Search

Purpose: Abnormalities in the bladder wall require careful investigation regarding type, spatial position and invasiveness. Construction of a 3-D model of the bladder is helpful to ensure adequate coverage of the scanning procedure, quantitative comparison of bladder wall textures between successive sessions and finding back previously discovered abnormalities. Methods: Videos of both an in vivo bladder and a textured bladder phantom were acquired. Structure-from-motion and bundle adjustment algorithms were used to construct a 3-D point cloud, approximate it by a surface mesh, texture it with the back-projected camera frames and draw the corresponding 2-D atlas. Reconstructions of successive sessions were compared; those of the bladder phantom were co-registered, transformed using 3-D thin plate splines and post-processed to highlight significant changes in texture. Results: The reconstruction algorithms of the presented workflow were able to construct 3-D models and corresponding 2-D atlas of both the in vivo bladder and the bladder phantom. For the in vivo bladder the portion of the reconstructed surface area was 58% and 79% for the pre- and post-operative scan, respectively. For the bladder phantom the full surface was reconstructed and the mean reprojection error was 0.081 mm (range 0–0.79 mm). In inter-session comparison the changes in texture were correctly indicated for all six locations. Conclusion: The proposed proof of concept was able to perform 3-D and 2-D reconstruction of an in vivo bladder wall based on a set of monocular images. In a phantom study the computer vision algorithms were also effective in co-registering reconstructions of successive sessions and highlighting texture changes between sessions. These techniques may be useful for detecting, monitoring and revisiting suspicious lesions. [ABSTRACT FROM AUTHOR]

Purpose: The prognosis of muscle-invasive bladder cancer (MIBC) has not improved for three decades. Transurethral resection of the bladder tumor (TURBT) is the standard procedure for local tumor staging. TURBT has several limitations, including the spread of tumor cells. Therefore, an alternative is needed in patients with suspected MIBC. Recent studies have shown that mpMRI is very accurate in staging bladder tumors. Because the diagnostic efficacy of urethrocystoscopy (UCS) has been reported as good as the efficacy of mpMRI to predict muscle invasion we performed this prospective multicenter study in which we compare UCS with pathology. Methods: From July 2020 until March 2022, 321 patients with suspected primary BC in seven participating Dutch hospitals were included in this study. A flexible UCS was performed by urologists, physician assistants, or residents. Predictions of muscle invasion using a 5-point Likert scale alongside the histopathology data were recorded. The sensitivity, specificity, predictive values, and 95% confidence intervals were determined using a standard contingency table. Results: Of the 321 included patients, 232 (72.3%) received a histopathological diagnosis of non-muscle-invasive bladder cancer (NMIBC) and 71 (22.1%) were histopathologically diagnosed as MIBC. In 2 patients (0.6%), classification was not possible (Tx). Cystoscopy predicted muscle invasion with a sensitivity of 71.8% (95% CI 59.9–81.9), and a specificity of 89.9% (95% CI 85.4–93.3). This corresponds to a positive predictive value (PPV) of 67.1% and a negative predictive value (NPV) of 91.7%. Conclusion: Our study shows a moderate accuracy of cystoscopy to predict muscle invasion. This result does not support the use of cystoscopy only instead of TURBT for local staging. [ABSTRACT FROM AUTHOR]

Objective: Curative treatment of low‐risk prostate cancer (LR‐PCa) does not improve cancer specific survival and active surveillance (AS) is recommended. Although AS is cost‐effective and reduces treatment‐related complications, it requires psychosocial support. Research on psychosocial interventions specifically focused on men undergoing AS is limited. Aim of this study is to reach consensus amongst relevant stakeholders on selecting interventions offering psychosocial support to PCa patients during AS. Methods: In accordance with the RAND/UCLA method, a modified Delphi approach was used to establish consensus on selecting interventions. During phase one, interventions were identified through a literature review and open survey among all participants. During phase two, three consensus rounds were conducted to rate potential interventions and obtain statistical consensus. The IQ healthcare consensus tool was used to calculate statistical consensus. Results: After the first consensus round, 31 participants scored individual interventions on relevance using a 9‐point Likert scale resulting in the selection of six interventions. During the second consensus round 13 discussion items were reviewed during a focus group. After the third consensus round, seven additional interventions were selected by 23 participants. Conclusions: In total, 13 interventions were selected for inclusion in a support program. This included four interventions within the domain information and education, three within coping andsupport, one intervention within physical wellbeing and four within the domain lifestyle. [ABSTRACT FROM AUTHOR]

