively collected and retrospectively analyzed. RSCP was performed following a standardized technique which always employed both anterior and posterior hand-shaped meshes. Outcomes were collected at follow-up and analyzed. LBTS were evaluated through the Wexner questionnaire.Results:Overall, 114 women underwent RSCP. Eleven were excluded for missing data, whereas 12 had insufficient follow-up. Thus, 91 (79.8%) patients were included in this cohort. Median follow-up was 42 [interquartile range (IQR), 19–62] months. Mean age was 65 ± 10 years. In our series, RSCP was mainly performed for anterior and apical/medium stage 3 POP (in 95.6% of patients). Anatomic success rate of RSCP was 97.8%, with 89 patients with POP stage 0–1 at 12-month follow-up. Two patients (2.2%) experienced POP recurrence and were treated with redo-SCP. No patient experienced clinically significant posterior vaginal wall prolapse after RSCP. When analyzing LBTS, there was no significant change in postoperative total Wexner’s score as compared to the preoperative value (p > 0.05). However, the manual assistance subscore was statistically significantly lower within the first-year follow-up (p = 0.04), but it spontaneously improved during the follow-up (p = 0.12).Conclusion:RSCP with simultaneous placement of both anterior and posterior mesh is safe and successful to treat high-stage POP in carefully selected patients. Of note, LBTS appear unaffected by posterior mesh placement, supporting its routine use to prevent posterior POP recurrence. Larger prospective studies are needed to confirm our results.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-04-21T12:38:33Z
      DOI: 10.1177/17562872221090884
      Issue No: Vol. 14 (2022)
  • Development of a prediction model in female pure or predominant urge
           urinary incontinence: a retrospective cohort study

    • Authors: Tess van Doorn, Sarah H.M. Reuvers, Monique J. Roobol, Sebastiaan Remmers, Jan F.M. Verbeek, Jeroen R. Scheepe, Josien H. Wolterbeek, Deric K.E. van der Schoot, Daan Nieboer, Lisette A. ‘t Hoen, Bertil F.M. Blok
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Background:Urinary incontinence is a prevalent form of pelvic floor dysfunction, with a non-negligible impact on a patient’s quality of life. There are several treatment options, varying from conservative to invasive. The aim of this study is to predict treatment outcomes of pure or predominant urge urinary incontinence (UUI) in women to support shared decision-making and manage patient expectations.Methods:Data on patient characteristics, disease history, and investigations of 512 consecutive women treated for UUI in three hospitals in the Netherlands were retrospectively collected. The predicted outcome was the short-term subjective continence outcome, defined as patient-reported continence 3 months after treatment categorized as cure (no urinary leakage), improvement (any degree of improvement of urinary leakage), and failure (no improvement or worsening of urinary leakage). Multivariable ordinal regression with backward stepwise selection was performed to analyze association between outcome and patient’s characteristics. Interactions between patient characteristics and treatment were added to estimate individual treatment benefit. Discriminative ability was assessed with the ordinal c-statistic.Results:Conservative treatment was applied in 12% of the patients, pharmacological in 62%, and invasive in 26%. Subjective continence outcome was cure, improvement, and failure in 20%, 49%, and 31%, respectively. Number of incontinence episodes per day, voiding frequency during the day, subjective quantity of UI, coexistence of stress urinary incontinence (SUI), night incontinence, and bladder capacity and the interactions between these variables were included in the model. After internal validation, the ordinal c-statistic was 0.699.Conclusions:Six variables were of value to predict pure or predominant UUI treatment outcome in women. Further development into a comprehensive set of models for the use in various pelvic floor disorders and treatments is recommended to optimize individualized care. This model requires external validation before implementation in clinical practice.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-04-20T11:43:52Z
      DOI: 10.1177/17562872221090319
      Issue No: Vol. 14 (2022)
  • Xpert® bladder cancer detection as a diagnostic tool in upper urinary
           tract urothelial carcinoma: preliminary results

