Subjects -> MEDICAL SCIENCES (Total: 8821 journals)
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UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)                     

Showing 1 - 159 of 159 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
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: 42)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 38)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
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  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 34)
BJUI Compass     Open Access   (Followers: 2)
BMC Nephrology     Open Access   (Followers: 11)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 8)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 22)
Clinical Kidney Journal     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
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   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 33)
European Urology Focus     Hybrid Journal   (Followers: 5)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 10)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
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: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 2)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
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: 3)
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: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 5)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 31)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 46)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 46)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 22)
Nature Reviews Urology     Full-text available via subscription   (Followers: 13)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
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: 5)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
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: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
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   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 7)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 1)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 33)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 11)


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Asian Journal of Urology
Journal Prestige (SJR): 0.225
Citation Impact (citeScore): 1
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2214-3882
Published by Elsevier Homepage  [3305 journals]
  • A simple technique of tissue collection after morcellation during holmium
           laser enucleation of the prostate

    • Abstract: Publication date: Available online 15 March 2019Source: Asian Journal of UrologyAuthor(s): Pankaj Maheshwari, Saurabh Patil, Nick Okwi, Anant Pore
  • Spontaneous distal ureteric rupture: A rare case report and review of

    • Abstract: Publication date: Available online 7 March 2019Source: Asian Journal of UrologyAuthor(s): Li Sian Low, Shiva Madhwan Nair Spontaneous rupture of the ureter is a very interesting and unusual phenomenon which normally occurs due to ureteral obstruction. We present a case of spontaneous rupture of the distal ureter, secondary to a ureteric calculus. Our patient presented with a history of acute on chronic abdominal pain and was septic on arrival to hospital.
  • Diagnosis of prostate cancer

    • Abstract: Publication date: Available online 14 February 2019Source: Asian Journal of UrologyAuthor(s): Jean-Luc Descotes Diagnosis of prostate cancer (PCa) and adequate staging play a fundamental role for clinical and patient care. Despite major advances in biology and imaging, rectal examination and prostate-specific antigen (PSA) blood test remain the cornerstone for screening, and multiparametricmagnetic resonance imaging (mpMRI) for local staging. Recent advances in mpMRI lead to standardised interpretation and increased prescription by clinicians in order to improve detection of clinically significant PCa and select patients requiring targeted biopsies. However its indication remains controversial in biopsy-naïve patients. Nuclear medicine is also in a continuous evolution and utilisation of new radiopharmaceutical agent like choline or 68gallium with computed tomography or magnetic resonance imaging has led to the improvement in the detection of lymph nodes, distant metastases and prostate recurrence. Considering this very heterogneneous disease, combined utilisation of these tools will help clinicians and patients in choosing the most appropriate and personalised treatment.
  • Systemic treatment for metastatic prostate cancer

    • Abstract: Publication date: Available online 11 February 2019Source: Asian Journal of UrologyAuthor(s): Gwenaelle Gravis The management of metastatic prostate cancer (mPCa) has changed over the past ten years. Several new drugs have been approved with significant overall survival benefits in metastatic castration resistant prostate cancer (PCa) including chemotherapy (docetaxel, cabazitaxel), new hormonal therapies (abiraterone, enzalutamide), Radium-223 and immunotherapy. The addition of docetaxel to androgen deprivation therapy (ADT) versus ADT alone in the castration sensitive metastatic setting has gained significant overall survival benefit particularly for high volume disease. More recently two phase III trials have assessed the efficacy of abiraterone plus prednisone plus ADT over ADT alone in newly high risk castrate sensitive mPCa. Determination of the appropriate treatment sequence using these therapies is important for maximizing the clinical benefit in castration sensitive and castration resistant PCa patients. Emerging fields are the identification of new subtypes with molecular characterization and new therapeutic targets.
  • The role of radiotherapy in localised and locally advanced prostate cancer

    • Abstract: Publication date: Available online 8 February 2019Source: Asian Journal of UrologyAuthor(s): Michel Bolla, Ann Henry, Malcom Mason, Thomas Wiegel For a patient suffering from non-metastatic prostate cancer, the individualized recommendation of radiotherapy has to be the fruit of a multidisciplinary approach in the context of a Tumor Board, to be explained carefully to the patient to obtain his informed consent. External beam radiotherapy is now delivered by intensity modulated radiotherapy, considered as the gold standard. From a radiotherapy perspective, low-risk localized prostate cancer is treated by image guided intensity modulated radiotherapy, or brachytherapy if patients meet the required eligibility criteria. Intermediate-risk patients may benefit from intensity modulated radiotherapy combined with 4–6 months of androgen deprivation therapy; intensity modulated radiotherapy alone or combined with brachytherapy can be offered to patients unsuitable for androgen deprivation therapy due to co-morbidities or unwilling to accept it to preserve their sexual health. High-risk prostate cancer, i.e. high-risk localized and locally advanced prostate cancer, requires intensity modulated radiotherapy with long-term (≥2 years) androgen deprivation therapy with luteinizing hormone releasing hormone agonists. Post-operative irradiation, either immediate or early deferred, is proposed to patients classified as pT3pN0, based on surgical margins, prostate-specific antigen values and quality of life. Whatever the techniques and their degree of sophistication, quality assurance plays a major role in the management of radiotherapy, requiring the involvement of physicians, physicists, dosimetrists, radiation technologists and computer scientists. The patients must be informed about the potential morbidity of radiotherapy and androgen deprivation therapy and followed regularly during and after treatment for tertiary prevention and evaluation. A close cooperation is needed with general practitioners and specialists to prevent and mitigate side effects and maintain quality of life.
  • Practice patterns and outcomes of equivocal bone scans for patients with
           castration-resistant prostate cancer: Results from SEARCH

