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Treatment of Kidney Stones by Percutaneous Nephrolithotomy: Evaluation of the Results of the First Series of Our Experience in the urology Department of the Idrissa Pouye General Hospital in Dakar

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Open Journal of urology 2024年第2期14卷 104-114页

作者： Mouhamadou Moustapha Mbodji Mohamed Jalloh Medina Ndoye Abdourahmane Diallo Issa Labou Lamine Niang Serigne Magueye Gueye Department of urology and Andrology Hospital General Idrissa Pouye Dakar Senegal

The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.

关键词： HOGIP Kidney Stones PCNL Stone Free Uro CT Scan

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N-acetylcysteine ameliorates erectile dysfunction in rats with hyperlipidemia by inhibiting oxidative stress and corpus cavernosum smooth muscle cells phenotypic modulation

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Asian Journal of Andrology 2024年第1期26卷 99-106页

作者： Wei Ding Jun-Hong Fan Li-Ren Zhong Nan-Xiong Wang Lu-Hao Liu Hai-Bo Zhang Li Wang Ming-Qiang Wang Bing-Lin He An-Yang Wei Department of urology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang 550002China Department of urology Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou 510000China Department of urology Nanfang HospitalSouthern Medical UniversityGuangzhou 510000China Department of urology Shenzhen Immigration Inspection General Station HospitalShenzhen 518000China Department of Organ Transplantation The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510000China Department of Endocrinology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang 550002China

Hyperlipidemia is a major risk factor for erectile dysfunction(ED).Oxidative stress and phenotypic modulation of corpus cavernosum smooth muscle cells(CcSMCs)are the key pathological factors of ED.N-acetylcysteine(NAC)can inhibit oxidative stress;however,whether NAc can alleviate pathological variations in the corpus cavernosum and promote erectile function recovery in hyperlipidemic rats remains unclear.A hyperlipidemia model was established using 27 eight-week-old male Sprague-Dawley(SD)rats fed a high-fat and high-cholesterol diet(hyperlipidemic rats,HR).In addition,9 male SD rats were fed a normal diet to serve as controls(NC).HR rats were divided into three groups:HR,HR+normal saline(NS),and HR+NAC(n=9 for each group;NS or NAc intraperitoneal injections were administered daily for 16 weeks).Subsequently,the lipid profiles,erectile function,oxidative stress,phenotypic modulation markers of ccsMCs,and tissue histology were *** experimental results revealed that erectile function was significantly impaired in the HR and HR+NS groups,but enhanced in the HR+NAC *** lipid levels,over-activated oxidative stress,and multi-organ lesions observed in the HR and HR+NS groups were improved in the HR+NAC ***,the HR group showed significant phenotypic modulation of CCSMCs,which was also inhibited by NAC *** report focuses on the therapeutic effect of NAc in restoring erectile function using a hyperlipidemic rat model by preventing CcSMC phenotypic modulationand attenuating oxidativestress.

关键词： erectile dysfunction hyperlipidemia N-acetylcysteine oxidative stress henotypic modulation

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Can we predict the incidence of high-grade Clavien-Dindo complications in patients with forgotten encrusted stents undergoing endourologic management?

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Asian Journal of urology 2024年第1期11卷 99-104页

作者： Praanjal Gupta Ramanitharan Manikandan Lalgudi Narayanan Dorairajan Kodakattil Sreenivasan Sreerag Sidhartha Kalra Swapnil Singh Kushwaha Department of urology Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Objective:Ureteral stents are customarily inserted to facilitate urinary drainage,but they come with their own glitches of being forgotten and/or encrusted leading to serious *** present study aimed to report the complications in patients with forgotten and encrusted stents according to the Clavien-Dindo system specific to urological procedures and identify the factors leading to high-grade(Clavien-Dindo Grade 4A or above)***:The hospital records of patients with forgotten encrusted double-J stents over a period of 8 years were *** parameters recorded included patient demographics,indwelling time,need for percutaneous nephrostomy,hemodialysis,urine culture,blood culture,total blood counts,serum creatinine,radiologic findings,management techniques,number of surgical interventions,modified Clavien-Dindo complications,follow-up,and mortality,if ***:Forty patients were included in the *** median age was 52(range 6-85)*** the total,25(62.5%)patients had a“significant”stent load;31(77.5%)had renal failure or acute kidney injury on presentation;19(47.5%)patients had sepsis at *** the patients presented with sepsis,11(57.9%)patients demonstrated a positive urine culture;and 7/11(63.6%)patients exhibited pan-resistant *** out of 40(30.0%)patients in our series developed high-grade Clavien-Dindo *** univariate analysis,sepsis at presentation(p=0.007),stent load(p=0.031),diabetes(p=0.023),positive urine culture(p=0.007),and stent indwelling time of more than 1 year(p=0.031)were found to be *** multivariate logistic regression analysis,sepsis at presentation(p=0.017)and positive urine culture(p=0.016)were significant predictors for high-grade ***:It is prudent to identify specific risk factors,namely sepsis at presentation and positive urine culture to triage and optimize these patients before surgical management.

