Urological Diseases Research Articles

HLA as risk and protection antigens against urinary tract diseases

Abstract. Currently, there is no doubt about the feasibility of determining the frequency of HLA and analysis of genetic associations, including those that determine the state of immunity, in patients with the genitourinary disease.
 The study aimed to evaluate HLA phenotypes in patients with the most common diseases of the genitourinary system and identify risk antigens or protectors.
 Methods. HLA distribution was studied in 384 patients with pyelonephritis and glomerulonephritis and 464 patients with urological diseases (chronic cystitis, chronic proliferative cystitis, chronic prostatitis, prostate sclerosis, prostatic hyperplasia, and prostate cancer). HLAs were defined using a standard microlymphocytotoxic test (Terasaki’s test) on the Terasakiґs planchette with panels of anti-HLA serums (20 antigens of locus A, 31 – B and 9 – DR). The control group consisted of 350 healthy donors from Ukraine.
 The HLA frequencies in healthy and diseased subjects were compared taking each antigen separately, using the χ2 test. The value of the relative risk of disease (RR) was determined by the coefficient: RR = ab/cd, where a is the number of patients positive for this antigen, b is the number of persons in control, negative for this antigen; c is the number of patients negative for this antigen, d is the number of persons in control positive for this antigen. Indicators RR≥ 2.0 were considered significant.
 Absolute (attributive) risk of the disease as an etiological fraction, which was determined by the formula: s = x - y/1 - y, where x is the frequency of antigen in patients, y is the frequency in healthy people. The indicator s> 0,1 was considered reliable.
 Results. The association of the most common genitourinary diseases with certain histocompatibility antigens (RR≥2) is shown. The causal role of HLA with a significant absolute risk of pyelonephritis (А10, А11; В14, В16) and glomerulonephritis (A24, А28; B8; DR4, DR52), chronic cystitis, (including proliferative) (A10, B14, B16), chronic prostatitis (including with an autoimmune component or impaired fertility) (А24, В8, В52), sclerosis of the prostate (А24, А28), hyperplasia (А29, В38) and prostate cancer (А25, А29, В40, В44, В49) has been established. HLA-antigens associated with protection against these pathologies have also been identified - А2, А24, В21, В35 for pyelonephritis and А9, В12, В16, В18 for glomerulonephritis; А25, А26, В5, В14, В16, В17 for chronic prostatitis with its complications, А10, B15, B17 for prostate sclerosis, А9, А10, В17 for prostate hyperplasia, A1, B5, B13, B15 for prostate cancer.
 Conclusion. The study proves the feasibility of identifying antigens of the HLA system and analysis of their associations with different genitourinary diseases, which allows for predicting the risks of the disease and treatment optimization.

Increased Sulfation in Gracilaria fisheri Sulfated Galactans Enhances Antioxidant and Antiurolithiatic Activities and Protects HK-2 Cell Death Induced by Sodium Oxalate.

Urolithiasis is a common urological disease characterized by the presence of a stone anywhere along the urinary tract. The major component of such stones is calcium oxalate, and reactive oxygen species act as an essential mediator of calcium oxalate crystallization. Previous studies have demonstrated the antioxidant and antiurolithiatic activities of sulfated polysaccharides. In this study, native sulfated galactans (N-SGs) with a molecular weight of 217.4 kDa from Gracilaria fisheri were modified to obtain lower molecular weight SG (L-SG) and also subjected to sulfation SG (S-SG). The in vitro antioxidant and antiurolithiatic activities of the modified substances and their ability to protect against sodium oxalate-induced renal tubular (HK-2) cell death were investigated. The results revealed that S-SG showed more pronounced antioxidant activities (DPPH and O2− scavenging activities) than those of other compounds. S-SG exhibited the highest antiurolithiatic activity in terms of nucleation and aggregation, as well as crystal morphology and size. Moreover, S-SG showed improved cell survival and increased anti-apoptotic BCL-2 protein in HK-2 cells treated with sodium oxalate. Our findings highlight the potential application of S-SG in the functional food and pharmaceutical industries.

