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Diagnostics
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Diagnosis and Prognosis of Urological Diseases
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Diagnosis and Prognosis of Urological Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 12164

Special Issue Editor

Dr. Vineet Gauhar

E-Mail Website
Guest Editor
Department of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore
Interests: urology

Special Issue Information

Dear Colleagues,

This Special Issue is dedicated to advancing the diagnosis and prognosis of urological diseases. We welcome a diverse range of contributions, including reviews, original research articles, case reports, interesting images, and guidelines, all aiming to advance our understanding of urological diseases.

Dr. Vineet Gauhar
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • urological diseases
  • diagnosis
  • prognosis
  • marker
  • urothelial carcinoma

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Published Papers (7 papers)

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Research

Jump to: Review, Other

13 pages, 1554 KiB  
Article
Predictive Potential of Contrast-Enhanced MRI-Based Delta-Radiomics for Chemoradiation Responsiveness in Muscle-Invasive Bladder Cancer
by Kohei Isemoto, Yuma Waseda, Motohiro Fujiwara, Koichiro Kimura, Daisuke Hirahara, Tatsunori Saho, Eichi Takaya, Yuki Arita, Thomas C. Kwee, Shohei Fukuda, Hajime Tanaka, Soichiro Yoshida and Yasuhisa Fujii
Diagnostics 2025, 15(7), 801; https://doi.org/10.3390/diagnostics15070801 - 21 Mar 2025
Viewed by 570
Abstract
Background/Objectives: Delta-radiomics involves analyzing feature variations at different acquisition time-points. This study aimed to assess the utility of delta-radiomics feature analysis applied to contrast-enhanced (CE) and non-contrast-enhanced (NE) T1-weighted images (WI) in predicting the therapeutic response to chemoradiotherapy (CRT) in patients diagnosed [...] Read more.
Background/Objectives: Delta-radiomics involves analyzing feature variations at different acquisition time-points. This study aimed to assess the utility of delta-radiomics feature analysis applied to contrast-enhanced (CE) and non-contrast-enhanced (NE) T1-weighted images (WI) in predicting the therapeutic response to chemoradiotherapy (CRT) in patients diagnosed with muscle-invasive bladder cancer (MIBC). Methods: Forty-three patients with non-metastatic MIBC (cT2–4N0M0) who underwent partial or radical cystectomy after induction CRT were, retrospectively, reviewed. Pathological complete response (pCR) to CRT was defined as the absence of residual viable tumor cells in the cystectomy specimen. Identical volumes of interest corresponding to the index bladder cancer lesions on CE- and NE-T1WI on pre-therapeutic 1.5-T MRI were collaboratively delineated by one radiologist and one urologist. Texture analysis was performed using “LIFEx” software. The subtraction of radiological features between CE- and NE-T1WI yielded 112 delta-radiomics features, which were utilized in multiple machine-learning algorithms to construct optimal predictive models for CRT responsiveness. Additionally, the predictive performance of the radiomics model constructed using CE-T1WI alone was assessed. Results: Twenty-one patients (49%) achieved pCR. The best-performing delta-radiomics model, employing the “Extreme Gradient Boosting” algorithm, yielded an area under the receiver operating characteristic curve (AUC) of 0.85 (95% confidence interval [CI]: 0.75–0.95), utilizing four signal intensity-based delta-radiomics features. This outperformed the best model derived from CE-T1WI alone (AUC: 0.63, 95% CI: 0.50–0.75), which incorporated two morphological features and one signal intensity-based radiomics feature. Conclusions: Delta-radiomics analysis applied to pre-therapeutic CE- and NE-MRI demonstrated promising predictive ability for CRT responsiveness prior to treatment initiation. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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12 pages, 4881 KiB  
Article
Virtual Reality Head-Mounted Display (HMD) and Preoperative Patient-Specific Simulation: Impact on Decision-Making in Pediatric Urology: Preliminary Data
by Giulia Lanfranchi, Sara Costanzo, Giorgio Giuseppe Orlando Selvaggio, Cristina Gallotta, Paolo Milani, Francesco Rizzetto, Alessia Musitelli, Maurizio Vertemati, Tommaso Santaniello, Alessandro Campari, Irene Paraboschi, Anna Camporesi, Michela Marinaro, Valeria Calcaterra, Ugo Maria Pierucci and Gloria Pelizzo
Diagnostics 2024, 14(15), 1647; https://doi.org/10.3390/diagnostics14151647 - 30 Jul 2024
Cited by 1 | Viewed by 1390
Abstract
Aim of the Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes. Patients and Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in [...] Read more.
Aim of the Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes. Patients and Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts. Routine CT images were utilized to create a VR environment using advanced software platforms. The accuracy and fidelity of the VR simulations was validated through a multi-step process. This involved comparing the virtual anatomical models to the original medical imaging data and conducting feedback sessions with pediatric urology experts to assess VR simulations’ realism and clinical relevance. Results: A total of six pediatric patients were reviewed. The median age of the participants was 5.5 years (IQR: 3.5–8.5 years), with an equal distribution of males and females across both groups. A minimally invasive laparoscopic approach was performed for adrenal lesions (n = 3), Wilms’ tumor (n = 1), bilateral nephroblastomatosis (n = 1), and abdominal trauma in complex vascular and renal malformation (ptotic and hypoplastic kidney) (n = 1). Key benefits included enhanced visualization of the segmental arteries and the deep vascularization of the kidney and adrenal glands in all cases. The high depth perception and precision in the orientation of the arteries and veins to the parenchyma changed the intraoperative decision-making process in five patients. Preoperative VR patient-specific simulation did not offer accuracy in studying the pelvic and calyceal anatomy. Conclusions: VR patient-specific simulations represent an empowering tool in pediatric urology. By leveraging the immersive capabilities of VR technology, preoperative planning and intraoperative navigation can greatly impact surgical decision-making. As we continue to advance in medical simulation, VR holds promise in educational programs to include even surgical treatment of more complex urogenital malformations. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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20 pages, 836 KiB  