    • Authors: Carolina D’Elia, Emanuela Trenti, Philipp Krause, Alexander Pycha, Christine Mian, Christine Schwienbacher, Esther Hanspeter, Mona Kafka, Margherita Palermo, Giorgio Alfredo Spedicato, Stefanie Holl, Armin Pycha
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Objectives:Upper urinary tract urothelial carcinoma (UTUC) represents about 5–10% of all urothelial malignancies with an increasing incidence. The standard diagnostic tools for the detection of UTUC are cytology, computed tomography (CT) urography, and ureterorenoscopy (URS). No biomarker to be included in the daily clinical practice has yet been identified. The aim of our study was to evaluate the potential role of Xpert® Bladder-Cancer (BC)-Detection in the diagnosis of UTUC.Methods:Eighty-two patients underwent 111 URS with Xpert® BC-Detection, cytology, or Urovysion® analysis of UT for suspicion of UTUC. Twenty-four cases were excluded from the analysis due to a non-diagnostic Xpert® BC-Detection, cytology, or Urovysion®. Samples were analyzed with upper tract (UT) urinary cytology, with Xpert® BC-Detection on UT urines, and with Urovysion® Fluorescence in situ hybridization (FISH) test. After urine collection, the patients underwent retrograde pyelography and/or URS, and if positive a UT biopsy. The Xpert® BC-Detection was reported by the software as negative or positive [cut-off total Linear Discriminant Analysis (LDA) = 0.45]. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytology, Xpert® BC-Detection and Urovysion-FISH were calculated using URS and/or histology results as reference.Results:In all, 27 (31%) of 87 URS resulted positive, with 20 low-grade (LG) and 7 high-grade (HG) tumors. Overall sensitivity was 51.9% for cytology, 100% for Xpert® BC-Detection, and 92.6% for Urovysion. The sensitivity of cytology increased from 26% in LG to 100% in HG tumors. For Xpert® BC-Detection, sensitivity was 100% both in LG and in HG, and for Urovysion-FISH, it increased from 90% in LG to 100% in HG tumors. PPV was 82.4% for cytology, 35% for Xpert® BC-Detection, and 73.5% for Urovysion. NPV was 81.4% for cytology, 100% for Xpert® BC-Detection, and 96.2% for Urovysion.Conclusion:The excellent NPV of Xpert® BC-Detection allows to avoid unnecessary endoscopic exploration of the UT, reducing invasiveness and URS complications in the follow-up of UTUC.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-04-13T01:35:57Z
      DOI: 10.1177/17562872221090320
      Issue No: Vol. 14 (2022)
  • Surgery improves survival in bladder signet-ring cell carcinoma-a
           population-based study

