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Comparison of the retroperitoneal (RRPN) perioperative variables and the transperitoneal (TRPN) robot-assisted partial nephrectomy (RPN) using a matched-pair analysis.
A retrospective review was carried out for 224 patients who underwent RPN between 2014 and 2019. A matched-pair analysis was performed on 51 pairs of patients. The matching criteria were age, Charlson comorbidity index, body mass index, the grade of renal insufficiency, tumor diameter, and Preoperative Aspects and Dimensions Used for an Anatomical Classification of Renal Tumors score.
The time to reach the renal hilum (P < .001), the overall complication rate (P ¼ .008), and the major complication rate (P ¼ .01) were lower in the RRPN group. The operative time was 143 vs 150minutes (P ¼ .63) in RRPN vs TRPN, respectively. Warm ischemia time was 10minutes in RRPN vs 12minutes in TRPN (P ¼ .07). Early unclamping was used in 71% in RRPN vs 48% in TRPN (P ¼ .02). The length of hospital stay was 6 days in both groups (P ¼ .11). The cases' complexity, the rate of positive surgical margins, and postoperative kidney function were comparable in both groups (P > .05).
The advantages of RRPN lie in the shorter time to reach the renal hilum and the lower complication rates; the comparability with the other parameters proves the safety and feasibility of the RRPN access for localized kidney tumors.
The advantages of RRPN lie in the shorter time to reach the renal hilum and the lower complication rates; the comparability with the other parameters proves the safety and feasibility of the RRPN access for localized kidney tumors.
To evaluate early clinical and multiparametric prostate magnetic resonance imaging (mpMRI) results of irreversible electroporation (IRE) efficiency in treatment of localized prostate cancer.
For the patients in whom IRE was performed for local ablation, mpMRI was used for the sixth month follow-up. These images were compared with the mpMRI images obtained before the procedure. We performed transperineal fusion biopsy to patients with diagnosis of localized prostate cancer. We treated the eligible ones with IRE. Six of them have completed their 6-month follow-up period. We compared preoperative prostate specific antigen (PSA), international prostate symptom score, international index of erectile function (IIEF), and mpMRI of these patients with those obtained at the sixth month of follow-up. Side effects experienced by the patients were evaluated as well.
We had 10 patients who received IRE treatment. Six patients completed their sixth month-follow-up and came for control visits. At the end of 6 months, the mean decrease in PSA level was 73%. IIEF results were seen not to have changed significantly. On mpMRI, diffusion restriction was seen to have disappeared except for one patient, and Prostate Imaging Reporting Data System scores were decreased.
We concluded that early clinical and mpMRI results for IRE in the focal ablative treatment of localized prostate cancer were gratifying. As an ambulatory procedure with a low incidence of side effects, we look forward to seeing the long-term results of IRE treatment.
We concluded that early clinical and mpMRI results for IRE in the focal ablative treatment of localized prostate cancer were gratifying. As an ambulatory procedure with a low incidence of side effects, we look forward to seeing the long-term results of IRE treatment.
To compare the safety and effectivity of micro percutaneous nephrolithotomy (MicroPNL) in adults and children.
Twenty children and twenty adult patients underwent MicroPNL were evaluated prospective consecutively,between June 2016 and December 2017,who were not suitable for retrograde intrarenal surgery (RIRS).Demographic data,stone free rates,length of hospitalization,duration of the operation,fluoroscopy time,transfusion rates,requirement of double J (D-J) catheter implantation and complications were examined.
Seventeen patients with complete data in each group were evaluated within the scope of the study. Mean age was 40.76±14.96 (18-67) years in adults and 5.38±3.84 (10 months-14 years) years in children.There were no differences found between two groups for the mean operation time, fluoroscopy time,and length of hospitalization.Total success rate was noted 94.11% in each group (p=1).While no complications were seen in adults, three complications developed in the pediatric group (p=0.07). One patient in children group had steinstrasse.In addition,intraperitoneal fluid extravasation occurred in one pediatric patient during the operation.After paracentesis,postoperative period was observed uneventful.Also,one pediatric patient had high fever due to urinary tract infection.While there was no need for perioperative D-J catheter implantation in adults,D-J catheter was implanted in 6 (35.29%) pediatric patients, due to fragmented stone burden (p= 0.007) (Table 1).
According to our results, micaroPNL is safe and effective treatment option in symptomatic renal stones smaller than 2 cm, especially in adults. Unfortunately,it needs more attention due to the risk of complications in pediatric population.
According to our results, micaroPNL is safe and effective treatment option in symptomatic renal stones smaller than 2 cm, especially in adults. Unfortunately,it needs more attention due to the risk of complications in pediatric population.
To analyze the presence of Epstein-Barr-virus (EBV) in sperm samples from patients diagnosed with some impairment of the fertility parameters evaluated using seminogram and to observe if there is any difference with the normozoospermic samples. We hypothesize that an EBV infection is responsible for the upregulation of the miRNA 199-3p, which binds to the 3'UTR of endothelin-1 (ET-1). ET-1 is a key factor to produce Vimentin (Vim3), and therefore, it influences the expression of Vim3. Since Vim3 is predominantly detectable in sperms without any structural defects, the newly identified regulation mechanism can be responsible for the loss of sperm quality.
