In the article entitled“Preliminary study of the mechanism of isolinderalactone inhibiting the malignant behavior of bladder cancer”published in Current Urology 2025;19(1):49–58(DOI:10.1097/CU9.0000000000000259),th...In the article entitled“Preliminary study of the mechanism of isolinderalactone inhibiting the malignant behavior of bladder cancer”published in Current Urology 2025;19(1):49–58(DOI:10.1097/CU9.0000000000000259),the Statement of Ethics should be replaced to:“All the experimental protocols for animal studies were conducted in accordance with the National Institutes of Health Guide for the Care and Use of Laboratory Animals.This study was approved by the laboratory animal welfare ethics committee of Yunnan University(Approval No.YNU20230653).”We apologize for this error and any inconvenience this may have caused.展开更多
Pelvic organ prolapse(POP)and stress urinary incontinence(SUI)share common pathological mechanisms,[1]and are both manifestations of pelvic floor dysfunction,often co-occurring and developing concomitantly.Although PO...Pelvic organ prolapse(POP)and stress urinary incontinence(SUI)share common pathological mechanisms,[1]and are both manifestations of pelvic floor dysfunction,often co-occurring and developing concomitantly.Although POP develops concomitantly with evident SUI in some cases,there have been instances wherein POP occurs without prior urine leakage before repositioning the prolapsed organs,but urinary incontinence develops after the prolapsed organs are repositioned.The condition in such cases is termed as occult SUI(OSUI),with an incidence of approximately 23.5%among patients with POP.[2]展开更多
Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-vol...Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-volume BPH)but still experience the lower urinary tract infection.Medication treatment is typically not successful in these patients.In addition,their pathophysiologic pathways deviate from those previously observed.Furthermore,as there is no accepted protocol for the diagnosis and treatment of small-volume BPH,patients can experience great difficulties inmanaging surgical complications such as bladder neck contracture.Thus,we reviewed the features of small-volume prostates,preoperative assessment,surgical technique,and management of complications.展开更多
Objectives:We explored the expression levels and clinical significance of human epidermal growth factor receptor 2(HER2)in urothelial carcinoma(UC)tissues.Materials and methods:Patient data were reviewed,and 111 paraf...Objectives:We explored the expression levels and clinical significance of human epidermal growth factor receptor 2(HER2)in urothelial carcinoma(UC)tissues.Materials and methods:Patient data were reviewed,and 111 paraffin specimens of UC obtained from the Department of Urology,Shandong Provincial Hospital Affiliated to Shandong FirstMedical University,from 2020 to 2021 were collected.Immunohistochemistry was used to detect HER2 protein expression in all UC tumor tissues.The χ^(2) and Fisher exact testswere used to analyze the relationship between HER2 protein expression and clinicopathological data(sex,age,histopathological diagnosis,invasiveness,histopathological grade,maximum tumor diameter,muscle invasion,regional lymph node metastasis,and clinical stage).Results:In this study,92 cases(82.88%)showed HER2 protein expression,and there was a statistically significant difference in the distribution of HER2 positivity(immunohistochemistry 2+and 3+)according to the pathological grades of UC(p=0.021).Human epidermal growth factor receptor 2 positivity was not associated with sex,age,histopathological diagnosis,invasiveness,maximum tumor diameter,muscle invasion,regional lymph node metastasis,or clinical stage(all p<0.05).Conclusions:Human epidermal growth factor receptor 2 protein is highly expressed in UC,and its expressionmay be closely related to the high pathological grade of UC.展开更多
Benign prostatic hyperplasia(BPH)and benign prostatic obstruction(BPO)remain significant contributors to male lower urinary tract symptoms,often leading to bladder damage and dysfunction.The traditional approach focus...Benign prostatic hyperplasia(BPH)and benign prostatic obstruction(BPO)remain significant contributors to male lower urinary tract symptoms,often leading to bladder damage and dysfunction.The traditional approach focuses on the management of bothersome symptoms through the use of BPH medications and may delay essential interventions,leading to disease progression and a negative impact on quality of life.This review proposes a paradigm shift to focus on bladder health preservation,as the bladder is an end organ that cannot be transplanted.Therefore,earlier diagnosis and timely surgical treatment within the“window of curability”are required.We introduce the Man vs Prostate“Five Stages of Bladder Health”to provide the needed framework to build the next iterations of BPH/BPO care.This patient-facing decision-making aid categorizes BPH/BPO progression.It integrates clinical observations with underlying patho-physiology and patient experience.This categorization highlights how untreated BPH/BPO can progress to more serious and pressing stages,the possible consequences of not taking action,and the goal to prevent late-stage disease:stageⅠ,BPO;stageⅡ,detrusor over-activity;stageⅢ,urgency incontinence;stageⅣ,acute retention;and stageⅤ,detrusor underactivity.On an individual patient basis,tran-sitions are not distinct,stages can coexist,and stages can be skipped.Although promising,this proposed staging system requires further validation through prospective randomized clinical trials to confirm its clinical value and prognostic accuracy.The concept of the“window of curability”emphasizes the need for therapeutic intervention at the optimal time.By identifying patients in earlier stages and initiating appropriate treatment,disease progression can be potentially stabilized or even reversed while aiming to opti-mally preserve detrusor function.Along with the Man vs Prostate staging system,this framework provides a structure for future research,shared decision making,and personalized treatment strategies.This paradigm shift necessitates a collaborative effort among urologists to reevaluate current practices,focus on earlier intervention within the“window of curability,”and prioritize bladder health preservation.展开更多
Penile abscesses have been reported to occur because of a wide range of causes,including blunt trauma,infection(eg,gonorrhea),and intracorporeal injections(eg,for erectile dysfunction).[1]The reported incidences are l...Penile abscesses have been reported to occur because of a wide range of causes,including blunt trauma,infection(eg,gonorrhea),and intracorporeal injections(eg,for erectile dysfunction).[1]The reported incidences are low,and published images of this pathology are rare.[2]We share such images in the case of a 47-year-old man who was previously fit and well but presented with complications after circumcision and meatal dilation at another healthcare provider.The symptoms included penile swelling,localized pain,and chills.Computed tomography revealed a penile abscess originating fromthe corpus cavernosum(Fig.1).展开更多
