JournalTOCs

Urologia Journal
Journal Prestige (SJR): 0.189

Number of Followers: 0

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0391-5603 - ISSN (Online) 1724-6075
Published by Sage Publications

[1176 journals]

Evaluation of efficacy and safety of Botulinum toxin-A injection at three
deferent sites in treatment of premature ejaculation
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  Authors: Ahmed Rashad Elshahid, Abobakr Osama Abdel-Goad Taher, Ahmed Hassan Nouh
  Abstract: Urologia Journal, Ahead of Print.
  Background:Premature ejaculation (PE) is a common sexual problem, resulting in adverse effects on the quality of life, of both the patient and the partner. The idea of muscular contraction inhibition during the ejection phase of ejaculation by Botulinum toxin-A injection may delay ejaculation.Aim of study:This study was performed to assess the efficacy and safety of Botulinum toxin-A injection in PE treatment.Material and methods:This study included 45 married male patients diagnosed with primary PE. All included patients were injected with 75 units of Dysport equal efficacy of 25 units of Botulinum toxin-A (Botox) into three sites: the root of the penis (Group 1), glans penis (Group 2), and each side of the ischiocavernosus muscle (Group 3). All patients were subjected to an assessment of intravaginal ejaculation latency time (IELT) using a stopwatch and answering the Premature Ejaculation Diagnostic Tool (PEDT) Questionnaire before and after treatment.Results:There was a statistically significant improvement in IELT after treatment in all groups. The most significant improvement was shown in Group 3 (average 108% increase), followed by Group 1 (74%) and Group 2 (40%), respectively. There was a positive correlation between age and the improvement in improved IELT. There was a statistically significant improvement in PEDTq scores in Group 1 and Group 3.Conclusion:Botulinum toxin-A injection into the root of the penis and ischiocavernosus muscle could be recommended in the treatment of premature ejaculation.
  Citation: Urologia Journal
  PubDate: 2024-08-02T12:51:39Z
  DOI: 10.1177/03915603241265825
Transvesical blockade of the obturator nerve to prevent adductor
contraction in transurethral resection of urinary bladder tumor
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  Authors: Sunirmal Choudhury, Shahbaaz Ahmed, Anjana Ghosh Dastidar Bose, Debasish Ghosh
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Urinary bladder tumors are one of the most common urological malignancies. Traditionally, it has been managed with trans-urethral resection of urinary bladder tumor (TURBT) for both diagnostic and therapeutic purposes. During TURBT of lateral wall tumors, there is risk of obturator nerve reflex (ONR), which can lead to serious complications such as inadvertent bleeding and urinary bladder perforation. To prevent this, obturator nerve block is given after spinal anesthesia. In this study, we have used the transvesical approach to block the obturator nerve.Materials and methods:In total, 60 patients were included in the study. In 30 of them, TURBT was performed under only SA and transvesical obturator nerve block (ONB). In the other 30 patients, TURBT was performed under SA and peripheral nerve stimulator (PNS) guided obturator nerve block (performed by anesthetists) was given. The patients underwent TURBT using conventional monopolar cautery. The procedure time and peri-operative complications were studied. In all patients, informed consent was taken.Results:In this study, 30 ONBs (all bilateral) were performed transvesically. After confirming the location of the obturator nerve, transvesical ONB was given using local anesthetic. Two patients (6.67%) experienced adductor jerk during the operation. In the 30 patients who underwent peripheral nerve stimulator (PNS) guided ONB, 6 of the patients (20%) experienced adductor jerk during the operation and 1 of those (3.33%) suffered from urinary bladder perforation which was managed conservatively.Conclusion:Transvesical ONB is an easy method to prevent adductor jerk during TURBT of lateral wall tumors. The learning curve is less and it has a high success rate.
  Citation: Urologia Journal
  PubDate: 2024-07-26T01:20:55Z
  DOI: 10.1177/03915603241266907
Assessing the safety of bladder-preserving therapy as an alternative to
surgical intervention in elderly patients with muscle invasive bladder
cancer
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  Authors: Christopher R. Koller, Jacob W. Greenberg, Caleb Natale, L. Spencer Krane
  Abstract: Urologia Journal, Ahead of Print.
  Background:There is interest in using bladder-preserving therapy as an alternative definitive therapy for muscle invasive bladder cancer in certain high-risk groups such as the elderly.Objective:To determine if bladder-preserving therapy represents a safer alternative to surgical intervention in elderly patients with muscle invasive bladder cancer.Methods:We surveyed the Surveillance, Epidemiology and End Results database (SEER) for cases of non-metastasized malignant bladder cancer in patients aged 80+. Survival outcomes with radical cystectomy (RC) with or without chemotherapy were compared to those after chemotherapy and radiation without cystectomy. We performed log-rank tests and Kaplan-Meier and cox regression and hazard analyses before and after propensity score matching.Results:A total of 2995 patients were identified, with 49.98% treated with RC only, 8.65% treated with RC/chemotherapy, and 41.37% treated with chemotherapy and radiation without RC. Median overall survival for the RC only, RC/chemotherapy and chemotherapy/radiation groups were 31.4, 44.1, and 24.6 months, respectively. On multivariate analysis, hazard ratios (reference: RC/chemotherapy group) were RC Only (HR = 1.408 (95% CI 1.188–1.669), p
  Citation: Urologia Journal
  PubDate: 2024-07-26T01:15:26Z
  DOI: 10.1177/03915603241265828
A thematic analysis of the perceptions of reversible inhibition of sperm
under guidance as a potential family planning method in the United Kingdom
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  Authors: Cristina M Gheorghe, Olivia Slack, Amanda D Wilson
  Abstract: Urologia Journal, Ahead of Print.
  Background:This exploratory study aimed to look into public perceptions of Reversible Inhibition of Sperm Under Guidance (RISUG) as a family planning method in the United Kingdom (UK). It also aimed to discover if there were any sex differences in perceptions between males and females.Design:Twelve semi-structured interviews were conducted, six with males and six with females, all residents of the UK.Methods:The audio data from the interviews then was transcribed for analysis. An inductive and a semantic thematic analysis was conducted on the data set.Results:Three main themes were constructed, including: (i) RISUG Hesitancy, (ii) Females perceived benefits of RISUG and (iii) Males perceived concerns regarding RISUG. Hesitancy was related to vaccination hesitancy, females wanted males to have more reproductive autonomy and males placed their concerns through the lens of ‘other’ males that their may be unintended side effects. Together these three themes represent both perceived risk and overall benefits of the method. However, while randomized control trails have been completed to standard for RISUG, males perceived concerns, suggesting a disconnect between the public’s perceptions and professionals understanding of trails.Conclusion:RISUG was perceived as a viable option for family planning in the future, however trust of the new contraceptive method will need to be fostered among the public in order to effectively transfer knowledge on the potential side effects and the standard of pre-market testing for these. Effective public health messages can result in better education of people concerning the new contraceptive method, including the risks and benefits. By using perceptions to inform health messages around RISUG, researchers and practitioners can learn from potential users how to best address misinformation or concerns, while at the same time building an evidence base for when new male methods reach the contraceptive market.
  Citation: Urologia Journal
  PubDate: 2024-07-26T01:10:54Z
  DOI: 10.1177/03915603241261813
Tumor morphology evaluation using 3D-morphometric features of renal masses
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  Authors: Fiev Dmitry, Sirota Evgeniy, Kozlov Vasiliy, Proskura Alexandra, Ismailov Khalil, Shpot Evgeny, Chernenkiy Mikhail, Puzakov Kirill, Tarasov Alexander, Korolev Dmitry, Azilgareeva Camilla, Vinarov Andrey, Butnaru Denis, Glybochko Petr, Rapoport Leonid
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To assess the correlation between the general (gender, age, and maximum tumor size) and 3D morphotopometric features of the renal tumor node, following the MSCT data post-processing, and the tumor histological structure; to propose an equation allowing for kidney malignancy assessment based on general and morphometric features.Materials and methods:In total, 304 patients with unilateral solitary renal neoplasms underwent laparoscopic (retroperitoneoscopic) or robotic partial or radical nephrectomy. Before the procedure, kidney contrast-enhanced MSCT followed by the tumor 3D-modeling was performed. 3D model of the kidney tumor, and its morphotopometric features, and histological structure were analyzed. The morphotopometric ones include the side of the lesion, location by segments, the surface where the tumor, the depth of the tumor invasion into the kidney, and the shape of tumor.Results:Out of 304 patients, 254 (83.6%) had malignant kidney tumors and 50 (16.4%) benign kidney tumors. In total, 231 patients, out of 254 (90.9%) were assessed for the degree of malignant tumor differentiation. Malignant tumors were more frequent in men than in women (p
  Citation: Urologia Journal
  PubDate: 2024-07-26T01:06:54Z
  DOI: 10.1177/03915603241261499
Assessment of prevalence of sexual dysfunction in patients having lower
urinary tract symptoms with benign prostatic hyperplasia and effect of
various treatment modalities on sexual function
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  Authors: Jagamohan Mishra, Sunirmal Choudhury, Subham Sinha, Gourab Kundu, Partha Protim Mondal, Malay Bera
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Sexual dysfunction affects a couple’s relationship and quality of life of the patient and the partner irrespective of age. In Lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH), sexual dysfunction is highly prevalent. This study aims to evaluate prevalence of sexual dysfunction in patients having LUTS with BPH and effect of various treatment on it.Materials and methods:The study is hospital based prospective cross-sectional study. Total 106 patients were included in this study. Fifty-six patients underwent medical treatment and 50 patients underwent transurethral resection of prostate (TURP) according to lower urinary tract symptom score along with grades of prostate. We measured prevalence of lower urinary tract symptoms, erectile dysfunction (ED), ejaculatory dysfunction (EJD).We compared the pre and post treatment ED, EJD scores in both medical and TURP group.Result:In our study, 11 (10.4%) patients had very mild ED, 12 (11.3%) had mild ED, 54 (50.9%) had moderate ED and 23 (21.7%) had severe ED. In our study, 11 (10.4%) patients had very mild EJD, 7 (6.6%) had mild EJD, 28 (26.4%) had moderate EJD and 2 (1.9%) had severe EJD. In medical group, ED pre-treatment versus ED post treatment was statistically significant (p = 0.0046), treatment of LUTS improves ED. EJD pre-treatment versus EJD post treatment was not statistically significant (p = 0.8368), treatment of LUTS associated with deterioration of EJD. In TURP group association of ED pre-treatment versus ED post treatment was statistically significant (p = 0.0319). Post TURP patients shows improvement in ED Association of EJD pre-treatment versus EJD post-treatment was statistically significant (p = 0.03000). Post TURP EJD deteriorate.Conclusion:We concluded that the severity of sexual dysfunction correlates with severity of LUTS. Ejaculatory function deteriorates after treatment of TURP compared to medical.
  Citation: Urologia Journal
  PubDate: 2024-07-26T01:03:55Z
  DOI: 10.1177/03915603241254717
Assessment of the diagnostic efficacy of radiological and functional
evaluation of primary adrenal mass and its’ surgical outcomes
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  Authors: Yash Manharlal Tilala, Sabyasachi Panda, Abhilekh Tripathi, Sachin Sharma, Amiya Shankar Paul, Sanjay Choudhuri, Samir Swain
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Objective of this study was to assess the diagnostic efficacy of the most commonly used radiological evaluation in form of contrast enhanced computed tomography of abdomen with adrenal protocol, basic functional evaluation and surgical outcomes of primary adrenal masses.Material and methods:We have retrospectively analysed the institutional records of 108, patients admitted from August 2017 to September 2023, who had underwent surgical intervention for their adrenal mass after thorough evaluation and stabilization.Results:Flank pain was the most common symptoms in 44 (40.74%) patients. Non-functional adrenal adenoma was found in 36 (33.33%) patients. Pheochromocytoma was the most the common functional adrenal mass found in 24 (22.22%) patients. CECT abdomen had suggested features of malignancy in 16(14.81%) patients. In final histopathological report 26(24.07%) patients had pheochromocytoma and 12 (11.11%) patients had adrenocortical carcinoma. CECT abdomen had sensitivity of 75%, specificity of 95.6%. Plasma free metanephrines and normetanephrine analysis had shown sensitivity of 90%, specificity of 92.86%, aldosterone to renin ratio had sensitivity of 92%, specificity of 100%. Sensitivity and specificity of the low-dose dexamethasone suppression test and plasma dehydroepiandrosterone was 100% in our study. Eighty patients (74.07%) were operated with laparoscopic adrenalectomy, 20 (18.52%) patients with open adrenalectomy. Eight patients (7.41%) were converted from laparoscopic to open. Laparoscopic approach had significantly lesser mean operating time, lesser blood loss, lesser hospitalization and lesser post-operative complications.Conclusion:Radiological analysis and functional analysis has shown good sensitivity and high specificity. Laparoscopic approach has advantage of lesser operative time, lesser hospitalization and lesser post-operative complications.
  Citation: Urologia Journal
  PubDate: 2024-07-25T11:30:47Z
  DOI: 10.1177/03915603241259881
Phospholipase A2 expression in prostate cancer as a biomarker of good
prognosis: A comprehensive study in patients with long follow-up
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  Authors: Saulo da Cunha Recuero, Nayara I Viana, Sabrina T Reis, Keith T Mendes, Leda L Talib, Wagner F Gattaz, Vanessa R Guimarães, Iran A Silva, Ruan C. P Pimenta, Juliana A Camargo, Willian C Nahas, Miguel Srougi, Katia R. M Leite
  Abstract: Urologia Journal, Ahead of Print.