Programmed release of small molecular drugs from polymersomes is of great importance in drug delivery. A significant challenge is to adjust the membrane permeability in a well-controlled manner. Herein, we propose a strategy for controlling membrane phase separation by photo-cross-linking of the membrane-forming blocks with different molecular architectures. We synthesized three amphiphilic block copolymers with different membrane-forming blocks, which are poly(ethylene oxide)43-b-poly((ε-caprolactone)45-stat-((a-(cinnamoyloxymethyl)-1,2,3-triazol)caprolactone)25) (PEO43-b-P(CL45-stat-CTCL25)), PEO43-b-P(CL108-stat-CTCL16), and PEO43-b-PCTCL4-b-PCL79. These polymers were self-assembled into polymersomes using either a solvent-switch or powder rehydration method, and the obtained polymersomes were characterized by dynamic light scattering and transmission electron microscopy. Then the phase separation patterns within the polymersome membranes were investigated by mesoscopic dynamics (MesoDyn) simulations. To further confirm the change of the membrane permeability that resulted from the phase separation within the membrane, doxorubicin, as a small molecular drug, was loaded and released from the polymersomes. Due to the incompatibility between membrane-forming moieties (PCTCL and PCL), phase separation occurs and the release rate can be tuned by controlling the membrane phase pattern or by photo-cross-linking. Moreover, besides the compacting effect by formation of chemical bonds in the membrane, the cross-linking process can act as a driving force to facilitate the rearrangement and re-orientation of the phase pattern, which also influences the drug release behavior by modulating the cross-membrane distribution of the amorphous PCTCL moieties. In this way, the strategy of focusing on the membrane phase separation for the preparation of the polymersomes with finely tunable drug release rate can be envisioned and designed accordingly, which is of great significance in the field of delivery vehicles for programmed drug release. [ABSTRACT FROM AUTHOR]

Comprehensive Summary: Polymersomes, or polymer vesicles, have attracted a tremendous amount of interest over the last decade. This led to the development of polymer vesicles that are suitable for various biomedical applications, including blood sugar regulation, cancer theranostics, and antibacterial agents. This review mainly describes the research from our group on macromolecular self‐assembly of polymersomes and emerging particle assembly methods. First, the building blocks and general principles for the design of functional polymersomes are introduced. Thereafter, we present three polymersomes with various membrane structures: polymersomes with inhomogeneous membranes, asymmetrical coronas, and membranes that are fused with the coronas. Furthermore, given that N‐carboxyanhydrides‐induced self‐assembly (NCA‐PISA) is a convenient method for the large‐scale production of biodegradable polymersomes, recent advances in self‐assembly methods based on ring‐opening polymerization of NCA‐PISA are discussed. Finally, the mechanism of particle assembly and recent advances in producing higher‐order polymer vesicles, including tetrapod polymersomes and giant polymer vesicles with a latticelike membrane (GVLM), are discussed. What is the most favorite and original chemistry developed in your research group? Ring‐opening polymerization‐induced self‐assembly of N‐carboxyanhydrides (NCA‐PISA), and fusion‐induced particle assembly (FIPA). How do you get into this specific field? Could you please share some experiences with our readers? NCA‐PISA was developed to solve the biodegradability problem of nanoparticles by traditional PISA, while FIPA was inspired by nature. What is the most important personality for scientific research? The spirit of putting forward scientific problems. What are your hobbies? Driving, badminton, jogging, and music. What are your favorite journals? J. Am. Chem. Soc. and Macromolecules. Who influences you mostly in your life? My family and my Ph.D. and postdoctoral supervisors. [ABSTRACT FROM AUTHOR]

Purpose: Living with untreated prostate cancer (PCa) may cause anxiety and uncertainty in men undergoing active surveillance (AS). Developing a psychosocial support program for such patients might promote psychosocial well-being and patient engagement. This review aims to identify interventions with the potential to influence the psychosocial burden of prostate cancer patients undergoing AS.Methods: A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews Checklist. A systematic search was conducted in six databases and included publications dating from 2009. All available and eligible evidence was included in this review.Results: After screening 2824 articles, 12 studies were included in the review: nine quantitative, one qualitative, and two mixed method papers. The relative strength of these studies was limited and the quality of most was moderate.Conclusions: The described interventions can be categorized into three major themes: information and education, coping and (psycho)social support, and lifestyle. Psychosocial support for men undergoing AS should entail involvement of family and spouse during the decision-making process, tailored information about PCa treatments, risks, benefits, protocols, lifestyle adjustments, and complementary and alternative medicine. Assessment and promotion of effective coping and self-management strategies are recommended. Healthcare providers should actively promote physical activity and nutritional improvements. Physical activity programs may also be helpful in facilitating peer support, which is especially important for men with limited social support. Future research should investigate combining interventions to increase efficacy and optimize supportive care during AS. [ABSTRACT FROM AUTHOR]

