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Objectives: Many congenital hydronephroses spontaneously resolve. This study evaluated a long‐term follow‐up of more than 4 years of patients with congenital hydronephrosis at a single center. Methods: In total, 215 patients (286 kidneys) with congenital hydronephrosis were included. Hydronephrosis outcomes (resolution, improvement, and persistence) and time‐to‐outcome were evaluated. Results: Fourteen patients underwent early surgical intervention until the age of 2 years. A total of 189 congenital hydronephrosis cases (66%) showed resolution at a median of 16 months (interquartile range: 7–21 months) and 169 (80%) of 210 kidneys with grade I to II hydronephrosis showed resolution at a median of 14 months (interquartile range: 6–23 months). Of 76 kidneys with grade III to IV hydronephrosis, 24 (32%) showed resolution at a median of 29 months (interquartile range: 24–41 months), and 56 (74%) showed improvement to grade II or less at a median of 12 months (interquartile range: 5–23 months). Of the 76 kidneys with grade III to IV hydronephrosis, five required delayed pyeloplasty at a median of 66 months (interquartile range: 42–89 months). One patient was asymptomatic, with a marked worsening of hydronephrosis and decreased renal function 6 years after the resolution of hydronephrosis. Conclusions: None of the patients with grade I to II hydronephrosis required surgical treatment, and a shorter follow‐up may be sufficient. Grade III to IV severe hydronephrosis should be considered for a longer and more careful follow‐up, given the possibility of asymptomatic exacerbation of hydronephrosis. [ABSTRACT FROM AUTHOR]

Objectives: Cryptorchidism (CO) diagnosis by palpation is challenging. Patients with suspected CO are primarily referred to pediatric urologists by general pediatricians and urologists. Currently, surgical treatment for CO is recommended earlier than in previous guidelines. In this study, we evaluated factors that lead to diagnosis discordance and delayed orchidopexy in patients referred with suspected CO in addition to timing of initial screening. Methods: In total, 731 patients (1052 testes) with suspected CO were included. Risk factors for diagnostic discrepancy in CO diagnosis by pediatric urologists and risk of delayed orchiopexy were evaluated. Results: Herein, 659 (90%) patients were diagnosed during routine public health checkups for infants and young children, and 419 (57%) patients were referred by pediatric practitioners. Of 1052 testes, 374 (36%) were diagnosed with CO by pediatric urologists. In multivariate analysis, risk factors of diagnostic discrepancy for CO diagnosis by pediatric urologists were bilateral testis (odds ratio [OR] = 9.17, p < 0.0001), >6 months old at initial diagnosis (OR = 1.036, p < 0.0001), and pediatric referral (OR = 4.60, p < 0.0001). In total, 296 patients underwent orchiopexy for CO. In multivariate analysis, risk factors for delayed orchiopexy were presence of comorbidities (OR = 3.43, p = 0.003) and >10 months old at referral (OR = 12.62, p < 0.0001). Conclusions: Pediatric referral is a risk factor for discordant CO diagnostics, and late age at referral brings a risk of delayed orchiopexy. It is necessary to enlighten pediatricians, who are mainly responsible for routine health checkups, in teaching CO diagnostic techniques to ensure early referral. [ABSTRACT FROM AUTHOR]

The article discusses the feasibility of using the Lilium α-200 portable bladder scanner to measure bladder volume in children. The study compared the measurements obtained from the Lilium α-200 with those obtained from transabdominal ultrasound (TAUS), which is considered the gold standard for measuring bladder volume. The results showed a significant correlation between the measurements obtained from the Lilium α-200 and TAUS, indicating that the Lilium α-200 can accurately measure bladder volume in children. However, it was noted that the Lilium α-200 tends to overestimate lower filling volumes. Overall, the study suggests that the Lilium α-200 may be useful for continuous measurement of bladder volume in children, such as during sleep. [Extracted from the article]

