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The impact of chemotherapy-naïve open radical cystectomy delay and perioperative transfusion on the recurrence-free survival: A perioperative parameters-based nomogram

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Asian Journal of urology 2024年第2期11卷 294-303页

作者： Ahmed M.Harraz Ahmed Elkarta Mohamed H.Zahran Ahmed Mosbah Atallah A.Shaaban Hassan Abol-Enein urology and nephrology Center Mansoura UniversityEgypt

Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential ***: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve ***: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the ***: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.

关键词： Radicalcystectomy Blood transfusion Time to radical cystectomy Survival Nomogram

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Intravesical instillation of platelet-rich plasma for treatment of interstitial cystitis/bladder pain syndrome:A pilot study

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Current urology 2024年第1期18卷 49-54页

作者： Ahmed S.El Hefnawy Mohamed Attya Ahmed Hasan Esam El Sawy Mohamed Abdel-Razik Nasr El-Tabey Mansoura urology and nephrology Center Faculty of MedicineMansoura UniversityMansouraEgypt

Objective:The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma(PRP)to treat interstitial cystitis/bladder pain syndrome(IC/BPS).Materials and methods:Twenty PRP samples were tested in vitro for stability after exposure to urine samples with different pH.A pilot study involving 21 female patients with IC/BPS was conducted,and 6 weekly doses of autologous PRP(50 mL)were *** were followed up at the 2nd,4th,8th,and 12th weeks after terminating *** primary endpoint was the visual analog scale(VAS)for pain,and the secondary endpoints included the IC symptom index,IC problem index of the O'Leary-Sant questionnaire and global response assessment,urine culture,and *** was defined as a reduction in VAS by 30%or more compared with basal level,and adverse events were ***:The mean±SD of VAS was significantly reduced compared with basal level(4.4±2.6 vs.8.8±1.1,respectively,p=0.001).Meanwhile,80%of cases were considered successful,with a 50.1%reduction in the mean score compared with the basal *** mean±SD of IC symptom index and IC problem index significantly improved compared with the basal *** response assessment was markedly,moderately,and slightly improved in 2(10%),10(50%),and 5(25%)patients,respectively,and showed no change in 3(15%).Three patients had positive urine cultures at follow-up,but 1 withdrew after 2 sessions because of a lack of ***:Repeated intravesical instillation of PRP could be considered an effective and safe approach for treating IC/BPS.

关键词： Bladder pain syndrome Interstitial cystitis Platelet-rich plasma

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M2 macrophage-related molecular subtypes and prognostic index for prostate cancer patients through integrating single-cell and bulk RNA sequencing analysis

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Genes & Diseases 2024年第4期11卷 131-133页

作者： Dechao Feng Xu Shi Dengxiong Li Ruicheng Wu Jie Wang Wuran Wei Ping Han Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengduSichuan 610041China

Prostate cancer(PCa)is considered as an age-related disease and accounts for the most prevalence of urinary malignancies in men.1 We previously analyzed the cellular landscape of tumor microenvironment in PCa patients,where we found that cancer-related fibroblasts might play an important role in tumorigenesis and the development of PCa and tumor-associated macrophage(TAM)could function synergistically with them.2 Thus,we further integrated single-cell and bulk RNA sequencing with meta-analysis to specify the prognostic effect of TAM on PCa and construct molecular subgroups and predictive index to guide clinical practice.

关键词： patients macrophage cancer

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Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?

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Asian Journal of urology 2024年第2期11卷 156-168页

作者： Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang Department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduSichuanChina

Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient ***: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time ***: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse ***: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.

关键词： Laser lithotripsy Urolithiasis Thulium laser Holmium:yttrium-aluminum-garnet Moses effect

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Curcumin Interferes with TGF-β1-Induced Fibrosis in NRK-49F Cells by Reversing ADAMTS18 Gene Methylation

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Chinese Journal of Integrative Medicine 2024年第7期30卷 600-607页

作者： XU Ben ZHANG Jia-en YE Lin YUAN Chang-wei Department of urology Peking University First Hospital and Institute of UrologyPeking UniversityNational Urological Cancer CenterBeijing100034China

Objective To explore the molecular mechanism by which curcumin affects renal interstitial fibrosis(RIF)progression by regulating ADAM metallopeptidase with thrombospondin type 1 motif 18(ADAMTS18)*** NRK-49F cells RIF model were induced with transforming growth factorβ1(TGF-β1).Effects of different concentrations of curcumin(0,10,20,and 30μmol/L)on cell proliferation,cell cycle,cell apoptosis as well as cyclin D1 expression were analyzed by cell counting kit-8,flow cytometry and Western blot,***18 methylation levels were determined by methylation-specific polymerase chain ***18,fibronectin(FN),type I collagen(Col-I)and alpha-smooth muscle actin(α-SMA)mRNA and protein expressions were analyzed by real-time PCR(RT-PCR)and Western blot,***,cells were treated with 50 mmol/L 5-aza-2′-deoxycytidine(5-aza-dC,demethylation agent)for 72 *** of curcumin on extracellular matrix(ECM)deposition was evaluated by immunochemical staining and Western ***-49F cells were transfected with ADAMTS18 small interfering RNA and grouped into a normal control,ADAMTS18-knock-out(KO),and ADAMTS18-KO+30μmol/L curcumin groups,and whether curcumin can reverse the effect of ADAMTS18 knockdown on RIF was *** Compared with the control group,TGF-β1 significantly inhibited the proliferation of NRK-49F cells,blocked the G1/G0 phase,promoted cell apoptosis and inhibited cyclin D1 expression(P<0.01).Among the different concentrations of curcumin,30μmol/L curcumin significantly reversed these processes(P<0.01).Immunochemical staining and Western blot results showed that curcumin significantly inhibited the deposition of FN,Col-I andα-SMA(P<0.01).Curcumin and 5-zaz-dC had synergistic effects,promoting ADAMTS18 expression,removing ADAMTS18 methylation,and reducing ECM ***18 knockdown promoted ECM accumulation,and curcumin reversed this process(P<0.01).Conclusion TGF-β1-induced fibrosis in NRK-49F ***