    • Authors: Mohammed Alradhi, Mohammed Safi, Shenghua Tao, Abdullah Al-danakh, Marwan Almoiliqy, Salem Baldi, Xiancheng Li
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Objectives:The purpose of this study is to determine the therapeutic value of surgery in individuals with urinary bladder signet ring cell carcinoma (SRCC). Surgery has not been examined as a prognostic factor for urinary bladder cancer (SRCC).Materials and Methods:Using the Surveillance, Epidemiology, and End Results program (SEER), patients with urinary bladder SRCC who presented from 1975 to 2018 were included in a retrospective study. The effect of surgical therapy on cause-specific survival (CSS) and overall survival (OS) was examined using univariate and multivariate Cox regression models. We subdivided 595 patients with SRCC into 2 groups, as follows: 496 who underwent surgery; and 99 who did not undergo surgery.Results:Males had high predominance in all cases in both groups (p = 0.04). Moderate and poor differentiation (III–IV) were observed in the majority of patients who underwent surgery (77.2 vs 58.6, p ⩽ 0.001) and had no insurance (p ⩽ 0.001). By using KM, the OS and CSS of the surgery group were found to be significantly better than those of the non-surgery group (p  = 0.001,%) after adjusting for the variables of age, race, sex, primary site, grade, stage, lymph node removal, chemotherapy record, radiotherapy record, insurance, and marital status in the multivariate Cox proportional hazard model (hazard ratio [HR]= 0. 592; 95% confidence interval [CI] = 0.449–0.782; p = 0.0001). In comparison with chemotherapy and radiation, which resulted in poorer survival rates, surgery considerably improved survival outcomes in urinary bladder SRCC. The nomogram prediction model was built with C-index values of 0.70 and 73 for OS and CSS prediction, respectively. AUC in OS values were 0.77, 0.76, and 0.74, whereas AUC in CSS were 0.83, 0.80, and 0.79 for the 1-, 3-, and 5-year survival nomograms, respectively.Conclusion:Surgery was a significant independent predictor of bladder SRCC survival. Patients who underwent surgery had higher CSS and OS than people who did not undergo surgery. Surgery also led to better survival than the combination of the different treatment modalities.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-04-07T11:08:52Z
      DOI: 10.1177/17562872221079473
      Issue No: Vol. 14 (2022)
  • Is there a role for stem cell therapy in erectile dysfunction secondary to
           cavernous nerve injury' Network meta-analysis from animal studies and
           human trials

    • Authors: Mudassir M. Wani, Bhavan P. Rai, William Richard Webb, Sanjeev Madaan
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Introduction:We carried out systematic review and network meta-analysis to investigate the role of stem cell therapy (SCT) in the management of erectile dysfunction (ED) secondary to cavernous nerve injury in rats and post-radical prostatectomy (RP) in humans.Patients and Methods:The protocol was registered with PROSPERO database. We searched studies analyzing the efficacy of SCT for ED due to bilateral cavernous nerve injury (BCNI) in rats using Healthcare Databases Advanced Search (HDAS) Export software (MEDLINE, EMBASE, Scopus) from inception to September 2020. The outcome measurements, for 29 animal studies, were intracavernosal pressure (ICP), ICP/MAP (mean arterial pressure) ratio, and histological/molecular changes. All three available human trials evaluating SCT in post-RP ED were assessed for International Index for Erectile Function (IIEF) Score and Erection Hardness Score (EHS).Results:For ICP measurement, animal studies were divided into adipose-derived stem cells (ADSCs) subgroup and bone marrow–derived stem cells (BMSCs) subgroup. Pooled analysis of these studies showed a beneficial effect of SCT in improving erectile function in rats with BCNI using network meta-analysis (95% confidence interval, CI; p 
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-29T09:24:03Z
      DOI: 10.1177/17562872221086999
      Issue No: Vol. 14 (2022)
  • Predictors of clinically significant prostate cancer in biopsy-naïve and
           prior negative biopsy men with a negative prostate MRI: improving
           MRI-based screening with a novel risk calculator

    • Authors: Luigi A.M.J.G. van Riel, Auke Jager, Dennie Meijer, Arnoud W. Postema, Ruth S. Smit, André N. Vis, Theo M. de Reijke, Harrie P. Beerlage, Jorg R. Oddens
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Purpose:A pre-biopsy decision aid is needed to counsel men with a clinical suspicion for clinically significant prostate cancer (csPCa), despite normal prostate magnetic resonance imaging (MRI).Methods:A risk calculator (RC) for csPCa (International Society of Urological Pathology grade group (ISUP) ⩾ 2) presence in men with a negative-MRI (Prostate Imaging–Reporting and Data System (PI-RADS) ⩽ 2) was developed, and its performance was compared with RCs of the European Randomized Study of Screening for Prostate Cancer (ERSPC), Prostate Biopsy Collaborative Group (PBCG), and Prospective Loyola University mpMRI (PLUM). All biopsy-naïve and prior negative biopsy men with a negative-MRI followed by systematic prostate biopsy were included from October 2015 to September 2021. The RC was developed using multivariable logistic regression with the following parameters: age (years), family history of PCa (first- or second-degree family member), ancestry (African Caribbean/other), digital rectal exam (benign/malignant), MRI field strength (1.5/3.0 Tesla), prior negative biopsy status, and prostate-specific antigen (PSA) density (ng/ml/cc). Performance of RCs was compared using receiver operating characteristic (ROC) curve analysis.Results:A total of 232 men were included for analysis, of which 18.1% had csPCa. Parameters associated with csPCa were family history of PCa (p 
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-26T04:24:51Z
      DOI: 10.1177/17562872221088536
      Issue No: Vol. 14 (2022)
  • Cognitive function in patients undergoing cystectomy for bladder cancer
           – results from a prospective observational study