关键词： Forgotten Encrusted stent Outcome Predictor Clavien-Dindo complication

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Management and nursing strategies for different patterns of adverse events in patients with urological cancer treated with immune checkpoint inhibitors

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Current urology 2024年第3期18卷 212-217页

作者： Xiaojuan Huang Xiaolei Li Lulin Ma Chunxia Liu Department of urology Peking University Third HospitalBejingChina

Background This study aimed to explore the patterns of treatment-related adverse events(AEs)associated with immune checkpoint inhibitor(ICI)monotherapy and in combination with chemotherapy or tyrosine kinase inhibitor(TKI)therapy and to summarize the corresponding management and nursing *** and methods A total of 69 patients with malignant urological tumors who received ICI treatment between June 2019 and October 2022 were retrospectively analyzed,and AEs that occurred during treatment were observed and *** on the different types of treatment,the patients were divided into ICI monotherapy,ICI plus chemotherapy,and ICI plus TKI therapy *** analysis was *** incidence,distribution,and severity of AEs in the different subgroups were *** A total of 138 AEs occurred in 69 patients,among which grade 1 plus 2,and grade 3 plus 4 AEs accounted for 78.99%and 21.01%,*** incidence of AEs per patient in the ICI-TKI therapy group was the highest(3.75 times/person),followed by the ICI-chemotherapy(2.33 times/person)and ICI monotherapy(0.82 times/person)*** AEs,such as fatigue,nausea,and myelosuppression,were much more common in the ICI-gemcitabine and cisplatin group,whereas renal injury,skin lesions,and diarrhea were most common ones in the ICI-TKI *** Immune checkpoint inhibitors are new treatment options for advanced urological tumors and renal cell *** AE patterns were observed among the different treatment ***,strict and meticulous clinical management and nursing measures are required to ensure the safety of patients receiving ICI treatment.

关键词： Immune checkpoint inhibitor Immunotherapy Adverse events Nursing Urological tumor

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Analysis of the urethral stricture score and patient-related factors as predictors of outcomes following oral mucosal graft urethroplasty

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Asian Journal of urology 2024年第3期11卷 473-479页

作者： Nikita Shrivastava Rahul Jena Deepak Prakash Bhirud Mahendra Singh Gautam Ram Choudhary Arjun Singh Sandhu Department of urology All India Institute of Medical SciencesJodhpurRajasthanIndia

Objective:The complexity of urethral strictures can predict outcomes following *** previously described urethral stricture score(U score)considered only stricture-related factors to grade the complexity of urethral strictures and to predict recurrence post urethroplasty,but not considered patient-related factors for the *** aimed to study the correlation of both of these factors to the outcomes of oral mucosal graft ***:We retrospectively reviewed data of 101 patients who underwent oral mucosal graft urethroplasty in our institute with a minimum follow-up of 6 *** patient characteristics and stricture-related parameters were *** U score was calculated for all patients which consisted of the length,location,number,and etiology of *** and multivariate Cox proportional hazard regression models were used to determine significant risk factors of ***:The mean follow-up of patients was 15 *** was seen in 28 patients and the mean time for detection of recurrence was 8 months of *** Charlson Comorbidity Index,history of previous intervention,length of strictures,location of strictures,number of strictures,history of smoking,and etiology were independent predictors of recurrence following *** on these parameters,we formulated the modified U score(MU score).The scores ranged from 0 to 6 and a score of>2 was found to be predictive of *** comparing receiver operating characteristic curves for both scores by the DeLong test,the MU score had larger area under the curve than the U ***:The MU scoring system is the first of its kind attempt taking into consideration both patient-and stricture-related factors to predict recurrence following oral mucosal graft urethroplasty.