1.The Urology Workforce Shortage Problem The United States(US)is facing a dramatic shortage of urologists,negatively impacting access to specialized care and exacerbating healthcare inequalities,particularly in rural ...1.The Urology Workforce Shortage Problem The United States(US)is facing a dramatic shortage of urologists,negatively impacting access to specialized care and exacerbating healthcare inequalities,particularly in rural areas.Advocating for this problem is essential for understanding its causes and providing potential solutions for planning and implementing effective inter-ventions to mitigate its impact.Despite its significance,this issue remains underrecognized in the current discourse,suggesting a critical gap in advocacy efforts to prevent its consequences.The urologist shortage discussion is often framed as a concern for the future;however,the reality is that this issue is already manifesting today,although it remains frequently overlooked.展开更多
Clinical guidelines universally recommend active surveillance—monitoring with curative intent—for indolent-grade group(GG)1 prostate cancer(PCa).Moreover,a growing body of literature supports reclassifying GG 1 as“...Clinical guidelines universally recommend active surveillance—monitoring with curative intent—for indolent-grade group(GG)1 prostate cancer(PCa).Moreover,a growing body of literature supports reclassifying GG 1 as“non-cancer.”^([1])However,PCa is often multifocal,and a biopsy may be performed for diagnosis.To assess potential biopsy undersampling,we characterized upgrading and upstaging at radical prostatectomy(RP)among males initially diagnosed with GG1 disease using data from 2 large cohorts:Sur-veillance,Epidemiology,and End Results(SEER)and the National Cancer Database(NCDB).展开更多
Renal cell carcinoma with inferior vena cava(IVC)tumor thrombus(RCC-IVCTT)has a high mortality rate,and surgery is the only promising treatment.Open surgery has been the gold standard treatment for several decades.How...Renal cell carcinoma with inferior vena cava(IVC)tumor thrombus(RCC-IVCTT)has a high mortality rate,and surgery is the only promising treatment.Open surgery has been the gold standard treatment for several decades.However,with the development of minimally invasive surgical technologies,the advantages of robotic surgery have gradually emerged.The classicMayo Clinic Classification system has certain limitations in guiding robotic surgery.Therefore,a newclassification systemthat is compatible with robotic surgery is urgently needed.Advancements in robotic surgerymust be systematically summarized and evaluated.Since Abaza's initial report on robotic surgery,the exploration of robotic radical nephrectomy(RRN)with IVC thrombectomy has resulted in numerous related techniques and approaches,including surgical positions and approaches,control of blood vessels,assisted exposure,step-by-step strategy,and preoperative and intraoperative auxiliary technology and equipment.Our team proposed a new tumor thrombus classification system termed the“301 Classification”based on RRN with venous thrombectomy,which matches each level of tumor thrombus with a distinct robotic surgical strategy.With advances in technology and accumulated experience,RRN with IVC thrombectomy holds promise as the preferred surgical option for RCC-IVCTT.Although“301 Classification”can provide objective advantages in robotic surgery,more cases are needed to be optimized for guiding surgery accurately.The overview provided in this paper aims to serve as a reference and inspiration for future research and clinical practice regarding RCC-IVCTT.展开更多
Objectives:To describe the surgical approach and perioperative outcomes of a multicenter series evaluating a robotic-assisted approach to radical cystectomy with total intracorporeal urinary diversion in the setting o...Objectives:To describe the surgical approach and perioperative outcomes of a multicenter series evaluating a robotic-assisted approach to radical cystectomy with total intracorporeal urinary diversion in the setting of prior pelvic radiotherapy.Materials and methods:We analyzed our prospective cystectomy database for patients who underwent robotic-assisted radical cystectomy for bladder cancer after radiotherapy between 2018 and 2022.Demographic information and data regarding preoperative factors including stage of disease,preoperative hydronephrosis,and history of pelvic radiotherapy were collected via reviewof electronic medical records.All operations were performed by 1 of 2 experienced urologists using the da Vinci X,Xi,or Si surgical platforms.Results:Ten patients were identified for this study.The median age of participants was 73.5 years(range,41-84 years).The median American Society of Anesthesiologists classification score was 3(range,3-4).The median Charlson Comorbidity Index was 6(range,2-12).Among the patients,4 out of 10 patients(40%)had muscle invasive bladder cancer before salvage surgery.Intracorporeal ileal conduit urinary diversion was performed in 8 patients,whereas 2 patients underwent intracorporeal neobladder formation.Median intraoperative blood loss was 250 mL(range,150-600 mL),and median operative duration was 390 minutes(range,195-450 minutes).The overall 30-day complication rate was 60%with a Clavien-Dindo grade≥3 complication rate of 15%.Perioperativemortalitywas 0%.Median duration of follow-up was 210 days(range,60-1580 days).Conclusions:This series describing the outcomes of salvage robotic-assisted radical cystectomy using total intracorporeal urinary diversion demonstrates the safety of this technique.Further studies with long-term follow-up,including oncological outcomes,are required to support the widespread adoption of this procedure.展开更多
Background:Radiomics refers to the conversion of medical images into high-throughput,quantifiable data to analyze disease patterns,aid decision-making,and predict prognosis.Radiogenomics is an extension of radiomics a...Background:Radiomics refers to the conversion of medical images into high-throughput,quantifiable data to analyze disease patterns,aid decision-making,and predict prognosis.Radiogenomics is an extension of radiomics and involves a combination of conventional radiomics techniques withmolecular analysis in the formof genomic and transcriptomic data.In the field of bladder cancer,studies have investigated the development,implementation,and efficacy of radiomic and radiogenomic nomograms in predicting tumor grade,gene expression,and oncological outcomes,with variable results.We aimed to perform a systematic review of the current literature to investigate the development of a radiomics-based nomogram to predict oncological outcomes in bladder cancer.Materials and methods:The Medline,EMBASE,and Web of Science databases were searched up to February 17,2023.Gray literature was also searched to further identify other suitable publications.Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Radiomics Quality Score.Results:Radiogenomic nomograms generally had good performance in predicting the primary outcome across the included studies.The median area under the curve,sensitivity,and specificity across the included studies were 0.83(0.63–0.973),0.813,and 0.815,respectively,in the training set and 0.75(0.702–0.838),0.723,and 0.652,respectively,in the validation set.Conclusions:Several studies have demonstrated the predictive potential of radiomic and radiogenomic models in advanced pelvic oncology.Further large-scale studies in a prospective setting are required to further validate results and allow generalized use in modern medicine.展开更多