    • Authors: Camilla M. Grunewald, Vera Feldmeier, Tillmann Supprian, Peter Albers, Markus Giessing, Günter Niegisch
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Background:Impaired cognitive function of bladder cancer patients plays a role in coping with the kind of urinary diversion and may impact perioperative morbidity. In this study we therefore aimed to assess the prevalence of mild cognitive impairment in patients undergoing radical cystectomy. Secondary objectives included correlation of common cognition tests, assessment of the admitting physician, and perioperative complication rates.Methods:Patients undergoing radical cystectomy for bladder cancer were prospectively screened by neuropsychological tests including cognition tests [DemTect (Dementia Detection test), MMSE (Mini-Mental State Examination), clock drawing test] prior to surgery. Besides, clinical characteristics and perioperative outcomes were documented. Frequency of mild cognitive impairment as assessed by DemTect was correlated with the results of MMSE and clock drawing test, the occurrence of anxiety and depression, the assessment of the admitting physician, and perioperative complication rates as calculated by Spearman rank correlation coefficient. Comparative analysis (parametric and nonparametric) of patient characteristics (nonpathological versus pathological DemTect suggestive of mild cognitive impairment) was performed.Results:A total of 51 patients (80% male, median age 69 years) were analyzed. DemTect was suspicious of mild cognitive impairment in 27% (14/51) of patients, whereas MMSE and clock drawing test showed pathological results only in 10/51 and 6/51 patients, respectively. We found no correlation between mild cognitive impairment and anxiety/depression status. In all, 5/20 patients (25%) with suspicious DemTect results were considered suitable for a continent diversion neobladder by the admitting physician. Suspicious DemTect results were predictive for higher perioperative complication rates (29% versus 5%). Study limitations include small sample size and missing long-term follow-up.Conclusions:Mild cognitive impairment was observed in more than a quarter of radical cystectomy patients prior to surgery. Preoperative assessment should be supplemented by neuropsychological testing such as the DemTect as mild cognitive impairment is often underestimated and associated with significantly higher perioperative complication rates.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-24T01:09:13Z
      DOI: 10.1177/17562872221087660
      Issue No: Vol. 14 (2022)
  • Major adverse cardiovascular events following partial nephrectomy: a
           procedure-specific risk index