  Background:Phospholipase A2 (PLA2) is a large family of enzymes involved in the inflammatory process that catalyzes the hydrolysis of membrane phospholipids, leading to the production of free fatty acids and lysophospholipids, starting the arachidonic acid cascade. Their expression has been related to the behavior of several cancers. Our objective is to search for PLA2 expression in prostate cancer (PCa) tissue that correlates with prognosis and survival.Methods:Using qRT-PCR, we analyzed the expression levels of PLA2G1B, PLA2G2A, PLA2G2D, PLA2G4A, PLA2G4B, PLA2G4C, PLA2G4D, PLA2G4E, PLA2G4F, PLA2G6, PLA2G7, PLA2G16, PNPLA1, and PNPLA2 in PCa tissue from 108 patients submitted to radical prostatectomy, followed by a mean time of 163 months.Results:All PLA2 was overexpressed in PCa compared to normal tissue. Interestingly, higher expression of some PLA2 was related to favorable prognostic factors: lower levels of PSA (PLA2G2A, PLA2G4D), lower rates of lymph node metastasis (PLA2G16 and PLA2G1B), and organ-confined disease (PLA2G4A). Most importantly, PLAG4B was independently related to longer disease-free survival.Conclusion:This is the first study exploring comprehensively the expression levels of PLA2 in PCa, showing that the higher expression of some PLA2 should be used as biomarkers of good prognosis and longer disease-free survival.
  Citation: Urologia Journal
  PubDate: 2024-07-25T10:47:46Z
  DOI: 10.1177/03915603241257362
Neutrophil to lymphocyte ratio and serum procalcitonin level as a
predictor of spontaneous ureteral stone passage: A prospective study
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  Authors: Gaurav Faujdar, Sanjeev Jaiswal, Satyaveer Singh, Rahul Singh, Prashant Sevach, Saurabh Negi, Shivam Priyadarshi
  Abstract: Urologia Journal, Ahead of Print.
  Background:Ureteric stone is responsible for around 20% of urinary tract stones and among them 70% of these are located in distal portion of the ureter. Stone causing ureter obstruction produce inflammatory changes in ureteric wall and prevent spontaneous passage of stone. The objective of the study is to compare the predictive role of procalcitonin and Neutrophil-to-lymphocyte ratio (NLR) for spontaneous passage of stone.Materials and methodology:Total 150 participants having ureteric stone of 4–8 mm, were included in prospective observational study. The patients were followed up for 4 weeks. Spontaneous Stone Passage (SSP) was confirmed with either the patient collecting the stone during urination or by Non-Contrast CT performed at 4 weeks. Blood samples of the patients were analysed and White blood cells, sedimentation, Neutrophile to Lymphocyte (NLR), procalcitonin level compared to analyse predictors of future SSP.Result:The procalcitonin levels of the Spontaneous stone passing SSP (−ve) group (209.05 ± 78.45 pg/ml) were significantly higher than the not passing the SSP (+ve) group (130.76 ± 24.18) (p
  Citation: Urologia Journal
  PubDate: 2024-07-25T10:44:04Z
  DOI: 10.1177/03915603241254957
Exploring the landscape of urinary tract melanomas: A review for
pathologists and clinicians
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  Authors: Elisabetta Maffei, Antonio D’Antonio, Maria Addesso, Savio Domenico Pandolfo, Paolo Verze, Alessandro Caputo
  Abstract: Urologia Journal, Ahead of Print.
  Melanomas originating within the urinary tract represent a rare and clinically challenging subset of malignancies. Despite extensive research on cutaneous melanomas, urinary tract melanomas remain relatively unexplored, presenting diagnostic dilemmas and limited treatment consensus. In this comprehensive review, we synthesize current knowledge on the epidemiology, risk factors, clinical presentation, histopathological characteristics, and treatment strategies specific to this disease. Enhancing clinical awareness, refining diagnostic approaches, and exploring novel therapeutic interventions hold promise for improving outcomes in this challenging malignancy subset.
  Citation: Urologia Journal
  PubDate: 2024-07-24T08:34:48Z
  DOI: 10.1177/03915603241263215
Downward trend in male reproductive health and fertility in Eastern Iran
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  Authors: Hamid Pakmanesh, Nasrin Nazarirobati, Shahriar Dabiri, Tooraj Reza Mirshekari, Hamidreza Momeni, Sajedeh Jadidi, Hamidreza Rouientan, Hamideh Hanafi Bojd, Parham Torabinavid, Behzad Narouie
  Abstract: Urologia Journal, Ahead of Print.
  This study aimed to assess the ten-year trend in semen quality among couples referred to the Infertility Center in Kerman between 2008 and 2017. The study included 2952 semen samples from men 18 to 60 years old referred to the infertility center as infertile couples living in Kerman province, Iran, whether they had normal or abnormal semen analysis. A total of 2952 sperm samples were included. Statistically significant changes were observed in semen parameters. Particularly, significant changes were observed for volume (−0.08 mL/year), sperm concentration (−2.34 (mio/mL)/year), total sperm count (−13.17 (mio/ejaculate)/year), progressive motility (−2.62%/year), non-progressive motility (−0.59%/year), immotile sperm (2.49%/year), and normal morphology (−0.134%/year). In bivariate analysis, the prevalence of oligozoospermia in this study showed a statistically significant association with age (OR = 1.019; 95% CI = 1.007−1.032; p = 0.003). Likewise, there was a statistically significant association with the year (OR = 1.087; 95% CI = 1.050−1.125; p = 0.000). Semen quality parameters showed a downtrend during the last 10 years in this study, emphasizing the importance of male reproductive health monitoring and warning public health coordinators to pay more attention to this important issue.
  Citation: Urologia Journal
  PubDate: 2024-07-24T08:31:56Z
  DOI: 10.1177/03915603241261144
The role of alternative medicine and complimentary therapies in urologic
disease: New horizons
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  Authors: Bizzarri Francesco Pio, Campetella Marco, Ragonese Mauro, Scarciglia Eros, Russo Pierluigi, Marino Filippo, Filomena Giovanni Battista, Gavi Filippo, Rossi Francesco, D’Amico Lorenzo, Gandi Carlo, Foschi Nazario, Recupero Salvatore Marco, Sacco Emilio
  Abstract: Urologia Journal, Ahead of Print.
  The world of complementary and alternative medicine (CAM) encompasses a wide range of practices, treatments, and products that fall outside the realm of conventional (mainstream) medicine. The use of complementary and CAM has become increasingly popular in Western nations. People are turning to CAM for a variety of reasons, including managing chronic diseases, relieving symptoms of various conditions, and improving their overall health and well-being. There’s a growing trend of people using and showing interest in complementary and alternative medicine therapies, especially in Western countries. CAM encompasses a wide range of treatments, some offering complete alternatives to conventional medicine, while others aim to complement existing medical approaches. Urologists should stay informed about CAM to guide their patients effectively to treat patients in a modern and personalized way. The aim of review is to analyze the scenario of complimentary and alternative medicine with a specific focus in the urological field.
  Citation: Urologia Journal
  PubDate: 2024-07-24T08:29:30Z
  DOI: 10.1177/03915603241258697
Robotic bladder diverticulectomy with concurrent management of bladder
outlet obstruction: A choice to consider
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  Authors: Angelo Orsini, Alessio Digiacomo, Simone Ferretti, Flavia Tamborino, Martina Basconi, Rossella Cicchetti, Giulio Litterio, Guglielmo Dello Stritto, Gaetano Salzano, Michele Marchioni, Luigi Schips
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Acquired bladder diverticula (BD) are associated with bladder outlet obstruction. The aim of our study is to analyse the improvement in lower urinary tract symptoms (LUTS) in patients who underwent robot-assisted bladder diverticulectomy (RABD) combined with transurethral prostatectomy (TURP).Material and methods:A prospectively single-centre, single surgeon cohort of four patients with posterolateral BD due to bladder outlet obstruction (BOO) undergoing RABD combined with TURP between 2018 and 2023 was analysed.Results:Median age and maximum BD diameter were 73.5 years and 16 cm, respectively. All patients had severe LUTS and elevated postvoid residual (PVR). Preliminary uroflowmetry revealed bladder outlet obstruction with a median of maximum urine flow rate of 8.5 ml/s. The median operative time and blood loss were 212 min and 100 ml, respectively. No intraoperative complications were recorded. The median length of stay was 4 days. The International Prostate Symptom Score (IPSS) and PVR were compared between baseline, 1 month and 6 months after surgery. IPSS significantly decreased from 24 (IQR 24–25) preoperatively compared to the postoperative, at 1 month follow up 7 (IQR 6–8) (p
  Citation: Urologia Journal
  PubDate: 2024-06-18T04:59:48Z
  DOI: 10.1177/03915603241258107
Comparison of the overall survival of different treatment methods in
patients with Muscle-invasive bladder cancer: A retrospective study
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  Authors: Hamid Pakmanesh, Azadeh Khajehsalimi, Mohammadamin Hesamarefi, Mohamad reza Ebadzadeh, Azam Bazrafshan, Reza Malekpourafshar, Mahboubeh Mirzaei, Azar Daneshpajouh, Armita Shahesmaeili, Nazanin Eslami
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:Bladder-Sparing Approach was presented in patients who are not willing or not suitable for Radical Cystectomy (RC). There have been inconsistencies in the literature regarding the comparison of survival rates of these two methods. Our objective is to evaluate the survival rate of patients with muscle-invasive bladder cancer (MIBC) undergoing different treatment methods.Design:Retrospective cross-sectional study.Setting:A secondary care, multicenter study in Kerman, Iran 2008 to 2016.Participants:All 200 patients who were diagnosed with Muscle Invasive Bladder Cancer and were admitted to our hospitals. Patients with inaccessible medical files and patients with pathologies other than TCC were excluded.Main outcome measures:Radical cystectomy and different methods of bladder preservation were compared based on their survival rate.Interventions:Radical cystectomy or bladder preservationResults:Overall survival of the patients was 2 years [95% CI: 1.37–2.63]. The overall 5-year survival rate of patients with MIBC was 32%. Having a 6.4 years overall survival, the RC group showed the highest survival compared with others (p = 0.01); the overall survival of patients undergoing TMT, TURT, chemotherapy, or radiotherapy monotherapy was 3.15 years [95% CI: 2.242–4.061], 4.06 [95% CI: 3.207–4.931], 2.58 [95% CI: 1.767–3.399], and 3.14 [95% CI: 1.614–4.672] years, respectively. Patients younger than 65 undergoing RC had an overall survival of 7 years, compared with 2 years for the TMT group. (p = 0.0001).Conclusions:The Bladder-Preservation method, as a replacement for RC, showed a lower overall survival rate in our study. A prospective randomized clinical trial may declare the best treatment.
  Citation: Urologia Journal
  PubDate: 2024-06-13T05:59:34Z
  DOI: 10.1177/03915603241256009
In-bore MRI targeted biopsy. Lights and shadows
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  Authors: Totaro A. Cretì, Mauro Ragonese
  Abstract: Urologia Journal, Ahead of Print.
  Multiparametric Magnetic Resonance Imaging (MpMRI) and MRI-guided biopsy (MRGB) are the diagnostic gold standard in the management of men with suspicious prostate cancer (PCa). There are not enough studies, yet, that compare TRUS-MRGB, COG-TB and IB-MRGB. Despite IB-MRGB could be more accurate in detecting PCa in smaller lesions and a less operator dependent technique, there are still some concerns regarding high resource costs and the chance of missing lesions not visible at MRI or detected by systematic biopsy.
  Citation: Urologia Journal
  PubDate: 2024-05-23T12:19:21Z
  DOI: 10.1177/03915603241252912
2012 Briganti nomogram predict prostate cancer progression in EAU
intermediate risk with unfavorable tumor grade: A single center experience
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  Authors: Antonio Benito Porcaro, Sonia Costantino, Claudio Brancelli, Alberto Baielli, Francesco Artoni, Francesca Montanaro, Sebastian Gallina, Alberto Bianchi, Emanuele Serafin, Alessandro Veccia, Andrea Franceschini, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Riccardo Giuseppe Bertolo, Maria Angela Cerruto, Alessandro Antonelli
  Abstract: Urologia Journal, Ahead of Print.
  Background:To investigate the potential prognostic impact of Briganti’s 2012 nomogram in EAU intermediate-risk patients presenting with an unfavorable tumor grade and treated with robot-assisted radical prostatectomy, eventually associated with extended pelvic lymph node dissection.Materials and methods:From January 2013 to December 2021, the study included 179 EAU intermediate-risk patients presenting with an unfavorable tumor grade (ISUP 3), eventually associated with a PSA of 10–20 ng/ml and/or cT-2b. Briganti’s 2012 nomogram was assessed as both a continuous and dichotomous variable, categorized according to the median (risk score ⩾7% vs
  Citation: Urologia Journal
  PubDate: 2024-05-23T12:17:50Z
  DOI: 10.1177/03915603241252911
3D virtual model for robot-assisted partial nephrectomy in highly-complex
cases (PADUA ⩾ 10)
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  Authors: Antonio Andrea Grosso, Fabrizio Di Maida, Luca Lambertini, Anna Cadenar, Simone Coco, Elena Ciaralli, Vincenzo Salamone, Gianni Vittori, Agostino Tuccio, Andrea Mari, Andrea Minervini
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:To compare two cohorts of patients submitted to robot-assisted partial nephrectomy (RAPN) for highly-complex renal masses (PADUA ⩾ 10) with versus without the use of 3DVMs.Materials and Methods:We screened a prospective consecutive cohort of 152 patients submitted to RAPN with 3DVM and 1264 patients submitted to RAPN without 3DVM between 2019 and 2022. Only PADUA ⩾ 10 cases were considered eligible for analysis. Propensity score matching (PSM) analysis was applied. Primary endpoint was to evaluate whereas RAPNs with 3DVM were superior in terms of functional outcomes at 12-month. Secondary outcomes were to compare perioperative and oncological outcomes. Multivariable logistic regression analyses (MVA) tested the associations of clinically significant eGFR drop and 3DVMs. Subgroups analysis was performed for PAUDA-risk categories.Results:Thirty seven patients for each group were analyzed after PSM. RAPN with 3DVM presented a higher rate of selective/no clamping procedure (32.5% vs 16.2%, p = 0.03) and a higher enucleation rate (43.2% vs 29.8%, p = 0.04). Twelve-month functional preservation performed better within 3DVM group in terms of creatinine serum level (median 1.2 [IQR 1.1–1.4] vs 1.6 [IQR 1.1–1.8], p = 0.03) and eGFR (median 64.6 [IQR 56.2–74.1] vs 52.3 [IQR 49.2–74.1], p = 0.03). MVA confirmed 3DVM as a protective factor for clinically significant eGFR drop in this subgroup of patients.Conclusions:RAPN performed with the use of 3DVM assistance for PADUA ⩾ 10 cases resulted in lower incidence of global ischemia and higher rate of enucleations. The positive impact of such technology was found at 12-month follow-up.