Background:Renal anastomosing hemangiomas(RAHs)are rare.This study aimed to summarize the clinical,pathological,and imag-ing characteristics of RAH.Materials and methods:We retrospectively analyzed 14 patients who und...Background:Renal anastomosing hemangiomas(RAHs)are rare.This study aimed to summarize the clinical,pathological,and imag-ing characteristics of RAH.Materials and methods:We retrospectively analyzed 14 patients who underwent surgery for RAH at our center between December 2014 and December 2023.In addition,we conducted a literature review of case reports and case series on RAH published between 2009 and 2023.Results:Renal anastomosing hemangioma predominantly affected men and was typically solitary.More than half of the tumors were localized in the renal parenchyma.Approximately 70.7%(65/92)of patients were asymptomatic.The mean maximum tumor diameter was 20 mm(range,14–28 mm).A total of 35.2%(37/105)of patients had end-stage renal disease.Patients with end-stage renal dis-ease and RAH are generally younger and have bilateral multifocal tumors.However,these tumors were smaller in size.Continent of or-igin of patient and tumor location were significant factors influencing tumor size.No tumor recurrence or distant metastases were ob-served during a median follow-up period of 18 months.Postoperative pathological staining remains the criterion standard for diagnosing RAH;however,preoperative multiparametric magnetic resonance imaging provides valuable diagnostic information.The RAH typically exhibits peripheral,discontinuous,and nodular enhancement during the corticomedullary phase,followed by centripetal fill-in enhance-ment during the excretory phase.Preoperative ultrasound-guided percutaneous biopsy is recommended when these characteristic magnetic resonance imaging features are observed.Conclusions:Renal anastomosing hemangioma is a rare benign renal tumor that is often misdiagnosed on imaging,leading to potential overtreatment.Surgeons must be well versed in the differential diagnosis of tumors to provide optimal treatment for patients.展开更多
Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation interventi...Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation intervention in patients with bladder cancer who un-derwent radical cystectomy.Materials and methods:We collected the medical records of consecutive patients who underwent radical cystectomy and preoperative cognitive screening based on the Mini-Cog test in our department between 2020 and 2021(n=114).Univariate and multivariate logistic re-gression analyses were used to identify the clinical risk factors for requiring rehabilitation intervention because of failure to wean postoperatively.Results:The median age of the participants was 76 years,and 96(84%)were male.Of the 114 patients,31(27%)required rehabilita-tion intervention for weaning.Based on the Mini-Cog test,the patients were classified into 2 groups:22(19%)had probable cognitive impairment(Mini-Cog score<3).Of the 22 patients with a Mini-Cog score of<3,13(59%)required rehabilitation intervention because of failure to wean postoperatively.In the multivariate analysis,being 75 years or older(odds ratio[OR],9.7;95%confidence interval[CI],2.6–36.3;p<0.001),a Mini-Cog score of<3(OR,3.7;95%CI,1.2–11.2;p=0.02),and an operative time≥310 minutes(OR,3.6;95%CI,1.1–11.9;p=0.04)were independent risk factors for requiring postoperative rehabilitation intervention.Conclusions:Effective screening with the Mini-Cog test,a simple cognitive screening tool with only 2 components(delayed 3-word recall task and clock drawing),reflects not only cognitive function but also physical frailty and may lead to the establishment of appro-priate rehabilitation programs during the perioperative period for early patient mobility after surgery.展开更多
Because of the anatomical characteristics of the prostate,benign prostatic hyperplasia(BPH)often occurs in the transition zone,whereas prostate cancer(PCa)tends to occur in the peripheral zone.This distribution charac...Because of the anatomical characteristics of the prostate,benign prostatic hyperplasia(BPH)often occurs in the transition zone,whereas prostate cancer(PCa)tends to occur in the peripheral zone.This distribution characteristic indicates that the prostate gland has cell type and distribution heterogeneity.However,the current research cannot answer these questions precisely.As research has progressed,the significance of many newly discovered cell types for the treatment of BPH and PCa has sparked widespread concern.Prostate heterogeneity is closely associated with gland development and formation and the regional distribution of the disease.Prostate heterogeneity can be observed at the gland and cell levels and determines disease distribution,presentation,and characteristics,including changes in the microenvironments of BPH and PCa.Cell population interactions promote disease onset and development;single-cell sequencing techniques may help elucidate specific cell types and gene expression patterns in different prostate zones.The stem cell characteristics of club/hillock cells and the inflammatory environment induced by immune cells offer alternative interpretations of the pathogenic mechanisms of BPH and PCa,and molecular omics studies can help identify novel avenues for treatment development.展开更多
We present the case of a 59-year-old Chinese man diagnosed with stage III clear cell renal cell carcinoma who developed 2 suspicious lung lesions 5 years after follow-up.Pathological evaluation revealed 2 distinct typ...We present the case of a 59-year-old Chinese man diagnosed with stage III clear cell renal cell carcinoma who developed 2 suspicious lung lesions 5 years after follow-up.Pathological evaluation revealed 2 distinct types of cancer:lung adenocarcinoma in situ and clear cell renal carcinoma with lung metastasis.Lung tissue samples were sequenced using a panel of 1267 cancer-related genes.The analysis revealed completely different molecular profiles between the 2 lung lesions and similar clonal mutations in the superior lingular lobe and kidney.This indicates multiple metachronous primary tumors.展开更多