    • Authors: Ali A. Nasrallah, Habib A. Dakik, Nassib F. Abou Heidar, Jad A. Najdi, Oussama G. Nasrallah, Mazen Mansour, Hani Tamim, Albert El Hajj
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Introduction:Partial nephrectomy (PN) is associated with a non-negligible risk of postoperative cardiovascular morbidity and mortality. Identification of high-risk patients may enable optimization of perioperative management and consideration of alternative approaches. The authors aim to develop a procedure-specific cardiovascular risk index for PN patients and compare its performance to the widely used revised cardiac risk index (RCRI) and AUB-HAS2 cardiovascular risk index.Methods:The cohort was derived from the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database. The primary outcome was the incidence of major adverse cardiovascular events (MACE), defined as 30-day postoperative incidence of myocardial infarction, stroke, or mortality. A multivariate logistic regression model was constructed; performance and calibration were evaluated using an ROC analysis and the Hosmer–Lemeshow test and compared to the RCRI and the AUB-HAS2 index.Results:In a cohort of 4795 patients, MACE occurred in 52 (1.1%) patients. A univariate analysis yielded 13 eligible variables for entry into the multivariate model. The final PN-A4CH model utilized six variables: Age ⩾75 years, ASA class >2, Anemia, surgical Approach, Creatinine >1.5, and history of Heart disease. Index ROC analysis provided a C-statistic of 0.81, calibration R2 was 0.99, and sensitivity was 85%. In comparison, the RCRI and AUB-HAS2 C-statistics were 0.59 and 0.68, respectively.Conclusion:This study proposes a novel procedure-specific cardiovascular risk index. The PN-A4CH index demonstrated good predictive ability and excellent calibration using a large national database and may enable further individualization of patient care and optimization of patient selection.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-18T11:28:41Z
      DOI: 10.1177/17562872221084847
      Issue No: Vol. 14 (2022)
  • Patient characteristics predicting prolonged length of hospital stay
           following robotic-assisted radical prostatectomy

    • Authors: Albert El Hajj, Muhieddine Labban, Guillaume Ploussard, Jabra Zarka, Nassib Abou Heidar, Aurelie Mailhac, Hani Tamim
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Objective:The objective of this study is to determine the preoperative patient characteristics predicting prolonged length of hospital stay (pLOS) following robotic-assisted radical prostatectomy (RARP).Methods:The National Surgical Quality Improvement Program (NSQIP) database was used to select patients who underwent RARP without other concomitant surgeries between 2008 and 2016. Patients’ demographics, comorbidities, and laboratory markers were collected to evaluate their role in predicting pLOS. The pLOS was defined as length of stay (LOS) >2 days. A multinomial logistic regression was constructed adjusting for postoperative surgical complications to assess for the predictors of pLOS.Results:We obtained data for 31,253 patients of which 20,774 (66.5%) patients stayed ⩽1 day, 6993 (22.4%) patients stayed for 2 days, and 3486 (11.2%) patients stayed for >2 days. Demographic variables – including body mass index (BMI)
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-18T11:26:11Z
      DOI: 10.1177/17562872221080737
      Issue No: Vol. 14 (2022)
  • Could the vaginal wall sling still have a role after the FDA’s
           warning' Functional outcomes at 20 years

    • Authors: Ester Illiano, Francesco Trama, Alessandro Marchesi, Consuelo Fabi, Stefano Brancorsini, Elisabetta Costantini
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Introduction:Aims of this study were to evaluate the functional outcomes of a vaginal wall sling technique in patients with stress urinary incontinence at 20 years after surgery and to evaluate the patient’s satisfaction after the surgical procedure.Material and Methods:This was a prospective single-center study on patients with stress urinary incontinence who underwent in situ vaginal sling surgery. Presurgery evaluation included history, pelvic examination, and urodynamic test. All patients completed Urogenital Distress Inventory–6 (UDI-6) questionnaire. They underwent checkups at 1, 3, 6, and 12 months postoperatively and then annually. The sling was created by making a rectangle (15–20 × 25 mm) on the anterior vaginal wall and it was reinforced by one roll of Marlex mesh on each side of the sling. The sutures were passed through the vagina at the suprapubic level after suprapubic incision, above the rectus fascia and tied without excessive tension.Results:From May 1996 to May 2002, 40 women underwent vaginal wall sling surgery for stress urinary incontinence. Last visit was performed on 20 women between March 2020 and April 2020. Median follow-up was 251.3 months (20.9 years) (range = 204.3–285.4 months). The success rate after 5 years of surgical procedure was 80%; over 5 years, the objective cure rate was 45%. Considering only the group of 13 patients with pure stress urinary incontinence, the objective cure rate decreased to 38%, in particular 7 years after surgery. Women who did not resolve their urinary incontinence needed to undergo a new treatment. At over 5 years after surgery, there was an increase in urgency (p = 0.001) and voiding symptoms (p = 0.008) and urgency urinary incontinence (UUI) (p = 0.04). Ninety-five percent were very much worse or much worse according to the Patient Global Impression of Improvement (PGI-I) scale.Conclusion:The in situ vaginal wall sling does not guarantee good long-term functional outcomes in women with stress urinary incontinence.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-03-07T10:00:24Z
      DOI: 10.1177/17562872221084391
      Issue No: Vol. 14 (2022)
  • How did the first year of the COVID-19 pandemic affect urology practice in
           Arab countries' A cross-sectional study by the Arab Association of
           Urology research group