  Citation: Urologia Journal
  PubDate: 2024-05-21T10:07:40Z
  DOI: 10.1177/03915603241252905
Efficacy and safety of antegrade sclerotherapy for varicocele in pediatric
patients: A systematic review
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  Authors: Giuseppe Aiello, Alessandro Morlacco, Giovanni Motterle, Marta Bianco, Mariangela Mancini, Paolo Beltrami, Fabio Zattoni, Massimo Iafrate, Fabrizio dal Moro
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:Antegrade sclerotherapy (Tauber’s) procedure has been extensively used for the minimally-invasive treatment of varicocele; however, the results in the pediatric population are less defined. This systematic review evaluates the efficacy and safety of antegrade sclerotherapy for varicocele in the pediatric population.Evidence acquisition:The review was conducted following the PRISMA guidelines. Systematic research of available literature in English language from 1980 until May 2022 was conducted through EMBASE, MEDLINE, Cochrane Library, and NIH Registry of Clinical Trials. For each study, information was gathered regarding the study design, the inclusion/exclusion criteria, the indications for treatment, the success rate and the complications. When available, the details about sperm analysis were reported.Evidence synthesis:The 10 studies were included in the final sample (564 patients). Median age of patients ranged 13.3–15.3 years. The indications for scleroembolization varied in the different studies, while most studies included patients with clinical G2-G3 varicocele and clinical symptoms or testicular asymmetry. The treatment was successful in 88%–98% of the patients, while the complication rate was
  Citation: Urologia Journal
  PubDate: 2024-05-20T12:34:42Z
  DOI: 10.1177/03915603241252916
BCG and bladder cancer. Forty-eight years after Morales report
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  Authors: Vincenzo Serretta
  Abstract: Urologia Journal, Ahead of Print.
  Although BCG use as an anticancer drug was nearly abandoned due to the poor results in most tumors, in 1976 Morales reported a relevant reduction in recurrence with intravesical BCG in few patients affected by NMIBC. Since then BCG was globally accepted as an empirical and effective therapy in treating Tis and preventing recurrence of intermediate and high risk NMIBC. Forty-eight years after Morales’ report, although some open questions remain object of debate, we have been able to find answers to many doubts improving BCG activity and toxicity. We better select patients undergoing BCG and many trials have indicated the best dosage and schedule. Moreover, we are able to better identify the patient unresponsive to BCG who might benefit of a timely radical cystectomy. We are also aware of the difficulties and toxicities that can be encountered with BCG use in every-day clinical practice. Research is ongoing to obtain genetically modified BCG to increase its efficacy and reduce toxicity. Moreover, the combination of BCG with other immunotherapeutic drugs given intravesically or systemically, first immune checkpoint inhibitors, is under study to obtain a response in patients unresponsive or intolerant to BCG. Almost 50 years after Morales publication, intravesical BCG remains an inalienable tool against NMIBC
  Citation: Urologia Journal
  PubDate: 2024-05-17T11:15:38Z
  DOI: 10.1177/03915603241252909
Step by step technique of Stentless Florence Robotic Intracorporeal
Neobladder (FloRIN), does the ureteral management influence functional
outcomes'
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  Authors: Luca Lambertini, Fabrizio Di Maida, Anna Cadenar, Antonio Andrea Grosso, Francesca Valastro, Mara Bacchiani, Sofia Giudici, Alessandro Sandulli, Filippo Lipparini, Vincenzo Salamone, Daniele Paganelli, Simone Coco, Andrea Mari, Andrea Minervini
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Benefits and harms of avoid the sent placement during IntraCorporeal Neobladder configuration are still debated. Our objective was to describe the step-by-step technique of Florence intracorporeal neobladder (FloRIN) configuration performed with stentless procedure focusing on perioperative and mid-term functional outcomes.Materials and methods:In this single institution prospective randomized 1:1 series all consecutive patients underwent Robot-Assisted Radical Cystectomy (RARC) and FloRIN reconfiguration from January 2021 to March 2021 were enrolled. Functional perioperative and mid-term outcomes were gathered. Postoperative complications were graded according to Clavien-Dindo classification and divided in early (30 days).Results:Overall, 10 patients were included in the analysis. Of these, the 50.0% was treated with Stentless FloRIN. In terms of baseline features, no differences were recorded between the two groups. Median age was 65 and 66 years while median BMI was 27 and 25 in the stentless and in the stent group, respectively. Concerning intraoperative variables, no intraoperative complications as well as open conversion occurred among both groups. As regard introperative features, a shorter console time was associated with stentless procedure (331 min vs 365 min). In terms of perioperative outcomes, canalization and time to drainage removal didn’t differ between groups while length of hospital stay was significantly lower in stentless group 10 days versus 14 days. Early and delayed postoperative complication rate was not influenced by the ureteral management at a preliminary assessment with comparable rates of Clavien Dindo ⩾ 3a between the two groups. Mid-term functional outcomes did not differ between groups in terms of kidney function loss.Conclusions:FloRIN with Stentless technique showed functional and perioperative preliminary outcomes comparable with the standard ureteral management strategy. Further series with longer functional follow-up assessment will be needed to confirm our preliminary results.
  Citation: Urologia Journal
  PubDate: 2024-05-16T10:58:48Z
  DOI: 10.1177/03915603241252908
Novel composite BPH3 trifecta for robotic assisted simple prostatectomy
(RASP) versus BPH6: A multicenter outcomes comparison
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  Authors: Alfredo Maria Bove, Rigoberto Pallares-Méndez, Aldo Brassetti, Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Simone D’Annunzio, Mariaconsiglia Ferriero, Rocco Simone Flammia, Leonardo Misuraca, Flavia Proietti, Daniele Amparore, Francesco Porpiglia, Costantino Leonardo, Giuseppe Simone
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To assess disobstructive proficiency of BPH3 trifecta in RASP according to different techniques.Methods:Baseline prostate volume (PV), uroflowmetry parameters and Validated questionnaires: IIEF, Incontinence severity index score (ISI), International prostatic symptoms score (IPSS), MSHQ, Quality of recovery (QOR), were recorded preoperatively and 12 months postoperatively. RASP was conducted using both the urethra-sparing (Madigan) technique and a non-urethral-sparing transvesical (Freyer) approach. Two groups were evaluated for achievement rates in terms of BPH-3 and BPH-6. BPH-3 was defined by a combination of: a reduction of ⩾30% in IPSS compared to baseline, ISI score ⩽ 4, and absence of complications beyond Clavien grade 1.Results:About 158 patients underwent RASP, with 93 undergoing the Madigan procedure and 65 the Freyer approach. Patients in the Madigan group were younger, with lower PV, baseline IPSS score, overactive symptoms (ISI score), but higher MSHQ and IIEF score, when compared to the Freyer population (all p
  Citation: Urologia Journal
  PubDate: 2024-05-16T10:56:17Z
  DOI: 10.1177/03915603241252903
Does enzalutamide related PSMA upregulation affect outcomes of
lutetium-177 PSMA radioligand therapy'
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  Authors: Turgut Bora Cengiz, Raksha Kulkarni, Matteo Novello, Anthony Hafez, Somali Gavane, Munir Ghesani, Nasrin Ghesani
  Abstract: Urologia Journal, Ahead of Print.
  Background:Enzalutamide is an antiandrogen drug used prior to lutetium-177 prostate specific membrane antigen (Lu-PSMA) radioligand therapy and has shown promising results for upregulating the PSMA expression on prostate cancer cells. In this study, we aim to compare prostate specific antigen (PSA) level changes in prostate cancer patients who received enzalutamide to those who did not.Methods:Prostate cancer patients who underwent Lu-PSMA between 2021 and 2023 were retrospectively included. Patients were grouped based on prior enzalutamide therapy: those who received enzalutamide (EZ+) for at least 14 days and those who did not (EZ−). PSA changes and F-18 DCFPyL SUV (Standardized Uptake Values) were compared.Results:Thirty-seven patients were included, 18 EZ+ and 19 EZ−. The median age, Gleason score, and prior chemo/hormonal therapies were similar for EZ+ and EZ−, except for radium-223. Eleven patients (61%) in EZ+ and 13 patients (68%) in EZ− showed a decrease in PSA after the first cycle (p = 0.64). Four patients (22%) in EZ+ and seven patients (37%) in EZ− had more than 50% decrease in PSA after the first cycle (p = 0.33). The average percent decline at the end of the treatment was 23.3% in EZ+ and 50.4% in EZ− (p = 0.4). There was no difference in terms of lesion with highest SUVmax, mean SUV, total tumor volume or activity on pre-therapy PSMA imaging.Conclusion:Enzalutamide treatment prior to Lu-PSMA does not improve patient outcomes when applied remotely. Larger studies evaluating the combination therapies and the timing of enzalutamide are needed to assess its correlation with Lu-PSMA outcomes.
  Citation: Urologia Journal
  PubDate: 2024-05-16T10:54:09Z
  DOI: 10.1177/03915603241249230
Evaluation of antioxidant enzyme levels, oxidative stress markers and
serum prolidase activity in testicular cancer
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  Authors: Mehmet Kaba, Sinan Kılıç, Halit Demir
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Testicular cancer is a significant malignancy affecting males, and understanding the underlying biochemical changes associated with the disease is essential for improved management and treatment strategies. Prolidase enzyme, has been implicated in various disease processes. The assessment of serum prolidase activity and its relationship with testicular cancer can provide valuable insights into the pathophysiology of the disease. The objective of this study was to investigate serum prolidase activity, oxidative stress markers, and antioxidant enzyme levels in patients with testicular cancer and evaluate their potential associations, aiming to enhance our understanding of the biochemical alterations and potential implications for testicular cancer management.Methods:A total of 33 male patients diagnosed with testicular cancer were included, along with 35 age-matched male volunteers as the control group. Serum samples were collected and stored at −20°C until analysis. The measurement of superoxide dismutase (SOD), glutathione peroxidase (GSHPx), glutathione-S-transferase (GST), malondialdehyde (MDA), glutathione (GSH), and prolidase levels was performed.Results:The findings demonstrated significantly elevated serum prolidase activity and malondialdehyde (MDA) levels in testicular cancer patients compared to the control group (all, p
  Citation: Urologia Journal
  PubDate: 2024-05-14T07:25:23Z
  DOI: 10.1177/03915603241249232
Prognostic significance of Klotho expression in patients with renal cell
carcinoma
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  Authors: Kumar Rajiv Ranjan, Shrawan Kumar Singh, Nandita Kakkar, Ravimohan Mavuduru
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Various molecular markers have been investigated in renal cell carcinoma (RCC) without significant reliability. We analyzed Klotho (tumor suppressive protein) expression in RCC to investigate its association with tumor-stage, grade, disease-free-survival (DFS) and overall-survival (OS).Methods:Data of histologically confirmed patients of RCC with complete clinical follow-up were retrieved from Medical-Record-Library. Tissue sections of tumor and normal parenchyma were prepared from the blocks. Immunohistochemical studies for Klotho were done with commercially available kit (EPR6856, Ab181373; Abcam, Cambridge MA, USA). Klotho expression was scored between 0–3 and grouped into weak/absent (0, 1) and moderate/strong (2, 3). Tumors stages and grades were grouped into low stage (I and II) and high stage (III and IV) and into low grade (grade 1 and 2) and high grade (grade 3 and 4) according to WHO/ISUP grading. The histopathologists were blinded as to the clinical and follow-up data. Various prognostic factors were analyzed with respect to Klotho expression. Kaplan-Meier curves were created for DFS and OS.Results:Fifty-four patients of mean age 55.15 ± 13.34 years and M:F ratio of 1.8:1 were included. Normal renal tissue had strong expression of Klotho in all. In tumor tissue 20 (37%) had negative, 7 (13%) had weak, 14 (25.9%) had moderate and 13 (24.1%) had strong Klotho expression. Significantly more patients had absent/weak Klotho expression with higher grade (16/24 (66.7%) vs 7/25 (28%); p = 0.007), higher stage (22/33 (66%) vs 5/21 (23.8%); p = 0.002), LVI (12/14 (85.7%) vs 2/14 (14.3%); p = 0.002), sinus-fat-invasion (16/21 (76.2%) vs 5/21 (23.8%); p = 0.002), renal-vein-involvement (14/18 (77.8%) vs 4/18 (22.2%); p = 0.004), necrosis (17/26 (65.3%) vs 9/26 (34.6%); p = 0.029) and metastasis (8/9 (88.9%) vs 1/9 (11.1%); p = 0.01). Median DFS and OS were significantly lower in patients with weak/absent Klotho expression (12 vs 23 months, p = 0.023 and 15 vs 33 months, p = 0.006 respectively). Kaplan-Meier curves showed lower estimated DFS and OS in patients with weak/absent expression.Conclusions:We conclude that Klotho expression in renal tumor could be a good prognostic marker in patients with RCC.