Preventive and therapeutic effects of Aerva lanata (L.) extract on ethylene glycol-induced nephrolithiasis in male Wistar albino rats

ObjectiveNephrolithiasis is a common urological disease. This study aims to evaluate the preventive and therapeutic effects of hydro-alcoholic extract of Aerva lanata (L.) roots (HAEAL) on ethylene glycol-induced nephrolithiasis in rats. MethodsFifty grams of shade-dried coarsely powdered Aerva lanata (L.) root was successively extracted with organic solvents in increasing order of polarity [petroleum ether (60 −80 °C), chloroform, and ethanol] using a Soxhlet apparatus, and then concentrated. Physical tests including nature, color, odor, and texture were performed on the herbal suspension. In vitro nephrolithiasis assessment was performed by nucleation assay, aggregation assay, and crystal growth assay. Thirty adult male Wistar albino rats were randomly divided into five groups (six rats in each group). Group 1: negative control group without induction or treatment till day 28. Group 2: positive control group receiving a daily oral solution of 0.75% ethylene glycol till day 14, and mixed with distilled water till day 28. Group 3: standard group receiving a daily oral solution of 0.75% ethylene glycol till day 14 and Cystone (750 mg/kg) from day 15 to day 28. Group 4: low dose HAEAL group receiving a daily oral solution of 0.75% ethylene glycol till day 14, and 400 mg/kg HAEAL from day 15 to day 28 (1 mL per day). Group 5: high dose HAEAL group receiving a daily oral solution of 0.75% ethylene glycol till day 14, and 800 mg/kg HAEAL from day 15 to day 28 (1 mL per day). Urine (urine volume, pH value, appearance, odor, and turbidity) examination and serum test were performed. On day 29, the kidneys were dissected, and histopathology examination was performed to determine the degree of tubular injury. ResultsThe suspension showed stability and aroma with no turbidity at room temperature. The suspension did not show changes in color and odor until day 3, indicating that the preparation was stable for 72 h. Body weight decreased in the positive control group indicating stone formation and changes in water intake. Both standard and HAEAL treatments restored the body weight to normal levels after treatment, indicating the beneficial effects of the treatment. Histopathological examination revealed no significant findings in the negative control group, whereas the positive control group showed inflammation in the kidney parenchyma. Compared with positive control group, there was increase in urine volume and excretion of urinary constituents such as calcium and oxalate (P < 0.01) as well as improved clearance rate (P < 0.05) in HAEAL treatment groups, in addition, the urine pH value of HAEAL groups was increased. ConclusionHAEAL reduced nephrolithiasis formation and had a diuretic effect, which could be used to promote the expulsion of stones. Further studies are needed to enhance the stability of the suspension for the production of better pharmaceutical formulations.

AUTHOR REPLY

We thank the author for highlighting the significance of access for early detection and prompt treatment of urologic disease. Healthcare access for Medicaid-insured patients will be important to monitor as private equity acquisitions continue to reshape the urology landscape. In the year since our initial study, at least 1 additional private equity backed platform company has formed and numerous practices have been acquired in roll-up acquisitions. 1 Nie J Demkowicz PC Hsiang W et al. Urology practice acquisitions by private equity firms from 2011–2021. Urol Pract. 2021; https://doi.org/10.1097/UPJ. 0000000000000269 Crossref Google Scholar ,2 S&P Capital IQ. Available at: https://www.capitaliq.com. Accessed March 15, 2021. Google Scholar In addition, the first known “exit” by a private equity firm has occurred with the sale of northeast urology platform to a for-profit, multispecialty physician group. 3 Summit Health. Summit Health Adds Westmed Medical Group and New Jersey Urology, expanding access to its unique connected care model [press release]. 2022. Business Wire. Google Scholar Changes in ownership should underscore to readers that private equity acquisitions are not intended as longitudinal partnerships with physicians or communities but are instead, by design, short-term investment opportunities.

Estrogen and G protein-coupled estrogen receptor accelerate the progression of benign prostatic hyperplasia by inducing prostatic fibrosis