Objectives: We investigated the diagnostic and therapeutic benefits of limited or extended pelvic lymph node dissection during a robot‐assisted radical prostatectomy for localized prostate cancer. Methods: Diagnostic and therapeutic benefits were assessed according to the rates of pN1 and biochemical recurrence, respectively. The primary outcome was the biochemical recurrence‐free rate, and secondary outcomes included the diagnostic and therapeutic benefits of pelvic lymph node dissection. Results: A total of 534 patients were analyzed. Out of the 534 patients, 207 (38.8%) received limited pelvic lymph node dissection while 134 (25.1%) received extended dissection. There were 297 patients with a Briganti index ≥5%. Extended dissections yielded significantly more resected lymph nodes (p < 0.0001), and 72.2% of cases of pN1 were located outside the obturator. The incidence rate of pN1 was 6.1%, and performance of extended lymph node dissection was an independent predictor for pN1 (odds ratio 9.0, 95% confidence interval 2.5–33.1). The rate of biochemical recurrence was 14.9%, and Cox proportional hazards regression analysis of the propensity score matched population revealed that patients with high or very‐high risk tended to benefit from limited lymph node dissection (hazard ratio 8.4, 95% confidence interval 0.8–82.3) while the therapeutic benefit of extended dissection was unclear by comparison. Conclusions: Extended pelvic lymph node dissection significantly improves diagnostic accuracy; however, the therapeutic benefit of pelvic lymph node dissection was not observed in this study. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the effect of available treatment modalities on primary treatment selection in patients with localized prostate cancer and that of introducing robotic surgery. Methods: We retrospectively studied 12 061 patients diagnosed with localized prostate cancer between 2004 and 2018 from 21 institutions. These institutions were divided into five groups according to the availability of surgery and radiotherapy. Differences in primary treatment selection between the institutions were investigated, and the predictive factors involved in the selection were explored. Results: Surgery, radiotherapy, androgen deprivation therapy, and active surveillance/watchful waiting were selected as primary treatment in 4115, 3621, 3188, and 821 patients, respectively, while the remaining 316 patients selected other modalities. The number of patients, particularly young patients, was much higher in institutions with both surgery and radiotherapy. With the introduction of robotic surgery, open radical prostatectomy has decreased, and robotic surgery made up approximately 70% of all prostatectomies. Institutions with both surgery and radiotherapy tended to treat patients with very low or low risk by surgery or radiotherapy, while institutions without surgery and radiotherapy tended to select active surveillance or watchful waiting. Multivariate analysis revealed that primary treatment selection for prostate cancer was affected not only by clinical factors, but also by the available modalities in each institution. Conclusions: Differences in available treatment modalities affect the selection of primary treatment for localized prostate cancer. Introduction of robotic surgery also has a strong influence on the number of patients in each institution. [ABSTRACT FROM AUTHOR]

Objective: To investigate useful objective variables and factors supporting the diagnosis of retractile testis and cryptorchidism by primary care providers, including urologists. Methods: This retrospective study included 512 boys diagnosed with retractile testis or cryptorchidism at our institute. Boys with retractile testis were followed up and underwent orchiopexy once the testis became undescended, while boys with cryptorchidism underwent orchiopexy immediately. We investigated trends in the prevalence of testicular malposition and explored useful diagnostic factors for retractile testis and cryptorchidism. Results: Of 512 boys, 199 were diagnosed with retractile testis and 313 were diagnosed with cryptorchidism. Comparison of clinical information between retractile testis and cryptorchidism showed that age at diagnosis, laterality, and location of the testis were significantly different between the groups (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The comparison of surgical information also showed that epididymal abnormality and state of processus vaginalis is patency or closure were significantly different between the groups (P = 0.0088 and P = 0.0003, respectively). Multivariate analysis showed that diagnosis at age 0–1 years, unilaterality, and canalicular testis were predictive factors for cryptorchidism (P = 0.001, P < 0.0001, and P < 0.0001, respectively). Conclusions: Age at diagnosis, laterality, and location of the testis could be factors to aid the diagnosis of retractile testis and cryptorchidism. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy, safety and tolerability of vibegron for the treatment of antimuscarinic‐resistant neurogenic bladder dysfunction in patients with spina bifida. Methods: In this retrospective study, 15 patients with antimuscarinic‐resistant neurogenic bladder dysfunction due to spina bifida underwent a video‐urodynamic study before and during the administration of vibegron 50 mg once daily instead of antimuscarinic agents from February 2019 through April 2021. The video‐urodynamic study was carried out to evaluate bladder compliance, maximum cystometric bladder capacity, detrusor overactivity, detrusor leak point pressure and vesicoureteral reflux before and >3 months after the beginning of vibegron administration. Results: Treatment with vibegron significantly improved bladder compliance and maximum cystometric bladder capacity compared with antimuscarinic agents, respectively (7.4 ± 4.2 vs 30.4 ± 48.2 mL/cmH2O, P = 0.0001; 231.4 ± 81.2 vs 325.2 ± 106.5 mL, P = 0.0005). Detrusor overactivity did not change after the administration of vibegron. Bladder deformity, which was confirmed in 12 patients, improved in half of the patients after taking vibegron. Vesicoureteral reflux, which was confirmed in two patients, was extinguished after taking vibegron. Newly occurring adverse events were not observed, and all patients continued to take vibegron during the treatment period. Conclusions: Favorable efficacy of vibegron for antimuscarinic‐resistant neurogenic bladder dysfunction due to spina bifida was shown video‐urodynamically without apparent adverse events. Vibegron is a favorable option for the treatment of antimuscarinic‐resistant neurogenic bladder dysfunction in patients with spina bifida. [ABSTRACT FROM AUTHOR]