Background:Lupus cystitismay cause significant lower urinary tract symptoms(LUTS).This study aimed to evaluate LUTS and identify potential risk factors in female patients with systemic lupus erythematosus(SLE).Materia...Background:Lupus cystitismay cause significant lower urinary tract symptoms(LUTS).This study aimed to evaluate LUTS and identify potential risk factors in female patients with systemic lupus erythematosus(SLE).Materials and methods:In this case-control study,46 female patients with SLE were assessed for LUTS using the International Consultation on IncontinenceModular Questionnaire on Female Lower Urinary Tract Symptoms(ICIQ-FLUTS).The findings were compared with a control group of 20 women.Results:The total incidence rates of LUTS in the SLE and control groups were 82.6%and 55%,respectively(p=0.022).Statistically significant differences were observed between the 2 groups in symptom duration(p<0.001),filling(p<0.001),voiding(p=0.001),incontinence(p<0.001),and total LUTS scores(p<0.001)asmeasured by ICIQ-FLUTS.Additional significant differences included renal echogenicity(p=0.003),bladder wall thickness(p=0.045),and the presence of pus cells in urine(p=0.045).The possible risk factors for the occurrence of LUTS in patients with lupus cystitis included rapid weight loss(p=0.025),easy fatigability(p=0.006),fever(p=0.046),psychosis(p=0.033),and both renal(p=0.025)and clinical(p=0.047)SLE disease activity indices.The Spearman correlation between the total ICIQ-FLUTS score and the SLE Disease Activity Index was not significant(r=−0.203;p=0.181).However,a statistically significant but weak correlation was observed between the ICIQ-FLUTS score and easy fatigability(r=0.381;p=0.013).Conclusions:The ICIQ-FLUTS demonstrated acceptable content validity and consistency in evaluating LUTS in patients with lupus cystitis.Rapid weight loss,easy fatigability,fever,psychosis,and elevated renal and clinical SLE Disease Activity Index scores were significantly associated with the occurrence of LUTS in these patients.展开更多
Background:In this study,we aimed to evaluate the efficacy of dorsal plication(DP)in correcting mild-to-moderate ventral penile cur-vature(VPC)during primary hypospadias repair with urethral plate preservation.Materia...Background:In this study,we aimed to evaluate the efficacy of dorsal plication(DP)in correcting mild-to-moderate ventral penile cur-vature(VPC)during primary hypospadias repair with urethral plate preservation.Materials and methods:We retrospectively reviewed medical records of patients who underwent DP during primary hypospadias re-pair with urethral plate preservation between January 2018 and December 2021.Patients were categorized into 2 groups based on the degree of curvature following degloving:<30°(group 1)and 30°to 40°(group 2).Recurrent VPC,urethral complications,and pediatric penile perception scores were analyzed.Results:Seventy-six patients met the inclusion criteria:59 in group 1 and 17 in group 2.The incidences of recurrent VPC(1.7%vs.5.9%;p=0.928)and urethral complications(32.2%vs.29.4%;p=0.827)were comparable between groups.A total of 29 completed pediatric penile perception scores questionnaires were collected.No significant difference was observed in dissatisfaction with penile length(13.6%vs.14.3%;p=0.692).Conclusions:Dorsal plication did not increase the rates of VPC recurrence,urethral complications,or dissatisfaction with penile length in cases with 30°to 40°VPC after degloving.Long-term follow-up with larger sample sizes is warranted to further assess the efficacy of DP.展开更多
Recurrent uncomplicated lower urinary tract infections(RULUTIs)are common among women without anatomical or physiological abnormalities and affect women of all age groups,races,and ethnicities.Herein,we summarized the...Recurrent uncomplicated lower urinary tract infections(RULUTIs)are common among women without anatomical or physiological abnormalities and affect women of all age groups,races,and ethnicities.Herein,we summarized the sources of epidemiology,etiology,diagnosis,treatment,prophylaxis,and follow-up evaluations in cases of RULUTIs.Patients'medical histories,symptoms,and signswere recorded.The review showed that urinalysis,culture,and sensitivity should be tested before empiric treatment.A first-line therapeutic strategy should be applied based on the results of the urine culture and sensitivity tests.Therefore,estrogen should be used as anancillary therapy.After the successful treatment of acute infections,intermittent or continuous prophylaxis can be administered.Patientsmay benefit from follow-up evaluations to avoid recurrent infections.We expect that clinicians will pay more attention to RULUTIs.展开更多
Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragment...Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragmentation index(DFI).Materials and methods:Infertile men with oligo-asthenospermia,no underlying urogenital disease(such as varicocele),and medically fertile partners were enrolled over 1 year.Semen parameters,FSH,luteinizing hormone,and testosterone levels were determined;also,a Sperm DNA Fragmentation Assay Kit(Hamun Teb Pishro,Tehran,Iran)was used for determining sperm DFI at baseline.Participants were categorized into 3 groups based on DFI:DFI<15%(group 1),DFI of 15%-30%(group 2),and DFI>30%(group 3).All participants received subcutaneous recombinant FSH(150 mg every other day)for 6 months.Sperm specimens were tested 6months after intervention(a single sperm control test).Results:Sixty males whose average age was 28.4 years were enrolled.Only group 3(poor fertility)exhibited a significant rise in sperm concentration(p=0.001)and motility(p<0.05)after FSH treatment.Group 1(DFI<15%)and group 2(DFI of 15%-30%)showed increased mean sperm concentration and motility postintervention,although these alterations were not significantly different.Folliclestimulating hormone levels increased significantly in all 3 groups after FSH administration.Serum luteinizing hormone and testosterone levels were not significantly increased in any of the groups.Conclusions:Follicle-stimulating hormone treatment improves sperm concentration andmotility in men with oligo-asthenospermia,with significant improvements observed in men with DFI>30%.DNA fragmentation index can be a predictive indicator of response to FSH treatment in such patients.展开更多