Benign prostatic hyperplasia (BPH) is the most common and progressive urological disease in elderly men worldwide. Epidemiological studies have suggested that the speed of disease progression varies among individuals, while the pathophysiological mechanisms of accelerated clinical progression in some BPH patients remain to be elucidated. In this study, we defined patients with BPH as belonging to the accelerated progressive group (transurethral resection of the prostate [TURP] surgery at ≤50 years old), normal-speed progressive group (TURP surgery at ≥70 years old), or non-progressive group (age ≤50 years old without BPH-related surgery). We enrolled prostate specimens from the three groups of patients and compared these tissues to determine the histopathological characteristics and molecular mechanisms underlying BPH patients with accelerated progression. We found that the main histopathological characteristics of accelerated progressive BPH tissues were increased stromal components and prostatic fibrosis, which were accompanied by higher myofibroblast accumulation and collagen deposition. Mechanism dissection demonstrated that these accelerated progressive BPH tissues have higher expression of the CYP19 and G protein-coupled estrogen receptor (GPER) with higher estrogen biosynthesis. Estrogen functions via GPER/Gαi signaling to modulate the EGFR/ERK and HIF-1α/TGF-β1 signaling to increase prostatic stromal cell proliferation and prostatic stromal fibrosis. The increased stromal components and prostatic fibrosis may accelerate the clinical progression of BPH. Targeting this newly identified CYP19/estrogen/GPER/Gαi signaling axis may facilitate the development of novel personalized therapeutics to better suppress the progression of BPH.

Association Between Prostate Size and MRI Determined Quantitative Prostate Zonal Measurements.

PurposeBenign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the two most prevalent and common urologic diseases impacting elderly men. The current literature has well documented an inverse relationship between prostate/BPH-size and incidence of PCa, but the exact interaction between these two disease entities is not well understood. The purpose of this study is to analyze prostatic zonal measurements with magnetic resonance imaging (MRI) in order to investigate the dynamic changes of the transition zone (TZ) and peripheral zone (PZ) in response to prostate/BPH growth.MethodsMultiparametric magnetic resonance imaging (mpMRI) scans of 430 consecutive male patients aged 18–89 years were obtained to measure the different zonal areas of the prostate. The data were statistically analyzed to identify specific associations between the different measurement parameters and total prostate volume (TPV).ResultsThe Mann–Whitney U-test showed a significant decline of the average peripheral zone thickness (PZT) (z = −4.5665, p < 0.0001) in larger prostates when compared to smaller prostates. The Spearman correlation between TPV and PZT demonstrated a significant negative correlation (−0.20, p < 0.0001).ConclusionThe data revealed that PZT was significantly smaller in the subgroup of patients with higher TPV. This supports the hypothesis of PZ compression and thinning caused by the growing and expanding TZ in BPH prostates. This dynamic growth-related process in the different prostatic zones may explain the protective effect of BPH against PCa.

Epigenetics: Through the pediatric urology looking glass

Epigenetics: Through the pediatric urology looking glass

Machine learning diagnosis by immunoglobulin N-glycan signatures for precision diagnosis of urological diseases.

Early diagnosis of urological diseases is often difficult due to the lack of specific biomarkers. More powerful and less invasive biomarkers that can be used simultaneously to identify urological diseases could improve patient outcomes. The aim of this study was to evaluate a urological disease‐specific scoring system established with a machine learning (ML) approach using Ig N‐glycan signatures. Immunoglobulin N‐glycan signatures were analyzed by capillary electrophoresis from 1312 serum subjects with hormone‐sensitive prostate cancer (n = 234), castration‐resistant prostate cancer (n = 94), renal cell carcinoma (n = 100), upper urinary tract urothelial cancer (n = 105), bladder cancer (n = 176), germ cell tumors (n = 73), benign prostatic hyperplasia (n = 95), urosepsis (n = 145), and urinary tract infection (n = 21) as well as healthy volunteers (n = 269). Immunoglobulin N‐glycan signature data were used in a supervised‐ML model to establish a scoring system that gave the probability of the presence of a urological disease. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC). The supervised‐ML urologic disease‐specific scores clearly discriminated the urological diseases (AUC 0.78–1.00) and found a distinct N‐glycan pattern that contributed to detect each disease. Limitations included the retrospective and limited pathological information regarding urological diseases. The supervised‐ML urological disease‐specific scoring system based on Ig N‐glycan signatures showed excellent diagnostic ability for nine urological diseases using a one‐time serum collection and could be a promising approach for the diagnosis of urological diseases.

