Urological Science

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ISSN / EISSN : 1879-5226 / 1879-5234
Published by: Medknow (10.4103)
Total articles ≅ 1,345
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ShukhratAnvarovich Abbosov, NikolayIvanovich Sorokin, AzizbekBakhodirovich Shomarufov, AlekseyViktorovich Kadrev, KhusniddinZafariddin Ugli Nuriddinov, ShukhratTursunovich Mukhtarov, FarkhadAtaullaevich Akilov, ArmaisAlbertovich Kamalov
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_127_21

Abstract:
Bladder neck contracture (BNC) is one of the most common complications of surgical treatment of prostate diseases. The rate of postoperative BNC varies depending on the type of surgical treatment used. The options for treatment techniques for BNC can vary from endoscopic interventions to complex (abdominal) surgical interventions. This review evaluates various alternative surgical methods of BNC treatment. The search and analysis of publications in the databases PubMed (MEDLINE), Scopus, Cochrane Library, according to the keywords, “bladder neck sclerosis,” “benign prostatic hyperplasia,” “BNC,” “bladder neck stenosis,” “balloon dilation,” “treatment.” As a result, 71 publications were selected and included in this review. In addition to the standard treatment methods in the form of transurethral resection and incision of the bladder neck using electricity and laser energy, the urologist also has alternative methods of treatment, such as balloon dilation, placement of urethral stents, instillation of the bladder or intraoperative injection of cytostatic drugs, hormones, hyaluronic acid derivatives, and biomedical cell products into the bladder neck area. Although transurethral resection is currently the main treatment option for BNC, the recurrence rate after this procedure can reach up to 38%. According to the literature, balloon dilation can be a promising and minimally invasive method of treatment for recurrent BNC. This method can be used as the first stage in the treatment of recurrent contracture deformity. Furthermore, intravesical instillation of various anti-inflammatory drugs and cytostatics can be promising directions in the treatment and prevention of BNC.
TomF Lue, Bohan Wang, AmandaB Reed-Maldonado, Kim Ly, Guiting Lin
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_56_21

Abstract:
For many years, low-intensity extracorporeal shock-wave therapy (Li-ESWT) has been clinically applied as a noninvasive therapeutic method, for urological diseases. The major corresponding biological molecular mechanisms of Li-ESWT are to induce stem cell differentiation, neural regeneration, and angiogenesis. This narrative review aims to present an overview of the potential utility of Li-ESWT and its effects on stem cell therapies. Recent studies have also shown that the combination treatment of Li-ESWT and stem cell therapies can be a new option for the treatment of erectile dysfunction (ED), urinary incontinence, bladder dysfunction, and other diseases. The potential contributions of Li-ESWT on stem cell therapies for these diseases are studied, highlighting the influence of Li-ESWT on proliferation, viability, and differentiation capacity of certain stem cells. The potential mechanisms, including the increased expression of vascular endothelial growth factor, chemokine CXC motif ligand 5, and transforming growth factor-β1 are described herein. Li-ESWT can also activate many cellular signaling pathways. The combination of Li-ESWT and stem cell therapies is a promising strategy for urological diseases. However, a much greater understanding of the mechanisms by which Li-ESWT enhances the efficacy of stem cell therapy is still needed before this combined treatment can be recommended for large-scale clinical application.
Ta-Min Wang, Pai-Yen Pan, Kuo-Jen Lin, Hsu-Han Wang, Sheng-Hsien Chu, Yang-Jen Chiang, Chih-Te Lin
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_78_21

Abstract:
Purpose: We report the outcomes of transperineal urethroplasty in patients with pelvic fracture urethral distraction defects (PFUDDs) over the past 12 years. Materials and Methods: Patients who received transperineal anastomotic repair of PFUDDs from January 2007 to December 2019 were retrospectively analyzed, specifically focusing on demographic findings, pelvic fracture type, urethral distraction defect length (based on retrograde urethrography and cystography), previous treatments, and ancillary maneuvers during surgery. Simultaneously, differences in clinical factors between successful and failed cases were also analyzed. Results: A total of 36 patients were included, with a final success rate of 83%. The mean age was 40.4 years, whereas the mean urethral distraction defect length was 31.9 mm. Most patients (69%) presented with unstable pelvic fractures. Treatment before referral included endoscopic treatment and urethroplasty in 13 (36%) and 2 cases (6%), respectively. For difficult cases, ancillary procedures, which included corporeal splitting (61.1%) and inferior pubectomy (8.3%), were performed. The postoperative average peak flow rate was 14.9 mL/s in the success group. Age and urethral defect length differed significantly between the success and failure groups. Conclusions: Over the past 12 years, transperineal urethral reconstruction demonstrated a success rate of 83% in 36 patients with PFUDD. Age and urethral defect length were identified as the two main factors affecting surgical prognosis.
P Puvai Murugan, A Bhalaguru Iyyan, Shree Vishnu Siddarth Rajagopal, Sheik Asik Abu Sali
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_85_21