  Citation: Urologia Journal
  PubDate: 2024-05-10T09:23:28Z
  DOI: 10.1177/03915603241248303
Long term outcomes and impact on renal function following radical
cystectomy
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  Authors: Yash Manharla Tilala, Sabyasachi Panda, Abhilekh Tripathi, Sachin Sharma, Amiya Shankar Paul, Sanjay Choudhuri, Samir Swain
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:To assess clinical, oncological outcomes and impact on renal function in patients who underwent the radical cystectomy with pelvic lymphadenectomy for muscle invasive and high risk non-muscle invasive transitional cell carcinoma of urinary bladder without evidence of non-regional lymph nodes and distant metastasis.Materials and methods:With curative intent total 156 patients underwent radical cystectomy with pelvic lymphadenectomy from January 2015 to December 2022. Total 132/156 patients had primary transitional cell carcinoma of bladder. Thirty patients, presented with obstructive nephropathy, operated after stabilization of renal function. Pre-operatively and post-operatively eGFR calculated using modified diet in renal disease formula.Results:In present study 114 (86.36%) patients had high grade TCC, 70 (53.02%) patients had organ confined disease. Nodal extension seen in 74 (56.06%) patients. Perioperative mortality noted in 36 (27.2%) patients. The overall survival and recurrence free survival (RFS) over 5 years was 66.67 and 45.45%. RFS was significantly related to pathological stage, nodal status, histological-grade, positivity of surgical margin and time of surgery from diagnosis. Total 92/132 (69.7%) patients had recurrence. Pelvic recurrence in 10/92 (10.87%) whereas 82/92 (89.13%) patients had distant recurrence. Pre-operatively mean creatinine was 2.6 mg/dl and mean eGFR was 38.9 ml/h in patients who presented with obstructive nephropathy after stabilization of renal function. Post-operatively in 46/132 (34.8%) patients had improvement in eGFR while 86/132 (65.2%) patients had deterioration of eGFR over 62 months of median follow up.Conclusion:Radical cystectomy provides good overall survival outcomes. Pre-operative eGFR has significant impact on post-operative renal function in long term.
  Citation: Urologia Journal
  PubDate: 2024-05-10T09:22:28Z
  DOI: 10.1177/03915603241249231
The efficacy and safety of retrograde ureteral stenting in the management
of complicated cases of ureteral obstruction caused by urolithiasis
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  Authors: Mahmoud Mustafa, Amir Aghbar, Ibraheem Alami, Nabil Khalil
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:To investigate the efficacy and safety of retrograde double J stent (RDJS) placement in the management of complicated obstructive uropathy caused by urolithiasis.Patients and Methods:An observational study done at a tertiary center was implemented in which a total of 27 patients (10 males, 17 females) with average age of 48.74 years (range: 15–88) who underwent RDJS or percutaneous nephrostomy (PCN) between 2017 and 2021 due to complicated obstruction caused by urolithiasis were included.Results:A total of 27 patients (10 males, 17 females) with average age of 48.74 years (range: 15–88) who underwent kidney decompression between 2017 and 2021 due to complicated unilateral or bilateral kidney obstruction caused by ureteral stones were included. Twenty-two patients (81.48%) underwent successful RDJS placement, two patients had RDJS placement then PCN was also placed, and two patients underwent PCN placement. Three patients needed an intensive care unit “ICU” after intervention, two of them were in the ICU before intervention. All septic parameters were normalized within a short period postoperatively. Two patients with failed previous ureteroscopy had a successful RDJS placement.Conclusion:Retrograde DJS placement is a feasible option in the management of complicated cases of obstructive uropathy caused by urolithiasis. Short hospitalization period, low rate of complications and better quality of life are the most prominent advantages of RDJS placement. In the hands of experienced surgeons, RDJS should be offered as the first choice of decompression for obstructive uropathy caused by urolithiasis.
  Citation: Urologia Journal
  PubDate: 2024-05-10T09:19:29Z
  DOI: 10.1177/03915603241253140
Manual detorsion in pediatric testicular torsion: A narrative review of
the literature
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  Authors: Eric Scheier
  Abstract: Urologia Journal, Ahead of Print.
  Manual detorsion is infrequently performed in pediatric emergency medicine, particularly in centers with urology coverage. In no other emergency condition does an emergency physician not take immediate action to alleviate pain and damage, even if definitive care is close by. A small number of case reports exist in which pediatric emergency physicians have performed manual detorsion. This review the literature presents the case for routine manual detorsion prior to definitive orchiopexy.
  Citation: Urologia Journal
  PubDate: 2024-05-09T12:54:01Z
  DOI: 10.1177/03915603241229800
Testicular histopathology and follicular stimulating hormone to predict
fertility in nonobstructive azoospermia
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  Authors: Faris Abushamma, Rami S Alazab, Mohammed Z Allouh, Rafeef Abu Shamleh, Rola Abu Alwafa, Ibrahim Ghalayini
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:To examine the ability of testicular histopathology in Non-obstructive azoospermia (NOA) in predicting sperm retrieval rate (SR), sperm quality and assisted reproductive technology success.Methods:A retrospective study recruited clinically diagnosed NOA patients between 2007 and 2015. Testicular biopsy and conventional sperm extraction (TESE) were done concomitantly. Correlation between pathological categories, SR rate, sperm quality and success of intracytoplasmic sperm injection (ICSI) was studied. FSH was measured as a predictor of fertility.Results:One hundred eighteen patients were recruited. Histopathological classification was hypospermatogenesis (HS) 45 (38%), maturation arrest (MA) 22(19%), Sertoli cell only syndrome (SCOS) 34 (29%) and normal spermatogenesis (NS) 17 (14%). FSH value was above normal level in 34 (76%) of HS, 19 (86%) of MA, 32 (94%) of SCOS and 5 (29%) of NS. Positive SR was obtained in 108 (92%) patients. The highest SR rate was seen in NS group 100% and the lowest was in SCOS 26 (77%). The worst sperm quality was found in SCOS as type C represents 46%, followed by MA 40% and HS 24%. Patients had ICSI following TESE had variable success rate as success of ICSI was seen (9/15) for HS, (0/7) for MA, (5/15) for SCOS and (8/9) for NS. FSH is strongly correlated to SR, quality of sperm and success of ICSI as positive SR in normal FSH patients was obtained in 28 (100%) of normal FSH, 70 (97%) of high FSH and 10 (56%) of double high FSH (p value
  Citation: Urologia Journal
  PubDate: 2024-04-29T12:12:22Z
  DOI: 10.1177/03915603241249229
Assessing safety and feasibility of monopolar transurethral resection of
the prostate without post-operative catheter traction: A randomized
controlled trial
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  Authors: Abhineeth KP, Kumar Madhavan, Devashish Kaushal, Manoj Biswas, Sonu Kumar Plash, Viswas MR
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Traction on the per-urethral catheter is commonly employed after monopolar transurethral resection of the prostate (mTURP) to reduce bleeding. However, its efficacy and impact on postoperative pain remain uncertain. Further, there is limited evidence to suggest any benefit regarding post-operative blood loss.Materials and methods:In a randomized controlled trial, 62 patients undergoing mTURP were assigned to either a traction (n = 30) or non-traction (n = 32) group. Blood loss, postoperative pain, and analgesic requirements were assessed between January 2022 and April 2023. {(IHEC-PGR/2021/DM/M.Ch/Jan/02), CTRI Registration: CTRI/2022/01/039199.}Results:No significant differences were observed between the traction and non-traction groups regarding postoperative blood loss (p-value- 0.632), fall in hemoglobin (p-value- 0.719) and hematocrit (p-value- 0.937) levels, and length of postoperative hospital stay (p-value- 0.797). However, the traction group reported significantly higher postoperative pain scores (p-value
  Citation: Urologia Journal
  PubDate: 2024-04-29T10:37:01Z
  DOI: 10.1177/03915603241249227
Kidney computed tomography perfusion in patients with ureteral obstruction
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  Authors: Ksenia Belyaeva, Vadim Rudenko, Natalya Serova, Andrey Morozov, Mark Taratkin, Alexander Androsov, Nirmish Singla, Igal Shpunt, Juan Gomez Rivas, Harun Fajkovic, Dmitry Enikeev, Lida Kapanadze
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Kidney perfusion on CT is an encouraging surrogate for renal scintigraphy in assessing renal function. However, data on dynamic volumetric CT in patients with kidney obstruction is lacking. Thus, the aim of this study is to determine the feasibility of CT-based renal perfusion using a dynamic volume to assess renal hemodynamics at different degrees and durations of obstruction.Materials and methods:We included patients with unilateral kidney obstruction in our single-center, prospective study. The patients were divided into three groups. Patients without dilatation of the pelvicalyceal system (PCS) and normal parenchyma thickness were included into Group 1; patients with PCS dilatation and parenchyma thickness 1.8–2.4 cm—into Group 2; and patients with ureteropyelocalicoectasia and parenchyma thickness less than 1.8 cm—into Group 3.Results:Total of 56 patients were enrolled. In Group 1 mean values of cortical and medullar arterial blood flow, blood volume, and extraction fraction were within the normal range. Changes in contralateral kidney were not determined. Patients from Group 2 showed significant differences in blood flow parameters in the cortical and medulla of the obstructed kidney. No changes in perfusion values in the contralateral kidney was observed. In patients from Group 3 there was a marked decrease in perfusion on the side of obstruction compared to Group 2, indicating that the degree of expansion of the PCS directly correlates with the change in blood flow. However, in the contralateral kidney, these indicators exceeded the normal values of perfusion.Conclusion:CT perfusion allows to objectively assess changes in blood flow in the setting of renal obstruction. The degree of obstruction directly affects the measured rate of blood flow.
  Citation: Urologia Journal
  PubDate: 2024-04-26T12:09:45Z
  DOI: 10.1177/03915603241244935
The role of preoperative immune cell metrics in renal cell carcinoma with
a tumor thrombus
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  Authors: Maxwell Sandberg, Mary Namugosa, Rory Ritts, Claudia Marie Costa, Davis Temple, Mitchell Hayes, Wyatt Whitman, Emily Ye, Justin Refugia, Reuben Ben-David, Parissa Alerasool, Benjamin Eilender, Rafael Ribeiro Zanotti, Thiago Camelo Mourão, Jung Kwon Kim, Patricio Garcia Marchiñena, Seok-Soo Byun, Diego Abreu, Reza Mehrazin, Philippe Spiess, Stenio de Cassio Zequi, Alejandro Rodriguez
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy.Methods:Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson’s bivariate correlation, and analysis of variance.Results:One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p
  Citation: Urologia Journal
  PubDate: 2024-04-25T11:17:17Z
  DOI: 10.1177/03915603241248020
Medical photography and the reconstructive urologist: A 6-month
prospective study
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  Authors: Ines M Pina, Ahmad M Omar, Michael S Floyd
  Abstract: Urologia Journal, Ahead of Print.
  Medical photography has multiple, important roles. The education of medical practitioners, documentation of disease, response to treatment, research, publication, intraoperative recording and trauma documentation all rely on medical photography. Additionally, there are important medicolegal implications pertaining to medical photography across many medical disciplines. Other than specific image use to document cases, there remains a paucity of urological literature regarding the use of medical photography in Urology. The aims of this 6-month study were to document the use of medical photography by a Reconstructive Urological Service in a tertiary referral centre and to assess the range of urological conditions photographed. A secondary aim was to specifically document intraoperative use of the medical photography.
  Citation: Urologia Journal
  PubDate: 2024-04-23T12:36:05Z
  DOI: 10.1177/03915603241241183
Treatment of chronic post-radiation cystitis with trans-urethral amniotic
bladder therapy appears durable at 9 months: A clinical study
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  Authors: Jonathan Lutchka, Jack Vercnocke, Emily Fisher, Codrut Radoiu, Julian Jeberaeel, Steven Lucas, Nivedita Dhar
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:Chronic radiation cystitis (CRC) develops after radiation therapy and can present with symptoms like urinary frequency, urgency, pelvic pain, and nocturia. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months.Materials and methods:CRC patients recalcitrant to previous treatments received ABT comprised of intra-detrusor injections of 100 mg micronized AM diluted in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool, SF-12 Health Survey) were repeated at pre-op and 2, 4, 8, 12, 16, 20, 24, and 36 weeks post-injection.Results:Five consecutive patients with a mean age of 64.4 ± 20.1 years with a median CRC duration of 10 years were included and followed for 6 months. After ABT, the lower urinary tract symptoms improved as early as 2 weeks and were maintained up to 20 weeks. BPIC significantly improved from 36.6 ± 1.1 at baseline to 12.6 ± 1.5 at 16 weeks and 13.8 ± 2.9 at 20 weeks. At 24 and 36 weeks, the improvement was maintained in four (80%) of the five patients (BPIC = 13.8 ± 1.0). Uroflow assessment showed voiding volume improved two-fold in four of the five patients at 24 weeks compared to baseline.Conclusion:Our data suggest that a significant number of CRC patients may have durable benefit after ABT. Despite this, some of them can show symptoms rebound at 24 weeks.