MicroRNA (miRNA) therapeutics are a promising cancer treatment approach with high efficacy and low side effects. Although substantial progress regarding pharmacokinetics and pharmacodynamics of miRNAs is made, it remains challenging for effective and harmless intracellular delivery. In this study, instant and efficient intracellular delivery of miRNA against esophageal cancer via photothermal effects induced on plasmonic pyramid arrays is reported. An instantaneous high temperature can be generated (≈470 °C) on a plasmonic pyramid after laser stimulation (≈8 μs @640 nm), which is enough to disrupt the cell membranes to facilitate intracellular delivery of biocargos like miRNA. Within ≈150 μs after removal of laser stimulation, the pyramid temperature would decrease to ≈37 °C to avoid cell damage. By this approach, intracellularly delivery of miRNA‐185 to Taxol‐resistance esophageal cancer cells is successfully achieved within minutes with decent delivery efficiency (64%) and cell viability (>95%) are observed after optimization. Moreover, for combating drug resistance, 61.9% of KYSE30/Taxol cell is inhibited after laser‐stimulation via the combined effects of miR‐185 and Taxol with efficient intracellular delivery. This study provides a convenient intracellular delivery approach for large biocargos and a possible solution for overcoming cancer drug resistance. [ABSTRACT FROM AUTHOR]

Dented nanospheres show promising potential in drug delivery, nanomotors, etc. However, it is still challenging to prepare them by homopolymer self-assembly because of the strict structural requirements of the homopolymer. Herein, we propose a strategy for preparing dented nanospheres from homopolymers by co-assembly with a short peptide. They were co-assembled from poly(2-hydroxy-3-((4-(ethoxycarbonyl)phenyl)amino)propyl methacrylate) (PHBzoMA59) and (S)-2-((S)-2-((((9H-fluoren-9-yl)methoxy)carbonyl)amino)-3-phenylpropanamido)-3-phenylpropanoic acid (Fmoc-FF-OH). PHBzoMA homopolymers can only self-assemble into nanospheres without dent, and the addition of a short peptide introduced hydrogen bonding and complementary π-π stacking interactions led to the final dented nanosphere morphology. The weight fractions of the short peptide can be adjusted to regulate the final morphology. It was confirmed that the radius of curvature of the dent on the surface was related to the organic bubble inside the protospheres prepared at critical aggregation concentration (CAC). The organic bubble can be adjusted by altering the kind of organic solvent and solution pH, which allowed control over the dented nanosphere dimension. The use of different organic solvents with various polarities allows adjustment of the interfacial tension, and hence the denting degree. This degree can also be controlled by manipulating the solution pH to (de)protonate the short peptide and homopolymer. Furthermore, the versatility of this method was highlighted by using a different homopolymer and the applicability of the resulting dented nanospheres was demonstrated by decoration with gold nanoparticles. Overall, this study provided important insights and a new simple strategy to prepare dented nanospheres in a controlled fashion. [ABSTRACT FROM AUTHOR]

Copyright of Tijdschrift voor Urologie is the property of Springer Nature 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.)

Ultrasound-responsive polymeric materials have received a tremendous amount of attention from scientists for several decades. Compared to other stimuli-responsive materials (such as UV-, thermal-, and pH-responsive materials), these smart materials are more applicable since they allow more efficient drug delivery and targeted treatment by fairly non-invasive means. This review describes the recent advances of such ultrasound-responsive polymer-based drug delivery systems and illustrates various applications. More specifically, the mechanism of ultrasound-induced drug delivery, typical formulations, and biomedical applications (tumor therapy, disruption of blood–brain barrier, fighting infectious diseases, transdermal drug delivery, and enhanced thrombolysis) are summarized. Finally, a perspective on the future research directions for the development of ultrasound-responsive polymeric materials to facilitate a clinical translation is given. [ABSTRACT FROM AUTHOR]

Copyright of Tijdschrift voor Urologie is the property of Springer Nature 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.)