    • Abstract: Publication date: Available online 18 January 2019Source: Asian Journal of UrologyAuthor(s): Brian T. Hanyok, Mary M. Everist, Lauren E. Howard, Amanda M. De Hoedt, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Christopher L. Amling, Martha K. Terris, Stephen J. Freedland ObjectiveTo review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer (CRPC) and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging.MethodsWe identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CRPC diagnosis, of whom 99 (15%) had equivocal scans. Men with equivocal scans were segregated into “high-risk” and “low-risk” subcategories based upon wording in the bone scan report. All follow-up imaging (bone scans, computed tomography [CT], magnetic resonance imaging [MRI], and X-rays) in the 3 months after the equivocal scan were reviewed. Variables were compared between patients with a positive vs. negative follow-up imaging after an equivocal bone scan.ResultsOf 99 men with an equivocal bone scan, 43 (43%) received at least one follow-up imaging test, including 32/82 (39%) with low-risk scans and 11/17 (65%) with high-risk scans (p = 0.052). Of follow-up tests, 67% were negative, 14% were equivocal, and 19% were positive. Among those who underwent follow-up imaging, 3/32 (9%) low-risk men had metastases vs. 5/11 (45%) high-risk men (p = 0.015).ConclusionWhile 19% of all men who received follow-up imaging had positive follow-up imaging, only 9% of those with a low-risk equivocal bone scan had metastases versus 45% of those with high-risk. These preliminary findings, if confirmed in larger studies, suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging.
  • A rare cause of acute urinary retention - Primary malignant melanoma of

    • Abstract: Publication date: Available online 12 January 2019Source: Asian Journal of UrologyAuthor(s): Kalpesh Parmar, Ashish Khanna, S.K. Singh, Manjeet Sharma Acute urinary retention is commonly seen in elderly male patient due to benign enlargement of prostate. We report A 65year-old male presenting with acute urinary retention diagnosed to have primary malignant melanoma of prostate. Primary malignant melanoma of genitourinary tract is very uncommon diagnosis in urology and prostate involvement is extremely rare. Till now only five cases have been reported.
  • Prostate cancer: On the road of progress

    • Abstract: Publication date: Available online 9 January 2019Source: Asian Journal of UrologyAuthor(s): Michel Bolla, René-Olivier Mirimanoff
  • Prostate tumor neuroendocrine differentiation via EMT: The road less

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Haley Dicken, Patrick J. Hensley, Natasha Kyprianou The long-standing challenge in the treatment of prostate cancer is to overcome therapeutic resistance during progression to lethal disease. Aberrant transforming-growth factor-β (TGF-β) signaling accelerates prostate tumor progression in a transgenic mouse model via effects on epithelial-mesenchymal transition (EMT), and neuroendocrine differentiation driving tumor progression to castration-resistant prostate cancer (CRPC). Neuroendocrine prostate cancer (NEPC) is highly aggressive exhibiting reactivation of developmental programs associated with EMT induction and stem cell-like characteristics. The androgen receptor (AR) is a critical driver of tumor progression as well as therapeutic response in patients with metastatic CRPC. The signaling interactions between the TGF-β mechanistic network and AR axis impact the EMT phenotypic conversions, and perturbation of epithelial homeostasis via EMT renders a critical venue for epithelial derived tumors to become invasive, acquire the neuroendocrine phenotype, and rapidly metastasize. Combinations of microtubule targeting taxane chemotherapy and androgen/AR targeting therapies have survival benefits in CRPC patients, but therapeutic resistance invariability develops, leading to mortality. Compelling evidence from our group recently demonstrated that chemotherapy (cabazitaxel, second line taxane chemotherapy), or TGF-β receptor signaling targeted therapy, caused reversion of EMT to mesenchymal-epithelial transition and tumor re-differentiation, in in vitro and in vivo prostate cancer models. In this review, we discuss the functional contribution of EMT dynamic changes to the development of the neuroendocrine phenotype—the newly characterized pathological feature of prostate tumors in the context of the tumor microenvironment-navigated cell lineage changes and the role of this neuroendocrine phenotype in metastatic progression and therapeutic resistance.
  • Regulatory signaling network in the tumor microenvironment of prostate
           cancer bone and visceral organ metastases and the development of novel

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Gina Chia-Yi Chu, Leland W.K. Chung, Murali Gururajan, Chia-Ling Hsieh, Sajni Josson, Srinivas Nandana, Shian-Ying Sung, Ruoxiang Wang, Jason Boyang Wu, Haiyen E. Zhau This article describes cell signaling network of metastatic prostate cancer (PCa) to bone and visceral organs in the context of tumor microenvironment and for the development of novel therapeutics. The article focuses on our recent progress in the understanding of: 1) The plasticity and dynamics of tumor–stroma interaction; 2) The significance of epigenetic reprogramming in conferring cancer growth, invasion and metastasis; 3) New insights on altered junctional communication affecting PCa bone and brain metastases; 4) Novel strategies to overcome therapeutic resistance to hormonal antagonists and chemotherapy; 5) Genetic-based therapy to co-target tumor and bone stroma; 6) PCa-bone-immune cell interaction and TBX2-WNTprotein signaling in bone metastasis; 7) The roles of monoamine oxidase and reactive oxygen species in PCa growth and bone metastasis; and 8) Characterization of imprinting cluster of microRNA, in tumor–stroma interaction. This article provides new approaches and insights of PCa metastases with emphasis on basic science and potential for clinical translation. This article referenced the details of the various approaches and discoveries described herein in peer-reviewed publications. We dedicate this article in our fond memory of Dr. Donald S. Coffey who taught us the spirit of sharing and the importance of focusing basic science discoveries toward translational medicine.
  • Combination therapy with androgen deprivation for hormone sensitive
           prostate cancer: A new frontier

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Tyler Etheridge, Shivashankar Damodaran, Adam Schultz, Kyle A. Richards, Joseph Gawdzik, Bing Yang, Vincent Cryns, David F. Jarrard Androgen deprivation therapy (ADT) has been the standard of care for the last 75 years in metastatic hormone sensitive prostate cancer (PCa). However, this approach is rarely curative. Recent clinical trials have demonstrated that ADT combined with other agents, notably docetaxel and abiraterone, lead to improved survival. The mechanisms surrounding this improved cancer outcomes are incompletely defined. The response of cancer cells to ADT includes apoptosis and cell death, but a significant fraction remains viable. Our laboratory has demonstrated both in vitro and in vivo that cellular senescence occurs in a subset of these cells. Cellular senescence is a phenotype characterized by cell cycle arrest, senescence-associated β-galactosidase (SA-β-gal), and a hypermetabolic state. Positive features of cellular senescence include growth arrest and immune stimulation, although persistence may release cytokines and growth factors that are detrimental. Senescent tumor cells generate a catabolic state with increased glycolysis, protein turnover and other metabolic changes that represent targets for drugs, like metformin, to be applied in a synthetic lethal approach. This review examines the response to ADT and the putative role of cellular senescence as a biomarker and therapeutic target in this context.
  • Potential impact of combined inhibition of 3α-oxidoreductases and
           5α-reductases on prostate cancer