  Citation: Urologia Journal
  PubDate: 2024-04-22T10:01:44Z
  DOI: 10.1177/03915603241248014
The gender gap in stone-related surgery: A comprehensive analysis from an
Israeli perspective
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  Authors: Dor Golomb, Amir Cooper, Orit Raz
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To investigate the gender gap in the context of stone-related surgery within an Israeli population.Methods:We conducted a retrospective cohort study using administrative databases from Clalit Health Services to identify adults aged 18 and above who had their initial surgical treatment for upper tract urolithiasis. We employed descriptive statistics to outline the baseline patient characteristics, and the Cochran–Armitage test for trend was utilized to analyze surgical trends.Results:Between 2003 and 2020, a total of 36,624 adult patients underwent surgical treatment for upper tract urinary stones. The mean age of patients was 55.01 years (standard deviation (SD) 16.6) for ureteroscopy (URS), 55.05 years (SD 15.1) for percutaneous nephrolithotripsy (PCNL), and 51.07 years (SD 15.1) for shockwave lithotripsy (SWL). When considering the distribution of procedures by gender, males accounted for 69.5% of URS cases, 58.3% of PCNL cases, and 70.6% of SWL cases, whereas females represented 30.5%, 41.7%, and 29.4% of URS, PCNL, and SWL cases, respectively. Across all surgical modalities, the male-to-female ratio exhibited fluctuations without a consistent trend, with both increases and decreases observed. In URS, the ratio saw a modest increase from 1.967 in 2003 to 2.173 in 2020. For PCNL, the ratio initially increased from 2.361 in 2003 to 2.549 in 2014, followed by subsequent fluctuations, but an overarching trend was not apparent. In contrast, for SWL, the ratio decreased from 2.15 in 2003 to 1.32 in 2020, with varying changes in between.Conclusion:This study highlights the dynamic nature of gender gap in stone-related surgery outcomes. While the male-to-female ratio exhibited fluctuations over a 17-year period, no consistent trend emerged. The absence of a clear trend underscores the complex and multifaceted factors influencing the gender gap in urolithiasis.
  Citation: Urologia Journal
  PubDate: 2024-04-18T11:55:04Z
  DOI: 10.1177/03915603241248013
Semen parameter enhancement after varicocelectomy: Insights into varicose
vein diameter and BMI influence: A cross-sectional study
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  Authors: Mohammad Kazem Hariri, Mohammad-Bagher Rajabalian, Behzad Narouie, Sina Ahmadaghayi, Ghasem Rostami, Khadijeh Ezoji, Hamidreza Momeni, Negar Radpour
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Varicocele is a condition in which the veins in the spermatic cord become enlarged and twisted. Varicocele is widely recognized as the leading cause of male infertility due to its significant impact on reproductive health in men. The aim of this study was to investigate the relationship between the diameter of the varicose vein and the recovery rate of the spermogram after varicocelectomy. Also, the effect of body mass index (BMI) on sperm parameters after varicocelectomy.Methods:This descriptive and analytical cross-sectional study was conducted in Valiasr Hospital’s urology clinic in Qaemshahr, Iran from August 2018 to August 2019 and involved 27 men with unilateral left varicocele who met the inclusion criteria for surgical repair. Before the operation, we recorded demographic information, the maximum diameter of varicose veins in the pampiniform plexus, and spermogram results. We repeated semen analysis 3 months after the operation and analyzed the data using Statistical Package for the Social Sciences version 21 software.Results:Our findings showed that the diameter of the varicose vein before varicocelectomy was not significantly associated with the improvement of main semen parameters after the operation. Furthermore, our study suggested that a lower body mass index might contribute to a greater improvement in sperm motility, as individuals with lower BMI showed more significant improvement.Discussion:There is a significant inverse relationship between BMI and sperm motility improvement after surgery. Patients with a lower BMI showed greater improvement in sperm motility.
  Citation: Urologia Journal
  PubDate: 2024-04-18T11:53:23Z
  DOI: 10.1177/03915603241247290
Turkish validation of the chronic orchialgia symptom index and its
association with the visual analog scale
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  Authors: Aykut Demirci, Fatih Hızlı, Halil Başar
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language.Material and methods:The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method.Results:The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 (p
  Citation: Urologia Journal
  PubDate: 2024-04-11T05:59:22Z
  DOI: 10.1177/03915603241246669
Discrepancies in Gleason score between needle core biopsy and radical
prostatectomy specimens with correlation between clinical and pathological
staging
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  Authors: Vikram Singh, Kartik Sharma, Mahendra Singh, Shashank Shekhar Tripathi, Deepak Prakash Bhirud, Rahul Jena, Shiv Charan Navriya, Gautam Ram Choudhary, Arjun Singh Sandhu
  Abstract: Urologia Journal, Ahead of Print.
  Background:The studies have shown that GS given after assessment of the entire prostate gland on the radical prostatectomy specimen may differ from GS given after examination of a small sample from needle core biopsy. We conducted this study to assess discrepancies in the Gleason score between NCB and RP specimens and to find out the correlation between the clinical stage and pathological stage.Methods:The study included 174 patients with carcinoma prostate which underwent robotic-assisted radical prostatectomy (RARP). Pre-operative Gleason score was determined on 12-core biopsy samples under trans-rectal ultrasound (TRUS) guidance. The Gleason score obtained from the radical prostatectomy specimen was compared with that of the NCB Gleason score to find out differences.Results:The preoperative Gleason score (GS) ranges from 6 to 9 with a mean GS of 6.97 ± 1.02. The post-operative GS ranges between 6 and 10 with mean and GS of 7.5 ± 1.10. On the pre-operative assessment of biopsy specimens, 70 (43.2%) patients had a GS of 6, while 44 patients had a GS of 7 (27.1%) and 48 (29.8%) patients had a GS of more than 7. On the postoperative assessment of specimens, 31 (19.1%) patients had post-operative GS of 6, while 66 (41%) patients had GS of 7 and 74 (41.1%) patients had GS of more than 7. When pre-operative GS and post-operative GS were compared, no changes were observed in the GS of 79 patients, whereas 83 patients showed the difference in GS, with 75 patients showing up-gradation and eight patients marked as down-gradedConclusion:concordance between biopsy and the pathology results directly affects the prognosis of the patient. The results of our study demonstrated the rate of discordance between Gleason scores obtained from transrectal prostate biopsy and RP surgical specimens. This rate brings into question the accuracy of the chosen treatment.
  Citation: Urologia Journal
  PubDate: 2024-04-05T12:33:34Z
  DOI: 10.1177/03915603241244942
Predictors for surgical treatment in male patients with non-neurogenic
lower urinary tract symptoms (LUTS)
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  Authors: Florin V Hopland-Nechita, John R Andersen, Christian Beisland
  Abstract: Urologia Journal, Ahead of Print.
  Objective:This study aimed to identify clinical and biochemical predictors for future surgical intervention in male LUTS patients.Materials and Methods:In a prospective cohort study, parameters as International Prostate Symptom Score (IPSS) and IPSS “bother question” (IPSS-BQ), prostate volume (PV), maximal urine flow (Qmax), Prostate specific antigen (PSA), post-voidal residual urine (PVR) were assessed alongside comorbidities quantified using Charlson Comorbidity Index without age adjustment and American Society of Anesthesiology (ASA) score. For the statistical analysis, patients were categorized based on subsequent treatment approaches: Group 1: underwent surgery during follow-up; Group 2: received medical or no treatment. T-test was used to test differences between the groups. Logistic regression models were used to identify independent predictors of the need for future surgery. Following this analysis, we calculated the probability of requiring surgical intervention, with this likelihood being determined based on the accumulation of identified predictive factors.Results:Of 63 patients, 22 underwent surgery over a median follow-up of 42 months. Significant baseline differences were observed in IPSS (p = 0.003), International Prostatic Symptom Score-Voiding subscore (IPSS-VS) (p = 0.002), IPSS-BQ (p = 0.001), Qmax (p = 0.007), and PVR (p = 0.02) between the groups. Higher IPSS-BQ, IPSS-VS, and lower Qmax are emerging as independent surgical treatment predictors in logistic regression analyses.Conclusion:The study identified IPSS-VS, IPSS-BQ, and Qmax as baseline predictors of future surgical intervention. A clear pattern of a gradual increase in the likelihood of requiring surgery was directly proportional to the cumulative number of these identified predictive factors.
  Citation: Urologia Journal
  PubDate: 2024-04-02T12:47:13Z
  DOI: 10.1177/03915603241238128
Appropriate prescription of cytobacteriological urine examinations in
older adults
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  Authors: Hendriniaina Raveloson, Jihène Ben Hassen, Rihab Koraib, Aziza Jhouri, Joël Schlatter
  Abstract: Urologia Journal, Ahead of Print.
  Cytobacteriological urine examinations (CBEU) are frequently ordered for the older adults, sometimes without straightforward indication and with the risk of prescribing empirical antibiotics. The aim of this study was to evaluate the relevance of the CBEU prescription and empiric antibiotic therapy in our geriatric hospital. Among 129 patients (mean age 84 years, sex ratio 0.69), 229 CBEU were collected with 20.9% of inappropriate indication. Cultures were sterile in 43% (n = 99) of cases and positive in 57% (n = 130) cases. Gram-negative bacilli dominated the isolated bacteria (76.9%) followed by gram-positive cocci (17.6%). In 113 patients, probabilistic antibiotic therapy was prescribed of which 68 treatments were initiated before the CBEU. Ceftriaxone and amoxicillin plus clavulanic acid were the main therapeutic option used representing 70.8% of cases. Antibiotic therapy was re-evaluated after 3 days in 74.3% of patients. Efforts to reduce the number of useless ECBUs by training doctors to follow official guidelines are a priority.
  Citation: Urologia Journal
  PubDate: 2024-04-01T11:20:58Z
  DOI: 10.1177/03915603241244936
Elderly and bladder cancer: The role of radical cystectomy and orthotopic
urinary diversion
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  Authors: Francesco Pio Bizzarri, Eros Scarciglia, Pierluigi Russo, Filippo Marino, Simona Presutti, Seyed Koosha Moosavi, Mauro Ragonese, Marco Campetella, Carlo Gandi, Angelo Totaro, Giuseppe Palermo, Emilio Sacco, Marco Racioppi
  Abstract: Urologia Journal, Ahead of Print.
  The incidence of bladder cancer (BC) depends on advancing age and other risk factors, significantly impacting on surgical, functional and oncological outcomes. Radical cystectomy (RC) with urinary diversion is the gold standard therapy for muscle invasive bladder cancer; however, it remains a complex surgery and requires careful analysis of risk factors in order to potentially decrease post-surgical complication rates. Age in surgery is a limiting factor that can modify surgical and oncological outcomes, and is correlated with a high rate of post-dimssion hospital readmissions. The reconstruction of the bladder with the intestine represents a crucial point of radical cystectomy and the urinary derivation (UD) is at the center of many debates. A non-continent UD seems to be the best choice in elderly patients (>75 years old), while orthotopic neobladder (ON) is poorly practiced. We reviewed the literature to identify studies reporting outcomes, complications, patient- selection criteria, and quality-of-life data on elderly patients, who underwent ON following radical cystectomy. Reviewing the literature there is no clear evidence on the use of age as an exclusion criterion. Certainly, the elderly patient with multiple comorbidities is not eligible for ON, preferring other UD or rescue therapies. A careful preoperative selection of elderly patients could greatly improve clinical, surgical and oncological outcomes, giving the chance to selected patients to receive an ON.
  Citation: Urologia Journal
  PubDate: 2024-03-29T10:29:02Z
  DOI: 10.1177/03915603241240644
The impact of long term COVID-19 infection on the patients’ erectile
function and on anxiety and on depression as well as the impact of daily
tadalafil 5 mg supplementation in patients with erectile dysfunction
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  Authors: Ahmed Said Zaghloul, Elnashar A.M., Sameh Fayek GamalEl Din, Mahmoud Fawzy Ghaly, Hany Mohammed Saad, Hossam Refaat Eldebs, Shady Zaki Said
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:The study examined the impact of long term COVID-19 infection on the patients’ erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function.Methods:Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively.Results:At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (r = 0.249, p = 0.008; r = 0.241, p = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively.Conclusions:ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil.
  Citation: Urologia Journal
  PubDate: 2024-03-29T10:27:01Z
  DOI: 10.1177/03915603241237402
Augmented anastomotic ureteral reconstruction using buccal mucosal graft,
initial experience
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  Authors: Ahmed M Reyad, Ahmed Mamdouh Abd Elhamed, Ahmed Mahmoud Elsherief, Hassan Ali Abdelhaleem, Tarek Ahmed Mahmoud
  Abstract: Urologia Journal, Ahead of Print.
