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The Institute of Urology, Peking University prostatectomy score： a simple preoperative classification of prostate cancer for predicting surgical difficulty and risk

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Asian Journal of Andrology 2018年第6期20卷 581-586页

作者： Bing-Lei Ma Lin Yao Wei Yu Yu Wang Hai-Feng Song Zhe-Nan Zhang Si-Meng Lu Qian Zhang Zhi-Song He Jie Jin Li-Qun Zhou Department of urology Peking University First Hospital and Institute of Urology Peking University Beijing 100034 China

Traditional laparoscopic radical prostatectomy is a treatment choice in many developing countries and regions for most patients with localized prostate cancer; however, no system for predicting surgical difficulty and risk has been established. This study aimed to propose a simple and standard preoperative classification system of prostate cancer using preoperative data to predict surgical difficulty and risk and to evaluate the relationship between the data and postoperative complications. We collected data from 236 patients and divided them into three groups to evaluate and validate the relationships among preoperative, operative, and postoperative data. This new scoring system is based on the body mass index, ultrasonic prostate volume, preoperative prostate-specific antigen level, middle lobe protrusion, and clinical stage. In the scoring group, we classified 89 patients into two groups： the low-risk group （score of 〈4） and high-risk group （score of ~4）, and then compared the postoperative data between the two groups. The positive surgical margin rate was higher in the high-risk group than low-risk group. The results in validation Groups A and B were similar to those in the scoring group. The focus of our scoring system is to allow for preliminary assessment of surgical difficulty by collecting the patients＇ basic information. Urologists can easily use the scoring system to evaluate the surgical difficulty and predict the risks of a positive surgical margin and urinary incontinence in patients undergoing laparoscopic radical prostatectomy.

关键词： laparoscopic radical prostatectomy prostate cancer scoring system surgical difficulty and risk

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Robotic assisted laparoscopic simple suprapubic prostatectomy--The Smith institute for urology experience with an evolving technique

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Asian Journal of urology 2014年第1期1卷 55-59页

作者： Sammy E.Elsamra Nikhil Gupta Haris Ahmed David Leavitt Jessica Kreshover Louis Kavoussi Lee Richstone The Smith institute for urology New Hyde ParkNYUSA

Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,however,is associated with significant morbidity.Recently,a few reports touting robotic application to simple prostatectomy have been published.Herein,we reviewed our series of robotic assisted laparoscopic simple suprapubic prostatectomy(RALSSP)and detailed modifications in our technique as our experience increased.Methods:All RALSSP cases performed between January 2013 and January 2014 were reviewed for demographics,pre-operative features,and perioperative outcomes.All parameters were tabulated and mean values were calculated.Student’s t-test was utilized with p<0.05 deemed significant.Details regarding surgical technique were reviewed and highlighted.Results:Fifteen patients underwent RALSSP during this period.Mean age of these men was 68.7 years.Mean body mass index(BMI)was 28.5 kg/m^2.American Society of Anesthesiologists(ASA)score was on average 2.6.Average International Prostate Symptom Score(IPSS)was 16.2 with the majority of men experiencing some adverse clinical sequela of such benign prostatic hyperplasia(BPH).For those patients not in retention,preoperative post-void residual(PVR)was 428 mL.All patients underwent successful RALSSP without need for conversion or need for blood transfusion.Mean estimated blood loss(EBL)was 290 mL.Five patients underwent other concurrent procedures(e.g.,cystolithotomy).Mean length of hospital stay(LOS)was 2.4 days and only five patients required continuous bladder irrigation(CBI)postoperatively.Postoperative PVR improved to a mean of 33 mL and IPSS improved to 4.5(p<0.001).No major complications were identified.Adaptation of low transverse cystotomy,utilization of a robotic tenaculum in the#3 arm with its control by a surgeon on a second console,and the utilization of mucosal advancement have all subjectively aided in performance of RALSSP and perioperative

关键词： Robotic assisted laparoscopic simple suprapubic prostatectomy Benign prostatic hyperplasia Blood loss Hospital stay

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Predictors of renal angioembolization outcome:A retrospective analysis with 148 patients at a tertiary urology institute