Aims: The use of Argus‐T adjustable sling may be a promising alternative option for the treatment of urinary incontinence after radical prostatectomy, however long‐term data is lacking. The aim of this study is to evaluate the long‐term results of the Argus‐T sling on incontinence rates, patient's quality of life and tape‐related complications. Methods: Patients were eligible if persistent stress incontinence was present ≥12 months after radical prostatectomy. Measurements included 24 h frequency volume micturition list, 24 h pad test, 24 h pad count and quality of life questionnaires. Argus‐T adjustable sling was placed with a single perineal route incision approach. Results: Seventy‐eight patients were included, 69 ± 6 years, pre‐intervention 24 h urinary loss 212 (75–385) g. Directly after surgery, 63.6% of the patients was completely dry, 79.2% of the patients reported greater than 90% improvement of their urinary loss and 92.2% > 50% improvement. Median follow‐up time was 3.2 (2.5–6.1) years. After 5 years of follow‐up, 53.3% of the patients were completely dry, 71.5% reported an improvement greater than 90% and 79.6% reported an improvement of greater than 50%. Patients with preoperative urinary loss less than 250 g reported significantly higher improvement of their urinary loss compared to patients with urinary loss ≥250 g (p =.02). Patients satisfaction was still increased after 5 years follow‐up (70 ± 21 vs.16 ± 9, p <.001) and patients quality of life remained high (85 ± 20 vs. 88 ± 13, p =.1). Complications were mainly observed directly after surgery. Two patients (2.6%) needed reimplantation of the sling. Conclusion: These data indicate that Argus‐T sling is an effective treatment option in obtaining substantial long‐term incontinence relief in patients with invalidating moderate stress urinary incontinence after radical prostatectomy. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) angiography is powerful for the diagnosis of vascular diseases. Unfortunately, this method usually requires a high dosage of iodinated contrast agents, which can lead to severe elevation of reactive oxygen species (ROS) levels within kidneys. This causes oxidative stress, apoptosis, and hence contrast‐induced nephropathy (CIN), a leading cause of iatrogenic renal failure, especially for patients with renal insufficiency. Herein, a route is shown to circumvent such problems with the usage of rationally designed renoprotective angiographic polymersomes (RAPs) as blood pool CT contrast agents. RAPs are biodegradable nanoparticles prepared via self‐assembly of poly(ethylene oxide)‐block‐poly(triiodobenzoic chloride‐conjugated polylysine‐stat‐phenylboronic acid pinacol ester‐conjugated polylysine) (PEO45‐b‐P[(Lys‐IBC)45‐stat‐(Lys‐PAPE)15]). The key to the efficiency of such nanoparticles as renoprotective contrast agents arises from the rationally chosen repeat units: Lys‐IBC exhibits a concentration‐dependent X‐ray attenuation capability and Lys‐PAPE introduces an ROS‐scavenging ability to the polymersome. The study shows that RAPs can reduce the risk of CIN in mice with kidney injury. Additionally, a 5‐fold increase in angiographic live time is observed using RAPs, compared to commonly used iodinated small molecule contrast agents. In summary, a new strategy is proposed for the design of a renoprotective angiographic contrast agent that is capable of reducing the risk of CIN. [ABSTRACT FROM AUTHOR]

What are the psychosocial support needs of prostate cancer (PCa) patients undergoing active surveillance (AS)? The preferred management strategy for low‐risk PCa (LR‐PCa) is AS. Patients remain under close surveillance to monitor disease progression. However, living with untreated disease has psychosocial implications. The objective of this study was to investigate the psychosocial support needs in PCa patients undergoing AS. According to Marzouk (2018) 30% of patients risk developing anxiety during the first year of AS. Parker (2015) and Tan (2016) suggest approximately 10% of AS‐patients request a change to active treatment, often based on anxiety. Pickles (2007) states that psychosocial support can effectively reduce anxiety and uncertainty. A literature based interview guide was used to conduct 17 semi‐structured interviews following an explorative qualitative approach. LR‐PCa patients, eligible for AS, were enrolled from two participating Dutch urology clinics experienced with AS. Written informed consent was obtained. Inclusion ended after attaining data saturation. The interviews were transcribed verbatim. NVIVO 10 was used for open coding. Participants expressed recurring uncertainty and anxiety caused by medical examinations, lower urinary tract symptoms and erectile dysfunction. Various effective and ineffective coping strategies were adopted by participants. The use of specific strategies was associated with patient‐physician relationship, locus‐of‐control and disease‐acceptation. Ineffective coping strategies seemed to impede resilience during stressful situations. Satisfactory decision‐making and disease‐acceptation were promoted by immediate availability of relevant, reliable information regarding disease characteristics and treatment options. Early‐stage reliable and relevant information, assessment and encouragement of effective coping strategies appear to be important psychosocial support needs during AS. Most participants in this study had spousal support and completed higher education. Future research should determine the generalizability of these findings in a more heterogeneous population. [ABSTRACT FROM AUTHOR]