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Michael V. Fiandalo, Daniel T. Gewirth, James L. Mohler Prostate cancer (PCa) growth and progression rely on the interaction between the androgen receptor (AR) and the testicular ligands, testosterone and dihydrotestosterone (DHT). Almost all men with advanced PCa receive androgen deprivation therapy (ADT). ADT lowers circulating testosterone levels, which impairs AR activation and leads to PCa regression. However, ADT is palliative and PCa recurs as castration-recurrent/resistant PCa (CRPC). One mechanism for PCa recurrence relies on intratumoral synthesis of DHT, which can be synthesized using the frontdoor or primary or secondary backdoor pathway. Androgen metabolism inhibitors, such as those targeting 5α-reductase, aldo-keto-reductase family member 3 (AKR1C3), or cytochrome P450 17A1 (CYP17A1) have either failed or produced only modest clinical outcomes. The goal of this review is to describe the therapeutic potential of combined inhibition of 5α-reductase and 3α-oxidoreductase enzymes that facilitate the terminal steps of the frontdoor and primary and secondary backdoor pathways for DHT synthesis. Inhibition of the terminal steps of the androgen metabolism pathways may be a way to overcome the shortcomings of existing androgen metabolism inhibitors and thereby delay PCa recurrence during ADT or enhance the response of CRPC to androgen axis manipulation.
  • Detection of androgen receptor (AR) and AR-V7 in small cell prostate
           carcinoma: Diagnostic and therapeutic implications

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Pei Zhao, Yezi Zhu, Liang Cheng, Jun Luo ObjectiveSmall cell prostate carcinoma (SCPC) is a rare and highly malignant subtype of prostate cancer. SCPC frequently lacks androgen receptor (AR) and prostate-specific antigen (PSA) expression, and often responds poorly to androgen deprivation therapy (ADT). AR splice variant-7 (AR-V7) is a truncated AR protein implicated in resistance to AR-targeting therapies. AR-V7 expression in castration-resistant prostate cancers has been evaluated extensively, and blood-based detection of AR-V7 has been associated with lack of response to abiraterone and enzalutamide. However, whether AR-V7 is expressed in SCPC is not known.MethodsUsing validated antibodies, we performed immunohistochemistry (IHC) assay for the full-length AR (AR-FL) and (AR-V7) on post-ADT surgical SCPC specimens.ResultsSeventy-five percent (9/12) of the specimens showed positive staining for the AR-FL with various intensities. Thirty-three percent (4/12) of the specimens showed positive staining for AR-V7. Among the specimens with positive AR-V7 staining, two samples displayed very weak staining, one sample showed weak-to-moderate staining, and one sample showed strong staining. All positive specimens displayed a heterogeneous pattern of AR-FL/AR-V7 staining. All specimens positive for AR-V7 were also positive for AR-FL.ConclusionThe study findings support the existence of measurable AR-FL and AR-V7 proteins in SCPC specimens. The results also have implications in detection of AR-V7 in specimens obtained through systemic sampling approaches such as circulating tumor cells. A positive AR-V7 finding by blood-based tests is not impossible in patients with SCPC who often demonstrate low PSA values.
  • Current strategies for targeting the activity of androgen receptor

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Cameron M. Armstrong, Allen C. Gao Current therapies for advanced prostate cancer, such as enzalutamide and abiraterone, focus on inhibiting androgen receptor (AR) activity and reducing downstream signaling pathways to inhibit tumor growth. Unfortunately, cancer cells are very adaptable and, over time, these cells develop mechanisms by which they can circumvent therapeutics. One of the many mechanisms that have been discovered is the generation of AR variants. These variants are generated through alternative splicing of the full length AR and often lack the ligand binding domain. This leads to forms of the AR that are constitutively active that continue to promote prostate cancer cell growth even in the absence of ligand. The high prevalence of AR variants and their role in disease progression have prompted a number of studies investigating ways to inhibited AR variant expression and activity. Among these are the anti-helminthic drug, niclosamide, which selectively promotes degradation of AR variants over full length AR and re-sensitizes anti-androgen resistant prostate cancer cells to treatment with enzalutamide and abiraterone. Other AR variant targeting mechanisms include interfering with AR variant co-activators and the development of drugs that bind to the DNA or N-terminal AR domains, which are retained in most AR variants. The clinical efficacy of treating prostate cancer by targeting AR variants is under investigation in several clinical trials. In this review, we provide an overview of the most relevant AR variants and discuss current AR variant targeting strategies.
  • Metastatic prostate cancer remains incurable, why'

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Liang Dong, Richard C. Zieren, Wei Xue, Theo M. de Reijke, Kenneth J. Pienta Metastatic prostate cancer patients present in two ways—with already disseminated disease at the time of presentation or with disease recurrence after definitive local therapy. Androgen deprivation therapy is given as the most effective initial treatment to patients. However, after the initial response, almost all patients will eventually progress despite the low levels of testosterone. Disease at this stage is termed castration resistant prostate cancer (CRPC). Before 2010, the taxane docetaxel was the first and only life prolonging agent for metastatic CRPC (mCRPC). The last decade has witnessed robust progress in CRPC therapeutics development. Abiraterone, enzalutamide, apalutamide and sipuleucel-T have been evaluated as first- and second-line agents in mCRPC patients, while cabazitaxel was approved as a second-line treatment. Radium-223 dichloride was approved in symptomatic patients with bone metastases and no known visceral metastases pre- and post-docetaxel. However, despite significant advances, mCRPC remains a lethal disease. Both primary and acquired resistance have been observed in CRPC patients treated by these new agents. It could be solely cell intrinsic or it is possible that the clonal heterogeneity in treated tumors may result from the adaptive responses to the selective pressures within the tumor microenvironment. The aim of this review is to list current treatment agents of CRPC and summarize recent findings in therapeutic resistance mechanisms.
  • If this is true, what does it imply' How end-user antibody validation
           facilitates insights into biology and disease