Evolving Hypothesis that Prostate/BPH Size Matters in Protection against Prostate Cancer

Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the two predominant urologic diseases affecting aging men. As a matter of fact, 95–98% of elderly men with prostate as their “primary organ disease” for consulting urologists have either the clinical diagnosis of BPH, PCa or both. Other primary diagnoses of the prostate such as sarcoma, lymphoma or isolated bacterial prostatitis (not in the context of a systemic urinary tract infection) are rare entities. Although BPH and PCa are very common, their interaction is currently not well understood. Numerous clinical studies and meta-analysis reviews have demonstrated a negative correlation between prostate BPH size and the probability of PCa presence, but little is known to explain this clinical phenomenon. Recent histo-anatomical and magnetic resonance imaging studies have revealed data leading to a hypothesis indicating the expanding transition zone (TZ) in a growing BPH prostate causes mechanical stress within the peripheral zone (PZ) with secondary fibrosis and atrophy of the glands within the PZ. This dynamic interaction of the TZ against the PZ in a growing BPH-prostate could explain the negative correlation between BPH size and PCa incidence. The purpose of this review is to present and discuss the evolving hypothesis that prostate size may matter and be protective against prostate cancer.

Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019.

Background: There are still no detailed data about the burden of bacterial antimicrobial resistance (AMR) in urinary tract infections (UTI). Concrete knowledge of global and regional bacterial AMR data is crucial for developing informed programs and policies to control bacterial AMR and for prudent use of antibiotics to optimize antibiotic therapy in patients with UTI. This study aimed to provide comprehensive global and regional estimates for the AMR burden of UTI in 2019. Methods: Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), including death, disability-adjusted life-years (DALYs), year lived with disability (YLD), and years of life lost (YLL) for bacterial AMR in UTI for 7 GBD super-regions, 21 regions, 14 pathogens, 13 antibiotic classes, and 66 pathogen-antibiotic combinations in 2019. The estimates were based on two counterfactual scenarios: drug-susceptible infection and no infection. Results: Globally, there were 64.89 thousand deaths (95% uncertainty interval [UI]: 45.86–93.35) attributed to and 0.26 million deaths (95% UI: 0.18–0.36) associated with bacterial AMR in UTI in 2019. Among regions, the all-age death rates were higher in southern Latin America, tropical Latin America, and Europe and lower in sub-Saharan Africa. Escherichia coli and Klebsiella pneumoniae accounted for more than 50% of deaths attributable to and associated with AMR, and resistance was high among multiple types of antibiotic class, including fluoroquinolones, carbapenems, and third-generation cephalosporins. There were 2 pathogen-drug combinations that caused more than 6000 resistance-attributable deaths: third-generation cephalosporin-resistant Escherichia coli and fluoroquinolone-resistant Escherichia coli. Conclusions: AMR in UTI is an unignorable health problem, both for the management of urology disease and for global antibiotic resistance. Special tailored strategies, including enhanced surveillance and rational use of antibiotics, should be developed for different regions according to the region-specific pathogen-antibiotic situations and resources.

Urological stone disease: a 5-year update of stone management using Hospital Episode Statistics.

To reassess the trends in upper urinary tract (UUT) stone disease burden and management in the UK during the last 5 years. The present paper is our third quinquennial analysis of trends in the management of renal stones in England. Data were collected using the Hospital Episode Statistics database for the years 2015-2020 inclusive. These were then analysed, summarized and presented. The number of UUT stone episodes increased by 2.2% from 86 742 in 2014-2015 to 88 632 in 2019-2020 but annual prevalence remained static at 0.14%. The number of UUT stone episodes in those of working age has remained static but increased by 9% for patients aged > 60 years (from 27 329 to 29 842). The number of shockwave lithotripsy (SWL) treatments decreased by 6.8%. There was a further increase in the use of ureteroscopy (URS) between 2015 and 2020 of 18.9%. Within this subgroup, flexible URS had the most rapid increase in use, with a rise of 20.4% from 7108 to 8558 recorded cases. Over the 20-year period from 2000 to 2020 there was a remarkable 257% increase in URS cases. There was a further decline in open surgery for UUT stone disease by 40%. Stone surgery day-case numbers have increased by 14.7% (from 31 014 to 35 566), with a corresponding decline in the number of bed days of 14.3%. Emergency cases increased by 40%, while elective cases saw a slight increase of 1.9%. The present study shows a plateauing in the prevalence of UUT stone disease in England in the last 5 years, with a move towards day-case procedures and an increase in the proportion of emergency work. For the first time in England, URS has overtaken SWL as the most common procedure for treating UUT stone disease, which might reflect patients' or physicians' preference for a more effective definitive treatment.

