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New Advances in Urology and Nephrology Disease: From Diagnosis to...
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New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Urology & Nephrology".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 19367

Special Issue Editors

Dr. Razvan-Ionut Popescu

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Guest Editor
Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 061344 Bucharest, Romania
Interests: kidney stone; prostate cancer; renal cancer; bladder cancer; chronic kidney disease; urinary tract infections; laparoscopy and endourology
Special Issues, Collections and Topics in MDPI journals
Dr. Bogdan Florin Geavlete

E-Mail Website
Guest Editor
Department of Urology, “Saint John” Clinical Emergency Hospital, 077160 Bucharest, Romania
Interests: endourology; lasers; renal cancer; bladder cancer; kidney stones; upper tract urinary tumor
Special Issues, Collections and Topics in MDPI journals
Dr. Daniel George Radavoi

E-Mail Website
Guest Editor
Department of Urology, “Prof. Dr. Theodor Burghele” Clinical Hospital, 050659 Bucharest, Romania
Interests: laparoscopic and robotic surgery; prostate cancer; renal cancer; bladder cancer; kidney stones

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue, entitled “New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment”, to be published in the journal Medicina (ISSN: 1648-9144, IF 2.6).

The modern era has brought about both technological and molecular advancements to the field of medicine. Regarding the diagnosis, treatment, and progression of a variety of diseases, new frontiers and horizons have emerged over time. All of these occurrences have occurred very rapidly, and medical personnel are frequently confronted with the challenge of rapidly acquiring new information for the patient's benefit.

Urology and nephrology are two closely related specialties in which collaboration is frequently the key to effective treatment. In the disciplines of surgery and medicine, the rate of new discoveries is likely at its peak. By enhancing medical equipment robotics, laparoscopy, and endourology, as well as further training personnel, these factors can contribute to improved postoperative outcomes. Increasingly, new imaging technologies shorten the duration of the diagnostic process and enhance patients' prognoses. In the battle against chronic diseases, the emergence of new biomarkers and diagnostic schemes, as well as new treatment modalities, help urological and nephrological patients, improving their chances of recovery or their quality of life.

Modern technologies such as artificial intelligence, human augmentation, and brain science will enable greater advancements and will demonstrate their efficacy in assisting physicians in providing better medical care.

This Special Issue solicits studies that will expand the teaching and clinical application of these recent advances or their results in the fields of urology and nephrology. In addition to research that has steadily improved existing problems, we embrace papers that present new opportunities.

We cordially invite you to submit a paper to this Special Issue, and we would greatly appreciate it if you would recommend it to your colleagues. If you are interested in contributing an article, please let us know as soon as possible.

Please provide a working title and brief abstract in advance so that we can conduct a suitability check. The final submission deadline is 31 August 2024.

Sincerely,
Dr. Razvan-Ionut Popescu
Prof. Dr. Bogdan Florin Geavlete
Dr. Daniel George Radavoi
Guest Editors

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • prostate cancer
  • bladder cancer
  • renal cancer
  • kidney stones
  • urinary tract infections
  • chronic kidney disease
  • dialysis

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Related Special Issue

Published Papers (14 papers)

