Urological Diseases Research Articles

Determining the Severity of Benign Urologic Health States in Men Using Utilities Measures

ObjectivesTo assess a population level perceived health status of common reconstructive urologic conditions using health utilities. MethodsHealth utilities are generic quality of life measures that can help describe overall health status and can quantitatively compare different disease states and the perceived benefits of various interventions. An a priori determined, representative sample of adult men were recruited by Qualtrics™ to review standardized scenarios describing typical patients with reconstructive urologic conditions, surgeries to treat conditions, and control conditions (e.g. blindness, osteoarthritis). Condition-specific health status was measured using four tools: visual analog scale, standard gamble, time-trade off and willingness-to-pay and reported in Quality-adjusted Life Years (QALY; range 0.0 (death) to 1.0 (perfect health)). ResultsWe analyzed 562 completed surveys from condition-naive participants. Condition-specific health status ranged from a mean of 0.52 QALY to 0.66 QALY, with all reconstructive conditions perceived to be worse than osteoarthritis and monocular blindness (QALY 0.68). Health status was lowest for adult acquired buried penis (0.52 QALY) and pelvic radiation disease (0.53 QALY), comparable to binocular blindness (QALY 0.52). Treatment of erectile dysfunction with inflatable penile prosthesis (∆QALY +0.02; p<0.001) and stress urinary incontinence with artificial urinary sphincter (∆QALY +0.04; p<0.001) offered only nominal perceived gain in health status. ConclusionsHealth utilities may improve the ability to discriminate between heterogeneous reconstructive urologic disease states. For non-oncologic disease states in which mortality is not measured, health utilities could improve the ability to measure societal impact and justification for clinical and research investment.

Tortuosed dilated üreter and urinary retention due to giant Gartner Duct Cyst

Gartner duct cyst (GDC) is a type of benign congenital vaginal cyst. It is rarely seen in girls and young women. It can also be observed in urological anomalies, and acquired urinary system diseases secondary to GDC have not been well defined. GDC is generally observed to be smaller than 2 cm and is asymptomatic. The larger GDC causes lower urinary tract complaints, sexual dysfunction and intestinal problems. GDC coming out of the vagina can also be perceived as vaginal organ prolapse. Pelvic Magnetic Resonance Imagınıng (MRI) is the best radiological examination to identify GDC. Surgical treatment is applied to symptomatic due to GDC. There is no standardized surgical treatment method. Case presentation: In this study, we presented the case of a 74-year-old female patient who developed urinary retention and left tortuosed dilated ureter due to giant GDC. Cystoscopy, left üreterorenoscopy and vajinal marsupialization were applied. Conclusions: Acquired urologic disease due to giant GDC can be seen in elderly woman. Vaginal marsupialization can be applied to giant GDC that mimic vaginal organe prolapse.

A review of Artificial Intelligence methods in bladder cancer: segmentation, classification, and detection

Artificial intelligence (AI) and other disruptive technologies can potentially improve healthcare across various disciplines. Its subclasses, artificial neural networks, deep learning, and machine learning, excel in extracting insights from large datasets and improving predictive models to boost their utility and accuracy. Though research in this area is still in its early phases, it holds enormous potential for the diagnosis, prognosis, and treatment of urological diseases, such as bladder cancer. The long-used nomograms and other classic forecasting approaches are being reconsidered considering AI’s capabilities. This review emphasizes the coming integration of artificial intelligence into healthcare settings while critically examining the most recent and significant literature on the subject. This study seeks to define the status of AI and its potential for the future, with a special emphasis on how AI can transform bladder cancer diagnosis and treatment.

Effect of incision location and type of fistula on postoperative urinary retention after radical surgery for anal fistula: a retrospective analysis