MP30-06 FINANCIAL IMPACT OF UROLOGIC CONDITIONS IN MEN AND WOMEN IN BELIZE

You have accessJournal of UrologyCME1 May 2022MP30-06 FINANCIAL IMPACT OF UROLOGIC CONDITIONS IN MEN AND WOMEN IN BELIZE Clinton Yeaman, Devang Sharma, Raj Desai, Rajesh Balkrishnan, and David Rapp Clinton YeamanClinton Yeaman More articles by this author , Devang SharmaDevang Sharma More articles by this author , Raj DesaiRaj Desai More articles by this author , Rajesh BalkrishnanRajesh Balkrishnan More articles by this author , and David RappDavid Rapp More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002573.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologic disease (UD) is highly prevalent in low- and middle-income countries (LMIC). Concurrently, the inability to maintain employment or provide care for family are significant factors that contribute to extreme poverty in these countries. The impact of urologic disease on economic productivity and caretaking responsibilities in developing countries is poorly understood. METHODS: We conducted a prospective survey-based study of patients treated during two separate global health trips from 2019-2021 with the charity Global Surgical Expedition. Patients completed a 17-item survey with focus on urologic disease, work and caretaking responsibilities, and financial data. Items from the Work Productivity and Activity Impairment Questionnaire (WPAI) were used to assess financial impact. RESULTS: A total of 114 patients completed surveys, with 61 having financial data sufficient for analysis. Most common presenting urologic diagnosis category included Female (pelvic organ prolapse, urinary incontinence)- 41.4%, BPH/strictures- 28.4%, urolithiasis- 19.8%, oncology- 7.7%, and other- 2.6%. Diagnoses were not mutually exclusive. Overall, 87.7% and 36.8% reported a negative impact of urologic disorders on job and caretaking responsibilities, respectively. 9 patients (7.7%) were unemployed secondary to their UD. Mean percent work time missed and percent impairment while working due to UD was 21.8% and 42.0%, respectively. Overall activity impairment due to UD was 30.4%. Mean weekly income of respondents was BZ $461 BZD (approximately $230.50 USD). Accordingly, the percent overall work impairment resulted in $59.10 BZD per capita in lost potential income per week. This represents a loss of 12.8% of total income attributable to UD. 88.6% of patients reported that cure of UD would increase ability to work and/or care for family. CONCLUSIONS: In Belize, UD results in significant impairment and time missed as related to work and caretaking responsibilities. This impairment is associated with a significant level of lost income. Focused efforts are necessary to provide urologic surgeries in developing countries as not only do they impact quality of life but also deleteriously impact financial health of patients and families. Source of Funding: University of Virginia Center for Global Inquiry and Innovation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e480 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Clinton Yeaman More articles by this author Devang Sharma More articles by this author Raj Desai More articles by this author Rajesh Balkrishnan More articles by this author David Rapp More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP26-12 CHANGING NATIONAL TRENDS IN OPIOID PRESCRIPTIONS FOR PAIN MANAGEMENT IN ACUTE KIDNEY STONE DISEASE

You have accessJournal of UrologyCME1 May 2022MP26-12 CHANGING NATIONAL TRENDS IN OPIOID PRESCRIPTIONS FOR PAIN MANAGEMENT IN ACUTE KIDNEY STONE DISEASE Chinmayee Katragadda, Alexis Steinmetz, Alexander Cranwell, and Rajat Jain Chinmayee KatragaddaChinmayee Katragadda More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , Alexander CranwellAlexander Cranwell More articles by this author , and Rajat JainRajat Jain More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002569.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Deaths from opioid-related overdose contributed to the decline in life expectancy seen in the US from 2014-2018 and surpassed deaths from automobile accidents. Urologic surgery and disease, including benign conditions such as kidney stone disease (KSD), are a significant source of opioid prescriptions. We investigated prescription patterns for opioids and non-opioids for KSD in the Emergency Department (ED) setting. These data provide important information as urologists seek opioid sparing approaches and effective alternative therapies for the KSD population. METHODS: The US National Hospital Ambulatory Medical Care Survey (NHMACS) was queried for ED visits for KSD from 2012 to 2017. Adult patients with KSD-related diagnoses that visited the ED were identified using International Classification of Diseases codes. Prescription rates of opioids and non-opioids were analyzed with respect to age, sex, region, race/ethnicity, and payer type. Survey weighted chi-square and logistic regression, and adjusted odds ratios were used to analyze associations. RESULTS: Six million KSD-related ED visits were identified. The percentage of patients receiving opioid prescriptions decreased from 33% to 16% from 2012-2017 (p-trend <0.001) while non-opioid prescriptions rose from 67% to 84% in that same time period (p-trend <0.02). Compared to 2012, the odds of receiving an opioid prescription decreased significantly in 2016 and 2017 (OR 0.27, p=0.01 and OR 0.12, p<0.0001, respectively). There was a concurrent increase in the odds of receiving a non-opioid prescription in 2016 and 2017 (OR 2.02, p=0.03 and OR 2.63, p=0.01 respectively). Payer type, episode of care and gender were not associated with type of prescription. CONCLUSIONS: The dramatic decrease in opioid prescriptions for kidney stone disease has been accompanied by a concomitant rise in non-opioid prescriptions. This represents a fundamental shift in the management of pain in acute kidney stone disease which is reflective of the nationwide public health effort to curb the opioid epidemic. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e443 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chinmayee Katragadda More articles by this author Alexis Steinmetz More articles by this author Alexander Cranwell More articles by this author Rajat Jain More articles by this author Expand All Advertisement PDF DownloadLoading ...