Article
Clinical Presentation of Peyronie’s Disease: A Retrospective Study of 564 Cases
by Gianni Paulis, Giovanni De Giorgio and Andrea Paulis
Diagnostics 2024, 14(11), 1125; https://doi.org/10.3390/diagnostics14111125 - 29 May 2024
Cited by 3 | Viewed by 1864
Abstract
Peyronie’s disease (PD) affects the penile albuginea, resulting in penile deformity, pain, erectile dysfunction (ED), and an anxious–depressive state. PD diagnosis involves a thorough medical history, penile palpation, documentation of the penile deformation, a dynamic penile echo color Doppler ultrasound (PCDU), and the [...] Read more.
Peyronie’s disease (PD) affects the penile albuginea, resulting in penile deformity, pain, erectile dysfunction (ED), and an anxious–depressive state. PD diagnosis involves a thorough medical history, penile palpation, documentation of the penile deformation, a dynamic penile echo color Doppler ultrasound (PCDU), and the completion of questionnaires for the evaluation of pain, ED, and psychometric tests. The aim of this study was to evaluate the symptoms of PD and their prevalence in PD patients in the active phase who had access to our andrology clinic. Inclusion criteria: availability of data on patients diagnosed with PD, including detailed medical history, blood tests, penile palpation, photographic documentation of penile deformity, and penile PCDU. Exclusion criteria: PD patients in the stable phase or those without the specified tests and data mentioned above. Our study found a higher prevalence of PD in younger patients (24.2%), a higher coexistence of PD with chronic prostatitis (35.6%), a higher percentage of cases of association between penile deformity and penile curvature (84.4%), a higher prevalence of “significant anxiety” (88.4%), a higher presence of plaque calcification (35.6%), and the detection of a longer duration of the first phase of PD (>18 months). The most frequently observed type of penile curvature was dorsal, followed by left lateral, right lateral, and, less commonly, ventral. We observed a significant statistical correlation between patient age and IIEF score, indicating that patients over the age of 40 years are at a higher risk of experiencing ED. We found a strong statistical relationship between VAS score and age. As age increases, the VAS score decreases, suggesting that younger patients reported more penile pain compared to those who were older than 40 years. Furthermore, we found that penile pain has a significant impact on the psychological state of PD patients. We also found that 38.8% of PD patients suffered from severe anxiety. In relation to this, psychotherapy should be integrated into PD treatment to improve the quality of life and treatment adherence. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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10 pages, 865 KiB  
Article
The Diagnostic Value of Soluble Triggering Receptor Expressed on Myeloid Cells for Patients with Acute Stone Pyelonephritis
by Metin Özsoy, Miraç Ataman, Serhat Kazım Şahin, İbrahim Şenocak, Artuner Varlibaş, Ercan Yuvanç, Aydın Çifci, Mustafa Kemal Başaralı, Gül Kırtıl and Erdal Yilmaz
Diagnostics 2024, 14(7), 777; https://doi.org/10.3390/diagnostics14070777 - 7 Apr 2024
Viewed by 1825
Abstract
Soluble triggering receptor expressed on myeloid cells (sTREM-1) is a new biomarker that can be used for the diagnosis and monitoring of urinary system infections. This study aimed to evaluate the diagnostic performance of serum sTREM-1 in patients with a diagnosis of acute [...] Read more.
Soluble triggering receptor expressed on myeloid cells (sTREM-1) is a new biomarker that can be used for the diagnosis and monitoring of urinary system infections. This study aimed to evaluate the diagnostic performance of serum sTREM-1 in patients with a diagnosis of acute stone pyelonephritis (ASP). This prospective study included 46 patients with a diagnosis of ASP and a control group of 23 individuals without urinary system infection. Blood samples were taken from participants upon hospital admission, and basal serum sTREM-1 levels were analyzed using the ELISA method. Serum sTREM-1 concentrations were measured after treatment of ASP patients. Basal leukocyte counts, C-reactive protein (CRP) levels, procalcitonin (PCT), and sTREM-1 (98.6 vs. 68.4 pg/mL, p < 0.001) levels were higher in the ASP group compared to the control group. After treatment, the median leukocyte counts, PCT, and sTREM-1 levels decreased and were similar to those of the control group. The median CRP level also decreased after treatment, but it remained higher than that of the control group. In predicting patients with ASP, the baseline sTREM-1 exhibited a sensitivity of 74.6% and a specificity of 78.2%, while its diagnostic performance was lower than that of leukocyte counts, CRP, and PCT. Despite the findings that levels of sTREM-1 were higher upon hospital admission in patients with ASP and significantly decreased after treatment, the utility of sTREM-1 as a biomarker for predicting patients with ASP remains constrained when compared to established inflammatory markers. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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Review