BackgroundPostoperative urinary retention (POUR) is a common complication characterized by fullness of the bladder without the ability to urinate. Its etiology in proctology surgery is multifactorial. This study aimed to identify the risk factors for POUR after radical surgery for anal fistula.MethodsWe retrospectively reviewed the clinical records of 511 patients who underwent radical surgery for anal fistula at the China-Japan Friendship Hospital from August 2022 to December 2023. Risk factors for POUR were analyzed by means of binary logistic regression analyses.ResultsPOUR occurred in 57 patients (11.2%) within 48 h post-surgery, and males were predominantly affected (84.4%). Independent risk factors included a history of urological disease (OR = 6.048; p < 0.001), incisions at position 1 (OR = 2.228; p = 0.046), high anal fistula (OR = 4.768; p < 0.001), VAS score ≥ 7 (OR = 2.805; p = 0.010), and GAD-7 score ≥ 5 (OR = 2.405; P = 0.024).ConclusionPOUR is a significant complication post-radical surgery for anal fistula, particularly among patients with urological disease, high anal fistula, and incisions at position 1. Surgeons should pay more attention to surgical methods for high anal fistulas and fistulas in the anterior rectum, and monitor postoperative bladder volume in high-risk patients. Enhanced postoperative pain and anxiety management can reduce the incidence of POUR and prevent long-term bladder damage.

A genetic study to identify pathogenic mechanisms and drug targets for benign prostatic hyperplasia: a multi-omics Mendelian randomization study

Benign prostatic hyperplasia (BPH) as a common geriatric disease in urology, the incidence and prevalence are rapidly increasing with the aging society, prompting an urgent need for effective prevention and treatment of BPH. However, limited therapeutic efficacy and higher risk of complications result in the treatment of BPH remaining challenging. The unclear pathogenic mechanism also hampers further exploration of therapeutic approaches for BPH. In this study, we used multi-omics methods to integrate genomics, transcriptomics, immunomics, and metabolomics data and identify biomolecules associated with BPH. We performed transcriptomic imputation, summary data-based Mendelian randomization (SMR), joint/conditional analysis, colocalization analysis, and FOCUS to explore high-confidence genes associated with BPH in blood and prostate tissue. Subsequently, three-step SMR was used to identify the DNA methylation sites regulating high-confidence genes to improve the pathogenic pathways of BPH. We also used cis-instruments of druggable genes to conduct SMR analysis to find potential drug targets for BPH. Finally, we used MR analysis to explore the immune pathways and metabolomics related to BPH. Multiple analytical methods identified BTN3A2 (Blood: TWAS Z score = 5.02912, TWAS P = 4.93 × 10–7; Prostate: TWAS Z score = 4.89, TWAS P = 1.01 × 10–6) and C4A (Blood: TWAS Z score = 4.90754, TWAS P = 9.22 × 10–7; Prostate: TWAS Z score = 5.084, TWAS P = 3.70 × 10–7) as high-confidence genes for BPH and identified the cg14345882-BTN3A2-BPH pathogenic pathway. We also used druggable gene data to identify 30 promising therapeutic target genes, including BTN3A2 and C4A. For MR analysis of immune pathways, we identified immune cell surface molecules as well as the inflammatory factor IL-17 (OR = 1.25, 95% CI = 1.09–1.43, PFDR = 0.12, Maximum likelihood) as risk factors for BPH. In addition, we found that disulfide levels of cysteinylglycine (OR = 1.11, 95% CI = 1.05–1.18, P = 5.18 × 10–4, Weighted median), oxidation levels of cysteinylglycine (OR = 1.09, 95% CI = 1.04–1.14, P = 3.87 × 10–4, Weighted median), and sebacate levels (OR = 1.05, 95% CI = 1.02–1.08, P = 3.0 × 10–4, Maximum likelihood) increase the risk of BPH. This multi-omics study explored biomolecules associated with BPH, improved the pathogenic pathways of BPH, and identified promising therapeutic targets. Our results provide evidence for future studies aimed at developing appropriate therapeutic interventions.

Prevalence of urolithiasis in Saudi Arabia: A systematic literature review

Urolithiasis is a common urological disease that can have a negative impact on health and quality of life in people worldwide. Multiple studies have investigated the prevalence of urolithiasis worldwide. However, research on this disease in Saudi Arabia is very limited. This review was conducted to investigate the prevalence of urolithiasis and its associations in Saudi Arabia. A standardized, systematic search strategy was conducted to identify observational studies that reported the prevalence of urolithiasis in Saudi Arabia. The search included published studies between January 2000 and October 2023. A variation in prevalence between regions was found and was reported to range from 6% to 19%. A significant association between urolithiasis and two factors, increasing age and family history, was found. Studies on urolithiasis are limited in Saudi Arabia. Despite this, it is evident that the prevalence of urolithiasis is comparable in other parts of the world. Public awareness and lifestyle modification efforts may help reduce this disease’s impact on our population.

Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021

BackgroundThe burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.MethodsWe obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI).ResultsIn 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths.ConclusionsThe global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.