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Karen S. Sfanos, Srinivasan Yegnasubramanian, William G. Nelson, Tamara L. Lotan, Ibrahim Kulac, Jessica L. Hicks, Qizhi Zheng, Charles J. Bieberich, Michael C. Haffner, Angelo M. De Marzo Antibodies are employed ubiquitously in biomedical sciences, including for diagnostics and therapeutics. One of the most important uses is for immunohistochemical (IHC) staining, a process that has been improving and evolving over decades. IHC is useful when properly employed, yet misuse of the method is widespread and contributes to the “reproducibility crisis” in science. We report some of the common problems encountered with IHC assays, and direct readers to a wealth of literature documenting and providing some solutions to this problem. We also describe a series of vignettes that include our approach to analytical validation of antibodies and IHC assays that have facilitated a number of biological insights into prostate cancer and the refutation of a controversial association of a viral etiology in gliomas. We postulate that a great deal of the problem with lack of accuracy in IHC assays stems from the lack of awareness by researchers for the critical necessity for end-users to validate IHC antibodies and assays in their laboratories, regardless of manufacturer claims or past publications. We suggest that one reason for the pervasive lack of end-user validation for research antibodies is that researchers fail to realize that there are two general classes of antibodies employed in IHC. First, there are antibodies that are “clinical grade” reagents used by pathologists to help render diagnoses that influence patient treatment. Such diagnostic antibodies, which tend to be highly validated prior to clinical implementation, are in the vast minority (e.g. 3 800 000), which are often not extensively validated prior to commercialization. Given increased awareness of the problem, both the United States, National Institutes of Health and some journals are requiring investigators to provide evidence of specificity of their antibody-based assays.
  • Current progress and questions in germline genetics of prostate cancer

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): William B. Isaacs, Jianfeng Xu Dramatic progress has been made in the area of germline genetics of prostate cancer (PCa) in the past decade. Both common and rare genetic variants with effects on risk ranging from barely detectable to outright practice-changing have been identified. For men with high risk PCa, the application of genetic testing for inherited pathogenic mutations is becoming standard of care. A major question exists about which additional populations of men to test, as men at all risk levels can potentially benefit by knowing their unique genetic profile of germline susceptibility variants. This article will provide a brief overview of some current issues in understanding inherited susceptibility for PCa.
  • In honor of Dr. Donald S. Coffey – Prostate cancer biology and

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Allen C. Gao, James L. Mohler
  • Application of fluorescence in situ hybridization in the detection of
           bladder transitional-cell carcinoma: A multi-center clinical study based
           on Chinese population

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Liqun Zhou, Kaiwei Yang, Xuesong Li, Yi Ding, Dawei Mu, Hanzhong Li, Yong Yan, Jinyi Li, Dongwen Wang, Wei Li, Yulong Cong, Jiangping Gao, Kewei Ma, Yajun Xiao, Sheng Zhang, Hongyi Jiang, Weilie Hu, Qiang Wei, Xunbo Jin, Zhichen Guan ObjectiveTo evaluate the diagnostic value of fluorescence in situ hybridization (FISH) in bladder cancer.MethodsWe enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) values were calculated for both the FISH and urine cytology tests.ResultsA cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population. A total of 4807 patients with hematuria were prospectively, randomly enrolled for the simultaneous analysis of urine cytology, FISH testing, and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen. Overall, the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%, while that of cytology was 33.4% (p 
  • Albumin-linked prostate-specific antigen-activated thapsigargin- and
           niclosamide-based molecular grenades targeting the microenvironment in
           metastatic castration-resistant prostate cancer

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Emmanuel S. Akinboye, W. Nathaniel Brennen, Samuel R. Denmeade, John T. Isaacs Localized prostate cancer is curable via annihilation of the entire cancer neighborhood by surgery or local radiation. Unfortunately, once metastatic, no available therapy is curative. The vast majority will die despite aggressive systemic combinational androgen-ablation therapies. Thus, there is an urgent need for effective systemic therapeutics that sterilize the entire microenvironment in metastatic castration-resistant prostate cancer (mCRPC). To accomplish this goal, advantage can be taken of the unique biology of mCRPC cells. Like their normal cell of origin, mCRPCs retain expression of the prostate-specific differentiation protein, prostate-specific antigen (PSA), which they abundantly secrete into their extracellular fluid (ECF). This unique, and essentially universal, secretion of enzymatically active PSA into the ECF by mCRPCs creates an exploitable therapeutic index for activation of systemically delivered highly lipophilic toxins as “molecular grenades” covalently linked to cysteine-34 of human serum albumin (HSA) via a stable maleimide containing PSA cleavable peptide such that PSA-dependent hydrolysis (i.e., “detonation”) releases the grenades restrictively within the ECF of mCRPC. This approach decreases dose-limiting host toxicity while enhancing plasma half-life from minutes to days (i.e., pharmacokinetic effect) and increasing the tissue concentration of the maleimide coupled albumin delivery (MAD) in the ECF at sites of cancer due to the enhanced permeability of albumin at these sites (i.e., enhanced permeability and retention effect). This allows the MAD-PSA detonated grenades to circulate throughout the body in a non-toxic form. Only within sites of mCRPC is there a sufficiently high level of enzymatically active PSA to efficiently “pull the pin” on the grenades releasing their lipophilic cell-penetrant toxins from HSA. Thus, if a sufficient level of “detonation” occurs, this will kill mCRPC cells, and sterilize the entire PSA-rich metastatic sites via a bystander effect. In this review, two examples of such MAD-PSA detonated molecular grenades are presented—one based upon thapsigagin and the other on niclosamide.
  • Targeting androgen receptor-independent pathways in therapy-resistant
           prostate cancer

    • Abstract: Publication date: January 2019Source: Asian Journal of Urology, Volume 6, Issue 1Author(s): Lingfan Xu, Junyi Chen, Weipeng Liu, Chaozhao Liang, Hailiang Hu, Jiaoti Huang Since androgen receptor (AR) signaling is critically required for the development of prostate cancer (PCa), targeting AR axis has been the standard treatment of choice for advanced and metastatic PCa. Unfortunately, although the tumor initially responds to the therapy, treatment resistance eventually develops and the disease will progress. It is therefore imperative to identify the mechanisms of therapeutic resistance and novel molecular targets that are independent of AR signaling. Recent advances in pathology, molecular biology, genetics and genomics research have revealed novel AR-independent pathways that contribute to PCa carcinogenesis and progression. They include neuroendocrine differentiation, cell metabolism, DNA damage repair pathways and immune-mediated mechanisms. The development of novel agents targeting the non-AR mechanisms holds great promise to treat PCa that does not respond to AR-targeted therapies.
  • Revisiting the morphology of pelvicalyceal system in human cadaveric
           kidneys with a systematic review of literature

