Management Of Urological Diseases Research Articles

Future Perspectives: A Literature Review of the Urologist’s New Potential Tool-Artificial Intelligence

Introduction: The overview aims to present the current state of artificial intelligence (AI) tools in the decision-making process, diagnosis, treatment possibilities, or outcome predictions in functional urology. Terminology: Artificial intelligence in healthcare includes computer systems that use reasoning and learning to analyze complex medical data and make predictions. Machine learning focuses on training computers with data to improve performance over time, especially in the case of processing medical information. Deep learning uses complex neural networks, inspired by the functional structure of the human brain, to extract information from medical data, improving the accuracy of diagnoses and speeding up investigations. Current AI Applications in Urology: The integration of artificial intelligence (AI) and artificial neural networks (ANN) in urological practice as a branch of medicine represents a promising potential for improving various aspects of patient care, diagnosis, surgical approaches with subsequent procedures resulting from rational and quick decision-making in the management of urological diseases (urolithiasis, BPH, oncology). AI technologies provide the opportunity to analyze large volumes of complex data, assist in clinical decision-making, optimize treatment strategies, and improve patient outcomes. Conclusion: The future and potential prospects of artificial intelligence as an auxiliary tool are significant, and the complete transition to them is still ahead. The field of AI support in urology is rapidly evolving, with continuous research and development focused on increasing the accuracy of diagnostic tools, refining surgical techniques, and improving treatment optimization. Continued research and clinical trials will be crucial for validating the effectiveness of AI and directing their integration into everyday urological practice.

The Molecular Mechanism and Therapeutic Application of Autophagy for Urological Disease.

Autophagy is a lysosomal degradation process known as autophagic flux, involving the engulfment of damaged proteins and organelles by double-membrane autophagosomes. It comprises microautophagy, chaperone-mediated autophagy (CMA), and macroautophagy. Macroautophagy consists of three stages: induction, autophagosome formation, and autolysosome formation. Atg8-family proteins are valuable for tracking autophagic structures and have been widely utilized for monitoring autophagy. The conversion of LC3 to its lipidated form, LC3-II, served as an indicator of autophagy. Autophagy is implicated in human pathophysiology, such as neurodegeneration, cancer, and immune disorders. Moreover, autophagy impacts urological diseases, such as interstitial cystitis /bladder pain syndrome (IC/BPS), ketamine-induced ulcerative cystitis (KIC), chemotherapy-induced cystitis (CIC), radiation cystitis (RC), erectile dysfunction (ED), bladder outlet obstruction (BOO), prostate cancer, bladder cancer, renal cancer, testicular cancer, and penile cancer. Autophagy plays a dual role in the management of urologic diseases, and the identification of potential biomarkers associated with autophagy is a crucial step towards a deeper understanding of its role in these diseases. Methods for monitoring autophagy include TEM, Western blot, immunofluorescence, flow cytometry, and genetic tools. Autophagosome and autolysosome structures are discerned via TEM. Western blot, immunofluorescence, northern blot, and RT-PCR assess protein/mRNA levels. Luciferase assay tracks flux; GFP-LC3 transgenic mice aid study. Knockdown methods (miRNA and RNAi) offer insights. This article extensively examines autophagy's molecular mechanism, pharmacological regulation, and therapeutic application involvement in urological diseases.

The impact the COVID-19 pandemic on urology literature: a bibliometric analysis.