Polymerization‐induced self‐assembly (PISA) enables the scalable synthesis of functional block copolymer nanoparticles with various morphologies. Herein we exploit this versatile technique to produce so‐called "high χ–low N" diblock copolymers that undergo nanoscale phase separation in the solid state to produce sub‐10 nm surface features. By varying the degree of polymerization of the stabilizer and core‐forming blocks, PISA provides rapid access to a wide range of diblock copolymers, and enables fundamental thermodynamic parameters to be determined. In addition, the pre‐organization of copolymer chains within sterically‐stabilized nanoparticles that occurs during PISA leads to enhanced phase separation relative to that achieved using solution‐cast molecularly‐dissolved copolymer chains. [ABSTRACT FROM AUTHOR]

Polymerization‐induced self‐assembly (PISA) enables the scalable synthesis of functional block copolymer nanoparticles with various morphologies. Herein we exploit this versatile technique to produce so‐called "high χ–low N" diblock copolymers that undergo nanoscale phase separation in the solid state to produce sub‐10 nm surface features. By varying the degree of polymerization of the stabilizer and core‐forming blocks, PISA provides rapid access to a wide range of diblock copolymers, and enables fundamental thermodynamic parameters to be determined. In addition, the pre‐organization of copolymer chains within sterically‐stabilized nanoparticles that occurs during PISA leads to enhanced phase separation relative to that achieved using solution‐cast molecularly‐dissolved copolymer chains. [ABSTRACT FROM AUTHOR]

Current guidelines for the development of decision aids recommend that they have to include a process for helping patients clarify their personal values, for example, by using values clarification methods. In this article, we extensively described the development process of the web-based values clarification method for patients with localized low- to intermediate-risk prostate cancer based on the analytic hierarchy process. With analytic hierarchy process, the relative importance of different attributes of available treatments can be determined through series of pairwise comparisons of potential outcomes. Furthermore, analytic hierarchy process is able to use this information to present respondents with a quantitative overall treatment score and can therefore give actual treatment advice upon patients' request. The addition of this values clarification method to an existing web-based treatment decision aid for patients with localized prostate cancer is thought to improve the support offered to patients in their decision-making process and their decision quality. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the safety and effectiveness of the injectable bulking agent Opsys® (Promedon, Cordoba, Argentina) for treating minimal postprostatectomy stress urinary incontinence (SUI). Patients and Methods. Single-centre, pilot study on ten male patients with SUI, < 30 g urine loss/ 24 h, more than 1 year after radical prostatectomy. Patients were treated by endoscopic transurethral injections of bulking agent in the presphincteric zone of the urethral submucosa. The results were evaluated using a pad weight test to quantify the differences in urine loss at 1, 3, and 6 months after intervention. Subsequently, the results of treatment were also evaluated by International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory Short Form (UDI-6-SF), and the Patient Global Impression of Improvement (PGI-I) at 1, 3, and 6 months after intervention. Results. The primary outcome was the absolute result of the 24-hour pad weight test after treatment. Treatment success was defined as <3 g urine loss/24 h, improvement as ≥50% decrease in urine loss/ 24h, failure as <50% decrease in urine loss/24 h, or worsening of urine loss. Success was demonstrated in one, improvement in one, and failure in eight patients one month after treatment. One patient improved and 9 failed 3 and 6 months after treatment. The median 24-hour pad weight test was higher at all three moments of follow-up (1, 3, and 6 months after treatment). The median 24-hour pad weight test was before treatment 17.3g (6.4-20.9) and 1, 3, and 6 months after treatment, respectively, 40.3g (5.9-130.6) p= 0.038, 38.3g (18.3-202.1) p= 0.014, 55.0g (16.5-314.6) p= 0.028. The ICIQ-SF was significantly higher at 3 and 6 months, respectively 15.0 (12.0-18.5) p= 0.007 and 16.0 (12.5-17.5) p=0.012 versus 10.0 (9.0-12.0) before injection. No significant differences were found between IIQ-7, UDI-6-SF, and PGI-I before and after injection. Complications occurred in four patients: two patients reported spontaneously resolved haematuria and two patients reported urinary frequency. All complications were classified as Clavien–Dindo 1. Conclusion. Injection therapy with Opsys® bulking agent is not an effective treatment option for male SUI after radical prostatectomy. It is not a safe treatment option, due to worsening urine loss after treatment. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to test if patients' health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL.Methods: Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N = 126) filled out a follow-up questionnaire on HRQoL within 2 weeks after treatment was chosen but had not yet started (t1).Results: HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate-specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimism was associated with HRQoL at baseline; decisional self-efficacy was positively associated with HRQoL at follow-up. No associations between HRQoL and the "big five" personality traits were found.Conclusion: Patients who have undergone prostate biopsy and treatment decision-making for Pca experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making. [ABSTRACT FROM AUTHOR]