    • Abstract: Publication date: Available online 21 December 2018Source: Asian Journal of UrologyAuthor(s): Kusum Rajendra Gandhi, Sushama Chavan ObjectiveRenal collecting system macroscopically consists of minor calyx, major calyx, renal pelvis and ureter. Stone in renal collecting system is a common presentation in everyday urological practice. The prevalence of renal calculi ranges from 4% to 20% in different geographical distribution. Anatomical variation in renal collecting system plays a significant role in formation of calculi in its parts. The large extra renal pelvis leads to stagnation of urine for longer durations and formation of stones. The stone free rate after percutaneous nephrolithotomy and extra corporeal shock wave lithotomy is significantly related to anatomical factors, particularly the type of renal pelvis and dimensions (length and width) of lower infundibulum. Previous authors described the morphology of pelvicalyceal system in a highly variable manner and the available anatomical description of pelvicalyceal system is contradictory and incomplete. Hence an attempt has been made to provide the precise anatomy of pelvicalyceal system in adult human kidneys.MethodsWe studied 196 formalin embalmed kidneys to note the number of infundibulum, major and minor calyces. The location and shape of pelvis were also studied.ResultsThe intra-renal pelvis was narrow and had funnel shaped appearance in 95 of total 196 (48.5%) specimens, the extra-renal pelvis was dilated as balloon shaped in 43 of 196 (21.9%) specimens. In 41 (20.9%) specimens, the renal pelvis was having partially intra- and extra-renal in location. Bilateral symmetry was found in only 27.1% of 196 renal collecting systems. The length of lower infundibulum was more than 22 mm in 19 (9.7%) of 196 cases which directly affects the stone clearance rate during open and endoscopic surgeries on pelvicalyceal system.ConclusionThis study provides the accurate morphological details of the shape and dimensions of renal pelvicalyceal system to help the urologists and nephrologists.
  • Contemporary approach to active surveillance for favorable risk prostate

    • Abstract: Publication date: Available online 15 December 2018Source: Asian Journal of UrologyAuthor(s): Laurence Klotz The approach to favorable risk prostate cancer known as “active surveillance” was first described explicitly in 2002. This was a report of 250 patients managed with a strategy of expectant management, with serial prostate specific antigen and periodic biopsy, and radical intervention advised for patients who were re-classified as higher risk. This was initiated as a prospective clinical trial, complete with informed consent, beginning in 2007. Thus, there are now 20 years of experience with this approach, which has become widely adopted around the world. In this chapter, we will summarize the biological basis for active surveillance, review the experience to date of the Toronto and Hopkins groups which have reported 15-year outcomes, describe the current approach to active surveillance in patients with Gleason score 3 + 3 or selected patients with Gleason score 3 + 4 with a low percentage of Gleason pattern 4 who may also be candidates, enhanced by the use of magnetic resonance imaging, and forecast future directions.
  • Priapism secondary to chronic myeloid leukemia treated by a surgical
           cavernosa-corpus spongiosum shunt: Case report

    • Abstract: Publication date: Available online 15 December 2018Source: Asian Journal of UrologyAuthor(s): Min Qu, Xin Lu, Lei Wang, Zhiyong Liu, Yinghao Sun, Xu Gao Priapism secondary to chronic myeloid leukemia (CML) is rarely observed in the clinic. Here, we present an 18-year-old patient with priapism for over 72 h due to hyperleukocytosis. Emergent interventions such as therapeutic aspiration and intracorporal injection of phenylephrine failed before a surgical corpora cavernosa-corpus spongiosum shunt was insertedto relieve symptoms. During hospitalization, bone marrow aspiration confirmed the diagnosis of CML.
  • The current role of prostate multiparametric magnetic resonance imaging

    • Abstract: Publication date: Available online 11 December 2018Source: Asian Journal of UrologyAuthor(s): Olivier Rouviere, Paul Cezar Moldovan Prostate multi-parametric magnetic resonance imaging (mpMRI) has shown excellent sensitivity for Gleason ≥7 cancers, especially when their volume is ≥0.5 mL. As a result, performing an mpMRI before prostate biopsy could improve the detection of clinically significant prostate cancer (csPCa) by adding targeted biopsies to systematic biopsies. Currently, there is a consensus that targeted biopsies improve the detection of csPCa in the repeat biopsy setting and at confirmatory biopsy in patients considering active surveillance. Several prospective multicentric controlled trials recently showed that targeted biopsy also improved csPCa detection in biopsy-naïve patients. The role of mpMRI and targeted biopsy during the follow-up of active surveillance remains unclear. Whether systematic biopsy could be omitted in case of negative mpMRI is also a matter of controversy. mpMRI did show excellent negative predictive values (NPV) in the literature, however, since NPV depends on the prevalence of the disease, negative mpMRI findings should be interpreted in the light of a priori risk for csPCa of the patient. Nomograms combining mpMRI findings and classical risk predictors (age, prostate-specific antigen density, digital rectal examination, etc.) will probably be developed in the future to decide whether a prostate biopsy should be obtained. mpMRI has a good specificity for detecting T3 stage cancers, but its sensitivity is low. It should therefore not be used routinely for staging purposes in low-risk patients. Nomograms combining mpMRI findings and other clinical and biochemical data will also probably be used in the future to better assess the risk of T3 stage disease.
  • Open and robotic radical prostatectomy

    • Abstract: Publication date: Available online 8 December 2018Source: Asian Journal of UrologyAuthor(s): Hendrik van Poppel, Wouter Everaerts, Lorenzo Tosco, Steven Joniau Open retropubic radical prostatectomy has been the “gold standard” treatment for locally confined prostate cancer (PCa) but in recent years minimal invasive techniques as laparoscopy and robot-assisted prostatectomy have become widely available. The trifecta of the surgical treatment of PCa is cancer control, the preservation of continence, and erectile potency. Over the years the complication rates of radical prostatectomy have become very limited with improved cancer control and better functional results. We review the indications and the surgical technique of radical prostatectomy, be it open or laparoscopic, eventually robot-assisted as well as the pre- and postoperative measures and the surgery-related consequences.
  • Present indications and techniques of percutaneous nephrolithotomy: What
           the future holds'