A mucoadhesive-to-penetrating nanomotors-in-hydrogel system for urothelium-oriented intravesical drug delivery

Intravesical therapy (IT) is widely used to tackle various urological diseases. However, its clinical efficacy is decreased by the impermeability of various barriers presented on the bladder luminal surface, including the urinary mucus layer and the densely packed tissue barrier. In this study, we report a mucoadhesive-to-penetrating nanomotors-in-hydrogel system for urothelium-oriented intravesical drug delivery. Upon intravesical instillation, its poloxamer 407 (PLX) hydrogel gelated and adhered to the urothelium to prolong its intravesical retention. The urea afterwards diffused into the hydrogel, thus generating a concentration gradient. Urease-powered membrane nanomotors (UMN) without asymmetric surface engineering could catalyze the urea and migrate down this concentration gradient to deeply and unidirectionally penetrate the urothelial barrier. Moreover, the intravesical hybrid system-delivered gemcitabine could effectively inhibit the bladder tumor growth without inducing any side effect. Therefore, our mucoadhesive-to-penetrating nanomotors-in-hydrogel system could serve as an alternative to IT to meet the clinical need for more efficacious therapeutics for urological diseases.Graphical

Renal Cell Carcinoma Discrimination through Attenuated Total Reflection Fourier Transform Infrared Spectroscopy of Dried Human Urine and Machine Learning Techniques.

Renal cell carcinoma (RCC) is the sixth most common cancer in men and is often asymptomatic, leading to incidental detection in advanced disease stages that are associated with aggressive histology and poorer outcomes. Various cancer biomarkers are found in urine samples from patients with RCC. In this study, we propose to investigate the use of Attenuated Total Reflection-Fourier Transform Infrared Spectroscopy (ATR-FTIR) on dried urine samples for distinguishing RCC. We analyzed dried urine samples from 49 patients with RCC, confirmed by histopathology, and 39 healthy donors using ATR-FTIR spectroscopy. The vibrational bands of the dried urine were identified by comparing them with spectra from dried artificial urine, individual urine components, and dried artificial urine spiked with urine components. Urea dominated all spectra, but smaller intensity peaks, corresponding to creatinine, phosphate, and uric acid, were also identified. Statistically significant differences between the FTIR spectra of the two groups were obtained only for creatinine, with lower intensities for RCC cases. The discrimination of RCC was performed through Principal Component Analysis combined with Linear Discriminant Analysis (PCA-LDA) and Support Vector Machine (SVM). Using PCA-LDA, we achieved a higher discrimination accuracy (82%) (using only six Principal Components to avoid overfitting), as compared to SVM (76%). Our results demonstrate the potential of urine ATR-FTIR combined with machine learning techniques for RCC discrimination. However, further studies, especially of other urological diseases, must validate this approach.

Neural networks in oncourology

In recent decades, neural networks have been widely applied in many fields of science and medicine. Accurate and early diagnosis of malignancies is a key challenge in oncology. Neural networks can analyse a wide range of medical data and identify relationships between qualitative and quantitative features. This allows for more precise and timely diagnoses. Moreover, they can be used to predict tumour progression, evaluate treatment effectiveness, and optimise treatment plans for each patientIn oncourology, the use of neural networks offers new perspectives for the diagnosis, prognosis, and treatment of various cancer conditions related to the urinary tract and male reproductive system. This review article explores how neural networks are being used in this field and present research into the use of neural networks for diagnosing, predicting the course and treating urological oncological diseases. The advantages and limitations of using neural networks in this field are demonstrated, and possible directions for future research are suggested. The application of neural networks in oncourology opens new horizons for the development of a personalised approach to diagnosing and treating oncological diseases. Artificial intelligence has the potential to become a powerful tool for improving the accuracy of patient outcome predictions and reducing undesirable side effects of therapy. Introducing neural networks into oncourological practice creates new opportunities for enhancing the work of healthcare organisations and improving the quality of care provided to patients. This can lead to better treatment outcomes and improved patient satisfaction.