    • Authors: Yasser A. Noureldin, Basheer Elmohamady, Amr S. El-Dakhakhny, Mohamed Omar, Esam E.A. Desoky, Yahia Ghazwani, Saeed Bin Hamri, Abdullah Alkhayal, Khalid Alrabeeah, Wissam Kamal, Fawzy Farag, Yasser Farahat
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Objective:The aim of this study was to assess of the effect of coronavirus disease 2019 (COVID-19) pandemic on urology practice in the Arab world during the first year of the crisis.Methods:An Internet-based questionnaire was created and sent out via email to members of the Arab Association of Urology (AAU) using ‘Google Forms’. The survey assessed participants’ demographics in terms of age, gender, country of origin, type of practice and position. Impacts of COVID-19 on urological practice were assessed in terms of the changes in hospital policies regarding consultations, and elective and emergency surgical cases. Moreover, impacts of COVID-19 on urologists were assessed.Results:A total of 255 AAU members across 14 Arab countries (Emirates, Egypt, Saudi Arabia, Iraq, Jordan, Algeria, Kuwait, Yemen, Qatar, Lebanon, Libya, Oman, Sudan and Syria) completed the survey; 4% were female urologists. Consultations at outpatient clinics were closed or restricted to emergency cases or replaced by telemedicine in almost 15%, 40% and 25% of hospitals, respectively. Elective surgeries were stopped or reduced to under 25% of surgical capacity in >10% and about 25% of hospitals, respectively. Almost 90% (228) reported changes in the policy for emergency theatres. Nearly 65% of hospitals offered preoperative COVID-19 testing to patients and 50% of hospitals provided personal protective equipment (PPE) to their urologists. Of 99% (253) who reported a change in urological education, 95% relied on online webinars. About 56% of respondents had their own private practice, of whom 91% continued private practice during the crisis. About 38% of participants reported exposure to intimidation (75% emotional, 20% verbal and 5% physical).Conclusion:The COVID-19 pandemic resulted in major changes in hospitals’ policies regarding outpatient consultations, elective and emergency operative cases, and the shift to telemedicine. Arab urologists have been facing major challenges either in both the governmental or the private sectors, and some of them were exposed to emotional, verbal and even physical intimidation.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-02-28T10:24:16Z
      DOI: 10.1177/17562872221079492
      Issue No: Vol. 14 (2022)
  • Evaluation of early scoring predictors for expedited care in patients with
           emphysematous pyelonephritis