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24 pages, 1606 KiB  
Review
Scoping Review of Experimental and Clinical Evidence and Its Influence on Development of the Suction Ureteral Access Sheath
by Steffi Kar Kei Yuen, Olivier Traxer, Marcelo Langer Wroclawski, Nariman Gadzhiev, Chu Ann Chai, Ee Jean Lim, Carlo Giulioni, Virgilio De Stefano, Carlotta Nedbal, Martina Maggi, Kemal Sarica, Daniele Castellani, Bhaskar Somani and Vineet Gauhar
Diagnostics 2024, 14(10), 1034; https://doi.org/10.3390/diagnostics14101034 - 16 May 2024
Cited by 23 | Viewed by 3185
Abstract
The ureteral access sheath (UAS) has been a boon and a bane in flexible ureteroscopy (FURS), with its merits and demerits well established. Its design and dimensions were instrumental in reshaping the way flexible scopes were used and were key adjuncts to establishing [...] Read more.
The ureteral access sheath (UAS) has been a boon and a bane in flexible ureteroscopy (FURS), with its merits and demerits well established. Its design and dimensions were instrumental in reshaping the way flexible scopes were used and were key adjuncts to establishing retrograde intrarenal surgery (RIRS) as a standard of care in the endourological management of renal stones. With the ever-changing landscape of RIRS over the decades shaped by technological advancements in lasers and flexible scopes, the UAS has also continuously evolved. The utility of suction in endourology has recently changed the way RIRS is performed and is a game changer for FURS outcomes. With strong clinical and experimental evidence to support its use, the UAS has undergone a transformative change in the recent past, with its ability to monitor intrarenal pressure and provide a superior vacuum-cleaner effect that improves the trifecta of RIRS, namely an improved single-stage stone-free rate (SFR), minimise complications, and reduce reinterventions. Our comprehensive review outlines the key clinical and experimental evidence and traces the developments that were key to modifying the traditional UAS into a flexible and navigable suction ureteric access sheath (FANS) and highlights how the design and modifications, in turn, influence the ability to push the boundaries of RIRS. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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Other