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Itay M. Sabler, Ioannis Katafigiotis, Ofer N. Gofrit, Mordechai Duvdevani The purpose of the review was to present the latest updates on percutaneous nephrolithotomy (PCNL) procedure in terms of indications and evolving techniques, and to identify the advantages and disadvantages of each modality. The data for this review were collected after a thorough PubMed search in core clinical journals in English language. The key words included “PCNL” and “PNL” in combination with “indications”, “techniques”, “review” and “miniaturized PCNL”. Publications relevant to the subject were retrieved and critically reviewed. Current European and American Urology Association Nephrolithiasis Guidelines were included as well. The indications for standard PCNL have been changed through the past decade. Despite evolution of the procedure, innovations and the development of new technical approaches, the indications for miniaturized PCNL have not been standardized yet. There is a need for well-constructed randomized trials to explore the indications, complications and results for each evolving approach. A continuous reduction of tract size is not the only revolution of the last years. There is constant ongoing interest in developing new efficient miniature instruments, intracorporeal lithotripters and sophisticated tract creation methods. We can summarize that, PCNL represents a valuable well-known tool in the field of endourology. We should be open minded to future changes in surgical approaches and technological improvements.
  • Retrograde intrarenal surgery: An expanding role in treatment of

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): María Rodríguez-Monsalve Herrero, Steeve Doizi, Etienne Xavier Keller, Vincent De Coninck, Olivier Traxer During the past 3 decades, the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy. The development of this instrument as well as ancillary equipment such as baskets, graspers, and others, and improvements in lithotripsy with Holmium: YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors. The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.
  • Ureteral stents in urolithiasis

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Matthias Beysens, Thomas O. Tailly Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago, its use has gained tremendous momentum, aiding in the rise and evolution of endourology and has confidently kept its place in modern time urology. Over the past four decades, several designs, coating and biomaterials have been developed, trying to reduce infection, encrustation and other stent related symptoms. As the ideal stent has not yet been discovered, different ways of helping patients with their complaints have been researched. This review will cover these aspects of stent use in urolithiasis.
  • Epidemiology of urolithiasis in Asia

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Yu Liu, Yuntian Chen, Banghua Liao, Deyi Luo, Kunjie Wang, Hong Li, Guohua Zeng In Asia, about 1%–19.1% of the population suffer from urolithiasis. However, due to variations in socio-economic status and geographic locations, the prevalence and incidence have changed in different countries or regions over the years. The research for risk factors of urinary tract stones is of predominant importance. In this review, we find the prevalence of urolithiasis is 5%–19.1% in West Asia, Southeast Asia, South Asia, as well as some developed countries (South Korea and Japan), whereas, it is only 1%–8% in most part of East Asia and North Asia. The recurrence rate ranges from 21% to 53% after 3–5 years. Calcium oxalate (75%–90%) is the most frequent component of calculi, followed by uric acid (5%−20%), calcium phosphate (6%−13%), struvite (2%−15%), apatite (1%) and cystine (0.5%−1%). The incidence of urolithiasis reaches its peak in population aged over 30 years. Males are more likely to suffer from urinary calculi. Because of different dietary habits or genetic background, differences of prevalence among races or nationalities also exist. Genetic mutation of specific locus may contribute to the formation of different kinds of calculi. Dietary habits (westernized dietary habits and less fluid intake), as well as climatic factors (hot temperature and many hours of exposure to sunshine) play a crucial role in the development of stones. Other diseases, especially metabolic syndrome, may also contribute to urinary tract stones.
  • Miniaturised percutaneous nephrolithotomy: Its role in the treatment of
           urolithiasis and our experience

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Guohua Zeng, Wei Zhu, Wayne Lam Miniaturized percutaneous nephrolithotomy (PCNL) procedures have gained increased popularity in recent years. They aim to reduce percutaneous tract size in order to lower complication rates, while maintaining high stone-free rates. Recently, miniaturized PCNL techniques have further expanded, and can currently be classified into mini-PCNL, minimally invasive PCNL (MIP), Chinese mini-PCNL (MPCNL), ultra-mini-PCNL (UMP), micro-PCNL, mini-micro-PCNL, and super-mini-PCNL (SMP). However, despite its minimally-invasive nature, its potential superiority in terms of safety and efficacy when compared to conventional PCNL is still under debate. The aim of this review is to summarise different available modalities of miniaturized PCNL, details of instruments involved, and their corresponding safety and efficacy. In particular, this article highlights the role of the SMP and our experience with this novel technique in management of urolithiasis. Overall, miniaturized PCNL techniques appear to be safe and effective alternatives to conventional PCNL for both adult and pediatric patients. Well-designed, randomized studies are required to further investigate and identify specific roles of miniaturized PCNL techniques before considering them as standard rather than alternative procedures to conventional PCNL.
  • The influence of metabolic syndrome and its components on the development
           of nephrolithiasis

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Carter Boyd, Kyle Wood, Dustin Whitaker, Dean G. Assimos The prevalence of kidney stone disease is increasing, afflicting 7%–11% of the United States population. Multiple systemic conditions, including obesity and diabetes, are also on the rise. Further, the literature has demonstrated a strong association between metabolic syndrome, its components, and kidney stone disease. In this article, we aim to review the associations of metabolic syndrome and nephrolithiasis, discussing the pathophysiology, urinary parameters, and clinical presentations. With this knowledge, urologists will have a more comprehensive understanding of this complex population of metabolic stone formers enabling improved patient management and treatment of stone disease.
  • Stones in pregnancy and pediatrics

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Jennifer Bjazevic, Hassan Razvi Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population, and has increased in incidence significantly over the past 20 years. Along with this, the rate of stone disease among women and children is also on the rise. The management of stone disease in specific populations, such as in children and during pregnancy can present unique challenges to the urologist. In both populations, a multi-disciplinary approach is strongly recommended given the complexities of the patients. Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure. In general, management proceeds from conservative to more invasive approaches and must be individualized to the patient with careful consideration of the potential adverse effects. However, innovations in endourologic equipment and techniques have allowed for the wider application of surgical stone treatment in these patients, and significant advancement in the field. This review covers the history and current advances in the diagnosis and management of stone disease in pregnant and pediatric populations. It is paramount for the urologist to understand the complexities of properly managing stones in these patients in order to maximize treatment efficacy, while minimizing complications and morbidity.
  • Defining metabolic activity of nephrolithiasis – Appropriate evaluation
           and follow-up of stone formers