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10 pages, 664 KiB  
Article
Relation between Urine Cytological Findings and Renal Function in Patients with Kidney Stones in Taif, Saudi Arabia
by Sahar Ali Qahtani, Khadiga A. Ismail, Howaida M. Hagag, Maram Jamel Hulbah, Maha M. Bakhuraysah, Nidaa Mahmoud Johari, Salman Mohammed Alotaibi, Seham Alajmani, Hani Diafallah Alseyali, Manal Ali Ayoub, Khalid Abdullah Althagafi, Ali Awad Alnofaie, Abdulbadea Dawod Abdulaziz, Abdulhadi Samman, Hussain Noorwali, Mohammed S. Abdelwahed and Abdulkarim Hasan
Medicina 2024, 60(10), 1630; https://doi.org/10.3390/medicina60101630 - 5 Oct 2024
Viewed by 433
Abstract
Background and Objectives: Urine serves as a vital diagnostic fluid, and urine cytology analysis plays a crucial role in identifying urinary system illnesses such as bladder cancer and kidney stones. The Paris System for Reporting Urinary Cytology establishes a uniform method for [...] Read more.
Background and Objectives: Urine serves as a vital diagnostic fluid, and urine cytology analysis plays a crucial role in identifying urinary system illnesses such as bladder cancer and kidney stones. The Paris System for Reporting Urinary Cytology establishes a uniform method for diagnosing urinary tract cancer. This study aimed to provide valuable insights that can inform diagnostic strategies related to kidney stones and ultimately improve patient outcomes via the early detection of the cellular changes associated with kidney stones and their relation to kidney function tests. Materials and Methods: A comparative study was conducted and comprised two groups: group 1, consisting of 50 patients diagnosed with kidney stones, and group 2, comprising 50 patients diagnosed with other kidney diseases. Renal function tests and urinalysis (via the PAP staining of urine cellular deposits to detect nuclear changes) were performed, and the results were analyzed. Results: There was a statistically significant increase in urinary red blood cells, white blood cells, and nuclear reactive atypical changes in urinary sediments of kidney stone patients compared to the patients without stones, while there was a decrease in the estimated glomerular filtration rate (eGFR). eGFR showed a 96.7% specificity in detecting cases with nuclear reactive atypia. Conclusions: eGFR emerges as a reliable diagnostic marker for the comprehensive assessment of kidney stones, particularly when associated with nuclear atypia. The significant correlation between the indicators of chronic kidney disease, such as decreased eGFR, and the presence of kidney stones emphasizes the urgent need for efficient diagnostic practices. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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9 pages, 288 KiB  
Article
Predictive Factors of Transient Urinary Incontinence Following Holmium Laser Enucleation of the Prostate (HoLEP): Single-Center Experience
by Roxana Andra Coman, Thomas Bschleipfer, Nadim Al Hajjar and Bogdan Petrut
Medicina 2024, 60(9), 1460; https://doi.org/10.3390/medicina60091460 - 6 Sep 2024
Viewed by 431
Abstract
Background and Objectives: The aim of this study was to assess the predictive factors associated with transient urine incontinence (TUI) following holmium laser enucleation of the prostate (HoLEP). Materials and Methods: A retrospective analysis was conducted on a prospectively maintained database [...] Read more.
Background and Objectives: The aim of this study was to assess the predictive factors associated with transient urine incontinence (TUI) following holmium laser enucleation of the prostate (HoLEP). Materials and Methods: A retrospective analysis was conducted on a prospectively maintained database containing the first 149 consecutive HoLEP cases between June 2022 and December 2023. The study recorded several patient characteristics, and preoperative data such as IPSS score, total gland volume, preoperative catheterization, Qmax, and PVR volume were collected. During the operation, data on total operating time, enucleation time, morcellation time, and weight of enucleated tissue were recorded. Finally, postoperative data were also documented. TUI refers to a patient’s complaint of urine leakage, irrespective of type. Univariate and multivariate logistic regression analyses were performed to determine factors that predict TUI. Results: The study included 119 patients with BPH. Nineteen (15.96%) of them experienced postoperative TUI. Of those 19 patients, 15 (78.94%) recovered within three months from the date of the surgery. In the multivariate regression analysis, increased age (odds ratio [OR], 3.47; 95% confidence interval [CI], 1.56~7.78; p = 0.002), prostate volume ≥ 100 mL (OR 1.86; 95% CI 1.54–2.13; p = 0.001), preoperative PVR volume ≥ 250 mL (OR 1.22; 95% CI 1.10–1.32; p = 0.02), preoperative catheterization (OR, 0.56; 95% CI 0.34–0.78; p = 0.003), increased operation time (OR, 3.87; 95% CI 1.62–4.19; p = 0.002), and resected tissue weight ≥ 40 g (OR, 1.032; 95% CI, 1.015–1.048; p = 0.002) were found to be independent predictors of TUI. Conclusions: The incidence of TUI following HoLEP was found to be 15.96% in patients, with a recovery rate of 78.94% within three months post-surgery. Predictive factors for TUI included age at surgery, prostatic volume, preoperative catheterization, high PVR, longer operative time, and resected tissue weight. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