Purpose: To correlate treatment effects of MRI-guided focal laser ablation in patients with prostate cancer with imaging using prostatectomy as standard of reference. Methods: This phase I study was approved by the Institutional Review Board. Three weeks prior to prostatectomy, five patients with histopathologically proven, low/intermediate grade prostate cancer underwent transrectal MRI-guided focal laser ablation. Per patient, only one ablation was performed to investigate the effect of ablation on the tissue rather than the effectiveness of ablation. Ablation was continuously monitored with real-time MR temperature mapping, and damage-estimation maps were computed. A post-ablation high-resolution T1-weighted contrast-enhanced sequence was acquired. Ablation volumes were contoured and measured on histopathology specimens (with a shrinkage factor of 1.15), T1-weighted contrast-enhanced images, and damage-estimation maps, and were compared. Results: A significant volume correlation was seen between the ablation zone on T1-weighted contrast-enhanced images and the whole-mount histopathology section ( r = 0.94, p = 0.018). The damage-estimation maps and histopathology specimen showed a correlation of r = 0.33 ( p = 0.583). On histopathology, the homogeneous necrotic area was surrounded by a reactive transition zone (1-5 mm) zone, showing neovascularisation, and an increased mitotic index, indicating increased tumor activity. Conclusions: The actual ablation zone was better indicated by T1-weighted contrast-enhanced than by damage-estimation maps. Histopathology results highlight the importance of complete tumor ablation with a safety margin. [ABSTRACT FROM AUTHOR]

Purpose: Rigid and flexible cystoscopies are both routinely used in female patients. Literature is conflicting whether flexible cystoscopy is less painful compared to rigid cystoscopy. The aim of this study was therefore to investigate whether using flexible cystoscopy leads to less discomfort and pain compared to rigid cystoscopy in female patients who underwent first time cystoscopy. Materials and Methods: One hundred eighty-nine female patients, who never had undergone cystoscopy, were randomized into 2 groups: 92 patients underwent rigid cystoscopy and 97 patients flexible cystoscopy. Directly after the cystoscopy procedure all patients were asked to fill out their pain experience on a 100-mm visual analogue pain scale (VAS). Results: Median VAS score was significantly lower for women undergoing flexible cystoscopy (0 [0-20]) compared to rigid cystoscopy (15 [0-38], p<0.001). In addition, age was inversely associated with VAS score, indicating that younger females experienced more pain (R=-0.30, p=0.001). The use of flexible cystoscopy was associated with a decrease in VAS score and remained significant after adjustment for age, sex of urologist, performing urologist and indication (standardized β =-0.17, p=0.048). Conclusions: The use of flexible cystoscopy resulted in a significantly lower pain experience compared to rigid cystoscopy. Based on patient's pain experience during cystoscopy, this study implicates to use flexible cystoscopy in female patients who undergo first time cystoscopy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate MR-targeted TRUS prostate biopsy using a novel local reference augmentation method. Patients and methods: Tracker-based MR-TRUS fusion was applied using local reference augmentation. In contrast to conventional whole gland fusion, local reference augmentation focuses the highest registration accuracy to the region surrounding the lesion to be biopsied. Pre-acquired multi-parametric MR images (mpMRI) were evaluated using PIRADS classification. T2-weighted MR images were imported on an ultrasound machine to allow for MR-TRUS fusion. Biopsies were targeted to the most suspicious lesion area identified on mpMRI. Each target was biopsied 1-5 times. For each biopsied lesion the diameter, PIRADS and Gleason scores, visibility during fusion, and representativeness were recorded. Results: Included were 23 consecutive patients with 25 MR suspicious lesions, of which 11 patients had a previous negative TRUS-guided biopsy and 12 were biopsy naïve. The cancer detection rate was 64 % (Gleason score ≥6). Biopsy was negative (i.e., no Gleason score) in seven patients confirmed by follow-up in all of them (up to 18 months). After MR-TRUS fusion, 88 % of the lesions could be visualized on TRUS. The cancer detection rate increases with increasing lesion size, being 73 % for lesions larger than 10 mm. Conclusion: Tracker-based MR-TRUS fusion biopsy with local reference augmentation is feasible, especially for lesions with an MR maximum diameter of at least 10 mm or PIRADS 5 lesions. If this is not the case, we recommend in-bore MR-guided biopsy. [ABSTRACT FROM AUTHOR]