关键词： Urethral stricture Urethral stricture score Recurrence Urethroplasty

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Treatment-induced neuroendocrine prostate cancer and de novo neuroendocrine prostate cancer:Identification,prognosis and survival,genetic and epigenetic factors

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World Journal of Clinical Cases 2024年第13期12卷 2143-2146页

作者： Mohamed Wishahi Department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Neuroendocrine prostate cancer(NEPC)shows an aggressive behavior compared to prostate cancer(PCa),also known as prostate *** foci in PCa can harbor genetic alternation that can arise in a heterogeneity of prostate *** may arise de novo or develop following androgen deprivation therapy(ADT).NEPC that arise following ADT has the nomenclature“treatmentemerging/induced NEPC(t-NEPC)”.t-NEPC would be anticipated in castration resistant prostate cancer(CRPC)and metastatic PCa.t-NEPC is characterized by low or absent androgen receptor(AR)expression,independence of AR signaling,and gain of neuroendocrine phenotype.t-NEPC is an aggressive metastatic tumor,develops from PCa in response to drug induced ADT,and shows very short response to conventional therapy.t-NEPC occurs in 10%-17%of patients with *** novo NEPC is rare and is accounting for less than 2%of all *** molecular mechanisms underlying the trans-differentiation from CRPC to t-NEPC are not fully *** kinase 1 plays a significant role in t-NEPC *** neuroendocrine markers:Synaptophysin,chromogranin A,and insulinoma associated protein 1(INSM1)are expressed in t-NEPC,they are non-specific for diagnosis,prognosis,and follow-up of therapy.t-NEPC shows enriched genomic alteration in tumor protein P53(TP53)and retinoblastoma 1(RB1).There are evidences suggest that t-NEPC might develop through epigenetic *** are genomic,epigenetic,and transcriptional alterations that are reported to be involved in development of ***-outs of TP53 and RB1 were found to contribute in development of *** is resistant to immunotherapy,and at present there are running trials to approach immunotherapy for PCa,CRPC,and t-NEPC.

关键词： Prostate cancer Neuroendocrine carcinoma Treatment induced neuroendocrine prostate cancer Androgen deprivation therapy Genetic and epigenetic factors Castration resistant prostate cancer De novo neuroendocrine prostate cancer

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Developing a diagnostic model for predicting prostate cancer: a retrospective study based on Chinese multicenter clinical data

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Asian Journal of Andrology 2024年第1期26卷 34-40页

作者： Chang-Ming Wang Lei Yuan Xue-Han Liu Shu-Qiu Chen Hai-Feng Wang Qi-Fei Dong Bin Zhang Ming-Shuo Huang Zhi-Yong Zhang Jun Xiao Tao Tao Department of urology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Department of Radiology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Core Facility Center for Medical Sciences The First Affiliated Hospital of USTcDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Department of urology Affiliated Zhongda Hospital of Southeast UniversityNanjing 210009China Department of urology Shanghai East HospitalTongji University School of MedicineShanghai 200120China Department of urology Shanghai Changhai HospitalSecond Military Medical UniversityShanghai 200000China Department of urology Affiliated Anhui Provincial Hospital of Anhui Medical UniversityHefei 230001China

The overdiagnosis of prostate cancer(PCa)caused by nonspecific elevation serum prostate-specific antigen(PSA)and the overtreatment of indolent PCa have become a global problem that needs to be solved *** aimed to construct a prediction model and provide a risk stratification system to reduce unnecessary *** this retrospective study,clinical data of 1807 patients from three Chinese hospitals were *** final model was built using stepwise logistic regression *** apparent performance of the model was assessed by receiver operating characteristic curves,calibration plots,and decision curve ***,a risk stratification system of clinically significant prostate cancer(csPCa)was created,and diagnosis-free survival analyses were *** multivariable screening and evaluation of the diagnostic performances,a final diagnostic model comprised of the PSA density and Prostate Imaging-Reporting and Data System(PI-RADS)score was *** validation in the development cohort and two external cohorts showed excellent discrimination and ***,we created a risk stratification system using risk thresholds of 0.05 and 0.60 as the cut-off *** follow-up results indicated that the diagnosis-free survival rate for csPCa at 12 months and 24 months postoperatively was 99.7%and 99.4%,respectively,for patients with a risk threshold below O.05 after the initial negative prostate biopsy,which was significantly better than patients with higher *** diagnostic model and risk stratification system can achieve a personalized risk calculation of *** provides a standardized tool for Chinese patients and physicians when considering thenecessity of prostatebiopsy.