    • Authors: Arun Chawla, Sunil Pillai Bhaskara, Ravi Taori, Jean J.M.C.H de la Rosette, Pilar Laguna, Akhilesh Pandey, Sitaram Mummalaneni, Padmaraj Hegde, Shwetapriya Rao, Prakashini K
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Introduction:Emphysematous pyelonephritis (EPN), an acute necrotizing infection of the kidney and surrounding tissues, is associated with considerable mortality. We evaluated how existing critical care scoring systems could predict the need for intensive care unit (ICU) management for these patients. We also analyzed if CT-imaging further enhances these predictive systems.Patients and Methods:A retrospective analysis of 90 consecutive patients diagnosed clinico-radiologically with EPN from January 2011 to September 2020. Five scoring systems were evaluated for their predictive ability for the need for ICU management and mortality risk: National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), ‘quick’ Sequential Organ Failure Assessment score (qSOFA), Systemic Inflammatory Response Syndrome score (SIRS), and Sequential Organ Failure Assessment score (SOFA). CT images were classified as per Huang & Tseng and evaluated as stand-alone or added to the different predictive models. Receiver operating characteristic (ROC) curves were plotted for each critical care score and CT-Class using logistic regression, to obtain the area under curve (AUC) value for comparison of ICU admission predictability. Patients were analyzed up till discharge.Results:Ninety patients were diagnosed with EPN. Twenty-six patients required ICU management and nine patients died. The best scoring system to predict the need of early ICU management is NEWS (AUC 0.884). CT Class had no independent predictive power, nor did it add significantly to improvement in most of the early warning scoring systems, but rather guided us to the need for radiological, endourological or surgical intervention.Conclusion:In patients with EPN, the NEWS scoring system predicts best the requirement of ICU care. It aids in triage of patients with EPN to appropriate early management and reduce mortality risk.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-02-22T11:59:34Z
      DOI: 10.1177/17562872221078773
      Issue No: Vol. 14 (2022)
  • Combating antimicrobial resistance with cefiderocol for complicated
           infections involving the urinary tract

    • Authors: Hongmei Wang, Brittany N. Palasik
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Cefiderocol is a unique siderophore cephalosporin antimicrobial agent that has shown promise in treating complicated urinary tract infections (cUTI). Urinary tract infections are commonly diagnosed infections with risk increasing with age and prevalence more common in women. cUTI poses a risk of recurrence and is more likely to be associated with antibiotic-resistant bacteria. The Food and Drug Administration approved cefiderocol for use as a last-line option in the treatment of cUTI including pyelonephritis. Cefiderocol has activity against all forms of carbapenemases due to its ability to overcome the mechanisms of carbapenemase resistance. Because of this, resistance to cefiderocol is unlikely to occur. Studies show cefiderocol is well tolerated among younger patients and patients greater than 65 years of age, the latter making up most of the study population. Renal dose adjustments are recommended. Dose adjustment in the presence of hepatic impairment is not recommended, as hepatic clearance represents a minor elimination pathway for cefiderocol. The ability of cefiderocol to overcome multiple resistance mechanisms makes it a novel choice in combating multidrug-resistant bacteria in the treatment of cUTI.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-02-01T06:26:19Z
      DOI: 10.1177/17562872211065570
      Issue No: Vol. 14 (2022)
  • Concurrent placement of SpaceOAR gel and gold fiducials during HoLEP: a
           case report

    • Authors: Meera B. Ganesh, Briana S. Kaplunov, Matthew S. Lee, Mark A. Assmus, Ashley E. Ross, Joy Coleman, Amy E. Krambeck
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Herein, we describe a case of a patient diagnosed with prostate cancer (PCa) who presented with lower urinary tract symptoms (LUTS) and elevated Prostate Specific Antigen (PSA). He underwent Holmium Laser Enucleation of the Prostate (HoLEP) for his severe LUTS with concurrent placement of SpaceOAR gel and gold fiducials in preparation for radiation therapy (RT). After a successful operation, the patient underwent same-day discharge and catheter removal. He regained continence at 2 weeks and started RT at 9 weeks post-HoLEP. We present that concurrent placement of fiducials and SpaceOAR during HoLEP appears to be feasible, well tolerated and effective for PCa patients who elect RT.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-01-20T06:15:08Z
      DOI: 10.1177/17562872211072637
      Issue No: Vol. 14 (2022)
  • Comment on: update on the management of overactive bladder

    • Authors: David Staskin
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.