IntroductionThe COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. The impact of these changes on peer-reviewed research journals, including those dedicated to urology, is still unknown.Material and methodsThe Web of Science database was queried to retrieve all COVID-19 urological articles written in English language and published between January 1st, 2020 and December 10th, 2021. Only original and review articles were considered. A bibliometric analysis of the total number of papers, citations, institutions and publishing journals was performed. Non-COVID-19 publications were also retrieved to compare the duration of publication stages.ResultsA total of 428 COVID-19 articles and 14,874 non-COVID-19 articles were collected. Significant differences in the duration of all the publication stages were found between COVID-19 and non-COVID-19 articles (all p <0.001). The most productive countries were the USA (100 articles), Italy (59 articles) and the United Kingdom (55 articles). The published literature has focused on four topics: COVID-19 genitourinary manifestations, management of urological diseases during the pandemic, repercussions on quality of life and impact on healthcare providers.ConclusionsA significant reduction in peer review time for COVID-19 articles might raise concerns regarding the quality of peer review itself. USA, Italy and UK published the highest number of COVID-19 related articles. Restrictive measures taken by governments to reduce the spread of infection had a strong impact on mental stress and anxiety of patients and healthcare professionals. A coerced deferral of diagnosis and treatment of emergencies and uro-oncological cases represented the most challenging task from a clinical standpoint.

A review of thulium-fiber laser in stone lithotripsy and soft tissue surgery.

To evaluate emerging evidence and practical applications of thulium-fiber laser (TFL) for genitourinary soft tissue disease and urinary stone disease treatment. A systematic review was developed using the PubMed, ScienceDirect, Wiley, SpringerLink and Mary Ann Liebert Scopus databases between 2012 and 2020 years, using the PRISMA statement. We analyzed recent publications including in vitro and in humans outcomes of surgery using TFL. This new laser technology can be used in soft tissue diseases and stones present in the genitourinary system. Most of the comparisons are made with the Ho:YAG laser, using completely different settings. Nevertheless, TFL is safe, feasible and effective in the management of urologic diseases, showing superiority to Ho:YAG even in some studies. The introduction of pulsed TFL technology has enabled the ablation of stones at rates comparable to or better than currently existing lasers in vitro, while also potentially reducing stone retropulsion. TFL is effective in treating genitourinary soft tissue diseases, including benign prostatic hyperplasia, and early data indicate that it may be effective in the treatment of urinary stone disease. More clinical studies are needed to better understand the indications for this novel technology and clarify its position in the urologic endoscopy armamentarium.

Special strategies and management of urological diseases during the COVID-19 pandemic: initial experiences from a Medical Center of China.

ABSTRACTAlthough urological diseases are not directly related to coronavirus disease 2019 (COVID-19), urologists need to make comprehensive plans for this disease. Urological conditions such as benign prostatic hyperplasia and tumors are very common in elderly patients. This group of patients is often accompanied by underlying comorbidities or immune dysfunction. They are at higher risk of COVID-19 infection and they tend to have severe manifestations. Although fever can occur along with urological infections, it is actually one of the commonest symptoms of COVID-19; urologists must always maintain a high index of suspicion in their clinical practices. As a urological surgeon, how we can protect medical staff during surgery is a major concern. Our hospital had early adoption of a series of strict protective and control measures, and was able to avoid cross-infection and outbreak of COVID-19. This paper discusses the effective measures that can be useful when dealing with urological patients with COVID-19.

Role of Transarterial Embolization in the Management of Urologic Diseases

Role of Transarterial Embolization in the Management of Urologic Diseases

Minimizing complications in endourological surgery

The development of newer minimally invasive technologies has led to a paradigm shift in management of urological diseases. Although endourological procedures are effective, they too have their own set of complications. The aim of this study is to review contemporary literature and outline the various protocols one can utilize to prevent and mitigate complications in endourological procedures. This article is divided into three major portions covering percutaneous nephrolithotomy, ureteroscopy and transurethral resections. Untreated urinary tract infection and uncorrected coagulopathy are the only absolute contraindications for endourological procedures. Following existing anatomical landmarks during the procedure avoids complications. Finally, last but not the least, knowing when to stop and to stage the procedure is of paramount importance to avoid complications in endourological procedures.

Publication of Original Research in Urologic Journals – A Neglected Orphan?