Background:Kidney renal clear cell carcinoma(KIRC)is a major subtype of renal cell carcinoma.Because of its rapid progression and resistance to targeted therapies,KIRC poses a significant threat to human health.KRBA2,...Background:Kidney renal clear cell carcinoma(KIRC)is a major subtype of renal cell carcinoma.Because of its rapid progression and resistance to targeted therapies,KIRC poses a significant threat to human health.KRBA2,a member of the KRBA family,is recognized as a transcription factor.Nevertheless,limited research has focused on the effect of KRBA2 in KIRC.Materials and methods:The Cancer Genome Atlas database was utilized to analyze the expression of KRBA2 in KIRC,and quanti-tative real-time PCR was used to validate KRBA2 mRNA expression in clinical KIRC samples and KIRC cell lines.The correlation be-tween KRBA2 expression and clinicopathological features was determined via the Wilcoxon rank sum test.Next,we assessed the prog-nostic value of KRBA2 in patients with KIRC using Kaplan-Meier survival analysis.The association between KRBA2 expression and im-mune infiltration in KIRC was investigated using the Tumor Immune Estimation Resource.Results:Our research demonstrated that KRBA2 expression was downregulated in KIRC and was correlated with multiple clinicopath-ological characteristics.Low KRBA2 expression was associated with poorer overall survival,progression-free interval,and disease-specific survival.Enrichment analysis suggested that KRBA2 was related to immune processes and the cell cycle,and Tumor Immune Estimation Resource analysis indicated that KRBA2 expression correlated with immune infiltration levels and immune characteristics of multiple immune cells.Conclusions:These findings suggest that KRBA2 may serve as a potential prognostic biomarker associated with KIRC immunity and could be a promising target for KIRC diagnosis and treatment.展开更多
文摘In the article entitled“Preliminary study of the mechanism of isolinderalactone inhibiting the malignant behavior of bladder cancer”published in Current Urology 2025;19(1):49–58(DOI:10.1097/CU9.0000000000000259),the Statement of Ethics should be replaced to:“All the experimental protocols for animal studies were conducted in accordance with the National Institutes of Health Guide for the Care and Use of Laboratory Animals.This study was approved by the laboratory animal welfare ethics committee of Yunnan University(Approval No.YNU20230653).”We apologize for this error and any inconvenience this may have caused.
文摘Pelvic organ prolapse(POP)and stress urinary incontinence(SUI)share common pathological mechanisms,[1]and are both manifestations of pelvic floor dysfunction,often co-occurring and developing concomitantly.Although POP develops concomitantly with evident SUI in some cases,there have been instances wherein POP occurs without prior urine leakage before repositioning the prolapsed organs,but urinary incontinence develops after the prolapsed organs are repositioned.The condition in such cases is termed as occult SUI(OSUI),with an incidence of approximately 23.5%among patients with POP.[2]
基金supported by the NationalNature Science Foundation of China(No.82270810).
文摘Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-volume BPH)but still experience the lower urinary tract infection.Medication treatment is typically not successful in these patients.In addition,their pathophysiologic pathways deviate from those previously observed.Furthermore,as there is no accepted protocol for the diagnosis and treatment of small-volume BPH,patients can experience great difficulties inmanaging surgical complications such as bladder neck contracture.Thus,we reviewed the features of small-volume prostates,preoperative assessment,surgical technique,and management of complications.
基金supported by Integrated Research on Intelligent Precision Diagnosis and Treatment of High-Risk Tumors of the Urinary System(grant 6020119027)Shandong Provincial Natural Science Foundation(ZR2023LZL005,ZR2021QH313).
文摘Objectives:We explored the expression levels and clinical significance of human epidermal growth factor receptor 2(HER2)in urothelial carcinoma(UC)tissues.Materials and methods:Patient data were reviewed,and 111 paraffin specimens of UC obtained from the Department of Urology,Shandong Provincial Hospital Affiliated to Shandong FirstMedical University,from 2020 to 2021 were collected.Immunohistochemistry was used to detect HER2 protein expression in all UC tumor tissues.The χ^(2) and Fisher exact testswere used to analyze the relationship between HER2 protein expression and clinicopathological data(sex,age,histopathological diagnosis,invasiveness,histopathological grade,maximum tumor diameter,muscle invasion,regional lymph node metastasis,and clinical stage).Results:In this study,92 cases(82.88%)showed HER2 protein expression,and there was a statistically significant difference in the distribution of HER2 positivity(immunohistochemistry 2+and 3+)according to the pathological grades of UC(p=0.021).Human epidermal growth factor receptor 2 positivity was not associated with sex,age,histopathological diagnosis,invasiveness,maximum tumor diameter,muscle invasion,regional lymph node metastasis,or clinical stage(all p<0.05).Conclusions:Human epidermal growth factor receptor 2 protein is highly expressed in UC,and its expressionmay be closely related to the high pathological grade of UC.
文摘Benign prostatic hyperplasia(BPH)and benign prostatic obstruction(BPO)remain significant contributors to male lower urinary tract symptoms,often leading to bladder damage and dysfunction.The traditional approach focuses on the management of bothersome symptoms through the use of BPH medications and may delay essential interventions,leading to disease progression and a negative impact on quality of life.This review proposes a paradigm shift to focus on bladder health preservation,as the bladder is an end organ that cannot be transplanted.Therefore,earlier diagnosis and timely surgical treatment within the“window of curability”are required.We introduce the Man vs Prostate“Five Stages of Bladder Health”to provide the needed framework to build the next iterations of BPH/BPO care.This patient-facing decision-making aid categorizes BPH/BPO progression.It integrates clinical observations with underlying patho-physiology and patient experience.This categorization highlights how untreated BPH/BPO can progress to more serious and pressing stages,the possible consequences of not taking action,and the goal to prevent late-stage disease:stageⅠ,BPO;stageⅡ,detrusor over-activity;stageⅢ,urgency incontinence;stageⅣ,acute retention;and stageⅤ,detrusor underactivity.On an individual patient basis,tran-sitions are not distinct,stages can coexist,and stages can be skipped.Although promising,this proposed staging system requires further validation through prospective randomized clinical trials to confirm its clinical value and prognostic accuracy.The concept of the“window of curability”emphasizes the need for therapeutic intervention at the optimal time.By identifying patients in earlier stages and initiating appropriate treatment,disease progression can be potentially stabilized or even reversed while aiming to opti-mally preserve detrusor function.Along with the Man vs Prostate staging system,this framework provides a structure for future research,shared decision making,and personalized treatment strategies.This paradigm shift necessitates a collaborative effort among urologists to reevaluate current practices,focus on earlier intervention within the“window of curability,”and prioritize bladder health preservation.