This study was performed from January 2017 to December 2020 and included 27 patients who provided ejaculated samples obtained by masturbation. Ejaculates were evaluated according to the Word Health Organization's criteria. Posteriorly, the samples were sorted according to the seminogram diagnosis and further analyzed using different enzyme-linked absorbed immune assays to determine the level or concentration of Epstein-Barr nuclear antigen (EBNA), ET-1, and Vim3.
All sperm samples with the impairment of fertility parameters contained the EBNA and presented a downregulation of ET-1 and Vim3. In addition, sperms located in the swim ups are also partially positive for the EBV virus in different clinical aspects.
Based on the regulation mechanism here presented, it seems that the EBV induces changes at the miRNA level, which are responsible for the decreasing of sperm quality.
Based on the regulation mechanism here presented, it seems that the EBV induces changes at the miRNA level, which are responsible for the decreasing of sperm quality.
To compare the outcome of microscopic subinguinal varicocelectomy versus oral antioxidants for the management of male infertility due to isolated teratozoospermia.
Clinical patients' database of a tertiary infertility referral center was retrospectively reviewed to collect data on male infertility due to isolated teratozoospermia from July 2014 to January 2019. Seventy-two patients who underwentmicroscopic subinguinal varicocelectomy for their clinically palpable varicoceles were considered as a study group, while 60 patients who were treated with antioxidants (L-carnitine, vitamin C, and vitamin E) were included as controls. The improvement in the sperm morphology, sperm DNA fragmentation (SDF), and the achievement of natural pregnancy were compared between the two groups.
In the varicocelectomy group, all sperm parameters and SDF statistically improved 6months after the operation (P-value <.001). In the control group, the percentage of sperm morphology and SDF statistically improved 6months after the treatment (P-value <.05). The improvement in sperm parameters, SDF, and the pregnancy rate was statistically higher in the varicocelectomy group compared to the control group. Within the range of follow-up (12-18 months), 30.5% of patients' partners achieved natural pregnancy in the varicocelectomy groups compared to 16.7% in the control group.
We believe that varicocelectomy has a positive effect on the sperm morphology, SDF, and pregnancy rate in male infertility caused by isolated teratozoospermia.
We believe that varicocelectomy has a positive effect on the sperm morphology, SDF, and pregnancy rate in male infertility caused by isolated teratozoospermia.Extracorporeal Shock Wave Lithotripsy (ESWL) is one of the treatment options for patients with renal and ureteral calculi. Even though the procedure is less invasive compared to others, pain caused by the procedure is a major concern. Several studies recommended the use of either local or systemic analgesia with varying results. We aimed to compare the use of local anesthetics and systemic analgesics from randomized controlled trials evaluating pain management during ESWL. A systematic search adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol was performed in theMedline, ScienceDirect, and Cochrane library databases. https://www.selleckchem.com/products/triapine.html The bias was evaluated using the Cochrane risk of bias tool. Mean difference (MD) was used to analyze continuous outcomes. A total of seven studies were obtained. The topical anesthesia used was eutectic mixture of local anesthetic cream and xylocaine gel. In contrast, the local injection anesthesia used was subcutaneous prilocaine and intracutaneous sterile water injection. The systemic analgesics used were intramuscular and oral forms of sodium diclofenac. There is no significant difference between the visual analogue scale results between the local and systemic groups (P> .05). The differences in ESWL frequency were also insignificant (P > .05). Additional analgesics supplementation (MD 8.44, 95% CI 2.28-14.61, P¼ .007) and the duration of the procedure (MD 1.39, 95% CI 0.21-2.56, P¼ .02) were significantly lower in the local group. Local anesthesia in ESWL shows a similar degree of pain and frequency but has a shorter duration and fewer analgesics supplementation than systemic analgesics.Some studies suggest that chemoresection with mitomycin C (MMC) is comparable to transurethral resection of bladder tumor (TURBT) in the management of recurrent nonmuscle-invasive bladder cancer (NMIBC). In this meta-analysis, we compared the efficacy and safety of MMC and TURBT in recurrent NMIBC. A search was conducted for studies published in English in the electronic databases of MEDLINE/PubMed, the Cochrane Library, Scopus, Web of Science, Google Scholar, ProQuest, System for information on Grey Literature, and ClinicalTrials.gov, with no publication date restrictions. Risk of bias was assessed using the Risk of bias 2 tool for randomized controlled trials and Risk of Bias inNon-Randomized Studies of Interventions-I tool for observational studies. Data analysis was performed using the RevMan 5.4 software. Three studies were included in this systematic review(total participants is 291); two studieswere included in themeta-analysis. The rate of complete response was significantly lower in MMC group compared with TURBT (relative risk [RR] 0.