  Objective:To assess the augmented anastomotic ureteral reconstruction using buccal mucosal graft based on omental flap for managing ureteral stricture.Subjects and methods:This prospective cohort study was conducted on 13 patients with ureteric strictures of different lengths secondary to Bilhalziasis, iatrogenic (post endoscopy) and post inflammatory etiology in upper and mid ureteral segments were treated with buccal mucosal patch grafts and The graft is fixed to the undersurface or the posterior surface of the omentum before doing graft anastomosis to the ureteral walls as to ensure the process of graft take sticky to the principles of tissue transfer. All patients were subjected to full history taking, clinical examination for assessment of pain, lower or upper urinary track symptoms and laboratory investigation (complete blood count, CRP, liver function test and kidney function test (serum urea and creatinine).Results:The mean operative time was 148.85 min and mean hospital stay was 3 days. Mean blood loss was ranged from 20 to 210 ml and Stent was removed after 8–12 weeks. The mean follow up was 13 months, all patients had a non-obstructive RI value
  Citation: Urologia Journal
  PubDate: 2024-03-28T10:57:26Z
  DOI: 10.1177/03915603241241829
Evaluation of tadalafil supplementation on the neutrophil/lymphocyte and
the platelet/lymphocyte ratios in patients with erectile dysfunction: A
prospective study
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  Authors: Sameh Fayek GamalEl Din, Nashaat Nabil Ismail, Hanan Hosni Moawad, Iten Mohamed Adel, Ahmad Motawi, Hisham Foaad
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:We aimed to evaluate the effect of daily 5 mg tadalafil on the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) in patients with erectile dysfunction (ED).Patients and methods:30 subjects with ED were given tadalafil as well as 30 subjects with ED who were not receiving tadalafil were recruited. 30 healthy individuals served as controls.Results:Receiver operating characteristic curve (ROC) showed that the best cut off point of pre-treatment and post treatment NLR in the ED treatment group was found
  Citation: Urologia Journal
  PubDate: 2024-03-27T05:40:25Z
  DOI: 10.1177/03915603241240649
Robot-assisted buccal mucosal graft ureteroplasty for the treatment of
proximal ureteral strictures
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  Authors: Flavio Tanese, Salvatore Liguigli, Giuseppe Torre, Paolo Minafra, Luciano Rella, Michele Battaglia, Giuseppe Lucarelli, Marco Spilotros, Pasquale Ditonno
  Abstract: Urologia Journal, Ahead of Print.
  The authors describe their initial experience with robot-assisted buccal mucosal graft (BMG) ureteroplasty for the management of proximal ureteral strictures.
  Citation: Urologia Journal
  PubDate: 2024-03-23T11:48:07Z
  DOI: 10.1177/03915603241240919
Relationship between vitamin D receptors gene polymorphism and
arteriogenic erectile dysfunction
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  Authors: Ahmed Rashad Elshahid, Amr Mohamed Zaky, Yasser Mamdouh Hasanein Goda, Nabil Fathy Ismail
  Abstract: Urologia Journal, Ahead of Print.
  Background:Over the past few decades, a number of studies have linked vitamin-D deficiency with ED (Erectile dysfunction) risk factors. There is a clear correlation between VD (vitamin-D) levels and ED, according to observational and interventional researches that have been reported in the literature. This crucial information encouraged scientists to investigate the impact of VD on erectile function in greater detail. The fact that vitamin D is a component of a healthy penis that begins in early life has just come to light, however there haven’t been many research looking at the connection between vitamin D receptor gene polymorphism and erectile dysfunction.Objective:To evaluate the relationship between arteriogenic erectile dysfunction and the vitamin D receptor gene polymorphism.Subjects and Methods:Between October 2022 and October 2023, at Al-Azhar University Hospitals, 40 patients with arteriogenic ED and 40 healthy controls underwent informed consent, a detailed history, a physical examination, a penile duplex ultrasound and the extraction of peripheral blood to determine the type of polymorphism for each of the vitamin D receptors: FokI, BsmI, ApaI and TaqI by polymerase chain reaction (PCR).Results:There is no statistically significant association between arteriogenic erectile dysfunction and the vitamin D receptors (VDR) gene polymorphisms FokI, BsmI, ApaI and TaqI.Conclusion:Since there is no statistically significant association between the polymorphism of the vitamin D receptor (VDR) gene and arteriogenic erectile dysfunction, it is advised to investigate other VDR gene polymorphisms as well as alternative clinical subtypes of erectile dysfunction.
  Citation: Urologia Journal
  PubDate: 2024-03-23T11:45:47Z
  DOI: 10.1177/03915603241241430
Are adverse events during surgery for benign prostatic hyperplasia device
related' A review of the MAUDE database
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  Authors: Daniel J Heidenberg, Ethan Nethery, Kevin M Wymer, Nathanael Judge, Scott M Cheney, Karen L Stern, Mitchell R Humphreys
  Abstract: Urologia Journal, Ahead of Print.
  Purpose:The Manufacturer and User Facility Device Experience database contains anonymous, voluntary medical device reports. A review of device-related adverse events associated with Benign Prostatic Hyperplasia surgeries was completed. The objective was to evaluate the occurrence and contributing factors to clinically significant complications in a cohort of patients electing to undergo surgical intervention for Benign Prostatic Hyperplasia.Methods:The Manufacturer and User Facility Device Experience database was queried for “Aquablation, Greenlight Laser, Holmium Laser, Morcellator, Water Vapor Thermal Therapy, Loop Resection, and Prostatic Urethral Lift” from 2018 through 2021. A complication classification system (Level I–IV) based on the Clavien-Dindo system was used to categorize events. These events were then correlated with procedural technology malfunctions and classified as “device related” and “non-device related.” Chi squared analysis was performed to identify associations between procedural technology and complication classification distribution.Results:A total of 873 adverse events were identified. The adverse events were classified into level I (minimal harm) versus levels II–IV (clinically significant). Aquablation (p
  Citation: Urologia Journal
  PubDate: 2024-03-23T11:43:47Z
  DOI: 10.1177/03915603241240646
The correlation between obesity and prostate volume in patients with
benign prostatic hyperplasia: A prospective cohort study
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  Authors: Saurabh Kumar Negi, Sandip Desai, Gaurav Faujdar, Sanjeev Jaiswal, Ram Dayal Sahu, Nachiket Vyas, Shivam Priyadarshi
  Abstract: Urologia Journal, Ahead of Print.
  Objective/background:Benign prostatic hyperplasia (BPH) is increasing substantial burden on health care systems. Men with high body mass index (BMI) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH.Method:The study included 560 patients (50–80 years) with BPH. Weight and height measured to calculate BMI. TRUS was used to measure PV. Patient demographics such as IPSS score and prostate specific antigen (PSA) were also noted.Results:Patients in the study had a mean age of 65.3 ± 9.45 years and the mean BMI was 23.97 ± 4.89 kg/m2. The mean PV of each BMI group were 37.45 ± 0.81, 57.89 ± 1.52 and 77.94 ± 2.17 (ml) for normal, overweight and obese groups, respectively, and the average PV score was 57.76 ± 1.50 ml. The mean PSA score was 3.26 ± 0.94 (ng/dl) with a range of 0.6–10.4. There was significant correlation between BMI and PV (p = 0.001) as well as between BMI with PSA and IPSS (p = 0.02, 0.001, respectively).Conclusion:The results showing strong correlation between BMI and PV also BMI with PSA and IPSS. Therefore reducing weight may lead to a lower prostate volume in the elderly stage, making LUTS less noticeable and improving quality of life.
  Citation: Urologia Journal
  PubDate: 2024-03-23T11:41:28Z
  DOI: 10.1177/03915603241240645
Genitourinary Fistula: epidemiology, changing trends in etiology and
management: A tertiary care institute’s perspective
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  Authors: Singh Vikram, Yadav Om Kumar, Sandhu Arjun Singh, Singh Mahendra, Bhirud Deepak Prakash, Tripathi Shashank, Bhargava Priyank, Jena Rahul, Navriya Shivcharan, Choudhary Gautam Ram
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Urogenital fistula is a physically, socially and psychologically devastating condition for the patient. In developed countries, these fistulae are typically related to gynecological surgery, pelvic pathology like malignancy or post radiation therapy. In contrast, classical teaching is that urogenital fistulae in the developing countries like India are usually associated with prolonged labor and obstetric complications. This retrospective study conducted at a tertiary care health Institute shows a paradigm shift in epidemiology, etiology and management of genitourinary fistulae in India in recent times.Methods:This retrospective study included patients undergoing surgical repair for various genitourinary fistulae at our institute from 2016 to 2022. Epidemiology, etiology, site, size and number of fistulae, clinical presentation, and management records of these patients were recorded and reviewed retrospectively.Results:In our study, the mean age of the patients was 38.4 ± 10.2 years. Vesicovaginal Fistula (VVF) was found to be most common fistula in the study population (87.5%) followed by vesicouterine (7.1%) and urethrovaginal fistula (5.4%). The causes of genitourinary fistula were iatrogenic (73.2%), carcinoma of cervix (16.1%), obstructed prolonged labor (7.1%), and genitourinary tuberculosis (3.57%). Among the 48 vesicovaginal fistulas that underwent surgery, 45.8% were treated using a transvaginal approach, 29.2% were managed through a laparoscopic transabdominal repair, and 25% were addressed using a robotic approach. Recurrence occurred in 7.1% of the operated patients.Conclusion:Enhanced healthcare services in the country have contributed to a decrease in the incidence of obstructed labor, subsequently reducing related injuries. Iatrogenic injuries resulting from gynecological surgeries and carcinoma cervix have given rise to more complex fistulas, necessitating the implementation of advanced treatment strategies.
  Citation: Urologia Journal
  PubDate: 2024-03-18T11:38:44Z
  DOI: 10.1177/03915603241238597
Supine versus prone percutaneous nephrolithotomy in management of patient
with complex renal stone diseases
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  Authors: Krishnendu Maiti, Kani Dayal Khare, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:Compare the surgical outcomes, safety, stone free rate, hospital stay, and complication of prone and supine PCNL in case of complex renal stone.Materials and methods:This is an observational study conducted in our institute, it consist of 120 patients over the period of 2 years from July 2021 to June 2023, all the patients were divided into two groups: 60 patients underwent modified supine percutaneous nephrolithotomy (PCNL) and remaining 60 patients underwent standard prone PCNL. The measured data included operative time, number of punctures, blood loss, stone-free rate, length of hospital stays, and rate of complications.Results:The two groups were comparable in mean age, male to female ratio, number of punctures, number of tract, size of tract, residual calculi in follow up period, blood transfusion, re-do surgery, chest complication, hospital stay, and postoperative fever and pain. The mean operating time was 1.59 h in supine PCNL and 2.49 h in prone PCNL. The p value was significant (p = 0.001).Conclusions:By this study we observed that the supine PCNL is associated with statistically significant reduced operating time as compared to conventional prone PCNL with advantages of not putting the patient in prone position. The postoperative complications such as pain and fever were not significant when compared in both groups. We conclude our study and found that, the supine PCNL is an equally effective in treating complex renal stone as compared to prone PCNL.
  Citation: Urologia Journal
  PubDate: 2024-03-18T08:42:48Z
  DOI: 10.1177/03915603241229801
Degree of awareness and practices on urinary tract infections: A study of
Sri Lankan school teachers selected from a chronic kidney disease
high-prevalent setting
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  Authors: Mohomed Safwan, Bhavantha Dias, Ayomi Dilhari
  Abstract: Urologia Journal, Ahead of Print.
  Objective:As key stakeholders in educational settings, teachers’ awareness on Urinary Tract Infections (UTI) will ultimately enhance its management in schools and community. This study aimed to assess the level of knowledge, attitudes, and practices (KAP) on UTIs among teachers in Sri Lanka.Materials and methods:Conveniently selected 373 school teachers were assessed using a pre-tested questionnaire. Each of the individual was scored and categorized as either satisfactory or poor. Descriptive statistics and chi-square tests were performed to describe the outcomes.Results:Around 80% of respondents demonstrated awareness regarding the microbial origin of UTIs, while 42% possessed knowledge of women’s increased susceptibility to UTIs. Over 90% of participants had favorable attitudes toward drinking adequate amounts of water, personal hygiene, and consulting doctors for UTI symptoms. Each inquiry demonstrated significant disparities between individuals with satisfactory and poor attitudes (p = 0.000), with over 95% adhered to effective hygiene practices as a preventive measure against UTIs. The demographics of the participants did not show any significance over the KAP results of the study (p
  Citation: Urologia Journal
  PubDate: 2024-03-18T08:41:08Z
  DOI: 10.1177/03915603241237563
Estimation of B-inhibin and anti mullerian hormone in functional
azoospermia and their correlations with surgical sperm retrieval: A
prospective case-control study
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  Authors: Sameh Fayek GamalEl Din, Nashaat Nabil, Hanan Hosni Moawad, Medhat Amer, Wael Zohdy, Abdel Rahman Bakry, Martina Tharwat Raoof, Asmaa Mohammed, Yasser Salem
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:The current study estimated the levels of anti mullerian hormone (AMH) and inhibin-B and reproductive hormones in non obstructive azoospermic (NOA) cases and obstructive azoospermic (OA) cases as well as comparing between them as regards the sensitivity and specificity in determining the sperm retrieval hope in the NOA cases. Finally, we analyzed any potential correlation between all the hormones measured in the current study.Methods:The current case control study was conducted at the andrology outpatient clinic from June (2021) to March (2022). The study recruited 135 participants divided equally into three groups NOA cases, OA cases and controls, respectively.Results:The mean inhibin-B was significantly lower in the NOA cases compared to the OA cases and the controls. There was a positive moderate correlation between AMH and Inhibin-B. Also, there was a positive moderate correlation between inhibin-B and free testosterone (FT) and positive weak correlation between beta Inhibin and leutinizing hormone (LH).Conclusions:The current study asserts the observation that inhibin-B is also expressed by Leydig cells as it has demonstrated positive correlations with FT and LH.
  Citation: Urologia Journal
  PubDate: 2024-03-15T12:55:45Z
  DOI: 10.1177/03915603241235716
Spectrum and antibiotic resistance in community- and hospital-acquired
urinary tract infections among adults: Experience from a large tertiary
care center in a developing country
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  Authors: Aya Herbawi, Adham Abu Taha, Banan M. Aiesh, Ali Sabateen, Sa’ed H. Zyoud
  Abstract: Urologia Journal, Ahead of Print.