Global burden of benign prostatic hyperplasia in males aged 60–90 years from 1990 to 2019: results from the global burden of disease study 2019

BackgroundBenign prostatic hyperplasia (BPH) is a prevalent urological disease in elderly males. However, few studies have estimated the temporal and spatial distributions of the BPH burden in male adults aged 60 years and over at the global, national, and regional scales.MethodsLeveraging the Global Burden of Disease, Injuries, and Risk Factors Study, we estimated the global epidemiological trends in the prevalence, incidence, and disability-adjusted life-years (DALYs) of BPH in 204 countries and 21 regions and 5 sociodemographic index (SDI) regions in males aged 60 years and over between 1990 and 2019. The average annual percentage changes (AAPCs) in age-specific rates were estimated to quantify overall trends. We estimated the contribution of population aging and epidemiological alterations in disease burden via composition analysis.ResultsOver the past three decades, the global prevalent cases, incident cases and DALYs of BPH have increased, ranging from 118.78 to 121.22%. The global number of prevalent BPH cases reached 79 million in people aged 60 years and older in 2019. The prevalence, incidence, and DALYs rates gradually increased, with AAPCs of 0.02, 0.02, and 0.01, respectively. Low-middle, middle, and low SDI regions experienced rapid increases in the number of prevalent cases of BPH. In 2019, China, India, and United States of America bore the largest burden of prevalent cases among people aged 60 years and over. The three regions with the highest prevalence rates of BPH were Eastern Europe, Central Latin America, and Andean Latin America. The increased prevalence was attributed to population growth (94.93%), epidemiological changes (3.45%), and aging (1.62%), globally.ConclusionsBPH is a global health issue that imposes substantial economic burdens on most countries, particularly males aged 60 years and over. Effective health decisions are imperative for BPH prevention and treatment.

The evolving world of the urinary microbiome.

The existence of urinary microbiome in healthy individuals is now widely accepted as the longstanding belief in urinary tract sterility was disproved over a decade ago. The urinary microbiome has since been implicated in multiple urologic conditions including urinary tract infection (UTI), urinary incontinence, and bladder cancer. This review relays new findings of urinary microbiome compositional changes associated with aging and UTI susceptibility. Recent advancements have established how the urinary microbiome changes over the lifespan. Studies finding distinct urinary microbiomes in prepubescent, reproductive age, and postmenopausal females have identified sex hormones as potential modulators of urinary microbiome composition and have identified prevalent species that may be markers of dysbiosis. Research in male children finds a cultivable urinary microbiota that varies with age or urologic history but not delivery mode. Emerging research also addresses the function of the urinary microbiota, including genetic factors associated with urinary tract colonization and interactions with uropathogens. The urinary microbiome is a promising therapeutic target for urologic disease. However, a more functional understanding is necessary for the development of microbiome-based therapies. Future research should develop accurate animal models and explore functional relationships between the urinary microbiome and the host environment.

Risk factors and nomogram for predicting urinary tract infection in patients with ureterolithiasis complicated with hydronephrosis.

Urinary tract infection (UTI) is a common disease in urology and often occurs in patients with urolithiasis. This study aimed to identify the risk factors for UTI in patients with ureterolithiasis complicated with hydronephrosis, and to construct a simple and practical nomogram to predict the incidence of UTI for patients. A total of 383 patients were enrolled from September 2019 to June 2022. The results from univariate and multivariate logistic regression showed the risk factors for predicting UTI and a prediction model was constructed. Subsequently, the differentiation, calibration, and clinical applicability of the model were estimated by receiver operating characteristic (ROC) curve analysis, calibration curve, and decision curve analysis (DCA), respectively. The study included 72 (18.80%) patients with UTI. Multivariate logistic regression showed that tissue rim sign (P=0.04), positive urinary nitrite (P<0.001), and positive urinary leukocyte esterase (P=0.005) were independent predictive indexes of UTI for patients with ureterolithiasis complicated with hydronephrosis, and a nomogram was constructed in accordance with these indicators. The area under the ROC curve was 0.773, which indicated good prediction ability. The Hosmer-Lemeshow test (P=0.97) indicated that the model fitted well. The calibration curve and DCA showed good consistency and clinical applicability, respectively. The prediction model constructed with the risk factors including tissue rim sign, positive urinary nitrite, and positive urinary leukocyte esterase can better detect patients with UTI early and take timely intervention measures.