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Asian Journal of urology 2022年第2期9卷 103-108页

作者： Hashim Mohamed Farg Mohamed Mohamed Elawdy Karim Ali Soliman Mohamed Ali Badawy Ali Elsorougy Abdalla Abdelhamid Tarek Mohsen Tarek El-Diasty Department of Radiology Urology and Nephrology CentreMansoura UniversityMansouraEgypt Department of urology Urology and Nephrology CentreMansoura UniversityMansouraEgypt

Objective:The aim of this study was to evaluate the predictor of unsuccessful outcome of renal angioembolization(RAE).Knowing those predictors may help in avoiding unnecessary RAE procedures and their associated side effects,while helping to prepare for an alternate procedure and improving patient's overall satisfaction.Methods:A retrospective analysis between January 2006 and December 2018 was performed,and the indications for RAE were classified into post-traumatic,iatrogenic,renal tumors,and spontaneous.Patients who underwent RAE prior to nephrectomy were eliminated.Computed tomography angiography was performed in patients with normal renal function and those who had no contrast allergy,otherwise magnetic resonance angiography was performed.For the purpose of statistical analysis,we stratified patients into two main categories based on the final outcome—successful or failed.Results:Of 180 patients,32 with negative angiography were eliminated,leaving 148 patients;136(91%)had successful outcomes after one or more trials and 12 had unsuccessful outcomes.The mean age was 45±15 years,and 105(71%)were male.Neither gender,side of the lesion,presence of hematuria,indication for RAE,nor the type of lesion affected the outcome.On the other hand,renal anatomy with presence of accessory artery was the only predictor to failed RAE(p=0.001).Failed RAE trial was a predictor for nephrectomy as a secondary procedure(p=0.03).Conclusion:No pre-procedural predictors could anticipate the RAE outcome,and different indications can be scheduled to RAE,which is equally effective.The presence of accessory renal artery on diagnostic angiography is the only factor that may predict the failure of the procedure.

关键词： Angioembolization Renal angioembolization Embolization Renal trauma Outcome

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The effect of COVID-19 vaccines on sperm parameters: a systematic review and meta-analysis

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Asian Journal of Andrology 2023年第4期25卷 468-473页

作者： Yu-Cheng Ma Chao Cheng Chi Yuan Li-Yuan Xiang Jun Wen Xi Jin Department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengdu 610000China

Published data were gathered for a meta-analysis to determine the difference in sperm parameters before and after administration of different types of coronavirus disease 2019(COVID-19)vaccines,because the reproductive toxicity of COVID-19 vaccines has not yet been evaluated in clinical trials and COVID-19 has been associated with decreases in sperm quality.The preferred procedures for systematic reviews and meta-analyses were followed in the conduct and reporting of this study.The average sperm parameters of all sperm donors’multiple sperm donations were compared before and after receiving various COVID-19 vaccinations.Semen volume,total sperm motility,total sperm count,morphological change,and sperm concentration were the primary outcome measures.We compiled and analyzed the results of six studies on total sperm motility,six studies on semen volume,six studies on sperm concentration,two studies on morphological change,and two studies on total sperm count.Parameter comparisons with patients who had and had not been vaccinated were only reported in one of the included studies.When different types of COVID-19 vaccine injections were compared,no discernible differences in parameters were observed.According to the available data,the parameters of semen are unaffected by inactivated or messenger RNA(mRNA)COVID-19 vaccinations.To support these findings,additional prospectively designed research is required.

