Can Multiparametric Ultrasound Analysis Predict Malignancy in Testes? An 11-Year Single Center Experience with Testicular Masses.

Contrast-enhanced ultrasound (CEUS) is a promising modality for differentiating benign and malignant lesions in various organs, including the testis. Testicular tumors, common in young men, are often treated with radical orchiectomy, which can have significant consequences. This study aimed to analyze CEUS parameters and their association with malignant testicular tumors.

Impact of Intraoperative Opioid Use and a Combined Anesthesia Regimen in Patients Undergoing Radical Prostatectomy for Prostate Cancer in a Single-Center Cohort.

Higher intraoperative opioid doses may be associated with worse long-term oncological outcomes after radical prostatectomy (RP) for prostate cancer. We aimed to evaluate the impact of higher doses of intraoperative opioids and type of anesthesia on biochemical recurrence (BCR) and mortality after RP in a high-volume tertiary center. All patients underwent RP at our center between 2015 and 2021.

The Effect of Resistance and/or Aerobic Training on Quality of Life, Fitness, and Body Composition in Prostate Cancer Patients-A Systematic Review and Meta-Analysis.

: Prostate cancer (PC) and its treatment are often associated with side effects such as fatigue, muscle loss, and diminished quality of life (QoL). Physical exercise, particularly resistance training (RT) and aerobic training (AT), has been suggested as a strategy to mitigate these effects. However, the comparative efficacy of RT, AT, and combined RT/AT on QoL, body composition, physical fitness, and laboratory markers in PC patients is still insufficiently understood.

The impact of ureteral access sheaths on radiation exposure in the ureterorenoscopic treatment of urolithiasis.

Introduction: Ureteral access sheaths (UAS) are widely used in the endoscopic treatment of urolithiasis. In modern medicine, radiation exposure from diagnostics and therapy is increasing; however, the impact of UAS on procedure duration, fluoroscopy time, and radiation exposure is still uncertain.

Methods: This retrospective study included 1,026 patients who received ureterorenoscopic treatment for urolithiasis between 2016 and 2018 at a large academic center.

Radical Cystectomy with Ileal Orthotopic Neobladder after 70 Years Leads to Worse Health-Related Quality of Life.

Radical cystectomy (RC) with the formation of an ileal orthotopic neobladder (ONB) may adversely affect long-term health-related quality of life (HRQOL). An advanced age at the time of ONB construction could further exacerbate the decline in HRQOL. This study aims to establish an evidence-based age threshold at the time of RC with ONB, beyond which a significant deterioration in HRQOL is observed.

Optimizing risk stratification for intermediate-risk prostate cancer - the prognostic value of baseline health-related quality of life.

Objective: To investigate the prognostic value of baseline health-related quality of life (HRQOL) for patients with intermediate-risk localized prostate cancer (IR-PCa) undergoing radical prostatectomy (RP).

Methods: 4780 patients with IR-PCa according to NCCN risk stratification were identified from a prospectively maintained database. All patients were treated with RP and had prospectively assessed baseline HRQOL.

Effects of Intraoperative Opioid Use and a Combined Anesthesia Protocol in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma of the Bladder-A Single-Center Experience.

Background: An increased intraoperative opioid dose seems to lead to worse outcomes in several types of cancer. We assessed the effect of intraoperatively administered opioids as well as the type of anesthesia on survival, recurrence rates and major perioperative outcomes in patients who underwent radical cystectomy (RC) for urothelial carcinoma of the urinary bladder.

Methods: We included patients who underwent open RC at our center between 2015 and 2022.

Evolution of Robotic Urology in Clinical Practice from the Beginning to Now: Results from the GRAND Study Register.

Background And Objective: Major urological guidelines do not currently recommend robot-assisted surgery compared with laparoscopic or open surgery due to the lack of high-quality evidence. We aimed to provide real-world data on the evolution of robotic urology and to compare its perioperative outcomes with those of laparoscopic and open surgeries.

Methods: We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005-2021), and performed multiple patient-level analyses.

[Perineal prostate biopsy].

The prostate biopsy is an essential tool for diagnosing prostate cancer (PCa). While transrectal biopsy (TR-Bx) continues to be considered the gold standard in Germany, the European Association of Urology (EAU) guidelines increasingly recommend transperineal biopsy (TP-Bx) due to lower infection rates and higher tumor detection rates. This article provides an overview of the history and development of the perineal biopsy, compares TR-Bx and TP-Bx and discusses the need for antibiotic prophylaxis before TP-Bx.

PSMA-PET/CT response after metastasis-directed radiotherapy of bone oligometastases in prostate cancer.

Objective: Bone metastases are very common in advanced prostate cancer and can sensitively be detected utilizing PSMA-PET/CT. Therefore, our goal was to evaluate the suitability of PSMA-PET/CT-guided metastasis-directed external beam radiotherapy (MDT) as treatment option for patients with biochemical recurrence and oligometastatic bone lesions.

