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Objectives: We aimed to modify the Briganti 2019 nomogram and to test whether it is valid for patients who were diagnosed with prostate cancer through in‐bore prostate biopsies. Methods: Data for 204 patients with positive multiparametric prostate MRI and prostate cancer identified either by mpMRI‐cognitive/software fusion or in‐bore biopsy and who underwent robot‐assisted radical prostatectomy and extended pelvic lymph node dissection between 2012 and 2023 were retrospectively analyzed. The Briganti 2019 nomogram was applied to the mpMRI‐cognitive/software fusion biopsy group (142 patients) in the original form, and then, two modifications were tested for the targeted component. Original and modified scores were compared. These modifications were adapted for the in‐bore biopsy group (62 patients). The final histopathologic stage was regarded as the gold standard. Results: Nodal metastases were identified in 18/142 (12.6%) of mpMRI‐cognitive/software fusion biopsy patients and 8/62 (12.9%) of the in‐bore biopsy patients. In the mpMRI‐cognitive/software fusion biopsy group, tumor size/core size (%) of targeted biopsy cores and positive core percentage on systematic biopsy were significant parameters for lymph node metastasis based on univariate logistic regression analyses (p < 0.05). With the modifications of these parameters for the in‐bore biopsy group, V1 modification of the Briganti 2019 nomogram provided 100% sensitivity and 31.5% specificity (AUC:0.627), while V2 modification provided 75% sensitivity and 46.3% specificity (AUC:0.645). Conclusions: Briganti 2019 nomogram may be modified by utilizing tumor size/core size (%) for targeted biopsy cores instead of positive core percentage on systematic biopsy or by not taking both parameters into consideration to detect node metastasis risk of patients diagnosed with in‐bore biopsies. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the impact of neoadjuvant chemotherapy on survival and recurrence patterns in muscle‐invasive bladder cancer after robot‐assisted radical cystectomy. Materials and methods: The International Robotic Cystectomy Consortium database was reviewed to identify patients who underwent robot‐assisted radical cystectomy for muscle‐invasive bladder cancer between 2002 and 2019. Survival outcomes, response rates, and recurrence patterns were compared between patients who received neoadjuvant chemotherapy and those who did not. Survival distributions were estimated using Kaplan–Meier analyses and compared using the log‐rank test. Results: A total of 1370 patients with muscle‐invasive bladder cancer were identified, of whom 353 (26%) received neoadjuvant chemotherapy. After a median follow‐up of 27 months, neoadjuvant chemotherapy recipients had higher 3‐year overall survival (74% vs 57%; log‐rank P < 0.01), 3‐year cancer‐specific survival (83% vs 73%; log‐rank P = 0.03), and 3‐year relapse‐free survival (64% vs 48%; log‐rank P < 0.01). Neoadjuvant chemotherapy was a predictor of higher overall survival, cancer‐specific survival, and relapse‐free survival in univariate but not multivariate analysis. Pathological downstaging (46% vs 23%; P < 0.01), complete responses (24% vs 8%; P < 0.01), and margin negativity (95% vs 91%; P < 0.01) at robot‐assisted radical cystectomy were more common in the neoadjuvant chemotherapy group. Neoadjuvant chemotherapy recipients had lower distant (15% vs 22%; P < 0.01) but similar locoregional (12% vs 13%; P = 0.93) recurrence rates. Conclusions: In this analysis from a large international database, patients with muscle‐invasive bladder cancer who received neoadjuvant chemotherapy before robot‐assisted radical cystectomy had higher rates of survival, pathological downstaging, and margin‐negative resections. They also experienced fewer distant recurrences. [ABSTRACT FROM AUTHOR]

Introduction: We sought to describe the incidence, risk factors, and survival outcomes associated with pathologic upstaging from non-muscle invasive bladder cancer (NMIBC) to muscle invasive bladder cancer (MIBC) after robot-assisted radical cystectomy (RARC). Methods: We reviewed the International Robotic Cystectomy Consortium database between 2004 and 2020. Upstaging was defined as ≥pT2 or pathologic node positive (pN+) at final pathology analysis from clinical 2N0M0. Descriptive statistics were used to summarize data. Cochran–Armitage test was used to depict upstaging trend over time. Multivariate regression models were used to depict variables associated with upstaging. Kaplan–Meier curves were used to describe disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS). Results: A total of 463 patients underwent RARC for NMIBC. Upstaging occurred in 145 (31%) patients. Upstaged patients were older (70 vs 67 years, p < 0.01), more likely to have American Society of Anesthesiologists (ASA) score (≥3; 55% vs 44%, p = 0.04), and had higher rate of preoperative hydronephrosis (26% vs 10%, p < 0.01). They were more likely to have positive surgical margins (10% vs 3%, p = 0.01), recurrences (28% vs 9%, p < 0.01), and to receive adjuvant/salvage treatment (26% vs 3%, p < 0.01). On multivariate analysis, upstaging was associated with older age (odds ratio [OR] 1.04; confidence interval [CI] 1.01–1.07, p < 0.01), cT1vs cTis (OR 4.25; CI 1.57–11.48, p < 0.01), cT1vs cTa (OR 2.92; CI 1.40–6.06, p < 0.01), and preoperative hydronephrosis (OR 3.18; CI 1.60–6.32, p < 0.01). Upstaged patients had worse 5-year RFS (53% vs 85%, log rank p < 0.01), DSS (66% vs 93%, log rank p < 0.01), and OS (49% vs 74%, log rank p < 0.01). The rate of upstaging did not significantly change over time (38% in 2004 to 27% in 2019, p = 0.17). Conclusion: Upstaging to MIBC occurred in a significant proportion of patients after RARC for NMIBC and was associated with worse survival outcomes. Older patients, those with cT1 disease and hydronephrosis were more likely to upstage. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There has been an increase in the number of individuals seeking testosterone (T) replacement treatment (TRT) due to a decrease in their blood T levels. Prostate cancer (PCa) is also an important issue in the same age group. However, we, urologists, are anxious about PCa development after T treatment. This is because it has been assumed that T may cause PCa or exacerbate insidious PCa which is already present. In this paper, recent developments regarding the relationship between serum levels of sex hormone and prostate tissue, the causal relationship between T and development of PCa, the effect of TRT on the group of patients who are at high risk of developing PCa, the suitability of TRT for patients who have already been diagnosed with PCa, and the effect of TRT on serum prostate-specific antigen level are analyzed. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Urology is the property of Turkish Association of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A majority of foreign objects ingested pass through the gastrointestinal tract without any complications. Sometimes, complications such as perforation and adhesions of the neighboring organs occur and surgical treatment becomes necessary. We report the case of a 22-year-old female who was admitted with right flank pain. Past medical history revealed that the patient had accidentally swallowed a headscarf pin 11 months earlier. A computed tomography scan confirmed the swallowed foreign body posterior to and around the ileocecal region. The headscarf pin, causing stenosis and proximal ureteral dilatation, was removed surgically. To the authors' knowledge there has been no previous report of such ureteral obstruction published in the English literature. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Contralateral adrenal metastases from renal cell carcinomas are not commonly seen. To our knowledge, we are presenting the first case of extraadrenal metastasis in the English literature, from the contralateral RCC 6 months after radical nephrectomy. Patient was treated with robotic right adrenalectomy for continuous growing of a de novo right adrenal mass of 6 × 4 × 3cm in diameter. Tissue between vena cava, renal capsule, and inferior diaphragmatic surface was removed en block. Pathological evaluation revealed renal cell carcinomawithin the fatty tissue abutting the adrenal capsule fromoutside with negative surgical margins. Our experience dictates that removing adrenal tissue only after identifying the adrenal bordersmay sometimes result in insufficient tumor removal. Therefore, adrenal containing tissue within the anatomic boundaries should be removed en block, if surgical removal is planned for metachronous tumor metastasis in the treatment of renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Contemporary minimally invasive surgical (MIS) treatment options of patients with male Lower Urinary Tract Symptoms (LUTS) in men with prostate glands >80 mL include Holmium Laser Enucleation Prostate (HoLEP), Thulium laser VapoEnucleation Prostate (ThuVEP), and Laparoscopic (LSP) or Robotic-Assisted Simple Prostatectomy (RASP). Implementing new laser technologies is costly, and the steep learning curve of these laser techniques limit their wide range use. This promoted the use of LSP and RASP in centers with readily established laparoscopy or robotic surgery programs. The aim of this study is to review case and comparative series of RASP. We systematically reviewed published data from 2008 to 2020 on RASP and have identified 26 non-comparative and 9 comparative case series. RASP has longer operation time but less time spent in hospital and less blood loss. The outcomes of improvements in symptom score, post-voiding residual urine (PVR), postoperative PSA decline, complications, and cost are similar when compared to open and laser enucleation techniques. These outcomes position RASP as a viable MIS treatment option for patients with male LUTS needing surgical treatment for enlarged prostates. Nevertheless, prospective, randomized controlled trials (RCTs) with multicenter and large sample size are needed to confirm the findings of this systematic review. [ABSTRACT FROM AUTHOR]