文摘Penile abscesses have been reported to occur because of a wide range of causes,including blunt trauma,infection(eg,gonorrhea),and intracorporeal injections(eg,for erectile dysfunction).[1]The reported incidences are low,and published images of this pathology are rare.[2]We share such images in the case of a 47-year-old man who was previously fit and well but presented with complications after circumcision and meatal dilation at another healthcare provider.The symptoms included penile swelling,localized pain,and chills.Computed tomography revealed a penile abscess originating fromthe corpus cavernosum(Fig.1).
文摘1.The Urology Workforce Shortage Problem The United States(US)is facing a dramatic shortage of urologists,negatively impacting access to specialized care and exacerbating healthcare inequalities,particularly in rural areas.Advocating for this problem is essential for understanding its causes and providing potential solutions for planning and implementing effective inter-ventions to mitigate its impact.Despite its significance,this issue remains underrecognized in the current discourse,suggesting a critical gap in advocacy efforts to prevent its consequences.The urologist shortage discussion is often framed as a concern for the future;however,the reality is that this issue is already manifesting today,although it remains frequently overlooked.
文摘Clinical guidelines universally recommend active surveillance—monitoring with curative intent—for indolent-grade group(GG)1 prostate cancer(PCa).Moreover,a growing body of literature supports reclassifying GG 1 as“non-cancer.”^([1])However,PCa is often multifocal,and a biopsy may be performed for diagnosis.To assess potential biopsy undersampling,we characterized upgrading and upstaging at radical prostatectomy(RP)among males initially diagnosed with GG1 disease using data from 2 large cohorts:Sur-veillance,Epidemiology,and End Results(SEER)and the National Cancer Database(NCDB).
基金supported by the National Natural Science Foundation of China(NSFC):82372704.
文摘Renal cell carcinoma with inferior vena cava(IVC)tumor thrombus(RCC-IVCTT)has a high mortality rate,and surgery is the only promising treatment.Open surgery has been the gold standard treatment for several decades.However,with the development of minimally invasive surgical technologies,the advantages of robotic surgery have gradually emerged.The classicMayo Clinic Classification system has certain limitations in guiding robotic surgery.Therefore,a newclassification systemthat is compatible with robotic surgery is urgently needed.Advancements in robotic surgerymust be systematically summarized and evaluated.Since Abaza's initial report on robotic surgery,the exploration of robotic radical nephrectomy(RRN)with IVC thrombectomy has resulted in numerous related techniques and approaches,including surgical positions and approaches,control of blood vessels,assisted exposure,step-by-step strategy,and preoperative and intraoperative auxiliary technology and equipment.Our team proposed a new tumor thrombus classification system termed the“301 Classification”based on RRN with venous thrombectomy,which matches each level of tumor thrombus with a distinct robotic surgical strategy.With advances in technology and accumulated experience,RRN with IVC thrombectomy holds promise as the preferred surgical option for RCC-IVCTT.Although“301 Classification”can provide objective advantages in robotic surgery,more cases are needed to be optimized for guiding surgery accurately.The overview provided in this paper aims to serve as a reference and inspiration for future research and clinical practice regarding RCC-IVCTT.
文摘Objectives:To describe the surgical approach and perioperative outcomes of a multicenter series evaluating a robotic-assisted approach to radical cystectomy with total intracorporeal urinary diversion in the setting of prior pelvic radiotherapy.Materials and methods:We analyzed our prospective cystectomy database for patients who underwent robotic-assisted radical cystectomy for bladder cancer after radiotherapy between 2018 and 2022.Demographic information and data regarding preoperative factors including stage of disease,preoperative hydronephrosis,and history of pelvic radiotherapy were collected via reviewof electronic medical records.All operations were performed by 1 of 2 experienced urologists using the da Vinci X,Xi,or Si surgical platforms.Results:Ten patients were identified for this study.The median age of participants was 73.5 years(range,41-84 years).The median American Society of Anesthesiologists classification score was 3(range,3-4).The median Charlson Comorbidity Index was 6(range,2-12).Among the patients,4 out of 10 patients(40%)had muscle invasive bladder cancer before salvage surgery.Intracorporeal ileal conduit urinary diversion was performed in 8 patients,whereas 2 patients underwent intracorporeal neobladder formation.Median intraoperative blood loss was 250 mL(range,150-600 mL),and median operative duration was 390 minutes(range,195-450 minutes).The overall 30-day complication rate was 60%with a Clavien-Dindo grade≥3 complication rate of 15%.Perioperativemortalitywas 0%.Median duration of follow-up was 210 days(range,60-1580 days).Conclusions:This series describing the outcomes of salvage robotic-assisted radical cystectomy using total intracorporeal urinary diversion demonstrates the safety of this technique.Further studies with long-term follow-up,including oncological outcomes,are required to support the widespread adoption of this procedure.
文摘Background:Radiomics refers to the conversion of medical images into high-throughput,quantifiable data to analyze disease patterns,aid decision-making,and predict prognosis.Radiogenomics is an extension of radiomics and involves a combination of conventional radiomics techniques withmolecular analysis in the formof genomic and transcriptomic data.In the field of bladder cancer,studies have investigated the development,implementation,and efficacy of radiomic and radiogenomic nomograms in predicting tumor grade,gene expression,and oncological outcomes,with variable results.We aimed to perform a systematic review of the current literature to investigate the development of a radiomics-based nomogram to predict oncological outcomes in bladder cancer.Materials and methods:The Medline,EMBASE,and Web of Science databases were searched up to February 17,2023.Gray literature was also searched to further identify other suitable publications.Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Radiomics Quality Score.Results:Radiogenomic nomograms generally had good performance in predicting the primary outcome across the included studies.The median area under the curve,sensitivity,and specificity across the included studies were 0.83(0.63–0.973),0.813,and 0.815,respectively,in the training set and 0.75(0.702–0.838),0.723,and 0.652,respectively,in the validation set.Conclusions:Several studies have demonstrated the predictive potential of radiomic and radiogenomic models in advanced pelvic oncology.Further large-scale studies in a prospective setting are required to further validate results and allow generalized use in modern medicine.