Objectives: The study aims to investigate and evaluate the influence of 2 different methods of implantation of the Argus transobturator (Argus-T) adjustable male sling on complication rate and short-term efficacy. Methods: A prospective mono-center evaluation was conducted on consecutive patients treated for persistent post-radical prostatectomy incontinence. Thirty-six patients were implanted with the Argus-T adjustable male sling - 18 by inguinal-perineal incision (IPI) and 18 by single-perineal incision (SPI). Measurements included 24-hour frequency volume micturition list, 24-hour pad test, 24-hour pad count, Visual Analogue Scale for continence and satisfaction, flowmetry and residual voided urine. Results: Cure rate for IPI and SPI at 1, 6 and 12 months was 67, 75, 62% and 59, 63, 63%, respectively (no statistically significant difference). Although more clinically significant complications were seen in the IPI group, a statistical significant difference was observed only for wound infection between the IPI and the SPI groups (33 vs. 0%, p = 0.019). Conclusions: The Argus-T male sling SPI suspension operation is a minimally invasive and safe procedure for the management of male postoperative stress incontinence which is highly appreciated by the patients. © 2016 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Between March 2017 and February 2020 133 patients underwent an MRI target biopsy with prophylactic 500 mg ciprofloxacin 2 h before biopsy at our hospital. The authors conclude that by incorporating multiparametric MRI in the diagnostic work-up, which makes it possible to perform an MRI target biopsy or a cognitive registration TRUS target biopsy, this lead to a more effective diagnostic procedure and to a reduction of the number of biopsies. Since it is assumed that every biopsy attempt is a potential risk for UTI, we postulate by lowering the numbers of biopsies by performing multiparametric MRI target biopsies, the risk for UTI may diminish. [Extracted from the article]

A Ni-catalyzed benzannulation reaction of cyclobutenones and alkynes provides a rapid synthesis of heavily substituted phenols. The regioselectivity of this reaction can be modulated by variation of substituents on the alkyne. Though the incorporation of Lewis basic donors provides modest selectivities, the use of aryl substituents can provide high levels of regiocontrol. Finally, alkynylboronates derived from alkyl-substituted acetylenes provide both high yields and regioselectivities. This study suggests that alkynes bearing one sp2- and one sp3-based substituent can undergo benzannulation with high levels of regiocontrol whereby the sp3-based group is incorporated ortho-to the phenolic OH. [ABSTRACT FROM AUTHOR]

Study Type – Therapy (prospective cohort) Level of Evidence 2b OBJECTIVE To evaluate the short-term outcomes of the prospective international Prostate Cancer Research International: Active Surveillance (‘PRIAS’) study (Dutch Trial Register NTR1718), as active surveillance (AS) for early prostate cancer might provide a partial solution to the current overtreatment dilemma in this disease. PATIENTS AND METHODS The first 500 (of >950) participants with asymptomatic T1c/T2 prostate cancer, with a prostate-specific antigen (PSA) level of ≤10.0 ng/mL, a PSA density of <0.2 ng/mL/mL, a Gleason score of ≤3 + 3 = 6, and one or two positive biopsy cores, were analysed. The follow-up protocol consisted of frequent PSA measurements, digital rectal examinations, and standard repeat biopsies (the first after 1 year). The primary outcome is survival free of active therapy; the secondary endpoints are reasons for stopping AS, findings in 1-year repeat biopsies, and outcomes after radical prostatectomy (RP). RESULTS Patients were included between December 2006 and July 2008. The median (25–75th percentile) follow-up after diagnosis was 1.02 (0.6–1.5) years. The 2-year survival rate free from active therapy was 73%. Of the 82 men who changed to active therapy during the follow-up, 68 (83%) did so based on the protocol. Of the 261 repeat biopsies available for analysis, 90 (34%) showed no cancer, while 57 (22%) showed a Gleason score of >6 or more than two positive biopsy cores. There was a relatively unfavourable PSA doubling time of 0–10 years in 53% (102/194) and 62% (33/53) of men with favourable and unfavourable re-biopsy results, respectively. After RP, four of 24 (17%) men had T3 disease and 12 (50%) had a Gleason score of >6. CONCLUSION AS seems feasible, but mortality outcomes are unknown. A strict follow-up protocol including standard 1-year repeat biopsies resulted in a quarter of men stopping AS after 2 years. [ABSTRACT FROM AUTHOR]