关键词： renal fibrosis curcumin Chinese medicine ADAMTS18 methylation modification

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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of Transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

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World Journal of Transplantation 2024年第1期14卷 154-163页

作者： Ameet Kumar Jesrani Syed M Faiq Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan Muhammed Mubarak Department of Radiology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Transplantation Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of urology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term *** and novel ultrasound-based investigations are being increasingly used for this purpose with variable *** To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological *** This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh institute of urology and Transplantation,Karachi,Pakistan,from August 2022 to February *** consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this *** and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic *** The mean age of all patients was 35.32±11.08 *** these,126(81.8%)were males and 28(18.2%)were *** mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 *** allograft biopsy results showed chronic changes in 55(37.66%)*** sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft *** can be of great help during the routine follow-up of kidney transplant recipients for screening a

关键词： Shear wave Sonoelastography Resistive index Chronic allograft changes Biopsy Histopathology

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The effect of bladder function on the efficacy of transurethral prostatectomy in patients with benign prostatic hyperplasia:a retrospective,single-center study

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Asian Journal of Andrology 2024年第1期26卷 112-118页

作者： Jin Li Xian-Yan-Ling Yi Ze-Yu Chen Bo Chen Yin Huang Da-Zhou Liao Pu-Ze Wang De-Hong Cao Jian-Zhong Ai Liang-Ren Liu West China School of Medicine Sichuan UniversityChengdu 610041China Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia(BPH)on the efficacy of transurethral ***,imaging,and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University(Chengdu,China)from July 2019 to December 2021 were ***-up data included the quality of life(QoL),International Prostate Symptom Score(IPSS),and IPSS storage and voiding(IPSS-s and IPSS-v).Moreover,urinary creatinine(Cr),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),and prostaglandin estradiol(PGE2)were measured in 30 patients with BPH and 30 healthy *** indicators were determined by subgroup analyses and receiver operating characteristic(ROC)curve *** the 313 patients with BPH included,patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate ***,good bladder sensation,compliance,and detrusor contractility(Dc)were predictors of low postoperative IPSS and *** urinary concentrations of BDNF/Cr,NGF/Cr,and PGE2/Cr in patients were significantly higher than those in healthy participants(all P<***1).After evaluation,only DC was significantly related to both urinary indicators and postoperative recovery of *** with good DC,as predicted by urinary indicators,had lower IPSS and IPSS-v than those with reduced DC at the 1st month postoperatively(both P<0.05).In summary,patients with impaired bladder function had poor *** combined levels of urinary BDNF/Cr,NGF/Cr,and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladderfunction and postoperative recovery.

关键词： BPH function of bladder IPSS:urodynamics

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Reinforcing the management of type 1 gastric esophageal varices

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World Journal of Gastroenterology 2024年第19期30卷 2615-2617页

作者： Zain Majid Ghazi Abrar Department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan

Variceal bleed represents an important complication of cirrhosis,with its presence reflecting the severity of liver *** varices,though less frequently seen than esophageal varices,present a distinct clinical challenge due to its higher intensity of bleeding and associated *** upon the Sarin classification,GOV1 is the most common subtype of gastric varices seen in clinical practice.

关键词： Gastric varices Sarin classification Gastroesophageal varices Cyanoacrylate Endoscopic variceal ligation Trans jugular intrahepatic portosystemic shunt

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Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong Mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan Mark Taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann urology Unit IRCCS INRCAAncona 60127Italy urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy Department of urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel Department of urology and Robotic Surgery ICUA-Clínica CEMTROMadrid 28701Spain urology Division Akfa Medline HospitalTashkent 100211Uzbekistan Advanced urology Gleneagles HospitalSingapore 258499Singapore Department of urology National University HospitalSingapore 119228Singapore Divisionof urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada Department of urology Mahatma Gandhi Mission’s Medical College and HospitalAurangabad 431003India institute for urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation Department of urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation Department of urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India Department of urology Medical University of ViennaVienna 1090Austria Department of urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation Department of urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho urologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China Department of urology University Hospitals Southampton NHS TrustSouthampton SO166YDUnited Kingdom Department of urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January *** were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group *** in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow ***,morcellation,and total surgical time weresignificantly shorter in Group *** 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/***,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

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