基金funded by the National Natural Science Founda-tion of China(grant number 82273412).
文摘Background:Renal anastomosing hemangiomas(RAHs)are rare.This study aimed to summarize the clinical,pathological,and imag-ing characteristics of RAH.Materials and methods:We retrospectively analyzed 14 patients who underwent surgery for RAH at our center between December 2014 and December 2023.In addition,we conducted a literature review of case reports and case series on RAH published between 2009 and 2023.Results:Renal anastomosing hemangioma predominantly affected men and was typically solitary.More than half of the tumors were localized in the renal parenchyma.Approximately 70.7%(65/92)of patients were asymptomatic.The mean maximum tumor diameter was 20 mm(range,14–28 mm).A total of 35.2%(37/105)of patients had end-stage renal disease.Patients with end-stage renal dis-ease and RAH are generally younger and have bilateral multifocal tumors.However,these tumors were smaller in size.Continent of or-igin of patient and tumor location were significant factors influencing tumor size.No tumor recurrence or distant metastases were ob-served during a median follow-up period of 18 months.Postoperative pathological staining remains the criterion standard for diagnosing RAH;however,preoperative multiparametric magnetic resonance imaging provides valuable diagnostic information.The RAH typically exhibits peripheral,discontinuous,and nodular enhancement during the corticomedullary phase,followed by centripetal fill-in enhance-ment during the excretory phase.Preoperative ultrasound-guided percutaneous biopsy is recommended when these characteristic magnetic resonance imaging features are observed.Conclusions:Renal anastomosing hemangioma is a rare benign renal tumor that is often misdiagnosed on imaging,leading to potential overtreatment.Surgeons must be well versed in the differential diagnosis of tumors to provide optimal treatment for patients.
文摘Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation intervention in patients with bladder cancer who un-derwent radical cystectomy.Materials and methods:We collected the medical records of consecutive patients who underwent radical cystectomy and preoperative cognitive screening based on the Mini-Cog test in our department between 2020 and 2021(n=114).Univariate and multivariate logistic re-gression analyses were used to identify the clinical risk factors for requiring rehabilitation intervention because of failure to wean postoperatively.Results:The median age of the participants was 76 years,and 96(84%)were male.Of the 114 patients,31(27%)required rehabilita-tion intervention for weaning.Based on the Mini-Cog test,the patients were classified into 2 groups:22(19%)had probable cognitive impairment(Mini-Cog score<3).Of the 22 patients with a Mini-Cog score of<3,13(59%)required rehabilitation intervention because of failure to wean postoperatively.In the multivariate analysis,being 75 years or older(odds ratio[OR],9.7;95%confidence interval[CI],2.6–36.3;p<0.001),a Mini-Cog score of<3(OR,3.7;95%CI,1.2–11.2;p=0.02),and an operative time≥310 minutes(OR,3.6;95%CI,1.1–11.9;p=0.04)were independent risk factors for requiring postoperative rehabilitation intervention.Conclusions:Effective screening with the Mini-Cog test,a simple cognitive screening tool with only 2 components(delayed 3-word recall task and clock drawing),reflects not only cognitive function but also physical frailty and may lead to the establishment of appro-priate rehabilitation programs during the perioperative period for early patient mobility after surgery.
基金supported byNationalNatural Science Foundation of China(grant no.82260362)Hainan Province Health Science and Technology Innovation Joint Project(grant no.WSJK2024MS196).
文摘Because of the anatomical characteristics of the prostate,benign prostatic hyperplasia(BPH)often occurs in the transition zone,whereas prostate cancer(PCa)tends to occur in the peripheral zone.This distribution characteristic indicates that the prostate gland has cell type and distribution heterogeneity.However,the current research cannot answer these questions precisely.As research has progressed,the significance of many newly discovered cell types for the treatment of BPH and PCa has sparked widespread concern.Prostate heterogeneity is closely associated with gland development and formation and the regional distribution of the disease.Prostate heterogeneity can be observed at the gland and cell levels and determines disease distribution,presentation,and characteristics,including changes in the microenvironments of BPH and PCa.Cell population interactions promote disease onset and development;single-cell sequencing techniques may help elucidate specific cell types and gene expression patterns in different prostate zones.The stem cell characteristics of club/hillock cells and the inflammatory environment induced by immune cells offer alternative interpretations of the pathogenic mechanisms of BPH and PCa,and molecular omics studies can help identify novel avenues for treatment development.
文摘We present the case of a 59-year-old Chinese man diagnosed with stage III clear cell renal cell carcinoma who developed 2 suspicious lung lesions 5 years after follow-up.Pathological evaluation revealed 2 distinct types of cancer:lung adenocarcinoma in situ and clear cell renal carcinoma with lung metastasis.Lung tissue samples were sequenced using a panel of 1267 cancer-related genes.The analysis revealed completely different molecular profiles between the 2 lung lesions and similar clonal mutations in the superior lingular lobe and kidney.This indicates multiple metachronous primary tumors.