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Daniel A. Wollin, Adam G. Kaplan, Glenn M. Preminger, Pietro Manuel Ferraro, Antonio Nouvenne, Andrea Tasca, Emanuele Croppi, Giovanni Gambaro, Ita P. Heilberg Considering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologic follow-up. A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis. Both single and recurrent stone formers share many similarities in metabolic profiles. The study group determined that based on an assessment of risk for stone recurrence and metabolic activity, single and recurrent stone formers should be evaluated comprehensively, including two 24 h urine studies on a random diet. Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence. Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient, the risk of chronic kidney disease and the risk of osteoporosis/osteopenia. A standard scheme includes a baseline metabolic profile, a repeat study 3–6 months after initiation of treatment, and then yearly when stable, with abdominal imaging obtained every 1–2 years.
  • Medical therapy for nephrolithiasis: State of the art

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Igor Sorokin, Margaret S. Pearle The prevalence of nephrolithiasis is increasing worldwide. Understanding and implementing medical therapies for kidney stone prevention are critical to prevent recurrences and decrease the economic burden of this condition. Dietary and pharmacologic therapies require understanding on the part of the patient and the prescribing practitioner in order to promote compliance. Insights into occupational exposures and antibiotic use may help uncover individual risk factors. Follow-up is essential to assess response to treatment and to modify treatment plans to maximize therapeutic benefit.
  • Indications and contraindications for shock wave lithotripsy and how
           to improve outcomes

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): Luke F. Reynolds, Tad Kroczak, Kenneth T. Pace For over 35 years shock wave lithotripsy has proven to be an effective, safe and truly minimally invasive option for the treatment of nephrolithiasis. Various technical factors as well as patient selection can impact the success of the procedure. We used published work focusing on outcomes of shock wave lithotripsy, risk of complications, and strategies for improving stone fragmentation to create this review. Multiple patient and technical factors have been found to impact success of treatment. Skin to stone distance, stone density and composition, size and location of the stone within the urinary system all influence stone free rates. A slower rate with a gradual increasing voltage, precise targeting, proper coupling will improve stone fragmentation and decrease risk of complications. The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.
  • Medical and surgical management of urolithiasis

    • Abstract: Publication date: October 2018Source: Asian Journal of Urology, Volume 5, Issue 4Author(s): John D. Denstedt
  • Minimally invasive open dismembered pyeloplasty technique: Miniature

    • Abstract: Publication date: Available online 11 August 2018Source: Asian Journal of UrologyAuthor(s): Farzaneh Sharifiaghdas, Mahboubeh Mirzaei, Azar Daneshpajooh, Shahin Abbaszadeh ObjectiveTo report the outcomes and complications of open dismembered Anderson-Hynes pyeloplasty with miniature incision in treating children's ureteropelvic junction obstruction.MethodsBetween March 2007 and April 2011, 109 children with a mean age of 2 years and 8 months old with ureteropelvic junction obstruction underwent open dismembered pyeloplasty. Clinical manifestations, radiographic assessments, incision size, surgery time, hospital stay, and complication rate were recorded. All patients had a documented ureteropelvic junction obstruction (having T1/2 more than 20 min in diethylenetriaminepentaacetic acid (DTPA) scan) with symptomatic stenosis or decreased kidney function (differential function
  • Single-port transperitoneal robotic-assisted laparoscopic radical
           prostatectomy (spRALP): Initial experience

    • Abstract: Publication date: Available online 10 August 2018Source: Asian Journal of UrologyAuthor(s): Yifan Chang, Xiaojun Lu, Qingliang Zhu, Chuanliang Xu, Yinghao Sun, Shancheng Ren ObjectiveTo assess the feasibility of single-port transperitoneal robotic-assisted laparoscopic radical prostatectomy (spRALP) and discuss its surgical technique.MethodsA 60-year-old male was admitted with an elevated prostate-specific antigen (PSA) level of 13.89 ng/mL and confirmed with prostate cancer on biopsy showing three of 22 positive cores with a Gleason score of 3 + 4 = 7. Multiparametric magnetic resonance (MR) and bone scintigraphy showed organ-confined disease. spRALP was performed using da Vinci Si HD surgical system, with access of a quadri-channel laparoscopic port placed supraumbilically. Two drainage tubes were placed before wound closure. The surgical procedure was largely in consistence with a conventional robotic-assisted laparoscopic radical prostatectomy.ResultsThe surgery was successfully carried out with a duration of 152 min and an estimated blood loss of 100 mL. The patient was discharged on postoperative Day 4 after removal of both pelvic drainage tubes. Foley catheter was removed on postoperative Day 14. No major complications were encountered. Postoperative pathology showed a Gleason score of 3 + 4 = 7 with no extraprostatic extension and negative surgical margins.ConclusionSingle-port robotic prostatectomy is feasible using the currently available robotic instruments in most Chinese robotic urological centers. Meticulous preoperative planning and careful patient selection is mandatory. Further studies concerning perioperative complications and pentafecta outcome compared with the conventional multi-port robotic prostatectomy is required.
  • Effect of warm bladder irrigation fluid for benign prostatic hyperplasia
           patients on perioperative hypothermia, blood loss and shiver: A

    • Abstract: Publication date: Available online 18 July 2018Source: Asian Journal of UrologyAuthor(s): Jie Cao, Xia Sheng, Yan Ding, Lingjuan Zhang, Xiaoying Lu ObjectiveTo find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia, blood loss and shiver in patients treated with benign prostatic hyperplasia (BPH).MethodA comprehensive literature review and meta-analysis that included randomized controlled trials (RCTs) related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers. The relevant literature were searched in Chinese database, such as Retrieval Chinese Journal Full-text Database, VIP Journal Database, Wanfang database, as well as in English search engine and database, including Embase, Cochrane and Medline till January 2018. The study quality was assessed by recommended standards from Cochrane Handbook (version 5.1.0).ResultsA total of 28 RCTs and 3858 patients were included. The results showed that the incidence of shiver (risk ratio (RR) = 0.32, 95% confidence interval (CI): 0.28–0.36, p 
  • Mixed epithelial and stromal tumour with extension to vesicoureteric

    • Abstract: Publication date: Available online 30 June 2018Source: Asian Journal of UrologyAuthor(s): Arun Ramdas Menon, T.P. Rajeev, Nivedita Suresh, Suraj Hegde Mixed epithelial and stromal tumour (MEST) is an uncommon renal tumour with a tendency to protrude into the collecting system. We present a 50-year-old woman with a renal tumour extending up to the vesicoureteric junction (VUJ) who was suspected to have an upper tract transitional cell carcinoma for which a nephroureterectomy was performed. Histopathologic examination revealed a MEST arising from the kidney and extending up to the VUJ. To the best of our knowledge, this is the first report of a renal MEST with extension to the VUJ.
  • Use of a specific questionnaire and perineal electromyography to assess
           neuropathic pain after radical retropubic prostatectomy