To study the time-to-recurrence and duration of response in non-muscle invasive bladder cancer (NMIBC) patients, with a complete ablative response after intravesical apaziquone instillations. Transurethral resection of bladder tumour(s) (TURBT) was performed in patients with multiple pTa-T1 G1-2 urothelial cell carcinoma (UCC) of the bladder, with the exception of one marker lesion of 0.5–1.0 cm. Intravesical apaziquone was administered at weekly intervals for six consecutive weeks, without maintenance instillations. A histological confirmed response was obtained 2–4 weeks after the last instillation. Routine follow-up (FU) was carried out at 6, 9, 12, 18 and 24 months from the first apaziquone instillation. At 3 months FU 31 of 46 patients (67.4%) had a complete response (CR) to ablative treatment. Side-effects on the long-term were only mild. Two CR patients dropped out during FU. On intention-to-treat (ITT) analysis 49.5% of the CR patients were recurrence-free at 24 months FU, with a median duration of response of 18 months. Of 15 no response (NR) patients, only two received additional prophylactic instillations after TURBT. On ITT-analysis 26.7% of the NR patients were recurrence-free (log rank test, P = 0.155). The overall recurrence-free survival was 39% (18 of 46 patients) at 24 months FU. The CR of the marker lesion in 67% of patients was followed by a recurrence-free rate of 56.5% at 1-year FU, and 49.5% at 2-year FU. These long-term results are good in comparison with the results of other ablative studies. [ABSTRACT FROM AUTHOR]

Instant Intracellular Delivery of miRNA via Photothermal Effect Induced on Plasmonic Pyramid Arrays (Adv. Funct. Keywords: esophageal cancer; miRNA; photothermal effects; SPR; taxol-resistance EN esophageal cancer miRNA photothermal effects SPR taxol-resistance 1 1 1 02/24/22 20220223 NES 220223 B Intracellular miRNA Delivery b In article number 2107999, Zhen Fan, Xiaobin Xu, and co-workers report using scanning laser stimulation to generate instantaneous high temperature on plasmonic pyramid arrays to disrupt the cell membranes to facilitate intracellular delivery of biocargos like miRNA. Esophageal cancer, miRNA, photothermal effects, SPR, taxol-resistance. [Extracted from the article]

We conducted a genome-wide SNP association study on 1,803 urinary bladder cancer (UBC) cases and 34,336 controls from Iceland and The Netherlands and follow up studies in seven additional case-control groups (2,165 cases and 3,800 controls). The strongest association was observed with allele T of rs9642880 on chromosome 8q24, 30 kb upstream of MYC (allele-specific odds ratio (OR) = 1.22; P = 9.34 × 10−12). Approximately 20% of individuals of European ancestry are homozygous for rs9642880[T], and their estimated risk of developing UBC is 1.49 times that of noncarriers. No association was observed between UBC and the four 8q24 variants previously associated with prostate, colorectal and breast cancers, nor did rs9642880 associate with any of these three cancers. A weaker signal, but nonetheless of genome-wide significance, was captured by rs710521[A] located near TP63 on chromosome 3q28 (allele-specific OR = 1.19; P = 1. 15 × 10−7). [ABSTRACT FROM AUTHOR]

We evaluated the efficacy of transurethral deroofing of a midline prostatic cyst in subfertile men with one or more of the following semen abnormalities: decreased ejaculatory volume, decreased sperm motility and oligo- or azoospermia. Results from treatment of a series of 11 subfertile men with a midline prostatic cyst by transurethral deroofing of the cyst are presented. Five patients showed an improvement of seminal volume. Only one patient demonstrated an improvement of sperm count. Sperm motility was not influenced. No relationship was found between positive outcome following operation and either size of the cyst or dilatation of the seminal vesicles. Spontaneous pregnancies did not occur after transurethral deroofing of the midline prostatic cyst. In conclusion, our study suggests a poor efficacy of transurethral deroofing of a midline prostatic cyst in subfertile men with the above mentioned semen abnormalities. [ABSTRACT FROM AUTHOR]

OBJECTIVE To confirm the recently published positive effect on visual analogue pain (VAS) scale levels for men watching their flexible cystoscopy. PATIENTS AND METHODS From June 2007 to September 2007, 154 men had a flexible cystoscopy for various indications, all carried out by one urologist. Patients were randomized into two groups; those in group 1 were allowed to watch the video screen together with the urologist during the procedure; those in group 2 were not allowed to watch the procedure on the video screen. All patients received the same real-time explanation during the cystoscopy. After the cystoscopy procedure the patients were asked to record their experience of pain on the 100 mm VAS as soon as they left the room. The two groups were further stratified by the number of previous cystoscopies experienced to evaluate the possible modifying effect of their previous experience. RESULTS Although the results suggested a small decrease in perceived pain there were no statistically significant differences between the groups, regardless of cystoscopy experience. CONCLUSIONS Our results show that, in contrast to an earlier report, the pain experienced by men undergoing a first or repeated flexible cystoscopy is not strongly influenced by watching the procedure. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Surgery Illustrated-Surgical Atlas: Transurethral Resection of Bladder Tumours," by C. Weisner, W. Jäger and J. W. Thüroff in the 2010 issue.