Abstract:
Purpose: To assess the clinical outcomes following dorsal buccal mucosal graft urethroplasty (BMGU) in perimenopausal women (PMW) suffering from urethral stricture disease. Materials and Methods: PMW (40–65 years) presenting with urinary symptoms were evaluated with uroflowmetry, voiding cystourethrogram (VCUG), and urethral calibration. PMW with maximum flow rate (Qmax) less than 10 ml/s or postvoid residual (PVR) volume greater than 50 ml, VCUG showing evidence of urethral stricture, and failure to calibrate with 14 Fr Foley catheter were included in the study. Patients with underactive bladder, carcinoma cervix, pelvic trauma, and oral submucosal fibrosis were excluded from the study. Patients satisfying inclusion and exclusion criteria underwent dorsal BMGU. Outcomes of the surgery were assessed by uroflowmetry at 3-monthly intervals. Results: The number of patients satisfying the inclusion and exclusion criteria between March 2014 and March 2020 was eight. The mean age of the patients was 52.1 years. The mean stricture length was 1.9 cm. The mean preoperative Qmax and PVR were 4.2 ml/s and 110 ml, respectively. The mean postoperative Qmax and PVR at 6 months were 15.4 ml/s and 39.1 ml, respectively. One patient had a recurrent stricture and underwent dilatation. Donor site complications were minor. The overall success rate of the procedure was 87%. Conclusion: Dorsal BMGU in females for urethral stricture disease offers successful urethral reconstruction and the advantage of least disruption of continence mechanism and resilience to hormonal changes in PMW.
Shashikant Asabe, Sunil Mhaske, Vilas Sabale, Vikram Satav, Sonu Sharma, Hareesh Belagalli
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_83_20

Abstract:
Purpose: This study evaluated the effectiveness and safety of transperitoneal laparoscopic ureterolithotomy (TPLU) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the surgical management of ureterolithiasis. Materials and Methods: The current prospective study was conducted at the Department of Urology, Dr. D. Y. Patil Medical College. The complete patient medical history including patient's age, sex, stone (size, number, and laterality), and past history of stone surgeries were evaluated. Based on the treatment method, the patients were divided into TPLU and RPLU group. Both the procedures were evaluated for parameters including operative technique, operating time, hospital stay, intra- and postoperative complications, conversion rate, success rate, and surgical ergonomics. Results: A total of 50 patients were included (TPLU, n = 25; and RPLU, n = 25). The average age was 43.6 years in the TPLU and 46.7 years in the RPLU group. The average size of calculi was >15 mm in both the groups. The operation time and blood loss were relatively higher in the TPLU group than RPLU group. The complete stone clearance was observed in both the groups. The pain in loin area and burning micturition were the most common complaints reported by the patients from both the groups. One patient from RPLU group was converted to open surgery. The calculi size in TPLU group was positively correlated with operative time (r = 0.535, P = 0.006), blood loss (r = 0.440, P = 0.028), and hospital stay (r = 0.430, P = 0.032). Conclusion: TPLU and RPLU are feasible techniques for the management of large ureteric stones that are not amenable to ureteroscopy or extracorporeal shockwave therapy.
Aaron J Huang, John R Heard, Isabelle K Sharma, Fradah E Gold, Omran Gdara, Corey Weinstein, Mahyar Kashani, Andrew G Winer
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_83_21

Abstract:
Purpose: The purpose of this study was to determine the impact of COVID-19 on the urology residency application cycle on social media engagement and account creation by urology residency programs and applicants. Materials and Methods: A list of accredited urology residency programs was taken from the Electronic Residency Application Service, excluding military-sponsored programs. Twitter, Instagram, and Facebook accounts of programs and applicants were then identified through Google and individual platform searches. Results: One hundred and nineteen out of 140 urology programs had Twitter accounts, with 29 created in 2020. Urology program Instagram accounts had the largest growth rate in 2020 of 227.8%. Almost all urology programs that had Instagram or Facebook accounts also had a Twitter account. Urology programs promoted a total of 277 virtual events on Twitter, 83 on Instagram, and 48 on Facebook. Sixteen subinternships were promoted on Twitter, two on Instagram, and two on Facebook. In the 2021 match, 136 of the 237 matched applicants on Twitter made their accounts in the year leading up to the match and 42 of the 162 matched applicants on Twitter created their Twitter accounts during the 2019 cycle. Conclusion: The number of urology programs on Twitter and Instagram increased in 2020 at a faster rate than previous years. Many programs used their accounts to promote virtual events and subinternships. Applicants who matched in 2021 made Twitter accounts during their application year at a higher rate than the previous application cycle. During the COVID-19 pandemic, urology programs and applicants utilized social media, especially Twitter, to engage and learn about each other.
Yao-Chi Chuang
Published: 1 January 2022
Urological Science, Volume 33; https://doi.org/10.4103/uros.uros_36_22

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