The pathophysiologic mechanisms behind urologic disease are increasingly being elucidated. The object of this investigation was to evaluate the publication policies of urologic journals during a period of progressively better understanding and management of urologic disease. Based on the ISI Web of Knowledge Journal Citation Reports and the PubMed database, the number and percentage of original experimental, original clinical, review or commentarial articles published between 2002–2010 in six leading urologic journals were analyzed. “British Journal of Urology International”, “European Urology”, “Urologic Oncology-Seminars and Original Investigations” (“Urologic Oncology”), “Urology”, “The Journal of Urology”, and “World Journal of Urology” were chosen, because these journals publish articles in all four categories. The publication policies of the six journals were very heterogeneous during the time period from 2002 to 2010. The percentage of original experimental and original clinical articles, related to all categories, remained the same in “British Journal of Urology International”, “Urologic Oncology”, “Urology” and “The Journal of Urology”. The percentage of experimental reports in “World Journal of Urology” between 2002–2010 significantly increased from 10 to 20%. A distinct elevation in the percentage of commentarial articles accompanied by a reduction of clinical articles became evident in “European Urology” which significantly correlated with a large increase in the journal’s impact factor. No clearly superior policy could be identified with regard to a general increase in the impact factors from all the journals. The publication policy of urologic journals does not expressly reflect the increase in scientific knowledge, which has occurred over the period 2002–2010. One way of increasing the exposure of urologists to research and expand the interface between experimental and clinical research, would be to enlarge the percentage of experimental articles published. There is no indication that such policy would be detrimental to a journal’s impact factor.

Pure and hybrid natural orifice transluminal endoscopic surgery (NOTES): current clinical experience in urology

An exciting era of discovery in the field of scarless urological surgery has just begun. Hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy has been reported by a few groups in the last two years. Recently, our group at the Cleveland Clinic was able to demonstrate the feasibility of a transvaginal pure NOTES nephrectomy. During this pioneering period, a critical appraisal of results and a scrupulous determination of benefits are of utmost importance. Further studies are awaited to define the actual role of NOTES in the management of urological diseases.

Proteomics of semen and its constituents

Semen is a complex fluid comprising sperm and other products of the testes together with secretions from the accessory sex glands including the prostate, seminal vesicles, and the bulbourethral gland. Studies of the protein components of seminal fluid, with or without the sperm present, can improve our understanding of reproductive biology; have potential clinical applications in the assessment and treatment of infertility; can assist with the diagnosis and management of urological diseases; and, at times, can offer important forensic insights. This review examines the application of proteomic methods to the study of spermatozoa and seminal fluid and highlights some of the unique challenges associated with the collection, fractionation, and analysis of this fluid. The discussion is restricted to issues relating to human semen, although we make occasional reference to important studies from animals.

Robotics in urology.

Robotic urologic surgery, an exciting and new emerging frontier in the field of urology, has tremendous potential to progress in the future. It is important, therefore, that urologists keep abreast of the new technologies, their limitations, and the possibility of incorporating them in day-to-day surgery. There are a substantial number of reports on performing complex urological procedures with robotic assistance in humans that document their safety, efficacy and feasibility. Most of the recent reports pertaining to robotic surgery have been in the domain of localized cancer of the prostate (radical prostatectomy), bladder cancer (radical cystectomy and urinary diversion for muscle invasive bladder cancer), kidney surgery (nephrectomy, donor nephrectomy and pyeloplasty), and adrenal surgery. There are also a few anecdotal reports. With the potential advantages and latent qualities of robotic assistance in minimally invasive surgery over conventional surgery, robot-assisted surgeries may be developed to the next level and lead to a future revolution of the way surgery is performed. Robot-assisted radical prostatectomy in the management of localized cancer of the prostate is one such example. The impact of robotics is therefore very promising. However, controlled clinical trials and comparisons from various centers are needed. Other important concerns are the cost and training implications. Future application may also allow integration of pre- and intraoperative imaging in the management of urological diseases. In the not too distant future, newer robotic instruments will be added to the armamentarium for performing different urological procedures.

Directions in urological research and drug therapies.