10 pages, 499 KiB  
Article
The Effect of Anesthesia Type on the Stability of the Surgical View on the Monitor in Retrograde Intrarenal Surgery for Renal Stone: A Prospective Observational Trial
by Dongwook Won, Sung Yong Cho, Hyun-Joung No, Jiwon Lee, Jin-Young Hwang, Tae Kyong Kim, Jee-Eun Chang, Hyerim Kim, Jae-Hyun Choi and Jung-Man Lee
Medicina 2024, 60(9), 1435; https://doi.org/10.3390/medicina60091435 - 2 Sep 2024
Viewed by 706
Abstract
Background and Objectives: Retrograde intrarenal surgery (RIRS) is a minimally invasive technique for nephrolithiasis. RIRS is performed via a monitor screen displaying a magnified surgical site. Respiration can affect the stability of the surgical view during RIRS because the kidneys are close [...] Read more.
Background and Objectives: Retrograde intrarenal surgery (RIRS) is a minimally invasive technique for nephrolithiasis. RIRS is performed via a monitor screen displaying a magnified surgical site. Respiration can affect the stability of the surgical view during RIRS because the kidneys are close to the diaphragm. The purpose of this trial is to compare the effect of anesthesia type on the stability of the surgical view during RIRS between spinal anesthesia and general anesthesia. Materials and Methods: Patients were allocated to the general anesthesia group or spinal anesthesia group. During surgery, movement of the surgical field displayed on the monitor screen was graded by the first assistant on a 10-grade numeric rating scale (0–10). Next, it was also graded by the main surgeon. After surgery, we evaluated the discomfort with the anesthesia method for all patients. Results: Thirty-four patients were allocated to the general anesthesia group and 32 patients to the spinal anesthesia group. The average values of the two surgeons for surgical field oscillation grade showed vision on the monitor screen was more stable in the general anesthesia group than the spinal anesthesia group (3.3 ± 1.6 vs. 5.0 ± 1.6, p < 0.001). The degrees of the inconvenience of the surgery did not differ between the groups (0.7 ± 1.8 vs. 1.6 ± 2.6, p = 0.114), even though more patients reported inconvenience with a grade of 3 or more in the spinal anesthesia group (8.8% vs. 28.1%, p = 0.042). Conclusions: In terms of the visualization of the surgical site, general anesthesia might provide a more stable surgical view during RIRS compared to spinal anesthesia without increasing inconvenience induced by the type of anesthesia. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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10 pages, 572 KiB  
Article
A Comparison of the First 60 Enucleation Cases Using a Thulium Fiber Laser without a Mentor to a Transurethral Resection of the Prostate (TURP) and Open Prostatectomy, and the Learning Curve
by Ender Cem Bulut, Burak Elmas, Murat Yavuz Koparal, Çağrı Coşkun, Uğur Aydın, Kadir Şerefhan Erten, Serhat Çetin, Sabuhi Alishov, Ali Atan, Süleyman Yeşil and Bora Küpeli
Medicina 2024, 60(8), 1356; https://doi.org/10.3390/medicina60081356 - 20 Aug 2024
Viewed by 740
Abstract
Background and Objectives: In the surgical treatment of benign prostatic hyperplasia (BPH), laser enucleation of the prostate is recommended as an alternative to transurethral resection (TURP) and open prostatectomy (OP). The thulium fiber laser, with its superficial penetration depth, can offer a [...] Read more.
Background and Objectives: In the surgical treatment of benign prostatic hyperplasia (BPH), laser enucleation of the prostate is recommended as an alternative to transurethral resection (TURP) and open prostatectomy (OP). The thulium fiber laser, with its superficial penetration depth, can offer a rapid learning process by causing less heat injury and capsule damage. This study compares the first 60 cases of an endourologist performing thulium fiber enucleation of the prostate (ThuFLEP) without a mentor to the results of OP and TURP performed by experienced surgeons. It also identifies the case number at which the operation time for ThuFLEP starts to plateau. Materials and Methods: Between 1 November 2021 and 1 November 2023, the initial 60 ThuFLEP cases of an endourologist with no prior enucleation experience were compared with TURP and OP operations performed by experienced surgeons. Since the first 60 ThuFLEP cases involved 80–120 cc prostates, TURP and OP operations within this size range performed during the same period were included in the study. The groups were assessed for age, preoperative and postoperative prostate volume, PSA levels, the IPSS, the IPSS Quality of Life (QoL), and maximum urinary flow (Qmax). The 60 consecutive ThuFLEP cases were divided into three groups of 20 (Groups 1, 2, and 3) and compared for operation time, IPSS, and Qmax. Results: The operation time for TURP was shorter than for ThuFLEP and OP (p < 0.001). There was no significant difference between ThuFLEP and OP in postoperative Qmax and IPSS, while TURP had lower values than the other two methods. For ThuFLEP, the operation time was longer in the first 20 cases but plateaued in groups 2 and 3 (p < 0.001). Postoperative Qmax and IPSS values showed no significant differences among the three ThuFLEP groups (p > 0.05). Conclusions: For large prostates, ThuFLEP provides better postoperative results than TURP and offers shorter catheterization and hospital stay times than OP. Its short learning curve makes it a preferable method for treating BPH compared to other laser techniques. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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8 pages, 473 KiB  