Knowledge domain and emerging trends in chronic prostatitis/chronic pelvic pain syndrome from 1970 to 2020: a scientometric analysis based on VOSviewer and CiteSpace

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological disease, and research on CP/CPPS has increased over the past 50 years. However, few studies have statistically analyzed these publications. In this work, we conducted the knowledge domain and highlighted current research hotspots and emerging trends in CP/CPPS from 1970 to 2020 based on VOSviewer and CiteSpace. Relevant original articles were obtained from the Web of Science (WoS) database between 1970 and 2020. VOSviewer and CiteSpace software were used to perform the analysis and visualization of scientific productivity and emerging trends. Our results show that the articles related to CP/CPPS have dramatically increased every year from 1 publication in 1970 to 111 publications in 2020. The USA dominated the field in all countries, and Queen's University (Canada) has more extensive cooperating relationships with other institutions. J. Curtis Nickel may have a significant influence on CP/CPPS research with more publications and cocitations. The Journal of Urology is the foremost productive journal and has the most citations of all the journals. A total of 11 major clusters were explored based on the reference cocitation analysis (RCA). Definition, incidence rate or clinical characteristics, etiology or pathogenesis, epidemiological studies (cross-sectional study and cohort study), clinical studies (inflammation, pain, lower urinary tract symptoms (LUTS), α-blockers, antibiotic) and relationships with other diseases [benign prostatic hyperplasia (BPH), prostate cancer, sexual dysfunction] are the knowledge bases for CP/CPPS research. The treatment mode also changed gradually from anti-inflammatory therapy to symptom improvement, and NIH-CPSI was taken as the evaluation criterion. This scientometric study comprehensively reviewed publications related to CP/CPPS during the past 50 years using quantitative and qualitative methods, and the information provides some references for scholars to conduct further research on CP/CPPS.

MP04-03 CAN HANDHELD POINT OF CARE ULTRASOUND PROBES RELIABLY MEASURE TRANSABDOMINAL PROSTATE VOLUME? A PROSPECTIVE RANDOMIZED STUDY