    • Abstract: Publication date: Available online 21 June 2018Source: Asian Journal of UrologyAuthor(s): Nicolas Turmel, Samer Sheikh Ismael, Camille Chesnel, Audrey Charlanes, Claire Hentzen, Frederique Le Breton, Gérard Amarenco ObjectiveProstate cancer is the most frequent cancer in men and radical retropubic prostatectomy (RRP) is one of the first-line treatment. However, RRP has some side effects and can lead to chronic perineal pain. The objective of the study was to determine in patients suffering from perineal pain after RRP the possibility of a neurogenic damage by means of a specific questionnaire dedicated to track down neuropathic pain.MethodsForty patients were explored by a specific and validated questionnaire, the Neuropathic Pain Symptom Inventory (NPSI). Patients were divided into two groups: Group A with an NSPI score ≥4 was considered as suffering from neuropathic pain, and Group B was considered as a control group without neuropathic pain (NSPI score
  • Inadvertent insertion of nephrostomy tube into the renal vein following
           percutaneous nephrolithotomy: A case report and literature review

    • Abstract: Publication date: Available online 21 June 2018Source: Asian Journal of UrologyAuthor(s): Guangju Ge, Zhenghui Wang, Mingchao Wang, Gonghui Li, Zuhao Xu, Yukun Wang, Shawpong Wan Percutaneous nephrolithotomy (PCNL) is an effective and well accepted procedure for the treatment of large and complex renal calculi. We encountered a patient with a misplaced percutaneous nephrostomy drainage tube (PNDT) into the contralateral renal vein resulting thrombus formation after undergoing right side PCNL. We placed a temporary filter to prevent embolism and started anti-coagulation therapy immediately and finally the PNDT was removed without bleeding.
  • Mesenteric metastases from mature teratoma of the testis: A case report

    • Abstract: Publication date: Available online 5 June 2018Source: Asian Journal of UrologyAuthor(s): Zoe Loh, Todd G. Manning, Jonathan S. O'Brien, Marlon Perera, Nathan Lawrentschuk Metastatic spread of testicular cancer has been well documented, with 95% of cases involving para-aortic retroperitoneal lymph nodes. Mesenteric lymphatic basins do not lie within the canonical drainage pathway of the testes and represent a rare site of metastasis. Various mechanisms of spread to the mesentery have been described, including direct extension and haematogenous dissemination. We present a case of a previously-well 43-year-old man who presented with right scrotal discomfort and intermittent lower back pain, who was found to have mesenteric metastases from a non-seminomatous germ cell tumour of the testis. Managing lymphadenopathy that lies outside of standard resection templates remains a complex surgical challenge. Here we present the first case in the English medical literature with co-existing supradiaphragmatic axillary and mediastinal nodal disease.
  • Management of bladder pheochromocytoma by transurethral resection

    • Abstract: Publication date: Available online 26 May 2018Source: Asian Journal of UrologyAuthor(s): Aditya P. Sharma, Girdhar S. Bora, Ravimohan S. Mavuduru, Vikas K. Panwar, Bhagwant R. Mittal, Shrawan K. Singh Bladder pheochromocytoma is the most common extra-adrenal genitourinary tumor. Endoscopic management is feared due to the risk of intra-operative hypertensive crisis. We described a case of successful endoscopic management of a bladder pheochromocytoma and discussed its technical aspects.
  • Acute testicular ischaemia following aortoiliac stenting for aortoiliac
           occlusive disease

    • Abstract: Publication date: Available online 17 May 2018Source: Asian Journal of UrologyAuthor(s): Li-Tsa Koh, Kiat Huat Ooi, Foo Cheong Ng Endovascular treatment is increasingly employed as the treatment for symptomatic aortoiliac occlusive disease. One of the possible complications of aortoiliac stenting is the development of emboli. We present a case of a 60-year-old patient presenting with right scrotal pain immediately following aortoiliac stenting for right common iliac, proximal external iliac and proximal internal iliac arteries thrombosis. He was found to have testicular ischaemia with absent blood flow on duplex ultrasonography. The patient was managed expectantly and reduced blood flow spontaneously returned to the testis over the next few weeks.
  • Compliance in patients with dietary hyperoxaluria: A cohort study and
           systematic review

    • Abstract: Publication date: Available online 29 March 2018Source: Asian Journal of UrologyAuthor(s): Hennessey Derek Barry, Kinnear Ned, Rice Gilbert, Curry David, Woolsey Siobhan, Duggan Brian ObjectiveHyperoxaluria leads to calcium oxalate crystal formation and subsequent urolithiasis. This study aims to analyse the effect of treatment compliance in hyperoxaluria, firstly by analysis of patients with non-primary hyperoxaluria and secondly via systematic review in patients with any hyperoxaluria.MethodsIn a retrospective cohort study, adults with non-primary hyperoxaluria managed with dietary counselling in 2013 were enrolled. Twenty-four-hour (24 h) urine collections initially and at 6 months were obtained. Compliance was assessed by self-reported dietary compliance and 24 h urinary volume>2 L. Patients were followed for 24 months. Primary outcomes were urinary oxalate and calcium 24 h load at 6 months, and urolithiasis-related procedural rates at 24 months. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compatible systematic review of compliance among hyperoxaluric patients was performed.ResultsIn the cohort study, of 19 eligible patients (4 female) with median age 52 years, 10 (53%) were considered compliant. Compared with the non-compliant group, these patients had significantly increased subsequent 24 h urinary volume (2250 mL vs. 1600 mL; p = 0.008) and lower procedural rates (10% vs. 56%; p = 0.033). Subsequent 24 h urinary oxalate load was non-significantly lower in compliant patients. Systematic review regarding compliance in hyperoxaluric patients revealed five studies. Only one utilised dietary counselling or analysed compliant vs. non-compliant patients, finding no difference. None examined the effect of compliance on procedural rates.ConclusionHyperoxaluria is an important cause of recurrent urolithiasis. Increasing fluid intake and reducing dietary oxalate reduce the risk of operative intervention and remain fundamental to the treatment of hyperoxaluria.
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Heriot-Watt University
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