Article
Which Position for Novice Surgeons? Effect of Supine and Prone Positions on Percutaneous Nephrolithotomy Learning Curve
by Ender Cem Bulut, Uğur Aydın, Çağrı Coşkun, Serhat Çetin, Ali Ünsal, Fazlı Polat and Bora Küpeli
Medicina 2024, 60(8), 1292; https://doi.org/10.3390/medicina60081292 - 10 Aug 2024
Viewed by 722
Abstract
Background and Objectives: Percutaneous nephrolithotomy (PCNL) is a current treatment method with high success rates and low complication rates in treating large kidney stones. It can be conducted in different positions, especially supine and prone positions. PCNL in the supine position is [...] Read more.
Background and Objectives: Percutaneous nephrolithotomy (PCNL) is a current treatment method with high success rates and low complication rates in treating large kidney stones. It can be conducted in different positions, especially supine and prone positions. PCNL in the supine position is becoming increasingly common due to its advantages, such as simultaneous retrograde intervention and better anesthesia management. This study aimed to assess how the choice of position impacts the PCNL learning curve. Materials and Methods: The results of the first 50 consecutive PCNL cases performed by two separate chief residents as primary surgeons in supine and prone positions in a reference center for stone treatment between August 2021 and January 2023 were evaluated. The two groups’ demographic and clinical data, stone-free rates, operation times, and fluoroscopy times were compared. Results: While the mean operation time was 94.6 ± 9.8 min in the supine PCNL group, it was 129.9 ± 20.3 min in the prone PCNL group (p < 0.001). Median fluoroscopy times in the supine PCNL and prone PCNL groups were 31 (10–89) seconds and 48 (23–156) seconds, respectively (p = 0.001). During the operation, the plateau was reached after the 10th case in the supine PCNL group, while it was reached after the 40th case in the prone PCNL group. Conclusions: For surgeons who are novices in performing PCNL, supine PCNL may offer both better results and a faster learning curve. Prospective and randomized studies can provide more robust conclusions on this subject. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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12 pages, 659 KiB  
Article
Prognostic Value of Inflammation Scores and Hematological Indices in IgA and Membranous Nephropathies: An Exploratory Study
by Nicolae Pană, Gabriel Ștefan, Tudor Popa, Otilia Ciurea, Simona Hildegard Stancu and Cristina Căpușă
Medicina 2024, 60(8), 1191; https://doi.org/10.3390/medicina60081191 - 23 Jul 2024
Viewed by 914
Abstract
Background and Objectives: Systemic-inflammation-based prognostic scores and hematological indices have shown value in predicting outcomes in various clinical settings. However, their effectiveness in predicting outcomes specifically for IgA nephropathy (IgAN) and membranous nephropathy (MN), the most common primary glomerular diseases diagnosed by kidney [...] Read more.
Background and Objectives: Systemic-inflammation-based prognostic scores and hematological indices have shown value in predicting outcomes in various clinical settings. However, their effectiveness in predicting outcomes specifically for IgA nephropathy (IgAN) and membranous nephropathy (MN), the most common primary glomerular diseases diagnosed by kidney biopsy, has not been thoroughly investigated. Materials and Methods: We conducted a retrospective, observational study involving 334 adult patients with biopsy-proven IgAN (196 patients) and MN (138 patients) from January 2008 to December 2017 at a tertiary center. We assessed six prognostic scores [Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-C-reactive protein ratio (LCRP)] and two hematological indices [red blood cell distribution width (RDW), platelet distribution width (PDW)] at diagnosis and examined their relationship with kidney and patient survival. Results: End-stage kidney disease (ESKD) occurred more frequently in the IgAN group compared to the MN group (37% vs. 12%, p = 0.001). The mean kidney survival time was 10.7 years in the IgAN cohort and 13.8 years in the MN cohort. After adjusting for eGFR and proteinuria, lower NLR and higher LCRP were significant risk factors for ESKD in IgAN. In the MN cohort, no systemic-inflammation-based scores or hematological indices were associated with kidney survival. There were 38 deaths (19%) in the IgAN group and 29 deaths (21%) in the MN group, showing no significant difference in mortality rates. The mean survival time was 13.4 years for the IgAN group and 12.7 years for the MN group. In the IgAN group, a lower PLR was associated with a higher mortality after adjusting for age, the Charlson comorbidity score, eGFR, and proteinuria. In patients with MN, higher NLR, PLR, and RDW were associated with increased mortality. Conclusions: NLR and LCRP are significant predictors of ESKD in IgAN, while PLR is linked to increased mortality. In MN, NLR, PLR, and RDW are predictors of mortality but not kidney survival. These findings underscore the need for disease-specific biomarkers and indicate that systemic inflammatory responses play varying roles in the progression and outcomes of these glomerular diseases. Future studies on larger cohorts are necessary to validate these markers. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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7 pages, 715 KiB  
Article
Robot-Assisted Radical Prostatectomy (RARP) Trifecta Learning Curve for Surgeons with Previous Experience in Laparoscopy
by Altez-Fernandez Carlos, Vazquez-Martul Dario, Răzvan-Ionut Popescu, Corrales Mariela and Chantada-Abal Venancio
Medicina 2024, 60(7), 1032; https://doi.org/10.3390/medicina60071032 - 24 Jun 2024
Viewed by 795
Abstract
Background and Objectives: Robot-assisted radical prostatectomy (RARP) is a complex surgery with a steep learning curve (LC). No clear evidence exists for how previous laparoscopic experience affects the RARP LC. We report the LC of three surgeons with vast experience in laparoscopy (more [...] Read more.
Background and Objectives: Robot-assisted radical prostatectomy (RARP) is a complex surgery with a steep learning curve (LC). No clear evidence exists for how previous laparoscopic experience affects the RARP LC. We report the LC of three surgeons with vast experience in laparoscopy (more than 400 procedures), analyzing the results of functional and oncological outcomes under the “Trifecta” concept (defined as the achievement of continence, potency, and oncological control free of biochemical recurrence). Materials and Methods: The surgical experience of the three surgeons from September 2021 to December 2022, involving 146 RARP consecutive patients in a single institution center, was evaluated prospectively. Erectile disfunction patients were excluded. ANOVA and chi-square test were used to compare the distribution of variables between the three surgeons. LC analysis was performed using the cumulative sum control chart (CUSUM) technique to achieve trifecta. Results: The median age was 65.42 (±7.34); the clinical stage were T1c (68%) and T2a (32%); the biopsy grades were ISUP 1 (15.9%), ISUP 2 (47.98), and ≥ISUP 3 (35%). The median surgical time was 132.8 (±32.8), and the mean intraoperative bleeding was 186 cc (±115). Complications included the following: Clavien–Dindo I 8/146 (5.47%); II 9/146 (6.16%); and III 3/146 (2.05%). Positive margins were reported in 44/146 (30.13%). The PSA of 145/146 patients (99%) at 6 months was below 0.08. Early continence was achieved in 101/146 (69.17%), 6-month continence 126/146 (86%), early potency 51/146 (34.9%), and 6-month potency 65/146 (44%). Surgeons “a”, “b”, and “c” performed 50, 47, and 49 cases, respectively. After CUSUM analysis, the “Trifecta” LC peak was achieved at case 19 in surgeon “a”, 21 in surgeon “b”, and 20 in surgeon “c”. Conclusions: RARP LC to accomplish “Trifecta” can be significantly reduced in surgeons with previous experience in laparoscopy and be achieved at around 20 cases. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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11 pages, 7214 KiB  
Article
Selenoprotein-P1 (SEPP1) Expression in Human Proximal Tubule Cells after Ischemia-Reperfusion Injury: An In Vitro Model
by Giuseppe Coppolino, Marilena Celano, Michela Musolino, Mario D’Agostino, Mariateresa Zicarelli, Michele Andreucci, Carmen De Caro, Diego Russo, Emilio Russo and Davide Bolignano
Medicina 2024, 60(6), 875; https://doi.org/10.3390/medicina60060875 - 27 May 2024
Viewed by 1213
Abstract
Background and Objectives: Selenium deficiency represents a risk factor for the occurrence of severe diseases, such as acute kidney injury (AKI). Recently, selenoprotein-p1 (SEPP1), a selenium transporter, mainly released by the liver, has emerged as a promising plasmatic biomarker of AKI as [...] Read more.
Background and Objectives: Selenium deficiency represents a risk factor for the occurrence of severe diseases, such as acute kidney injury (AKI). Recently, selenoprotein-p1 (SEPP1), a selenium transporter, mainly released by the liver, has emerged as a promising plasmatic biomarker of AKI as a consequence of cardio-surgery operations. The aim of the present study was to investigate, on an in vitro model of hypoxia induced in renal tubular cells, HK-2, the effects of sodium selenite (Na2SeO3) and to evaluate the expression of SEPP1 as a marker of injury. Materials and Methods: HK-2 cells were pre-incubated with 100 nM Na2SeO3 for 24 h, and then, treated for 24 h with CoCl2 (500 µM), a chemical hypoxia inducer. The results were derived from an ROS assay, MTT, and Western blot analysis. Results: The pre-treatment determined an increase in cells’ viability and a reduction in reactive oxygen species (ROS), as shown by MTT and the ROS assay. Moreover, by Western blot an increase in SEPP1 expression was observed after hypoxic injury as after adding sodium selenite. Conclusions: Our preliminary results shed light on the possible role of selenium supplementation as a means to prevent oxidative damage and to increase SEPP1 after acute kidney injury. In our in vitro model, SEPP1 emerges as a promising biomarker of kidney injury, although further studies in vivo are necessary to validate our findings. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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11 pages, 2670 KiB  