Jump to: Research, Review

14 pages, 2884 KiB  
Case Report
Pleural Metastasis as an Initial Presentation of Prostate Cancer: Case Report and Literature Review
by Katarzyna Skrobisz, Kevin Miszewski, Laura Miszewska, Michał Bieńkowski, Marcin Matuszewski and Michał Studniarek
Diagnostics 2025, 15(6), 666; https://doi.org/10.3390/diagnostics15060666 - 10 Mar 2025
Viewed by 859
Abstract
Background and Clinical Significance: Prostate cancer (PCa) is among the most commonly diagnosed malignancies in men worldwide. While bone and lymph nodes are the most frequent metastatic sites, prostate cancer cells have the potential to spread to virtually any organ, including the [...] Read more.
Background and Clinical Significance: Prostate cancer (PCa) is among the most commonly diagnosed malignancies in men worldwide. While bone and lymph nodes are the most frequent metastatic sites, prostate cancer cells have the potential to spread to virtually any organ, including the pleura, which is an exceedingly rare initial site of presentation that can mimic mesothelioma or primary lung cancer. Case Presentation: We describe a 77-year-old man who presented with exertional dyspnea and intermittent cough, initially suggesting a cardiopulmonary etiology. Imaging revealed multiple pleural nodules and an extensive right-sided pleural effusion. Despite a borderline serum prostate-specific antigen (PSA) level of 2.91 ng/mL, histopathology and immunohistochemistry of pleural biopsies confirmed metastatic prostate adenocarcinoma. Subsequent imaging identified a PIRADS 5 lesion in the prostate, and a biopsy confirmed ISUP Grade Group 5 disease (Gleason score 4 + 5 = 9). A bone scan showed no skeletal metastases, and a contrast-enhanced CT of the abdomen found no additional metastatic lesions. The patient was started on androgen deprivation therapy followed by abiraterone. This case underscores the diagnostic challenge posed by atypical metastatic presentations of prostate cancer. Low or moderately elevated PSA can obscure suspicion of prostate origin, especially with pleural-based lesions suggestive of mesothelioma. Immunohistochemical markers, including androgen receptors, AMACR, and Prostein, are critical for accurate diagnosis. Conclusions: Clinicians must maintain a high index of suspicion for prostate cancer in older men with unexplained pleural effusions, nodules, or masses, even with low-normal PSA levels. Early recognition and prompt treatment can improve outcomes, despite the rarity and aggressiveness of pleural metastases. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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13 pages, 1865 KiB  
Case Report
Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review
by Đorđe Todorovic, Bojan Stojanovic, Milutinovic Filip, Đorđe Đorđevic, Milos Stankovic, Ivan Jovanovic, Marko Spasic, Bojan Milosevic, Aleksandar Cvetkovic, Dragce Radovanovic, Marina Jovanovic, Bojana S. Stojanovic, Damnjan Pantic, Danijela Cvetkovic, Dalibor Jovanovic, Vladan Markovic and Milica Dimitrijevic Stojanovic
Diagnostics 2024, 14(7), 761; https://doi.org/10.3390/diagnostics14070761 - 3 Apr 2024
Viewed by 1830
Abstract
This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented [...] Read more.
This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented with acute abdomen symptoms. Emergency diagnostic procedures identified a significant lesion in the small intestine. Surgical intervention revealed a perforated jejunal segment due to metastatic RCC. Postoperatively, the patient developed complications, including pneumonia and multi-organ failure, leading to death 10 days after surgery. Histopathological analysis confirmed the metastatic nature of the lesion. This case underscores the unpredictable nature of RCC metastasis and highlights the need for vigilance in post-nephrectomy patients. The rarity of small bowel involvement by RCC metastasis, particularly presenting as perforation, makes this case a significant contribution to medical literature, emphasizing the challenges in the diagnosis and management of such atypical presentations. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Urological Diseases)
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