  Background:It is important to note that the causative agents and patterns of antibiotic resistance vary between urinary tract infections (UTIs) acquired in the community and those acquired in a hospital setting. Therefore, the aim of this study was to compare the types of organisms and patterns of antibiotic resistance in adult patients with community-acquired urinary tract infections (CA-UTIs) and hospital-acquired urinary tract infections (HA-UTIs).Methods:Retrospectively, we collected urine samples from patients at An-Najah National University Hospital who experienced nonrecurring urinary tract infections (UTIs) between January 2019 and December 2020. The data were subsequently analyzed using IBM-SPSS® 21.0 software to determine the distribution of microorganisms and evaluate the rates of antibiotic resistance.Results:A total of 798 nonrepetitive UTI patients were included in our study, in which more than half of the UTIs occurred in female patients (472; 59.1%), and most of the UTIs were of community origin (611; 76.6%). Both community-acquired urinary tract infections (CA-UTIs) and hospital-acquired urinary tract infections (HA-UTIs) were more common in female patients (45.6% and 13.5%, respectively). Escherichia coli was the most commonly isolated urinary pathogen in both the CA-UTIs and HA-UTIs. The five most common isolated urinary pathogens were E. coli, Klebsiella pneumoniae, Enterococcus faecalis, E. faecium, and Pseudomonas aeruginosa. Among the isolated bacteria, 28.2% were extended-spectrum beta-lactamase (ESBL)-producing bacteria, 4.1% were carbapenem-resistant Enterobacterales (CRE), and 6.5% were vancomycin-resistant Enterococci. The most commonly isolated urinary pathogens from HA-UTIs showed higher resistance rates against all the tested antibiotics except for E. faecium, which showed greater resistance to tetracycline (42.5%) and quinupristin/dalfopristin (17.5%) in CA-UTIs.Conclusions:There are similarities in the etiological profiles of CA-UTI and HA-UTI, but the resistance rates are high, and urine culture is essential for the correct treatment of individual cases, even in primary care.
  Citation: Urologia Journal
  PubDate: 2024-03-15T12:53:26Z
  DOI: 10.1177/03915603241236361
Thiazide diuretics and their role in prevention of recurrent calcium renal
calculi
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  Authors: Muhammad Saad, Ifrah Sanaullah, Dureshum Kabir
  Abstract: Urologia Journal, Ahead of Print.
  
  Citation: Urologia Journal
  PubDate: 2024-03-11T11:25:33Z
  DOI: 10.1177/03915603241236362
A study on immunohistochemical expression of HER2/Neu and p63 and its
association with grade and invasiveness in case of bladder carcinoma
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  Authors: Subham Sinha, Sunirmal Choudhury, Jagamohan Mishra, Gourab Kundu, Malay Kumar Bera, Partha Protim Mondol
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Bladder cancer is a global disease, ranks as the fourth most prevalent cancer. The incidence and prevalence increase with age. Grade and aggressiveness have been found to be related with different genetic expression and mutation.Aims:To evaluate any relation of grade and invasiveness of urothelial cancer with varied expression of immune histochemical marker p63 and her2/neu.Materials and methods:The present study was a hospital based prospective cross-sectional study. This Study was conducted from July 2021 to April 2023 in the Urology department of a tertiary care hospital. Total 90 patients undergoing trans urethral resection of bladder tumour (TURBT) were included in this study.Result:It was found that, patients who had decreased p63 expression had high grade in tumours (93.1%) compared to patients who were expressing normal p63 (32.8%) and this was statistically significant (p
  Citation: Urologia Journal
  PubDate: 2024-02-23T09:26:04Z
  DOI: 10.1177/03915603241229764
Efficacy of transurethral botulinum toxin A injections for bladder outlet
obstruction: A systematic review and meta-analysis
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  Authors: Filippo Gavi, Mauro Ragonese, Daniele Fettucciari, Riccardo Bientinesi, Carlo Gandi, Marco Campetella, Filippo Marino, Marco Racioppi, Emilio Sacco, Nazario Foschi
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Botulinum toxin A (BoNT-A) injections in the prostate gland have been used as a minimally invasive option for treating bladder outlet obstruction (BOO). However, the efficacy of transurethral BoNT-A injections for BOO is not well established in the literature. The aim of this study is to collect evidence on the efficacy of transurethral BoNT-A injections for the treatment of BOO.Materials and methods:This systematic review and meta-analyses was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A systematic literature search was performed till December 2022. The study population consisted of adult patients diagnosed with BOO, who underwent transurethral injections of BoNT-A for the treatment of BOO.Evidence synthesis:Out of 883 records, we identified seven studies enrolling 232 participants, of which only one nonrandomized controlled trial was found. Four prospective studies and two retrospective studies. Three studies included patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) and were included in the meta-analysis. Three studies included patients with urethral sphincter hyperactivity. One study included patients with primary bladder neck disease (PBND). All studies showed significant improvements from baseline in maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) at 3 and 6 months. The adverse events were mild in all studies. Hematuria, UTI, and urinary retention were reported across all studies.Conclusion:In conclusion, transurethral BoNT-A injections have been shown to improve LUTS, QoL, and urodynamic parameters of individuals with BOO at 3 and 6 months after injections, and no serious adverse effects have been reported. However, data on the long-term benefits of this treatment are scarce, and more prospective, randomized studies with larger samples examining various injection techniques, dosages, and extended follow-up of recurrent injections are needed.
  Citation: Urologia Journal
  PubDate: 2024-02-19T11:35:28Z
  DOI: 10.1177/03915603241228166
Comparison of narrow band imaging versus white light imaging in detecting
non muscle invasive bladder cancer
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  Authors: Raghavendra RT, Amit Sharma, Deepak Biswal, Saryu Goel
  Abstract: Urologia Journal, Ahead of Print.
  Background:In the present study, we compared Narrow Band Imaging (NBI) and White Light Cystoscopy (WLC) in Non-muscle invasive bladder cancer (NMIBC) for detection and its impact on recurrence.Materials and methods:This prospective study was conducted in the department of Urology at a tertiary institution from August 2021 to April 2023. The main aim was to determine the benefit of addition of NBI during TURBT in NMIBC. All patients with Urinary Bladder Mass (size less than 5 cm on USG/CT) aged>18 years of age planned for TURBT were included.Results:Amongst 63 patients, the mean age was 59.84 ± 11.3 years; 80% were males. Sixty percent of patients had history of Tobacco consumption and Type II DM was the most common comorbidity (59%). Commonest symptom was gross haematuria. Posterior wall was most commonly involved and papillary lesions were commonest. A total of 125 lesions were identified on WLI, with mean 1.98 ± 1.75 and 78 additional lesions were identified only on NBI with mean 1.24 ± 1.63 lesions. Four patients had intra-operative complications. Five patients had recurrence at 6 weeks and eight patients had recurrence at 3 months. NBI had detected more lesions in patients who developed recurrence at 6 weeks and 3 months (mean: 1.41 and 1.43).Conclusion:NBI has additive role in detecting NMIBC lesions missed on WLI. NBI has significant role in preventing recurrence at 3 months and more so by detecting high grade tumours.
  Citation: Urologia Journal
  PubDate: 2024-02-19T11:33:04Z
  DOI: 10.1177/03915603241232115
Response to “Outcomes of infants undergoing laparoscopic pyeloplasty: A
single-center experience”
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  Authors: Jorge Panach-Navarrete, Lorena Valls-González, José María Martínez Jabaloyas
  Abstract: Urologia Journal, Ahead of Print.
  Although studies such as that of Erol et al. can raise doubts to a pediatric urologist about whether or not to carry out a laparoscopic approach in a pyeloplasty in infants, especially due to the percentage of complications, meta-analyses such as the one mentioned reinforce the safety and good results of the laparoscopic approach in these patients. The laparoscopic approach provides potential benefits over open surgery, such as better visualization of polar vessels, less aggressive dissection of periureteral tissues, or smaller scars. Although many open pyeloplasty incisions can be made small, they will never be smaller than those with 3 or 5 mm ports. Thus, any urologist or pediatric surgeon with experience in laparoscopic surgery has sufficient data at their disposal to be confident in the reproducibility and safety of laparoscopic surgery for pyeloplasties in infants. It is appreciated that works such as that of Erol et al. help minimally invasive techniques expand within pediatric urology.
  Citation: Urologia Journal
  PubDate: 2024-02-12T12:54:20Z
  DOI: 10.1177/03915603241232748
Acontractile detrusor as an initial presentation of sacral spinal cord
lesion: Case series
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  Authors: Faris Abushamma, Rola Abu Alwafa, Amir Aghbar, Mosab Maree, Moutaz Sweileh, Maha Akkawi
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:This study aims to investigate cases of acontractile bladder as the initial presentation of benign and malignant spinal conditions. The focus is on the challenges in making a diagnosis and the importance of a thorough neurological evaluation.Methods:We conducted a retrospective case series involving three patients who exhibited symptoms of acontractile bladder. Detailed clinical histories, urodynamic studies, and imaging techniques such as lumbosacral magnetic resonance imaging (MRI) were analyzed. Histopathological findings from relevant biopsies were also taken into account.Results:Case 1: A 14-year-old female presented with urinary retention, back pain, and an acontractile bladder on urodynamic study. Further examination, including lumbosacral MRI and histopathology, confirmed a diagnosis of metastatic Ewing’s Sarcoma. Case 2: A 39-year-old female with urinary incontinence and elevated post-void residual exhibited delayed bladder sensation. Lumbar spine MRI revealed a grade I Schwannoma after surgical resection. Case 3: A 15-year-old male with lower urinary tract symptoms and an acontractile detrusor on urodynamic study was found to have a Tarlov cyst on lumbosacral MRI.Conclusion:Atonic or Underactive bladder syndrome may be the initial presentation of a serious spinal condition. Complete neurological evaluation is mandatory if no obvious clinical cause.
  Citation: Urologia Journal
  PubDate: 2024-02-12T12:53:00Z
  DOI: 10.1177/03915603241230116
Single dartos flap versus double dartos flap in hypospadias repair: A
systematic review and meta-analysis with trial sequential analysis and
fragility index
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  Authors: Nitinkumar Borkar, Charu Tiwari, Abhijit Nair, CK Sinha, Simmi K Ratan, Bikash Kumar Naredi
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Hypospadias is a common congenital urogenital anomaly. Despite advancements in surgical techniques, still it presents challenges in management. An important aspect of hypospadias repair is the use of protective layers to cover neourethra. This review focuses on comparing the Single Dartos Flap (SDF) and Double Dartos Flap (DDF) techniques, used to cover the neourethra. These techniques differ in terms of the number of dartos layers used to cover the neourethra.Methods:This systematic review, follows PRISMA guidelines, included six RCTs from PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, and CINAHL. Patients with hypospadias repair with use of SDF or DDF were analyzed for outcome, Urethrocutaneous fistula, meatal stenosis, glans dehiscence, penile torsion and cosmetic outcomes. Statistical analysis was done using Review Manager, with TSA and FI ensuring result robustness.Results:Six studies met inclusion criteria, and risk of bias assessment indicated low risk across all domains. Meta-analysis results favored DDF over SDF for reducing urethrocutaneous fistula (RR 0.37, 95% CI 0.20–0.68) but showed no significant difference in meatal stenosis and glans dehiscence. DDF also associated with lower risk of penile torsion (RR 0.05, 95% CI 0.01–0.35).Conclusion:The systematic review, based on randomized controlled trials (RCTs), provides evidence supporting the use of DDF over SDF in hypospadias repair, particularly in distal hypospadias using the TIP procedure. The article emphasizes the potential advantages of DDF in reducing UCF but further robust evidence is needed to confirm these results based on the findings of TSA and FI.
  Citation: Urologia Journal
  PubDate: 2024-02-12T12:51:40Z
  DOI: 10.1177/03915603241231058
Comparison of serum uric acid levels between localised prostate cancer
patients and a control group
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  Authors: Satyaveer Singh, Sanjeev Jaiswal, Gaurav Faujdar, Shivam Priyadarshi
  Abstract: Urologia Journal, Ahead of Print.
  Aim:The aim of this study is to find out whether serum uric acid levels in patients with localised prostate cancer differ from patients with lower urinary tract symptoms without carcinoma prostate.Material and methods:We performed a prospective observational study of 60 patients having age ⩾ 50 years with c/o lower urinary tract symptoms( LUTS) evaluated by digital rectal examination (DRE), prostate-specific antigen (PSA) level and ultrasonography kidney, ureter, bladder (USG KUB) prostate and patients who were suspicious for carcinoma prostate underwent trans rectal ultrasonography (TRUS) biopsy of prostate. Patients with biopsy s/o prostate cancer were evaluated for metastasis and localised cancer patients were considered as CASE group. Patients with negative biopsy and other patients having LUTS were considered as CONTROL group. The age, serum uric acid level, PSA value, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count were measured. Serum uric acid level was compared in both the groups.Results:The mean serum uric acid level was lower in prostate cancer group (4.77 mg/dl) than control group (6.22 mg/dl) that was statistically significant (p
  Citation: Urologia Journal
  PubDate: 2024-02-12T12:49:18Z
  DOI: 10.1177/03915603241228892
Robot-assisted ureteric reconstructive surgeries for benign diseases:
Initial single-center experience with point of technique
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  Authors: Nikita Shrivastava, Priyank Bhargava, Pritesh Jain, Gautam Ram Choudhary, Rahul Jena, Mahendra Singh, Shivcharan Navriya, Vijay Kumar Sarma Madduri, Deepak Prakash Bhirud, Arjun Singh Sandhu
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:We present our initial experience with robot-assisted reconstructive surgeries with the Da Vinci Xi robotic system for benign ureteric pathologies.Materials and methods:This is a retrospective review of prospectively collected data of patients who underwent robot-assisted reconstructive procedures for benign diseases of the ureter at our department from April 2018 to November 2022. Demographic and perioperative details were recorded. Patients were followed up and surgical success was evaluated on the basis of symptomatic, functional, and radiological improvement.Results:A total of 34 patients underwent robot-assisted reconstructions for benign ureteric pathologies by various techniques. Mean age, body mass index (BMI), hospital stay and follow-up duration were 36 years, 24.1 kg/m2, 5.29 days, and 7.08 months respectively. Procedures included pyeloplasty in eight, primary ureteroneocystostomy (UNC) in seven, Psoas hitch UNC in five, Boari flap UNC in six, Ureteroureterostomy in four, ureterocalicostomy in two and ileal ureteral transposition in two patients. Mean docking time, total operative time, and estimated blood loss were 31.5 min, 178 min, and 64.3 ml, respectively. All patients had radiologic or functional improvement on follow-up after 6 months.Conclusion:Robot-assisted reconstructive surgery for benign ureteric and bladder pathologies imparted excellent short-term outcomes without major complications with all the advantages of a minimally invasive approach.