关键词： nomogram prostate biopsy prostate cancer Prostate Imaging-Reporting and Data System prostate-specific antigen density

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Hypoxia activates the hypoxia-inducible factor-1α/vascular endothelial growth factor pathway in a prostatic stromal cell line:A mechanism for the pathogenesis of benign prostatic hyperplasia

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Current urology 2024年第3期18卷 185-193页

作者： Tao Zhang Changlin Mao Yao Chang Jiaju Lyu Delong Zhao Sentai Ding Department of urology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanChina Department of urology Mindong Hospital Affiliated to Fujian Medical UniversityFuanChina

Background The development of benign prostatic hyperplasia(BPH)is closely related to hypoxia in the prostatic stroma,and the hypoxia-inducible factor-1α/vascular endothelial growth factor(HIF-1α/VEGF)pathway has been shown to significantly activate in response to *** underlying mechanism for activation of this pathway in the pathogenesis of BPH remains *** and methods We constructed HIF-1αoverexpression and knockdown BPH stromal(WPMY-1)and epithelial(BPH-1)cell lines,which were cultured under different oxygen conditions(hypoxia,normoxia,and hypoxia+HIF-1αinhibitor).Quantitative real-time polymerase chain reaction(qPCR)and Western blotting were applied to detect the expression of the HIF-1α/VEGF *** proliferation and apoptosis were analyzed by Cell Counting Kit-8 and flow *** used the miRWalk 2.0 database and Western blotting to predict the potential miRNA that selectively targets the HIF-1α/VEGF pathway,and verified the prediction by qPCR and dual-luciferase *** In a BPH stromal cell line(WPMY-1),the expression of VEGF was in accordance with HIF-1αlevels,elevated in the overexpression cells and decreased in the knockdown ***-induced HIF-1αoverexpression,which could be reversed by a HIF-1α***,the HIF-1αinhibitor significantly depressed cellular proliferation and promoted apoptosis in hypoxic conditions,assessed by Cell Counting Kit-8 and flow ***,in the BPH epithelial cell line(BPH-1),the expression level of HIF-1αdid not influence the expression of ***,a potential miRNA,miR-17-5p,regulating the HIF-1α/VEGF pathway was predicted from the miRWalk 2.0 database and Western blotting,and verified by qPCR and dual-luciferase *** In hypoxia,activation of the HIF-1α/VEGF pathway plays a crucial role in regulating cell proliferation in a BPH stromal cell *** by miR-17-5p may be the potential mechanism for the activation of this *** of thi

关键词： Benign prostatic hyperplasia Hypoxia-inducible factor-1α Vascular endothelial growth factor Pathogenesis miR-17-5p

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Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes

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Asian Journal of urology 2024年第3期11卷 366-372页

作者： David Strauss Eric Cho Matthew Loecher Matthew Lee Daniel Eun Department of urology Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA

Objective:A vesicourethral anastomotic leak(VUAL)is a known complication following robotic-assisted radical *** natural history of a VUAL has been well described and is frequently managed with prolonged *** increasing emphasis on patient reported outcomes,catheter duration and VUAL are associated with significant short-term quality of life *** aimed to present a case series of our robotic early post-prostatectomy anastomotic repair technique,defined as revision within 6 weeks from index ***:A single institution prospective database identified eleven patients with a VUAL from July 2016 to October 2022 who underwent robotic early post-prostatectomy anastomotic repair by a single *** were diagnosed with a VUAL on pre-operative CT urogram or CT/fluoroscopic *** primary outcome was resolution of the anastomotic leak,defined as no contrast extravasation on post-operative *** outcomes included post-repair catheter duration and continence on the last follow-up defined as pad(s)per ***:The mean time to intervention after robotic-assisted radical prostatectomy was 21 *** of the eleven(72.7%)patients had no evidence of extravasation on postrepair *** range from intervention to first cystogram was 7e20 *** median catheter duration for those with successful intervention was 10 *** median catheter duration for those with the leak on initial post-operative cystogram was 20 *** a mean follow-up time of 25 months,eight(72.7%)patients reported using no pads per day,and three(27.3%)patients reported one pad per ***:Management of a VUAL has traditionally relied on prolonged catheter drainage and the tincture of *** the role of robotic reconstruction has been shown to be a viable modality for management of bladder neck contracture,it is important to reconsider prior dogmas of urologic *** case series suggests that an early repair is saf

关键词： Minimallyinvasive surgery Vesicourethral anastomotic leak Robotic-assisted laparoscopic reconstruction

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Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul Dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.Deebel David D.Thiel Ram Anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA Mayo Clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 ***:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were *** analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical ***:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were *** and multivariable analysis exhibited similar *** LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant *** hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant ***:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program *** the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： Minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

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