Materials & Methods: We retrospectively examined 32 prostate cancer patients with biochemical recurrence and PSMA-positive oligometastatic disease limited to the bone (n = 1-3).

Prospective close monitoring of the effect of vascular-targeted photodynamic therapy and high intensity focused ultrasound of localized prostate cancer by multiparametric magnetic resonance imaging.

Purpose: The aim of this study is to describe the anatomical and functional changes observed in multiparametric magnetic resonance imaging (mpMRI) during follow-up after focal therapy (FT) for localized prostate cancer (PCa).

Materials And Methods: In this prospective study, we analyzed pre- and postoperatively acquired mpMRI of 10 patients after FT (7 days; 3, 6, 9, 12 months). 7/10 (70%) patients underwent vascular-targeted photodynamic therapy (VTP).

The impact of preoperative 5-alpha reductase inhibitors on functional outcomes and health-related quality of life following radical prostatectomy - A propensity score matched longitudinal study.

Objectives: While the impact of treatment with 5-alpha Reductase Inhibitors (5-ARI) on the risk of cancer-related mortality in men with prostate cancer (PC) has been extensively studied, little is known about the impact of preoperative 5-ARI use on patient-reported outcomes (PROs) following radical prostatectomy (RP).

Methods: Within our prospectively maintained institutional database of 5899 patients treated with RP for PC (2008- 2021), 99 patients with preoperative 5-ARI therapy were identified. A 1:4 propensity-score matched analysis of 442 men (n = 90 5-ARI, n = 352 no 5-ARI) was conducted.

Ligand-Receptor Interactions and Structure-Function Relationships in Off-Target Binding of the β-Adrenergic Agonist Mirabegron to α-Adrenergic Receptors.

The β-adrenoceptor agonist mirabegron is available for the treatment of storage symptoms of overactive bladder, including frequency, urgency, and incontinence. The off-target effects of mirabegron include binding to α-adrenoceptors, which are central in the treatment of voiding symptoms. Here, we examined the structure-function relationships in the binding of mirabegron to a cryo-electron microscopy structure of α.

Immunomodulatory imide drugs inhibit human detrusor smooth muscle contraction and growth of human detrusor smooth muscle cells, and exhibit vaso-regulatory functions.

Background: The immunomodulatory imide drugs (IMiDs) thalidomide, lenalidomide and pomalidomide may exhibit therapeutic efficacy in the prostate. In lower urinary tract symptoms (LUTS), voiding and storage disorders may arise from benign prostate hyperplasia, or overactive bladder. While current therapeutic options target smooth muscle contraction or cell proliferation, side effects are mostly cardiovascular.

Toxicity-Induced Discontinuation of Immune Checkpoint Inhibitors in Metastatic Urothelial Cancer: 6-Year Experience from a Specialized Uro-Oncology Center.

Immune checkpoint inhibitor (ICI) therapies have been established as the standard-of-care in various uro-oncological cancers. Immune-related adverse events (irAEs) are frequent, but their degree rarely leads to the discontinuation of immunotherapies. Unplanned permanent treatment discontinuation may negatively impact the outcomes of patients, but there are emerging data about a positive correlation between emergence of severe irAEs and therapeutic cancer responses.

Surgical Outcomes and Genomic Insights of Nonclear Cell Renal Cell Carcinoma With Synchronous and Metachronous Nodal Disease.

Introduction: Oncological outcomes in patients with nonclear cell renal cell carcinoma (non-ccRCC) treated with surgery for locoregional nodal disease (ND) remain incompletely characterized. The objective was to investigate the characteristics and outcomes of non-ccRCC patients treated with lymph node dissection (LND) and salvage-LND (S-LND).

Methods: A total of 1627 patients underwent nephrectomy for nonmetastatic non-ccRCC at Memorial Sloan Kettering Cancer Center between 2007 and 2023.

Self-reported exhaustion and a 4-item physical frailty index to predict the incidence of major complications after onco-geriatric surgery.

Background: The aim of this study was to analyze four pre-operative physical frailty indicators from a geriatric assessment (GA) independently and combined in a physical frailty index, in their ability to predict postoperative 30 d-complications.

Materials And Methods: In this secondary analysis of data from the published PERATECS study (ClinicalTrials.gov: NCT01278537), the predictive value of four physical frailty indicators from a defined GA battery was examined with univariable and multivariate logistic regression models in a sample of 493 onco-geriatric surgical patients.

Effects of carvedilol on human prostate tissue contractility and stromal cell growth pointing to potential clinical implications.

Background: Apart from antagonizing ß-adrenoceptors, carvedilol antagonizes vascular α-adrenoceptors and activates G protein-independent signaling. Even though it is a commonly used antihypertensive and α-adrenoceptors are essential for the treatment of voiding symptoms in benign prostatic hyperplasia, its actions in the human prostate are still unknown. Here, we examined carvedilol effects on contractions of human prostate tissues, and on stromal cell growth.