Article
Deciphering the Role of ERBB3 Isoforms in Renal Cell Carcinoma: A Comprehensive Genomic and Transcriptomic Analysis
by Mingyu Kim, Hyung Ho Lee, So Dam Won, YeonSue Jang, Baek Gil Kim, Nam Hoon Cho, Young Deuk Choi, Jin Soo Chung and Hyun Ho Han
Medicina 2024, 60(1), 181; https://doi.org/10.3390/medicina60010181 - 20 Jan 2024
Viewed by 1636
Abstract
ERBB3, a key member of the receptor tyrosine kinase family, is implicated in the progression and development of various human cancers, affecting cellular proliferation and survival. This study investigated the expression of ERBB3 isoforms in renal clear cell carcinoma (RCC), utilizing data from [...] Read more.
ERBB3, a key member of the receptor tyrosine kinase family, is implicated in the progression and development of various human cancers, affecting cellular proliferation and survival. This study investigated the expression of ERBB3 isoforms in renal clear cell carcinoma (RCC), utilizing data from 538 patients from The Cancer Genome Atlas (TCGA) Firehose Legacy dataset. Employing the SUPPA2 tool, the activity of 10 ERBB3 isoforms was examined, revealing distinct expression patterns in RCC. Isoforms uc001sjg.3 and uc001sjh.3 were found to have reduced activity in tumor tissues, while uc010sqb.2 and uc001sjl.3 demonstrated increased activity. These variations in isoform expression correlate with patient survival and tumor aggressiveness, indicating their complex role in RCC. The study, further, utilizes CIBERSORTx to analyze the association between ERBB3 isoforms and immune cell profiles in the tumor microenvironment. Concurrently, Gene Set Enrichment Analysis (GSEA) was applied, establishing a strong link between elevated levels of ERBB3 isoforms and critical oncogenic pathways, including DNA repair and androgen response. RT-PCR analysis targeting the exon 21–23 and exon 23 regions of ERBB3 confirmed its heightened expression in tumor tissues, underscoring the significance of alternative splicing and exon utilization in cancer development. These findings elucidate the diverse impacts of ERBB3 isoforms on RCC, suggesting their potential as diagnostic markers and therapeutic targets. This study emphasizes the need for further exploration into the specific roles of these isoforms, which could inform more personalized and effective treatment modalities for renal clear cell carcinoma. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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13 pages, 596 KiB  
Article
Prevention of Postoperative Urethral Strictures by Irrigation with 5-Fluorouracil via a Modified Urinary Catheter
by Yerbol Kairambayev, Tolkyn Bulegenov, Nazarbek Omarov, Muratkan Kuderbayev, Marat Syzdykbayev, Natalya Glushkova, Dinara Akhmetzhanova, Alida Kaskabayeva, Zhanna Muzdubayeva, Kuat Akimzhanov and Lyudmila Pivina
Medicina 2024, 60(1), 102; https://doi.org/10.3390/medicina60010102 - 5 Jan 2024
Viewed by 1579
Abstract
Background and Objectives: Urethral strictures are the most common complications after surgical treatments of benign prostatic hyperplasia (BPH). Despite various preventive measures, the search for medications with antiproliferative activity and the development of surgical procedures to prevent the development of urethral strictures are [...] Read more.
Background and Objectives: Urethral strictures are the most common complications after surgical treatments of benign prostatic hyperplasia (BPH). Despite various preventive measures, the search for medications with antiproliferative activity and the development of surgical procedures to prevent the development of urethral strictures are still relevant. We evaluated the preventive efficacy of 5-fluorouracil against urethral strictures in patients undergoing surgery for BPH. Materials and Methods: A non-randomized clinical trial including 246 male patients with an average age of 70.0 ± 8.0 years was conducted. The main study group included 124 patients who, in addition to the standard treatment, received lavage with a 5-fluorouracil solution (1000 mg/20 mL per 500 mL of 0.9% isotonic saline) using a modified three-way urethral catheter. The monitoring of clinical, laboratory, and instrumental parameters was carried out 10 days, 3 months, and 6 months after surgery. Results: The evaluation of severity for dysuria symptoms in patients using the IPSS scale throughout the entire follow-up period showed a statistically significant decrease in ischuria and stranguria, prolongation of the interval between urinations, a decrease in intermittent urination, urinary incontinence, and straining before urination in the main group in comparison with the control patients. The patients of both study groups noted an improvement in the quality of life. It was found statistically significant decrease in the maximum urinary flow rate in the main group (p < 0.001). In the control group, after three months, four cases of urethral strictures and stenosis were recorded; after six months, this rate reached nine cases (7.3%), while in the main group, only one patient with infravesical obstruction was found (0.8%) (χ2 = 3.855, p < 0.05). Conclusions: The results of our study could indicate the effectiveness of the antiproliferative drug 5-fluorouracil in combination with use of a modified catheter in relation to the development of postoperative urethral strictures. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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12 pages, 336 KiB  
Article
Management of Pediatric Urolithiasis in an Italian Tertiary Referral Center: A Retrospective Analysis
by Francesco Lasorsa, Claudia Caliolo, Antonia Silecchia, Nicola Laricchiuta, Michele Raguso, Pasquale Ditonno and Giuseppe Lucarelli
Medicina 2023, 59(12), 2165; https://doi.org/10.3390/medicina59122165 - 14 Dec 2023
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Abstract
Background and Objectives: In recent years, the prevalence of pediatric urolithiasis has increased in North America and Western countries, though it is endemic in developing countries. The aim of this study is to describe the experience of a tertiary pediatric referral center [...] Read more.
Background and Objectives: In recent years, the prevalence of pediatric urolithiasis has increased in North America and Western countries, though it is endemic in developing countries. The aim of this study is to describe the experience of a tertiary pediatric referral center in the surgical management of pediatric urolithiasis. Materials and Methods: We retrospectively reviewed the experience of patients ≤ 16 years old affected by urinary stones who underwent surgery. Results: From April 2021 to September 2023, 31 pediatric patients underwent surgical procedures for stone diseases at our department: 13 preschool-aged (1–5 years) and 18 school-aged (6–16 years) children. During this period, 12 URSs, 17 RIRSs, and 2 PCNLs were recorded. Five patients had residual fragments at first, so three of them underwent a second endourological lithotripsy (2 RIRSs and 1 URS). Complete clearance was finally achieved in 27 patients. The stone composition was evaluated in 25 cases. Conclusions: Numerous innovations in the surgical treatment of pediatric urolithiasis have resulted from the development of smaller devices and new technology. Our results show how, in experienced centers, retrograde and percutaneous lithotripsy are safe and effective procedures for use in pediatric populations. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
11 pages, 495 KiB  
Article
Assessment of Health-Related Quality of Life in Chronic Kidney Disease Patients: A Hospital-Based Cross-Sectional Study
by Shivam Sharma, Darpan Kalra, Ishfaq Rashid, Sudhir Mehta, Manish Kumar Maity, Khushi Wazir, Sumeet Gupta, Siddique Akber Ansari, Obaid S. Alruqi, Roohi Khan, Imran Khan and Sirajudheen Anwar
Medicina 2023, 59(10), 1788; https://doi.org/10.3390/medicina59101788 - 8 Oct 2023
Cited by 1 | Viewed by 3378
Abstract
Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt [...] Read more.
Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. Materials and Methods: This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis was utilized to identify the potential QoL determinants. A p value of 0.05 or lower was used to determine statistical significance. Results: Among a total of 105 participants, the mean (±standard deviation) age was found to be 54.53 ± 13.47 years; 48 were male patients, and 57 were female patients. Diabetes Mellitus (61.9%), hypertension (56.2%), chronic glomerulonephritis (7.6%), chronic pyelonephritis (6.7%), and polycystic kidney disease (5.7%) were identified to be the most frequent disorders associated with CKD. The current study also demonstrated that the HRQoL score domains such as symptom problem list, the effect of kidney disease, and the burden of kidney disease decline significantly and progressively as the patient advances into higher stages of CKD (p = 0.005). A similar pattern was observed in work status, sleep, and general health (p < 0.005). Additionally, a statistically significant difference was noted for cognitive function, quality of social interaction, overall health, dialysis staff encouragement, patient satisfaction, social support, physical functioning, role of physical health, pain, emotional well-being, role of emotional health, social functioning, and energy fatigue (p < 0.005). The mean difference for PCS and MCS based on CKD stages was found to be statistically significant (p < 0.005). The PCS and MCS showed a positive correlation with GFR (r = 0.521), and Hb (r = 0.378), GFR (r = 0.836), and Hb (r = 0.488), respectively. Conclusions: The findings of this study demonstrated that a significant decrease in HRQoL was observed among CKD patients, with a progressive deterioration of HRQoL dimensions as the patient advances to end-stage renal disease. This study also revealed that CKD imposes various restrictions on patients’ day-to-day lives, particularly in terms of their physical and mental functioning, even in the initial stages of the disease. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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17 pages, 5386 KiB  