Acupuncture for overactive bladder in adults: Study protocol for a randomized controlled trial

BackgroundOveractive bladder (OAB) is a prevalent condition that substantially degrades patient quality of life. Acupuncture is recognized as an effective therapeutic approach for various urological diseases. However, there is limited evidence validating the effectiveness and safety of acupuncture for OABs. ObjectiveTo assess the therapeutic efficacy of acupuncture for OAB and to investigate the potential mechanisms by analyzing its effects on relevant urinary biomarkers. MethodsThis is a randomized, participants and outcome assessors blinded, sham acupuncture controlled trial. A total of 110 patients with OABs will be randomly divided in a 1:1 ratio between the acupuncture and sham acupuncture groups. Participants in the acupuncture group will undergo 30-min authentic acupuncture, while their counterparts in the sham acupuncture group will undergo sham acupuncture needling non-acupoints superficially three times weekly for a duration of 8 weeks. The two co-primary outcomes will be the change in the mean number of micturitions per 24 h from baseline to the end of the 8-week treatment and 20-week follow-up. The secondary outcomes will encompass the change in Overactive Bladder Symptom Score, Overactive Bladder Questionnaire Short Form, and average 24 h values of urgency, daytime micturition, nocturia, and mean volume voided per micturition from baseline to weeks 8 and 20. Urinary nerve growth factor, brain-derived neurotrophic factor, and monocyte chemoattractant protein-1 levels will be measured at baseline and week 8. Adverse events will also be documented. DiscussionThe results of this trial provide evidence for the effectiveness and safety of acupuncture in the management of OAB.

Protective effect of astaxanthin on chronic prostatitis/chronic pelvic pain syndrome in rat through modulating NF-κB signaling pathway.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male urological disease characterized by chronic pelvic pain and various discomforts. Astaxanthin (AST) has multiple functions, including anti-inflammatory property, but it is unclear whether AST plays a key role in CP/CPPS and how it works. This study aimed to investigate the protective effect of AST on CP/CPPS in rats and the underlying mechanism. A CP/CPPS rat model was induced by intraprostatic injection of carrageenan and the blood specimens and prostates were harvested for further research after oral administration of AST for 4 weeks. Tactile allodynia test showed that AST ameliorated chronic pelvic pain in a dose-depended manner. In addition, histological evaluation indicated that AST alleviated CP/CPPS rat prostate histological inflammation. Meanwhile, AST suppressed the expression of proinflammatory cytokines, including interleukin-1β (IL-1β), IL-6, IL-8, and tumor necrosis factor-α (TNF-α). Besides, AST inhibited the activities of prostaglandin E2 (PGE2) and cyclooxygenase 2 (COX2). Furthermore, AST decreased the activation of the nuclear factor-κB (NF-κB) signaling pathway. Our study has shown that AST exerts an anti-inflammatory and protective effect against CP/CPPS and the function is mediated at least through the suppression of NF-κB signaling pathway. These results provide evidence of AST as the potential agents for the treatment of CP/CPPS.

Investigation of urologic diseases in dogs in Ho Chi Minh City, Vietnam

Investigation of urologic diseases in dogs in Ho Chi Minh City, Vietnam

Label-free detection of kidney stones urine combined with SERS and multivariate statistical algorithm

Kidney stones are a common urological disease with an increasing incidence worldwide. Traditional diagnostic methods for kidney stones are relatively complex and time-consuming, thus necessitating the development of a quicker and simpler diagnostic approach. This study investigates the clinical screening of kidney stones using Surface-Enhanced Raman Scattering (SERS) technology combined with multivariate statistical algorithms, comparing the classification performance of three algorithms (PCA-LDA, PCA-LR, PCA-SVM). Urine samples from 32 kidney stone patients, 30 patients with other urinary stones, and 36 healthy individuals were analyzed. SERS spectra data were collected in the range of 450–1800 cm−1 and analyzed. The results showed that the PCA-SVM algorithm had the highest classification accuracy, with 92.9 % for distinguishing kidney stone patients from healthy individuals and 92 % for distinguishing kidney stone patients from those with other urinary stones. In comparison, the classification accuracy of PCA-LR and PCA-LDA was slightly lower. The findings indicate that SERS combined with PCA-SVM demonstrates excellent performance in the clinical screening of kidney stones and has potential for practical clinical application. Future research can further optimize SERS technology and algorithms to enhance their stability and accuracy, and expand the sample size to verify their applicability across different populations. Overall, this study provides a new method for the rapid diagnosis of kidney stones, which is expected to play an important role in clinical diagnostics.