Approximately 20% of the patients had experienced some symptoms related to COVID-19 and had undergone a PCR or antigen test. Fortunately, no patient was diagnosed with COVID-19 in this cohort. Clinical and emotional factors for the acceptance or refusal of deceased-donor kidney transplantation in patients on waiting lists during the coronavirus disease 2019 pandemic Abbreviations & Acronyms CI confidence interval COVID-19 coronavirus disease 2019 DDKT deceased-donor kidney transplantation HD hemodialysis IQR interquartile range KT kidney transplantation LDKT living-donor kidney transplantation OR odds ratio PCR polymerase chain reaction PD peritoneal dialysis SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 WL waiting list Caused by the SARS-CoV-2, COVID-19 has caused substantial changes in the practice of KT. [Extracted from the article]

Objectives: To investigate the natural course of retractile testis by analyzing its prevalence and outcomes. Methods: This retrospective study included 215 boys in whom retractile testis was diagnosed after reviewing the medical history and physical examinations of the patients. Orchiopexy was performed once the testis became undescended. We investigated the trends in the prevalence and outcomes of retractile testis and compared clinical factors between cases that resolved spontaneously and those that required orchiopexy. Results: Of 215 boys, 145 were finally evaluated. The mean age at diagnosis was 2 years, and 100 boys were aged ≤2 years when they were hospitalized. Seventy‐three boys were referred to our institution through health examinations as babies. The condition improved spontaneously in 89 boys, while 43 boys underwent orchiopexy, and 13 boys remained under follow‐up. The follow‐up period between diagnosis and resolution was significantly longer in the spontaneous resolution group than in the surgical intervention group (P = 0.011). Bilateral retractile testis improved spontaneously in significantly more boys compared to unilateral retractile testis (P = 0.0010). Spontaneous resolution was observed in boys of all ages, but those diagnosed at ≤3 years of age had a significantly higher rate of spontaneous resolution compared to those who were diagnosed at >3 years of age (P = 0.0019). Conclusions: Our findings suggest that retractile testis cannot be affirmed as a variant of normal testis. Performing examinations at a young age is critical for preventing misdiagnosis, screening failures, and unnecessary surgery. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the use of cyclooxygenase‐2 inhibitors in patients receiving low‐dose‐rate brachytherapy for prostate cancer. Methods: A total of 310 patients with prostate cancer (cT1c‐3aN0M0) who received low‐dose‐rate brachytherapy between May 2010 and July 2013 were enrolled and allocated to one of the two treatment groups (tamsulosin alone 0.2 mg/day for 6 months vs tamsulosin 0.2 mg/day for 6 months plus celecoxib 200 mg/day for 3 months). The primary end‐point was the chronological change in international prostate symptom score, and the number of patients was assessed for the primary end‐point. Biochemical recurrence‐free, cancer‐specific survival and overall survival rates 5 years after the last patient received low‐dose‐rate brachytherapy were retrospectively examined. Results: The median follow‐up period after low‐dose‐rate brachytherapy was 72.0 months (range 3–99 months). A total of 12 (3.9%) patients experienced biochemical recurrence. The biochemical recurrence‐free rate in the celecoxib group (5‐year biochemical recurrence‐free rate 98.5%) was significantly better (log–rank test P = 0.023, 95% confidence interval 0.07–0.63, hazard ratio 0.20) than that in the tamsulosin group (5‐year biochemical recurrence‐free rate 93.4%). None of the patients died from prostate cancer. However, 14 (4.5%) patients died of other causes. No significant difference was observed in terms of overall survival between the celecoxib and tamsulosin groups. Conclusions: The combination of cyclooxygenase‐2 inhibitor and low‐dose‐rate brachytherapy can contribute to a better biochemical control of prostate cancer. [ABSTRACT FROM AUTHOR]

The article discusses the use of radical cystectomy as a treatment for non-metastatic muscle-invasive bladder cancer (MIBC) without opting for chemotherapy. It talks about the success of systemic chemotherapy along with drugs like avelumab, brolizumab and durvalumab which are a mixture of immune checkpoint inhibitor (ICI).

The article focuses on the risk of patients with bladder cancer developing transient liver toxicity after being given 5-aminolevulinic acid (ALA) for the sake of accuracy in diagnosis. It talks about the toxicity from the drug being low as it an amino acid produced by the mitochondria in plants. It tells about the changes in the liver parameters in patients being given 5-ALA.