Review
Sacral Neuromodulation: Device Improvement and Current Applications in Urology
by Marco Spilotros, Salvatore Gerbasi, Francesco Lasorsa, Gaetano de Rienzo, Lorenzo Balducci, Pasquale Ditonno and Giuseppe Lucarelli
Medicina 2024, 60(3), 509; https://doi.org/10.3390/medicina60030509 - 20 Mar 2024
Viewed by 2296
Abstract
Sacral neuromodulation (SNM) offers a therapeutic approach to urological patients suffering from idiopathic overactive bladder (OAB) syndrome, with or without incontinence and non-obstructive urinary retention (NOR), who are not responding to or are not compliant with conservative or medical therapies. The exact mechanism [...] Read more.
Sacral neuromodulation (SNM) offers a therapeutic approach to urological patients suffering from idiopathic overactive bladder (OAB) syndrome, with or without incontinence and non-obstructive urinary retention (NOR), who are not responding to or are not compliant with conservative or medical therapies. The exact mechanism of action of SNM is not fully understood but modulation of the spinal cord reflexes and brain networks by peripheral afferents is regarded as the main pathway. Over the years, surgical techniques improved, leading to the development of the modern two-stage implantation technique. The quadripolar lead is positioned percutaneously under fluoroscopy guidance through the third sacral foramen following the trajectory of S3. The procedure can be performed under local or general anesthesia with the patient in prone position. Current applications of sacral neuromodulation in urology are increasing thanks to the recent improvements of the devices that make this a valuable option not only in conditions such as overactive bladder and non-obstructing urinary retention but also neurogenic lower urinary tract dysfunction. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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16 pages, 2979 KiB  
Systematic Review
Poly (ADP-ribose) Polymerase Inhibitors in Patients with Metastatic Castration-Resistant Prostate Cancer: A Meta-Analysis of Randomized Controlled Trials
by Zheng Chao, Zefeng Wang, Le Li, Yi Jiang, Yunxing Tang, Yanan Wang, Xiaodong Hao, Chunyu Zhang, Xiangdong Guo, Weimin Yu, Fan Cheng and Zhihua Wang
Medicina 2023, 59(12), 2198; https://doi.org/10.3390/medicina59122198 - 18 Dec 2023
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Abstract
Context: Several recent randomized controlled trials (RCTs) have reported on the survival benefits of poly (ADP-ribose) polymerase inhibitors (PARPi) compared to standard-of-care (SOC) treatment (enzalutamide, abiraterone, or docetaxel) in patients with metastatic castration-resistant prostate cancer (mCRPC). However, there is a limited integrated [...] Read more.
Context: Several recent randomized controlled trials (RCTs) have reported on the survival benefits of poly (ADP-ribose) polymerase inhibitors (PARPi) compared to standard-of-care (SOC) treatment (enzalutamide, abiraterone, or docetaxel) in patients with metastatic castration-resistant prostate cancer (mCRPC). However, there is a limited integrated analysis of high-quality evidence comparing the efficacy and safety of PARPi and SOC treatments in this context. Objective: This study aims to comprehensively analyze the survival benefits and adverse events associated with PARPi and SOC treatments through a head-to-head meta-analysis in mCRPC. Evidence acquisition: A systematic review search was conducted in PubMed, Embase, Clinical trials, and the Central Cochrane Registry in July 2023. RCTs were assessed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The systematic review was prospectively registered on PROSPERO (CRD42023441034). Evidence synthesis: A total of 8 studies, encompassing 2341 cases in the PARPi treatment arm and 1810 cases in the controlled arm, were included in the qualitative synthesis. The hazard ratio (HR) for radiographic progression-free survival (rPFS) and overall survival (OS) were 0.74 (95% CI, 0.61–0.90) and 0.89 (95% CI, 0.80–0.99), respectively, in the intention-to-treatment patients. For subgroup analysis, HRs for rPFS and OS in the BRCA-mutated subgroup were 0.39 (95% CI, 0.28–0.55) and 0.62 (95% CI, 0.38–0.99), while in the HRR-mutated subgroup, HR for rPFS was 0.57 (95% CI, 0.48–0.69) and for OS was 0.77 (95% CI, 0.64–0.93). The odds ratio (OR) for all grades of adverse events (AEs) and AEs with severity of at least grade 3 were 3.86 (95% CI, 2.53–5.90) and 2.30 (95% CI, 1.63–3.26), respectively. Conclusions: PARP inhibitors demonstrate greater effectiveness than SOC treatments in HRR/BRCA-positive patients with mCRPC. Further research is required to explore ways to reduce adverse event rates and investigate the efficacy of HRR/BRCA-negative patients. Full article
(This article belongs to the Special Issue New Advances in Urology and Nephrology Disease: From Diagnosis to Treatment)
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