You have accessJournal of UrologyCME1 May 2022MP04-03 CAN HANDHELD POINT OF CARE ULTRASOUND PROBES RELIABLY MEASURE TRANSABDOMINAL PROSTATE VOLUME? A PROSPECTIVE RANDOMIZED STUDY Henry Wright, Hermen Brar, Fabrice Henry, Dillon Corrigan, and Smita De Henry WrightHenry Wright More articles by this author , Hermen BrarHermen Brar More articles by this author , Fabrice HenryFabrice Henry More articles by this author , Dillon CorriganDillon Corrigan More articles by this author , and Smita DeSmita De More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002521.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate gland volume (PGV) helps guide management for prostatic disease. The American Urological Association (AUA) benign prostatic hyperplasia (BPH) guidelines recommend PGV assessment prior to BPH surgery via one of the following: magnetic resonance imaging (MRI), trans rectal or trans abdominal ultrasound (TRUS/TAUS), or computed tomography (CT). Handheld ultrasound (HUS) probes show promise as point of care ultrasound (POCUS) for PGV, yet evidence is limited. Our objective was to independently evaluate the accuracy of two HUS probes (Butterfly IQ, Clarius C3) in measuring trans abdominal PGV compared to guideline imaging (MRI, TRUS, TAUS, or CT). METHODS: In this prospective clinical study, enrolled subjects were randomized in a 1:1 ratio to undergo HUS PGV measurement with either the Clarius or Butterfly probe. Demographics, urologic history, and PGV data were collected. Reliability was quantified by estimating the intraclass correlation coefficient (ICC) between the HUS and guideline imaging and its 95% confidence interval (R version 4.1.0). We used the following standard criteria: ICC <0.5: poor reliability; 0.5 ≤ ICC <0.75: moderate reliability; ICC ≥0.75: good reliability. RESULTS: 78 men were randomized (38 Butterfly, 40 Clarius). Baseline characteristics similar between groups (p >0.05). The mean PGV based on HUS and gold standard imaging was higher in the Clarius group compared to Butterfly (p=0.011 and 0.044, respectively). The ICCs were 0.78 (95% CI: 0.62, 0.88) and 0.71 (95% CI: 0.51, 0.83) for the Butterfly and Clarius probes, respectively (Table 1), indicating that the Butterfly IQ produced good reliability between HUS and reference measurements, and the Clarius C3 produced moderate reliability between HUS and reference measurements. CONCLUSIONS: When compared to guideline imaging, the Butterfly IQ demonstrated good reliability for PGV, in comparison to moderate reliability for the Clarius C3. Further studies evaluating these probes as POCUS for urologic diseases are warranted. Source of Funding: Cleveland Clinic Research Programs Committee Grant © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e57 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Henry Wright More articles by this author Hermen Brar More articles by this author Fabrice Henry More articles by this author Dillon Corrigan More articles by this author Smita De More articles by this author Expand All Advertisement PDF DownloadLoading ...

The Effects of Short-Chain Fatty Acids in Urological Diseases

The Effects of Short-Chain Fatty Acids in Urological Diseases

Clinical and anthropometric parallels in the diagnostics of pyelonephritis in pregnant women

BACKGROUND: The most dangerous disease in the structure of urinary tract infections during pregnancy is pyelonephritis. Favorable ground for its occurrence is created by anatomical and physiological changes in the urinary system in pregnant women against the background of gestational restructuring of the body. It seems very relevant to study the constitutional features of pregnant women with pyelonephritis and reference points - markers associated with the risk of developing pyelonephritis, the individual characteristics of its course and the effectiveness of therapy using the fundamental basis of clinical anthropology.&#x0D; AIM: Evaluation and comparative analysis of anthropometric and bioelectrical impedance body parameters in pregnant women with pyelonephritis.&#x0D; MATERIALS AND METHODS: The study included 94 pregnant women with pyelonephritis hospitalized in the urological department of the Clinical Regional Hospital (Krasnoyarsk) from 2019 to 2021. In addition to traditional tests, anthropometric and bioelectrical impedance analysis was carried out to assess the constitutional features and criteria of normal and pathological variability boundaries of pregnant women with pyelonephritis. The control group included 39 women with physiological course of pregnancy without urological diseases.&#x0D; RESULTS: The constitutional identification in the group of women with pyelonephritis in pregnancy was dominated by the mesomorph body type, with a smaller proportion presenting the endomorph type and the rarely detected central and ectomorph types. Vector analysis of soma components in pregnant women with pyelonephritis are characterized by high mesomorph scores reflecting the degree of skeletal and muscular development compared to the control group, with the lowest ectomorph values. According to bioelectrical impedance analysis, most patients have significant differences in a number of body composition parameters. Morphometric features of the pelvicalyceal system on the affected side are most prominent in the representatives of endomorph and central body types. There are significant correlations between the degree of pelvicalyceal system dilatation on the affected side and anthropometric and bioimpedance parameters of body composition.&#x0D; CONCLUSION: The study revealed a number of clinical and anthropometric parallels and constitutional features of pregnant women with pyelonephritis with the characteristics of the component body composition. Relationships have been established between various indicators, which at first glance are not related to each other, but have a significant impact on the clinical manifestations of gestational pyelonephritis. The results of the pilot study and further development of the methodology will make it possible to determine the most significant constitutional predictors of the development of pyelonephritis in pregnancy and the possibility of conducting preventive therapy.