关键词： COVID-19 mRNA vaccine sperm parameters sperm quality vaccine safety

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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 safety.Methods: 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 restriction.Results: 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 frequency.Conclusion: 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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Identification of senescence-related molecular subtypes and key genes for prostate cancer

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Asian Journal of Andrology 2023年第2期25卷 223-229页

作者： De-Chao Feng Wei-Zhen Zhu Xu Shi Qiao Xiong Jia You Qiang Wei Lu Yang Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

We identified distinct senescence-related molecular subtypes and critical genes among prostate cancer(PCa)patients undergoing radical prostatectomy(RP)or radical radiotherapy(RT).We conducted all analyses using R software and its suitable packages.Twelve genes,namely,secreted frizzled-related protein 4(SFRP4),DNA topoisomerase II alpha(TOP2A),pleiotrophin(PTN),family with sequence similarity 107 member A(FAM107A),C-X-C motif chemokine ligand 14(CXCL14),prostate androgen-regulated mucin-like protein 1(PARM1),leucine zipper protein 2(LUZP2),cluster of differentiation 38(CD38),cartilage oligomeric matrix protein(COMP),vestigial-like family member 3(VGLL3),apolipoprotein E(APOE),and aldehyde dehydrogenase 2 family member(ALDH2),were eventually used to subtype PCa patients from The Cancer Genome Atlas(TCGA)database and GSE116918,and the molecular subtypes showed good correlations with clinical features.In terms of the tumor immune environment(TME)analysis,compared with cluster 1,cancer-associated fibroblasts(CAFs)scored significantly higher,while endothelial cells scored lower in cluster 2 in TCGA database.There was a statistically significant correlation between both CAFs and endothelial cells with biochemical recurrence(BCR)-free survival for PCa patients undergoing RP.For the GSE116918 database,cluster 2 had significantly lower levels of CAFs and tumor purity and higher levels of stromal,immune,and Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data(ESTIMATE)scores than cluster 1;in addition,patients with high levels of CAFs,stromal scores,immune scores,and ESTIMATE scores and low levels of tumor purity tended to suffer from BCR.Based on the median of differentially expressed checkpoints,high expression of CD96,hepatitis A virus cellular receptor 2(HAVCR2),and neuropilin 1(NRP1)in GSE116918 and high expression of CD160 and tumor necrosis factor(ligand)superfamily member 18(TNFSF18)in TCGA database were associated with a significantly higher risk of BCR than their counterparts.In

关键词： cellular senescence immune checkpoints molecular subtypes prostate cancer tumor immune environment

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Asian Journal of Andrology 2023年第2期25卷 208-216页

作者： Wei-Zhen Zhu De-Chao Feng Qiao Xiong Xu Shi Fa-Cai Zhang Qiang Wei Lu Yang Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

Given the dual role of autophagy presenting in tumorigenesis and inhibition,we established an autophagy-related gene prognostic index(ARGPI)with validation to well predict the biochemical recurrence(BCR),metastasis,as well as chemoresistance for patients with prostate cancer(PCa)who underwent radical radiotherapy or prostatectomy.Then,Lasso and COX regression was used to develop the ARGPI.We performed the whole analyses through R packages(version 3.6.3).Secreted phosphoprotein 1(SPP1),single-minded 2(SIM2),serine protease inhibitor b5(SERPINB5),aldehyde dehydrogenase 2(ALDH2),and acyl-CoA synthetase long-chain 3(ACSL3)were eventually used to establish the ARGPI score.Patients were divided into two different-risk groups based on the median ARGPI score,high-risk patients with a higher risk of BCR than low-risk patients(hazard ratio[HR]:5.46,95%confidence interval[CI]:3.23–9.24).The risk of metastasis of high-risk patients was higher than low-risk patients(HR:11.31,95%CI:4.89–26.12).In The Cancer Genome Atlas(TCGA)dataset,we observed similar prognostic value of ARGPI in terms of BCR-free survival(HR:1.79,95%CI:1.07–2.99)and metastasis-free survival(HR:1.80,95%CI:1.16–2.78).ARGPI score showed a diagnostic accuracy of 0.703 for drug resistance.Analysis of gene set enrichment analysis(GSEA)indicated that patients in the high-risk group were significantly positively related to interleukin(IL)-18 signaling pathway.Moreover,ARGPI score was significantly related to cancer-related fibroblasts(CAFs;r=0.36),macrophages(r=0.28),stromal score(r=0.38),immune score(r=0.35),estimate score(r=0.39),as well as tumor purity(r=−0.39;all P<0.05).Drug analysis showed that PI-103 was the common sensitive drug and cell line analysis indicated that PC3 was the common cell line of PI-103 and the definitive gene.In conclusion,we found that ARGPI could predict BCR,metastasis,and chemoresistance in PCa patients who underwent radical radiotherapy or prostatectomy.