      Citation: Therapeutic Advances in Urology
      PubDate: 2022-01-20T06:09:47Z
      DOI: 10.1177/17562872211070645
      Issue No: Vol. 14 (2022)
  • Pulmonary lymphangioleiomyomatosis with an associated giant renal

    • Authors: Jeff John, Alessandro Pietro Aldera, Dap Louw, John Lazarus, Ken Kesner
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Pulmonary lymphangioleiomyomatosis (LAM), a rare, progressive disease predominantly affecting the lungs of women of reproductive age, is often associated with renal angiomyolipoma (AML). We report the case of a 29-year-old female patient who presented to our obstetrics department at 37 weeks’ gestation, complaining of abdominal pain, and constipation. Ultrasound noted a viable singleton with a large left-sided abdominal mass. After undergoing a caesarean section, she was referred to our urology department to assess her flank mass further. Computed tomography demonstrated a large, exophytic left renal mass measuring 22 cm x 16 cm x 13 cm, suggestive of an AML and numerous bilateral pulmonary cysts. A diagnosis of LAM and associated unilateral giant renal AML was made. As soon as she had fully recovered from her caesarean section, we removed the huge AML via a standard left-sided open nephrectomy without incident. We report this rare case of giant AML associated with LAM and review the literature about the association of these two conditions.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-01-20T06:06:26Z
      DOI: 10.1177/17562872211069700
      Issue No: Vol. 14 (2022)
  • Can urethral re-bulking improve the outcomes of a prior urethral

    • Authors: Alessandro Giammò, Enrico Ammirati, Paolo Geretto, Alberto Manassero, Luisella Squintone, Marco Falcone, Giulio Del Popolo, Donatella Pistolesi, Oreste Risi, Elisabetta Costantini, Antonella Giannantoni, Vito Mancini, Vincenzo Li Marzi, Enrico Finazzi Agrò, Mauro Pastorello, Stefania Musco, Paolo Gontero
      Abstract: Therapeutic Advances in Urology, Volume 14, Issue , January-December 2022.
      Aims:To analyze the outcomes of urethral re-bulking in the treatment of female stress urinary incontinence.Materials and Methods:We performed a multicenter observational retrospective study, which included all consecutive patients treated with urethral re-bulking for the treatment of persistent stress or mixed urinary incontinence after a previous urethral bulking. Objective outcomes were evaluated with the 24 h pad-test, while PGI-I questionnaires were administered to evaluate subjective outcomes. Clinical outcomes were assessed before re-bulking procedure and at last follow-up. Mann–Whitney’s U test was used for subgroup analysis. Shapiro-Wilk’s tests were used as normality tests.Results:In total, 62 patients who underwent urethral re-bulking between 2013 and 2020 in a multicenter setting were included. Most patients did not reach complete continence after the first procedure (n = 56) while the remainder reported recurrence of urinary incontinence after initial benefit. Median age at surgery was 66 (IQR: 55-73). Median overall follow-up was 30 months (IQR: 24-41). Median time occurred between the first procedure and reintervention was 12 months (IQR: 7-27). Bulking agents for the re-bulking procedures were bulkamid(n = 56), macroplastique(n = 4), and Prolastic(n = 2). A statistically significant reduction of median 24 h pad test from 100 g(IQR: 40-200) to 35 g(IQR: 0-120) was observed (p = 0.003). Dry rate after rebulking was 36.6%, while 85.4% patients declared themselves ‘very much improved’ or ‘much improved’ (PGI-I 1-2). Very few low-grade complications were observed (n = 4). A single case of major complication occurred.Conclusions:Urethral re-bulking can be an effective technique for the treatment of stress urinary incontinence refractory to a previous urethral bulking and can determine a cumulative benefit after the first procedure.
      Citation: Therapeutic Advances in Urology
      PubDate: 2022-01-18T08:02:19Z
      DOI: 10.1177/17562872211069265
      Issue No: Vol. 14 (2022)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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