This meeting report summarizes advances and notable developments in the pharmaceutical management of urological diseases presented at various sessions during the Annual Meeting of the American Urological Association held in Anaheim, California, June 2-7, 2001. More than 10,000 attendees drawn from clinical and preclinical research deliberated on the latest trends in surgical and pharmacotherapeutic management in diverse areas of urology. In particular, several forums were dedicated to reviewing scientific trends, emerging concepts and therapies in urological diseases, such as overactive bladder, erectile dysfunction and lower urinary tract symptoms, which are the focus of this report.

Total healthcare budget: Assigning priority and level of asset allocation to the diagnosis and management of urologic diseases

During the past decade increasing concern has developed as to how money should best be allocated in the healthcare sector and to the different disciplines within health care. In the Western world, healthcare budgets increase dramatically each year, even during periods of economic recession. There are many reasons explaining this evolution, but publicly funded healthcare systems, as in the United Kingdom, appear to control their growth more effectively than the private systems as, for instance, in the United States. The bulk of the increase in healthcare expenditure happens to be attributed to elderly people who are becoming high consumers of healthcare facilities. There are, however, two important ways to tackle the problem: one is based on free market regulation systems, introducing diagnosis related groups and resource based relative value scales, as in the United States. The other starts from evaluating the needs and the demands of the population and, based on these results, tries to build up an appropriate healthcare system, as in The Netherlands. In the realm of urology where most of the workload is concentrated around older patients, one can foresee difficulties concerning budget allocation. New medical treatments are introduced, demanding new management skills of the urologist. This should involve new ways of evaluating the benefits of the interventions. Quality of life measurements seem to be crucial for the future where, for cost-effectiveness reasons, more care than cure could be the new function of the urologist.

Book Review Surgical Management of Urologic Disease: An Anatomic Approach Edited by Michael J. Droller. 1300 pp., illustrated. St. Louis, Mosby-Year Book, 1992. $139. 0-8016-0398-6

Book Review Surgical Management of Urologic Disease: An Anatomic Approach Edited by Michael J. Droller. 1300 pp., illustrated. St. Louis, Mosby-Year Book, 1992. $139. 0-8016-0398-6

The Role of Interventional Radiology in the Management of Genitourinary Trauma

The role of the radiologist in the management of urologic disease has changed dramatically in the last 10 years with the introduction of new imaging methods and the evolution of the angiographic catheter into a therapeutic instrument. The authors review the diagnostic options in genitourinary trauma, the indications for and techniques of transcatheter arterial embolization for renal and other retroperitoneal hemorrhage, and nonvascular interventions such as antegrade nephrostomy, stenting of urethral disruptions, percutaneous bladder drainage, and drainage of abscesses, hematomas, and urinomas.

Use of transrectal ultrasound in the management of urologic diseases in a tertiary hospital in North-Western Nigeria

Transrectal ultrasound (TRUS)-guided biopsy of the prostate is considered as a standard of care for diagnosis of prostate cancer. The objective of this study was to document our experience in the use of TRUS in the management of urologic diseases in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. This was a retrospective study of patients who had TRUS at UDUTH from December 2009 to November 2017. Relevant data were extracted from the procedure register, and case folders of the patients. Data analysis was performed using IPSS 20.0 version. A total of 844 patients had the procedure within the period of the study. The mean age of the patients was 65.6 ± 10.6 years with a range of 7-98 years. The main clinical diagnoses of the patients were benign prostatic hyperplasia in 528 patients (62.6%), prostate cancer in 285 patients (33.8%) and primary infertility + azoospermia in 17 patients (2.1%). Transrectal ultrasound-guided prostate biopsy was done for 807 patients (96%). TRUS only was done for assessment of seminal vesicle and ejaculatory duct in 17 patients (2.1%), prostate volume assessment in 10 patients (1.1%) and deflation of retained urethral catheter balloon in 9 patients (1%). There was self-limiting rectal bleeding in 600 patients (74.4%) and 3 patients (0.4%) each developed haematuria and postbiopsy infections. Prostate biopsy is the most common indication for TRUS in our practice. Other indications were estimation of prostatic volume, evaluation of azoospermia and deflation of retained urethral catheter balloon.