文摘Background:Lupus cystitismay cause significant lower urinary tract symptoms(LUTS).This study aimed to evaluate LUTS and identify potential risk factors in female patients with systemic lupus erythematosus(SLE).Materials and methods:In this case-control study,46 female patients with SLE were assessed for LUTS using the International Consultation on IncontinenceModular Questionnaire on Female Lower Urinary Tract Symptoms(ICIQ-FLUTS).The findings were compared with a control group of 20 women.Results:The total incidence rates of LUTS in the SLE and control groups were 82.6%and 55%,respectively(p=0.022).Statistically significant differences were observed between the 2 groups in symptom duration(p<0.001),filling(p<0.001),voiding(p=0.001),incontinence(p<0.001),and total LUTS scores(p<0.001)asmeasured by ICIQ-FLUTS.Additional significant differences included renal echogenicity(p=0.003),bladder wall thickness(p=0.045),and the presence of pus cells in urine(p=0.045).The possible risk factors for the occurrence of LUTS in patients with lupus cystitis included rapid weight loss(p=0.025),easy fatigability(p=0.006),fever(p=0.046),psychosis(p=0.033),and both renal(p=0.025)and clinical(p=0.047)SLE disease activity indices.The Spearman correlation between the total ICIQ-FLUTS score and the SLE Disease Activity Index was not significant(r=−0.203;p=0.181).However,a statistically significant but weak correlation was observed between the ICIQ-FLUTS score and easy fatigability(r=0.381;p=0.013).Conclusions:The ICIQ-FLUTS demonstrated acceptable content validity and consistency in evaluating LUTS in patients with lupus cystitis.Rapid weight loss,easy fatigability,fever,psychosis,and elevated renal and clinical SLE Disease Activity Index scores were significantly associated with the occurrence of LUTS in these patients.
文摘Background:In this study,we aimed to evaluate the efficacy of dorsal plication(DP)in correcting mild-to-moderate ventral penile cur-vature(VPC)during primary hypospadias repair with urethral plate preservation.Materials and methods:We retrospectively reviewed medical records of patients who underwent DP during primary hypospadias re-pair with urethral plate preservation between January 2018 and December 2021.Patients were categorized into 2 groups based on the degree of curvature following degloving:<30°(group 1)and 30°to 40°(group 2).Recurrent VPC,urethral complications,and pediatric penile perception scores were analyzed.Results:Seventy-six patients met the inclusion criteria:59 in group 1 and 17 in group 2.The incidences of recurrent VPC(1.7%vs.5.9%;p=0.928)and urethral complications(32.2%vs.29.4%;p=0.827)were comparable between groups.A total of 29 completed pediatric penile perception scores questionnaires were collected.No significant difference was observed in dissatisfaction with penile length(13.6%vs.14.3%;p=0.692).Conclusions:Dorsal plication did not increase the rates of VPC recurrence,urethral complications,or dissatisfaction with penile length in cases with 30°to 40°VPC after degloving.Long-term follow-up with larger sample sizes is warranted to further assess the efficacy of DP.
文摘Recurrent uncomplicated lower urinary tract infections(RULUTIs)are common among women without anatomical or physiological abnormalities and affect women of all age groups,races,and ethnicities.Herein,we summarized the sources of epidemiology,etiology,diagnosis,treatment,prophylaxis,and follow-up evaluations in cases of RULUTIs.Patients'medical histories,symptoms,and signswere recorded.The review showed that urinalysis,culture,and sensitivity should be tested before empiric treatment.A first-line therapeutic strategy should be applied based on the results of the urine culture and sensitivity tests.Therefore,estrogen should be used as anancillary therapy.After the successful treatment of acute infections,intermittent or continuous prophylaxis can be administered.Patientsmay benefit from follow-up evaluations to avoid recurrent infections.We expect that clinicians will pay more attention to RULUTIs.
基金funded by a research grant from Mashhad University of Medical Sciences(grant number 971700).
文摘Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragmentation index(DFI).Materials and methods:Infertile men with oligo-asthenospermia,no underlying urogenital disease(such as varicocele),and medically fertile partners were enrolled over 1 year.Semen parameters,FSH,luteinizing hormone,and testosterone levels were determined;also,a Sperm DNA Fragmentation Assay Kit(Hamun Teb Pishro,Tehran,Iran)was used for determining sperm DFI at baseline.Participants were categorized into 3 groups based on DFI:DFI<15%(group 1),DFI of 15%-30%(group 2),and DFI>30%(group 3).All participants received subcutaneous recombinant FSH(150 mg every other day)for 6 months.Sperm specimens were tested 6months after intervention(a single sperm control test).Results:Sixty males whose average age was 28.4 years were enrolled.Only group 3(poor fertility)exhibited a significant rise in sperm concentration(p=0.001)and motility(p<0.05)after FSH treatment.Group 1(DFI<15%)and group 2(DFI of 15%-30%)showed increased mean sperm concentration and motility postintervention,although these alterations were not significantly different.Folliclestimulating hormone levels increased significantly in all 3 groups after FSH administration.Serum luteinizing hormone and testosterone levels were not significantly increased in any of the groups.Conclusions:Follicle-stimulating hormone treatment improves sperm concentration andmotility in men with oligo-asthenospermia,with significant improvements observed in men with DFI>30%.DNA fragmentation index can be a predictive indicator of response to FSH treatment in such patients.
基金supported by the National Natural Science Foundation of China(No.82072816).
文摘Background:Kidney renal clear cell carcinoma(KIRC)is a major subtype of renal cell carcinoma.Because of its rapid progression and resistance to targeted therapies,KIRC poses a significant threat to human health.KRBA2,a member of the KRBA family,is recognized as a transcription factor.Nevertheless,limited research has focused on the effect of KRBA2 in KIRC.Materials and methods:The Cancer Genome Atlas database was utilized to analyze the expression of KRBA2 in KIRC,and quanti-tative real-time PCR was used to validate KRBA2 mRNA expression in clinical KIRC samples and KIRC cell lines.The correlation be-tween KRBA2 expression and clinicopathological features was determined via the Wilcoxon rank sum test.Next,we assessed the prog-nostic value of KRBA2 in patients with KIRC using Kaplan-Meier survival analysis.The association between KRBA2 expression and im-mune infiltration in KIRC was investigated using the Tumor Immune Estimation Resource.Results:Our research demonstrated that KRBA2 expression was downregulated in KIRC and was correlated with multiple clinicopath-ological characteristics.Low KRBA2 expression was associated with poorer overall survival,progression-free interval,and disease-specific survival.Enrichment analysis suggested that KRBA2 was related to immune processes and the cell cycle,and Tumor Immune Estimation Resource analysis indicated that KRBA2 expression correlated with immune infiltration levels and immune characteristics of multiple immune cells.Conclusions:These findings suggest that KRBA2 may serve as a potential prognostic biomarker associated with KIRC immunity and could be a promising target for KIRC diagnosis and treatment.