关键词： autophagy biochemical recurrence immune checkpoint metastasis-free survival prostate cancer tumor immune microenvironment

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Circadian rhythm in prostate cancer: time to take notice of the clock

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Asian Journal of Andrology 2023年第2期25卷 184-191页

作者： Wei-Zhen Zhu Qi-Ying He De-Chao Feng Qiang Wei Lu Yang Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

The circadian clock is an evolutionary molecular product that is associated with better adaptation to changes in the external environment.Disruption of the circadian rhythm plays a critical role in tumorigenesis of many kinds of cancers,including prostate cancer(PCa).Integrating circadian rhythm into PCa research not only brings a closer understanding of the mechanisms of PCa but also provides new and effective options for the precise treatment of patients with PCa.This review begins with patterns of the circadian clock,highlights the role of the disruption of circadian rhythms in PCa at the epidemiological and molecular levels,and discusses possible new approaches to PCa therapy that target the circadian clock.

关键词： chronotherapy circadian clock circadian rhythm prostate cancer

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The comparison of survival between active surveillance or watchful waiting and focal therapy for low-risk prostate cancer:a real-world study from the SEER database

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Asian Journal of Andrology 2022年第3期24卷 305-310页

作者： Qi-Ming Yuan Tian-Hai Lin Kun Jin Shi Qiu Xiang-Hong Zhou Di Jin Jia-Kun Li Lu Yang Qiang Wei Department of urology Institute of UrologyWest China Hospital of Sichuan UniversityChengdu 610041China

To reduce treatment-related side effects in low-risk prostate cancer(PCa),both focal therapy and deferred treatments,including active surveillance(AS)and watchful waiting(WW),are worth considering over radical prostatectomy(RP).Therefore,this study aimed to compare long-term survival outcomes between focal therapy and AS/WW.Data were obtained and analyzed from the Surveillance,Epidemiology,and End Results(SEER)database.Patients with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were included.Focal therapy included cryotherapy and laser ablation.Multivariate Cox proportional hazards models were used to compare overall mortality(OM)and cancer-specific mortality(CSM)between AS/WW and focal therapy,and propensity score matching(PSM)was performed to reduce the influence of bias and unmeasured confounders.A total of 19292 patients with low-risk PCa were included in this study.In multivariate Cox proportional hazards model analysis,the risk of OM was higher in patients receiving focal therapy than those receiving AS/WW(hazard ratio[HR]=1.35,95%confidence interval[CI]:1.02–1.79,P=0.037),whereas no significant difference was found in CSM(HR=0.98,95%CI:0.23–4.11,P=0.977).After PSM,the OM and CSM of focal therapy and AS/WW showed no significant differences(HR=1.26,95%CI:0.92–1.74,P=0.149;and HR=1.26,95%CI:0.24–6.51,P=0.782,respectively).For patients with low-risk PCa,focal therapy was no match for AS/WW in decreasing OM,suggesting that AS/WW could bring more overall survival benefits.

关键词： active surveillance cancer-specific mortality focal therapy low-risk prostate cancer overall mortality watchful waiting

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Rigid ureteroscopy, a neglected choice for stent removal: a randomized controlled trial to compare rigid ureteroscopy, flexible cystoscopy, and rigid cystoscopy

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Chinese Medical Journal 2022年第22期135卷 2767-2769页

作者： Boya Li Xiongfeng Zeng Deyi Luo Yucheng Ma Hong Li Kunjie Wang Department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduSichuan 610041China

To the Editor:As one of the most powerful tools for urologists,ureteral stents are often used in diseases such as calculi,obstruction,ureteral injury,and kidney transplantation and are removed after 3 days to 4 weeks with a visualization instrument.Initially,rigid cystoscopy(RC)was most often used for stent removal,but due to its inflexibility and large diameter,RC often results in pain and potential damage to patients like hematuria,pain,and lower urinary tract symptoms,especially to men.

关键词： urinary rigid diseases

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