Quality by design approach of apocynin loaded clove oil based nanostructured lipid carrier as a prophylactic regimen in hemorrhagic cystitis in vitro and in vivo comprehensive study

Apocynin (APO) is a naturally occurring acetophenone with eminent anti-inflammatory and anti-oxidant peculiarities. It suffers from poor bioavailability due to low aqueous solubility. Herein, APO was loaded in a Clove oil (CO) based Nanostructured lipid carrier (NSLC) system using a simple method (ultrasonic emulsification) guided by a quality-by-design approach (23 full factorial design) to optimize the formulated NSLCs. The prepared NSLCs were evaluated regarding particle size (PS), polydispersity index (PDI), zeta potential (ZP), and entrapment efficiency (EE%). The optimal formula (F2) was extensively investigated through transmission electron microscope (TEM), Fourier transform infrared (FT-IR) spectroscopy, Differential scanning calorimetry (DSC), X-ray diffractometry (XRD), in vitro release, and stability studies. Cytotoxicity against human urinary bladder carcinoma (T24) cell line and in vivo activity studies in rats with induced cystitis were also assessed. The results disclosed that the optimal formula (F2) had PS of 214.8 ± 5.8 nm with EE% of 79.3 ± 0.9%. F2 also exhibited a strong cytotoxic effect toward the T24 cancer cells expressed by IC50 value of 5.8 ± 1.3 µg/mL. Pretreatment with the optimal formula (orally) hinted uroprotective effect against cyclophosphamide (CP)-induced hemorrhagic cystitis (HC) in rat models, emphasized by histopathological, immunohistochemical, and biochemical investigations. In consideration of the simple fabrication process, APO-loaded CO-based NSLCs can hold prospective potential in the prophylaxis of oncologic and urologic diseases.

Role of circular RNAs (CircANXA2 and CircFBXW7) in bladder cancer

BackgroundThe most prevalent malignancy in the urinary tract is bladder cancer, which is becoming more commonplace globally. Circular RNAs, or circRNAs, have a role in cancer pathogenesis as they can be used as biomarkers to help identify new cases and predict the likelihood of recurrence. The current work examined the gene expression of CircANXA2 and CircFBXW7 and evaluated their potential utility in bladder cancer diagnosis.Subjects and methodologySeventy people with benign urologic diseases, seventy people with bladder cancer, and seventy healthy controls participated in the study. The polymerase chain reaction in real time quantified the gene expressions of CircANXA2 and CircFBXW7.ResultsCompared to the benign group and controls, bladder cancer patients had significantly greater levels of CircANXA2 expression (p < 0.001). In contrast to the benign group and controls, bladder cancer patients had significantly decreased levels of CircFBXW7 expression (p < 0.001). CircANXA2 and CircFBXW7 have comparable sensitivity and specificity; CircANXA2 had sensitivity, and specificity (77.14% and 76.43) and CircFBXW7 had sensitivity, and specificity (80.0% and 70.0%) respectively in detecting bladder cancer. CircANXA2 and CircFBXW7 were found to be the risk variables for bladder cancer using multivariate analysis. The odds ratios (OR) for CircANXA2 and CircFBXW7 were 1.240 (1.135–1.354) and 0.026 (0.006–0.107), in that order. In conclusion, CircANXA2 and CircFBXW7 may be highly specific and sensitive diagnostic markers for bladder cancer.

Management of overactive bladder: consensus statements from the Hong Kong Urological Association and the Hong Kong Geriatrics Society.

Overactive bladder (OAB) is a common urological disease with a high prevalence in older adult populations. Antimuscarinic drugs have been the most common treatment for OAB for more than a decade, but their anticholinergic side-effects and potential impact on cognitive function among older patients are usually underestimated. This consensus aimed to provide practical recommendations concerning OAB management, with a particular emphasis on older patients. A joint consensus panel was formed by representatives of the Hong Kong Urological Association and the Hong Kong Geriatrics Society. Literature searches regarding OAB and its management were performed in PubMed and Ovid. Several working meetings were held to present and discuss available evidence, develop consensus statements, and vote for the statements. A modified Delphi method was used in this consensus process. To address questions regarding various aspects of OAB, 29 consensus statements were proposed covering the following areas: diagnosis, initial assessment, non-pharmacological treatments, considerations before administration of pharmacological treatments, various pharmacological treatments, combination therapy, and surgical treatment. Twenty-five consensus statements were accepted.