Effect of endoscopic urethral procedures applied after robotic radical prostatectomy on urinary incontinence: A prospective cohort pilot study.

The most common complications after radical prostatectomy (RP) are erectile dysfunction (ED) and urinary incontinence (UI). After RP, patients may require endoscopic urethral procedures (EUP) for other urological diseases such as hematuria, urinary system stone disease, and suspicion of bladder tumor. In clinical practice we observed that EUP performed after robot assisted RP (RARP) can cause an increase in the UI level. In this study, we investigated whether there is a change in the UI level in patients that underwent EUP after RARP and whether this change was affected by the duration of the procedure and type of endoscopic device used. Twenty-six patients were included who underwent EUP after RARP in this study. The patients were divided into three groups based on the endoscopic device used: group 1 rigid cystoscopy (n = 9), group 2 flexible cystoscopy (n = 7), and group 3 semi-rigid ureterorenoscopy (URS) (n = 10). The Turkish version of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) and the number of pads used daily was questioned before the EUP and 1 month after the procedure. While a significant increase in ICIQ-SF score was observed in group 1 (p = 0.027), no significant increase was observed in group 2 and group 3 (p > 0.05). No significant difference was observed between the number of pads used preoperatively and the postoperative first month in all groups (p > 0.05). There was no significant correlation between increased operation time and both the pad usage and ICIQ-SF score (p > 0.05). The use of small diameter endoscopic instruments and flexible instruments is important for patient comfort and to avoid damage to urethrovesical anastomosis in patients who need to undergo EUP after RP.

Association of prostate size with capsule thickness and glandular epithelial cell density: The possible clinical implications on prostate cancer development

Objective: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the two most common urologic diseases in aging males. The negative association between prostate/BPH size and incidence of PCa is well documented in the literature. However, the exact mechanism is not well understood. This study aims to further investigate the possible effect of prostate volume on prostate capsule thickness and glandular cell density in the prostatic peripheral zone (PZ). Materials and Methods: A total of 100 patients were selected that had undergone radical prostatectomy with prostate sizes ranging from 20 to 160 mL. Quantitative measurements of capsule thickness and density of epithelial glands within the peripheral zone not affected by cancer were analysed and calculated on histo-anatomical slides using computer-based imaging software. Associations between the different variables were calculated using Spearman correlation with 95% confidence intervals (CIs). Results: In the non-cancerous areas of the PZ, prostate volume and average capsule thickness are positively associated ( rs = +0.6526, 95% CI +0.5233 to +0.7526, p &lt; 0.0001), while prostate volume and average glandular epithelial cell density of the PZ are negatively associated ( rs = −0.6011, 95% CI −0.7133 to −0.4589, p &lt; 0.0001). These associations remain consistent on subgroup analysis. Conclusion: The findings of this study support the hypothesis that transition zone (TZ) growth in large BPH prostates may cause pressure on the outer PZ, leading to fibrosis and atrophy of the glandular tissue. This may provide a protective effect against PCa, as most PCa originates in the PZ of the prostate. Level of evidence: Not applicable

Diagnostic Value of microRNA-375 as Future Biomarker for Prostate Cancer Detection: A Meta-Analysis.

Background and Objectives: Responding to the need for additional biomarkers for the diagnosis of prostate cancer (PCa), mounting studies show that microRNAs (miRNAs/miRs) possess great potential as future promising diagnostic tools. However, the usefulness of these miRNAs is still highly debated, as the degree of inconsistency between study designs and results is still elevated. Herein, we present a meta-analysis evaluating the diagnostic value and accuracy of circulating miR-375, as it is one of the most studied types of miRs in PCa. Materials and Methods: The diagnostic accuracy of miR-375 was evaluated using the QUADAS-2 tool, analyzing different statistical parameters. The seven studies (from six articles) that matched our selection included 422 PCa patients and 212 controls (70 healthy volunteers + 142 with benign prostate diseases). Results and Conclusion: We obtained a p-value of 0.76 for sensitivity, 0.83 for specificity, 16 for DOR, 4.6 for LR+, 0.29 for LR−, and 0.87 for AUC (95% CI 0.83–0.89). Our results confirm that miRNA-375 has high diagnostic potential for PCa, suggesting its usefulness as a powerful biomarker. More comprehensive studies are warranted to better assess its true value as a diagnostic biomarker for this urologic disease.