  Citation: Urologia Journal
  PubDate: 2024-02-12T12:46:53Z
  DOI: 10.1177/03915603241229144
Thanks to Reviewers
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  Abstract: Urologia Journal, Ahead of Print.
  
  Citation: Urologia Journal
  PubDate: 2024-02-12T09:36:59Z
  DOI: 10.1177/03915603241233132
Etiology, presentation and management of urinary tract infections in
multiple sclerosis patients: A review of the current literature
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  Authors: Marco Campetella, GB Filomena, F Marino, F Fantasia, P Russo, F Gavi, F Rossi, C Gandi, M Ragonese, N Foschi, A Totaro, E Sacco, M Racioppi, R Bientinesi
  Abstract: Urologia Journal, Ahead of Print.
  Urinary tract infections (UTIs) present a formidable challenge in the care of individuals affected by multiple sclerosis (MS). Lower urinary tract dysfunction is a prevalent issue among MS patients, predisposing them to an elevated risk of UTIs. When left untreated, UTIs can further exacerbate the already compromised quality of life in individuals with MS. The diagnosis and management of UTIs in MS patients necessitate a careful clinical evaluation. The objective of this review is to delineate preventive strategies and current and developing therapeutic approaches for preventing and treating UTIs associated with urinary dysfunction, catheterization, and upper urinary tract infections in patients with MS. Effectively addressing UTIs and urinary tract dysfunction in individuals with multiple sclerosis calls for a comprehensive, interdisciplinary approach.
  Citation: Urologia Journal
  PubDate: 2024-01-27T12:50:22Z
  DOI: 10.1177/03915603231224511
The correlation between academic stress, overactive bladder syndrome (OAB)
and quality of life among healthy university students: A cross-sectional
study
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  Authors: Faris Abushamma, Rola Abu Alwafa, Sara Shbaita, Amir Aghbar, Sa’ed H Zyoud, Hashim Hashim
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:This study aims to assess the presence of overactive bladder syndrome (OAB), academic stress, and their impact on quality of life (QoL) of healthy university students.Methods:A cross-sectional study recruited university students from different academic streams, between January 2021 to December 2021. Demographics, overactive bladder-validated 8 questionnaire (OAB-V8), International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB) questionnaire, and Perception of Academic Stress (PAS) scale were collected. The correlation between the variables was assessed using the Social Sciences Statistical Package (SPSS) version 21.Results:Three hundred and 89 people met the inclusion criteria. There were 241 (62%) females, and 248 (63.8%) of the students were under the age of 22. Four academic streams were included: Engineering 96 (24.7%), Humanities 121 (31.1%), Medicine 85 (21.8%) and Nursing 87 (22.4%). OAB was found among 103 (26%) students. The mean OAB-V8 score was 5.8 ± 6.6. The mean PAS scale was 53.9 ± 9.4. The mean ICIQ-OAB score was 1.5 (0–9). Male gender 62 (60%), smoking 42 (40.8%), academic stream (Humanity 40 (38.8%)) and year (third and fourth-year students 34 (33%) and 33 (32%), respectively) have a statistically significant positive correlation with OAB (p
  Citation: Urologia Journal
  PubDate: 2024-01-22T05:42:55Z
  DOI: 10.1177/03915603231225632
Evaluation of functional and oncological outcomes of localized prostate
cancer after different minimally invasive therapeutic methods: A single
center experience
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  Authors: D. V. Chinenov, E. V. Shpot, Y. N. Chernov, A. N. Gerasimov, L. Y. Kazachevskaya, K. A. Lyapichev, H. M. Ismailov, Z. K. Tsukkiev, D. O. Korolev, L. M. Rapoport
  Abstract: Urologia Journal, Ahead of Print.
  Objectives:To study the functional and oncological results of minimally invasive treatment methods: cryoablation, brachytherapy, and high-intensity focused ultrasound (HIFU) therapy of localized prostate cancer in a single hospital.Methods:One hundred sixty patients with localized prostate cancer were treated with minimally invasive methods (53, 52, 55 patients with cryoablation, brachytherapy and HIFU therapy, respectively). Prostate-specific antigen and evaluation of post-procedure biopsies were used as an assessment. The review of functional indicators and quality of life was made with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), quality of life (QoL) questionnaires.Results:Patients after cryoablation showed worse results of oncological control according to positive repeat biopsies, best indicators were observed after brachytherapy. When considering the IPSS results, there were statistically significantly worse scores in the brachytherapy group in the early postoperative period, these differences do not reach statistical significance in the late period in the brachytherapy and cryoablation groups. Patients in the cryoablation group showed worse indicators of IIEF-5; in the early postoperative period; in the late follow-up period, the indicators of erectile function in patients in the cryoablation group did not statistically significantly differ from those in patients after brachytherapy. Patients after HIFU therapy showed fewer cases of de novo erectile dysfunction during the follow-up period of 3 years, higher average IIEF-5 scores, lower IPSS scores and better QoL results.Conclusion:The recurrence of prostate cancer was statistically significantly higher in the International Society of Urological Pathology (ISUP) 3 grade group. HIFU therapy had better urination indicators compared to other groups, that can be associated with the laser enucleation of prostatic hyperplasia. The advantage was noted in patients after HIFU therapy when comparing the parameters to the IIEF-5 thus, HIFU treatment had a better impact on patients’ QoL with localized prostate cancer.
  Citation: Urologia Journal
  PubDate: 2024-01-22T05:35:47Z
  DOI: 10.1177/03915603231226366
Short time (10 min) Catheter Traction Following TURP: IS it helpful
with less morbidity'
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  Authors: Krishnendu Maiti, Pankaj Kanti Dey, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Transurethral Resection of Prostate (TURP) is the most common treatment for Benign Prostatic Hyperplasia (BPH). Blood loss during and after transurethral resection of the prostate (TURP) is a potential cause of morbidity and clot retention. Usual practise is to apply traction in every case of TURP to reduce early postoperative hematuria and clot retention. There are very few studies in the literature and they have mainly concentrated on the effect of traction on reducing blood loss but there is scanty data regarding the morbidity associated with the use of traction. Various authors have described their method of traction application. So, in this study, we will compare the result of short term (10 min) traction with standard (4–6 h) traction.Materials and methods:It is a prospective comparative study with 50 participants, conducted at the department of Urology of a tertiary care hospital in eastern India after taking ethical clearance and consent from the patient. The patients attending urology O.P.D. with LUTS and diagnosed as BPH and planned for elective TURP and who had prolonged traction after TURP were excluded. Study period was one and the half year.Results:Post operatively 25 patients were managed with catheter traction while 25 patients were managed with short term traction of 10 min. Pain which is assessed by visual analog scale (VAS) at 2 and 4 h post operatively is statistically significant with p value of
  Citation: Urologia Journal
  PubDate: 2024-01-12T12:58:28Z
  DOI: 10.1177/03915603231222959
Genetic variants in the mTOR pathway with renal cancer risk and subtypes
in East Indian population
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  Authors: Subhajit Malakar, Srilagna Chatterjee, Madhusudhan Das, Dilip Kumar Pal
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Renal Cell Carcinoma (RCC), which accounts for 2%–3% of all adult malignant neoplasms with a male-to-female predominance of 1.9 to 1 with typical presentation between 55 and 75 years. The phosphoinositide-3-kinase–protein kinase B/Akt (PI3KPKB/Akt) pathway is a main pathway in control of cell growth. mTOR pathway plays a key role in the pathogenesis of RCC.Material and methods:Its a prospective observational study. Tissue samples were collected and processed and DNA isolation and sequencing was done to see for any association and expression.Results and analysis:Polymorphism analysis of the sequence of three genes MTOR, AKT1, and PIK3CA done and found an intronic variant of the MTOR gene (rs3737611) and AKT1 gene (rs2498797) to be significantly associated with clear cell Renal Cell Carcinoma tumor samples.Discussion:This study will help to understand the pathogenesis better and the information can be used to develop new drugs and personalized treatment strategies that are tailored to an individual’s genetic makeup. The study identify individuals who are at heightened risk for developing renal cancer and could benefit from targeted screening or preventative measures. Some sample size and definite geographical sample pool remains the main limitation of the study which may not be externally validate the study results.
  Citation: Urologia Journal
  PubDate: 2024-01-11T01:05:10Z
  DOI: 10.1177/03915603231222081
Risk factors of stone residual after retrograde intrarenal surgery: A
prospective cohort study
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  Authors: Mohamed Mahmoud Abdelfatah Zaza, Ahmed Mohamed Tawfeek, Tarek Abd El-Mageed Salem, Muhammad Ibrahim Salim Soliman, Mohammed Hassan Ali
  Abstract: Urologia Journal, Ahead of Print.
  Background:Complete removal of renal stones is crucial for optimal patient outcomes, but recent studies have reported residual stones after retrograde intrarenal surgery (RIRS). This study aimed to identify the associated risk factors to improve patient management and treatment selection.Methods:This cohort study was conducted over 18 months at two hospitals and recruited adult patients with renal stones less than 3 cm. Preoperative assessment included medical history, physical examination, laboratory tests, and radiological imaging. Intraoperative and postoperative data collection and follow-up were conducted to evaluate surgical success and potential complications.Results:A total of 100 patients were included, with a mean age of 45.3 ± 10.7 years and a mean BMI of 26.2 ± 1.4 kg/m2. Approximately 19% of the patients had residual stones after the RIRS procedure. The RUSS score showed good diagnostic performance with an AUC of 0.843, and the optimal cut point was ⩾2.0 with a sensitivity of 52.6% and specificity of 95.1%. Independent predictors of residual stones were multiple sites (OR = 24.98; p = 0.002), multiple stones (OR = 13.62, p = 0.002), stone size of 21–30 mm (OR = 4.91, p = 0.038), lower calyx site (OR = 4.85, p = 0.033), and surgeon experience of fewer than 50 cases (OR = 6.82, p = 0.020),Conclusions:This study identifies several factors associated with residual stones after RIRS for renal stones, including stone size, location, number, and surgeon experience. The study suggests that the RUSS score can be used as a reliable tool for predicting the likelihood of residual stones, which can help clinicians in patient selection and treatment planning.
  Citation: Urologia Journal
  PubDate: 2024-01-09T11:20:47Z
  DOI: 10.1177/03915603231222083
Robot-assisted partial nephrectomy using the novel Hugo™ RAS system:
Feasibility, setting and perioperative outcomes of the first off-clamp
series
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  Authors: F Prata, A Ragusa, A Civitella, P Tuzzolo, F Tedesco, L Cacciatore, A Iannuzzi, P Callè, G Raso, M Fantozzi, M Pira, M Ricci, M Pino, A Minore, S Basile, A Testa, VG Crimi, N Deanesi, A Travino, G D’Addurno, RM Scarpa, R Papalia
  Abstract: Urologia Journal, Ahead of Print.
  Introduction:Hugo Robot-Assisted Surgery (RAS) System has been conceived with enhanced modularity but its role for nephron-sparing surgery setting still remains poorly explored. We aimed to describe our experience in robot-assisted partial nephrectomy (RAPN) with a three-arms setting for the first off-clamp series using the new Hugo RAS System.Methods:Patients were placed on an extended flank position at the margin of the surgical bed with a slightly flexion (45°). The first 11 mm robotic trocar (camera port) was placed along the pararectal line 14 ± 2 cm far from the umbilicus. The pneumoperitoneum was then induced through the AirSeal system (SurgiQuest, Milford, Connecticut, USA©). Two more 8 mm operative robotic ports were placed under direct vision, either 8 ± 1 cm far from optic’s port. Two 12 mm laparoscopic ports for bed-assistant were placed between robotic ports. Monopolar curved shears, fenestrated grasper, and large needle driver were used in a three-instruments configuration.Results:Off-clamp RAPN was successfully performed in seven patients with cT1 renal masses using a trans-peritoneal route. Median port placement and docking time was 6 min (IQR, 4–8 min). Hemostasis was achieved through renorraphy using a single transfix stitch with sliding clips technique. There was no need for additional ports placement. No intraoperative complications occurred, no clashing of robotic instruments or between the robotic arms was observed. No technical failures of the system occurred. Median console time was 83 min (IQR, 68–115 min). Median estimated blood loss were 200 ml (IQR, 50–400 ml). All patients were discharged between post-operative day 2 and 3, without the need of hospital readmission. No complications were recorded within the first 30 post-operative days.Conclusions:We performed the first series of off-clamp RAPN using the novel HUGO RAS System. This novel robotic platform showed an easy-friendly docking system, providing excellent perioperative outcomes with a simple three-arms configuration.
  Citation: Urologia Journal
  PubDate: 2024-01-04T11:44:05Z
  DOI: 10.1177/03915603231220109

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